Booster Shots

Oddities, musings and news from the health world

Category: Depression

How are sadness and happiness like diseases? They're infectious, study finds

July 8, 2010 | 12:20 pm

Face Is sadness a sickness? It appears to spread like one, a new study has found.

Researchers at Harvard University and MIT wanted to see if a mathematical model developed to track and predict the spread of infectious diseases such as SARS and foot-and-mouth disease could also apply to the spread of happiness -- and found that it worked. 

They used data collected from 1,880 subjects in the Framingham Heart Study, a long-term research effort that has followed subjects since 1948 (and added some new ones along the way), giving them physical and emotional exams every two years. At each visit, subjects were classified as content, discontent or neutral. The researchers monitored how these emotional states changed over time and how these changes depended on the emotions of the people with whom the participants came into contact.

When the information was put into a traditional infectious-disease simulation, slightly modified to reflect the unique qualities of emotional spread rather than actual disease, the researchers found a correlation between an individual's emotional state and those of the person's contacts.

In other words, it appears that you can catch happiness. Or sadness. Moreover, the "recovery time" doesn't depend on your contacts at all, which is a hallmark of diseases but surprising in an emotional context, since continuing contact with happy or sad people could be expected to affect one's emotional state even after the initial "infection."

People were found to "recover" (return to neutral) more quickly from discontent than from content; on average, a contentedness "infection" sticks around for 10 years, but it takes only five years to recover from discontent. While this may still seem like a long time, the work focused on long-term emotional states because they are more accurate measures of general life satisfaction than fleeting moods, which are already known to be contagious (think laughter).

On the other hand, sadness is more contagious than happiness: A single discontent contact doubles one's chances of becoming unhappy, while a happy contact increases the probability of becoming content by only 11%.

Researchers also found one way that emotions act differently than diseases -- they can arise due to events in your own life, such as a promotion or a disease diagnosis, rather than solely being "contagious." In another win for the good guys, it appears that happiness is more likely to come about spontaneously than is sadness.

A report of the emotions-as-diseases research has been published in the Proceedings of the Royal Society B.

-- Rachel Bernstein

Photo: We may recover from sadness more quickly than we do from happiness, but it appears to be more infectious. Credit: Reuters

Rodent of the Week: Why women are more vulnerable to psychiatric stress

June 18, 2010 |  5:13 pm

It’s well known that women are more susceptible to some kinds of psychiatric disorders than men. For instance, studies have found that depression and post-traumatic stress disorder are twice as common among women as among men. But why?

Rodent One theory involves a brain hormone called corticotropin-releasing factor, or CRF. It is responsible for kicking off the stress response, and it is regulated by the female sex hormone estrogen. So perhaps estrogen causes female and male brains to respond differently to CRF.

To test this, scientists at Children’s Hospital of Philadelphia and the nearby Thomas Jefferson University subjected male and female rats to a swim stress test. Then they studied their brains in minute detail.

It turned out that the female rats were more responsive to CRF – it registered more strongly in their brains than it did in the male rats. What’s more, the female rats weren’t able to tone down the hormone after their stressful swims. But the male rats were – their brain cells changed in a way that prevented some of the CRF from doing its usual job.

“The findings identify molecular and cellular mechanisms that could result in enhanced sensitivity of female rats to CRF and a decreased ability to adapt to excessive CRF,” the researchers wrote. But they cautioned that further research is needed to see if the same gender differences are at play in human brains.

The study was published this week in the June issue of Molecular Psychiatry.

-- Karen Kaplan

Photo: Advanced Cell Technology Inc.

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Which comes first: Obesity or depression?

June 10, 2010 |  1:01 pm

Obesity2 Obesity and depression are often linked, but it's not clear whether one condition tends to precede the other. One new study suggests depression may help cause obesity, but obesity doesn't necessarily cause depression.

Researchers at the University of Alabama, Birmingham, looked at data from a longitudinal study of more than 5,000 men and women ages 18 to 30. Over the 20-year study, participants' waist circumference and body mass index was measured and they were asked about symptoms of depression.

The study found that the waist circumference among the people who started the study with depression was about 1 inch larger than those who started the study reporting lower levels of depression. This was true regardless of race, gender, ethnicity and education level. In contrast, those who started the study with higher body-mass index and waist circumference did not show a change in depression symptoms over time.

"If you are interested in controlling obesity, and ultimately eliminating the risk of obesity-related diseases, then it makes sense to treat people's depression," the lead author of the study, Belinda Needham, said in a news release.

There is a possible physiological explanation why the two conditions occur together. Both conditions are linked to higher levels of the stress hormone cortisol.

