Pain linked to risk of suicide
BACK pain and migraine are associated with an increased risk of death from suicide that is independent of psychiatric diagnoses, new US data reveals.
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depression
The following articles have the tag depression
Pain linked to risk of suicide
BACK pain and migraine are associated with an increased risk of death from suicide that is independent of psychiatric diagnoses, new US data reveals.
Stroke risk double in depressed
DEPRESSED middle-aged women in Australia have almost double the risk of stroke, a study suggests.
Prolonged grief not included in DSM-5
BOWING to pressure, the authors of DSM-5 have kept grief out of the diagnostic manual, according to an Australian psychiatrist.
GP treatment could be lifesaving
ONE in 10 primary care patients with depression attempt suicide within five years, but the risk is confined almost exclusively to major depressive episodes (MDE), a study shows.
Push to screen for depression in heart disease patients
THE National Heart Foundation wants all patients presenting with coronary heart disease (CHD) to be screened for depression.
Sleep difficulty leads to increased risk of depression
YOUNG women in their 20s who have difficulty sleeping are at risk of depression during the next decade of their life, new Australian research shows.
Online mood disorder tool gives vital info
AN AUSTRALIAN-developed online mood disorders diagnostic tool can elicit vital information from patients and encourage disclosure of symptoms, according to analysis of data from 16,000 users.
‘Alarming’ number of carers contemplate suicide
AN “ALARMING” one quarter of people caring for a family member with dementia have contemplated committing suicide, an Australian study shows.
Online mood tool a time-saver for GPs
AN AUSTRALIAN-developed online mood disorders diagnostic tool can elicit vital information from patients and encourage disclosure of symptoms, according to analysis of data from 16,000 users.
Mental health survey needs doctors' support
AUSTRALIAN doctors and medical students are being urged to get involved in what is understood to be the largest mental health survey of its kind ever undertaken.
Spike in drug-treatment seekers
A NSW drug and alcohol rehabilitation centre has experienced a spike in the number of people seeking treatment for amphetamine-type stimulants.
GPs 'vital' in preventing suicide in older men
GPs have a vital role in curbing high rates of suicide among older men, according to a leading psychiatrist.
Doctors to take part in mental health survey
HALF of Australia’s doctors and medical students – including every doctor in a regional area – will be surveyed in one of the biggest ever studies of medical professionals’ mental health.
Diabetes patients' emotional distress not monitored routinely
DESPITE international guidelines recommending the routine monitoring of wellbeing in people with diabetes it is not commonplace and relies on the enthusiasm of individual clinicians, an expert says.
Doctors, med students to take part in biggest ever mental health survey
HALF of Australia’s doctors and medical students – including every doctor in a regional area – will be surveyed in one of the biggest ever studies of medical professionals’ mental health.
Caution over SSRI use in infertility and pregnancy
PRESCRIBING SSRIs in pregnancy and for women struggling with infertility is fraught with risk, researchers say after a literature review.
Fear of discrimination a barrier for depressed patients
PEOPLE with depression may experience similar levels of discrimination from family and friends to patients with schizophrenia, research suggests.
$16.4m ‘virtual’ mental health clinic to be launched
THE federal government will launch later this year a $16.4 million ‘virtual’ clinic which it hopes will increase patient access to phone and online support services for mental health.
Indigenous suicide rates ‘tragic, unacceptable’
SUICIDE rates among Indigenous Australians are tragic and unacceptable, the national depression and anxiety initiative beyondblue said today.
Med dropouts due to depression, finances
RESEARCHERS have urged universities and governments to review existing psychological and financial supports for medical students following a study indicating the two issues are the most common reasons for student dropout.
OSA prevalence soars with majority undiagnosed
A RESPIRATORY physician has called for wider screening for obstructive sleep apnoea (OSA) among men older than 40 after a study revealed most cases are undiagnosed.
Depression and financial stress leading causes of med school dropouts
RESEARCHERS have urged universities and governments to review existing psychological and financial supports for medical students following a study indicating the two issues are the most common reasons for student dropout.
Child custody fears an obstacle to seeking help for mental illness
ALMOST half of all parents with a mental illness have failed to seek help because they feared losing custody of their child, according to a study by the national mental health charity SANE Australia.
Self-help website for anxiety patients launched
AN INTERACTIVE self-help website designed to offer those struggling with anxiety and depression the tools they need to recover has been launched.
Surveillance increasing for early prostate cancer
ALMOST half of men diagnosed with low risk prostate cancer are being treated with surveillance only, new Australian figures show, amid continued controversy about PSA testing.
Study finds exercise ineffective in alleviating depressive symptoms
ADVICE to increase a patient’s physical activity is not an effective strategy to reduce symptoms of depression, according to new research.
Exercise ineffective in reducing depression
ADVICE to increase a patient’s physical activity is not an effective strategy to reduce symptoms of depression, according to new research.
