Raj Persaud in conversation - the podcasts ((6) PSYCHIATRY AT THE CUTTING EDGE Academic Psychiatrists and Psychologists discuss the latest research findings)

You can also listen to this interview on a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8

 

The Voices Within

http://www.charlesfernyhough.com/tvw.html

 

 

The Voices Within is a book about the voices in our heads. It is published by Basic Books in the US and by Profile Books/Wellcome Collection in the UK.

The Voices Within was picked as a top neuroscience book of 2016 by Forbes and a science book of the year by the Observer and ABC. It was chosen as a top spring science book by Nature and selected as a summer reading pick in the Guardian and Times Higher Education. It was the subject of an essay-review in the New Yorker.

I spoke about the themes of the book on the Diane Rehm Show, and discussed them in this Q&A with The Atlantic. These pieces for TIME Ideas and the LA Times explore the benefits of talking to yourself. I spoke about these ideas on BBC Radio 4's Start the Week; you can listen again here. You can also see me speaking about the themes of the book in this talk for 5x15 and in this Royal Institution lecture. The book featured in a Guardian Books podcast. An abridged extract from the book was published by BBC Future.

Translation agreements have been concluded for German, Spanish, French, Turkish, Italian, Korean and simplified Chinese.

Order from the Guardian BookshopHive.co.uk or Amazon.com.

 

 

 

 

 

'A lucid, authoritative survey of our current knowledge… The author’s investigations, at once scientific and humane, represent the discipline of psychology at its rare best.' Raymond Tallis, Wall Street Journal

'An intriguing and deeply humane book… particularly good when addressing the role of inner voices in creativity… In ‘The Voices Within’, [Fernyhough] has again rendered complicated mental experience without losing its human texture.' Casey Schwartz, New York Times Book Review

'Fernyhough’s book … provides enough science to ground the argument, but the real achievement here is the writing. The author is a psychologist and a novelist, and his prose has a narrative feel that separates it from most books on the psych shelf. The subject is one of the tough brain conundrums that’s far from settled; we’ll be trying to figure out the role of the inner voice long from now, but Fernyhough’s book is a readable take on what we know and where the questions may go next.' David DiSalvo, Forbes Brain Books of 2016.

'From explaining the hurdles of studying our internal dialogue to setting the record straight on schizophrenia and “hearing voices,” this book is a must-read for those seeking to understand the voices in their heads.' DiscoverMagazine

'Fernyhough has built up an interesting picture of inner speech and its functions… making a case for the role of inner speech in memory, sports performance, religious revelation, psychotherapy, and literary fiction.' The New Yorker

'This sophisticated and appealing work scrutinizes a tangled topic with aplomb and will leave readers permanently observing their own thought processes differently. Perfect for readers of Oliver Sacks and Malcolm Gladwell.' Booklist (starred review)

'After reading the book, I couldn’t help noticing my thoughts more closely—asking myself, Is this dialogic thinking? or What perspective was that voice taking?At one point, there’s mention of “the idea that, when we internalise dialogue, we internalise other people. Our brains, like our minds, are full of voices.” For me, at least for now, one of those voices is Fernyhough’s.' New York Magazine, The Science of Us

   

'Though the book is not about creativity per se, one of its highlights is its fascinating insight into the process of artistic creation, particularly writing. In another high point, the narrative gently prods readers into a wider and more empathetic view of pathologies such as aural hallucinations. Fernyhough's book is a valuable addition to the literature surrounding the unending human quest to understand the location—and the creation—of the self.' Publishers Weekly

'Fernyhough examines the phenomenon of "inner voices," which manifests in two broad components: the more or less ordinary business of talking to oneself and the more fraught existence of voices inside one's head... with much to say about how the brain works at the interface of thought and language.' Kirkus Reviews

'This expansive review offers a stimulating blend of theory, research, and insight on inner speech and voice hearing that will complement more prevalent behaviorist and biomedical perspectives.' Library Journal

'A book that will challenge some of our preconceptions about how we think and how "the voices within" may be plentiful, or infrequent, helpful or problematic and variable from person-to-person. This is a valuable book for those who want to understand one important aspect of our human mind.' New York Journal of Books

'Intriguingly challenges conventional assumptions about the self as unified and coherent, while also posing the question: how might that which we deem pathological be shaped by the mores of our times?' Christine Gross-Loh, Guardian summer reading picks.

'As enlightening as it is surprising… By entwining inner voice theories, research, and data into easy-to-digest literary, pop culture, and personal anecdotes, Fernyhough has (quite intentionally) crafted a book that reads like a novel but never strays from its carefully examined scientific foundation.' Kirkus Reviews author interview

'Charles Fernyhough isn't just a scholar and a scientist, he is also a novelist, and this book reflects his unusual combination of gifts. It is an engaging and humane exploration of the experience of voices in our heads, delving into the origin of these voices in children, their contribution to problem-solving, creativity, and religious experience, their role in madness, and much else. This is a beautifully written and fascinating work.' Paul Bloom, Professor of Psychology at Yale University, and author of Just Babies

'Perceptive, illuminating and humane.' Gavin Francis, author of Adventures in Human Being

'Fascinating and elegantly humane... [Fernyhough’s] book is refreshingly interdisciplinary in its insistence that philosophy and literature are going to be just as important investigative tools for this subject as clinical psychology and brain scan.' Steven Poole, Guardian

Fascinating… the book traces in detail (the footnotes are just as interesting as the text) the various attempts to pin down inner voices… an expert blend of the scientific and artistic.' Erica Wagner, New Statesman

'Persuasively unravels connections between the voices we hear inside and the words we say out loud... an elegantly written survey.' Nick Rennison, Sunday Times

'If Fernyhough is to be believed, there is a sense in which we are visited all the time by good or bad angels and it is the ability to question and discriminate that distinguishes creative thoughtfulness from madness... His book, The Voices Within, is the intriguing result of his research.' Salley Vickers, Observer

'Fascinating… thought provoking… intriguing… clear presentation of the slippery nature of both our inner and spoken worlds.' Suzanne O’Sullivan, Lancet

'Stimulating and fruitful... A fascinating tour d'horizon.' Mike Jay, Literary Review

'Profound and eloquent... an intriguing array of fresh findings and perspectives.' Douwe Draaisma, Nature

'Compelling… reassures those of us who worry that we have a chorus of voices jabbering in our heads.' Mail on Sunday

'This is a truly exceptional book for its scope, richness of detail and originality… a book that informs as well as provoking thought and reflection… It is quite simply a remarkable book.' British Journal of Psychiatry

'With its extensive illustrations of the creative effects of inner speech and voice-hearing, sane and mad, [The Voices Within] is a thought-provoking and engaging read.' Times Higher Education

'Fernyhough presents his work as a wide-ranging investigation, spanning psychological research – including the brain-plundering marvels of fMRI – as well as philosophy, spirituality, literature and the arts. If there’s a drawback to The Voices Within, it’s that it may make you spend even more of your waking hours listening to yourself think.' The Saturday Paper(Australia)

'Utterly fascinating... the main joy of Fernyhough’s book comes from watching him chase down the faintest conceptual ripples extending outward from the ideas he discusses.' The National (UAE)

'A surprisingly humanitarian approach to a necessarily human topic… a vital, illuminating, engaging exploration of the things that make us who we are.' Ilkley Gazette

'Most of us talk to ourselves. In fact, many people describe their thoughts as being like a conversation between the different voices of their consciousness. In his eye-opening new book, Charles Fernyhough explores this inner speech, revealing what purpose it serves, what it says about us, and what it can tell us about those who experience hallucinated voices.' BBC Science Focus

Biography

 

I was born in Chelmsford, Essex, in 1968, and educated at Brentwood School, Essex, and Queens’ College, Cambridge, where I read Natural Sciences.

I returned to Cambridge to study for a PhD in Developmental Psychology, which I was awarded in 1995.

My writing has been published in several anthologies, including New Writing 11 and New Writing 14, and my books have been translated into eleven languages.

 

 

 

Photo credit: Ben Gilbert/Wellcome Images

 

My awards include a Time to Write Award from the Northern Writers’ Awards and an Arts Council of England Grant for the Arts

I have taught creative writing, with a particular focus on psychological processes in reading and writing, in a variety of contexts around the UK, including a short course on Creative Writing and Psychology at Newcastle University. Between 2004 and 2006 I worked as a mentor on the British Council’s Crossing Borders project for African writers.

I have appeared at festivals in Barcelona, Sydney, Durham, Newcastle, Sheffield, Edinburgh, Hay-on-Wye, LSE, Wigtown and Bath.

I work as a part-time Professor of Psychology at Durham University, with interests in child development, memory and hallucinations.

  photo credit, it’s Ben Gilbert/Wellcome Images


Dr Charlotte Hanlon is a British psychiatrist who lives and works in Ethiopia, linked to Addis Ababa University and King’s College London. Dr Hanlon provides clinical supervision to psychiatric trainees working in general adult psychiatry in Ethiopia. She co-ordinates a PhD programme in mental health epidemiology at Addis Ababa University, from which 6 Ethiopian students have graduated and a further 20 students are enrolled. Her research interests focus on public mental health, women’s mental health, cultural validity of measurement, intervention studies and health service and system implementation research. She is research director for the Programme for Improving Mental health carE  (PRIME:www.prime.uct.ac.za) which is developing evidence to support scale-up of integrated mental health care, and country lead for the ASSET project (health system strengthening in sub-Saharan Africa: https://www.healthasset.org) and PST project (adaptation and piloting parent skills training for child developmental disorders).

Dr Hanlon works to support efforts of the Federal Ministry of Health to scale up mental health care in Ethiopia and is a member of the Ministry’s technical working group on mental health. Dr Hanlon and Professor Vikram Patel have just co-edited a revised version of Where there is no Psychiatrist (https://www.cambridge.org/core/books/where-there-is-no-psychiatrist/47578A845CAFC7E23A181749A4190B54) to support the delivery of integrated mental health care in primary care settings.

Dr. Hanlon received her PhD in psychiatric epidemiology from the University of London, a master's in epidemiology from the London School of Hygiene & Tropical Medicine, and her medical degree from the University of Oxford. 

You can also listen to this interview on a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8



 


https://www.amazon.co.uk/Delusions-Understanding-understandable-Peter-McKenna-ebook/dp/B07314FDKD

Delusions, in their many different manifestations, are central to the concepts of madness and psychosis. Yet what causes them remains in many ways a complete mystery. McKenna's Delusions is the first comprehensive attempt to tackle one of the most arresting phenomena in psychiatry: an in-depth and critical review of what delusions are, the forms they can take and how they might be explained from both psychological and biological perspectives. Delusions covers key topics such as the clinical features of delusions, the disorders they are seen in, other oddities that resemble them in both health and disease and the different approaches that have been taken to try and understand them. It is an essential book for psychiatrists and psychologists who work with delusional patients, as well as being of interest to neuroscientists engaged in research into major psychiatric disorders.

Peter McKenna qualified in medicine in the university of Birmingham and has a degree in psychology and physiology from the university of Oxford. He worked as a clinical psychiatrist in Cambridge and then became professor of psychiatry in Glasgow. His research focuses on neuropsychological aspects of schizophrenia and other major mental disorders and their relationship to symptoms and brain function. He has published over 100 papers in peer-reviewed journals and is the author of a book on schizophrenia (currently in its 2nd edition). He is also, with a linguist, Tomasina Oh, the co-author of a book on on disordered speech in schizophrenia. For the last five years he has worked as a senior researcher in FIDMAG and is a principal investigator in the CIBERSAM mental health research network.

You can also listen to this interview on a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


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.


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.

 


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


Does Eating More Fish Cure or Prevent Depression?

Walk into any health food shop and you would think that  omega-3 highly unsaturated fatty acids (HUFAs) were a panacea for all ills - the hype for these dietary supplements arises from recent research which appeared to find various benefits but now a study published by Brian Hallahan and colleagues attempts to pool all the data accumulated on the subject and cut through to the truth.

From the original recently published paper by Brian Hallahan and colleagues

Efficacy of omega-3 highly unsaturated fatty acids in the treatment of depression* Brian Hallahan, Timothy Ryan, Joseph R. Hibbeln, Ivan T. Murray, Shauna Glynn, Christopher E. Ramsden, John Paul SanGiovanni and John M. Davis

The British Journal of Psychiatry 1–10. doi: 10.1192/bjp.bp.114.160242

Many randomised controlled trials (RCTs) have reported beneficial effects for omega-3 highly unsaturated fatty acids (HUFAs) in bipolar and major depressive disorder, but others have reported essentially no effect.... possible explanatory factors: (a) that only eicosapentaenoic acid (EPA)-predominant formulations of omega-3 HUFA have an antidepressant effect;37,38 and (b) that the putative antidepressant effects of omega-3 HUFAs only occur in episodes of diagnosed clinical depression...

The study found that:  

Among participants with diagnosed depression, eicosapentaenoic acid (EPA)-predominant formulations (450% EPA) demonstrated clinical benefits compared with placebo... whereas docosahexaenoic acid (DHA)-predominant formulations (450% DHA) did not. EPA failed to prevent depressive symptoms among populations not diagnosed for depression.

