Shifting Roles...

Shifting Roles
Supporting Your Spouse

Two people in a relationship may shift in and out of various roles and it is important to ebb and flow together like a tide.



Throughout the course of a successful marriage or long-term commitment, the two people in the relationship may shift in and out of various roles. For example, one person in the couple may support the other person going back to school. In order to do this, he or she steps into a supporting role, setting aside certain goals or aspirations in order to provide a stable base from which his or her partner can launch in a new direction. There are many gifts of learning inherent in this role—from having the opportunity to embody a nurturing stance to feeling the pleasure of seeing a loved one thrive. When our partner expands his or her horizons, ours expand, too, and we gain access to a world that would otherwise remain closed to us.

However, there is also much to be said for having a turn to be the one stepping outside the box, perhaps taking time to attend to our personal healing, spiritual pursuits, or other interests. In order to maintain balance within our relationships, it's important that we address these issues each time one person steps into a supporting role so the other can try something new. When we are conscious about acknowledging that one person is bearing a bit more of a burden so that the other can grow, we stand a better chance of making sure the ebb and flow in the relationship remains fair and equal.

The most important part of this process is open communication in which each person has a chance to express how they feel and come to an understanding about the roles they have agreed to play and when they expect them to shift. Each time a dynamic shift occurs, a ceremony of acknowledgment can lend an air of distinction to the moment. This can be a simple dinner date or an elaborate ritual, depending upon what works best for us at the time. Perhaps the most important thing is expressing gratitude to the person in the supporting role and encouragement to the person moving in a new direction. When the flow of feeling and communication is open, a healthy closeness develops that allows each person in the relationship to have a turn at each of these important roles

 

 

 

 

 

Growing Pains
Difficult Times

We are like children, and the universe is our wise mother who knows what our souls need to thrive better than we do.



It can be very challenging to maintain a positive attitude and a measure of faith when you are in the midst of difficult times. This is partly because we tend to think that if the universe loves us we will experience that love in the form of positive circumstances. However, we are like children, and the universe is our wise mother who knows what our souls need to thrive better than we do. Just as a young child does not benefit from getting everything she wants, we also benefit from times of constriction and difficulty to help us grow and learn. If we keep this in mind, and continue to trust that we are loved even when things are hard, it helps us bear the difficult time with grace.

This period of time in history is full of difficulty for a lot of human beings, and you may feel less alone knowing you are not being singled out. There are extreme energy changes pulsing through the universe at every level and, of course, we are all part of the growing process and the growing pains. It helps if we remember that life is one phase after another and that this difficult time will inevitably give way to something new and different. When we feel overwhelmed we can comfort ourselves with the wise saying: This too shall pass.

At the same time, if you truly feel that nothing is going right for you, it's never a bad idea to examine your life and see if there are some changes you can make to alleviate some of the difficulty. Gently and compassionately exploring the areas giving you the most trouble may reveal things you are holding onto and need to release: unprocessed emotions, unresolved transitions, or negative ways of looking at yourself or reality. As you take responsibility for the things you can change, you can more easily surrender to the things you can't, remembering all the while that this phase will, without doubt, give way to another.

 

 

 

 

 

Life As It Is
Making Life Work for You

At the end of the day, we must come to terms with changing what we can and accepting what we cannot change.



Sometimes we have so many varying responsibilities in our lives, ranging from work obligations to caring for children to running a household, we feel we cannot possibly make it all work. We may feel overwhelmed in the face of it all, ending each day feeling hopelessly behind schedule. However, regardless of how frustrating this can be, these are the parameters that make up our lives, and we owe it to ourselves to find a way to make it work. Rather than buckling under the pressure of an impossible to-do list, we might take a moment to view the larger perspective.

Like the president of a large organization, we must first realize that we cannot do every job ourselves. The first step to sanity is learning how to delegate some of the responsibility to other people, whether by paying someone to clean our house or trading childcare duties with another parent. In addition, we might find places where we can shift our expectations in ways that make our lives easier. For example, expecting ourselves to create a healthy home-cooked meal every night after a full day of work, errands, or caring for an infant or toddler may be a bit excessive. We might allow ourselves to order in food once in a while without any guilt. Accepting the adjustments needed to make our lives work is an essential ingredient to being at peace with our situation.

At the end of the day, we must come to terms with changing what we can and accepting what we cannot change. Sometimes the laundry piles up, a sick child demands more of our attention than usual, and we temporarily get behind with our schedule. Accepting this momentary state of affairs and trusting in our ability to get back on track when the time is right, we gracefully accept our life as it is, letting go of perfectionism and embracing life as it stands.

