Raj Persaud in conversation - the podcasts
Are those sympathetic to violent protest and terrorism suffering from psychological problems?

Professor Kamaldeep Bhui works as a clinical academic psychiatrist in London. He qualified in Medicine at the United Medical Schools of Guy's & St Thomas in 1988, and subsequently worked at the Maudsley, Institute of Psychiatry, Guy's, King's, St Thomas' Hospitals and Medical Schools being appointed to his first consultant clinical academic post as a senior lecturer in 2000.

He was appointed Professor in 2003 at QMUL. Previously he was a Wellcome Training Fellow in Health Services Research and Senior Medical Officer in the policy research programme at Department of Health. He is Director at the Cultural Consultation Service at QMUL (Culturalconsultion.org) and Director of MSc Psychological Therapies, MSc Transcultural Mental Healthcare at QMUL and MSc Mental Health & Law.

He is also the co-founder of Careif (www.careif.org), an international mental health charity that promotes work for young people and their health through culture, sport and arts.

Professor Bhui is President of WACP and Public Health Lead at the Royal College of Psychiatrists.

He is editor of British Journal of Psychiatry, and International Journal of Culture and Mental Health.

He is on the editorial board of Transcultural Psychiatry, Ethnicity and Health, Int.J.Social Psychiatry, and Social Psychiatry and Psychiatric Epidemiology.

His recent paper is titled: 

Pathways to sympathies for violent protest and terrorism

by 

Kamaldeep Bhui, Maria Joao Silva, Raluca A. Topciu and Edgar Jones

and is published in The British Journal of Psychiatry

 

From the paper:

Radicalisation is proposed to explain why some individuals begin to support and take part in violent extremism. However, there is little empirical population research to inform prevention, and insufficient attention to the role of psychiatric vulnerabilities. In this study a cross-sectional survey of a representative sample of Pakistani and Bangladeshi men and women from two English cities were investigated. Depressive symptoms were associated with a higher risk of Sympathies for Violent Protest and Terrorism.

Direct download: raj_persaud_talks_to_kamaldeep_bhui.mp3
Category:general -- posted at: 1:14pm UTC

Some surprising causes of mental illness - interview with Ardesheer Talati Assistant Professor of Clinical Neurobiology (Psychiatry) at Columbia University Medical Center

Raj Persaud talks to Ardesheer Talati.

Ardesheer Talati’s research focuses on understanding long-term clinical, behavioral, and neurobiological problems in offspring that result from prenatal exposures.  Two particular areas of interest are tobacco and selective serotonin reuptake inhibitor (SSRI) antidepressant exposures during pregnancy. Although the rates of smoking have decreased in the general population, about 5-10% of women smoke during pregnancy today. On the other hand, the rates of antidepressant medication use have been rising. When used in pregnancy, both nicotine and SSRIs cross the placental and the blood-brain barriers and thus can enter the developing fetal brain.  His research focuses on trying to understand what (if any) the long term consequences of these exposures are, with a particular focus on brain development. For example, he tests whether maternal smoking or use of SSRIs during pregnancy impairs normative development of fetal brain structure, connectivity, and circuitry; and if so, whether those alterations persist through childhood development and increase risk for clinical or behavioral disorders.

American Journal of Psychiatry Volume 170, Issue 10, October 2013, pp. 1178-1185

Maternal Smoking During Pregnancy and Bipolar Disorder in Offspring

Ardesheer Talati, Ph.D., Yuanyuan Bao, M.S., Jake Kaufman, B.A., Ling Shen, Ph.D., Catherine A. Schaefer, Ph.D., and Alan S. Brown, M.D., M.P.H

 


Why are the children of depressed parents more likely to die earlier and from unnatural causes?

Dr Raj Persaud talks to Professor Myrna Weissman about what happens to the children of depressed people

HEADLINE FINDING OF THIS MAJOR NEW STUDY:

There was increased mortality in the children whose parents had serious depression (5.5% compared with 2.5%) due to unnatural causes, with a nearly 8-year difference in the mean age at death (38.8 years compared with 46.5 years in the control group - children of parents without depression).

