Category Archives: Mental health

Stigma in Ireland – people with mental health problems are less intelligent

The results of a survey carried out by St Patrick’s Hospital in Dublin involving a total of 240 participants shows that stigma is still very much attached to mental health problems and what’s more, around a quarter of people who took part in the survey said that they believed people suffering from mental health problems were of below average intelligence.

Incidentally, many studies have shown the exact opposite to be true, that people suffering from mental disorders such as bipolar, are often of above average intelligence.

One such study by James H Macabe Senior Institute of Psychiatry, Kings College London, and his colleagues revealed that youngsters who excelled at school were at an increased risk of developing bipolar. This study was published in the February 2010 issue of the British Journal of Psychiatry.

Anyway, shockingly, nearly half of the respondents in the Dublin survey (45 percent) said that they would not be willing to accept someone with a mental health problem as a close friend.

Other findings included 65 percent who said they would not want to hire someone who had a mental health problem and 37 percent said that receiving treatment for mental health issues was a sign of personal failure.

“It is a sad fact that because of this stigma, many sufferers feel embarrassment and shame and are reluctant to seek appropriate supports. Our findings echo those of the national anti-stigma ‘See Change’ survey carried out recently and show the vital necessity for the kind of anti-stigma campaign that ‘See Change’ is running” Irish Health quotes Paul Gilligan, CEO of St. Patrick’s as saying.

What’s interesting about stigma is that it still persists despite mental health problems being extremely common.

Irish Health also reported that that survey results showed that more than half of the respondents said that a close member of their family had been treated for a mental health problem, 60 percent said a close friend had been treated, and 51 percent said they had worked with someone who had received treatment for a mental health problem.

“See Change” is an attempt to combat this sort of stigma in Ireland. It is a new partnership to challenge discrimination associated with mental health problems and to bring about positive change in public attitudes and behaviour towards people with mental health problems.

Judging by the results of the Dublin survey, they’ve got a real challenge ahead of them.

Mentally ill neglected in poorer countries says WHO: New guide launched

The World Health Organisation (WHO) are concerned that millions of people in poorer countries struggling with mental health problems are neglected and are often left untreated.

Part of the reason for this says WHO, is lack of knowledge of mental health issues on the part of health professionals, as well as lack of funds to deal with the problem, and of course social stigma that surrounds mental health problems.

“Stigma remains a serious problem, with many cases of human rights violations like chaining or beating experienced by people with mental illness. Mental health problems remain a huge stigma in Nigeria with most people, even families of victims, choosing to ignore them in the hope the problems will simply go away” Reuters quotes Nigeria’s charge d’affaires Cecilia Olufolake Yahaya as saying.

The World Health Organisation wants to address the problems of dealing with mental health issues in poorer countries and have launched the “Mental Health GAP Intervention Guide”.

The guide, which was drawn up by more than 200 experts from around the world, will help doctors and nurses to diagnose and treat not only people suffering from mental health problems such as depression, bipolar, behavioural and developmental disorders, dementia, and psychosis, but also epilepsy and drug and alcohol abuse too.

According to ‘WHO’, improving mental health care in developing countries does not have to be expensive and neither does it have to involve sophisticated equipment and highly trained professionals.

“Efforts to close the mental health gap have been impeded by a widespread assumption that improvements in mental health require sophisticated and expensive technologies, delivered in highly specialised settings by highly specialised staff” said WHO Director General Chan.

“We face a misperception that mental health care is a luxury item on the health agenda. But it costs $2 per person per year — it is one of the best buys” Chan added. Chan is hoping that the new guide will “change the landscape for mental health.”

So what about the stigma?

“Human rights are abused in a large number of countries, developed and developing. In fact it happens more often in specialized care settings than in primary care” Reuters quotes Shekhar Saxena, director of WHO’s department of mental health as saying.

Instead of being treated in specialised hospitals, people can by treated through low cost community services in smaller units by medical assistants says WHO.

Young Americans at risk of mental disorders

Adolescent is difficult enough even for so called normal teenagers but a survey carried out by the National Institute of Mental Health (NIMH) and published in the October issue of the Journal of the American Academy of Child and Adolescent Psychiatry, has found that 20 percent of American youth will go on to develop a mental health disorder that is severe enough to interfere with their ability to function on a day to day basis. These are worrying statistics.

It has already been observed mental disorders in adults, often begin much earlier in life, and this latest survey supports that view. This is the first nationally representative survey that has shown that one in four to five children will experience a mental disorder at some point.

Dr Kathleen Merikangas of NIMH and her colleagues looked at data from the National Comorbidity Study Adolescent Supplement (NCS-A) which involved face to face interviews with more than 10,000 youngsters between the ages of 13 and 18 as well as follow up questionnaires completed by a parent or guardian.