 


Being A Syrian Refugee - is this the toughest test of anyone's mental health?

Interview with Ruth Wells - lead author on new paper on mental health of Syrian Refugees published in the British Journal of Psychiatry - From the introduction in the paper:

The United Nations (UN) has labelled the current Syrian conflict as the worst humanitarian crisis that has occurred within the first part of the 21st century. It is estimated that there are in excess of 4 million displaced Syrian refugees in the Middle East and over 629 000 who have been displaced to Jordan, the focus of this review. Although many displaced Syrians live in refugee camps, the largest being Za’atari camp which is home to over 120 000 people, the vast majority live in the host community. In Jordan, people from Syria have limited access to work permits and are often required to work in the informal sector to secure livelihood. Those registered with the UN are eligible to access some cash assistance, food vouchers and education and health systems, although the health system has struggled to keep up with demand. Stressors inherent in forced displacement,5 combined with exposure to potentially traumatic events (PTEs) during conflict, are likely to contribute to the development of heightened mental health difficulties in such settings.

 

From the introduction to this new paper

Psychosocial concerns reported by Syrian refugees living in Jordan: systematic review of unpublished needs assessments Ruth Wells, Zachary Steel, Mohammad Abo-Hilal, Abdul Halim Hassan and Catalina Lawsin

The British Journal of Psychiatry 1–8. doi: 10.1192/bjp.bp.115.165084

Ruth Wells, BSc, University of Sydney, Australia; Zachary Steel, PhD, MClinPsych, School of Psychiatry, University New South Wales, The Black Dog Institute, Hospital Road, Prince of Wales Hospital, New South Wales, Australia; Mohammad Abo Hilal, MD, Syria Bright Future; Abdulhalim Hasan, MD, American Medical Center, Erbil, Iraq; Catalina Lawsin, PhD, Department of Behavioral Sciences, RUSH Medical Center, Chicago, USA


Prof Richard Bentall - can delusions be explained? Talking to Dr Raj Persaud

Raj Persaud talks to Richard Bentall at the Royal College of Psychiatrists Annual Conference and International Congress - Birmingham 2015. Professor Bentall was taking part in a session on the very latest developments in thinking about delusions and discussed his presentation after the conference session.

The conversation begins with Professor Bentall reminding us that how to understand what a delusion is, and what it isn't, in terms of strange beliefs, is not so straightforward, in certain 'tricky cases'.

Richard Bentall is Professor of Clinical Psychology at Liverpool University and has previously held chairs at Manchester University and Bangor University. He graduated with a BSc and then a PhD in experimental psychology at the University College of North Wales (now Bangor University) and then completed his clinical training at Liverpool University. He also holds an MA in philosophy applied to health care awarded by University College Swansea (now Swansea University). His research interests have mainly focused on psychosis. He has studied the cognitive and emotional mechanisms involved in psychotic symptoms such as hallucinations, paranoid delusions and manic states, using methods ranging from psychological experiments, and experience sampling to functional magnetic resonance imaging. Most recently, his research has focused on why social risk factors (for example childhood adversities such as poverty, abuse, and bullying) provoke the cognitive and emotional changes that lead to these symptoms. In collaboration with colleagues at Manchester and elsewhere he has also conducted large scale randomized controlled trials of psychological interventions for people diagnosed with schizophrenia, bipolar disorder and prodromal psychosis. He has published over 200 peer-review papers and a number of books including Madness explained: Psychosis and human nature (Penguin, 2003) and Doctoring the mind: Why psychiatric treatments fail (Penguin, 2009).

 

You can listen to the interview via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

 

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8

 

 

 


Direct Current Stimulation as a treatment in Psychiatry

Dr Philip Wilkinson talks to Dr Raj Persaud about Transcranial Direct Current Stimulation - a new promising treatment in Psychiatry?

from http://www.psych.ox.ac.uk/team/senior-researchers/philip-wilkinson

Dr Philip Wilkinson: I am a consultant old age psychiatrist with Oxford Health NHS Foundation Trust. Related to my work with inpatients, I have an interest in the management of late life depression and am currently working with colleagues in the Neurobiology of Ageing Group on transcranial direct current stimulation (tDCS).

 

I have an interest in psychological treatments with older people. I have recently worked with the Oxford Mindfulness Centre on developing a mindfulness intervention in dementia care and am a Trustee of the Oxford Mindfulness Foundation.

 FROM:  http://www.hopkinsmedicine.org/psychiatry/specialty_areas/brain_stimulation/tdcs.html

Transcranial Direct Current Stimulation

Transcranial direct current stimulation (tDCS), is a non-invasive, painless brain stimulation treatment that uses direct electrical currents to stimulate specific parts of the brain. A constant, low intensity current is passed through two electrodes placed over the head which modulates neuronal activity. There are two types of stimulation with tDCS: anodal and cathodal stimulation. Anodal stimulation acts to excite neuronal activity while cathodal stimulation inhibits or reduces neuronal activity. 

Although tDCS is still an experimental form of brain stimulation, it potentially has several advantages over other brain stimulation techniques. It is cheap, non-invasive, painless and safe. It is also easy to administer and the equipment is easily portable. The most common side effect of tDCS is a slight itching or tingling on the scalp.

Several studies suggest it may be a valuable tool for the treatment of neuropsychiatric conditions such as depression, anxiety, Parkinson’s disease, and chronic pain. Research has also demonstrated cognitive improvement in some patients undergoing tDCS. Currently, tDCS is not an FDA-approved treatment.

 

You can listen to the interview with Dr Philip Wilkinson via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

 

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8

 


How to Explain Delusions

Raj Persaud talks to Phillip Corlett Associate Professor of Psychiatry at Yale University about the latest thinking on delusions.

From http://psychiatry.yale.edu/people/philip_corlett.profile:

Dr. Philip Robert Corlett trained in Experimental Psychology, Cognitive Neuroscience and Psychiatry with Professors Trevor Robbins and Paul Fletcher at the University of Cambridge. He won a Wellcome Trust Prize Studentship and completed his PhD on the brain bases of delusion formation in the Brain Mapping Unit, Department of Psychiatry. After a short postdoc, he was awarded the University of Cambridge Parke- Davis Exchange Fellowship in Biomedical Sciences which brought him to the Yale University Department of Psychiatry to explore the maintenance of delusions with Professors Jane Taylor and John Krystal. He was named a Rising Star and Future Opinion Leader by Pharmaceutical Marketing Magazine and joined the Yale faculty in 2011 where he will continue to explore the cognitive and biological mechanisms of delusional beliefs as well as predictive learning, habit formation and addiction.

From: http://medicine.yale.edu/lab/corlett/

Delusions are odd beliefs. They accompany many psychiatric illnesses, notably schizophrenia. A major challenge is to understand delusions in terms of changes in brain function. 

Our lab attempts to meet this challenge by investigating the neural basis of human associative learning and belief formation, relating these processes to the formation of delusional beliefs. 

Dr. Corlett’s findings have shaped the development of a novel mechanistic model of delusion formation.

 

You can listen to the interview via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

 

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


Brain Inflammation Explains Psychosis?

Dr Paola Dazzan Reader in Neurobiology of Psychosis explains to Dr Raj Persaud the latest theory that psychosis may be related to an inflammation of the brain.

 

Inflammation and metabolic changes in First Episode Psychosis: Preliminary results from a longitudinal study

Contribution to journal › Article

Original language English
Journal Brain Behavior and Immunity
Journal publication date 19 Jun 2015
DOIs
State Published

Bibliographical note

Copyright © 2015. Published by Elsevier Inc.

King's Authors

 

Abstract

Metabolic abnormalities are commonly observed in patients with psychosis, and may confer greater risk of developing cardiovascular disease later in life. Such abnormalities are associated with inflammation in the general population, and there is increasing evidence for elevated inflammation in patients with first episode psychosis (FEP). The aim of this preliminary study is to examine the effect of changes in inflammation, as measured by high-sensitivity C-reactive protein (hsCRP), on metabolic changes in a three-month longitudinal study in a FEP sample. Fifty-three FEP patients from in- and out-patient services in South London, England, were included in this longitudinal study. Social and clinical data were collected, and fasting blood samples and anthropometric measurements (weight, Body Mass Index (BMI), lipid profile and gluco-metabolic parameters) were obtained at baseline and at three-month follow-up. Correlation analyses showed that those with increases in hsCRP over the three-month period also had increases in triglyceride levels (r = 0.49, p = 0.02). No association was observed with other lipid profile, or gluco-metabolic parameters. Increases in weight and BMI were also associated with increases in triglyceride levels (r = 0.33, p = 0.02; and r = 0.31, p = 0.03, respectively); however, a multiple linear regression analysis found that the effects of inflammation on triglycerides were independent from the effect of changes in weight, and from the baseline inflammatory state. Our preliminary findings suggest that those patients experiencing greater increases in inflammation early on in the course of their illness may be at greater risk of developing short-term metabolic abnormalities, in particular dyslipidaemia, independent of weight-gain. Future work should investigate the use of inflammatory markers to identify patients in greater need of physical health interventions.

You can listen to the interview via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

 

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8

 


'The Chimp Paradox' - Professor Steve Peters explains his 'chimp' model of human behaviour

From http://chimpmanagement.com/thechimpmodel.html

The Chimp Model is a Model for understanding and managing the functioning of the mind. The Model is not a hypothesis nor strict scientific fact but based on the neuroscience of the brain. The model is fun but meant to be taken seriously when it comes to applying it.

The model sees the brain as being divided into three teams. The first team is you, the Human (headed up by the dorsolateral prefrontal cortex). You are a conscious thinking analysing being that works with facts and truth and then makes deductions using logical thinking. The second team is the Chimp, an independent thinking brain that is not under your control. It works with feelings and impressions and then puts the ‘information’ together using emotional thinking. The third team is the Computer. This is really a brain that is at the disposal of the Human and Chimp to put information into for reference. It acts as a memory and can also act as an automatic thinking and acting machine that is programmed to take over if the Chimp or Human is asleep or if they allow it to run ahead of them with preformed decisions and beliefs that it can act with.

As the resident psychiatrist at GB cycling, Steve was described as a genius by Dave Brailsford. Working in several sports, he has an unparalleled reputation for giving people an edge – as well as the confidence to overcome defeat. As in his book The Chimp Paradox, Steve shows how to deal with fear and ‘become the person you want to be’. He explains how to visualise and break each challenge into small stages, focusing on the process rather than the outcome.

You can listen to the interview via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

 

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8

 


Transcranial Magnetic Stimulation - what you need to know

Dr Lena Palaniyappan qualified as a medical doctor from Stanley Medical College, Chennai, India along with a concurrent BA in Psychology. Since 2004 he has trained as a clinical psychiatrist, initially at the Maudsley Hospital, London and later at Nottingham where he obtained his M.Med.Sci. in Clinical Psychiatry. Between 2007 and 2009 he worked as an Academic Clinical Fellow (NIHR funded) at the Regional Affective Disorders Unit at Newcastle-upon-Tyne. Following a HEFCE funded clinical lecturer post during which he coordinated a MRC funded neuroimaging study in psychosis led by Prof. Liddle, he obtained a Wellcome Trust funded Clinical Research Fellowship in Translational Neuroimaging in Psychiatry.

He recently assumed the role of Associate Director of the Centre for Translational Neuroimaging in Mental Health. He is also a member of the editorial board for Frontiers in Neuropsychiatric Imaging and Stimulation. As a consultant psychiatrist, he works with young people who experience a psychotic episode for the first time in their lives.

My present clinical research aims to apply brain imaging to investigate symptom burden, treatment response and prognostic accuracy in major psychiatric disorders such as schizophrenia, bipolar disorder and depression.

To this end, my work focuses on understanding the intrinsically organized, large-scale brain networks in psychosis using structural, functional and electrophysiological imaging techniques. I am interested in the clinical application of neuroimaging observations made at an individual level (rather than group level) using advanced statistical approaches and mathematical models. I am also interested in developing hypothesis-driven neuromodulatory approaches that target resistant symptoms of depression and psychosis through the manipulation of dysfunctional brain networks (e.g. using magnetic stimulation and cognitive training approaches).

The major goal of my work is to understand the pathways that lead to poor long-term outcome in certain individuals with serious mental disorders.

PLEASE SEE BONUS CONTENT GIFT WRAP ICON AT TOP OF PAGE ON THE APP FOR A DOWNLOAD OF AN ORIGINAL PAPER ON TMS PUBLISHED IN THE BRITISH JOURNAL OF PSYCHIATRY

 

You can listen to the interview via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

 

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


Opening Up To Self-Disclosure

Anna Ruddle and Sarah Dilks consider whether therapists should talk about themselves in therapy

 

Psychologists Anna Ruddle and Sarah Dilks discuss with Psychiatrist Dr Raj Persaud when therapists should talk about themselves, and whey they shouldn't.

