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Sunday, 3 March 2013





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Psychiatric patients get stepmotherly treatment

The challenges of psychiatry are common to all the countries. However, the difference lies in the funding and staffing in the healthcare sector. What is more, funding is directly related to staffing.

According to the World Health Organisation (WHO) nearly 26 percent of the population in the United States suffer from mental illnesses.

One out of five people experiences mental illnesses in his lifetime. This is nearly 20 percent of the population in developed countries.

The ratio may be slightly higher in developing countries. About 20 percent of the mentally ill people are substance abusers. Out of the 20 percent of mentally ill people, one percent suffer from schizophrenia, seven percent from depression and 12 percent from anxiety disorder.On most occasions mental illnesses begin in childhood and adolescence. As a result, mental illnesses adversely affect society. It has been estimated that more females suffer from mental illnesses than males.


In both developed and developing countries, mental illnesses are the second highest cause of disability and death. What is more, those who suffer from mental illnesses frequently get absent from work. As a result, the economy at the country suffers.

Canada spends 51 billion dollars to look after mentally distressed people. The Canadian Government has found that it is not sufficient to deal with the mounting number of mental patients.

The situation in some Asian countries is even worse. For instance, India needs 150,000 psychiatrists to treat mentally ill patients. However, the Indian subcontinent has only 3,000 psychiatrists.

Nearly 10 percent of the population in Japan suffer from psychiatric disorders. While Japanese are the largest consumers of anxiety related drugs in the world, Japan has the highest number of suicides compared to other countries.

Although mental illnesses remain a major problem in the world, WHO statistics shows that 72 percent of the population are worried about cancer. Another 68 percent of the population is more concerned with diabetes than mental illnesses.

Only about 50 percent of the people are worried about mental illnesses. Mental illnesses have led to other problems. For instance, 49 percent of the people equate mental illnesses with bad behaviour.

To add insult to injury, 51 percent of the people do not socialise with mentally ill patients.

When there is a large number of mentally ill people in a given society, it can lead to more crimes being committed. Any increase in crimes can have a domino effect. When there are more criminals in a country we need more prisons.

Mobile Intervention Teams

In developed countries there are Mobile Intervention Teams to prevent people from committing suicide. Police and hospital staff are also kept on the alert to prevent suicides. Social workers visit mental patients every week. When patients do not visit the hospital for treatment, social workers bring them to hospital.

The commonest mental illness is depression. There are two types of depression. The unipolar depression is only depression. However, a person suffering from bipolar depression will have depression and high or low moods.

It is estimated that 29 percent of bipolar sufferers end up in committing suicide. Here again the females outnumber the males.


The treatment of mental illnesses has been hampered by the lack of funding for research in psychiatry. Most governments allocated funds lavishly for other diseases but psychiatry remains a neglected area.

There are certain limitations on drug treatment of mental patients. As far as other diseases are concerned, most drugs act specifically, on the right target with less side effects.

However, any treatment of depression has to take into account frequent changes of mood of the patient, his lack of interest, loss of energy and loss of appetite.

Unknown to most of us, nearly 3,000 people suffering from mental illness, commit suicide every day.

To combat the mounting number of mentally depressed people, we need psycho-social support at every stage. Anti-depressants can have side effects on patients.

Our thoughts, words and actions are interconnected. If you have positive thoughts, you will enjoy life. If you have negative thoughts, you court disaster. You can learn from your past, but you must not live in the past. It is always advisable to live in the present.

The writer is Deputy Chief of Psychiatry, Scarborough Grace Hospitals, Canada. He delivered the keynote address on the above topic at a seminar organised by Ballarat University Campus, Colombo recently.

Blood pressure during pregnancy may affect offspring's health

Up to 10 percent of all women experience some form of elevated blood pressure during pregnancy.

Researchers from the Centre for Social Evolution at the Department of Biology, University of Copenhagen show that mild maternal hypertension early in pregnancy actually benefits the foetus, but that late-pregnancy hypertension has negative health consequences for the child.

The study is based on more than 750,000 births in Denmark, with follow-up data on children's hospital diagnoses for up to 27 years.