 

 

 

 

Worth the Time
Meditating More When Our Plates Are Full

When you make time for meditation, it actually helps you get through a busier day as we are given what we need.



Ironically, when we get busy, the first thing that tends to get cut back is our meditation practice. We have less time and a lot on our plates, so it makes sense that this happens, but in the end it doesn't really help us. Most of us know from experience that we function much better when we give ourselves time each day to sit in silence. And the more we have to do, the more we need that solitary, quiet time for the day ahead. As a result, while it may sound counterintuitive, it is during busy times that we most need to spend more time in meditation rather than less. By being quiet and listening to the universe, we will be given what we need to get through our day.

Expanding our morning meditation by just 10 minutes can make a big difference, as can the addition of short meditations into our daily schedule. The truth is, no matter how busy we are, unless we are in the midst of a crisis we always have five or 10 minutes to spare. The key is convincing ourselves that spending that time in meditation is the most fruitful choice. We could be getting our dishes done or heading into work earlier instead, so it's important that we come to value the importance of meditation in the context of all the other things competing for attention in our lives. All we have to do to discover whether it works to meditate more when we are busy is to try it.

We can start by creating more time in the morning, either by getting up earlier or by preparing breakfast the night before and using the extra time for meditation. We can also add short meditation breaks into our schedule, from five minutes before or after lunch to a meditation at night before we go to sleep. When we come from a place of centered calm, we are more effective in handling our busy schedules and more able to keep it all in perspective. If more time in meditation means less time feeling anxious, panicky, and overwhelmed, then it's certainly worth the extra time.

 

 

 

 

 

 

Shifting the Mood
Attitude Follows Perspective

When we feel supported, it is easier to open our heart and minds when needing to look at a situation differently.



We all have days when we are faced with chores, errands, or responsibilities that we don't want to do. At times like these, it's easy to get into a bad mood and stay in one as we tackle these tasks. However, given the fact that our bad mood will not change the fact that we have to do these things, and will most likely make things worse, we could also try to shift our attitude. Many wise people have pointed out that it is not so much what we do as it is how we do it that makes the difference in our lives.

It's important when we're facing something that's really hard for us, whether it's doing taxes, paying bills, or visiting a challenging relative, that we lovingly support ourselves through the process. The more supported we feel, the easier it is to open our minds to the idea that we could change our way of looking at the situation. In truth, most of the chores we don't like doing are intimately intertwined with our blessings. When we remember this, we feel gratitude, which makes it hard to stay in a dark mood.

We can shift our attitude by considering how much we love our home as we clean it and how lucky we are to have a roof over our head. Any task can be transformed from a burden to a necessary aspect of caring for something we love. All we have to do is shift our perspective, and our attitude follows shortly behind.

 

 

 

Turn it Around
Laboring Under a Label

Are you living under the guise of a label? Do you put a label on people?



We live in a culture that uses labels as a means of understanding the world and the people living in it. As a result, many of us find ourselves laboring under a label that has a negative connotation. Unless we can find a way to see the good in such a label, we may feel burdened by an idea of ourselves that is not accurate. It is important to remember that almost nothing in this world is all good or all bad, and most everything is a complex mixture of gifts and challenges. In addition, different cultures revere certain qualities over others, but this does not mean that these qualities are inherently good or bad. For example, a culture that elevates outgoing behavior will label an introvert in a negative way, calling them antisocial. In truth, the ability to spend time alone is one that most great artists, mystics, and visionaries share. Owning the positive side of this label can lead us deeper into our gifted visions and fertile imaginations.

When we look into the lives of any of the great people in history, we always find that they had quirks and eccentricities that earned them less than ideal labels from the societies in which they lived. Many famous artists and musicians were considered to be isolated loners or disruptive troublemakers, or sometimes both, yet these people altered history and contributed to the world an original vision or advances in our understanding of the universe. If we can remember this as we examine our own selves and the labels people use to describe us, we find that there is a bright side to any characterization.

If you have been labeled, remember that all you have to do to see the positive side is to turn the label around. For example, you may be considered to be overly emotional, and the fact that you are perceived this way may make you feel out of control. But notice, too, the gifts of being able to feel and express your emotions, even in a world that doesn't always encourage that. You might begin to see yourself as brave and open-hearted enough to stay alive to your feelings. You may also see that there are certain paths and professions in which this is a necessary ability. As you turn your label around, the light of your true nature shines to guide you on your way.

