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August 2011



Recent Posts


By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on August 12, 2011


A new research report finds that depressed women may be at a higher risk for a cerebrovascular accident (CVA) or stroke.


Researchers following women participating in the Nurses’ Health Study discovered a history of depression was associated with a 29 percent increased risk of total stroke — even after considering other stroke risk factors.


Their findings are reported in Stroke: Journal of the American Heart Association.


Researchers also discovered women who use selective serotonin reuptake inhibitors (SSRI) class of anti-depressant medication, such as Prozac, Zoloft, and Celexa, had a 39 percent increased risk of stroke.


Anti-depressant medication use may be an indicator of depression severity, said Kathryn Rexrode, M.D., the study’s senior author. “I don’t think the medications themselves are the primary cause of the risk. This study does not suggest that people should stop their medications to reduce the risk of stroke.”


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Antidepressants Bad for Babies


By | Editor Shaheen E Lakhan


Recently, two studies reported that selective serotonin reuptake inhibitors (SSRIs), a common class of antidepressant medication, increase the risk for congenital malformations and developmental disorders among children when taken by mothers during pregnancy.


The first study, published in Obstetrics and Gynecology, evaluated more than half of a million offspring over 11 years. Of these, just over 1% of the children were exposed to an SSRI during the first trimester of pregnancy. The study provided evidence for a two- to four-fold increased risk of cardiac and neural tube defects with specific SSRIs. Fetal alcohol spectrum disorders were also 10 times more likely in children exposed to an SSRI during pregnancy.


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Childhood Maltreatment Linked to Long-Term Depression Risk and Poor Response to Treatment


ScienceDaily (Aug. 13, 2011) — People who have experienced maltreatment as children are twice as likely to develop both multiple and long-lasting depressive episodes as those without a history of childhood maltreatment, according to a new study. The research, led by a team at King’s College London Institute of Psychiatry also found that maltreated individuals are more likely to respond poorly to pharmacological and psychological treatment for depression.


The results, to be published in the American Journal of Psychiatry, have emerged from a combined analysis of 16 epidemiological studies involving more than 20,000 participants and of 10 clinical trials involving more than 3,000 participants.


Depression ranks among the most common psychiatric disorders worldwide, with one in ten children exposed to maltreatment including psychological, physical or sexual abuse or neglect. By 2020, depression is predicted to be the second leading contributor to the global burden of disease across all ages, according to the World Health Organisation. The societal impact of depression is largely accounted for by individuals who develop multiple and long-lasting depressive episodes.


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Children of Depressed Mothers Have a Different Brain: MRI Scans Show Their Children Have an Enlarged Amygdala

ScienceDaily (Aug. 15, 2011) — Researchers think that brains are sensitive to the quality of child care, according to a study that was directed by Dr. Sonia Lupien and her colleagues from the University of Montreal published in the Proceedings of the National Academy of Sciences. The scientists worked with ten year old children whose mothers exhibited symptoms of depression throughout their lives, and discovered that the children’s amygdala, a part of the brain linked to emotional responses, was enlarged.


Similar changes, but of greater magnitude, have been found in the brains of adoptees initially raised in orphanages. Personalized attention to children’s needs may be the key factor. “Other studies have shown that mothers feeling depressed were less sensitive to their children’s needs and were more withdrawn and disengaged,” explained Drs. Sophie Parent and Jean Séguin of the University of Montreal’s, who followed the children over the years.


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Program Helps High School Students Overcome Depression and Thoughts of Suicide

ScienceDaily (Aug. 12, 2011) — A suicide prevention program developed at Cincinnati Children’s Hospital Medical Center has significantly helped teens overcome depression and thoughts of suicide, according to a new study.


The study, published in the September 2011 edition of the Journal of School Health, shows that students who have gone through the program, Surviving the Teens®, are significantly less likely to report that they are considering suicide, planning suicide or have attempted suicide than before participating in the program.


The study, conducted by Keith King, PhD, a professor at the University of Cincinnati College of Education, Criminal Justice and Human Services, will be published online Aug. 11 and in the print edition Aug. 16.


“The overwhelming majority of students felt Surviving the Teens helped them to learn suicide warning signs, suicide and depression risk factors, how to effectively cope with stress, steps to take if they or a friend felt suicidal, and how to talk to their parents and friends about their problems,” says Cathy Strunk, RN, suicide prevention expert in the division of Psychiatry at Cincinnati Children’s who developed Surviving the Teens.


The program is one of the few suicide prevention programs to have data supporting its effectiveness.


Strunk taught the Surviving the Teens curriculum to more than 6,000 high school students in Warren, Butler and Hamilton counties during the 2008-2009 school year. For this study, more than 900 were surveyed before going through the program and after completing the program. More than 400 were surveyed three months later.


Among the findings in self-reported behaviors, feelings, intentions and attitudes three months following the program compared to pre-test:


  • *Students who reported considering suicide decreased 65 percent, from 4.2 percent of students to 1.5 percent.
  • *Students who reported planning to attempt suicide decreased 48 percent, from 9.9 percent of students to 5.2 percent.
  • *Students who reported having attempted suicide decreased 67 percent, from 5.2 percent of students to 1.7 percent.
  • *Students who reported feeling sad and hopeless decreased 26 percent, from 22.6 percent of students to 16.8 percent.


