Let's prevent psychological disorders affecting Lankans

by Dheena Sadik

Human Psychology has been a subject of interest for several centuries dating back to the ancient Greeks and Egyptian civilisations. Yet, are we aware of psychological disorders in Sri Lanka?

To enlighten us on the crucial subject, Dr. Kamanie Dassanayake, a doctor in psychology and natural medicine told the Sunday Observer said, "14 to 20 percent of the population has mental, emotional or behavioural disorders. Most disorders have their roots in childhood and adolescence."

She elaborated further on the common psychological disorders in Sri Lanka.

A) Obsessive Compulsive Disorder (OCD) - An Anxiety disorder in which individuals have unwanted and repeated thoughts, feelings, ideas, sensations (obsessions) or behaviours that make them feel driven to do something (compulsions). After the individual carries out the behaviour of the obsessive thoughts, there is temporary relief. Not performing the obsessive rituals can cause great anxiety. Most people who develop OCD show symptoms by 30 years of age. OCD is not due to any medical illness or drug use but can cause major distress and interfere with everyday life. Eg - checking and re-checking actions like locking the door, re-checking the iron and switches repeatedly, excessive fear of germs, repeatedly wash hands to ward off infections, etc.

Bipolar disorder - Affects men and women equally and usually starts between ages 15 - 25.

The exact cause is unknown. Life changes such as - child birth, medications such as anti-depressants or steroids, period of sleeplessness, recreational drug use could trigger this condition.

Social Anxiety aka Social Phobia - The fear of being scrutinised, judged or embarrassed in public.

One may be afraid that people will think badly of themselves or that they won't measure up in comparison to others.

Even though they probably realise their fears of being judged is at least somewhat irrational and overblown, they still can't help feeling anxious. Situations that are stressful with social anxiety disorders are - meeting new people, being the caner of attention, being watched while doing something, public speaking, being called on in class, going on a date, making phone calls, using public bathrooms, sitting for examinations, etc.

Clinical depression - A constant sense of hopelessness and despair as a sign with major depression. It may be difficult to work, study, sleep and enjoy activities. Some people have clinical depression only once, while others have it several times.

Many people feel sad or low at some point in their lives. This is a mental health condition and symptoms are-fatigue or loss of energy almost everyday, feeling of worthlessness or guilt, impaired concentration, indecisiveness, insomnia or hypersomnia (excessive sleeping), diminished interest or pleasure in almost all activities on a daily basis, restlessness or feeling slowed down, recurring thoughts of death or suicide, significant weight loss or gain. The depression affects older adults, teens and children, but frequently goes undiagnosed and untreated in our population. Almost twice as many woman as men have major orclinical depression and hormonal changes during puberty, while menopause may increase the risk.

Paranoid schizophrenia - This is a brain disorder that affects the way persons act, think and see the world. People with this condition have an altered perception of reality, often a significant loss of contact with reality. They may see or hear things that don't exist, speak in strange or confusing ways, believe that others are trying to harm them, or feel like they are being constantly watched with such blurred lines between the real and the imaginary.

Schizophrenia makes it difficult, even frightening, to negotiate activities of daily life. People having this condition may withdraw from the outside world or act out in confusion and fear. Most cases of Schizophrenia appear in late teens or during early adulthood. This condition can appear first time in middle age or even later. Schizophrenia is more severe in men than in women. It is a myth that this condition refers to "split personalities", rather they are 'split off' from reality.

Acute stress disorder - A psychological condition arising in response to terrifying or traumatic events. During and immediately following a traumatic event, people may manifest a pattern of dissociative and anxiety symptoms and reactions, referred to as acute stress disorder.

Symptoms can occur within one month after exposure to an extreme traumatic stressor ( eg- witnessing a death or serious accident).

The individual develops dissociative symptoms and have a decrease in emotional responsiveness, often finding it difficult or impossible to experience pleasure in previously enjoyable activities and frequently feel guilty about pursuing usual life tasks.