'It has been known for some time now that pregnancy-induced hypertension can lead to more serious toxic conditions (preeclampsia), but it has puzzled biologists why such a medical condition that can be quite dangerous for both mother and child has not previously been removed by natural selection in our stone-age ancestors.

Evolutionary theory

However, evolutionary theory also emphasises that paradoxes of this kind can be due to genetic parent-offspring conflicts, so we set out to test whether we could find statistical evidence for that type of explanation', says Prof Jacobus Boomsma, Director of the Centre for Social Evolution and coordinator of the study.

The results clearly indicate that mothers with minor increases in blood pressure in the first trimester of pregnancy have babies that enjoy generally better health than children of mothers who never get a hypertension diagnosis during pregnancy. The difference was between 10 and 40 percent fewer diagnoses across all disease categories during the 27 years of available follow-up data, a result that has never been documented before.

Increased risk

However, when hypertension continues or starts later in pregnancy, this advantage shifts to a ca. 10 percent disadvantage in terms of an increased risk of acquiring a diagnosis in the Danish public health data bases.

Child mortality during the first year of life showed the same trend.

In spite of this risk being very low in Denmark, no children of mothers with early pregnancy-induced hypertension died, whereas the mortality risk of children born to mothers with hypertension late in pregnancy was above average.

Parent-offspring-conflict theory maintains that father-genes in the placenta will have a tendency to 'demand' a somewhat higher level of nutrition for the foetus than serves the interests of mother-genes. It argues that father genes that somehow manage to enhance maternal blood pressure will likely be met by maternal genes compensating this challenge. Both types of genes are 50/50 represented and thus likely to find a 'negotiated' balance while creating an optimally functioning placenta. However, when the pull of paternal genes cannot quite be managed by maternal counterbalances, there is a risk of elevated blood pressure to develop and persist, leading to late occurring pregnancy complications and compromised offspring health.

The results obtained are consistent with the idea that some deep fundamental conflicts lay buried in our genes right from the moment of conception. Imprinted genes are prime suspects for mediating such conflicts as they 'remember' which parent they come from. 'Molecular biologists have recently found many such genes in mice and man, and they are particularly expressed in the placenta as the theory predicts.

Our study therefore suggests that further research to test whether different patterns of pregnancy-induced hypertension are indeed related to paternal or maternal imprints would be highly worthwhile', said PhD student Birgitte Hollegaard, who did the analyses together with EU Marie Curie Post-doctoral Fellow Sean Byars.

The authors of the study hope these results will help build bridges between their evolutionary inspired public health analyses and established clinical praxis.'Ultimately we are not only interested in the fundamental science aspects of genome level reproductive conflicts, but also in seeing some of these findings being made more directly useful, for example by adjusting pregnancy monitoring schemes to take long term risks for offspring health into account', said Jacobus Boomsma.


Eating too much? Maybe it's in the blood

Bone marrow cells that produce brain-derived eurotrophic factor (BDNF), known to affect regulation of food intake, travel to part of the hypothalamus in the brain where they "fine-tune" appetite, said researchers from Japan, in a report that appears in Nature Communications.

"We knew that blood cells produced BDNF," said Dr. Lawrence Chan, prof of molecular and cellular biology and professor and chief of the division of diabetes, endocrinology; metabolism in the department of medicine. The factor is produced in the brain and in nerve cells as well. "We didn't know why it was produced in blood cells."

Dr. Hiroshi Urabe and Dr. Hideto Kojima, looked for BDNF in the brains of mice who had not been fed for about 24 hours. The bone marrow-derived cells had been marked with a fluorescent protein that showed up on microscopy. To their surprise, they found cells producing BDNF in a part of the brain's hypothalamus called the para-ventricular nucleus. "We knew that in embryonic development, some blood cells do go to the brain and become microglial cells," said Chan. (Microglial cells form part of the supporting structure of the central nervous system. They are characterised by a nucleus from which "branches" expand in all directions.) "This is the first time we have shown that this happens in adulthood. Blood cells can go to one part of the brain and become physically changed to become microglial-like cells."

However, these bone marrow cells produce a bone marrow-specific variant of BDNF, one that is different from that produced by the regular microglial cells already in the hypothalamus.