The study is published in the June issue of the American Journal of Public Health.

-- Shari Roan

Photo: Tim Sloan  /  AFP/Getty Images

About 1 in 10 Iraq veterans develops a serious case of PTSD, researchers say

June 7, 2010 |  1:19 pm

It’s well known that combat takes a toll on the mental health of soldiers -- for instance, studies of people who served in the ongoing conflicts in Iraq and Afghanistan have found that those who experienced combat were two to three times more likely to develop post-traumatic stress disorder than their counterparts who remained out of harm’s way. But studies have been less consistent in determining how many soldiers develop PTSD and other mental health disorders after deployment.

PTSD So a group of experts from the U.S. Army Medical Research and Materiel Command examined 13,226 anonymous surveys completed by veterans of Operation Iraqi Freedom. Some of those veterans were part of active duty Army divisions, and others served in National Guard infantry brigades.

Using a strict definition of PTSD, the researchers found that roughly 1 in 10 survey-takers had PTSD that was severe enough to cause “serious functional impairment.” The prevalence ranged from 7.7% to 8.9% for active duty Army personnel and from 6.7% to 12.4% for members of the National Guard. In both cases, the numbers went up over the first 12 months of their deployments.

When adding serious depression to the mix, the researchers found that 8.5% to14% of the veterans had a mental health problem that made it “very difficult” or “extremely difficult” to function properly. The findings are published in Tuesday’s edition of Archives of General Psychiatry.

The problems of PTSD can last long after soldiers retire from combat duties, according to a second study from the same journal.

Researchers from UC San Francisco and the San Francisco Veterans Affairs Medical Center examined the health records of 181,093 vets who were at least 55 years old. They found that the vets who had been diagnosed with PTSD were almost twice as likely to have dementia compared with the vets who did not have PTSD.

It’s not known how PTSD would increase the risk of dementia, but the researchers offer several theories. Perhaps PTSD robs veterans of some of their cognitive reserve, leaving them more vulnerable to dementia. The chronic stress associated with PTSD may also damage the hippocampus, the part of the brain that plays a key role in learning and memory.

Scientists are researching ways of preventing cases of PTSD. A study released this year found that soldiers who received morphine within the first few hours of a painful combat injury were 50% less likely to develop PTSD than those who didn’t get the powerful analgesic. A hypertension drug called prazosin has also been shown to reduce nightmares in vets with PTSD.

-- Karen Kaplan

Photo: PTSD -- and its ill effects -- can linger long after combat ends. Credit: Rick Loomis/Los Angeles Times

In concussion's wake, sadness and anxiety thrive

May 18, 2010 | 11:09 am

In the year following a traumatic brain injury, roughly half of survivors likely experience a bout of clinical depression -- a rate almost eight times higher than that found in the general population, says a study published Tuesday in the Journal of the American Medical Assn. And those whose head trauma was followed by depression reported significantly more pain, greater mobility problems and more difficulty carrying out their usual responsibilities than those who were not plagued by post-injury depression.

Traumatic brain injury, or TBI, is sometimes called concussion. Often called the "silent epidemic," it affects some 1.5 million Americans yearly. Its symptoms are often subtle -- including personality changes, problems of memory and concentration, headaches and mood disturbances. While for most, the effects of a head trauma will clear within a year, many have more lasting effects. For at least 80,000 people a year, major disability will follow.  

The 559 participants in this study had all come to a trauma center in the Seattle area with a head injury, signs of brain trauma that could be detected by a CT scan, and at least a few complications -- including loss of consciousness, disorientation or other factors that qualified them as scoring at most a 13 on the 15-point Glasgow Coma scale. Over the next six months, and then again at eight, 10 and 12 months after the participant's injury, researchers conducted a detailed telephone interview to gauge his or her mood state and ability to function. The result, said the researchers, was likely to yield a conservative picture of how many suffered from depression.

Past efforts to measure the rate of post-brain injury depression have been limited in their usefulness and yielded estimates that ranged from 10% to 77%. While this study included participants whose injuries ranged widely in severity, its findings clearly suggest that even those thought to have had a relatively mild injury had far higher rates of subsequent depression than would be expected had they remained unhurt. Among those whose injury was considered mild to moderate, 51.9% and 51.6% suffered from subsequent depression. Among those with severe brain injury -- as measured by the Glasgow Coma Scale -- 57.1% did.