 

 

 

 

 

Gathering Our Straying Thoughts
Centering Ourselves

Learning to center yourself can be of the most important aspects of your spiritual growth.


When our thoughts are scattered in several directions at once and we are no longer conscious of what we are doing or why, it is time to center ourselves. When we center ourselves, we begin by acknowledging that we have become spread too thin and we are no longer unified inside. Our thoughts might be out of sync with our feelings, and our actions may be out of sync with both. The main signs that we need to center ourselves are scattered thoughts and a feeling of disconnection or numbness, as if we are no longer able to take anything in. In addition, we may feel unfocused and not present in our bodies. Centering ourselves is a way of coming to terms with all the different energies within us and drawing them back into ourselves.

Centering yourself means that you are working from or being aware of the core of your being in the solar plexus area of your body. At first it may not make sense, but as you progress you will understand what this feels like. We naturally know how to center ourselves when we take a deep breath, for example, before making a big announcement or doing something big. Another way to center ourselves is to sit down and engage in breath meditation. We can start by simply getting into a comfortable upright position and noticing as our breath enters and leaves our bodies. Our breath flows into our center and out from our center, and this process can serve as a template for all of our interactions in the world. In conversations, we can take what our friends are saying into the center of our beings and respond from the center. Our whole lives mirror this ebb and flow of energy that begins and ends at the center of ourselves. If we follow this ebb and flow, we are in harmony with the uni! verse, and when we find we are out of harmony, we can always come back into balance by sitting down and observing our breath.

When we sit down to center ourselves we can imagine that we are gathering our straying thoughts and energies back into ourselves, the way a mother duck gathers her babies around her. We can also visualize ourselves casting a net and pulling all the disparate parts of ourselves back to the center of our being, creating a sense of fluid integration. From this place of centeredness, we can begin again, directing ourselves outward in a more intentional way.

Alzheimer's CSF Test:...

Following Healthy Lifestyle Could Cut Colorectal Cancer by 23%
Medscape Medical News , 2010-10-27

 

 

 

Alzheimer's CSF Test: Useful or Useless?
Medscape Neurology & Neurosurgery , 2010-10-15

 

 

 

A Simple Way to Avoid Malpractice Litigation
Medscape Psychiatry & Mental Health , 2010-10-21

 

 

 

Mental Illness in 2010: Putting the Recovery Model Into Practice
Medscape Psychiatry & Mental Health , 2010-10-15

 

 

 

 

Clinical and Pharmacologic Strategies to Achieve Remission in Depression
MedscapeCME Psychiatry & Mental Health , 2010-10-11

 

 

 

 

Antiviral Agents in Alzheimer's Disease: Hope for the Future?
Therapeutic Advances in Neurological Disorders , 2010-05-01

 

 

 

Nearly Half of Primary Care Physicians Refer for Colonoscopy More Frequently Than Guidelines Recommend
Medscape Medical News , 2010-10-15

 

 

 

 

US Salt Intake Little Changed in 50 Years and Still Far Too High
Heartwire , 2010-10-11

 

 

 

 

Revised Definition of Alzheimer's Disease Proposed
Medscape Medical News , 2010-10-12

 

 

 

 

Is Recovery Attainable in Schizophrenia?
Medscape Psychiatry & Mental Health , 2010-10-08

 

 

 

 

Antipsychotic Dosing: How Much but Also How Often?
Schizophrenia Bulletin , 2010-09-01

 

 

 

 

Medications for Insomnia or Anxiety Linked to 36% Increase in Mortality Risk
Medscape Medical News , 2010-10-05

 

 

 

 

Nobel Prize Awarded to Developer of In Vitro Fertilization
Medscape Medical News , 2010-10-04

 

 

 

 

Depression Plus Heart Disease a Particularly Lethal Combination
MedscapeCME Clinical Briefs , 2010-09-21

New class of agents for treatment of hypertension...

