• "Recovery from the drop in heart rate variability during acute coronary syndromes (ACS) is impaired in depressed patients. At 4 months after hospitalization for ACS, depressed patients who were treated with the selective serotonin reuptake inhibitor sertraline (Zoloft, Pfizer) or whose mood lifted had increased heart rate variability compared with patients treated with placebo or patients without improved mood — but this was mainly due to decreased heart rate variability in the comparison groups.
  
  Heart rate variability — which is a known predictor of death and which usually recovers after a heart attack — doesn’t recover in depressed people, and that taking antidepressants and getting better improves it a little bit. Not only do depressed people have lower heart rate variability to start with, but after a heart attack, it doesn’t recover the way that it should.
  
  Previous studies have shown that low heart rate variability — beat-to-beat changes in heart rate — predicts death after a myocardial infarction (MI), and heart rate variability is reduced more in depressed than nondepressed patients after MI.
  
  Patients who took sertraline had a 9% increase in heart rate variability, but patients who took placebo had a 10% decrease in heart rate variability. Patients who had decreased symptoms of depression had increased heart rate variability compared with patients whose depression did not improve.
  
  Depression is associated with biological changes involving increased heart rate, inflammatory response, plasma norepinephrine, platelet reactivity, decreased heart rate variability, and now absent post-ACS heart rate variability recovery, all of which are associated with life-threatening consequences. Arch Gen Psychiatry. 2007;64:1025-1031.
• "Despite concerns that the rate of ADHD is on the rise, the national prevalence of ADHD among American children is not clear and has been estimated at anywhere from 2% to 26%.
  
  The researchers aimed to use a national sample with DSM-IV-based diagnostic criteria to estimate the prevalence of ADHD in American children and also to determine whether the prevalence, recognition, and treatment varied by socioeconomic group.
  
  To determine whether the child met the criteria for inattention, the caregiver was asked if their child had difficulty concentrating, avoided activities requiring long periods of attention, was very disorganized, omitted things that were necessary for schoolwork, had trouble finishing tasks, forgot what they were supposed to do, made mistakes that were careless in nature, did not listen when people were talking to them, or started things and did not finish them.
  
  To determine whether the child met the criteria for hyperactivity/impulsiveness, the caregiver was aksed if their child was overactive, seemed always on the go and driven by a motor, was fidgety or restless, left their seat when seating was expected, climbed and ran about when they were not supposed to, talked a lot and interrupted other people, made more noise than other children during an activity, butted in on what other people were doing, or had trouble waiting for their turn. The caregivers were asked if this behavior was seen at home and also at school.
  
  8.7% of the children (equivalent to 2.4 million children nationwide) met the criteria for having ADHD in the year prior to the survey. Hispanics were less likely than whites to meet the criteria, and boys were more likely than girls to meet the criteria, although girls with ADHD were less likely to have their disorder identified.
  
  DSM-IV–diagnosed ADHD is prevalent in American children, especially among poorer children, which needs to be further investigated. Second, less than half of the children who met the criteria for DSM-IV ADHD had their condition diagnosed or treated, "suggesting that some children with clinically significant inattention and hyperactivity may not be receiving optimal attention." Finally, poorer children were least likely to receive medication, which "warrants further investigation and possible intervention."
  
  Arch Pediatr Adolesc Med. 2007;161:857-864
   
• "Cognitive behavior therapy (CBT) has a direct effect on overall improvement of gastrointestinal symptoms in patients with irritable bowel syndrome (IBS), independent of its effects on distress. Improvement in IBS symptoms is linked to improvements in the quality of life, which may lower distress.
  
  Although multiple clinical trials support the efficacy of psychological treatments for reducing IBS symptoms, the mechanisms responsible for symptomatic improvement are unknown.
  
  CBT was associated with improvements in IBS symptoms. The therapeutic gains did not depend on changes in the patients' overall level of psychological distress. Treatment outcome was moderated by symptom severity, but not clinical status or sociodemographic factors.
  
  A non-drug behavioral self-management program (CBT) significantly improved primary symptoms of IBS (abdominal pain, diarrhea, and/or constipation), and...these improvements in gut symptoms did not occur because patients became less distressed. Instead, the reduction of distress was a result of their actual improvement in physical symptoms.
  
  CBT improved IBS symptoms, patients felt less distressed and that this reduction of distress improved the quality of life. The immediate implication is that patients who fail to respond to simple lifestyle changes like eliminating foods or medications should not grow hopeless but have confidence their condition is treatable. They can learn practical, concrete skills to take control and reduce symptoms that affect millions of Americans and are a source of considerable health care cost and personal suffering."
  Gastroenterology 2007;133:433-444.
• Very hostile older white men were more likely than their less hostile peers to cope poorly with stress and have lower high-density-lipoprotein (HDL), or "good," cholesterol levels.
  