 

From The American Journal of Psychiatry Volume 173, Issue 10, October 01, 2016, pp. 1024-1032

 

Offspring of Depressed Parents: 30 Years Later

 

Myrna M. Weissman, Ph.D., Priya Wickramaratne, Ph.D., Marc J. Gameroff, Ph.D., Virginia Warner, Dr.P.H., Daniel Pilowsky, M.D., M.P.H., Rajni Gathibandhe Kohad, M.D., M.P.H., Helena Verdeli, Ph.D., Jamie Skipper, M.A., Ardesheer Talati, Ph.D.

 

While the increased risk of psychological problems in the biological offspring of depressed parents has been widely studied and replicated, the long-term outcome through their full age of risk is less known. The authors present a 30-year follow-up of biological offspring (mean age=47 years) of depressed (high-risk) and nondepressed (low-risk) parents.

One hundred forty-seven offspring of moderately to severely depressed or non-depressed parents selected from the same community were followed for up to 30 years.

The risk for major depression was approximately three times as high in the high-risk offspring. The period of highest risk for first onset was between ages 15 and 25 in both groups. Pre-pubertal onsets were uncommon, but high-risk offspring had over 10-fold increased risk. The increased rates of major depression in the high-risk group were largely accounted for by the early onsets, but later recurrences in the high-risk group were significantly increased. The high-risk offspring continue to have overall poorer functioning and receive more treatment for emotional problems. There was increased mortality in the high-risk group (5.5% compared with 2.5%) due to unnatural causes, with a nearly 8-year difference in the mean age at death (38.8 years compared with 46.5 years).

The authors of the study conclude that the offspring of depressed parents remain at high risk for depression, morbidity, and mortality that persists into their middle years. While adolescence is the major period of onset for major depression in both risk groups, it is the offspring with family history who go on to have recurrences and a poor outcome as they mature. In the era of personalized medicine, until a more biologically based understanding of individual risk is found, a simple family history assessment of major depression as part of clinical care can be a predictor of individuals at long-term risk.


Could warming up the body cure depression?

Raising Body Temperature Relieves Depression Symptoms, Small Study Finds

 

www.med.wisc.edu/news-events/raising-body-temperature-relieves-depression-symptoms-small-study-finds/48472

 

Madison, Wisconsin — Raising the body temperature of depressed volunteers to the equivalent of a mild fever improved their symptoms of major depression for as long as six weeks after a single treatment, results from a new study show.

 

Researchers led by Dr. Charles Raison of the University of Wisconsin-Madison conducted a small, double-blind trial to test whole-body hyperthermia as a novel treatment for major depression.

 

They evaluated the depressed volunteers on the Hamilton Depression Rating Scale (HDRS) and found that 60 percent of them had a response and 40 percent met the criteria for remission of depression during at least one assessment after having received the treatment.

 

“Our hope is to find better and faster-acting treatments for depression than the antidepressants currently in use,’’ says Raison. “We think that using heat to stimulate the skin activates serotonin-producing cells in the mid-brain, which then produce a change in how the brain functions. In a way, one might think of this pathway from the skin to the brain as a deep-brain stimulator crafted by evolution. We tap into this pathway because heat makes the brain feel happy.”

 

The researchers used a whole-body hyperthermia device to raise the body temperatures of 16 volunteers to 38.5 Celsius, the equivalent of about 101.3 degrees Fahrenheit. Another 14 were randomized to a “sham” procedure that had them lie inside the hyperthermia device with fans and lights, but only a small amount of heat, not the intense infrared heat that produced the full treatment.

 

“Our sham intervention was so realistic that most of the participants (10 of 14) thought they were receiving the real treatment,’’ says Raison. That is important, because it suggests the antidepressant response was not due primarily to placebo factors associated with the treatment.

 

The real hyperthermic treatment improved depression scores by a mean of 5.67 points more than the sham at week one and a mean difference of 4.83 points at six weeks after the treatment. The HDRS rates scores of 0 to 7 to be normal, 8 to 13 to indicate mild depression, 14 to 18 to indicate moderate depression and 19 and above to indicate severe and very severe depression.

 

Researchers screened 338 volunteers and wound up with 34 patients with HDRS scores of 16 and above. The two arms began with 17 volunteers each, but with dropouts, 15 wound up completing the whole-body hyperthermia and 14 the sham treatment.

 

Those receiving the active treatment were in a type of tent, and were heated on their chest by infrared lights and on their legs with infrared heating coils. After their body core temperature reached 38.5 degrees Celsius (usually after about an hour and half) the heat was turned off and they were allowed to cool for an hour.