New class of agents for treatment of hypertension: Focus on direct renin inhibition (>> click to go to the journal's website)
Vascular Health and Risk Management, 10/13/10
Fogari R et al. – Aliskiren, the first orally active direct renin inhibitor, is an effective antihypertensive drug with distinctive characteristics, including good blockade of the renin–angiotensin system, a prolonged duration of action, pharmacologic effects that persist after drug discontinuation, and favorable tolerability comparable with placebo. The blood pressure–lowering effect of aliskiren monotherapy is similar, if not superior, to that of other first–line antihypertensive agents, and is greatly enhanced when aliskiren is combined with various other antihypertensive medications, without any adverse drug interactions. Aliskiren is also an effective and well tolerated therapy in special populations, including diabetic, obese, and elderly hypertensives. Beyond its blood pressure–lowering efficacy, results from experimental and clinical trials suggest that aliskiren has positive effects on markers of cardiovascular and renal damage.

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Other articles in Internal Medicine

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Diagnosis and Treatment of Hypertension in Children
Current Hypertension Reports, 09/28/10

Divergent Results Using Clinic and Ambulatory Blood Pressures : Report of a Darusentan-Resistant Hypertension Trial
Hypertension, 10/07/10

Common Variants in the ATP2B1 Gene Are Associated With Susceptibility to Hypertension : The Japanese Millennium Genome Project
Hypertension, 10/05/10

 

 

 

Cardiovascular risk factors and cognitive impairment (>> click to go to the journal's website)
Sang Thrombose Vaisseaux, 10/13/10
Farid K et al. – Although age is the most important risk factor, cardiovascular risk factors and a history of cardiovascular disease are established as risk factors for cognitive decline and dementia. The preventive effect of antihypertensive treatment on cognitive decline is now well established but effects of treatment of dyslipidemia on reducing cognitive decline and dementia are inconclusive. Strategies for screening for vascular cognitive impairment are not standardized and long–term studies are needed to establish better prevention of cognitive vascular disorders.

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Other articles in Internal Medicine

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Vitamin D and cardiovascular disease: Systematic review and meta-analysis of prospective studies
Preventive Medicine, 09/29/10

The relationship between retinal arteriolar and venular calibers is genetically mediated and each is associated with risk of cardiovascular disease
Investigative Ophthalmology and Visual Science, 10/12/10

Management of High Blood Pressure in Blacks : An Update of the International Society on Hypertension in Blacks Consensus Statement
Hypertension, 10/05/10

Stigma Resistance in Patients With Schizophrenia

Stigma Resistance in Patients With Schizophrenia (>> click to go to the journal's website)
Schizophrenia Bulletin, 09/21/10
Sibitz I et al. – Stigma Resistance is a new and promising concept. The development of stigma–resisting beliefs might help individuals in their hope of finding a fulfilling life and in their recovery from mental illness.

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Other articles in Psychiatry

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Examining the course and outcome of individuals diagnosed with schizophrenia and comorbid borderline personality disorder
Schizophrenia Research, 10/07/10

Paternal age at birth of first child and risk of schizophrenia
American Journal of Psychiatry, 10/20/10

Altered engagement of attention and default networks during target detection in schizophrenia
Schizophrenia Research, 10/19/10

 

 

 

 

The Role of Religion in the Well-Being of Older Adults With Schizophrenia (>> click to go to the journal's website)
Psychiatric Services, 09/08/10
Cohen CI et al. – Religiousness may have a favorable impact on the quality of life of older adults with schizophrenia, and it must be considered along with other therapeutically important agents.

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Other articles in Psychiatry

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Examining the course and outcome of individuals diagnosed with schizophrenia and comorbid borderline personality disorder
Schizophrenia Research, 10/07/10

Analysis of HapMap tag-SNPs in dysbindin (DTNBP1) reveals evidence of consistent association with schizophrenia
European Psychiatry , 10/07/10

Suicidal attempts and increased right amygdala volume in schizophrenia
Schizophrenia Research, 10/07/10

 

 

Efficacy of antidepressants in treating the negative symptoms of chronic schizophrenia: Meta-analysis (>> click to go to the journal's website)
British Journal of Psychiatry, 09/03/10
Singh SP et al. ?The goal of this sreview was to analyse the efficacy of add-on antidepressants for the treatment of negative symptoms of chronic schizophrenia. Antidepressants along with antipsychotics are more effective in treating the negative symptoms of schizophrenia than antipsychotics alone. Methods
  • Systematic review and meta-analysis of randomised controlled trials comparing effect of antidepressants and placebo on negative symptoms of chronic schizophrenia, measured through standardised rating scales
  • Outcome measured as standardised mean difference between end-of-trial and baseline scores of negative symptoms
Results
  • 23 trials from 22 publications (n = 819)
  • Antidepressants involved selective serotonin reuptake inhibitors, mirtazapine, reboxetine, mianserin, trazodone and ritanserin; trials on other antidepressants not available
  • Overall standardised mean difference moderate (?0.48) in favour of antidepressants and subgroup analysis revealed significant responses for fluoxetine, trazodone and ritanserin