  Coping with stress matters, since even in hostile men, positive coping was associated with positive health outcomes and negative coping was associated with negative health outcomes.
  
  Although studies have shown that hostility affects ability to cope with stress and that both factors are related to lipid levels, few studies have looked at whether different ways of coping with stress make a difference in the relationship between hostility and lipid levels.
  
  The researchers found that individuals who were very hostile were more likely to perceive problems as stressful and to cope with stress by using interpersonal hostility, self-blame, and social isolation; they also tended to have lower levels of HDL.
  
  In contrast, coping well with stress (for example, by making a plan of action and pursuing it, rather than using self-blame or self-isolation strategies) was linked with higher levels of HDL.
  
  There was no association between coping and low-density-lipoprotein (LDL) levels, and only 1 association between coping and triglycerides; rather the associations were with HDL levels.
  
  The results of (the) study suggest that coping processes also might influence lipid fractions differently and may play a protective role through their influence on HDL.
  
  The relationship between psychosocial factors and lipid profiles is likely to be different depending on age, sex, and ethnicity."
  
  American Psychological Association 115th Annual Convention. August 17-20, 2007.
• "Increased colonic pain sensitivity in patients with irritable bowel syndrome (IBS) appears to be related more to "a psychological tendency to report pain," rather than to increased neurosensory sensitivity.
  
  The implications of this finding are far reaching...it underscores the importance of accounting for psychological factors when interpreting tests of sensory function [and] it highlights the important part played by centrally mediated processes in the pathophysiology of visceral sensitivity in IBS and suggests that novel therapies for pain in IBS should target centrally mediated mechanisms....IBS patients, compared with controls, had significantly lower pain thresholds than controls, but similar neurosensory sensitivity. IBS patients also had a greater tendency to report pain.
  
  The findings also showed that pain thresholds were not correlated with neurosensory sensitivity, but were strongly correlated with the overall tendency to report pain.
  
  Similar results were seen for the non-painful sensation of urgency.
  
  These data indicate that physiological contributions to increased colonic pain sensitivity in IBS patients are relatively small compared to cognitive and psychological influences."
  
  Gut 2007;56:1202-1209.
   
• "the release of dopamine into the nucleus accumbens of subjects who received a placebo after a pain challenge correlated with their anticipation of receiving a reward (an analgesic agent). In a second part of the study, subjects who expected to receive a monetary reward for playing a game exhibited a similar placebo-induced increase in dopamine activity in this area of the brain.
  
  Individuals who were not activating the nucleus accumbens in response to the expectation of a monetary reward were the same individuals who didn’t release much dopamine in response to placebo administration, and they were the same individuals who didn’t have much of an analgesic placebo effect...interindividual differences in the function of this transmitter system are linked with the capacity to experience a placebo effect (a beneficial effect from positive expectations).
  
  As a group, the study subjects experienced a significant reduction in pain when they received a placebo vs no placebo...more dopamine activity in the left nucleus accumbens in the high responders than in the low responders. The high responders were the same individuals who had also anticipated that the "painkiller" would bring them good pain relief. Four of the low responders reported increases in pain intensity during placebo administration — a nocebo (negative placebo) effect.
  
  The subjects who had the most activity in their nucleus accumbens during the monetary reward game were the same individuals who had shown the strongest anticipation of an analgesic effect from a "painkiller" and the strongest placebo response in the pain challenge."
  
  Neuron. 2007;55:325-336
   
• "Swedish women who received cosmetic breast implants had suicide rates that were 3 times higher than other women; the risk appeared 10 years after surgery. Deaths due to drug and alcohol abuse also increased 3-fold in the women who received breast augmentation.
  
  Compared with women in the general population, the women with implants had higher rates of death from lung cancer and chronic respiratory disease, largely related to smoking, but they did not have higher rates of breast cancer.
  
  The large excesses of suicide, as well as alcohol- and drug-dependence-related deaths, suggest that a nontrivial proportion of women undergoing cosmetic breast augmentation may bring with them — or develop later — serious long-term psychiatric morbidity and eventually mortality.
  
  More than 300,000 cosmetic breast implants in the United States in 2006, and it remains to be seen whether that number will increase now that the Food and Drug Administration has approved the sale of silicone breast implants after their removal from the market from 1992 to 2006."
  