Almost 50 percent of the participants met the diagnostic criteria for at least one mental disorder, and 20 percent suffered from a mental disorder that was severe enough to impair day to day function. Just over 10 percent suffered from depression or a mood disorder like bipolar, with a similar number developing an attention deficit disorder, and 8 percent reported suffering from anxiety.

Of those that reported having some kind of disorder, 40 percent also met the diagnostic criteria for one or more additional disorder. Anxiety was likely to start as early as 6 years of age, behaviour disorders by the age of 11, mood disorders by 13 and substance abuse by the age of 15 according to NIHM.

The researchers also noted that mental disorders in the youngsters were more common than asthma or diabetes and highlighted the importance of early intervention for those deemed at risk.

However, the NIMH say on their site that “more research is needed to better understand the risk factors for developing a mental disorder in youth, as well as how to predict which disorders may continue into adulthood”

“In addition, the researchers acknowledge the need for more prospective research to tease apart the complex interplay among socioeconomic, biological and genetic factors that may contribute to the development of mental disorders in youth.”

College students suffering from mental illness says study

A study that was recently presented at the American Psychological Association Convention in San Diego, California, highlighted how an increasing number of college students are suffering from mental illness.

The study was led by John C. Guthman, director of student counselling at Hofstra University. The research involved analysing data on more than 3,000 students, both undergraduates and graduates, who had used campus counselling services for mental health problems in a twelve year period from 1997 to 2009.

The counselling services offered by the campuses included screening for mental disorders, suicidal thoughts, and behaviour that could lead to self harm.

What the researchers discovered in the course of the study was that during the 12 year period the number of people diagnosed with a mental disorder rose to 96 percent from 93 percent, the number of students taking medication for mental health problems doubled in percentage from 11 to 24 percent and there was almost a 10 percent increase in the diagnosis of depression.

“In the last 10 years, a shift in the needs of students seeking counselling services is becoming apparent,” said Guthman.

The study didn’t identify why there was an increase only that there was a change and a number of reasons have been put forward as to why this might be.

“University and college counselling services around the country are reporting that the needs of students seeking services are escalating toward more severe psychological problems. While the condition of students seeking counselling doesn’t necessarily reflect the experience of the average college student, our findings may suggest that students with severe emotional stress are getting better education, outreach and support during childhood that makes them more likely to attend college than in the past” said Guthman.

He also said that perhaps medication had improved and therefore some students are able to function well enough to go to college and succeed whereas they might not have been able to before.

Interestingly, the number of students who said they were experiencing suicidal thoughts in the first couple of weeks of counselling had dropped from 26 percent in 1998 to only 11 percent in 2009.

Guthman said this could be due to improvements in suicide prevention programmes and better awareness of what help is available.

He also said that youngsters used to come to the counselling centres because they had a relationship breakdown or because they had failed a test whereas “now, they are coming with emotional distress and requesting mental health treatment for the same reasons that other adult populations seeks out treatment” said Guthman.

People with depression experience brief episodes of mild mania

Some researchers claim that we may have underestimated the number of people in the general population suffering from bipolar disorder and now a new study backs up this claim.

The research report from the US National Institute of Mental Health (NIMH) suggested that almost 40 percent of all those suffering from major depression in the US also have episodes of mania. These episodes are happening repeatedly but are mild and only last a few days at a time whereas true mania is more severe and lasts at least a week.

The researchers are referring to this milder mania as “sub-threshold hypomania” which means it’s below the threshold for being picked up as bipolar disorder.

“With hypomania, people may be more active and energetic than usual, and they may sleep less and become agitated more easily,” said the study’s senior author, Professor Kathleen Merikangas, a senior investigator at the NIMH in Bethesda, Md.

“The behavior is definitely different than their usual state, but it doesn’t cause impairment in their lives.”

Merikangas and her colleagues analyzed data from a survey of more than 5,000  households in the US who had responded to the National Comorbidity Survey Replication (NCS-R), a nationally representative face to face survey of American adults ages 18 years of age and older.

They found that people who had sub-threshold mania were more likely to suffer from anxiety, substance abuse and behaviour problems, and had more depressive episodes and attempted suicides than those who had major depression but who did not have sub-threshold mania. Interestingly, they were also just as likely as people with bipolar disorder to have a family history of mania.

Those with sub-threshold mania may benefit more from different treatment but at the moment may not get this treatment because they wouldn’t meet the criteria for bipolar disorder.

The researchers are supporting a proposal to broaden the diagnostic criteria for bipolar disorder for the next edition of the Diagnostic and Statistical Manual for Mental Diseases (DSM-IV) which is expected in three years time.