 

A week after treatment, researchers who were blinded to whether the volunteers had the real treatment or not assessed their depression levels using HDRS. Further assessments were made at two, four and six weeks. Self-reports also showed lessening of symptoms, although not as dramatic. Both groups reported only mild adverse effects.

 

“We were surprised to see that the effect (of reduced depression symptoms) was still present six weeks after the initial treatment,’’ Raison says.

 

Co-author Christopher Lowry, associate professor of integrative physiology at the University of Colorado-Boulder, showed in an earlier study that whole-body heating activates neurons in the brain that synthesize the neurochemical serotonin, an effect that is shared by antidepressant drugs. In addition, Lowry said, “We know that warming the skin activates areas of the brain where activity is low in depressed patients.”

 

One brain area activated by heating the skin, the medial orbitofrontal cortex, is involved in the regulation of mood. This area of the brain responds to pleasant sounds, smells, images, tastes and other stimuli. A premise of the research is that certain sensory pathways evolved to mediate antidepressant-like responses. Lowry says depression is associated with over-activity of the brain’s default-mode network, which is engaged when a person is ruminating.

 

But throughout evolution, certain conditions made such a state of mind “extremely maladaptive,” Lowry observes. Extreme heat would demand that people shift their attention from internal thoughts to the external world.

 

Raison says that the current study extends results from an earlier open-treatment study his group did in Switzerland in inpatient volunteers with major depression. Hyperthermia has been used for many years, primarily in Europe, as part of a cancer-fighting regimen, although whole-body hyperthermia to treat cancer typically raises the body temperature to temperatures much higher than used in the depression studies.

 

According to Raison, the results of the small study are encouraging, but he cautions that because the sample size was small, more research is needed to determine how hyperthermia should be optimally delivered in terms of the temperature used and the amount of time patients are exposed to the heat. Additionally, the results may have been confounded by volunteers’ expectations that the treatment would work.

 

Raison is the Mary Sue and Mike Shannon Chair for Healthy Minds, Children & Families in the UW School of Human Ecology. He is also a member of the psychiatry faculty in the UW School of Medicine and Public Health.

 

The study was conducted at the University of Arizona and funded by the Brain & Behavior Research Foundation, the Depressive and Bipolar Disorder Alternative Treatment Foundation, the Institute for Mental Health Research, the Braun Foundation and Barry and Janet Lang and Arch and Laura Brown.

 

Clint Talbott, communications director at CU-Boulder’s College of Arts and Sciences, contributed to this report.


What roles do chance and luck play in our lives?

From the Princeton University Press site:

From New York Times bestselling author and economics columnist Robert Frank, a compelling book that explains why the rich underestimate the importance of luck in their success, why that hurts everyone, and what we can do about it

 

How important is luck in economic success? No question more reliably divides conservatives from liberals. As conservatives correctly observe, people who amass great fortunes are almost always talented and hardworking. But liberals are also correct to note that countless others have those same qualities yet never earn much. In recent years, social scientists have discovered that chance plays a much larger role in important life outcomes than most people imagine. In Success and Luck, bestselling author and New York Times economics columnist Robert Frank explores the surprising implications of those findings to show why the rich underestimate the importance of luck in success—and why that hurts everyone, even the wealthy.

 

Frank describes how, in a world increasingly dominated by winner-take-all markets, chance opportunities and trivial initial advantages often translate into much larger ones—and enormous income differences—over time; how false beliefs about luck persist, despite compelling evidence against them; and how myths about personal success and luck shape individual and political choices in harmful ways.

 

But, Frank argues, we could decrease the inequality driven by sheer luck by adopting simple, unintrusive policies that would free up trillions of dollars each year—more than enough to fix our crumbling infrastructure, expand healthcare coverage, fight global warming, and reduce poverty, all without requiring painful sacrifices from anyone. If this sounds implausible, you'll be surprised to discover that the solution requires only a few, noncontroversial steps.

 

Compellingly readable, Success and Luck shows how a more accurate understanding of the role of chance in life could lead to better, richer, and fairer economies and societies.

 

Robert H. Frank is the H. J. Louis Professor of Management and Professor of Economics at Cornell University's Johnson School of Management. He has been an Economic View columnist for the New York Times for more than a decade and his books include The Winner-Take-All Society (with Philip J. Cook), The Economic Naturalist, The Darwin Economy (Princeton), and Principles of Economics (with Ben S. Bernanke). He lives in Ithaca, New York.

