• "Hostility in young adults is inversely associated with pulmonary function in terms of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), according to a report in the May/June issue of Health Psychology.
  
  Previous work has demonstrated that hostility affects coronary heart disease, hypertension, the metabolic syndrome, and all-cause mortality, but little has been done to examine the relationship between hostility and lung function.
  
  Hostility was highest in black men, followed by black women, white men, and white women. Both race and ethnicity were also associated with FEV1 and FVC.
  
  The team observed that the inverse association of hostility with pulmonary function was maintained after controlling for age and height, socioeconomic status, smoking, and asthma.
  
  More research is needed to establish whether hostility is prospectively associated with change in pulmonary function or is associated with pulmonary function at other points in the life course, especially during older adulthood."
  
  Health Psychol 2007;26:333-340.
   
• "Patients with bipolar disorder can have difficulty in decision making in the informed consent process, but that does not mean that these patients are incompetent.
  
  Bipolar patients showed an impaired understanding compared with healthy controls. Their decisional capacity was equal to that of the schizophrenic patients.
  
  The investigators found that "neurocognitive deficits and negative symptoms were significantly correlated with the level of decisional capacity (particularly understanding of disclosed information). Repeating the missed information "improved the level of understanding in all groups. They suggested conducting consent as an interactive dialogue. The healthcare provider should "actively check the participant's understanding of key information by asking him or her to explain it in his or her own words, and then to re-explain that information and re-check the participant's understanding of that information.
  
  Many people with bipolar disorder may have subtle cognitive deficits even during periods (of symptom control)...This has not been widely appreciated or recognized until recently.
  
  Much less is known about the effect of acute manic or depressive symptoms, such as would be seen among patients in acute hospitalized settings, It seems rational to expect that acute manic symptoms would hinder the appreciation component of decisional capacity, but there remains a need for empirical research to find out for certain."
  
  J Clin Psychiatry 2007;68:689-696.
   
• "Americans were more willing and less embarrassed to seek mental health treatment in 2001–2003 than in 1990–1992, according a recent study.  The data came from 5388 individuals who answered the National Comorbidity Survey in 1990–1992 and 4319 individuals who replied to the National Comorbidity Survey-Replication in 2001–2003. Compared with respondents of the first survey, respondents in the second survey were more likely to have a positive attitude toward seeking help for mental health problems. Unlike the improvement in attitudes about seeking help for mental health illness, beliefs about treatment effectiveness did not change. In both surveys, most people, said that 50% – 74% of people seeing a professional are helped and only 0% – 24% of people who do not seek professional help get better. A lot of things happened between the 1990s to early 2000, such as direct-to-consumer advertising and information campaigns that aimed to make the general public believe that mental illness is curable and that it requires treatment." He observed that "these changes in public attitude have likely contributed to the growing demand for mental health services in the United States and will continue to do so in the coming years." Psychiatr Serv. 2007;58:642-651.
   
• "We really should be taking worry — at a level of severe or uncontrollable worry, even if it's less than generalized anxiety disorder — very seriously, because there are things that you can do to help people who are worrying. There are psychological treatments, cognitive behavior therapies, and so on, that might make a difference, because it does affect their quality of life. He added that this is a new area of research that he hopes will receive more attention in the future.
  
  The authors write that among the elderly, GAD — a condition whose unique feature is chronic, excessive worry — is common and occurs about as often as depression. It is unclear, however, where the boundary lies between normal and pathological worry.
  
  In the study, women worried more than men about the health of others and family matters, and both women and men worried about finances. Worries decreased with age, except for worry related to one's own health.
  
  Among the septuagenarians, severe worry affected almost half of the women and one quarter of the men. The prevalence of severe worry or GAD declined with age.
  
  The most severe worriers reported declining quality of life and happiness.
  Individuals whose level of worry was greater than simple worry had a very high risk of having depression; the risk increased with each successive level of worry.
  