“Such an expansion of the bipolar concept would likely lead to important changes in the treatment of patients who are undiagnosed or misdiagnosed despite elevated morbidity and mortality rates” wrote the researchers in their paper.

The findings were published this month in the online ahead of print edition of the American Journal of Psychiatry.

Teenagers who spend a lot of time online, more likely to develop depression

A recent study carried out by researchers in Australia and China has found that teenagers who spend several hours a day on the internet are more likely to develop depression than other teenagers who use their leisure time for other pursuits.

The study involved over 1,040 teenagers aged between 13 and 18, the average age of which was 15 years old. All the teenagers came from the Southern Guangzhou City in China and none of them had depression at the start of the study. However, just over 6 percent were identified as using the internet excessively.

Just nine months later 84 of the teenagers were identified as suffering from depression and the data showed that those who used the internet “excessively” were one and a half times more likely to have depression than those who didn’t.

Of course you may say that teenagers are at a difficult time of life and some may become depressed anyway, but in this case, the data was obtained after other factors that could contribute to depression had been ruled out.

The study was authored by Dr Lawrence Lam, a psychologist at Sydney’s University of Notre Dame’s School of Medicine and Zi-Wen Peng of the Ministry of Education and SunYat-Sen University in Guangzhou.

Warning signs that your teen is using the internet excessively is when they become anxious and agitated when not sat in front of their computer screens and who show little or no interest in socializing with their peers.

“They can’t get their minds off the Internet; they feel agitated if they don’t get back on after a short period of being away” the telegraph reports Dr Lam as saying in a telephone interview.

“They don’t want to see friends, don’t want to join family gatherings, don’t want to spend time with parents or siblings”.

The research has been published in the Archives of Paediatrics and Adolescent Medicine and the authors wrote:

“This result suggests that young people who are initially free of mental health problems but use the internet pathologically could develop depression as a consequence”.

The researchers are therefore calling for screening of at risk individuals in schools as a way of identifying those who are at risk in order to enable early counselling and treatment.

What isn’t clear by the study is whether teenagers who are prone to depression use the internet more frequently or if excessive internet use triggers the depression.

Poor mental health can increase the pain of arthritis

According to new research carried out by scientists at the Davis School of Medicine, University of California, people who are not in good mental health may experience worse arthritic pain than those who have better emotional wellbeing.

The research involved 266 arthritic patients each of whom had agreed to take part in the Longitudinal Examination of Arthritis Pain Study. This study was designed to investigate the relationship between pain, fluctuations in pain, and health outcomes.

Over a 12 week period the participants, all of whom had hip or knee pain, engaged in weekly telephone interviews where their pain levels were assessed using the Western Ontario and McMaster University Osteoarthritis Index of 0 – 10, and mental health scores were identified using the Mental Health Index-5 in which scores of between 5 and 30 were given. A higher score on the Mental Health index would indicate better mental health.

What the researchers found was that those who had better mental health reported less pain and those with poor mental health reported more pain.

“We found that increased levels of pain were associated with worse mental health at baseline” said lead study author Dr Barton Wise.

“And further, pain flares were associated with poorer mental health during the week prior to the pain flare.”

The results of the study showed that a mental health score of between 28 and 30 was associated with a low pain score. Those that fell in a lower range of mental health scores of between 13 and 22 had double the risk of pain than those who had higher mental health scores.
The study, “Psychological Factors and Their Relation to Osteoarthritis Pain” is published in the journal Osteoarthritis and Cartilage.
Pain is a subjective experience and is therefore very difficult to study and it could be argued that although many studies might identify a link between poor mental health and higher pain, perhaps the higher pain is actually causing the poor mental health.

However, this study was different in that it was able to gauge different people’s perception of their pain at different times and under different circumstances.

Dr Barton Wise did note that a person’s experience of pain is likely to be influenced by a “large group different factors” rather than a single physiological factor.

The authors concluded that mental health may offer a “new therapeutic target” for osteoarthritis related pain.

Feeling anxious? Anxiety increases risk of heart disease

Most of us feel anxious at some point or other, like before an important exam or a job interview, and that is perfectly normal. However, when someone is generally anxious, the effect on physical health can be devastating according to recent research.

Most of us are aware that feeling anxious over an extended period of time could have a negative impact on our health but how many of realise just how much.

Two recent studies from Sweden have now established that anxiety can increase the risk of coronary heart disease and death from heart attack.

The first study was carried about by Dr Annelike Roest and colleagues from the Tilburg University in the Netherlands and involved a meta-analysis of data from 20 studies originating in the US, Europe and Asia. An analysis of data on around 250,000 individuals was carried out and the results are pretty worrying.

The researchers discovered that anxious people had a 26 percent greater risk of heart disease than non anxious people and almost a 50 percent higher risk of dying from a heart attack over a follow up period of 11 years.

