News Round-Up: 29th September-5th October 2008

World Mental Health Day is approaching soon (10th October) and meanwhile there have been a number of interesting studies published recently including a relationship between GDP and length of untreated psychosis, sickness leave and mortality and a 10 year follow-up of people taking antidepressants.

Psychosis

There was found to be a significant inverse relationship between Gross Domestic Product and duration of untreated psychosis in this study in the British Journal of Psychiatry (STT2). In a very interesting study in which medications were donated by a number of different pharmaceutical companies, there was found to be no difference in incidence of EPSE’s or in scores of EPSE’s between groups treated with first or second generation antipsychotics. There were a number of findings in the secondary analysis for individual antipsychotics (STT2). A chinese study of 137 families with 2 or more members with schizophrenia showed significant familial aggregation in a number of categories including the DSM-IV categories of schizophrenia and positive symptoms (STT3). In a study looking at Swedish population registry data, and 2 million births, having a mother or father with schizophrenia was associated with a two-fold risk of infant mortality mainly in the post-neonatal period. It is not clear how well the findings from Sweden might generalise to other countries although there is no reason to suppose that they wouldn’t particularly given the size of this study. These findings suggest a need for further studies to examine this relationship which may in turn provide strategies to reduce mortality (STT1).

Mood Disorders

In a placebo-controlled trial looking at augmentation of Valproate or Lithium with Aripiprazole (15-30mg daily) in the treatment of mania (treatment number = 253, placebo number = 131), the researchers found that there was significant improvement in Young Mania Rating Scale scores after six weeks (-13.3 v -10.7) and that improvement was noticeable after one week (STT2). A cohort study (1946 British Cohort) found that 10 years after taking antidepressants, people were less likely to experience a mental disorder although the odds ratio of 0.3 had a 95% Confidence Interval of 0.1-1. Interestingly only a quarter of people were still taking antidepressants (STT2).

Anxiety and Related Disorders

A small randomised double-blind placebo study in the American Journal of Psychiatry suggests that compared to placebo, Olanzapine leads to higher weight gain and reduction of obsessive symptoms. The authors advise that further trials are warranted to replicate these findings (STT3). In another small study (30 controls and 30 subjects) people with OCD and their unaffected relatives had abnormal findings in the right inferior parietal white matter and right medial frontal white matter regions using diffuse tensor imaging (STT3-4). An alternative diagnostic process to DSM-IV criteria for diagnosing PTSD in children was used in this study and the researchers found that for the age group 7-10 years old, a combination of the child and parent’s report were better able to predicts PTSD, which in this case followed a motor accident. There were some other implications from this study in terms of diagnosis (STT2).

Miscellaneous

In this Japanese study of 84 people with high-functioning autism and 208 controls there was found to be a significant association between paternal age and high-functioning autism (STT2). In the Whitehall II prospective study of 65000 civil servants published in the BMJ and also covered here the researchers found that those who had taken a long period of sick leave were 66% more likely to die early. If a person had circulatory disorders and sickness leave the hazards ratio was 4.68 (2.58-8.51) in comparison to those who didn’t take sick leave. Those who took sick leave due to depression had a higher risk of mortality from cancer (2.4 CI95% 1.2-4.6). Being on sick leave with musculoskeletal disorders did not predict mortality. The authors conclude that long term sick leave may be useful for identifying high risk populations (STT1). In the Health Services Journal, Andrea Greatley comments on media portrayal of mental health issues (STT2). World Mental Health Day is on October 10th and MIND are organising a mass walk in their Get Moving campaign.

Appendix

STT

Disclaimer

The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

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