Better Access failing to reach half of most needy
LESS than half of patients with chronic, recurrent depression are receiving specialist care – a fact researchers from the Brain and Mind Research Institute (BMRI) say illustrates the failings of the Better Access system.
Mums with depression more likely to wake babies at night
DEPRESSED mothers are more likely than mothers with low levels of depressive symptoms to wake their infants at night, a study has found.
Chronic disease risk factors rife among Aussies
MOST Australians have at least one preventable risk factor in their lifestyle that could lead to chronic disease, according to a new report.
Insufficient red meat can lead to depression, anxiety in women
CONSUMPTION of an optimum amount of lean red meat may be good for mental health, Australian researchers suggest after a study in more than 1000 women.
Fetal growth affected by SSRIs in pregnancy
A STUDY of pregnant women taking SSRIs for depression has found an improvement in their depressive symptoms but reduced fetal head growth and a higher risk for preterm birth in their offspring.
School screening for depression mooted
SCHOOL-based delivery of screening for early signs of depression in adolescents would be a cost-effective move in Australia, health economists say.
Finding out if kids are depressed makes good financial sense
SCREENING adolescents for signs of depression – and then providing a psychological intervention where needed – represents good value for money, according to a study by Australian heath economists.
Magic mushrooms to tackle depression
CLINICAL trials of magic mushroom therapy for depression could be underway by the end of the year after promising preliminary studies.
Patients with psychosis turning to their GPs
PATIENTS with a psychotic illness are relying on their GPs to manage their psychosis as well as other mental health conditions, new Australian data suggest.
Young flood victims hit by depression
THE children of families fighting for flood insurance payouts are showing disturbing signs of depression, a federal inquiry has been told. Flood victims' health was being put at risk, with some having no choice but to continue living in damaged homes for months before insurance assessors arrived, the inquiry heard this week in Toowoomba, west of Brisbane. The inquiry is looking at how the insurance industry handled claims during Queensland's summer of natural disasters. Lockyer Valley Flood Recovery coordinator Derek Pingel told the hearing antidepressant medication was being prescribed to ...
Study shows how to beat depression - literally
MUSIC therapy involving improvisation with percussion instruments and drums is a useful adjunct to drugs and counselling, psychiatrists say.
Need for adult-onset early psychosis programs
RESEARCH is lacking on patients who present with early psychosis as adults compared with the many studies about youth-onset psychosis, an expert says. Dr Ajit Selvendra, consultant psychiatrist at St Vincent’s Hospital, Melbourne, presented data at the Royal Australian and New Zealand College of Psychiatrists’ recent annual meeting in Darwin on the characteristics of older patients presenting with early psychosis to the hospital’s Early Psychosis Program. He said that more than half the patients with early psychosis presenting to the program, which accepts patients aged between 16 and 65 years, were aged over 25 years. Older ...
Alcohol large part of life for Aussie men
MORE than half of Australian males from as young as 14 years are drinking alcohol either daily or weekly, an Australian Institute of Health and Welfare (AIHW) report says. In 2007, 58% of men surveyed were consuming alcohol either daily or weekly, with males aged 20–29 years most likely to be weekly drinkers and those over 60 most likely to drink alcohol daily, the report, The Health of Australia’s Males , found. Six per cent of the men surveyed drank alcohol at levels placing them at risk, and 4% at high risk, said the report, released ...
Depressed dads also need support in parenting role
EXPERTS are recommending doctors screen fathers with young children for depression, after their study showed good mental health in dads was important for optimal child health and development. An analysis of data from more than 1700 interviews with fathers of one-year-old children found that those with depression were four times more likely to spank their child, and half as likely to read to their child, as non-depressed dads. The majority of dads with depression (82%) also reported talking with their child’s doctor in the previous year, giving doctors the opportunity to engage fathers and refer them for ...
Pregnancy depression screening plan criticised
GUIDELINES recommending pregnant women be screened twice for depression using the Edinburgh Postnatal Depression Scale (EPDS) are continuing to attract criticism from experts. Controversy erupted over the issue last year with the release of draft beyondblue guidelines, but the advice remains in the final NHMRC-endorsed document. The clinical guidelines on depression and related disorders in the perinatal period suggest all women complete the EPDS at least once, “preferably twice”, both antenatally and postnatally. The advice is listed as a ‘good practice point’, indicating that evidence is lacking or limited and it is based on lower ...
Diabetes for life
A recent child suicide has highlighted the difficulties faced by kids with chronic conditions like diabetes. Kate Woods asks, are we focusing too much on the physical targets at the expense of the children’s mental wellbeing?
Putting a price on wellbeing
Is economic strength the only way to measure a country’s success? The UK thinks not and will start to measure wellbeing within the population. Should Australia follow suit? Kathryn Eccles reports.