  Severe worry and GAD have a significant prevalence in the elderly. Both clinical practice and research need to take these problems seriously."
  
  American Psychiatric Association 160th Annual Meeting: Abstract NR622. May 19 – 24, 2007.
• "Results of a study suggest an association between factors such as mood disturbances or social isolation and incident hospital admissions for asthma. Case series and case-control studies have shown high rates of psychosocial and behavioral risk factors amongst patients admitted to hospital with severe asthma. General population studies have shown associations between psychosocial factors and prevalent asthma.
  
  After adjustment for age, sex, indicators of socioeconomic status, physical functional health, and obesity, the likelihood of hospital admission was associated with baseline presence of current mood disorders, adverse circumstances in childhood, impact of life events, and negative perceived support from a close confidant.
  
  When the team restricted the analysis to those with lifetime doctor-diagnosed asthma at baseline, an association was observed between asthma hospital admission and the reported impact of adverse life events experienced in adulthood, and both confiding and negative aspects of support quality. These results highlight the potential importance of taking account of psychosocial factors, including availability and quality of support networks, in guiding long-term asthma management." Allergy 2007;62:554-560.
• In a study of subjects exposed to terrorism and civil conflict in Northern Ireland, cognitive therapy was found to be an effective treatment for post-traumatic stress disorder (PTSD). Immediate cognitive therapy was associated with significant improvements in PTSD symptoms, depression, and social and occupational functioning. By contrast, no significant changes were noted in the control group. Currently, the UK's National Institute for Health and Clinical Excellence (NICE) recommends cognitive behavior therapy as a treatment for non-terrorism related PTSD, the investigators note. The current findings suggest that such therapy is also effective in treating terrorism-related variants. BMJ 2007.
• "In a small study of autistic children, severe mirror-neuron system dysfunction correlated with high impaired ability to imitate facial expressions or empathize with others. The study emphasized that researchers and clinicians should now focus on developing ways to boost the activities of mirror neurons in individuals with developmental problems. Stated one researcher: "Clearly, it's not like the neurons are dead and not firing at all," she said. "The system is there, it is just not functioning to the full extent that it should, to help out in social interactions."
  
  Mirror neurons were first discovered by scientists at the University of Parma in Italy who were studying single neurons in monkeys' brains. Mirror neurons that fired when a monkey was performing a certain action also fired when a monkey simply observed another monkey performing the same action. These mirror neurons can do for monkeys and humans is allow you to 'translate' others' actions . . . when people watch other people talking and moving, neurons are firing in their brains that would be firing if they were doing these actions.
  
  The researchers found that, after they controlled for IQ, poor scores were linked with low activity in the right inferior frontal gyrus and to a lesser extent the insula and amygdala (2 brain regions previously associated with empathy). They also found that poor scores correlated with low mirroring activity in these brain regions.
  
  The more impaired the children were, the less activity they had in their mirror-neuron system, and, conversely, the less impaired they were, the more activity they had. The group writes that their findings provide additional evidence that a dysfunctional mirror-neuron system might underlie impairments that are characteristic of autism. The results further indicate that mirror-neuron system abnormalities may also negatively affect imitative behavior, leading to a cascade of negative consequences for the development of key aspects of social cognition and behavior."
• "Psychological treatment derived from cognitive behavioral models is effective for patients with obsessive-compulsive disorder (OCD). A total of 7 psychological studies and 10 comparisons studies were included in the meta-analysis. The psychological trials assessed three different variants of psychological interventions: cognitive behavior therapy, behavior therapy, and cognitive therapy.
  
  After analyzing the pooled data, the investigators found that patients receiving any form of cognitive behavioral treatment had significantly fewer obsessive-compulsive symptoms post-treatment than subjects receiving treatment as usual.
  