 

FROM THE ORIGINAL PAPER PUBLISHED IN THE PSYCHOLOGIST

 

As psychologists, we are increasingly encouraged to work

as equal partners with people to overcome problems or facilitate

recovery, as defined by the individual. There is an emphasis

on the common human experience of all parties. So should we be

behaving differently with clients, opening up more, sharing our own

experiences of stress, anxiety and resilience? Or would this be

considered unprofessional and even risky?

 

PLEASE SEE BONUS CONTENT GIFT WRAP ICON AT TOP OF PAGE ON THE APP FOR A DOWNLOAD OF THE ORIGINAL PAPER

 

You can listen to the interview via a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

 

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


Can Zombies Explain the Brain?

Raj Persaud talks to Timothy Verstynen about his new book on what Zombies can teach us about the brain, co-authored with Bradley Voytek

 

Do Zombies Dream of Undead Sheep?
A Neuroscientific View of the Zombie Brain
Timothy Verstynen & Bradley Voytek 


 

Winner of the 2015 PROSE Award in Biomedicine & Neuroscience, Association of American Publishers

Hardcover | 2014 | $19.95/ £13.95 | ISBN: 9780691157283

http://press.princeton.edu/titles/10305.html

Even if you’ve never seen a zombie movie or television show, you could identify an undead ghoul if you saw one. With their endless wandering, lumbering gait, insatiable hunger, antisocial behavior, and apparently memory-less existence, zombies are the walking nightmares of our deepest fears. What do these characteristic behaviors reveal about the inner workings of the zombie mind? Could we diagnose zombism as a neurological condition by studying their behavior? In Do Zombies Dream of Undead Sheep?, neuroscientists and zombie enthusiasts Timothy Verstynen and Bradley Voytek apply their neuro-know-how to dissect the puzzle of what has happened to the zombie brain to make the undead act differently than their human prey.

 

Combining tongue-in-cheek analysis with modern neuroscientific principles, Verstynen and Voytek show how zombism can be understood in terms of current knowledge regarding how the brain works. In each chapter, the authors draw on zombie popular culture and identify a characteristic zombie behavior that can be explained using neuroanatomy, neurophysiology, and brain-behavior relationships. Through this exploration they shed light on fundamental neuroscientific questions such as: How does the brain function during sleeping and waking? What neural systems control movement? What is the nature of sensory perception?

 

Walking an ingenious line between seriousness and satire, Do Zombies Dream of Undead Sheep? leverages the popularity of zombie culture in order to give readers a solid foundation in neuroscience.

 

Timothy Verstynen is an assistant professor in the Department of Psychology and at the Center for the Neural Basis of Cognition at Carnegie Mellon University. Bradley Voytek is assistant professor of computational cognitive science and neuroscience at the University of California, San Diego. They are both members of the Zombie Research Society and are preparing grant applications to research the coming zombie apocalypse.

Review:

"If you've ever wondered which pathologies are responsible for the stiff and murderous personalities of zombies, this actual scientific explainer is the book for you."--Mental Floss

"Verstynen and Voytek's entertaining book uses zombies to help illustrate human neuroscience. . . . Zombie fans will want this book, and anyone concerned with neuroscience will find the topic made accessible by this lighthearted exploration."--Library Journal

"Neuroscientists and zombie enthusiasts Timothy Verstynen and Bradley Voytek have recently come out with a new book called Do Zombies Dream of Undead Sheep?, in which they apply their neuroscience backgrounds to an investigation of the undead. It's filled with pages of increasingly nerdy explorations of zombie behavior, and I highly recommend it, but what really caught my eye was the authors' conclusion: All the walking dead have Consciousness Deficit Hypoactivity Disorder, or CDHD."--Kyle Hill, Nerdist

"Voytek and Verstynen serve up an introduction to neuroscience but through the guise of zombies. Each chapter tackles a different zombie behavior and breaks it down through the current neuroscientific understanding of it. It's a kind of Neuroscience 101 that tackles complex ideas in a fun, enjoyable manner."--KPBS.org

"[Do Zombies Dream of Undead Sheep? is] a quick, cheeky read told by the sort of people who toss out punchlines while watching films such as 28 Days Later and World War Z."--Gary Robbins, U-T San Diego

"[Do Zombies Dream of Undead Sheep?] is smart, informative, historically riveting, well referenced, and like all good zombie stories, wonderfully fun. . . . If you want a sophisticated primer of neuroscience, coupled with a Halloween spin, then there can be no other book."--Steven C. Schlozman, Science

The interview on the neuroscience of zombies can be listened to on a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


The Truman Show Delusion. The Truman Show Delusion and other curiosities - Dr Joel Gold talks to Dr Raj Persaud

Dr Joel Gold, Clinical Associate Professor, Department of Psychiatry, NYU School of Medicine, talks to Dr Raj Persaud about his new book which includes vivid descriptions of what may be a completely new delusion - The Truman Show Delusion - where a patient delusionally believes they are taking part in an all-encompassing reality TV show where they are the unwitting star as in the Jim Carrey movie 'The Truman Show'.

 

Suspicious Minds

How Culture Shapes Madness

 

A new book By Psychiatrist Dr Joel Gold and Philosopher Professor Ian Gold

 

What if you woke up with the alarming suspicion that you were being watched?

 

One day in 2003, a patient unlike any other that Dr. Joel Gold had seen before was admitted to his unit at Bellevue Hospital. This man claimed he was being filmed constantly and that his life was being broadcast around the world like The Truman Show—the 1998 film depicting a man who is unknowingly living out his life as the star of a popular soap opera. Over the next few years, Dr. Gold saw a number of patients suffering from what he and his brother, Dr. Ian Gold, began calling the “Truman Show delusion,” launching them on a quest to understand the nature of this particular phenomenon, of delusions more generally, and of madness itself.

 

The current view of delusions is that they are the result of biology gone awry, of neurons in the brain misfiring. In contrast, the Golds argue that delusions are the result of the interaction between the brain and the social world. By exploring the major categories of delusion through fascinating case studies and marshaling the latest research in schizophrenia, the brothers reveal the role of culture and the social world in the development of psychosis—delusions in particular. Suspicious Minds presents a groundbreaking new vision of just how dramatically our surroundings can influence our brains.

 

Order the book from here: http://books.simonandschuster.com/Suspicious-Minds/Joel-Gold/9781439181553

 

A related article which may be of interest:

 

Was it a Psychotic Episode in L. Ron Hubbard That Led Him to Found the Church of Scientology?

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/scientology-l-ron-hubbard_b_1656883.html

 

by Raj Persaud and Peter Bruggen

 

A French Psychoanalyst, Dr Thierry Lamote, claims in a book (La Scientologie déchiffrée par la psychanalyse. La folie du fondateur, Universitaires du Mirail Press), and in a paper just published in the academic Journal 'L'Évolution Psychiatrique', that L. Ron Hubbard, the founder of the religious group, The Church of Scientology, suffered a psychotic episode, which appears to be the foundation for the multi-million pound worldwide movement.

 

 

Scientology claims a host of celebrity followers, such as film star Tom Cruise. The unswerving devotion of many adherents alarms some people. Jenna Miscavige Hill, said to be an ex-Scientologist whose uncle is a Scientology Church leader, is quoted inThe Daily Telegraph Newspaper on 6 July as having publicly warned Katie Holmes, currently divorcing Tom Cruise, that Scientology was "no place for an innocent child", like her daughter Suri. Cruise and Holmes are said to be starting a custody battle, and it's possible that Cruise's high profile following of Scientology, might become a factor in the dispute.

 

 

Analysing the founder of Scientology's writings and biographical material, Dr Lamote's research contends it was Ron Hubbard's battle with psychotic symptoms that partly drew him to therapy approaches advocated by psychoanalyst Sigmund Freud. It seems he then exploited Freud to create a movement which its adherents would find difficult to leave.

 

 

In his paper entitled 'Scientology: A systematized delirious inspired by Breuer and Freud's Studies on hysteria', Dr Lamote claims Hubbard subsequently re-named various old techniques and ideas used by Freud (some dating from before Freud founded psychoanalysis) and incorporated them into Scientology. Part of the continuing power of the movement may lie in these Freudian approaches, Dr Lamote's analysis suggests. Supposedly unlocking and exploring the unconscious, can become psychologically 'addictive', explaining why so many find themselves drawn into Scientology, become dependent on it, and then are unable to understand why so many others remain suspicious of the movement.

 

 

Towards the end of the 1930s, Dr Lamote writes that Hubbard had a tooth extracted under nitrous oxide, also referred to as "laughing gas", used during general anaesthesia, but which can cause disturbing mind-altering effects. Lamote then points out that Hubbard, in a letter written on 1 January 1938, and other writings, relates a set of strange experiences as result, including hearing voices repeating enigmatic sentences such as, "Do not let him know!". They could sound like the kind of hallucinations Doctors associate with a psychotic illness.

 

 

Lamote found that Hubbard frequently returned to this painful experience, indicating how profoundly important it was to him, maybe a turning point.

 

 

Dr Lamote contends a psychotic process within Hubbard's mind had begun, but lay largely undetected by the outside world until possibly 1943 when Hubbard was a Lieutenant in the U.S. Navy. He was put in charge of a naval gun ship, the USS PC-815, a submarine chaser. In what remains a controversial episode, Lt. Hubbard, shortly after setting to sea, appears to have heard things through the sonar and hydrophone indicating contact with an enemy submarine.

 

 

Over the next three days, he launched 37 depth charges, and claimed to have sunk an enemy submarine, while critically damaging another. But no other official in the Navy seems to have agreed. Instead Dr Lamote's research suggests that Hubbard was fighting a battle with delusional enemies.

 

 

Dr Lamote wonders if this was part of his developing a paranoid picture of the universe?

 

 

Around this crucial time, Dr Lamote's paper points out, the exploding of the Hiroshima bomb perhaps profoundly shook and maybe further destabilised him. Formerly a science fiction writer, Hubbard appears to have become disillusioned, even perhaps frightened by the power of science. This combined with his mounting anxiety that society needed to be controlled, otherwise war and total annihilation was inevitable, possibly laid the seeds for the controlling nature of the movement he founded.

 

 

Lamote's paper contends that Hubbard turned to the science of cybernetics of control, in order to build a religious movement at the heart of which would be control over large numbers, in order to reduce the risk of self-destruction, which appeared to him to be mankind's destiny.

 

 

Into this mix Lamote believes Hubbard threw in teachings from psychoanalysts' Freud and his colleague Breuer, who were some of the earliest proponents of the idea that psychological distress arose out of repressed memories from earlier in life, which required access, through therapy, in order for us to achieve well-being. Hubbard had many physical symptoms and Lamote wonders whether the early psychoanalytic idea, that some physical symptoms had a psychological cause buried deep in the unconscious, may have influenced him. Through this approach, he may have found relief from his own physical symptoms.

 

 

Dr Lamote argues that Hubbard pioneered an idea of an 'engram' which is a kind of memory of pain which goes back so far into the past to include the pain of cell division, when we first started as an organism, but could retreat even further, to past or parental lives. The techniques of Dianetics, contends Dr Lamote's paper, include many which resembled counterparts in psychoanalysis such as hypnosis and abreaction, where past trauma is encouraged to be emotionally ventilated.

 

 

Tom Cruise did jump up and down in apparent agitation on Oprah's sofa during a televised interview.

 

 

It is this borrowing from psychotherapy and psychoanalysis that Dr Lamote work suggests partly explains the powerful appeal of Scientology to so many, and ironically enough, its founder Ron Hubbard. Just as therapy can be addictive, so can Scientology, because it borrows similar techniques but re-labels them. Like psychoanalysis it offers a universal therapeutic method, supposed to solve all human ills.

 

Dr Lamote points out there is almost a sense in which Freud has been re-discovered and re-packaged by Scientology.

 

 

Back in 2005 Tom Cruise was reported to have condemned the actress Brook Shields after she went public on the benefit she received from anti-depressant medication, while suffering from serious postpartum depression. Scientology is traditionally virulently anti-psychiatry, and anti-psychiatric treatments such as its medication.

 

 

It might be ironic, therefore, if Hubbard, founder of a strongly anti-psychiatric movement had been heavily influenced right back in the beginning, by what some would regard as the most famous psychiatrist of all, Sigmund Freud.

 

Raj Persaud and Peter Bruggen are joint podcast editors for the Royal College of Psychiatrists and also now have a free app on iTunes and Google Play store entitled ‘Raj Persaud in conversation’, which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

Download it free from these links:

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8

Books by Raj Persaud are available on amazon.co.uk here:

 


Are you in control of you? How much control do we have over our own lives? Magda Osman talks to Raj Persaud

If you are viewing this podcast from inside the free mobile phone app 'Raj Persaud in Conversation' you can click on the 'gift box' icon which might be on the top right hand corner of your screen to download bonus content - the original paper by Magda Osman published in 'The Psychologist' entitled 'Does our Unconscious rule?' You can also find this bonus content in the initial main menu screen that comes up when you open the app on the top right hand corner of the screen under a menu icon that reveals 'extras' - click on extras to see the bonus content.

