Tag: psychiatric disorders

Treating mental illness with drugs creates a chemical imbalance

The Harmful Myth About the Chemical Imbalance Causing Psychiatric Disorders

“A psychiatrist I respect highly, who only uses psychiatric drugs in rare cases as an aid when he withdraws drugs his colleagues have instituted, has said that most people are depressed because they live depressing lives. No drug can help them live better lives. It has never been shown in placebo-controlled trials that a psychiatric drug can improve people’s lives — e.g., help them return to work, improve their social relationships or performance at school, or prevent crime and delinquency. The drugs worsen people’s lives, at least in the long run.” …

Read The Harmful Myth About the Chemical Imbalance Causing Psychiatric Disorders, on crossfit, June 24, 2019.

“Psychiatrists routinely tell their patients that they are ill because they have a chemical imbalance in the brain and they will receive a drug that fixes this. The truth is just the opposite. There is no chemical imbalance to begin with, but when treating mental illness with drugs, we create a chemical imbalance, an artificial condition that the brain tries to counteract. This means that you get worse when you try to stop the medication.”…

Read Psychiatry Gone Astray, on davidhealy, January, 21, 2014.

Image credit /jayfeldmanwellness.

Depression pills increase suicides in adults too

Newer-Generation Antidepressants and Suicide Risk in Randomized Controlled Trials: A Re-Analysis of the FDA Database

“In this re-analysis of the FDA safety summaries, we found evi-dence that the rate of (attempted) suicide was about 2.5 times high-er in antidepressant arms relative to placebo. Our findings thus conflict with the work by Khan et al., who based their effect estimates on PEY rather than the number of patients. When haz-ards are not constant over time, PEY is inappropriate and may obscure a true adverse drug effect, since (attempted) suicide most-ly occurs shortly after treatment initiation and not during con-tinuation or maintenance phases [6, 9]. Adverse-event risk should therefore be calculated based on the number of patients exposed to treatments rather than PEY, and this is also the approach ap-plied by the FDA. Thus, when based on the number of patients randomized rather than PEY, the data presented herein suggest that antidepressants significantly increase the suicide risk in adults with major depression. Further research is required to establish whether the increased suicide risk observed in RCT generalizes to real-world practice, and we acknowledge that suicide attempts constitute just one aspect of a thorough risk-benefit evaluation.”

Read Newer-Generation Antidepressants and Suicide Risk in Randomized Controlled Trials: A Re-Analysis of the FDA Database, on karger, June 24, 2019.

Image credit Ian Espinosa.

La psychiatrie conserve une place importante dans les parcours de transition des personnes transgenres

Transidentité: la difficile question de la psychiatrie dans les parcours de transition

Pour débuter une thérapie hormonale, un examen psychiatrique est presque systématique en milieu hospitalier.
S’ensuit un passage devant une commission pluridisciplinaire, composée d’un psychiatre, d’un endocrinologue, ou encore d’un chirurgien.

La communauté scientifique spécialisée “s’accorde bien heureusement pour affirmer” que la “variance de genre” n’est pas une pathologie.

Air pollution associated to psychotic experiences in young people

Association of Air Pollution Exposure With Psychotic Experiences During Adolescence

A new study finds that teens living in dirty air 70% more likely to have symptoms such as paranoia, the guardian reports. Image Duke University.

2019 Study Key Points

Question
Is exposure to air pollution associated with adolescent psychotic experiences?

Findings
In this nationally representative cohort study of 2232 UK-born children, significant associations were found between outdoor exposure to nitrogen dioxide, nitrogen oxides, and particulate matter and reports of psychotic experiences during adolescence. Moreover, nitrogen dioxide and nitrogen oxides together explained 60% of the association between urban residency and adolescent psychotic experiences.

Meaning
The association between urban residency and adolescent psychotic experiences is partly explained by the higher levels of outdoor air pollution in urban settings.

Abstract

Importance
Urbanicity is a well-established risk factor for clinical (eg, schizophrenia) and subclinical (eg, hearing voices and paranoia) expressions of psychosis. To our knowledge, no studies have examined the association of air pollution with adolescent psychotic experiences, despite air pollution being a major environmental problem in cities.

Objectives
To examine the association between exposure to air pollution and adolescent psychotic experiences and test whether exposure mediates the association between urban residency and adolescent psychotic experiences.