  There were no differences observed between individual and group therapy in terms of symptom improvement. Psychological treatments were effective in reducing the severity of depressive and anxiety symptoms. There were no significant differences in the number of dropouts when the three types of psychological treatment were analyzed separately." Cochrane Library 2007;2.
• "Slow repetitive transcranial magnetic stimulation appears to be an effective treatment for resistant auditory hallucinations in schizophrenic patients. Several studies have now been reported regarding the efficacy of TMS treatment, but results were inconsistent.
  
  On a clinical level, the investigators note, rTMS may be a promising method for reducing the frequency and intensity of auditory hallucinations in treatment-resistant schizophrenic patients.
  
  On a more fundamental note, the evidence of reduction of hallucinations after magnetic stimulation over the left temporoparietal cortex may yield clues to the pathophysiology of auditory hallucinations. That is, the finding that reducing cortical excitability in speech perception areas may interfere with hallucinations suggests aberrant activation of language perception areas as a cause of auditory hallucinations." J Clin Psychiatry 2007;68:416-421.
• "Family-based cognitive-behavioral therapy (CBT) has little effect on many of the aspects of the bereavement following a suicide of a spouse or family member. On the other hand, the CBT approach seems to reduce participants' perceptions of blame and prevent maladaptive grief reactions.
  
  Earlier trials of psychotherapy among bereaved families have yielded conflicting results, at least partly because they were poorly designed and involved small sample sizes.
  
  "Complicated grief" is of unusually long duration with symptoms such as avoidance of reminders of the dead person, purposelessness, yearning, disbelief and bitterness.
  
  The authors observed trends towards greater reduction of perceptions of being to blame for the suicide and fewer maladaptive grief reactions, compared with control subjects." BMJ 2007.
• "Clinically diagnosable mental health problems, such as anxiety disorders and major depression, may be perpetuating smoking in some pregnant women. The high rate of depression among nicotine-addicted pregnant women could shed new light on this persistent problem, and bring needed help to the women and their babies at risk.
  
  After adjustment, nicotine dependence significantly predicted having any mental disorder and any mood disorder. There were no significant associations with non-dependent cigarette use and mental disorders.
  
  Health professionals with pregnant patients who smoke, but can't seem to quit, need to know that depression and anxiety might actually be the bigger problem standing in the way of their patients' efforts to quit. And for them, some form of mental health treatment, such as behavioral or supportive therapy, in addition to a smoking cessation plan may be a much more effective treatment plan than a simple nicotine patch." Obstet Gynecol 2007;109:875-883.
• "Findings from a small study suggest that combining a selective serotonin reuptake inhibitor (SSRI) with an anticonvulsant may be an effective treatment for depression with dysphoric mood, such as anger and hostility.
  
  A link between depression and anger was first made decades ago, but only in recent years have studies investigated this association and possible treatments.
  
  In fact, depression and concomitant anger/aggression is almost as common as depression with anxiety.
  
  The implication of serotonergic pathways in aggressive behaviors has led some researchers to consider SSRIs as the first-line therapy for depression complicated by dysphoric mood. There is also some evidence that anticonvulsants affecting GABAergic and glutamatergic pathways may be useful, but to the authors' knowledge, no trials have examined this.
  
  In the present study treatment with the two-drug regimen was associated with a significant improvement in depressive symptoms. In addition, marked improvements in anger/irritability and anxiety were noted." Clin Pract Epidemiol Mental Health 2007;3.
• The findings from a new study suggest that arthritic pain has a strong emotional component that is not present with experimental pain conditions.
  
  The results indicate that the cingulate cortex, thalamus, and the amygdala -- brain regions known for the role in processing fear and emotions -- are highly active during arthritic pain.
  
  The study demonstrates the importance of the medial pain system during the experience of arthritic pain and suggests that it is a likely target for both pharmacologic and nonpharmacologic interventions.
  
  Both the arthritic pain and experimental pain states activated the entire pain matrix in the brain. However, as stated, arthritic pain was also associated with heightened activation of the medial pain system, including the cingulate cortex, thalamus, and the amygdala.

©2007 David B. Adams, Ph.D.