Swiss support network for distressed doctors
A program to help doctors dealing with burn-out or depression is being rolled out nationally across Switzerland. After a successful three-year pilot phase in two regions in Switzerland, the support network ReMed (Rete Medicorum) will be available nationally to doctors struggling with burn-out, emotional exhaustion, depression and other forms of stress. Doctors who contacted ReMed primarily experienced burn-out and depression (43%), followed by practice and everyday life problems (32%), addiction (13%), feelings of guilt following a professional error, inability to work following an accident, post-traumatic stress and legal proceedings (12%). Surprisingly, a quarter of the doctors ...
My journey
Melbourne GP Dr Naomi Harris, 31, knows first hand what it’s like to battle severe depression. She courageously shares her very personal story.
ADHD in kids raises depression and suicide risk
CHILDREN aged 4-6 years with ADHD may be at increased risk of depression, dysthymia and suicide later in life, research reveals. Compared to their peers, children with ADHD had a four times greater risk of depression and three times the risk of suicidal ideation or attempts. Researchers followed two cohorts of US children with ADHD through to age 18 for the study.They found 18.4% of those with early ADHD made at least one suicide attempt compared to 5.7% of matched controls. Those with several concurrent disorders, such as depression, anxiety, oppositional defiant disorder and/or conduct disorder, ...
Fish oil not protective for PND
WHILE many benefits have been suggested for a diet rich in omega-3 fish oils, Australian researchers say there is no evidence that they reduce the risk of postpartum depression or boost newborns’ cognitive development. The five year double-blind randomised trial of 2399 women found n-3 oils did not reduce depression rates any more than did intake of vegetable oil capsules. They also did not improve cognition or language development in the offspring of users at 18 months of age. The study’s lead author, Maria Makrides, professor of human nutrition at ...
Mentally ill teens rely on social media for support
SOCIAL media are providing a new frontier for people with mental illness, who are increasingly turning to sites such as Facebook to meet people, according to a new survey. The research by the Mental Health Association NSW found that social isolation and friendship networks were strongly tied to mental health, with many respondents saying they found it difficult to make new friends. Sixty per cent of the 456 anonymous survey respondents, who had a history of mental illness, said they did not have a best friend, and 40 per cent would have trouble finding someone to drive ...
The need for sleep
Just what is the optimal amount of sleep and how does too little or too much affect us? Lynnette Hoffman finds out.
Many doctors battling depression on their own
IT appears that many doctors are heeding the words ‘physician heal thyself’ with Australian research suggesting while they have similar rates of depression and anxiety to the general population, doctors are considerably less likely to seek help, and more likely to commit suicide. Self-prescription of sedatives and benzodiazepines also remains relatively common, beyondblue research shows. The review of 86 doctors’ health studies is thought to be one of the largest in this area – although few of the papers were Australian. There was also almost no literature on how best to treat depression and anxiety in ...
Medico-legal matters cause doctors the most anxiety
INVOLVEMENT in medico-legal processes is one of the biggest predictors of psychiatric morbidity among doctors, Australian research has shown, prompting experts to call for greater education on the issue. A study of nearly 3000 medical practitioners found that of all work-related factors, dealing with a current medico-legal matter was most associated with psychiatric morbidity – more so than long working hours or lack of holidays. Lead researcher Dr Louise Nash, psychiatrist at the NSW Institute of Psychiatry, said that given the research also found that 65% of doctors would be involved in medico-legal matters at some point ...
Managing mental illness and substance abuse
Treatment of co-existing disorders can be challenging but brief counselling works.
Quick two-question tool to screen for depression in primary care
A SIMPLE two-question approach offers a convenient and effective first-line screen for depression in primary care, researchers say. A study of 2642 general practice patients in New Zealand found the two-question Patient Health Questionnaire (PHQ-2) had good sensitivity of 86%, although specificity was “poor” at 78 per cent. The PHQ-2 – comprising the first two questions from the longer PHQ-9 – asks patients whether they have experienced depression or lack of pleasure in the past two weeks. Those who score two or more out of six on the PHQ-2 – 26% of those in the study ...
Benefit of depression education fades over time in elderly
EDUCATING older adults about depression could help keep the black dog at bay but only temporarily, Australian research shows. Over-60s who took part in a two-year mental health literacy program showed improvements in depressive symptoms after six weeks, but the benefits were lost by six months. Other preventive attempts to stave off depression also failed: neither promotion of physical activity, nor supplementation with folic acid and vitamin B12 alleviated distress in a trial of 909 adults with elevated but sub-threshold depressive symptoms. Despite the setback – especially to hopes of a benefit from dietary supplementation – ...
Study ignites debate on treatment of resistant depression in teenagers
A SWIFT and decisive change of therapy could hold the key to addressing treatment resistant depression in teenagers. Data from the US Treatment of Resistant Depression in Adolescents (TORDIA) trial of 334 adolescents aged 12 to 18 showed that switching treatment regimens helped around 40% to achieve remission within six months. Most of those who achieved remission, however, had already done so by 12 weeks – prompting the authors to recommend early intervention in nonresponders. Australian experts welcomed the addition to a sparse area of research but were divided in their opinions of the study. ...