Design, Setting, and Participants
The Environmental-Risk Longitudinal Twin Study is a population-based cohort study of 2232 children born during the period from January 1, 1994, through December 4, 1995, in England and Wales and followed up from birth through 18 years of age. The cohort represents the geographic and socioeconomic composition of UK households. Of the original cohort, 2066 (92.6%) participated in assessments at 18 years of age, of whom 2063 (99.9%) provided data on psychotic experiences. Generation of the pollution data was completed on October 4, 2017, and data were analyzed from May 4 to November 21, 2018.

Exposures
High-resolution annualized estimates of exposure to 4 air pollutants—nitrogen dioxide (NO2), nitrogen oxides (NOx), and particulate matter with aerodynamic diameters of less than 2.5 (PM2.5) and less than 10 μm (PM10)—were modeled for 2012 and linked to the home addresses of the sample plus 2 commonly visited locations when the participants were 18 years old.

Main Outcomes and Measures
At 18 years of age, participants were privately interviewed regarding adolescent psychotic experiences. Urbanicity was estimated using 2011 census data.

Results
Among the 2063 participants who provided data on psychotic experiences, sex was evenly distributed (52.5% female). Six hundred twenty-three participants (30.2%) had at least 1 psychotic experience from 12 to 18 years of age. Psychotic experiences were significantly more common among adolescents with the highest (top quartile) level of annual exposure to NO2 (odds ratio [OR], 1.71; 95% CI, 1.28-2.28), NOx (OR, 1.72; 95% CI, 1.30-2.29), and PM2.5 (OR, 1.45; 95% CI, 1.11-1.90). Together NO2 and NOx statistically explained 60% of the association between urbanicity and adolescent psychotic experiences. No evidence of confounding by family socioeconomic status, family psychiatric history, maternal psychosis, childhood psychotic symptoms, adolescent smoking and substance dependence, or neighborhood socioeconomic status, crime, and social conditions occurred.

Conclusions and Relevance
In this study, air pollution exposure—particularly NO2 and NOx—was associated with increased odds of adolescent psychotic experiences, which partly explained the association between urban residency and adolescent psychotic experiences. Biological (eg, neuroinflammation) and psychosocial (eg, stress) mechanisms are plausible.

Screening for rare epigenetic variations in autism and schizophrenia

Additional evidence that rare epivariations likely contribute to the mutational spectra underlying neurodevelopmental disorders

2019 Study Abstract

While many studies have led to the identification of rare sequence variants linked with susceptibility to autism and schizophrenia, the contribution of rare epigenetic variations (epivariations) in these disorders remains largely unexplored.

Previously we presented evidence that epivariations occur relatively frequently in the human genome, and likely contribute to a subset of congenital and neurodevelopmental disorders through the disruption of dosage-sensitive genes.

Here we extend this approach, studying methylation profiles from 297 samples with autism and 767 cases with schizophrenia, identifying 84 and 268 rare epivariations in these two cohorts, respectively, that were absent from 4,860 population controls.

We observed multiple features associated with these epivariations that support their pathogenic relevance, including

  1. a significant enrichment for epivariations in schizophrenic individuals at genes previously linked with schizophrenia,
  2. increased brain expression of genes associated with epivariations found in autism cases compared with controls,
  3. in autism families, a significant excess of epivariations found specifically in affected versus unaffected sibs,
  4. Gene Ontology terms linked with epivariations found in autism, including “D1 dopamine receptor binding.”

Our study provides additional evidence that rare epivariations likely contribute to the mutational spectra underlying neurodevelopmental disorders. Image credit Brigham and Women’s Hospital.

DES DIETHYLSTILBESTROL RESOURCES

Prenatal and childhood exposure to phthalates and motor skills at age 11 years

Using Lipstick, Moisturizers During Pregnancy Linked To Motor Skill Deficiencies In Kids

2019 Study Highlights

  • Prenatal exposure to certain phthalates was associated with lower motor BOT-2 scores measured at 11 years of age among girls.
  • Postnatal exposure to certain phthalates was associated with lower motor proficiency among boys measured at 11 years of age.
  • The association between MEP measured at age 3 and motor performance at age 11 was different among girls and boys.

Abstract

Background
Previous reports suggest that prenatal phthalate exposure is associated with lower scores on measures of motor skills in infants and toddlers. Whether these associations persist into later childhood or preadolescence has not been studied.

