Are You Good At Recall?

Did I See What I Think I Saw?

ScienceDaily (Jan. 28, 2009) — Eyewitness testimony is a crucial part of many criminal trials even though research increasingly suggests that it may not be as accurate as we (and many lawyers) would like it to be. For example, if you witness a man in a blue sweater stealing something, then overhear people talking about a gray shirt, how likely are you to remember the real color of the thief’s sweater?

 Studies have shown that when people are told false information about an event, they become less likely to remember what actually happened – it is easy to mix up the real facts with fake ones. However, there is evidence that when people are forced to recall what they witnessed (shortly after the event), they are more likely to remember details of what really happened.

Psychologists Jason Chan of Iowa State University, Ayanna Thomas from Tufts University and John Bulevich from Rhode Island College wanted to see how providing false information following a recall test would affect volunteers’ memories of an event that they witnessed. A group of volunteers watched the first episode of “24” and then either took an immediate recall test about the show or played a game. Next, all of the subjects were told false information about the episode they had seen and then took a final memory test about the show.

The results, reported in the January issue of Psychological Science, were surprising. The researchers found that the volunteers who took the test immediately after watching the show were almost twice as likely to recall false information compared to the volunteers who played the game following the episode.

The results of a follow-up experiment suggest that the first recall test may have improved subjects’ ability to learn the false information – that is, the first test enhanced learning of new and erroneous information. These findings show that recently recalled information is prone to distortion. The authors conclude that “this study shows that even psychologists may have underestimated the malleability of eyewitness testimony.”

http://www.sciencedaily.com/releases/2009/01/090128160835.htm

Anxiety & Depression & Fertility Treatment

Fertility Treatment: Anxiety And Depression Do Not Affect Pregnancy And Treatment Cancellation Rates

ScienceDaily (Jan. 28, 2009) — Anxiety and depression before and during fertility treatment does not affect the likelihood of a woman becoming pregnant or of her cancelling her treatment, according to a new study.

Dr Bea Lintsen, a physician at the Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre (The Netherlands), and her colleagues used questionnaires to assess the levels of psychological distress in 783 women at two points before and during fertility treatment.

Results from the 421 women who completed both questionnaires showed that levels of depression or anxiety either before or during fertility treatment had no influence over cancellation rates and did not predict pregnancy rates either.

Until now, studies of the links between anxiety and depression and the success of fertility treatment have been inconclusive. Dr Lintsen believes hers is the largest prospective study yet to look at the influence of distress on the outcome of a first IVF or ICSI treatment, and that the findings are reliable.

However, she and her colleagues say the associations between psychological factors and pregnancy rates after IVF are complex and require further research into mediating factors such as lifestyle and sexual behaviour.


Adapted from materials provided by Oxford University Press, via EurekAlert!, a service of AAAS.

 http://www.sciencedaily.com/releases/2009/01/090128192131.htm

Omega-3 Fatty Acids Ease Depressive Symptoms Related To Menopause

omega3

ScienceDaily (Jan. 28, 2009)Omega-3 fatty acids ease psychological distress and depressive symptoms often suffered by menopausal and perimenopausal women, according to researchers at Université Laval’s Faculty of Medicine.

Their study, published in the February issue of The American Journal of Clinical Nutrition, presents the first evidence that omega-3 supplements are effective for treating common menopause-related mental health problems.

Dr. Michel Lucas and colleagues recruited 120 women age 40 to 55 and divided them into two groups. Women in the first group took three gel capsules containing a total of one gram of EPA, an omega-3 fatty acid of marine origin, every day for eight weeks. Those in the second group followed the same protocol, but took gel capsules containing sunflower oil without EPA.

Test results before and after the eight-week period indicate that omega-3s significantly improved the condition of women suffering symptoms of psychological distress and mild depression. “The differences we observed between the two groups are noteworthy,” commented Dr Lucas, “especially considering that omega-3s have very few side effects and are beneficial to cardiovascular health.” However, no positive effect was observed among a small group of women with more severe depressive symptoms.

Women with hot flashes also noted that their condition improved after consuming omega-3s. At baseline, the number of daily hot flashes was 2.8 and dropped by an average of 1.6 in the group taking omega-3s and by 0.5 in the control group. The change that can be attributed to the use of omega-3s, i.e. a decrease of 1.1 hot flashes per day, is equivalent to results obtained with hormone therapy and antidepressants. Details of these results were published in the November 20, 2008 online edition of the journal Menopause.

Many women suffer from depressive symptoms during menopause and perimenopause. Some take antidepressants for relief even though their effectiveness is controversial. Mistrust of hormone therapy and antidepressants leads certain women to turn to alternative methods whose effectiveness has not yet been scientifically demonstrated. This study by Université Laval researchers corrects this situation with regard to marine-sourced omega-3s.

http://www.sciencedaily.com/releases/2009/01/090128104702.htm

Medications and the Elderly

Common Medication Associated With Cognitive Decline In Elderly

ScienceDaily (Jan. 28, 2009) — A study published in Journal of the American Geriatrics Society suggested that the use of certain medications in elderly populations may be associated with cognitive decline. The study examined the effects of exposure to anticholinergic medications, a type of drug used to treat a variety of disorders that include respiratory and gastrointestinal problems, on over 500 relatively healthy men aged 65 years or older with high blood pressure.

Older people often take several drugs to treat multiple health conditions. As some of these drugs also have properties that affect neurotransmitters in the brain that are important to overall brain function, the researchers examined the total effects of all medications taken by the patients, both prescription and over-the-counter, that were believed to affect the function of a particular neurotransmitter, acetylcholine.