Depressed men still dying early despite treatment
NEW research has reaffirmed the poor health outcomes faced by depressed Australian men and the limitations of current treatments. Six-year follow-up of more than 5000 older men in Perth (aged 68 to 88 years) revealed high mortality rates among those with depression, with the most severely depressed more than three times as likely to die as men without depression. Treatment with antidepressants did not reduce mortality and may have even increased it, although one expert said it was unclear whether this was an effect of the treatment itself. Antidepressant use was linked to a 30% independent ...
The depressing truth on intern hours
WORKING long hours as a medical intern really does increase the risk of depression, despite previous claims to the contrary. A new US study has reaffirmed the strikingly high rates of depression in medical interns but, for the first time, has linked this directly to the number of hours worked. Earlier work had pointed to less tangible factors such as perceived working conditions as being more important contributors. Now, in the largest prospective study of its kind, researchers followed 740 interns at 13 hospitals, with assessments performed every three months. Depression rates soared from 3.9% ...
Hormones in menopausal depression queried
EXPERTS remain divided over the link between hormones and mental health, after a major study showed testosterone was the only hormone implicated in perimenopausal depression. Following more than 3000 women for eight years, US researchers found that levels of other hormones had little bearing on depression outcomes, despite previous work implicating estradiol, follicle-stimulating hormone and dehydroepiandrosterone. Even the association with testosterone was modest, with high levels linked to a 15% increased risk of depression. Professor Jayashri Kulkarni, director of the Monash Alfred Psychiatry Research Centre, said the findings were at odds with previous research, which linked ...
Adverse birth outcomes linked to rise in antidepressant use
CONCERN is growing over the use of antidepressants in pregnancy, as the list of adverse birth outcomes linked to the drugs continues to lengthen. A large Australian study has for the first time linked the SSRI citalopram to a significantly increased risk of vesico-ureteric reflux (VUR) in children. Children born to mothers taking citalopram in the first trimester were eight times as likely to have VUR compared to controls. They were also more likely to be born prematurely, have birth length under 50cm, need resuscitation at birth and to be hospitalized in the first ...
The down side of diabetes
How much of a role does depression play in diabetes? Kate Woods looks at which entity comes first and how it affects treatment.
Having a little faith can help elderly beat the blues
ELDERLY people with a strong commitment to religious beliefs may be less likely to experience depression, an Australian study shows. Researchers examined 94 patients admitted to a psychogeriatric unit with major depression and reviewed them at six, 12 and 24 months. They found the one-third of the patients defined as having intrinsic religiosity (that is, a strong commitment to and motivation by religious beliefs) were more likely to have lower depression scores over time than others. The effect was independent of social support and was consistent across the three reviews. The authors, Dr Vahid Payman, ...
Regular indoor tanning a bona fide addiction: experts
FREQUENT indoor tanning may be classified as an addiction for a sizeable number of users, and should be addressed in new skin cancer prevention strategies, US experts believe. A study of 421 university students found among those who used indoor tanning facilities, 39% met DSM-IV criteria for substance-related addiction, while 30.6% met the criteria for addictive behaviour based on responses to the CAGE [Cut down, Annoyed, Guilty, Eye-opener] questionnaire used to screen for alcoholism. Indoor tanners with addictive behaviour also reported greater use of alcohol, marijuana and other substances and twice the rate of moderate to severe ...
Pinpointing chronic fatigue
Two decades after chronic fatigue syndrome was defined, the illness continues to baffle doctors and wreak havoc on patients’ lives. Rosemarie Milsom looks at some of the theories behind the origin of the condition.
Heavy Internet use associated with increased risk of depression
BEING considered dependent on the Internet, particularly for socialising, is clearly linked with depression, especially among younger people, researchers say. A total of 1319 people (mean age 21 years), completed an Internet use questionnaire, along with the Beck Depression Inventory, with 1.2% identified as Internet dependent. Those addicted to the Internet were found to be moderately to severely depressed, compared to those not addicted, who all scored in the non-depressed range. However, the researchers said it was not possible to determine if depressed people were drawn to the Internet or if excessive Internet use made people more ...
Abstainers found to be low on spirits
WHILE everyone is increasingly aware of the harmful health outcomes resulting from excessive alcohol consumption, evidence is now accumulating that abstinence may also have health consequences. Based on a study of the drinking habits and mental health status of 38,000 individuals, Norwegian researchers have found that teetotallers are at greater risk of developing depression compared to moderate drinkers. While other factors such as age, physical health status and the number of close friends a person had could account for some of this effect, it did not explain all of the increased risk, the authors said. Another ...
