In a 27-year longitudinal study (n=757) researchers looked at people who had been diagnosed with a mood disorder (depression, mania or schizoaffective disorder). They examined the association between antidepressant use and suicide attempts or completed suicides using a propensity model which provides an estimate of a treatment effect in this type of study design. The researchers found that the antidepressants were associated with a large reduction in suicide attempts or suicides
‘Quintile-stratified, propensity-adjusted safety analyses using mixed-effects grouped-time survival models indicate that the risk of suicide attempts or suicides was reduced by 20% among participants taking antidepressants (hazard ratio, 0.80; 95% CI, 0.68-0.95; z = -2.54; P = .011)‘
This is a big effect size in a study with a large sample size over a very respectable follow-up period and will surely contribute to the debate in this area.
In a moderately sized study involving people with Alzheimer’s Disease (n=202) there was found to be an relationship between performance on memory and executive functioning and ratings on IADL – a measure of daily functioning. There were also gender differences with attention predicting bathing and eating ability in women while language skills predicted food preparation in men and driving skills in women. Such associations are useful and can be usefully investigated in larger replication studies.
In a small study (n=49), researchers looked at high and low fat diets in healthy people and those with Amnestic Mild Cognitive Impairment. The latter is a condition in which the person has subjective and objective memory impairments and in some but not all people can lead on to dementia. The researchers found that in both groups of people, the low diet was associated with a significant improvement in visual delayed recall. In other words switching from one diet to another improved the ability to recall visual information. Curiously the low fat did not seem to benefit some of the other skills. The researchers also found that the high fat diet changed some of the biological markers in the cerebrospinal fluid (the fluid that bathes the brain) making the pattern more like that seen in Alzheimer’s Disease. This is certainly very interesting research but it will need to be replicated in a larger sample and over a longer time period. What is most interesting about this though is the possibility that this type of research could lead to some very specific guidance on dietary changes that can affect cognition (that will complement some of the interesting findings e.g the benefits of the Mediterranean diet) but we will need to wait and see.
The World Psychiatric Association have a very interesting paper on the use of the ICD-10 diagnostic system by psychiatrists. The researchers surveyed 4887 psychiatrists across the world using an internet based survey tool. The use of ICD-10 varied from 0% in Kenya and 1% in the USA to 100% in Kyrgyzstan, FYRO Macedonia and Slovenia. 71% of the psychiatrists surveyed used ICD-10 as their main diagnostic system. DSM-IV was the main diagnostic system for 23% of the psychiatrists surveyed (unweighted). 14.1% (unweighted) of the sample set ‘sometimes’ used a diagnostic system and 1.3% used the older versions of ICD-10 – ICD-9 or ICD-8 for diagnostic purposes.
There is a very interesting article on culturomics in the journal Nature. Aiden a researcher is looking into analysing the content of culture through the textual analysis of books. He’s collaborated with Google who released a tool called the ‘Google Ngram Viewer’. Essentially the tool enables people to search all the books Google has digitised. The article discusses some of the controversies in this emerging field of the digital humanities.
Playing about with the Ngram Viewer tool I got some interesting results. Here’s one for psychiatry
This is showing a peak of the term ‘psychiatry’ in books in the late 1970 followed by a consistent decline. However there has to be some caution in interpreting the results. For instance we need to ensure there is no selection bias in the books that have been digitised and to know what percentage of the books published at that time are included in the analysis. Also are there any statistical comparisons between the years which would help to interpret apparent visual trends that are generated? Still if there is a large enough sample of books it does present an interesting proxy to culture and can be used to frame further investigation. For instance books can be sampled to confirm the results. If the results above are valid then we can ask what was happening in the late 1970’s in psychiatry? Also why has there been a decline subsequently? Perhaps the ascent in the 1940’s and 1950’s was associated with the advent of treatments including ECT, antipsychotics and antidepressants. Here are some other interesting results.
For psychosis there is a decline in more recent times (although the same is not true for the term schizophrenia).
For Autism there is a marked increase in the use of the term in more recent times.
For PTSD there is an increase with a slight dip at the end of the graph
For Dementia there has been a large increase in the use of the term in the digitised books.
An index of the site can be found here. The page contains links to all of the articles in the blog in chronological order. Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link. Podcast: You can listen to this post on Odiogo by clicking on this link (there may be a small delay between publishing of the blog article and the availability of the podcast). It is available for a limited period. TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link. Responses: If you have any comments, you can leave them below or alternatively e-mail firstname.lastname@example.org. 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.