“The program taught students how to have more self-confidence and how to engage in positive behavior, which lessens the risk of them contemplating suicide,” says Strunk.


Read More …



What Does a Depression Diagnosis Mean to You?

John Folk-Williams Updated: Aug 11th 2011


Getting a depression diagnosis is a big step in dealing with the illness. Up to that point you may have tried to ignore the symptoms or hoped they’d go away. By trying to find out more, you’ve taken action and broken the paralysis that often keeps people from getting effective treatment.


The diagnosis itself is simply a name given to a set of symptoms, but you’ll likely receive several messages along with the bare definition of what’s been happening to you. Some of those messages are hopeful, but some may be discouraging. What you hear depends on the attitudes and beliefs of the diagnosing physician. It’s easy to confuse the diagnosis with the message.


Some physicians, whether in primary care or psychiatry, are compassionate by nature and convey messages of hope and encouragement. Others express support by emphasizing their medical expertise and the importance of following their guidance for treatment. Still others reflect indifference to your emotional state and see you only as an example of a mental disorder, not as an individual.


The messages I found most hopeful were the most basic of all.


  • *You have a well-defined illness. The moods and negative beliefs about yourself, and the rest of the problems you’re living with, are all symptoms of depression.



  • *You’re not alone. Millions of people around the world also have the illness.



  • *Depression is treatable.


These are crucial messages of hope and support.


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Some Further Thoughts on Depression and Suicide

Allan Schwartz, LCSW, Ph.D. Updated: Aug 10th 2011


People have a natural tendency to empathize with those who are in the midst of painful depression. They have the same tendency to empathize with, and feel sorrow for, those who attempt or commit suicide because of the terrible suffering that caused them to commit such a tragic act. However, with full respect and feelings for those who are deeply depressed and who entertain thoughts of suicide, we need to look at some features that may make me appear to the reader as somewhat callous to their plight.


Most of us can agree with the fact that depression and suicide have to do with the individual feeling empty, hopeless and deeply despairing. Most of us subscribe to the well known theory that depression is anger turned inward, against the self, and that suicide is an attack on or murder of the self.



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The Great U.S. Depression: Antidepressant Pill Popping Numbers Up

Article Date: 05 Aug 2011 – 2:00 PDT


Antidepressants such as Prozac, Paxil and Lexapro are now the third most widely prescribed group of drugs in the United States, and Americans are popping more antidepressants than ever before. The increase doesn’t necessarily mean that the drugs are being used inappropriately, but it’s necessary to understand why antidepressant use is growing. More than 10% of Americans now take antidepressants in any given year.


Using data from annual surveys by the U.S. Centers for Disease Control and Prevention, the researchers reviewed the records of 233,144 adult patients who made doctor visits between 1996 and 2007.

The study found that the percentage of prescriptions for antidepressants written by non-psychiatrists more than doubled from about 4% to almost 9% over the 12 year period. This included 9,454 antidepressant prescriptions for patients without a diagnosis of depression or other mental illness typically treated with the medication. For that group, the rate jumped from 2.5% at the start of the study period to 6.4%.


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Antidepressants Overprescribed in Primary Care

By John M. Grohol, PsyD
Founder & Editor-in-Chief


Antidepressants have long enjoyed a reputation as being a quick and “easy” treatment for all types of depression — from a mild feeling of being a little down, all the way up to severe, life-debilitating depression.


But like all medications, they have side effects and instances where they should not be prescribed. Hence their continued need for a prescription after seeing a doctor.


So what does it mean when primary care physicians are handing them out like candy?


It suggests that your family doctor doesn’t really understand how antidepressants work, or what they are approved to treat. In short, it suggests that antidepressant medications are being over-prescribed by well-meaning doctors who are simply not using very good judgment.


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Bipolar Disorder Missed When Presenting with Depression?

By John M. Grohol, PsyD
Founder & Editor-in-Chief


Coming as a surprise to more than a few mental health professionals, a new study out today suggests that bipolar disorder is often missed in patients who present only with major depression. The study examined 5,635 adults seen at community and hospital psychiatry departments in a number of different countries.


The discrepancy was reported because of the use of “bipolarity specifier criteria” that are broader than the DSM-IV criteria, the standard for diagnosis of mental disorders by mental health professionals.


Using the broader bipolar criteria developed by the researchers found an additional 31 percent of patients who could have been diagnosed with bipolar disorder.


So what’s really going on here? Are professionals really “missing” bipolar disorder? Or have the researchers stacked the deck in this study simply to suggest it is so?


Read More …



Depression’s Other Symptoms

By Margarita Tartakovsky, M.S.
Associate Editor


The hallmark symptoms of clinical depression are no doubt sadness and loss of interest in activities previously enjoyed. Many people also are familiar with appetite and sleep changes.