Difficulty in concentrating, feel detached from their bodies, experiencing the world as unreal or dreamlike or have increasing difficulty recalling specific details of the traumatic event. At least one symptom can cause post traumatic stress disorder.Prevention of mental disorders can be achieved by:

1) Strengthening families by targeting problems such as substance use, aggressive behaviour, teaching effective parenting skills, improving communication and helping families deal with disruptions, such as divorce, parental mental illness or poverty.

2) Strengthening individuals by building resilience, skills and improving cognitive processes and behaviours.

3) Screening individuals at risk and offering training to those of specific disorders.

Promoting mental health in schools by offering support to children encountering serious domestic stresses. Modifying the school environment to promote pro-social behaviour, developing students' skills at decision-making, self-awareness and targeting violence, aggressive behaviour and substance use.

Dr. Dassanayake is a member of Mother Committee of Sri Lanka Seva Vanitha Organisation. In the USA, she served as a nutritionist at Rose Medical Centre and is a Gold Embossed Certificate Holder from American Red Cross for helping Sri Lanka on a large-scale during the tsunami.

Vitamin D won't keep the doctor away - Study

There is a lack of scientific evidence vitamin D can help prevent colds, Otago University researchers say.

Previous studies have suggested the vitamin from sunshine boosts the immune system and helps prevent colds, some cancers and heart disease, however the university's Vitamin D and Acute Respiratory Infection Study (VIDARIS) counters those claims.

The study, undertaken by researchers from the University of Otago, Christchurch, and published in the Journal of the American Medical Association (JAMA), found that taking vitamin D supplements did not result in participants having fewer or less severe episodes of upper respiratory tract infections. More than 300 Cantabrians took part in the study, taking either a placebo pill or a vitamin D pill every month for a year and half.

The researchers then measured the number and severity of participants' colds during this period.

The researchers found there was no statistical difference between those taking the placebo pills and those given vitamin D supplements.

The study's principal investigator Professor David Murdoch said there has been speculation about the potential role of vitamin D in preventing a variety of infections, including the common cold.

"Up to now we have lacked evidence to support any benefit from well-designed studies, despite so much money being spent on supplements," Dr Murdoch said.

"VIDARIS is the first study to convincingly show that vitamin D does not prevent colds in healthy adults. However, it is important to note that very few people in our study had extremely low levels of vitamin D at the beginning. So, our findings may not apply to these people and to children who should now be the focus of further research."

Dr Murdoch said vitamin D supplements may still be of benefit for bone health and for the prevention of other conditions.

The VIDARIS study, which is funded by the Health Research Council of New Zealand, is also looking at whether vitamin D prevents other infections, including carriage in the nose of staphylococcal bacteria.

- The New Zealand Herald

Laser beams 'may help spot bladder cancer'

A new technique using laser beams could help detect bladder cancer, scientists have said.

Researchers said that the technique, called Raman spectroscopy (RS), which involves shining a light beam on to a sample of tissue to reveal any abnormalities, could be quicker and more reliable than the current biopsy method. Diagnosis could be made almost instantly while biopsy results can take up to two weeks, they said. The scientists, from the University of Dundee, examined 14 patients at Ninewells Hospital in Dundee who presented with symptoms of bladder cancer. Their study, published in Analytical and Biological Chemistry, found that diagnosis made using RS was consistent with the biopsy results in 13 cases.

Dr Ghulam Nabi, lead researcher, suggested that RS has potential to be used to make less-invasive and quicker diagnoses.He said: "Obviously, the earlier we diagnose cancer, the better the prognosis is for the patient.

"There are some specific difficulties in making a reliable early diagnosis of bladder cancer, and very often it is not diagnosed until the cancer has manifested itself as a variety of symptoms.

"What we have been looking to do is develop an early and reliable diagnosis of urinary bladder cancer. Raman spectroscopy tells us about technical structure of tissue before morphological changes in structure happen as a result of the cancer developing. "The time that passes between a patient having a biopsy and receiving their results is an extremely anxious one for patients and their families. We believe that RS can remove this anxiety by providing a quick diagnosis and our results so far show that it does indeed show potential as a reliable tool for diagnosis. "What we need to do now is expand our study population and refine the process until it is as reliable as biopsy but without the negative side-effects."