From the Palgrave Macmillan website:

http://www.palgrave.com/page/detail/futureminded-magda-osman/?K=9781137022264

Future-Minded

The Psychology of Agency and Control

Magda Osman

 

What drives us to make decisions?

Future-Minded explores the psychological processes of agency and control. If you've ever wondered why we think of coincidences as matters of fate rather than the result of the laws of probability, this book provides the answer. From memory and reasoning to our experiences of causality and consciousness, it unpicks the mechanisms we use on a daily basis to help us predict, plan for and attempt to control the future.

ISBN 9781137022264
Publication Date March 2014
Formats Paperback Ebook (PDF) Ebook (EPUB) Hardcover 
Publisher Palgrave Macmillan

 

Future-Minded

 

A related article which may be of interest first published in The Huffington Post 02/08/2012 16:32 BST

http://www.huffingtonpost.co.uk/dr-raj-persaud/inside-the-mind-of-the-ol_b_1731758.html

 

Inside the Mind of the Olympic Gold Medal Winner

By Raj Persaud and Adrian Furnham

Winning the Gold Medal in the Olympics appears a pinnacle in any elite athlete's career, but physical fitness or technical skill may not, in fact, be the crucial factor. Increasingly sports scientists are becoming convinced that it's grit and determination, resilience and desire, which separates winners from losers.

Motivation triumphs over muscle.

But what precisely are these mysterious, hidden, but crucial mental aspects which separate the winners from the rest, who appear to be trying just as hard? Can the rest of us benefit as well from the psychological strategies of our Olympic Gold Medal winners?

Dr David Fletcher and Mustafa Sarkar, sport and performance psychologists at Loughborough University, (where much of the science behind the training of Team GB's current medal campaign has been developed) have just published one of the most in-depth studies ever, getting inside the mind of Olympic Gold Medal winners.

The investigation, published in the academic journal 'Psychology of Sport and Exercise', involved an analysis of 12 Olympic Gold Medal winners' accounts to the researchers of how they used their minds to win.

The first startling finding is that all these champions' lives were not dominated by accomplishment before getting Gold. Instead they constantly encountered obstacles and set backs on the path to success, yet it was their mental resilience in the face of adversity, which is what seemed to separate them from the rest of the field, and pulled them through to eventual victory.

One champion's reaction to being de-selected for a major international competition illustrates relentless optimism and a proactive approach, characteristic of Olympic Gold Medal winners; 'There were four of us challenging for these final two places and I got told I was on the reserve list. And at the time it was devastating but it's one of those things; if you don't take a ticket in the raffle, you're never going to win a prize. So you have to take the ticket that's part of life and it just makes you think "well, what can I do differently to make sure I do get success"?

Paradoxically, not being selected for major international competitions was frequently cited by Gold Medallists as the foundation for increased endeavour and exertion. Competition losses were viewed as learning opportunities, enabling future improved performances. Set-backs were re-interpreted in ways which meant they merely re-doubled their efforts, and didn't become disheartened.

Failure didn't break them - it made them.

One of the most intriguing findings from Fletcher and Sarkar's study is that while journalists love to wheel out the cliché of 'sacrifice' when invoking elite performance, it wasn't a concept these Gold Medal winners understood.

Instead the world's best athletes take huge personal responsibility for their choices, and are surprisingly uncomplaining about how much they forfeit for their sport. They accepted they actively chose the challenges they encountered, and as a result endured a wildly different work/life balance to the rest of us, as one commented to the researchers; 'We all worked. But in terms of the build up to the Olympics, we didn't bat an eyelid in doing it... it was our choice to do it. I don't like the word sacrifice... Sacrifice to me is about last resort and there's no alternative... that's rubbish. We made a choice to do that and I think that choice in what we did we highly valued and I think that inspired us, motivated us to perform on the pitch and as a group.'

One Gold Medal winner's reaction to training during unsociable hours is characteristic; 'I remember one of my coaches saying to me what was I doing over Christmas and I said 'Oh, I'll be training twice on Christmas Day . I know [opponent's name] won't be training on Christmas Day twice and that will give me the edge'. It was more the mental side of things because I knew that I'd be doing something that he wasn't doing.'

These private dimensions of winning tend not to be confided to the microphones thrust in winners' faces as they step down from the victory podium. Their sharing of such intimate secrets to success is therefore what makes this Loughborough University study so rare and valuable.

An example of their incessant thinking and re-thinking of every fine detailed aspect of their lives is this quote from a champion cyclist to the researchers; 'Initially, training was just something to get out of the way. And then gradually I'd do training and I'd think, "Am I getting the most out of this? Am I exploiting the session?" And, you know, if I did take a bad lift in the gym I'd think, "I could have done that better. That's a missed opportunity. What have I got to do to be better?" So I had an obsession on getting everything right rather than just waiting for the day of the final and then hoping. It was about getting everything right before the final so I had all the tools ready for when I was racing.'

Another undisclosed aspect of the mind of winners is what almost seems a sense of destiny - as this comment to Dr David Fletcher and Mustafa Sarkar illustrates; 'I don't know if there is going to be a theme where timing and luck have been in the right place, but I'm a great believer in it. I wasn't selected for the original trip... and on the Thursday night before they [the team] were leaving, I was called up because an individual's wife had gone into labor [and I was told] 'be at [the airport] the next day: we're playing [country] on the Saturday'.

They believe they make their own luck and that those who persevere will eventually benefit from chance.

Perhaps the greatest shock that is going to come from Fletcher and Sarkar's study entitled, 'A grounded theory of psychological resilience in Olympic champions', is that these Olympic Gold Medal winners were not as fixated, as the media and the nation appears to be, on winning gold.

Instead, it was fulfilling their athletic potential which primarily motivated them, rather than becoming an Olympic champion. Some involved in this research pointed out, amazingly, that their gold medal performance was not, in their view, the most outstanding moment in their career.

The following comment illustrates an athlete's viewpoint on her gold medal performance in the 2000 Olympic Games; 'This may come as a bit of a shock but I didn't have a great competition in Sydney. I was consistent... but it wasn't a great performance... '

The research on competitors who are most likely to cheat, via doping or any other means, is that if it's being on the podium, waving the Gold Medal and soaking up the applause which is what is primarily driving you, then you will be tempted to take a short cut to get there.

But there are competitors, and this may sound strange after a week when the nation became obsessed with getting a Gold, for whom the Gold Medal doesn't represent what it does for the rest of us praying for one. Instead the Gold Medal to these elite performers is merely an acknowledgement of excellence, and it's that total mastery of self and sport which has always been the primary ambition. For these athletes coming first would still be vital, no matter if there was no audience, no media and no medal.

The medal is merely a measure, not a goal.

These contestants, research has found, are much less likely to cheat in any way, no matter what temptation is placed in front of them.

In a week where various forms of 'cheating' have dominated the sports news agenda, there is a danger in our obsession for Gold, that we could forget this fundamental aspect of the Olympic ideal.

 

Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world. Download it free from these links

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


Virtual Reality Therapy. Will Virtual Reality replace therapists? Raj Persaud talks to Leanne Casey and Wesley Turner

Will therapists be replaced by Virtual Reality Technology? Psychiatrist Raj Persaud talks to psychologists Wesley Turner and Leanne Casey from Griffith University, Brisbane, Australia who have just published an analysis of how effective the latest Virtual Reality psychological treatments are.

 

Their study is entitled 'Outcomes associated with virtual reality in psychological interventions: where are we now?' and is published in the academic journal Clinical Psychology Review (Volume 34, Issue 8, December 2014, Pages 634–644)

 

If you are a professional and interested in further information on CPD Online or wish to earn CPD credit points, particularly from listening to this podcast, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

After listening to this podcast if you go to the College site and answer the mcq questions there about the interview, you can obtain on line CPD points.

 

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/religious-beliefs-and-depression_b_5165183.html

 

 

A recent article on other ways new technology is changing psychiatry and psychology:

 

 

Does Brain Scanning Research Reveal Your Real Religious Belief - More Than Church Attendance?

 

RAJ PERSAUD AND PETER BRUGGEN

A new brain scanning study has found that high personal importance of religion or spirituality in your life is associated with thicker cortex in several brain regions.

 

Some of these same regions were found to be associated with a higher risk for developing clinical depression, if that part of the brain cortex was thinner.

 

The study, entitled, Neuroanatomical Correlates of Religiosity and Spirituality - A Study in Adults at High and Low Familial Risk for Depression, concludes that a higher importance of religion or spirituality was associated with thicker cortex in certain brain regions, possibly conferring greater resilience to the development of depressive illnesses.

 

The study, published in the prestigious Journal of the American Medical Association - Psychiatry, focused on those with a high or low familial risk for developing clinical depression, because of a previously strong family history of this psychiatric diagnosis.

 

The team of academics who conducted this Magnetic Resonance Imaging (MRI) study, led by Dr Myrna Weissman, from Columbia University, argue that this brain finding could account for why being religious or spiritual, in certain circumstances, might contribute to improved resilience to depressive psychiatric illnesses.

 

Being religious or spiritual, possibly by expanding a physical brain reserve, counters to some extent the vulnerability that brain thinning in those areas poses for developing depression that runs in families.

 

For those attending church services this Easter weekend it may be surprising that the study found it was the personal importance of religion or spirituality in your life, but not the frequency of attendance of church, that was associated with thicker brain areas. In a sense the brain scans revealed your true faith more than church attendance did.

 

The same team had previously reported a 90% decreased risk, assessed over a 10-year period, of developing clinical depressive disorder in those from families where there was a high incidence of depression, if religion or spirituality was highly important to the adult studied.

 

Several others studies have found that intensity of religious experiences is associated with increased blood flow in similar brain regions found to be structurally thicker in this study.

 

The authors of this new study, Lisa Miller, Ravi Bansal, Priya Wickramaratne, Xuejun Hao, Craig Tenke, Myrna Weissman and Bradley Peterson, found that, oddly, a high frequency of attendance of religious services was not associated with brain thickness, yet rating religion or spirituality as personally important in your life was.

 

This appears a paradox - people who go to church a lot were not reaping the same benefit in their brains, in terms of protecting from depression, as those who believed that religion or spirituality was important to them.

 

The authors point out that although some may go to church in order to promote their spirituality, others may attend whether or not religion is genuinely personally important to them. In this study 49 participants reported high church attendance, yet only 21 of those also reported high importance of religion or spirituality in their lives. The remaining 28 participants may be attending services for a host of non-religious reasons, which may include social support. 

 

This research found that the participants who frequently attended religious services were in fact at increased risk of depression, suggesting that a subset of participants may attend religious services for comfort or management of depressive symptoms.

 

Although frequent attendance may express, sustain, and cultivate personal importance of religion or spirituality, these findings suggest that religious beliefs and experiences, and not overt behavior (such as attending church a lot), are associated with brain thickness.

 

That going to church might not be the key to the protective effect of religion or spirituality on those predisposed to depression, through a high risk family history, is further bolstered, according to Myrna Weissman and her colleagues, by other recent research. For example, those who regularly meditate also have certain thicker brain regions. Another recent study found that meditation training for eight weeks increased cerebral gray matter density in specific brain areas.

 

The authors of this study, from Columbia University and the New York State Psychiatric Institute, are not claiming that religion or spirituality generally protects you from depression. Instead, they are suggesting that if you consider that religion or spirituality in your life are important, then that appears to confer a neuroanatomical resilience. And that is in those who otherwise are predisposed to developing depressive illness, due to a strong family history for this kind of psychiatric problem.

 

Previously, we reported some other new research, from a team of academics led by Professor Michael King from University College London, where over 8,000 people were investigated, revealing that those who held a religious or spiritual understanding of life, had a higher incidence of depression compared with those with a secular life view.

 

Entitled Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study, the investigation had been published in one of the most respected academic psychiatric journals, Psychological Medicine.

 

Perhaps one way of resolving the differing results is that the Psychological Medicinestudy was conducted on populations outside the USA - in the UK, Spain, Slovenia, Estonia, the Netherlands, Portugal and Chile. It could be that how important religion is in your country and culture, as well as the particular population studied, also has an impact on your brain and psychology.

 

Generally speaking Europeans are perceived as less religious than North Americans.

In the Psychological Medicine study, their findings varied by country; in particular, people in the UK who had a spiritual understanding of life were the most vulnerable to the onset of major depression. Yet, regardless of country, the stronger the spiritual or religious belief at the start of the investigation, the higher the risk of onset of depression over the next year.

 

In the specific situation of where you inherit a brain that might be predisposed to developing depression, it appears that higher importance of religion or spirituality in your life, perhaps in the USA at least, could be protective. It is also notable that the more recent brain scanning study found it was sustained interest in religion or spirituality, over a longer period, which was most strongly associated with thicker brain structures, rather than reporting a high level of spirituality at only one point in time.

 

However, given the not dissimilar findings on the brain effects of meditation, whether these structural brain changes and protective effect of religion or spirituality, are something specific to beliefs in God, is open to question.

 

Science is revealing that merely attending religious services may not deliver brain or mental health benefits, instead these appear linked to what you really believe.