New mums face social issues
MORE than a third of new mothers are grappling with ‘social health’ issues such as family violence, housing or financial problems, a conference has heard. However, primary care opportunities to inquire about women’s psychosocial health after birth were being missed, Dr Jane Yelland (PhD) told the Public Health Association of Australia conference in Canberra last week. Dr Yelland, research fellow at the Murdoch Childrens Research Institute, Melbourne, said a survey of 2000 women conducted six months after childbirth found that while many had seen a GP or nurse several times, few had been asked about social issues ...
Study finds no suicide risk with smoking cessation drug
CONCERNS that the smoking cessation drug varenicline is associated with an increased risk of suicidal ideation and depression may be allayed by new research from UK health regulators. Researchers reviewed data from the UK general practice database including 80,000 adults prescribed a new course of a smoking cessation product from September 2006 to May 2008. Almost 11,000 of these patients were prescribed varenicline. Compared with users of nicotine replacement therapies, there was a non-significant 12% increased risk of self-harm among varenicline users. There was no evidence of an association with an increased risk of depression or suicidal ...
Safety fears over plan for truckie depression test
A PROPOSAL to screen truck drivers for depression as a requirement for licensing should not be implemented without ensuring access to mental health services is guaranteed, an expert has argued. As part of the National Transport Commission’s review into the medical standards on Assessing Fitness to Drive guidelines, the Australian Trucking Association recommended drivers be screened for depression, in line with tests already administered to safety-critical rail workers. In the association’s submission to the review, chair Trevor Martyn said severely depressed drivers were almost six times more likely to have a crash or ...
GP nurses are TrueBlue in monitoring depression
PRACTICE nurses are ideally placed to take the initiative in managing depression among patients with chronic diseases, a leading mental health advocate says, and a new study is set to reveal the benefits. Screening this patient group to determine their risk of depression is among a range of activities primary care nurses could be doing, said Professor Ian Hickie, executive director of Sydney’s Brain & Mind Institute. “This population are at very high risk of depression, and it is well identified that management of depression is key to achieving not only better depression outcomes but better physical ...
Skin problems linked with stress
REFERRING younger women with skin diseases for adjunct psychological therapy may be beneficial for symptom relief, Australian researchers say. The recommendation follows a study that added weight to the theory that depression symptoms and stress were significantly associated with skin problems. A total of 6630 women aged 22–27 taken from the Australian Longitudinal Study on Women’s Health answered a question on skin problems and stress levels in three surveys, in 2000, 2003 and 2006, with 8% reporting having skin problems in all three surveys. In each of the surveys, about a quarter of participants reported skin ...
GPs best placed to spot depression in cardiac patients
ALMOST three-quarters of patients with cardiovascular disease are not being diagnosed or treated for depression, experts say, and Australian cardiologists believe GPs are best placed to identify and treat depression in patients with cardiovascular disease. A nationwide survey examined beliefs and practices in relation to depression screening, diagnosis, treatment and referral among 511 cardiologists. Lead author, Andrew Stewart, a cardiology research fellow at the Austin Health department of cardiology in Melbourne, said 20% of patients with a myocardial infarct and 30% of heart failure patients had symptoms of depression. “Despite this, greater than 70% of cardiac ...
Family history affects severity of mental illness
PATIENTS with a family history of psychiatric disorder have more severe and recurrent depression, anxiety and substance abuse, new research shows. A New Zealand 30-year study of a birth cohort of 981 people found family history was associated with a greater likelihood of depression, anxiety disorder, and drug and alcohol dependence. For each disorder, patients with a family history were more likely to experience recurrence, with the exception of women with depression. The authors found patients with each disorder were also more likely to have impaired function and have greater service use, including hospitalisation, if they ...
Therapy combination cuts musculoskeletal pain
A COMBINATION of antidepressant therapy and a pain self-management program can reduce pain and disability experienced by patients with musculoskeletal pain. A US randomised controlled trial including 250 patients with moderate depression and persistent moderate pain found more than a quarter (26%) of the intervention group showed improvement in both depression and pain compared to only 8% of controls after one year. A third of intervention patients also showed 50% or greater reduction in severity of depression compared to only 16.5% of controls. Treatment for the intervention group included 12 weeks of therapy – with the ...
Alcohol and suicide attempts
The danger of drinking while feeling down. WHILE there have been improvements in suicide rates in recent years, it remains a significant public health problem for adolescents and young adults. During 2006, 1.3% of all deaths in Australia were due to suicide, according to the Australian Bureau of Statistics. In relation to total deaths, the percentage of deaths from suicide varies according to different age groups and gender. In 2006, 21% of male deaths and 14% of female deaths among those aged 20-24 years were attributed to suicide. The peak ages for suicide among males is ...