Methods
In a follow up study of 209 inner-city mothers and their children the concentrations of mono-n-butyl phthalate (MnBP), monobenzyl phthalate (MBzP), monoisobutyl phthalate (MiBP), monomethyl phthalate (MEP), mono-carboxy-isooctyl phthalate (MCOP), and four di-2-ethylhexyl phthalate metabolites (ΣDEHP) were measured in spot urine sample collected from the women in late pregnancy and from their children at ages 3, 5, and 7 years. The Bruininks-Oseretsky Test of Motor Proficiency short form (BOT-2) was administered at child age 11 to assess gross and fine motor skills.

Results
The total number of children included in the study was 209. Of the 209 children, 116(55.5%) were girls and 93 were (45%) boys. Among girls, prenatal MnBP(b=−2.09; 95%CI: [−3.43, −0.75]), MBzP (b=−1.14; [95%CI: −2.13, −0.14]), and MiBP(b=−1.36; 95%CI: [−2.51, −0.21] and MEP(b=−1.23 [95%CI: −2.36, −0.11]) were associated with lower total BOT-2 composite score. MnBP (b= –1.43; 95% CI: [–2.44, –0.42]) was associated with lower fine motor scores and MiBP(b = –0.56; 95% CI: [–1.12, –0.01]) and MEP (b = –0.60; 95% CI: [–1.14, −0.06])was associated with lower gross motor scores. Among boys, prenatal MBzP (b = –0.79; 95% CI: [–1.40, −0.19]) was associated with lower fine motor composite score.

The associations between MEP measured at age 3 and the BOT-2 gross motor, fine motor and total motor score differed by sex. In boys, there was an inverse association between ΣDEHP metabolites measured in childhood at ages 3 (b = –1.30; 95% CI: [–2.34, −0.26]) and 7 years (b = –0.96; 95% CI: [–1.79, −0.13]), and BOT-2 fine motor composite scores.

Conclusions
Higher prenatal exposure to specific phthalates was associated with lower motor function among 11- year old girls while higher postnatal exposure to ΣDEHP metabolites was associated with lower scores among boys. As lower scores on measures of motor development have been associated with more problems in cognitive, socioemotional functioning and behavior, the findings of this study have implications related to overall child development.

Research communication. Press release. Image mamans.femmesdaujourdhui.be.

Air pollution exposed children with mental health problems

Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents

Abstract

Objective
To investigate associations between exposure to air pollution and child and adolescent mental health.

Design
Observational study.

Setting
Swedish National Register data on dispensed medications for a broad range of psychiatric disorders, including sedative medications, sleeping pills and antipsychotic medications, together with socioeconomic and demographic data and a national land use regression model for air pollution concentrations for NO2, PM10 and PM2.5.

Participants
The entire population under 18 years of age in 4 major counties. We excluded cohort members whose parents had dispensed a medication in the same medication group since the start date of the register. The cohort size was 552 221.

Main outcome measures
Cox proportional hazards models to estimate HRs and their 95% CIs for the outcomes, adjusted for individual-level and group-level characteristics.

Results
The average length of follow-up was 3.5 years, with an average number of events per 1000 cohort members of ∼21. The mean annual level of NO2 was 9.8 µg/m3. Children and adolescents living in areas with higher air pollution concentrations were more likely to have a dispensed medication for a psychiatric disorder during follow-up (HR=1.09, 95% CI 1.06 to 1.12, associated with a 10 µg/m3 increase in NO2). The association with NO2 was clearly present in 3 out of 4 counties in the study area; however, no statistically significant heterogeneity was detected.

Conclusion
There may be a link between exposure to air pollution and dispensed medications for certain psychiatric disorders in children and adolescents even at the relatively low levels of air pollution in the study regions. The findings should be corroborated by others.

Reference.

The Guardian press releases : here, here, here, here, here, here.

Air pollution exposed adolescents with mental health problems

Exploration of NO2 and PM2.5 air pollution and mental health problems using high-resolution data in London-based children from a UK longitudinal cohort study

In the first analysis of how common air pollutants affect teenage mental health, researchers found young people were three to four times more likely to have depression at 18 if they had been exposed to dirtier air at age 12. Comparison with earlier work indicates that air pollution is a greater risk factor than physical abuse in raising the risk of teenage depression.

Study Highlights

    • High-resolution pollution estimates were successfully combined with cohort data.
    • Age-12 pollution exposure was not associated with age-12 mental health problems.
    • But age-12 pollution exposure was significantly associated with age-18 depression.
    • Associations with depression held even after controlling for common risk factors.
    • Elevated odds of age-18 conduct disorder among children exposed to air pollution.