 

Neuroscientists might now be able to tell, by examining your nervous system using the latest brain scanning technology, what you really believe, in the inner depths of your 'soul', but which you keep hidden from the rest of the congregation.

 

A private inner space that was supposedly only before accessible to God?

 

 

 

Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

Download it free from these links:

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


Freud on the Brain. Latest neuroscience research supports Freud?

Can neuroscience prove the existence of the Unconsious?

 

Dr Raj Persaud in conversation with Institute of Psychiatry neuropsychiatrist Professor Tony David: Does the latest neuroscience research support Freud?

This podcast is based on a paper recently published entitled:

Neural correlates of recall of life events in conversion disorder.

Aybek S, Nicholson TR, Zelaya F2, O'Daly OG, Craig TJ, David AS, Kanaan RA.

JAMA Psychiatry. 2014 Jan;71(1):52-60. doi: 10.1001/jamapsychiatry.2013.2842.

The paper is a brain imaging investigation of conversion disorder or hysteria. The study probes a neuroscience explanation for conversion symptoms, where a traumatic experience is transformed into a symptom, such as paralysis of a leg.

 

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

 

A related article which may be of interest originally published in The Huffington Post

http://www.huffingtonpost.co.uk/dr-raj-persaud/can-you-completely-forget-who-you-are-as-a-man-with-almost-total-amnesia-grabs-the-headlines---what-it-reveals-about-us_b_5577306.html

 

Can You Completely Forget Who You Are? As a Man With Almost Total Amnesia Grabs the Headlines - What It Reveals About Us

 

Raj Persaud and Peter Bruggen

The UK media reports that a man with severe amnesia, who still cannot remember even his own name, or where he comes from, but who was discovered in Peterborough, suffering from severe amnesia two months ago, is baffling mental health experts.

 

They are now appealing to the public for help, in the hope that someone might recognise him.
'Robert' is reportedly suffering from an upsetting and very severe case of amnesia where he cannot recall any details of his life, including his own name, age, where he is from; or his job.

 

One key clue is that although 'Robert' (a name given to him by hospital staff) speaks English, his accent seems to be eastern European, and he also appears to understand some Lithuanian and Russian.

 

Similar cases, which could explain this mysterious incident, include a clinical case report, published in 2010, entitled 'Running towards a different life: A case of Dissociative Fugue', by Dr M. Santos and Dr E. Gago from Hospital Magalhães Lemos, Portugal.

 

The paper, published in the academic journal 'European Psychiatry', explains that the diagnosis of fugue in psychiatry derives from the Latin word for flight-- fugere. Dissociative fugue is an extremely rare psychological condition - the sufferer suddenly and without warning travels far from home, completely unable to recall their past.

 

These episodes are usually linked, explain Santos and Gago, with severe stress or trauma, such as disasters, losses of loved ones or intolerable burdens at work or home. The amnesia appears completely genuine, with patients displaying no conscious understanding of the psychological reason for the flight. This is usually accompanied by muddles over personal identity and sometimes even complete assumption of a new self.

 

Santos and Gago report that the journeying associated with 'Dissociative Fugue' can last for several months. Some patients travel thousands of miles from home while in this state.

 

Another recent study entitled 'Dissociative memory impairments and immigration' also published in 'European Psychiatry' in 2010, by Dr A. Staniloiu, Dr S. Borsutzky and Dr H.J. Markowitsch, suggest there is even a possible link between this kind of psychological problem and immigration.

 

The authors from the University of Bielefeld, Germany, argue that stressful experiences arising during migration could precipitate these symptoms, though a delayed onset at times occurs reflecting an 'incubation' effect.

 

Another recent study suggests an effective treatment for 'Dissociative Fugue' which appears to have fallen out of favour recently, which might explain why it may not have been used in more current cases.

 

The case study entitled 'Amytal interview using intravenous lorazepam in a patient with dissociative fugue', reports a middle-aged white female picked up by emergency medical services in the USA, who could not remember her name, address, and did not know the name of the city.

 

Lorazepam (a sedative drug a bit like Valium) was given intravenously by the psychiatrist. Although relaxed and sleepy the patient was kept awake by asking her to restate the name of her present in-patient psychiatrist, whom she had become close to. She was led back in fantasy to the gas station where she was picked up and was requested to identify it. Once she successfully named a location from her personal history, she was led to give her name, hometown, birthday, social security number, employment, motherhood and marital status.

 

The investigation, published in the journal 'General Hospital Psychiatry' in 2006, reports that after she awoke the patient described past and recent sexual assaults. The recent rape was about 10 days before hospitalization. A final diagnosis of Dissociative Fugue was made, and the patient was discharged to outpatient follow-up and the Victims of Violent Crime clinic.

 

The authors of this paper, Dr Sunday Ilechukwu, from the Ann Arbor Health Care System and Dr Thomas Henry, then at Wayne State University, USA, argue that procedures like this provide the patient with an opportunity for the recall and review of recent emotional crisis, linkage to past trauma and provision of context to current experience.

 

The authors contend that the simple but critical process of naming her identity under sedation, probably helped her come to terms with the precipitating conflict.

 

The authors also argue care needs to be taken to minimize the risk of introducing false or distorted memories. The use of video-recorded feedback may also help consolidate gains made during the interview.

 

The authors conclude that the so-called 'sodium amobarbital' interviews have been in use for about 70 years and refers to the use of an older barbiturate type drug, could be brought back into modern psychiatric practice. The study suggests that such pharmacological-facilitated interviews continue to be a useful procedure with such cases, but that a safer more modern drug, such as lorazepam, can be used as an alternative.

 

But why should trauma lead some people to forget even who they are? Another study entitled 'A case of persistent retrograde amnesia following a dissociative fugue: Neuropsychological and neurofunctional underpinnings of loss of autobiographical memory and self-awareness', argues that, since memories can be vivid, threatening and painful, they may be removed from consciousness as a way of protecting the self-concept.

 

The authors, Kristina Hennig-Fast, Franziska Meister , Thomas Frodl , Anna Beraldi , Frank Padberg, Rolf Engel , Maximilian Reiser , Hans-Jürgen Möller and Thomas Meindl, brain scanned an individual suffering from these fugue like symptoms. The results highlighted the key role of visual and emotional properties of autobiographical memory in the maintenance of this kind of amnesia.

 

 

The study published in the journal 'Neuropsychologia', found reduced neural activity within the brain network producing autobiographical memory retrieval. The authors based at Ludwig-Maximilians-University, Munich, Germany, posit a protective defence mechanism caused by neuronal inhibition that serves to prevent an overflow of intensive aversive emotions.

 

 

The authors suggest that visual imagery plays a central role in the recall of autobiographical memories. Defects in the way the brain visually processes memory which might help explain puzzling phenomena such as Dissociative Fugue.

 

 

Their patient regained only three remote and strongly negative childhood memories dating from the time before the dissociative fugue. All were highly negative, vivid and fragmented episodes comparable to frozen images, e.g. of the coffin at his grandfather's funeral.

 

 

It must surely be one of the most disturbing experiences of all, not to recall anything of our past except alarming fragments. Psychiatric investigation of this kind of suffering is helping to reveal how the normal sense of personal identity is achieved. Visual aspects of memory may be more important than we previously realised. The fact that it can be lost suggests we shouldn't take it for granted.

 

 

Trying to uncover who 'Robert' really is, could also help us find ourselves.

 

 

 

If you are a psychiatrist, or a similar clinical professional, who is collecting Continuing Professional Development Points, after listening to this podcast and podcasts like this, it is possible to visit the Royal College of Psychiatrists CPD web site, and after completing some questions (plus registering with the site), gain CPD points on-line.

 

Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8

 

 

 

 


10,000 suicides. Did the recession lead to 10,000 excess suicides?

Did 10,000 people kill themselves because of the last recession?

 

Raj Persaud in conversation with Oxford University Sociologist Aaron Reeves - how did the recession lead to 10,000 excess suicides?

 

Aaron Reeves is a post-doctoral researcher and an adjunct lecturer in the Department of Sociology at the University of Oxford. He is also a post-doctoral research fellow at Nuffield College and his research interests include: political economy of health, social protection, social and cultural exclusion, and quantitative sociology.

 

He is currently working with Dr. David Stuckler examining natural experiments in relation to poverty-reduction and health as well as exploring the impact of the recession and austerity on health outcomes. In addition to this he is also working on projects analysing the association between social position and the intergenerational transference of cultural practice.

 

Dr Reeves completed his PhD in Applied Social & Economic Research with the Institute for Social and Economic Research, University of Essex and has published several articles linking healthcare and the economy.

 

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

 

A related article which may be of interest

 

http://rajpersaud.wordpress.com/2014/08/22/after-the-robin-williams-tragedy-will-there-by-copycats-raj-persaud-and-professor-sir-simon-wessely-president-of-the-royal-college-of-psychiatrists/

 

After the Robin William’s tragedy – will there be copycats? Raj Persaud and Professor Sir Simon Wessely (President of the Royal College of Psychiatrists)

 

Raj Persaud and Professor Sir Simon Wessely (President of the Royal College of Psychiatrists)

 

 

 

Robert Enke, a very famous German football goal keeper, killed himself on the railway on 10th November 2009.

 

 

 

The number of railway suicidal acts, in the following two weeks, more than doubled in Germany.

 

 

 

The study which uncovered this is entitled ‘One followed by many?—Long-term effects of a celebrity suicide on the number of suicidal acts on the German railway net’, and is recently published in the ‘Journal of Affective Disorders’. There was also an increase of railway suicides of 19% in the following two years, as compared to the two years before this tragic event.

 

 

 

The authors of the study,Ulrich Hegerl, Nicole Koburger, Christine Rummel-Kluge, Christian Gravert, Martin Walden and Roland Mergl, found the 25% increase of fatal railway suicides between 2007 and 2010 was significantly greater than the 6% increase in the total number of suicides in Germany over the same period.

 

 

 

The authors based at the University of Leipzig, and Deutsche Bahn AG (the German Railway Company), conclude that Enke’s suicide probably led to copycat suicidal behaviour on the railways.

 

 

 

 

 

The authors point out that the media attention of the footballer’s suicide was exceptional and enduring, and this may have had an impact. For example, television broadcasts of a public mourning ceremony, held in the team’s stadium, were viewed by almost 7 million German viewers.

 

 

 

30 railway suicidal acts occurred in the two-week interval before Encke’s suicide, 71 railway suicidal acts in the two week interval following this event; an increase of 137%.

 

 

 

But what is more ominous is that this research found an elevated long-term ‘attractiveness’ of railway suicidal acts after Enke’s suicide.

 

 

 

The authors conclude that their findings are a strong argument for improving media coverage of suicides, and community suicide preventive programs.

 

 

 

A study entitled ‘To What Extent Does the Reporting Behavior of the Media Regarding a Celebrity Suicide Influence Subsequent Suicides in South Korea?’, just published in the journal ‘Suicide and Life-Threatening Behavior’, investigated the world record copycat effect thus far. This was the suicide of the Asian star actress Choi Jin-shil; starring in 18 films, she has been described as South Korea’s equivalent of Julia Roberts .

 

 

 

The authors, Jesuk Lee, Weon-Young Lee, Jang-Sun Hwang and Steve Stack, found her death on 2 October 2008 was subsequently associated with 429 additional suicides in South Korea, which is a record copycat effect.

 

 

 

Another recent investigation entitled, ‘Changes in suicide rates following media reports on celebrity suicide: a meta-analysis’, examined 10 studies from around the world, probing for similar copycat effects, examining 98 suicides by celebrities.

 

 

 

The team of authors, led by Thomas Niederkrotenthaler,  King-wa Fu, Paul Yip, Daniel Fong, Steven Stack, Qijin Cheng and Jane Pirkis, report a change in suicide rates of on average roughly almost three suicides per 1000 000 population, in the month after a celebrity suicide across the world.

 

 

 

Extrapolating from these figures, the worse case scenario would be an additional almost 200 suicides over the next month, in the UK, with approaching 1000 in the USA. Whether or not that happens remains to be seen, but these non-celebrity suicides are unlikely to make the headlines.

 

 

 

 

 

The study, published in the ‘Journal of Epidemiology and Community Health’, report suicides by an ‘entertainment celebrity’, across the planet, had the greatest impact of all in Europe, in terms of copycat incidents, followed by a slightly smaller impact in the USA.

 

 

 

The authors based at the Universities of Vienna, Hong Kong, Melbourne and Wayne State, found a particular celebrity impact on copycat behaviour by entertainment celebrities, as opposed to other prominent people, such as politicians.

 

 

 

Thomas Niederkrotenthaler and co-authors argue the suicide of an entertainment celebrity is so influential perhaps because of audience identification.

 

 

 

Celebrities are revered and may therefore act as particularly strong role models even when it comes to taking their own lives.

 

 

 

Guidelines for media reporting of suicide include that detailed discussion of the particular method should be avoided, and as images of the death scene are highly influential, these should not be broadcast. For details see http://www.samaritans.org/sites/default/files/kcfinder/files/press/Samaritans%20Media%20Guidelines%202013%20UK.pdf. These and similar links may be of special interest for journalists reporting about suicides

 

 

 

But by writing this article are we ourselves violating the media guidelines? Not so, we contend, because the recommendations do not say there should be no media reporting, but that it should be sober and responsible.