In the mood for lifestyle advice
Appropriate treatment of mood disorders is vital to improve health and for prevention and treatment of lifestyle-related disease. LIFESTYLE-related disease is underpinned by physical inactivity and unhealthy weight gain. In women, this often manifests during the reproductive years as disturbances including obesity, menstrual disturbances, polycystic ovarian syndrome (PCOS) and gestational diabetes (GDM). It then progresses to pre-diabetes, diabetes and cardiovascular disease (CVD) as women age. Lifestyle-related diseases such as PCOS, type 2 diabetes mellitus (DM2) or CVD increase the risk of depression, while depression is a risk factor for lifestyle-related disease. 1 Anxiety is ...
Online CBT effective in depression
INTERNET-BASED cognitive behavioural therapy offers significant clinical benefits for patients with depression. An Australian study of 45 patients randomised to a waitlist control group or to the Internet-based, clinician-assisted Sadness program found those in the intervention group had significantly reduced symptoms of depression. The Sadness program consists of six online lessons, weekly homework assignments, weekly email contact from a clinical psychologist and participation in a moderated online discussion forum with other participants. “The treatment procedure used in the Sadness program has encouraged clinical efficacy, completion rates comparable to those associated with face-to-face treatment, and a procedure ...
Depression therapy may improve heart outcomes
PATIENTS with heart disease and concurrent depression may have better cardiac outcomes if they receive antidepressants. Melbourne psychiatrist Professor David Clarke told the Heart Foundation 2009 conference in Brisbane on Saturday there were “snippets of evidence” emerging that treatment with SSRIs might not only treat depression, but also impact on the course of coronary disease. Professor Clarke, clinical director of general hospital and primary care psychiatry at Monash Medical Centre and Southern Health, told the conference there was increasing evidence that depression was a “whole being” disease. Depression predicted later cardiovascular disease and the two conditions ...
Prenatal depression linked to unsettled sleep in infants
WOMEN who experience depression during pregnancy are more likely to have babies with significant sleep problems in the first six months of life. A small US study has found babies whose mothers had an index episode of depression during pregnancy, or a history of depression, took longer to fall asleep, had shorter sleep duration and more awakenings at night for up to six months compared to those born to non-depressed mothers. The authors said evidence showed increased cortisol levels during and after pregnancy in depressed mothers might prime a stress response in infants. However, they could not ...
Chronic sleep problems a red flag for suicide risk
CHRONIC sleep problems are linked to a greater risk of suicidality even among patients not undergoing treatment for a psychiatric disorder, researchers have found. Among a representative sample of 5692 US adults, those who reported having early morning awakening or regularly having difficulty in initiating or maintaining sleep had a more than two-fold greater risk of all measures of suicidality – including suicidal ideation, planning or attempting suicide – than did those without sleep disturbance. While links between chronic sleep problems and suicidality and depression have previously been found in clinical settings, the authors said this was ...
IVF success rates not affected by anxiety levels
WOMEN who experience anxiety and depression before or during treatment for infertility can be reassured that their mood state will not affect their chance of a successful pregnancy. Dutch researchers assessed anxiety and depression at baseline and before oocyte retrieval in 783 women undergoing their first IVF or intracytoplasmic sperm injection. They found levels of anxiety and depression before and during IVF treatment, or the anxiety difference from pre-treatment to oocyte retrieval, did not differ between pregnant and non-pregnant women. Ongoing pregnancy or cancellation rates were not affected by anxiety and depression when adjusted for potential ...
Review clarifies drug choice in depression
A LANDMARK analysis comparing patient responses to 12 second generation antidepressants should help GPs select the best tolerated and most effective medication for patients, experts say. Deciding which of these products to prescribe has been complicated by the quantity of research, much of it manufacturer-funded, and a lack of head-to-head studies of different agents, according to an editorial accompanying a new meta-analysis. The multinational research team reviewed 117 randomised controlled trials involving a total of 25,928 participants, comparing any of 12 antidepressants for the treatment of unipolar major depression in adults. They concluded that ...
World report - 5 December 2008
• DEADLY NEW EBOLAVIRUS SPECIES DISCOVERED IN UGANDA A NEW Ebolavirus species, responsible for a major haemorrhagic fever outbreak, has been discovered in western Uganda. Researchers from the US Centers for Disease Control and Prevention, the Uganda Virus Research Institute, the Uganda Ministry of Health, and Columbia University revealed the species ( Bundibugyo ebolavirus ) differed by more than 30% at the genome level from the three previously known Ebolavirus species. The new species was responsible for an outbreak in western Uganda in 2007 that resulted in 149 suspected cases ...
Australians may overinflate their risk of disease
AUSTRALIANS may overestimate their risk of contracting some serious diseases, a recent opinion poll has shown. Respondents were more worried about contracting arthritis than any other disease, with 43% believing they had a one in 10 or more chance of contracting it during their lifetime, which is a realistic view according to Arthritis Australia. Anxiety or depression were the next biggest perceived risk, with 39% of those polled expecting to contract one or the other condition during their lifetime. This was much higher than the actual risk of one in five people experiencing depression at some ...