In fact, the measures that physicians use to diagnose and treat brain injury were not very good predictors of whether a survivor would go on to suffer depression. Whether or not a victim had suffered bleeding in the brain or cortical contusions -- essentially, bruises of the brain's gray matter -- didn't make much difference in the likelihood of post-injury depression. That fact underscores the limits of what is understood about brain injury and its outcomes. (You can read more about what physicians are learning about brain injury -- much of it from the experience of U.S. troops in Iraq and Afghanistan but also on the playing fields of professional and college sports too -- here, here and here.)

Brain injury survivors who were depressed near or at the time of their accidents, who had suffered post-traumatic stress disorder or had any other past psychiatric diagnosis, and those who were intoxicated on cocaine or methamphetamine had far higher rates of post-injury depression. And victims were more likely to report depressive symptoms after their injury if they fit any of the following categories: they were African American, had not completed high school, or their injury was caused by violence (as opposed to a vehicular crash, fall or recreational injury). Also, those who were engaged in litigation associated with their injury were more likely to be depressed (65.5% vs 52.2%) than those who were not.

To learn more about TBI and its sometimes-persistent effects, this comprehensive website can't be beat. To learn about local support groups and national and state efforts to improve life for those with TBI, check this website out.  

--Melissa Healy

For depression, therapy should focus on thoughts rather than behavior

May 13, 2010 | 10:24 am

Cognitive behavioral therapy can be effective for even severely depressed people, but the therapy should focus on changing how people think instead of focusing on how they behave, according to a new study.

Encouraging behavior changes to improve mood appears to make a lot of sense. Depressed people are often advised to go for a walk, visit friends and schedule activities. But it may be more helpful for therapists to work with patients on their thought processes, such as challenging negative thoughts and replacing those thoughts with more positive and realistic ideas. Researchers at Ohio State University studied 60 patients with severe depression. Various therapists treated the patients and the sessions were analyzed to rate how much the therapists relied on cognitive and behavioral methods of therapy. The patients completed questionnaires to track their depression.

The study found that patients improved when therapists focused on cognitive techniques but didn't improve when therapists focused on behavioral techniques. The effects of cognitive techniques were strongest in the first few weeks of therapy. The patients who improved the most also were the ones who collaborated with the therapist on a treatment plan and who followed the plan.

"If you're a patient and willing to fully commit to the therapy process, our data suggest you will see more benefit," the lead author of the study, Daniel Strunk, said in a news release. The study is published online in the journal Behaviour Research and Therapy.

-- Shari Roan

Hold the phone -- a new study suggests phone therapy could lessen depression symptoms

May 10, 2010 |  6:56 pm

One-on-one talk therapy isn't the only option for psychological counseling. More people are opting for doing sessions by phone, and some studies have shown good results. A new study finds that phone psychotherapy for adults with major depression may be effective, reducing the severity of symptoms and even helping them to recover.

L07jiqnc The study focused on 30 men and women age 18 to 65 who had not seen a psychotherapist in the last month, were not bipolar and did not have a psychotic disorder, and had not been on antidepressants in the last six months. After enrolling, the participants could seek any other kind of treatment during the study.

More than three-fourths of the group had at least eight phone sessions with a therapist, and 90% had at least four sessions. Researchers evaluated the study subjects at three and six months to see if depression symptoms had changed.

From the beginning of the study to three months, symptom severity had, on average, gone from severe-moderate to moderate-mild. Symptoms lessened more from three to six months, but the change was not as dramatic. At the end of the study, 42% of people were considered cured, and 69% were very satisfied with their treatment. No significant differences were seen among those who took or didn't take antidepressants while receiving the counseling.

"Offering a phone or webcam option for psychotherapy does appear warranted from an efficacy point of view," said Diane Spangler, co-author of the study, in a news release. The Brigham Young University psychology professor added, "It's more user-friendly -- no commutes, more flexibility of place and time -- and has no side effects."

The study appears in the June issue of the journal Behavior Therapy.

Photo credit: Paul Sancya / Associated Press

Magnetic stimulation of the brain can ease drug-resistant depression, study shows

May 4, 2010 | 11:55 am

Daily application of magnetic stimulation to the brain for about 37 minutes can ease depression in patients who are not responding to antidepressants, researchers reported Monday. The procedure -- in effect, a mild form of electroconvulsive therapy, or ECT, which has been shown to be very effective against severe depression -- has been approved by the Food and Drug Administration since 2008, but critics have questioned its efficacy because of the lack of suitable blinded trials. That problem has arisen because of the difficulty of performing a sham procedure that recipients might think is an active procedure.George-rtms-magnet

Dr. Mark George at the Medical University of South Carolina in Charleston and his colleagues got around this problem by developing an apparatus that mimics the effects of the magnetic stimulator without actually producing a magnetic field. The device causes a tapping on the skull similar to that produced by the real treatment and causes eyes to twitch in the same manner. Even the physicians who were treating patients were unable to tell if a device was real or simulated.