 

 

 

Thomas Niederkrotenthaler points out that not all celebrity suicide reporting is associated with increases in suicides subsequently. This is exemplified by the suicide of Rock Star Kurt Cobain. His suicide was widely reported, but there was no copycat phenomenon afterwards, Dr Thomas Niederkrotenthaler maintains.

 

 

 

This may be due to Cobain’s widow, Courtney Love, expressing both her sadness and anger about her far too early loss, in the media, and contacts to support services were published, along with her statements, immediately after his suicide. Indeed, research showed that these mental health services experienced an increase in clients, but there was no upsurge in suicides.

 

 

 

Perhaps the celebrity obsession of the media is in fact a reflection of a deeper problem with journalism, of which suicide reporting is merely a symptom. Reporting of celebrities lives in general tends to remain somewhat naïve. Being rich and famous, according to the classic simplistic media analysis, inoculates against any serious psychological problems.

 

 

 

In a study entitled ‘Psychological strains found in the suicides of 72 celebrities’, the tensions experienced throughout the lives of 72 celebrities were systematically investigated.

 

 

 

The authors, Jie Zhang, Jiandan Tan and David Lester found of 72 ‘celebrity’ suicides, only one had no ‘strains’ at all.

 

 

 

 

 

The authors, from Shandong University School of Public Health and Central University of Finance and Economics, China, and The Richard Stockton College of New Jersey, USA, found the most common pressure was ‘aspiration strain’ – found in 97% of the lives of celebrities who kill themselves.

 

 

 

‘Aspiration strain’ was defined in this study, published in the ‘Journal  of Affective Disorders’, as a gap between an individual’s aspiration and the reality of their life. For example, wishing to be much richer than you actually are.

 

 

 

The study found 30 celebrities who killed themselves suffered at least two contrasting life strains, while 36 had endured three different ‘strains’.

 

 

 

Perhaps the take home message should be that despairing sadness may happen to anyone, irrespective of fame or wealth.

 

 

 

But what many people still do not know is that depression, and also other mental health problems, including personal crises, can be treated, and that there is help available.

 

 

 

That should be the headline story.

 

 

 

 

If you have been affected by any of the issues raised in this article you may find the following of help: Samaritans Helpline: 08457 90 90 90 http://www.samaritans.org

 

 

If you are a psychiatrist, or a similar clinical professional who is collecting Continuing Professional Development Points, after listening to this podcast and podcasts like this, it is possible to visit the Royal College of Psychiatrists CPD web site, and after completing some questions (plus registering with the site), gain CPD points on-line.

 

Raj Persaud is now joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


Can A Single Session Cure? Can a single session of therapy produce a cure? Professor Windy Dryden talks to Raj Persaud

The assumption that therapy should always be long term has been challenged repeatedly over the last twenty five years.

The difficulty is that Single Session Therapy has become associated in many therapists minds with being “money driven”, “superficial” and “poor quality”.

Professor Dryden builds on the work of a number of researchers and practitioners – from Moshe Talmon’s work on Single Session Therapy via Ost’s One Session CBT Treatment for Phobias and more recently, Andrea Reinecke's single session exposure based treatment of panic attacks at Oxford University.

Professor Dryden advocates an integrated approach combining belief and inference challenge with mindfulness and acceptance strategies.

Windy Dryden

Professor of Psychotherapeutic Studies

Windy Dryden, Emeritus Professor of Psychotherapeutic Studies at Goldsmiths College, University of London was one of the first people in the UK to be trained in CBT, and was the first Professor of Counselling in the UK.

The author or editor of 200 books and over 700 scholarly articles on CBT and Counselling – from “The Handbook of Brief Cognitive Behaviour Therapy” through to “Ten Steps To Positive Living”

He offers a uniquely informed perspective on CBT and psychotherapy as its practiced today and where it is heading in the future.

A RELATED ARTICLE WHICH MAY BE OF INTEREST - FIRST PUBLISHED IN THE HUFFINGTON POST:

http://www.huffingtonpost.co.uk/dr-raj-persaud/new-years-resolutions-psychology_b_4522926.html

 

Psychologists Find the Best Way to Achieve New Year's Resolutions - Is to Not Make Any by Raj Persaud and Peter Bruggen

 

 

New Year's resolutions commonly involve resolving to end bad habits - for example giving up alcohol or smoking.

However the latest psychological research suggests that, paradoxically, trying hard to not do something, might render it more likely you will perform negative habits.

This effect is referred to as ironic mental control. The 'ironic' part refers to the fact that trying not to do things, in particular trying not to think of something, or endeavouring not to have desires, seems to, paradoxically, bring them on more strongly.

If the theory is correct it explains why every year we make New Year's resolutions only to break them quite soon.

The theory of ironic mental control, it is suggested by some, might have been inspired by writer Fyodor Dostoevsky observing in his 'Winter Notes on Summer Impressions', (an 1863 account of his travels in Western Europe): "Try not to think of a polar bear, and you will see that the cursed thing will come to mind every minute."

Harvard psychologist, Daniel Wegner and colleagues in a famous experiment published in the 'Journal of Personality and Social Psychology', then found thoughts of a white bear were more likely to recur for those who initially suppressed thoughts of a white bear, than for participants who had not been asked to suppress such thoughts.

The study entitled, 'Paradoxical effects of thought suppression', found people were amazingly unsuccessful at prohibiting thoughts of a white bear, with at least one 'white bear thought' occurring each minute, despite explicit instructions not to think about a white bear. When told to try to think about a white bear in a subsequent period, these same participants reported even more thoughts of a white bear than participants who hadn't suppressed initially.

In other words, there is even a re-bound effect - which is when liberated to finally allow yourself to think of something you have been suppressing - you tend to go overboard and do even more of it than you would otherwise. So the problems with trying hard not to do something include even if you succeed temporarily, you are vulnerable to periods of lack of restraint, succumbing to splurge or binge even more than before.

One of the very latest studies entitled, 'Why the white bear is still there: Electrophysiological evidence for ironic semantic activation during thought suppression', measured brain electrical activity changes using scalp recordings, when suppressing different words.

The study, recently published in the journal 'Brain Research', has established that trying to suppress thoughts doesn't just produce the opposite effect, this occurs at a fundamental brain activity level.

The authors of the investigation Ryan Giuliano and Nicole Wicha from the University of Oregon and the University of Texas at San Antonio, conclude that thought suppression may be a causal factor in a vast array of psychological problems. It could be a human instinct to actively seek to avoid distressing thoughts, but unfortunately this strategy appears to backfire, resulting in the resurgence of the very thoughts one is attempting to avoid.

Given weight control is such a large part of many people's resolutions, a study entitled 'The ironic effects of weight stigma' by Brenda Major, Jeffrey Hunger, Debra Bunyan and Carol Miller from the University of California, Santa Barbara and the University of Vermont, USA, might explain the frequent failure of New Year's Resolutions over weight. Women were randomly assigned to read a news article about stigma faced by overweight individuals in the job market or to read a control article.

The study published in the 'Journal of Experimental Social Psychology' found weight-stigmatizing news articles caused self-perceived overweight women, to consume more calories and feel less capable of controlling their eating than exposure to non-stigmatizing articles.

The answer to the paradox of New Year's Resolutions might come from a recent study inspired by the common experience that internal dialogue in golfers to avoid hitting the ball into the pond often ends with a splash.

The study entitled 'Unwanted effects in aiming actions: The relationship between gaze behavior and performance in a golf putting task', asked participants to perform a golf putting task with instructions to land the ball on the hole (neutral instructions), avoid putting too short, and avoid putting too long.

The authors, Olaf Binsch, Raoul Oudejans, Frank Bakker and Geert Savelsbergh from VU University, Amsterdam, and Manchester Metropolitan University, found that when participants gazed for longer at a specific area, the ball was more likely to land there.

The investigation, published in the journal 'Psychology of Sport and Exercise' concludes that the negative instruction, for instance, not to putt past a hole, influences mental processes during the putt. Thinking about a behaviour increases the likelihood of engaging in that response, even when the person is trying to avoid it.

Daniel Wegner and Daniel Gold showed this effect applied even to thoughts of past lovers, where they investigated the futility of the desire to put departed relationships out of mind. It seems that the harder one tries to suppress the thoughts of an 'old flame', the more one is disturbed by them.

The study entitled, 'Fanning Old Flames: Emotional and Cognitive Effects of Suppressing Thoughts of a Past Relationship', found that the suppression of thoughts of an old flame promotes the persistent psychological presence of the ex in our minds.

The authors argue, in their study published in the 'Journal of Personality and Social Psychology', that one possible explanation is that thoughts which return to mind following suppression tend to be particularly intrusive. Thoughts that pop into mind in this way seem to create greater emotional disturbance than thoughts that follow from an intentional train of thought.

Daniel Wegner, one of the pioneers in the field of ironic mental control is quoted as arguing that the secret of making successful New Year's Resolutions is to keep them affirmative and positive. Don't resolve to give up smoking - resolve instead to become more fit.

Taking up running is likely to help you give up smoking as pursuing one goal becomes incompatible with the other. Pick goals that are irreconcilable with bad habits. Positive resolutions (do's) might be easier to control than negative ones (don'ts). Don'ts require constant effort and battling with distractions.

So rather than resolving not to do something this New Year, instead determine to be more positive and do something.

Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8

 

 


What is a disorder of Attention? What is Attention Deficit Hyperactivity Disorder (ADHD)?

Raj Persaud in conversation with Heidi Feldman Professor of Psychiatry at Stanford University

Professor Heidi Feldman discusses her recent paper in the New England Journal of Medicine on ADHD

Attention Deficit--Hyperactivity Disorder in Children and Adolescents Heidi M. Feldman, M.D., Ph.D., and Michael I. Reiff, M.D. N Engl J Med 2014; 370:838-846February 27, 2014

ADHD is characterized by inattention, hyperactivity, impulsivity, or a combination of these symptoms, which compromise functioning. Management includes medications (shown to improve core symptoms but not necessarily functional outcomes) and behavioral therapies.

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

Personal bio 

Heidi M. Feldman MD PhD holds the Ballinger-Swindells Endowed Professorship in Developmental and Behavioral Pediatrics at Stanford University School of Medicine and serves as the Medical Director of the Mary L Johnson Developmental-Behavioral Pediatrics Clinical Programs at Lucile Packard Children's Hospital. She earned a PhD at the University of Pennsylvania in Developmental Psychology and an MD at the University of California San Diego School of Medicine. She is currently combining neural imaging techniques and behavioral measures to understand the outcomes of children and adolescents born preterm. She has taught Developmental Disabilities: From Biology to Policy in Human Biology at Stanford University. Dr. Feldman is also a dedicated yoga enthusiast and yoga teacher. 

 

A related article first published in The Huffington Post which may be of interest

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/childrens-mental-health_b_4068424.html

 

Is our children's mental health worse than ours? If so - why?

 

Raj Persaud and Professor Sir Simon Wessely (President of the Royal College of Psychiatrists)

 

Under a headline: 'Children as young as five suffering from depression', The Daily Telegraph Newspaper recently declared that the National Institute of Health and Clinical Excellence (NICE)  reported 80,000 children in the UK with severe depression, including 8,000 below the age of 10. Children as young as five can suffer from the psychiatric disorder; NICE affirms more identification of these children is needed.

 

A few days later The Daily Telegraph's new headline was: ''Toxic childhoods’ blamed for 22,000 self-harm cases' - beneath the headline was a byline: 'More than 22,000 children and teenagers were treated in hospital for self-harming in 2012, according to official figures which experts said showed the “toxic” effects of social media and a society obsessed with body image'.

 

Might it be more relevant that the UK currently has one of the highest divorce rates in Europe? At least one in three children here experience parental separation before the age of 16 years. Between a third and a half of all children in the UK have a non-resident parent, usually the father, during some part of their childhood?

 

A study entitled 'Trends in adolescent emotional problems in England: a comparison of two national cohorts twenty years apart', compared large samples of youth 20 years apartusing identical symptom screening in each survey. Twice as many young people reported frequent feelings of depression or anxiety in 2006 as in 1986.

 

Stephan Collishaw, Barbara Maughan, Lucy Natarajan, and Andrew Pickles from Cardiff University and the Institute of Psychiatry, London concluded was there has has indeed been a real and substantial increase in adolescent emotional problems in England over recent decades, especially among girls. The proportion of girls with five or more psychological symptoms doubled.

 

Published in the 'Journal of Child Psychology and Psychiatry', the study found that whether or not they were raised in an intact or socially advantaged family was associated with girls' mental health, but not boys'. 

 

Iryna Culpin from the School of Social and Community Medicine, University of Bristol led a team which conducted a major study entitled, 'Father absence and depressive symptoms in adolescence: Findings from a UK cohort', whose results are just about to be published.