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Other articles in Psychiatry

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Antidepressant use and colorectal cancer risk: A Danish population-based case control study
British Journal of Cancer, 09/30/10

Bupropion for Depression in Schizophrenia
Clinical Neuropharmacology, 10/01/10

Longitudinal Evidence for Unfavorable Effects of Antidepressants on Heart Rate Variability
Biological Psychiatry, 09/21/10

 

Aripiprazole for late-life schizophrenia (>> click to go to the journal's website)
Clinical Interventions in Aging, 09/01/10
Rado J et al. – Antipsychotics are frequently used in elderly patients to treat a variety of conditions, including schizophrenia. While extensively studied for their impact in younger populations, there is comparatively limited evidence about the effectiveness of these agents in older patients. Further complicating this situation are the high co–morbidity rates (both psychiatric and medical) in the elderly; age–related changes in pharmacokinetics leading to a heightened proclivity for adverse effects; and the potential for multiple, clinically relevant drug interactions. With this background in mind, the authors review diagnostic and treatment–related issues specific to elderly patients suffering from schizophrenia and other psychotic conditions, focusing on the potential role of aripiprazole.

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Other articles in Psychiatry

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Neonatal vitamin D status and risk of schizophrenia: A population-based case-control study
Archives of General Psychiatry, 09/10/10

Slow wave sleep deficits as a trait marker in patients with schizophrenia
Schizophrenia Research, 09/29/10

Diagnostic and prognostic significance of Schneiderian first-rank symptoms: a 20-year longitudinal study of schizophrenia and bipolar disorder
Comprehensive Psychiatry, 09/13/10

 

 

Comparison of the metabolic and economic consequences of long-term treatment of schizophrenia using ziprasidone, olanzapine, quetiapine and risperidone in Canada: a cost-effectiveness analysis (>> click to go to the journal's website)
Journal of Evaluation in Clinical Practice, 07/28/10
Roussy JP et al. – Compared with olanzapine and quetiapine, ziprasidone produced savings to the health care system. Although ziprasidone generated incremental expenditures versus risperidone, it resulted in more QALYs. Based on this analysis, ziprasidone treatment possesses cost and therapeutic advantages compared with olanzapine and quetiapine.

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Other articles in Psychiatry

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Neonatal vitamin D status and risk of schizophrenia: A population-based case-control study
Archives of General Psychiatry, 09/10/10

Diagnostic and prognostic significance of Schneiderian first-rank symptoms: a 20-year longitudinal study of schizophrenia and bipolar disorder
Comprehensive Psychiatry, 09/13/10

Common genetic variation in Neuregulin 3 (NRG3) influences risk for schizophrenia and impacts NRG3 expression in human brain
Proceedings of the National Academy of Sciences of the United States of America, 09/09/10

A Mind-Body Program for Older Adults with Chronic...

A Mind-Body Program for Older Adults with Chronic Low Back Pain: Results of a Pilot Study (>> click to go to the journal's website)
Pain Medicine, 12/15/09
Morone NE et al. – Both the intervention group and the education control group improved on outcome measures suggesting both programs had a beneficial effect. Participants continued to meditate on 4–month follow–up. The control program was feasible but not inert. Piloting the control program in mind?body research can inform the design of larger clinical trials.

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Other articles in Psychiatry

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The Prevalence of Chronic Pain in United States Adults: Results of an Internet-based Survey
The Journal of Pain, 08/31/10

Veterans walk to beat back pain: study rationale, design and protocol of a randomized trial of a pedometer-based Internet mediated intervention for patients with chronic low back pain
BMC Musculoskeletal Disorders, 09/16/10

Longitudinal Treatment Outcomes for Geriatric Patients with Chronic Non-Cancer Pain at an Interdisciplinary Pain Rehabilitation Program
Pain Medicine, 08/25/10

 

 

 

Combination of intensive cognitive rehabilitation and donepezil therapy in Alzheimer's disease (AD) (>> click to go to the journal's website)
Archives of Gerontology and Geriatrics, 12/09/09
Giordano M et al. – These results suggest benefit of an intensive reality orientation therapy (ROT) program in dementia patients receiving donepezil that seems to be maintained as far as ROT is continued by the caregiver.