Abstract, Feb 2019

Air pollution is a worldwide environmental health issue. Increasingly, reports suggest that poor air quality may be associated with mental health problems, but these studies often use global measures and rarely focus on early development when psychopathology commonly emerges. To address this, we combined high-resolution air pollution exposure estimates and prospectively-collected phenotypic data to explore concurrent and longitudinal associations between air pollutants of major concern in urban areas and mental health problems in childhood and adolescence. Exploratory analyses were conducted on 284 London-based children from the Environmental Risk (E-Risk) Longitudinal Twin Study. Exposure to annualized PM2.5 and NO2 concentrations was estimated at address-level when children were aged 12. Symptoms of anxiety, depression, conduct disorder, and attention-deficit hyperactivity disorder were assessed at ages 12 and 18. Psychiatric diagnoses were ascertained from interviews with the participants at age 18. We found no associations between age-12 pollution exposure and concurrent mental health problems. However, age-12 pollution estimates were significantly associated with increased odds of major depressive disorder at age 18, even after controlling for common risk factors. This study demonstrates the potential utility of incorporating high-resolution pollution estimates into large epidemiological cohorts to robustly investigate associations between air pollution and youth mental health.

Reference.

The Guardian press releases : here, here, here, here, here, here.

Mental Health Medication Trends in the US, an Overview

Flooding the world with psychiatric drugs could boost the burden of mental disorders

Today in the United States, more than one in five adults — and more than one in 20 children and adolescents — take a psychiatric drug on a daily basis.

Overall, the number of Americans on medications used to treat psychological and behavioral disorders has substantially increased since 2001; more than one‐in‐five adults was on at least one of these medications in 2010, up 22 percent from ten years earlier. Women are far more likely to take a drug to treat a mental health condition than men, with more than a quarter of the adult female population on these drugs in 2010 as compared to 15 percent of men.

Women ages 45 and older showed the highest use of these drugs overall. Yet surprisingly, it was younger men (ages 20 to 44) who experienced the greatest increase in their numbers, rising 43 percent from 2001 to 2010.

The trends among children are opposite those of adults: boys are the higher utilizers of these medications overall but girls’ use has been increasing at a faster rate.

Read America’s State of Mind report and Flooding the world with psychiatric drugs could boost the burden of mental disorders on stat, OCTOBER 22, 2018.

Air pollution may increase dementia risk by 40 percent, London study finds

Are noise and air pollution related to the incidence of dementia ?
A cohort study in London, England, 2018

Air pollution may increase the chance of developing dementia, a study has suggested, in fresh evidence that the health of people of all ages is at risk from breathing dirty air, TheGuardian reports.

Abstract

Objective
To investigate whether the incidence of dementia is related to residential levels of air and noise pollution in London.

bmDesign
Retrospective cohort study using primary care data.

Setting
75 Greater London practices.

Participants
130 978 adults aged 50–79 years registered with their general practices on 1 January 2005, with no recorded history of dementia or care home residence.

Primary and secondary outcome measures
A first recorded diagnosis of dementia and, where specified, subgroups of Alzheimer’s disease and vascular dementia during 2005–2013. The average annual concentrations during 2004 of nitrogen dioxide (NO2), particulate matter with a median aerodynamic diameter ≤2.5 µm (PM2.5) and ozone (O3) were estimated at 20×20 m resolution from dispersion models. Traffic intensity, distance from major road and night-time noise levels (Lnight) were estimated at the postcode level. All exposure measures were linked anonymously to clinical data via residential postcode. HRs from Cox models were adjusted for age, sex, ethnicity, smoking and body mass index, with further adjustments explored for area deprivation and comorbidity.

Results
2181 subjects (1.7%) received an incident diagnosis of dementia (39% mentioning Alzheimer’s disease, 29% vascular dementia). There was a positive exposure response relationship between dementia and all measures of air pollution except O3, which was not readily explained by further adjustment. Adults living in areas with the highest fifth of NO2 concentration (>41.5 µg/m3) versus the lowest fifth (<31.9 µg/m3) were at a higher risk of dementia (HR=1.40, 95% CI 1.12 to 1.74). Increases in dementia risk were also observed with PM2.5, PM2.5 specifically from primary traffic sources only and Lnight, but only NO2 and PM2.5 remained statistically significant in multipollutant models. Associations were more consistent for Alzheimer’s disease than vascular dementia.

Conclusions
We have found evidence of a positive association between residential levels of air pollution across London and being diagnosed with dementia, which is unexplained by known confounding factors.