 

This team of researchers, including J. Heron, R. Araya, R. Melotti and C. Joinson, followed up 5631 UK children, and found an association between father absence during the first 5 years of life and increased depressive symptoms at 14 years. But father absence experienced during middle childhood (5–10 years) was not associated with increased depressive symptoms at 14 years.

 

The study - to be published in the medical journal 'Psychological Medicine', found that the association between father absence during the first 5 years of life and depressive symptoms at 14 years was stronger in girls than boys.

 

But exactly why girls are more sensitive to father absence during early childhood remains a mystery. The authors of the current study point to previous work which found father absence during the first 5 years is associated in daughters with earlier timing of first period, increased rate of sexual activity and teenage pregnancy, which are, in turn, associated with increased levels of depressive symptoms in girls.

 

Dr Benjamin Baig, Clinical Lecturer, Department of Child and Adolescent Psychiatry at the Institute of Psychiatry, London, points out that the age of first period has become younger by one year over the last 80 years. He suggests that modern childhood appears to mean becoming biologically older at a younger age, and displaying adult type psychiatric symptoms, chronologically earlier.

 

Karen Schepman, Stephan Collishaw, Frances Gardner, Barbara Maughan, Jacqueline Scott and Andrew Pickles in another study, posed the specific question, 'Do changes in parent mental health explain trends in youth emotional problems?'” English adolescents in 2006 were considerably more likely to be exposed to maternal emotional problems than their counterparts in 1986. The study published in 'Social Science and Medicine' found maternal emotional problems increased across all socio-demographic groups between 1986 and 2006, mirroring increases in adolescent emotional problems over this period. 

 

So if it's not so much bad parenting - but poor maternal mental health - which could be a major culprit, should another favourite media whipping boy - new technology - also still be in the frame for rising childhood mental health problems?   

 

A study just published entitled 'Older Versus Newer Media and the Well-being of United States Youth: Results From a National Longitudinal Panel', followed 719 nationally representative young people, ages 14-24 years in the USA, and found use of older media was more related to school grades. Television was negatively, and book readingpositively related to academic performance. 

 

The authors of the study, Daniel Romer, Zhanna Bagdasarov, and Eian More from the University of Pennsylvania, conclude that despite concerns that excessive use of new media is harmful to adolescent development, it's actuallytelevision which most detracts from academic performance and book reading which most supports it. 

 

Heavy use of the Internet and video gaming may in fact be more a symptom of mental health problems than a cause. The authors of the study, published in the 'Journal of Adolescent Health' point out that withdrawal from social activity, which is a symptom of depression, leads many young people to turn to media use as a replacement for hanging out with friends.

 

Depression in adolescents is linked with clinical low mood in adults, strengthening the case for early intervention if possible  

 

Yet Child and Adolescent Psychiatrists at the country's largest mental health trusts point out they face 30% cuts over the next two years.

 

Jane Costello, Professor of Psychiatry at Duke University in the USA, comments on the predicament: 'The bottom line is that services are so scarce that it hardly matters how many kids need them—the gap between need and availability is so huge.'

 

Cycles of unhappiness repeat themselves. Parental depression is associated with child and adolescent emotional problems, via a variety of pathways, and certainly not just genetic.

 

Given that parental mental health problems are amongst the strongest predictors of child and adolescent emotional disordersthis raises the prospect of a ‘vicious cycle’ of inter-generational transmission of anxiety and depression.

 

More support for Child and Adolescent Mental Health Services, is an investment not just for the present, but for the future.

 

49th Maudsley Debate: ‘Sick Children or Sick Society?’

 

“What should we make of the seemingly inexorable rise in psychiatric diagnoses in children?” Tuesday 15th October 2013, 6pm to 8pm (refreshments served from 5.30pm) Wolfson Lecture Theatre, Institute of Psychiatry Main Building, De Crespigny Park, London SE5 8AF. All Welcome.

 

 


Funeral Mania explained. Is there such a thing as 'Funeral Mania'?

It is said some go high at funerals - is this a real phenomenon?

Raj Persaud in Conversation with Katherine Keyes. 

Katherine Keyes is Associate Professor of Epidemiology Columbia University and with serveral colleagues had published a study in the 'American Journal of Psychiatry' investigating what happens when people suffer one of the worst stresses of all - the unexpected death of a loved one. She talks to Consultant Psychiatrist Raj Persaud about her study which with colleagues appears to have verified there really is such a thing as 'Funeral Mania'.

The Burden of Loss: Unexpected Death of a Loved One and Psychiatric Disorders Across the Life Course in a National Study

Katherine M. Keyes, Ph.D.; Charissa Pratt, M.P.H.; Sandro Galea, M.D., Dr.P.H.; Katie A. McLaughlin, Ph.D.; Karestan C. Koenen, Ph.D.; M. Katherine Shear, M.D.

Am J Psychiatry 2014;171:864-871. doi:10.1176/appi.ajp.2014.13081132

Abstract

Objective  Unexpected death of a loved one is common and associated with subsequent elevations in symptoms of multiple forms of psychopathology. Determining whether this experience predicts novel onset of psychiatric disorders and whether these associations vary across the life course has important clinical implications. The authors examined associations of a loved one’s unexpected death with first onset of common anxiety, mood, and substance use disorders in a population-based sample.

http://www.amazon.co.uk/Dr-Raj-Persaud-Latest-Users/dp/B0082XNF40

 

A related article from The Huffington Post which may be of interest:

 

 

Do Near Death Experiences Finally Confirm the After-life?

RAJ PERSAUD AND PETER BRUGGEN

A new near death experience study, widely reported in the media this week, found high levels of brainwaves at the point of death in rats. Published in the journalProceedings of the National Academy of Sciences, the University of Michigan research discovered in the 30-second period after the rodent's hearts stopped beating, there was a sharp increase in high-frequency brainwaves.

'Near death experience' or NDE research remains a key divide between religion and science - can consciousness function independently of the human body, and therefore, survive bodily death? Could this then prove the existence of a 'soul', and confirm ghosts, plus other paranormal or spiritual phenomena?

A near death experience is defined as unusual recollections associated with a period of unconsciousness during either serious illness or injury, or resuscitation from a cardiac or respiratory arrest. Some people who might have been technically dead, seem to report experiences 'near or beyond death'.

Dean Mobbs from the Medical Research Council Cognition and Brain Sciences Unit, Cambridge and Caroline Watt from the University of Edinburgh Department of Psychology, recently published a paper entitled, There is nothing paranormal about near-death experiences: how neuroscience can explain seeing bright lights, meeting the dead, or being convinced you are one of them, which vigorously rejects any spiritual account.

Published in the journal 'Trends in Cognitive Sciences', Dean Mobbs and Caroline Watt explain that while 3% of Americans declare near-death experiences, such as feeling the soul leaving the body, approaching a bright light and entering another reality, where love and bliss are all encompassing, there are other scientific accounts for all these phenomena.

They report over 50% of those who recount near-death experiences were not in fact in that much mortal danger, so a serious problem for the spiritual account is that, for many experiencers, NDE's aren't revealing what happens near death, but merely what happens when one believes one is in danger of dying.

The lead author of the rat study so widely reported this week, Dr Jimo Borjigin, suggested that the dying brain was also not shutting down as might be expected, but instead, "If anything, it is much more active during the dying process than even the waking state."

Dean Mobbs and Caroline Watt also point out that psychiatric phenomena such as 'Cotard' or 'walking corpse' syndrome, named after the French neurologist Jules Cotard, which results in the feeling and conviction of being dead, could explain some of the peculiar sensations reported in Near Death Experiences.

Mobbs and Watt report that in NDEs, 50% experience being dead, 24% said that they had had an out-of-body experience, 31% remembered moving through a tunnel, and 32% reported meeting with deceased people. Mobbs and Watt contend that electrical stimulation of brain regions can result in a sense of presence (i.e. someone is standing behind us). Meeting deceased people could therefore be hallucinations due to compensatory over-activation in brain structures near areas damaged by whatever is causing death.

But other academics vigorously disagree with Mobbs and Watts attempts to explain Near Death Experiences invoking a purely scientific or non-spiritual account.

For example, in a paper entitled Seeing Dead People Not Known to Have Died: "Peak in Darien" Experiences, Bruce Greyson from the Division of Perceptual Studies, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health System, argues that in his collection of 665 NDEs, 138 (21%) included a purported meeting with a deceased person, whereas only 25 (4%) included an encounter with a living human.

While this discrepancy might be viewed as evidence of post-mortem survival of the persons seen, it might also be no more than an expression of the dying person's expectations of imminent death.

But Bruce Greyson points out that more troubling for the scientific account of Near Death Experiences is where those on their deathbeds see, and often express surprise at meeting, a recently deceased person, of whose death neither they nor anyone around them had any knowledge. This excludes the possibility that the vision was a hallucination related to the experiencer's expectations.

Such NDEs are termed "Peak in Darien" cases, after a book by that name published in 1882 by Frances Power Cobbe. The title is taken from a John Keats poem describing the shock of the Spaniards, who, after scaling a peak in Darien (in what is now Panama), expect to see a continent, but are confronted instead with another ocean.

Bruce Greyson reports in his paper, published in the academic journal 'Anthropology and Humanism', many examples, including that of Physician K. M. Dale who related the case of 9-year-old Eddie Cuomo, whose fever finally broke after nearly 36 hours of anxious vigil on the part of his parents and hospital personnel. As soon as he opened his eyes, at 3:00 in the morning, Eddie related that he had been to heaven, where he saw his deceased Grandpa Cuomo, Auntie Rosa, and Uncle Lorenzo. Then Eddie added that he also saw his 19-year-old sister Teresa, who told him he had to go back. His father became agitated, because he had spoken with Teresa, who was attending college in Vermont, just two nights ago. Later that morning, Eddie's parents learned that Teresa had been killed in an automobile accident just after midnight, and that college officials had tried unsuccessfully to reach the Cuomos at their home.

Bruce Greyson relates many other examples, including cases in which the deceased person seen was someone whom the experiencer had never known. For example, Greyson reports cardiologist Maurice Rawlings describing the case of a 48-year-old man who had a cardiac arrest. In a NDE he perceived a gorge full of beautiful colours, where he met both his stepmother and his biological mother, who had died when he was 15 months old. His father had remarried soon after his biological mother's death, and this person had never even seen a photo of her. A few weeks after this episode, his aunt, having heard about this vision, brought a picture of his mother with a number of other people. The man picked his mother out of the group, to the astonishment of his father.

In response to Bruce Greyson's critique that the non-spiritual account of near death experiences ignores difficult to explain phenomena as above, Dean Mobbs points out that such cases Greyson has marshalled are all anecdotal reports, and therefore difficult to rigorously verify.

The spiritual understanding of what happens to us differs from the scientific view because it places greater faith in human experience, and these death-bed stories. Science demands proof that comes from brain scanners, replication and precise measurement.

But because these extraordinary accounts will always exist, does that mean religion will forever survive the onslaught of science?

Or could it be that our first proper glimpse of heaven will instead shortly arrive from a brain scan?

 

 

 

 

This podcast has been made on behalf of the Royal College of Psychiatrists (UK) by Raj Persaud and Peter Bruggen

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

 

For more general podcasts visit: www.rcpsych.ac.uk/discoverpsychiatry/podcasts.aspx


Sleep problems explained. The psychiatry of sleep problems

How to get a good nights sleep without pills?

Dr Raj Persaud in conversation with Dr Jeremy Beider. Problems sleeping are one of the commonest difficulties that doctors in the UK deal with - possibly leading to massive over-prescribing of hypnotic drugs which can be highly addictive. What are the non-pharmacological ways of achieving a good nights sleep? Raj Persaud in conversation with Jeremy Beider who was presenting on this topic at the Annual International Congress of the Royal College of Psychiatrists at the Barbican.

Jeremy Beider is a consultant in adult psychiatry in West London Mental Health Trust and holds a MSc in Behavioural Sleep Medicine from Glasgow University.

He has Clinical experience at Guy’s and St Thomas’ Sleep Disorders unit and the National Neuropsychopharmacology Clinic UK

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

As a Dream Predicts Lottery Win, and Malaysian Airlines Passenger Posts Eerily Prophetic Picture - Can Dream and Visions Foretell the Future?

 

RAJ PERSAUD AND PETER BRUGGEN

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/lottery-dream_b_5605068.html

 

The UK press has reported that a judge recently ordered a restaurant owner to split half of a million pound lottery prize with his waiter, because of a dream foretelling the future.

The boss of a Turkish restaurant in York, England, bought the winning lottery ticket following a vivid dream experienced by his superstitious employee, predicting the win.

Judge Mark Gosnell's ruling followed a protracted legal dispute between the two men as to whom the prize money belonged to. The Judge's final decision, that the jackpot had to be split by the boss with his waiter, partly turned on a premonition.

It is reported that the waiter dreamt that he was holding a large bundle of cash and standing in front of him was his boss. Being a strong believer in the power of such visions, the dreamer interpreted this to mean that he and his boss would scoop the lottery.

The following day the waiter apparently "pestered" his boss for hours, before the restaurant owner finally agreed to enter the EuroMllions draw.