12 myths of skincare
Dispelling some of the most common myths patients hold about their skin. Acne is caused by eating chocolate There is no conclusive evidence to suggest that diet has any major impact on acne. There have been a number of small studies demonstrating that high-GI foods may contribute to worsening of acne in a small group of younger patients. However, in general, dietary intake has no major impact on the severity of acne. Systemic isotretinoin is a major cause of adolescent depression Most studies do not demonstrate a link between depression and ...
Study casts doubt on depression screens in CVD
THE value of screening for depression in patients with cardiovascular disease (CVD) has been questioned by research showing the use of antidepressants or cognitive behavioural therapy did not improve CVD outcomes. A Canadian meta-analysis of 11 studies found that, while there were “modest” improvements in depressive symptoms among patients treated with these therapies when compared to placebo or standard care, there was no resulting improvement in cardiac outcome. The findings questioned the widespread recommendation for screening for depression among CVD patients, the authors said. The review did not find definitive evidence for or against the recommendations, they ...
GPs face image problem on depression
MORE than half of Australians think their GP spends too little time treating people with depression, a beyondblue survey has shown. A random telephone survey of 3200 Australian households also showed that 38% of respondents perceived that GPs were simply too busy to deal with patients’ depression, and that 32% perceived GPs believed other patients were in more urgent need of medical treatment. Nearly half did not believe GPs were well trained to deal with problems like depression. Dr Caroline Johnson, a Melbourne GP who is completing a PhD on depression in general practice, said the ...
Depression post CVS event predicts poor outcome
THE onset of depression following an acute cardiac event has a significant impact on a patient’s long-term survival and illness severity – and clinicians need to be alert for it, experts say. An Australian study, carried out by Sydney’s Black Dog Institute, found patients whose depression commenced only after their coronary event were seven times more likely to die or be readmitted to hospital. Alexander McFarlane, professor of psychiatry at the University of Adelaide, said the evidence showed the importance of GPs and cardiologists asking psychological questions following acute coronary syndrome (ACS). “Doctors often dismiss this ...
Space helps ground control
A PROGRAM to treat depressed astronauts could be brought down to Earth to help others in remote locations. Scientists with the US National Space Biomedical Research Institute are developing an interactive multimedia program that will assist astronauts to manage depression and other psychosocial problems that can occur during long space missions. The program, known as the Virtual Space Station, can be used for training before, and for help during, missions. Other problems addressed using the program include interpersonal conflict and stress and anxiety. The researchers believe the system could have applications on Earth, especially in ...
Depression during pregnancy doubles preterm delivery risk
THE push to establish a national screening program to detect depression in early pregnancy has been strengthened by findings linking antenatal depression with an increased risk of preterm delivery. A US study of 791 women who were assessed at 10 weeks’ gestation found those diagnosed with depression had twice the risk of preterm delivery (before 37 weeks) compared to those who were not depressed. The risk increased with the severity of depression. Women with significant depression had a 60% greater chance of preterm delivery, while those with severe depression had 2.2 times greater risk. The incidence ...
Vitamin D may have a mental health role
PATIENTS with depression have significantly lower serum vitamin D levels and may benefit from screening and vitamin D supplementation, Australian experts say. Researchers compared vitamin D (25-OHD) levels among 53 inpatients from a private psychiatric hospital with 691 community-based controls. Diagnoses among the inpatient group included bipolar disorder, depression, and personality and substance use disorders. Almost 60% of patients were found to be deficient in vitamin D (≤50 nmol/L) compared with only 30% of controls. Moderate vitamin D deficiency (≤25 nmol/L) was detected among 11% of inpatients compared with only 7.2% of controls. The ...
Euthanasia laws need to consider depression
TACKLING depression early among the terminally ill should be a high priority, especially given the current debate about assisted suicide, experts are warning. A US study of 58 terminally ill patients seeking physician-assisted deaths under the US State of Oregon Death with Dignity Act found 15 met the criteria for depression and 13 met criteria for anxiety. Among the nine study participants who died of lethal ingestion, three met the criteria for clinical depression, which would have made them ineligible under Oregon law. Professor Ian Hickie, executive director of the Brain & Mind Research Institute at ...
Diabetes and depression
Diabetes doubles the risk of depression, but what are the key triggers? Kirrilly Burton reports. “RUN away from Allison, she’s got diabetes – you don’t want to catch it.” Over two decades later, Allison Milnes, now aged 34, vividly recalls this childish jibe yelled out during a game of chase and the intense feelings of isolation it evoked. Diagnosed with type 1 diabetes at eight, Allison is all too familiar with the stigma associated with a chronic illness such as type 1 diabetes, an autoimmune disease unrelated to diet and lifestyle. She’s also ...