RS has also been used to discover counterfeit drugs and to investigate the chemical composition of historical documents.

- PA

High-sugar, high-salt intake creates 'A ticking time bomb of health problems'

The fat- and sugar-rich Western diet leads to a lifetime of health problems, dramatically increasing the risk of stroke or death at a younger age, according to a study presented at the Canadian Stroke Congress.

Researchers found that a high-calorie, high-sugar, high-sodium diet nicknamed the 'cafeteria diet' induced most symptoms of metabolic syndrome - a combination of high levels of cholesterol, blood sugar, blood pressure and obesity - in rats after only two months.

The animals were at an age roughly equivalent to 16 to 22 years in humans at the time of disease onset, according to lead researcher Dr. Dale Corbett, scientific director of the Heart and Stroke Foundation Centre for Stroke Recovery.

"I think we'll soon start to see people in their 30s or 40s having strokes, having dementia, because of this junk food diet," says Dr. Corbett. "Young people will have major, major problems much earlier in life."

Researchers gave sedentary rats unlimited access to both nutritional food pellets and a daily selection of common junk food items including cookies, sausage and cupcakes. Animals were also given access to both water and a 30 per cent sucrose solution designed to imitate soft drinks. Like humans, the animals greatly preferred to consume the treats.

Dr. Corbett highlighted the importance of preventing metabolic syndrome with regular exercise and a balanced diet. "We're not sure whether metabolic syndrome can be reversed. If it can't, and we continue to live and eat like this, then we're each a ticking time bomb of health problems."

"Metabolic syndrome and stroke are huge health concerns for the public," says Dr. Mark Bayley, Co-Chair of the Canadian Stroke Congress and Medical Director of the Neurological Rehabilitation Program at Toronto Rehab. "We cannot afford to continue making poor nutritional choices. Our diet is killing us." In addition to warning the Canadian public about the health dangers of a poor diet, the researchers' study opens the door to further research. "Laboratory models often use relatively young animals who are healthier and on better diets than we are," said Dr. Corbett."However, it is important to remember that for many people, the consequences would be even worse, since a lot of people with stroke also have pre-existing health problems."

- NYT

Cognitive improvements from exercise after stroke

Just six months of exercise can improve memory, language, thinking and judgment problems by almost 50 percent, says a study presented at the Canadian Stroke Congress.

Researchers found that the proportion of stroke patients with at least mild cognitive impairment dropped from 66 percent to 37 percent during a research study on the impact of exercise on the brain."People who have cognitive deficits after stroke have a threefold risk of mortality, and they're more likely to be institutionalised," says lead researcher Susan Marzolini of the Toronto Rehabilitation Institute. "If we can improve cognition through exercise, which also has many physical benefits, then this should become a standard of care for people following stroke."Forty-one patients, of whom 70 percent had mild to moderate walking problems requiring a cane or walker, followed an adapted aerobic and strength/resistance training program five days a week. Exercises designed to imitate daily life included walking, lifting weights and doing squats.

The research team found "significant improvements" in overall brain function at the conclusion of the program, with the most improvement in attention, concentration, planning and organising. Muscular strength and walking ability also increased.The study did not use a control group of people who didn't exercise. However, Ms. Marzolini says, "these results provide compelling evidence that by improving cardiovascular fitness through aerobic exercise and increasing muscle mass with resistance training, people with stroke can improve brain health."

Ms. Marzolini emphasises the need to give people with stroke-related impairments access to exercise programs. "Modified exercise programs are desperately needed - they can be adapted for people following stroke, and we think they can provide huge health benefits." "Healthy living is important for reducing your risk for stroke, recovering from stroke and preventing another," says Ian Joiner, director of stroke for the Heart and Stroke Foundation. "All of us should manage our risk factors for stroke and, when needed, have access to information and counseling about strategies to modify our lifestyle choices."

"These healthy lifestyle studies emphasize how important it is to exercise and stay active after stroke," says Dr. Mark Bayley, Co-Chair of the Canadian Stroke Congress and Medical Director of the Neurological Rehabilitation Program at Toronto Rehab. "By doing so, we can increase our chances of a better outcome after stroke."

-MNT