Only a few of these blood-derived cells actually reach the hypothalamus, said Chan. "It's not very impressive if you look casually under the microscope," he said. However, a careful scrutiny showed that the branching nature of these cells allow them to come into contact with a whole host of brain cells.

"Their effects are amplified," said Chan. Mice that are born lacking the ability to produce blood cells that make BDNF overeat, become obese and develop insulin resistance (a lack of response to insulin that affects the ability to metabolise glucose). A bone marrow transplant that restores the gene for making the cells that produce BDNF can normalise appetite, said Chan. However, a transplant of bone marrow that does not contain this gene does not reverse overeating, obesity insulin resistance. When normal bone marrow cells that produce BDNF are injected into the third ventricle (a fluid-filled cavity in the brain) of mice that lack BDNF, they no longer have the urge to overeat, said Chan.All in all, the studies represent a new mechanism by which these bone-marrow derived cells control feeding through BDNF and could provide a new avenue to attack obesity, said Chan.

- medicalxpress

Preventing chronic pain with stress management

For chronic pain sufferers, such as people who develop back pain after a car accident, avoiding the harmful effects of stress may be key to managing their condition. This is particularly important for people with a smaller-than-average hippo-campus, as these individuals seem to be particularly vulnerable to stress.

These are the findings of a study by Dr. Pierre Rainville, Professor in the Faculty of Dentistry at Université de Montréal, along with Étienne Vachon-Presseau, a student in Neuropsychology.

The study appeared in Brain, a journal published by Oxford University Press. "Cortisol, a hormone produced by the adrenal glands, is sometimes called the 'stress hormone' as it is activated in reaction to stress.

Our study shows that a small hippocampal volume is associated with higher cortisol levels, which lead to increased vulnerability to pain and could increase the risk of developing pain chronicity," said Étienne Vachon-Presseau.

As Dr. Pierre Rainville said, "Our research sheds more light on the neurobiological mechanisms of this important relationship between stress and pain. Whether the result of an accident, illness or surgery, pain is often associated with high levels of stress Our findings are useful in that they open up avenues for people who suffer from pain to find treatments that may decrease its impact and perhaps even prevent chronicity. To complement their medical treatment, pain sufferers can also work on their stress management and fear of pain by getting help from a psychologist and trying relaxation or meditation techniques."

This study included 16 patients with chronic back pain and a control group of 18 healthy subjects. The goal was to analyse the relationships between four factors: 1) cortisol levels, which were determined with saliva samples; 2) the assessment of clinical pain reported by patients prior to their brain scan (self-perception of pain); 3) hippocampal volumes measured with anatomical magnetic resonance imaging (MRI); and 4) brain activations assessed with functional MRI (f MRI) following thermal pain stimulations. The results showed that patients with chronic pain generally have higher cortisol levels than healthy individuals.


AIDS impairs the ability to recognise emotions in others

People with HIV are less able to recognise facial emotion than non-infected people says a study published in BMC Psychology. Reduction in their ability to recognise fear in others is linked to a similar loss in immediate recall, while those with a lower general neurocognitive performance also had a reduced ability to recognise happiness.

The mechanism behind recognition of facial emotion is complex, involving many different areas of the brain, including the frontostriatal pathway and amygdala. The frontostriatal pathway is essential for learning and behavioural adaption, while the amygdale is involved in memory and emotion. The loss of this ability can be debilitating, impacting daily life and personal interactions.

Comparing people with HIV to a control group without HIV, researchers in Rome discovered that from the six basic expressions of emotion (disgust, anger, fear, happiness, surprise, sadness) that fear is the most difficult emotion to recognise. People with HIV were less accurate in identifying fearful expressions than the controls and also tended to have difficulties in immediate recall of words indicating a link between the two. People with a higher number of AIDS-related events, such as pneumonia, Kaposi's sarcoma, or tuberculosis, and people with neurocognitive problems in memory, attention and decision making, language and speed of mental processing, were less able torecognise happiness in others. Dr Eleonora Baldonero, who led the study commented, "The severity of HIV-associated neurocognitive disorders has been significantly reduced thanks to combination antiretroviral therapy. Nevertheless our research highlights a link between cognition and facial recognition and that AIDS-related events affect both. Understanding this on a individual level can help the long-term personal management of HIV."




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