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.


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