Post Of The Week – Saturday 7th May 2016

1) Google And Health Data

In thinking about classification and diagnosis during lessons, we have had on the horizon for a while the idea that diagnoses of mental illness will be made on the basis of biomarkers measured via mobile devices. The data these devices generate has to be held somewhere. Stories have emerged this week about what happens to the data Google is currently collecting in projects with various healthcare providers. The best discussion of this is here.

https://theconversation.com/google-is-now-involved-with-healthcare-data-is-that-a-good-thing-58901

 

2)  A Couple From Neurosceptic

Firstly, here’s a piece about the nomenclature and categorisation of drugs.

“Neuroscience-Based Nomenclature” for Mental Health?

I’ve been marking work recently where people have had to describe the mode of action of antidepressants. This article describes a pair which proposes that rather than categorising drugs by their function – antidepressant, antipsychotic – we should categorise drugs according to their mode of action. This sounds sensible but there may be a sinister motive. Removing the function encourages off label prescriptions.

Secondly, here’s a piece about Ketamine.

Ketamine and Depression: A Breakthrough?

We’ve been impressed by the claim that SSRIs work because they reduce levels of serotonin, causing a rebalancing in the brain which has an antidepressant effect. There’s a similar story here about ketamine. It is a metabolite produced in the body’s reaction to Ketamine which has the antidepressant effect. The experiments are complicated and on non-human animals but we are moving closer to understanding the mechanisms by which drugs work.

 

3) More On Mindfulness

Here is some follow-up to the post on mindfulness from last week.

Is mindfulness safe?

This article, co-written by Willem Kuyken, compares mindfulness to exercise. Nobody denies that physical exercise is good for you but how you do it, how much you do and who keeps an eye on you all matter. It’s the same with mindfulness training.

Secondly, here is the estimable Ruby Wax talking about mindfulness and studying for a master’s degree in mCBT at Oxford.

https://www.alumni.ox.ac.uk/alumni-voices-podcast-interviews-oxonians

Finally, here is a piece by Zindel Segal which explains both some of the processes of mindfulness and how these processes can be observed and understood in brain imaging.

Mindfulness Changes How We Process Sadness

 

4) Pim Cuijpers On Preventing Depression

In our courses, we learn about the treatment of mental disorders. There is nothing about the prevention of them. There is a reason for this. In the UK, little work has been done on this. In other countries, notably Germany and Australia, prevention is more of a priority. In this podcast, Pim Cuijpers describes his trial of an internet based programme designed to prevent depression. It is interesting to hear him talk.

You can read about the trial here.

Web-based guided self-help can prevent or delay major depression

The notable thing about this intervention is that it replicated online the interaction a client would have with a therapist face to face. This might tell us that it is that interaction and its quality which determines the success of a therapy.

 

5) Co-morbidity and Addiction

We have used co-morbidity as a central commentary point for interventions for addiction. An intervention could in theory be highly effective but will not be so if the people to whom it is addressed use their addictive behaviour as self-medication for an underlying psychological problem.

Searching for solutions: a new brief intervention for comorbid substance misuse in acute psychiatric inpatients

This article concerns interventions to address cannabis and alcohol use in people admitted to psychiatric wards. The experimental group in this trial received an intervention with elements of Motivational Interviewing and CBT. It proved not to be significantly effective than the control intervention, having addictive behaviour monitored. The article notes the difficulty of studying this type of patient. They refuse treatment or they move settings quickly.

A further study looks at the treatment of co-morbid depression and alcohol abuse.

The statistics on the extent of the problem are telling. It is estimated that 30-40% of individuals with an alcohol use disorder, experience an episode of comorbid depression.

Depression in patients with alcohol use disorders

The article alludes to a traditional approach to co-morbidity which crops up on one of the videos we watch: sort out which of the two conditions is the main one and treat that. Current approaches try to treat both together while distinguishing in people with addiction to alcohol between independent depression and substance-induced depression. For both types of co-morbid depression, interventions with drugs can be effective, at least in the short term.

 

6) Tobacco Packaging

This has been a fascinating area of study this year, seeing how evidence in this area is building up and how tobacco companies fight against it. The European Court Of Justice has just ruled that an EU law which standardise packaging and control the size of health warning is appropriate and necessary. As a separate case is still in the British courts, this is likely to run for a bit longer yet.

http://www.bbc.co.uk/news/business-36200778

 

7) Obese Labradors

This news story concerns dogs and an abnormality in the POMC gene which was associated with weight, obesity and appetite.

http://www.bbc.co.uk/news/science-environment-36170267

This is important because a similar abnormality has been found in humans. The article states that “Research suggests that over 100 genes influence body weight in humans. Most function within the brain and are involved in eating behaviour.”

 

8) Neurohype

A news article appeared last week about a study showing brain activity in relation to language. Here is how the BBC reported it.

http://www.bbc.co.uk/news/science-environment-36150503

What was and wasn’t found is elegantly summarised by Neurosceptic here.

Words On The Brain: A Semantic Map of the Cortex

 

9) All In The Mind

This is worth a listen.

http://www.bbc.co.uk/programmes/b078z5mb

The first half of the programme deals with the grief and depression a doctor mother experienced following the sudden death of her daughter. The second half looks at the representation of psychology and neuroscience in the arts, including discussion of a play set in the future where whole areas of memory can be excised.

 

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