  Ann Plastic Surg. 2007;59:119-123. Abstract
   
• "In a study which compared healthy controls, adults with attention-deficit/hyperactivity disorder (ADHD), the latter had less dopamine released in the caudate — a brain region involved with attention and cognition — in response to intravenous methylphenidate (Ritalin, Novartis), a stimulant that increases extracellular dopamine levels in the brain.
  
  This blunted response to methylphenidate was linked with symptoms of inattention and higher reports of liking the drug, which suggests that in ADHD, dopamine dysfunction is related to inattention and to a greater risk for drug abuse.
  
  These findings document that the dopamine system, which is very important for modulating attention and motivation, is not working properly in individuals with ADHD. Although ADHD is the most prevalent psychiatric disorder of childhood and has been studied for decades, the specific neurobiological mechanisms underlying this disorder remain unclear. Although research findings point to a disruption in the brain dopamine system in ADHD, for many years there has been a debate about whether dopamine is increased, decreased, or not changed in ADHD.
  
  Compared with the controls, the subjects with ADHD had a significantly smaller decrease in binding of 11C-raclopride in the left and right caudate after methylphenidate, indicating that less dopamine was released in response to methylphenidate in these subjects. This blunted dopamine response to methylphenidate in the caudate in the subjects with ADHD was linked with symptoms of inattention and with higher reports of liking the drug.
  
  Also found was preliminary evidence of reduced 11C-raclopride binding in the hippocampus and the amygdala, which are part of the brain's limbic system that is involved in emotional responses and in memories.
  
  Ritalin or the amphetamine Adderall — are effective treatments for ADHD: they amplify the weak dopamine signals in the brain of individuals with ADHD.
  
  In addition, the findings help elucidate why, compared with members of the general public, individuals with ADHD have a much higher risk of abusing drugs. Drugs of abuse temporarily increase the concentration of dopamine in the brain. People with ADHD are at greater risk of taking drugs, not just because they want to get 'high,' but in their case, it may actually make them feel better. They may end up taking drugs to automedicate themselves." Arch Gen Psychiatry. 2007;64: 932-940
• "Patients with peripheral artery disease (PAD) who exhibit a type-D personality -- that is, a propensity to experience negative feelings without sharing them with others -- are at increased risk for impaired quality of life and depression, regardless of the severity of PAD, research shows. Indicators of PAD severity (ankle brachial index and walking distance) did not predict impaired quality of life or depressive symptoms at the follow up visit. In contrast, type-D personality predicted poor physical health, decreased level of independence, and poor overall quality of life, after controlling for age, sex, PAD severity, and cardiovascular risk factors. Type-D personality also independently predicted increased risk of depressive symptoms. These findings, the authors conclude, "demonstrate the need to study risk factors that may predict poor quality of life and depressive symptoms in patients with PAD above and beyond traditional indices of disease severity, such as ankle brachial index and walking distance."
  Arch Surg 2007;142:662-667.
• "Children born at less than 26 weeks of gestation have more mental and social problems at 11 years of age than do their full-term schoolmates. Children born extremely immature have significantly greater health problems and special health care needs that require ongoing services through the school years. It is notable that very few children have severe impairments that curtail major activities of daily living.
  
  Report from parents, teachers and the children themselves showed that they had significantly more problems with internalizing behaviors, social behavior and with depression. Teachers also reported that the children were less well adjusted to the school environment than were controls. They were also more likely to have chronic health problems.
  
  Despite having an increased risk for mental health problems, executive dysfunctions and school difficulties, 85% of the children were in the mainstream schools and a majority were not having major adjustment difficulties.
  
  The findings suggest that "current preterm follow-up programs might benefit from the addition of psychological and family services to traditional neurodevelopmental assessments especially in the neonatal period and first years of life."
  
  Pediatrics 2007;120:118-133.
   
• Deliberate self-harm (DSH) appears to be fairly common among adolescents, according to research. Repetitive self-mutilation -- primarily cutting and burning the skin -- is closely associated with suicidal ideation and suicide attempts, yet most teenagers who exhibit this behavior do not seek help.
  
  In one study, occasional self-harm over the previous year was reported by 630 students (10.9%). Repetitive self-injury was reported by 229 (4.0%).
  
  Suicidal behavior was the strongest risk factor for engaging in self-mutilation. Those who reported suicidal thoughts had a 3-fold higher risk of DSH, and a 7-fold higher risk of repetitive DSH. Those reporting frequent suicidal ideation showed an 18-fold greater risk of repetitive DSH.
  
  The high prevalence rate of DSH as well as its strong link to suicidal behavior and emotional and behavioral problems may serve as a forewarning to school counselors and public health authorities.
  
  In a second study, survey results showed that 10.2% had used DSH only, 7.9% reported just suicidality, and 6.9% reported both.
  