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Other articles in Psychiatry

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Cognitive stimulation therapy in the treatment of neuropsychiatric symptoms in Alzheimer's disease: a randomized controlled trial
Clinical Rehabilitation, 09/15/10

An MRI-Based Semiquantitative Index for the Evaluation of Brain Atrophy and Lesions in Alzheimer?s Disease, Mild Cognitive Impairment and Normal Aging
Dementia and Geriatric Cognitive Disorders, 08/27/10

Diagnosis-independent Alzheimer disease biomarker signature in cognitively normal elderly people
Archives of Neurology, 08/25/10

 

 

 

Cognitive functioning in schizophrenia, schizoaffective disorder and affective psychoses: meta-analytic study (>> click to go to the journal's website)
British Journal of Psychiatry, 12/02/09
Bora E et al. – Neuropsychological data do not provide evidence for categorical differences between schizophrenia and other groups. However, a subgroup of individuals with schizophrenia who have more severe negative symptoms may be cognitively more impaired than those with affective psychosis/schizoaffective disorder.

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Other articles in Psychiatry

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Is Arson the Crime Most Strongly Associated With Psychosis??A National Case-Control Study of Arson Risk in Schizophrenia and Other Psychoses
Schizophrenia Bulletin, 09/17/10

Trait and State Attributes of Insight in First Episodes of Early-Onset Schizophrenia and Other Psychoses: A 2-Year Longitudinal Study
Schizophrenia Bulletin, 10/08/10

The Violence Triad and Common Single Precipitants to Psychiatric Patient Assaults on Staff: 16-Year Analysis of the Assaulted Staff Action Program
Psychiatric Quarterly, 09/27/10

 

 

Future perspectives in psychotherapy (>> click to go to the journal's website)
European Archives of Psychiatry and Clinical Neuroscience, 11/23/09
Schnyder U – Promising developments include the mindfulness–based therapies, well–being therapy, the use of cognitive enhancers such as d–cycloserine, and Web–based therapies. There is also a trend in psychotherapy training toward teaching specific, disorder–oriented protocols or modules rather than universally applicable therapies.

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Other articles in Psychiatry

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Interpersonal Psychotherapy for Women With Comorbid Depression and Chronic Pain
The Journal of Nervous and Mental Disease, 08/13/10

Effects of antidepressant drug treatment and psychotherapy on striatal and thalamic dopamine D2/3 receptors in major depressive disorder studied with [11c]raclopride PET
Journal of Psychopharmacology, 09/14/10

Relaxation and Imagery for Chronic, Nonmalignant Pain: Effects on Pain Symptoms, Quality of Life, and Mental Health
Pain Management Nursing, 08/26/10

 

 

 

Efficacy of Treatment for Somatoform Disorders: A Review of Randomized Controlled Trials (>> click to go to the journal's website)
FOCUS (The Journal of Lifelong Learning in Psychiatry), 09/02/09
Kroenke K – CBT is the best established treatment for a variety of somatoform disorders, with some benefit also demonstrated for a consultation letter to the primary care physician. Preliminary but not yet conclusive evidence exists for antidepressants.

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Other articles in Psychiatry

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Symptom Presentation, Interventions, and Outcome of Emotionally-Distressed Patients in Primary Care
Psychosomatics, 09/20/10

Psychiatric diagnosis and quality of life: The additional burden of psychiatric comorbidity
Comprehensive Psychiatry, 09/30/10

Genetic and environmental influences on focal brain density in bipolar disorder
Brain, 09/29/10

 

 

Vascular diseases and old age mental disorders: an update of neuroimaging findings (>> click to go to the journal's website)
Current Opinion in Psychiatry, 09/30/10
De Toledo FATC et al. – As vascular risk factors are potentially modifiable when detected in midlife, the early characterization of brain changes associated with the presence of cardiovascular diseases holds promise to afford clinical applications in psychiatry, providing new perspectives for the prevention of old age psychiatric disorders.

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Other articles in Internal Medicine

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Child and adolescent mental health in the Middle East: an overview
Middle East Journal of Family Medicine, 09/07/10

Primary care-mental health integration in healthcare in the Department of Veterans Affairs
Families, Systems & Health , 09/24/10

Integrating mental health into primary care within the Veterans Health Administration
Families, Systems & Health , 09/22/10

 

 

The relationship between sales of SSRI, TCA and suicide rates in the Nordic countries (>> click to go to the journal's website)
BMC Psychiatry, 08/09/10
Zahl PH et al. – The authors found no evidence for the rapid increase in use of SSRIs and the corresponding decline in sales of TCAs being associated with a decline in the suicide rates in the Nordic countries in the period 1990–98.