The other study by Dr Imre Janszky from the Karolinska Institute in Sweden, involved an assessment of 50,000 Swedish men undergoing a medical for military service who were followed up for over 3 decades.

The researchers here found that anxiety disorders and not depression were predictors of heart disease and heart attack and this was after other factors like smoking and high blood pressure were taken into consideration.

The researchers are keen to point out how important it is for doctors to look out for symptoms of anxiety and to take this as seriously as they take physical symptoms when dealing with their patients.

Both studies were published in the June 29th Issue of the Journal of the American College of Cardiology.

If you are suffering from anxiety or anxiety related disorders then it’s vital that you do what you can to alleviate that anxiety. This will inevitably mean some lifestyle changes and maybe also a visit to the doctor who may prescribe medication or some form of therapy or even both.

Regularly exercise, a balanced diet and a regular sleeping routine will also help not only to reduce anxiety levels and improve your mental health, but will a positive effect on your physical health too.

Being a perfectionist is bad for your mental and physical health

There’s nothing wrong with trying to be good at everything you do, that’s only natural, but if you are a bit over the top about being perfect then you aren’t doing your mental or your physical health any good and it could in fact increase the risk of death says a recent study.

Professor Gordon Flett from York University in Canada has identified three different types of perfectionists.

There are the ones who are self orientated perfections, the ones who are other-oriented perfectionists and then there are the socially prescribed perfectionists.

Basically you either demand perfection from yourself, from others, or think others expect it from you.

“Perfectionism is the need to be, or to appear to be, perfect” says Professor Flett who also said that perfectionists are persistent, organised, and very detailed.

“Perfectionists vary in their behaviours: some strive to conceal their imperfections; others attempt to project an image of perfection.

“But all perfectionists have in common extremely high standards for themselves or for others.”

Professor Flett reckons that perfectionism can be linked to depression and even suicide, however, perfectionism is not yet recognised as a psychiatric disorder although he thinks it should be.

“Extreme forms of perfectionism should be considered an illness similar to narcissism, obsessive compulsiveness, dependent-personality disorder and other personality disorders because of its links to distress and dysfunction” says Dr Flett.

So how do you know if you or someone you know is overdoing it in the perfectionist arena? According to Dr Flett, perfectionists show their true colours in three ways. Firstly they might do it by bragging about themselves and this type is easy to spot because they often irritate other people says Dr Flett. The second is by avoiding situations where there is a possibility that they might be shown up. Or finally by not admitting failure to others and therefore may have a tendency to keep their problems to themselves.

Dr Flett and his colleagues followed 450 adults over the age of 65 for a period of 6 years to try and identify the effect of perfectionism. At the beginning of the study the researchers used a questionnaire to determine which of the participants had traits of perfectionism. At the end of the study the researchers found that those who did had a 50 percent higher risk of dying than those who were not considered perfectionists.

So, being perfect is not always a good thing.

‘Money Sickness Syndrome’ is causing mental health problems

According to the results of a survey carried out by insurance company Axa along with mental health expert Dr Roger Henderson, almost 90 percent of adults in the UK are displaying psychological symptoms brought on by financial stress and anxiety as a result of worries about money.

They have dubbed the condition Money Sickness Syndrome, which apparently can trigger symptoms such as anxiety, depression, sleeping problems and weight gain, loss of libido, palpitations as well as lack of concentration and an increase in alcohol consumption.

It seems that the thing people are worried about most is how they are going to pay their bills and the cost of living in general.

The results of the survey showed that less than 40 percent have done something to try and sort out their financial problems and a quarter of all those surveyed haven’t bothered to do anything at all.

“An alarming number of people seem to have their heads in the sand about money matters” said Eugene Farrel, head of psychological health and wellbeing with Axa.

It’s not the lower paid that seem to be affected the most either, the report shows that it is the high level managers that are experiencing the most stress about their finances. Interestingly, it’s also the high level managers that are more likely not to take steps to address the problem.

The skilled manual workers, lower level managers and those working in admin on the other hand, are the ones most likely to turn to alcohol or to comfort eating to ease their worries.

Many believe that financial strain has increased over the past year and that it’s likely to get worse next year.

“People at all income levels suffer Money Sickness Syndrome and the research shows that two thirds of people said they felt their levels of financial stress had worsened in the previous 12 months and almost half believed this would deteriorate further in the next 12 months” said Dr Roger Henderson, author of the report.

“For some people it may be the issue of making ends meet that is the problem but for others symptoms emerge from worrying about how to maintain a lifestyle that includes school fees and several foreign holidays.  Either way they need to take control.  The more in control you are the fewer the symptoms you are likely to experience.”

Anyone worried about their financial situation should seek expert independent financial advice.