The judge examined CCTV footage from the restaurant which showed the two men filling in the winning ticket, and ruled in the waiter's favour, accepting the dream explanation was "plausible".

While anecdotal reports of dreams predicting the future abound, Parapsychologists are interested in scientifically testing whether foretelling the future might be possible.

For example, a paper entitled, 'An ostensible precognition of the Arab surprise attack on the Day of Atonement, 1973', published in 1986 by Gilad Livneh, in the 'Journal of the Society for Psychical Research', presented just such a compelling case. A letter to Israeli Prime Minister, Golda Meir, was discussed in which a woman reports her vision about an Arab attack, two weeks before the actual event took place.

While accurate prophecy was a plausible explanation, however, the author also conceded that chance coincidence could not be ruled out, due to the inconsistency of certain details between the dream, and the actual event itself.

Caroline Watt, Natalie Ashley, Jack Gillett, Megan Halewood and Rebecca Hanson from the Department of Psychology, University of Edinburgh, have just published one of the most recent systematic studies on prophetic dreams.

These authors report surveys showing that around one quarter of the population believes in the ability to foretell the future, while about one third report 'precognitive' experiences (precognitive means literally fore-knowing).

The authors also point out the scientific and public importance should some dreams indeed turn out to be reliably prophetic. For example, if such precognitive dreams contain trustworthy information, it might be possible to warn of forthcoming disasters, or even to prevent them from occurring.

This has particular resonance right now given a Dutch passenger feared dead, is recently reported to have posted a photo of the Malaysian Airlines Jet he was boarding, destined to crash in the Ukraine, with the message: "if we disappear, this is what the plane looks like".

Caroline Watt, Rebecca Hanson and colleagues point out that following the Aberfan disaster the British Premonitions Bureau was set up in London, and in the USA the Central Premonitions Registry was established. Both appear to have faltered partly due to an insufficient number of predictions that could be related to specific incidents.

Linking an incident which has now happened with a prior dream could merely be a tendency to see patterns facilitated by the benefit of hindsight.

In another past study reported by the authors of the latest research, participants were asked to document their dreams upon awakening, and then to mail a copy to the researcher. The dreamers were asked to notify the investigator if they noticed any events occurring that corresponded to their dreams. In one series, it was judged that only two out of 265 dreams (over an 8-week period) appeared 'moderately' prophetic.

Caroline Watt, Rebecca Hanson and colleagues' current paper, entitled 'Psychological factors in precognitive dream experiences: The role of paranormal belief, selective recall and propensity to find correspondences', investigated the part of selective recall in prophetic dream experiences. Participants read two diaries, one purporting to be a dream diary, and one claiming to be a diary of incidents in the dreamer's life. The events either confirmed or disconfirmed the reported visions.

A significantly greater number of confirmed than disconfirmed dream-event pairs were recalled by participants taking part in the experiment, possibly indicating a human tendency to see connections over unconnected happenings.

The authors argue that their research, published in the 'International Journal of Dream Research' in April 2014, explain the seeming coincidence between dreams and events that can be interpreted as prophetic.

Two possible psychological mechanisms - selective recall and propensity to find correspondences seem to lead us to experience many more dreams apparently foretelling the future, than may genuinely exist.

These explain the discrepancy between the dearth of scientific support for prophetic dreams, compared with the rather frequently reported experience in the general population, of having dreamed about a seemingly unpredictable future event.

Psychologists Gergo Hadlaczky and Joakim Westerlund from Stockholm University have published a study in 2011 which argues that how surprised you are by coincidences could predict how likely you are to end up believing in phenomena such as parapsychology and the supernatural.

The study entitled 'Sensitivity to coincidences and paranormal belief' and published in the journal, 'Perceptual and Motor Skills' exposed participants to artificial coincidences, who were asked to provide remarkability ratings. Those who were more surprised, when experiencing coincidences, tend towards higher paranormal belief (beliefs such as in telepathy etc).

The most obvious explanation for many coincidences is 'just chance'. Tending to be more surprised by coincidence suggests a tendency to reject the 'it's just chance' account. For example, there will be some who put it down to just chance that two Malaysian Airlines Jets should suffer catastrophe in a short space of time. Others will be much more surprised.

It's possible that a tendency to be more shocked by coincidence simply betrays poor probability reasoning. But it could also have positive survival value in an evolutionary sense. Being more paranoid may mean seeing patterns in what others assume are random events.

Being more astonished by coincidence, could have made you more vigilant for threat in our ancestral environment, more paranoid, and therefore more able to detect and defend against predators in our ancestral past. We could be genetically wired up to be surprised by coincidence.

But paranoia and surprise by chance is only helpful if it leads to an actual action that then produces a positive outcome. The passenger reported to have posted the prophetic internet message about the Malaysian Airlines Jet due to be flying over Ukraine, apparently still did board the plane.

The recent lottery-winner case appears an excellent example of a kind of quasi-scientific proof that dreams can foretell the future, because the person who had the dream then engaged in an action the next day as a direct result - persuading his boss to buy a lottery ticket.

Yet if the waiter in the most recent legal judgement ruling was so convinced by his prophetic dream - why did he not take more precautions to safeguard his claim to the win?

Why did he not foresee that sharing the ticket purchase with his boss was going to lead to a protracted legal battle?

Depending on how you interpret it, this could become an example of how dreams or visions don't really predict the future.

 

This podcast has been made on behalf of the Royal College of Psychiatrists (UK) by Raj Persaud and Peter Bruggen

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

 

For more general podcasts visit: www.rcpsych.ac.uk/discoverpsychiatry/podcasts.aspx


The science of hearing voices

Raj Persaud in conversation with Professor Peter Woodruff. Professor Peter Woodruff from Sheffield University and Raj Persaud discuss the latest neuroscience research on hearing voices or auditory hallucinations with Raj Persaud - the conversation was recorded at the Annual Congress of the Royal College of Psychiatrists at the Barbican. The latest neuroscience developments appear to hold out the prospect of innovative new non-drug related therapies.

 

Professor Peter W R Woodruff MBBS PhD MRCP FRCPsych

Professor and Head of Academic Clinical Psychiatry
Director of the Sheffield Cognition and Neuroimaging Laboratory (SCANLab)
Deputy head of the Section of Neuroscience

  • 1 July 1999 – present: Professor and Head of Academic Clinical Psychiatry, University of Sheffield & Honorary Consultant Psychiatrist, Sheffield Care Trust (from 1 July 1999)
  • 1997- 1999: Senior Lecturer in Psychiatric Neuroimaging University of Manchester
    Honorary Consultant Psychiatrist, Mental Health Services of Salford.
  • 1995 – 1997: British Telecom Research Fellow in Functional MRI, Institute of Psychiatry London
    Senior Lecturer in Psychiatric Neuroimaging/Hon Consultant Psychiatrist in Psychiatric Intensive Care, Maudsley Hospital London
  • 1994 – 1995: Fulbright Fellow in Functional MRI, Harvard Medical School & Massachusetts General Hospital USA
  • If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

A related article which may be of interest originally published in The Huffington Post:

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/washington-shooting-naval-yard_b_3960983.html

 

 

Could Psychiatrists Have Prevented the Washington Naval Yard Shootings?

 

Raj Persaud and Peter Bruggen

 

As reports began to appear of the disturbed background of Aaron Alexis, the media seems to have universally decided that mass shootings are readily explained by severe mental illness.

 

The assumption is that as psychiatric disorder is so obviously linked to violence, there should be no surprise that the Washington Naval Yard killings involved someone with a mentally troubled history.

 

New research finds that media reporting of mass murder, such as this most recent tragedy, leads to more negative public attitudes to the mentally ill. This in turn may contribute to a pessimistic stereotyped image for psychiatric problems and services. As a result, people who suffer symptoms, as it appears Aaron Alexis could have, may not access treatment which possibly prevents these atrocities.

 

 

A vicious cycle is thus created, ironically perpetuated by media coverage. Is it possible the reporting is part of the cause of such senseless violence? Not because this encourages one sub-type of mass killers - 'infamy seekers' (which it may do) but also as it may discourage early psychiatric intervention?

 

 

Emma McGinty, Daniel Webster and Colleen Barry, from the Johns Hopkins Center for Gun Policy and Research, and the Johns Hopkins Bloomberg School of Public Health, Baltimore recently found that reading a news story about a mass shooting, heightened negative attitudes toward sufferers from mental illness.

 

 

The study entitled 'Effects of News Media Messages About Mass Shootings on Attitudes Toward Persons With Serious Mental Illness and Public Support for Gun Control Policies', involved a national sample of almost two thousand participants. Their findings suggest public perception is that serious mental illness, more than access to guns, accounts for mass shootings.

 

 

The study, recently published in the 'American Journal of Psychiatry', concludes that in the aftermath of mass shootings, the barrage of news stories describing the shooter with psychiatric symptoms, his history, and his actions during the shooting might raise public support for gun control policies. But such coverage also contributes to negative attitudes toward the mentally ill.

 

 

The authors go on to point out that pessimistic public attitudes are linked to poor treatment rates among persons with serious mental health conditions.

 

 

But if there were better psychiatric services, and if the taboo surrounding mental illness was less, so more people accessed better treatment earlier, would it make a difference to these tragic shootings? Could psychiatric interventions prevent these atrocities in the future?

 

 

'The American Journal of Psychiatry' was partly prompted by the Johns Hopkins media effects study, to wrestle with the question of how psychiatrists could make a difference to the apparently rising incidence of mass killing incidents.

 

 

Psychiatrists Richard Friedman and Robert Michels, were in fact responding to the Newtown Connecticut school shooting, at the time of their editorial. Yet their comments anticipate the likelihood that such tragedies would recur soon.

 

 

They did indeed, when Aaron Alexis recently killed 12 people in the Washington Naval Yard.

 

 

The media reports suggested the navy contractor was wrestling with mental illness. He appears to have been hearing voices and complained he was being followed by people using a microwave machine to send vibrations through his body.

 

 

Doctors Friedman and Michels agree that mass killings attract the kind of blanket media coverage which can create misleading impressions. For example, the attention they attract distracts from the fact mass killings are very rare. Friedman and Michels point out that in 2011, mass killings accounted for only 0.13% of all homicides in the United States.

 

 

Friedman and Michels believe the conundrum the public find most difficult to grasp is that although mass murderers probably suffer more mental illness than other killers, the mentally ill as a group actually pose relatively little risk of violence.

 

 

For example, their editorial entitled 'How Should the Psychiatric Profession Respond to the Recent Mass Killings?' quotes that only 4% of violence generally can be attributed to persons with mental illness. The prevalence of violence amongst those with serious mental illness throughout their lifetime is 16%, as compared with 7% among people without.

 

 

Alcohol and drug abuse are far more likely to produce aggression. Those who abuse alcohol or drugs but have no other mental disorder, are nearly seven times as likely as those without substance abuse, to commit violence.

 

 

One possibility is that improving mental health services might make a difference; Aaron Alexis appears to have fallen through the net of treatment.

 

 

But, remarkably, should a psychiatrist have been able to evaluate this man before the shootings, suffering though he appeared to be from hearing voices and delusions, it's not clear he could have been easily detained involuntarily by current mental health legislation. The law, both in the USA and the UK, supports doctors in seeking involuntary admission to hospital, only if they can convince the authorities that a patient is an immediate danger to himself or others.

 

 

Perhaps in the wake of these recent shootings, involuntary mental health legislation and practice should be loosened from 'imminent danger', to a 'reasonable likelihood of violent behaviour'.

 

 

But Friedman and Michels argue that lowering the threshold for involuntary treatment could discourage consulting doctors. People could become more wary of being candid or seeking help voluntarily.

 

Heightened fears of being committed to an institution against their will, might mean some of most unwell patients would be driven further away from the mental health system.

 

 

Mental illness is very treatable, and sufferers can and do return to productive well-being with the right healing, implemented early enough. Yet the fear of being 'locked away' forever in an asylum continues to stigmatise the system.

 

 

As psychiatrists, when we hear these tragic stories of what mental disturbance lay behind a mass shooting, we have a further concern. It is that sufferers from these severe psychiatric symptoms, over and over again, were not receiving adequate treatment.

 

 

The media clouds the key lesson to be learnt, which is that it's neglected and untreated mental illness, not psychiatric disorder alone, which is involved.

 

 

If the truth was more widely understood, about how effective modern treatment of psychiatric problems can be, particularly if dispensed by properly trained professionals, then it is possible that these incidents could indeed become rarer. Clinics might then attract adequate public funding, and even better clinicians, which would all help services become ever more effective.

 

 

Some may possibly argue that even the best mental health system would likely have little impact on deterring mass killings, as some of these killers largely avoid psychiatric treatment - but for the others - and those who might be influenced by friends and relatives observing something amiss, we still believe there could be a worthwhile impact.

 

 

If the USA is not going to embrace tougher gun control, as it appears reluctant to, then it may well be even more imperative they develop absolutely excellent mental health services.

 

In the aftermath of yet another mass shooting tragedy, this might just be our only hope.

 

 

Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


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