The researchers enrolled 190 patients who had suffered from depression for at least three months but less than five years and who had not responded to antidepressants. Half received the actual treatment every weekday for three weeks, while the rest received the sham treatment on the same schedule. Ninety percent of those in the sham group completed the study, compared with 86% of those in the treatment group.

The team reported in the Archives of General Psychiatry that 14.1% of those in the treatment group had their depression relieved, compared with 5.1% of those in the control group. When both groups were given the treatment for another three weeks, 30% responded.

"This study should help settle the debate about whether [the technique] works for depression," George said in a statement. Now the team can begin to investigate ways to improve its efficacy. One possible solution, as demonstrated in the study, is to extend the treatment period for longer durations.

The device uses a magnetic coil placed on the head that pulses about 3,000 times during each treatment, stimulating a minute electrical current in the brain. In the trial, the field was focused on the top left front part of the brain. The patient is conscious during the procedure and there appears to be no significant side effects. Patients can drive themselves home afterward. 

In ECT, in contrast, electrodes placed against the skin emit an electrical current that passes through the brain, causing convulsions. Patients must be sedated and have to be driven home afterward. Clinical trials are testing the new technique against a variety of other problems, including tinnitus [ringing in the ears] and schizophrenia.

The study was funded by the National Institute of Mental Health.

-- Thomas H. Maugh II

Photo: Fourteen percent of depressed patients responded to a three-week course of treatment by magnetic stimulation of the brain. Credit: Dr. Mark George / Medical University of South Carolina

Antidepressant use may be higher among Type 2 diabetics

April 16, 2010 |  3:23 pm

Use of antidepressants has gone up over the years, but those with Type 2 diabetes may be taking more than the general public.

Jpcysvnc That's what researchers discovered in a longitudinal study of people with and without diabetes who were part of a Finnish study. They looked at antidepressant use among 493 people who developed Type 2 diabetes as well as a group of 2,450 people without the disease, which acted as a control. Those findings were compared with antidepressant use among 748 people who developed cancer along with 3,730 who did not. The use of antidepressants was tracked for four years before a diagnosis of diabetes or cancer as well as four years after, and for the same number of years for the control groups.

Among the diabetics and non-diabetics, antidepressant use showed the same general rise during the eight years, which researchers believe is consistent with general antidepressant use. But antidepressant usage among those with Type 2 diabetes was twice that of non-diabetics over the study period. Also, antidepressant use among diabetics spiked temporarily during the year people were diagnosed.

Antidepressant use among those with and without cancer showed the same gradual increase until cancer diagnosis, when use among cancer patients rose significantly. That use continued to decline slightly after that among cancer patients, but stayed much higher compared with those without cancer.

Researchers believe the numbers show that diabetes diagnosis may not have an enduring effect on depression risk, and that the brief spike after diagnosis could represent a real increase in depression risk.

As for why antidepressant use was higher in diabetics before diagnosis, the study authors float a few theories, including the fact that depression could increase the risk of Type 2 diabetes, since common depression symptoms are eating more--especially fat- and sugar-laden foods--and exercising less.

The study was published online this week in the journal Diabetes Care.

-- Jeannine Stein

Photo credit: Joe Raedle / Getty Images

Many smokers are depressed

April 14, 2010 |  8:54 am

Despite the now well-known and far-reaching effects of smoking, more than one-fifth of Americans still smoke. Why?

Smoking For many, it may be hard to quit because they also have depression. According to government statistics released Tuesday, 43% of adult smokers age 20 and older have depression. Among men ages 40 to 54, a whopping 55% of those who smoke have depression. Among women ages 20 to 39 who smoke, 50% have depression.

The report, drawn from the National Health and Nutrition Examination Surveys of 2005 through 2008, also found depressed smokers are heavier smokers. Depressed people were more likely to smoke within five minutes of awakening and to smoke more than one pack of cigarettes a day. Twenty-eight percent of adult smokers with depression smoked more than a pack a day, which is almost twice the rate for adult smokers without depression.

Smokers with depression were also much less likely to have tried quitting. However, other studies have demonstrated that smokers with depression can succeed with intensive treatment. These treatments usually include therapies for help with depression and smoking cessation.

The report was published by the National Center for Health Statistics. Information on smoking cessation for people with depression can be found on the government website Smokefree.

-- Shari Roan

Photo: Kirk McCoy  /  Los Angeles Times


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