Depressed truck drivers are more accident prone: report
TRUCK drivers who suffer severe depression have a six-fold higher accident rate, an Australian report shows. And while mental health issues, and stimulant and other drug use, appear to be rife among drivers of heavy vehicles, few seek help from a GP or counsellor. Researcher Dr Michael Hilton (PhD), from the Park Centre for Mental Health at the University of Queensland, said he found 91% of drivers with symptoms of depression were not receiving treatment. The report, Health Survey of the NSW Transport Industry , revealed even drivers with mild depression symptoms had double the ...
Specialists fight GP access to acne drug
A PROPOSAL to allow GPs to prescribe isotretinoin (Roaccutane) for severe acne has met resistance from dermatologists who say the move could lead to birth defects, abortions and suicides. The TGA’s National Drugs and Poisons Schedule Committee will consider in October a proposal to extend prescribing of isotretinoin from dermatologists and specialist physicians to GPs. The Australasian College of Dermatologists will oppose the proposal, honorary secretary Dr Stephen Shumack said. “It’s a recipe for disaster because isotretinoin should be a last resort, but there could be lots of leakage to acne which isn’t severe and resistant, ...
Sadness or sickness?
A new book provides another challenge to the current thinking on depression. IN the last year, one book has rattled the ranks of the psychiatric profession at an unprecedented level. In this book, The Loss of Sadness , sociologist Allan Horwitz and social worker Jerome Wakefield argue that psychiatry has progressively pathologised sadness. They observe that to be human is to react with sadness to a range of negative life events. By contrast, they argue that clinical depression is a state that appears without apparent cause or is grossly disproportional to any preceding stressor. Their ...
World report - 8 August
• BRIT SANDWICHES SALT RICH PRE-PACKED sandwiches are loaded with salt and saturated fat, according to a UK study. Conducted by The Daily Mail and Channel 4, the study found Subway’s 12-inch Meatball Marinara contained 7.2 g of salt – the same salt content as 18 packs of chips. While Pret a Manger’s ‘Picnic cheddar, roast tomatoes and pickle bloomer’ sandwich contained 2.27 g of salt and 16.6 g of saturated fat, 80% more fat than in a Big Mac. The UK’s Foods Standards Agency recently called on the catering industry to revise ...
Digital addiction
From Internet addiction to obesity, the new media has a significant impact on mental and physical health. Kirrilly Burton reports. BORN roughly between 1980 and 1995, they have been dubbed everything from Generation Y to the Echo Boomers. They are tech-savvy, multitask-oriented, and they want everything now. They’ve grown up with the Internet, iPods, mobile phones and video games, and, according to a 2007 Australian Communications and Media Authority report on media use among eight to 17 year olds, the Internet is integral to their lives, with an average of an hour and a quarter ...
Evidence lacking for rising depression, say researchers
THERE is no evidence that depression is increasing in Australia, researchers say, despite some previous studies suggesting its prevalence is rising. Researchers from the University of Melbourne’s Department of Psychiatry reanalysed data from the 1998 and 2004 South Australian Health Omnibus Surveys, which included more than 3000 participant interviews. They found no “statistically significant increase” in the proportion of cases classified with major depression between 1998 and 2004. There was, however, a significant decrease in other types of depression such as dysthymia. Lead researcher Associate Professor Graeme Hawthorne said this showed conventional wisdom that depression was ...
Experts dispute doubts over SSRI efficacy
AUSTRALIAN experts have questioned the findings of a US meta-analysis that concluded SSRIs were no more effective than placebo in treating all but the most severe cases of depression. The widely publicised review of 47 published and unpublished registered trials found the SSRIs did not produce clinically significant improvements in depression in patients who had moderate to very severe depression at baseline when compared to placebo. Significant effects were recorded in only the most severely depressed patients ( PLoS Med 2008;5(2):e45 ). However, Professor Gordon Parker, executive director of the Black Dog Institute, Sydney, ...
Neurofibromatosis type 1
CASE HISTORY A 19-YEAR-OLD male complains of several unsightly papules that have appeared on his hand within the past month, and of enlarging brownish patches over his abdomen. He asks if these can be removed for cosmetic reasons. On examination, there are eight tan macular lesions measuring between 1 cm and 3 cm on the trunk, as well as multiple smaller tan macules in both axillae ( Figure 1 ). These represent café au lait macules (CALMs) and axillary freckling, characteristic of neurofibromatosis type I (NF1). There ...
‘These damn bugs’
A woman presents with what she believes is a parasitic infestation. A 45-year-old woman presents with a 12-month history of being plagued by “these damn bugs”. She brings along a jar containing evidence of these “wretched creatures”. She has consulted several other doctors but without any satisfaction. Her limbs show active excoriations as well as textural and pigmentary scarring from ongoing attempts at picking out the bugs from underneath her skin. Provisional diagnosis: delusion of parasitosis (DP). The patient had gathered what she believed to be evidence of an ...