Direct download: interview.mp3
Category:general -- posted at: 4:55am UTC

Does Extremism Protect You From Depression?

Professor Jeremy Coid completed medical training at Sheffield University and training in Forensic Psychiatry at the Maudsley and Broadmoor Hospitals.

 

He was trained in research at the Institute of Psychiatry, King's College London, where he completed his MD.

 

As Consultant Forensic Psychiatrist he established the medium secure service to East London for mentally disordered offenders.

 

He has extensive experience of giving evidence in court as an expert witness in cases of serious violence, sexual offending, and on childcare. He has been an advisor to the Department of Health, Ministry of Justice and Ministry of Defence on management of high risk offenders.

 

He was appointed Senior Lecturer in Forensic Psychiatry in 1987 and awarded a personal chair in 1995.

 

This Podcast focuses on the recently published paper entitled: ‘Extremism, religion and psychiatric morbidity in a population-based sample of young men’ published in the British Journal of Psychiatry by Jeremy W. Coid, Kamaldeep Bhui, Deirdre MacManus, Constantinos Kallis, Paul Bebbington and Simone Ullrich

Background (from the paper)

There is growing risk from terrorism following radicalisation of young men. It is unclear whether psychopathology is associated. Aims: To investigate the population distribution of extremist views among UK men. Method: Cross-sectional study of 3679 men, 18–34 years, in Great Britain. Results: Pro-British men were more likely to be White, UK born, not religious; anti-British were Muslim, religious, of Pakistani origin, from deprived areas. Conclusions: Men at risk of depression may experience protection from strong cultural or religious identity.

FROM THE PAPER:

 

The prevalence of depression was significantly higher among Pakistani and Black minority groups than UK-born White men...

The key finding was that men... with neutral or undecided views, were more likely to be depressed. Anti-British extremist views may have offered protection against depression, specifically among men of Pakistani origin. These findings correspond to the hypothesis that lack of personal identity and meaning, with unfulfilled need for belonging, create psychological vulnerability both to extremism and anxiety and depression. Within this theoretical framework, attributing blame, identifying responsible perpetrators, strong national or other cultural identity, and active support for or opposition to a cause, may protect against depression. For some men, depression may be a precursor to ‘mobilisation’, leading to active support for and consideration of involvement in terrorism or armed conflict along a pathway of radicalisation. Lack of identity and uncertainty, together with depression, may contribute to a vulnerable state in which personal crisis can act as a trigger, resulting in an opening for new beliefs and values, encouraged by people holding similar values that legitimise violence. Relatives’ and friends’ experiences of social exclusion, including poverty and reported experiences of racism, may have influenced these individuals to take a more active position. Factors such as turning to religion or new political beliefs triggered by a war (against people with similar cultural and religious characteristics) could result in a protective sense of empowerment involving new meaning, belief systems and identity along a pathway ultimately leading to violent action. However, since we cannot determine the direction of association in this cross-sectional survey, respondents with depression may simply have been less likely to fight for or against their country or to hold extreme views because of their depression.

 


EGO IS THE ENEMY - RYAN HOLIDAY IN CONVERSATION WITH RAJ PERSAUD

Ego Is The Enemy is a new book published by best-selling author Ryan Holiday and is a philosophical exploration of difficulties we create for ourselves in life. Early in our careers, Ryan argues, ego impedes learning and the cultivation of talent. With success, ego can blind us to our faults and sow future problems. In failure, ego magnifies each blow and makes recovery more difficult. At every stage, ego holds us back.

The book draws on a vast array of stories and examples, from literature to philosophy to history. Using the stories of people like William T. Sherman, Katharine Graham, Bill Belichick, and Eleanor Roosevelt, all of whom reached the highest levels of power and success by conquering their own egos.

http://ryanholiday.net/announcing-ego-is-the-enemy-how-you-can-get-involved/

 

 

Direct download: DR-100_0081.mp3
Category:(2) General Podcasts -- posted at: 11:07am UTC

If you hear voices - does that mean you are going to go insane?

Dr Kelly Diederen is a neuroscience researcher based at the University of Cambridge and has recently published a paper in the academic journal ‘Psychological Medicine’ which follows up a group of adults who hear voices but who are not formally diagnosed as psychotic – what happens to these people over a period of time?