But there’s a whole set of other physical symptoms that are less known but just as debilitating. In fact, depression can literally hurt. According to a study conducted at Massachusetts General Hospital and Harvard Medical School, up to about 76 percent of people who report the typical emotional symptoms also report physical signs, such as stomach problems, headaches, backaches and chest pain.


Depression also is a chameleon. It can look like various other illnesses and conditions, even, for instance, the flu. Which, not surprisingly, makes diagnosing depression tricky, and thereby finding the right treatment a big problem.



As Jodi Helmer writes in the fall 2010 issue of Esperanza, a magazine on coping with anxiety and depression:


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Smile! Parental happiness and teen depression… and other summer updates.

By On August 4, 2011


Hello everyone! It has been a while since my last posts and I have a few updates before I share with you some thoughts on a recent study on parental emotions and teen depression.


I wanted to start by thanking Dr. Anita Schimizzi, who has done an incredible job keeping child-psych running throughout the summer. We are very lucky that she is part of this project and I appreciate her very thoughtful and useful parenting posts. As I’m sure you are too, I’m looking forward to reading her posts every week.


Personally, my summer has been quite busy. Early this summer my job at the University of Michigan kept me away from child-psych. However, I’m now back but my role at child-psych will change slightly. Dr. Schimizzi will continue to post about parenting issues in general, while I will focus most of my posts on issues related to childhood and teen mood disorders (my primary area of research), and to a lesser degree, early childhood disruptive behavior problems (my primary area of clinical work).


On a more personal note, my summer was also quite busy due to some exciting life transitions. On May 29 I got married to an amazing woman and we spent some time traveling in Thailand and Japan. We are now settling back at home and getting ready to start the new academic year in September.


Ok, now for some quick thoughts on parental happiness and teen depression.


The Journal of Abnormal Child Psychology recently published a research report of a study by a team at the University of Melbourne in Australia that examined the impact of parental expression of emotions on their teen’s risk for mood disorders.


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Treating Depression By Harnessing The Power Of Positive Thoughts And Emotions

Article Date: 05 Aug 2011 – 1:00 PDT


Positive activity interventions (PAIs) offer a safe, low-cost, and self-administered approach to managing depression and may offer hope to individuals with depressive disorders who do not respond or have access to adequate medical therapy, according to a comprehensive review article in The Journal of Alternative and Complementary Medicine, a peer-reviewed journal published by Mary Ann Liebert, Inc.


More than 100 million people worldwide suffer from depression, and an estimated 70-90% either do not receive sufficient medical treatment, do not respond to therapy, or do not have access to quality care. As a result, there is an immense unmet need for alternative, economical, and effective strategies for treating major and minor depression.


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Newer Antidepressants May Be Riskier for Seniors

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on August 4, 2011


A new UK study finds that among individuals 65 or older, taking new generation antidepressants (SSRIs) is riskier than older tricyclic antidepressants (TCAs), increasing the likelihood of stroke, falls, even death.


Increased risk associated with SSRIs include dying or suffering from a range of serious health conditions including stroke, falls, fractures and epilepsy, say researchers at The University of Nottingham.


The research is published by the British Medical Journal website bmj.com.


The authors said the risks and benefits of different antidepressants should be carefully considered when prescribing these drugs to elderly patients. Additional research has been called for to further investigate the findings.


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25 Percent of Ontarians Hospitalized for Depression Required ER Visit or Readmission Within 30 Days

ScienceDaily (Aug. 3, 2011) — Twenty-five percent of people who were hospitalized for depression were readmitted or visited an emergency room again for depression within 30 days of discharge, according to a new study by the Centre for Addiction and Mental Health (CAMH). The results are published in this month’s edition of the Canadian Journal of Psychiatry.


A team led by Dr. Elizabeth Lin, Scientist in CAMH’s Social and Epidemiological Research Department, tracked hospitalizations for depression across Ontario and found that one-third of patients did not receive follow-up care. “The data tell us that while 63% of people who were hospitalized did see a physician within a month of leaving hospital, many did not, resulting in increased visits to the ER or repeat hospital stays,” said Dr. Lin. “We also found that men, older people and those who live in rural communities were more likely to fall into this group.”


The period immediately following discharge from an acute incident of depression is the most critical time for monitoring risk of relapse and suicidal behaviours. The data shows that more than 13,000 people were discharged from a hospital stay for depression and of these nearly 5,000 people did not receive appropriate follow-up care.


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Blue in the Brain – The Upside of Depression

By | Editor Shaheen E Lakhan


“You watch the world bang door after door in your face, numbly, bitterly. You have forgotten the secret you knew, once, ah, once, of being joyous, of laughing, of opening doors.”


— Sylvia Plath

Depression is generally associated with a poor intellectual and physical performance. The assumption that negativity and lack of interest in the outcome of one’s efforts are inherent to depressive states is partly accountable for this reputation. However, a recent study argues that there are certain cognitive abilities for which individuals diagnosed with depression measure better than non-depressed ones.


In a study published in 2009 — and immediately transformed into a popular story by prominent media such as The New York Times — evolutionary theory advocates forwarded the notion that depression could be seen as an evolutionary trait, developed to solve complex problems.


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