  In a multivariate model, factors significantly associated with suicidality included more than 2 to 10 lifetime incidents of self-injury. For subjects with at least 50 incidents during their lifetime, the risk was increased approximately 10-fold. Other factors included black race, history of sexual or emotional abuse, bisexual orientation, psychological distress over the previous month, and eating disorders.
  
  Since DSH is not a suicidal gesture in and of itself, many clinicians assume that suicide assessment is unnecessary. While DSH may serve as a functional, if maladaptive, copying mechanism used to avoid suicide, it may also serve as a harbinger of all forms of suicidality in a subset of individuals.
  
  Therefore, they recommend that DSH should trigger an assessment for suicide risk, as well as psychological assessment and referral.
  
  Arch Pediatr Adolesc Med 2007;161:634-640,641-649.
• In a recent large national survey, almost one-third of American adults reported that at some point in their lives they had an alcohol-use disorder — either alcohol abuse (17.8 %) or alcohol dependence (12.5%). Few, however, had sought treatment.
  
  Alcohol abuse is defined as drinking that leads to interpersonal, social, or legal problems; problems in fulfilling major role obligations in daily life; and/or drinking in hazardous situations. "Alcohol dependence" ("alcoholism") is characterized by an impaired control over drinking, compulsive drinking, alcohol tolerance, withdrawal symptoms, and/or drinking to relieve withdrawal symptoms.
  
  The main study findings are that, first, so few people with lifetime alcohol abuse or alcohol dependence received treatment: 7.0% and 24.1%, respectively. Second, there is a lag of about a decade between the time a person develops an alcohol disorder and seeks treatment.
  
  Alcohol-use disorders are associated with car crashes, domestic violence, fetal alcohol syndrome, and other serious consequences, and up-to-date epidemiological information is needed to plan research strategies and delivery of health services.
  
  In the United States in 2001–2002, 8.5% of adults reported experiencing alcohol-use disorders in the past 12 months (4.7% abuse and 3.8% dependence) and 30.3% reported alcohol-use disorders at some point in their lives (17.8% abuse and 12.5% dependence). Thus alcohol-use disorders continue to present a widespread and serious public health problem in the United States.
  
  Lifetime alcohol dependence was significantly more prevalent among men, whites, Native Americans, younger and unmarried individuals, and those with lower incomes. The highest risk of lifetime alcohol abuse was in the baby boom and Generation X cohorts.
  
  Alcohol abuse developed at age 22.5 years, and dependence developed at age 21.9 years, on average, but there was an 8- to 10-year lag before these individuals sought treatment such as 12-step programs or other help from professionals. The alcohol-use disorder episodes lasted on average 2.4 to 3.4 years. Most survey respondents (72%) reported only 1 lifetime episode, but those with multiple episodes had an average of 5 episodes.
  
  Many people are unaware of the advances for treatment of alcohol abuse and alcohol dependence that have been made over the past decade.
  
  Arch Gen Psychiatry. 2007;64:830-842
• "Depressed older women appear to lose bone at a faster rate than their non-depressed counterparts. These findings suggest that physicians should consider the presence of depression when deciding when to recommend bone mineral density testing for their older patients.
  
  Depressive symptoms were associated with greater rates of bone loss in a group of older women (average age about 75 years old); the more depressive symptoms women had, the greater their rates of bone loss.
  
  This association persisted after controlling for multiple potential confounders and after excluding users of antidepressant medications.
  
  Prior studies have shown an increased risk of fractures in association with depression. The mechanism of this association is unclear, but the finding of greater rates of bone loss in depressed subjects suggests that this may be a factor in the observed association with fractures." J Am Geriatr Soc 2007;55:824-831.
• "Patients with panic disorder or with major depression and panic attacks were more likely than control subjects to have panic attacks after drinking a high dose of caffeine.
  
  Caffeine is a substance that may induce anxiety symptoms, and in patients with panic disorder, it may even induce panic attacks.
  
  Patients with depression with anxiety symptoms such as panic attacks have a predisposition to develop panic attacks with caffeine.
  
  The anxiogenic effects of coffee have been shown in patients with panic disorders and patients with anxiety.
  
  Compared with the depressed patients who did not have panic attacks or with the control subjects, the patients with panic disorder or with major depression with panic attacks were more sensitive to caffeine and more likely to have panic attacks.
  
  The team concludes that not only patients with panic disorder but also patients with major depression and panic attacks are hyperreactive to an oral high-dose caffeine challenge and have increased risk of caffeine-induced panic attacks."
  
  Compr Psychiatry. 2007;48:257-263
• "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.