 

Daalman K, Diederen KMJ, Hoekema L, van Lutterveld R, Sommer IEC (2016), “Five year follow-up of non-psychotic adults with frequent auditory verbal hallucinations: are they still healthy?” Psychological Medicine 1-11


The Psychiatry of 'Breaking Bad' - Crystalline methamphetamine use and abuse

Professor Michael Farrell FRCP FRCPsych is the Director of NDARC (National Drug and Alcohol Research Centre). He moved to Sydney from London in March 2011 following his appointment to NDARC. Prior to joining NDARC he was Professor of Addiction Psychiatry at the Institute of Psychiatry at Kings College London. His extensive research interests include treatment evaluation, including the development of the National Treatment Outcomes Profile, a brief outcomes measurement instrument for drug and alcohol dependence. He has a long standing interest in drug dependence in prisons and within the wider criminal justice system. He has been a member of the WHO Expert Committee on Drug and Alcohol Dependence since 1995 and chaired the WHO External Evaluation of the Swiss Heroin Trial.

 

From the paper presented at the Annual Congress of the Royal College of Psychiatrists:

FROM AN ORIGINAL PAPER ENTITLED:

Crystalline methamphetamine use and methamphetamine-related harms in Australia

 

EXCERPT:

 

Concerns about crystal methamphetamine use and harm have increased in multiple countries. The harms of regular methamphetamine use include mental disorders such as anxiety, depression, dependence and psychosis, physical health problems, violent and aggressive behaviour, involvement in criminal activity, injecting and sexual risk, and in some cases, overdose deaths.

The types of methamphetamine used range from amphetamine-type-stimulant pills and amphetamine powder to high purity crystalline methamphetamine. ‘Ice’ is the street name given to the relatively pure preparation of methamphetamine hydrochloride salt because its translucent crystalline appearance resembles ice (also referred to by the street names ‘shard’, ‘crystal’ and ‘skates’). This pure preparation of methamphetamine originated in Taiwan and South Korea, and subsequently spread to the USA where it was dubbed the ‘drug of the 1990s’.

The increased use of crystal methamphetamine raises concerns because the high purity of the drug allows a new route of administration, inhalation. Crystal methamphetamine vaporises when heated, and can be inhaled, affording high bioavailability and an almost immediate drug effect because the drug is rapidly absorbed into the blood stream via the lungs, bypassing the metabolic processes that reduce the proportion of the drug that reaches the brain.

 

BY

Louisa Degenhardt1, Grant Sara2, Rebecca McKetin3, Amanda Roxburgh1, Timothy Dobbins1, Michael Farrell1, Lucinda Burns1 and Wayne D. Hall4,5

  1. National Drug and Alcohol Research Centre

UNSW Australia

Sydney NSW Australia 2052

  1. Sydney Medical School

Northern Clinical School

University of Sydney

Sydney NSW Australia

  1. National Drug Research Institute

Curtin University

Perth WA Australia 6008

  1. Centre for Youth Substance Abuse Research

University of Queensland

St Lucia QLD Australia

  1. National Addiction Centre

Institute of Psychiatry, Psychology and Neuroscience

Kings College London

London England

 

Corresponding author: Louisa Degenhardt

l.degenhardt@unsw.edu.au

 

 

Direct download: DR-100_0079.mp3
Category:(2) General Podcasts -- posted at: 10:37pm UTC

The Euthansia Program in Nazi-Psychiatry - Dr Michael Von Cranach talks to Dr Raj Persaud about German Psychiatry in the Nazi era.

The “Euthanasia “ Program in Nazi-Psychiatry

Dr Michael Von Cranach, an eminent German Psychiatrist, discusses with Dr Raj Persaud his research into the Nazi era, at the Royal College of Psychiatrists Annual Congress, London, 27th of June 2016.


More than 200000 psychiatric patients and handicapped persons where murdered in Germany between 1939 and 1945 by doctors and nurses. Alexander Mitscherlich, rapporteur of the Nuremberg Medical Trials wrote 1947, but published decades later,:
” Their atrocities were so unrestrained and at the same time organised with such technical bureaucratic coldness, malice and bloodthirstiness, that no one can read about it without feeling shame”.

Direct download: DR-100_0078.mp3
Category:general -- posted at: 6:49am UTC