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Other articles in Internal Medicine

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Altitude, gun ownership, rural areas, and suicide
American Journal of Psychiatry, 09/22/10

Suicidal attempts and increased right amygdala volume in schizophrenia
Schizophrenia Research, 10/07/10

Suicide in patients with pancreatic cancer
Cancer, 09/24/10

 

 

 

Depression and low bone mineral density: The correlation among Chinese (>> click to go to the journal's website)
Asian Journal of Psychiatry, 10/01/10
Kurmanji JM et al. – Depression is usually associated with changes in the endogenous hormonal system. The most important hormonal modifications are elevation of the serum cortisol level as well as the reduction of endogenous sex hormone levels. These changes have advanced side effects on a bone metabolism and bone remodelling process, which consequently, lead to the declining in bone mineral density and increase the risk of bone fractures, which is reported by current studies. Depression may be associated with low bone mineral density among the Malaysian Chinese.

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Other articles in Internal Medicine

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Association between major depression, depressive symptoms and personal income in US adults with diabetes
General Hospital Psychiatry, 08/11/10

The effect of major depression on preventive care and quality of life among adults with diabetes
General Hospital Psychiatry, 09/27/10

Depressive symptoms during the first chemotherapy cycle predict mortality in patients with advanced non-small cell lung cancer
Supportive Care in Cancer, 09/24/10

Pharmacotherapy for Body Dysmorphic Disorder

 

Pharmacotherapy for Body Dysmorphic Disorder (>> click to go to the journal's website)
Psychiatric Annals, 07/16/10

 

Phillips KA – Serotonin–reuptake inhibitors (SRIs or SSRIs) and cognitive behavioral therapy (CBT) are currently considered the first–line treatments for body dysmorphic disorder (BDD). A practice guideline and a Cochrane review that recommend these treatments have been published, although treatment research on BDD is still quite limited. The publication of these landmark documents underscores how important it is for clinicians to be knowledgeable about current treatment recommendations for BDD, which is a relatively common and often disabling disorder that is associated with high morbidity and mortality.

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Other articles in Psychiatry

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The effects of a pedometer-based behavioral modification program with telephone support on physical activity and sedentary behavior in type 2 diabetes patients
Patient Education and Counselling, 08/27/10

Behaviorally Defined Patient-Centered Communication--A Narrative Review of the Literature
Journal of General Internal Medicine, 09/14/10

Childhood cancer survivors show sustained benefit from common ADHD medication
EurekAlert, 09/14/10

 

 

Temperament, Character and Personality Disorders as Predictors of Response to Interpersonal Psychotherapy and Cognitive-Behavioural Therapy for Depression (>> click to go to the journal's website)
FOCUS (The Journal of Lifelong Learning in Psychiatry), 06/18/10
Joyce PR et al. – Despite the two therapies having comparable efficacy in patients with depression, response to interpersonal psychotherapy (but not cognitive–behavioural therapy) is affected by personality traits. This could suggest the two therapies are indicated for different patients or that they work by different mechanisms.

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Other articles in Psychiatry

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Association between major depression, depressive symptoms and personal income in US adults with diabetes
General Hospital Psychiatry, 08/11/10

The short-term outcome of depressive disorder in adolescents attending primary care: A cohort study
Social Psychiatry and Psychiatric Epidemiology, 09/15/10

Depressive and anxiety disorders and the association with obesity, physical, and social activities
Depression and Anxiety, 08/30/10

 

 

 

Long-term efficacy of a psychological intervention program for patients with refractory bipolar disorder: A pilot study (>> click to go to the journal's website)
Psychiatry Research, 04/01/10
Echeburua E et al. – Results of the repeated measurement analysis showed a significant increment in scores of Global Activity Functioning within the combined treatment group during the follow–up, which was not observed in the control treatment group. Therefore, the effectiveness of psychotherapy tends to increase with time, and this improvement is not significant until 12 months of follow–up.

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Cross-disorder genomewide analysis of schizophrenia, bipolar disorder, and depression
American Journal of Psychiatry, 08/20/10

Bipolar disorder and violent crime: New evidence from population-based longitudinal studies and systematic review
Archives of General Psychiatry, 09/08/10

Fibromyalgia and bipolar disorder: a potential problem?
Bipolar Disorders, 08/19/10

 

 

 

Psychotherapy for Depression in Adults: A Meta-Analysis of Comparative Outcome Studies (>> click to go to the journal's website)
FOCUS (The Journal of Lifelong Learning in Psychiatry), 03/26/10
Cuijpers P et al. – The study suggests that there are no large differences in efficacy between the major psychotherapies for mild to moderate depression.

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Other articles in Psychiatry

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Interpersonal Psychotherapy for Women With Comorbid Depression and Chronic Pain
The Journal of Nervous and Mental Disease, 08/13/10

Effects of antidepressant drug treatment and psychotherapy on striatal and thalamic dopamine D2/3 receptors in major depressive disorder studied with [11c]raclopride PET
Journal of Psychopharmacology, 09/14/10

Relaxation and Imagery for Chronic, Nonmalignant Pain: Effects on Pain Symptoms, Quality of Life, and Mental Health
Pain Management Nursing, 08/26/10

Diabetes and mental illness...

Highlights of this issue

Kimberlie Dean

Diabetes and mental illness

Two papers in the Journal this month examine the association between diabetes and mental illness: one considers survival in those dually diagnosed and the other investigates the impact of antipsychotic treatment on diabetes incidence. Vinogradova et al (pp. 272–277) utilised data from the QRESEARCH database of over 9 million patients drawn from general practices across the UK and found that those diagnosed with schizophrenia or bipolar disorder and diabetes had higher mortality rates than those with diabetes alone. The authors highlight the importance of improving diabetes care for those with severe mental illnesses. Using the Danish population registers, Kessing et al (pp. 266–271) found that those purchasing antipsychotic medication, either first- or second-generation, experienced an elevated incidence of diabetes. They found substantial differences between individual drugs and an increase in risk associated with both duration of treatment and polypharmacy

Near-lethal suicide attempts

In a matched case–control study based in 19 UK prisons, Rivlin et al (pp. 313–319) found that all those who had made a near-lethal suicide attempt had a current psychiatric disorder compared with 62% of the matched controls. The strongest associations were found for major depression and psychosis; alcohol misuse was not found to be associated with suicide attempt and the elevated risk of antisocial personality disorder did not reach statistical significance. In a qualitative study by Biddle et al (pp. 320–325), the main reasons for using hanging as a method of suicide attempt were found to be the nature of the death anticipated (certain, rapid and painless) and the accessibility of materials. The authors discuss the potential for preventive strategies aimed at countering perceptions of hanging.

Cost-effectiveness of treatments for depression

Siskind et al (pp. 291–296) evaluated the comparative costs and benefits of usual care and improved stepped care compared with no treatment at baseline, in a study of treatment for depression among women in Chile. Using the per-capita GDP for Chile as a threshold, the improved stepped-care programme appeared very cost-effective and usual care was found to provide value for money compared with no treatment. In a randomised controlled trial involving a sample of individuals identified in primary care as having a new episode of depression, therapist-delivered online cognitive–behavioural therapy (CBT) was found to be more expensive than usual care but outcomes were improved in the CBT group. Hollinghurst et al (pp. 297–304) concluded that if £20 000 per QALY were considered an acceptable minimum cost threshold, then online CBT delivered by a therapist is likely to be cost-effective.

Mental healthcare transition and cannabis-induced memory impairment

In a study conducted across six mental health trusts in England, Singh et al (pp. 305–312) found that, for most service users, transition from child to adult mental healthcare is poorly planned, poorly executed and leads to a poor experience for those involved. A significant proportion of young people who needed referral for transition were not referred and less than 4% of those accepted by adult services experienced optimal transition. Using a novel methodology in which the level of cannabinoids in the cannabis actually smoked by each study participant was analysed, Morgan et al (pp. 285–290) found that those who smoked cannabis low in cannabidiol demonstrated marked impairment in prose recall. Cannabidiol content did not affect psychotomimetic symptoms, which were found to be elevated in all those assessed when intoxicated.

Disability in those at high-risk of psychosis

Velthorst et al (pp. 278–284) compared baseline differences in disability between individuals at clinical high risk of psychosis who made a transition to psychosis compared with those who did not. From a range of social disability domains, difficulties in getting along with others was found to contribute to the prediction of transition to psychosis. The authors comment that in addition to improving psychosis prediction in such samples, an assessment of disability is likely to be important in identifying unmet needs for both the individual and their family.

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