The findings show that chronic use of medications with anticholinergic properties may have detrimental effects on memory and the ability to perform daily living tasks, such as shopping and managing finances. Participants showed deficits in both memory and daily function when they took these medications over the course of a year. The degree of memory difficulty and impairment in daily living tasks also increased proportionally to the total amount of drug exposure, based on a rating scale the authors developed to assess anticholinergicity of the drugs.

According to study co-author Dr. Ling Han of the Yale University Department of Internal Medicine, elderly patients may be more vulnerable to these types of medications due to neurological and pharmacokinetical changes related to aging.

“This study extends our previous findings on acute cognitive impairment following recent anticholinergic exposure in older medical inpatients,” says Han. “Prescribing for older adults who take multiple prescription and over-the-counter medications requires careful attention to minimize the risk of potential harms of the drugs while maximizing their health benefits.”


Adapted from materials provided by Wiley-Blackwell.

Tanning no cure for seasonal depression

By Anne Harding

 NEW YORK (Reuters Health) – Jan. 22, 2009 – People who suffer from winter depression known as “seasonal affective disorder” or SAD — or the less severe but more common “winter blues” — shouldn’t seek relief in a tanning bed or booth, a leading expert on light therapy warns.

 SAD is often treated with daily sessions of exposure to bright light. While some isolated reports have linked tanning to improvements in mood, Dr. Michael Terman told Reuters Health, the fact is that real light therapy works through the eyes, not the skin, and uses a completely different type of light.

 Even if artificial tanning did turn out to improve mood, the increased risk of skin cancer would far outweigh its benefits, added Terman, who is the director of the Center for Light Treatment and Biological Rhythms at New York-Presbyterian Hospital in Manhattan.

 According to The Skin Cancer Foundation, the newest sunlamps produce up to as a dozen times as much ultraviolet light as real sunshine, while tanning bed users are at greater risk of developing skin cancers. UV light can also harm the eyes, Terman noted, and studies have shown the goggles people use in tanning beds and booths can allow significant amounts of the damaging rays to reach the eyes.

 Some people become clinically depressed in the fall and winter months, while many more — an estimated one-quarter of people living in the middle and northern latitudes of the US — will see a drop in mood as the days get shorter. We rely on bright morning light to reset our biological clocks every day, and when work and school obligations force us to wake up well before sunrise, our biological clocks start running out of sync with our external environment. “That is a formula for depression,” Terman explained.

 So light therapy is believed to work by resetting our biological clocks with a properly timed dose of artificial sunshine. It’s effective both for SAD and for less severe seasonal mood problems. However, ultraviolet light that tanning beds and booths use to brown the skin is not part of the prescription.

 Neither is light on the blue end of the spectrum, Terman added. Some companies have latched on to studies suggesting extra benefits to blue light by making blue-light-only light boxes, despite the lack of any evidence for their clinical benefit. In fact, he noted, this type of light is so harsh that it’s difficult for people to look at.

 The Food and Drug Administration doesn’t regulate light boxes, so there’s no guarantee that devices on the market will help, he said, and some evidence that they could be harmful, for example by failing to adequately filter out ultraviolet radiation.

 Effective light boxes use soft white lights tending toward the red end of the spectrum, and should emit 10,000 lux of illumination to be optimally effective, according to Terman. Light boxes should also have a filter or diffuser to protect the eyes and skin from ultraviolet light, he added. Staring at a naked bulb can harm the eyes, and won’t be effective, because light actually exerts its beneficial effects at the periphery of our vision.

 Terman supervises a non-profit Web site, the Center for Environmental Therapeutics (www.cet.org), that offers information on how to choose a light box, as well as a self-test that lets people figure out if they might need to see a doctor for seasonal mood problems. “There’s a tendency to want to self-treat with light therapy,” Terman said. “Self-treatment with light therapy is clearly contraindicated for anyone with major depression. There are too many ways you can do it wrong, and you’ll be even worse for it.”

http://www.reuters.com/article/healthNews/idUSTRE50L4UW20090122

Migraines and mood disorders may be connected

migraine-headache

NEW YORK (Reuters Health) – Jan. 21, 2008 – Research suggests that people who suffer from migraine headaches are at increased risk of also suffering from mood and anxiety disorders.

“An expanding body of literature has shown that migraine headaches are associated with higher rates of mental disorders,” Dr. Jitender Sareen, of the University of Manitoba, Winnipeg, Canada, and colleagues point out in a published report. However, previous studies have been subject to a number of limitations.

To better clarify this relationship, Sareen and colleagues analyzed data from the German Health Survey conducted between 1997 and 1999. Migraines were diagnosed by a doctor and trained interviewers evaluated participants for mental disorders.

Among 7,124 adults, 11.7 percent reported a history of migraine headache. According to the team, there was a significant association between having migraine headaches in the past 12 months and suffering from various mood and anxiety disorders.

“Although the cross-sectional nature of this study cannot determine causality, there are several possible explanations of the relationship between migraine and mental disorders,” Sareen’s team notes.

It may be that a common environmental or genetic factor influences both migraines and mood/anxiety disorders, they suggest. A causal relationship may also exist between mental disorders and migraines, they add, noting that this study and others found that anxiety often precedes migraine, which often precedes depression.

SOURCE: General Hospital Psychiatry, January/February 2009.

http://www.nlm.nih.gov/medlineplus/news/fullstory_74048.html

Lexapro may ease anxiety in older adults: study

By Julie Steenhuysen

 CHICAGO (Reuters) – Jan 20, 2008 - The popular antidepressant Lexapro showed promise at easing anxiety symptoms in older adults, but the effect was “modest” and would need to be studied further, U.S. researchers said on Tuesday.

 They said antidepressants like Lexapro, made by Forest Laboratories Inc and known generically as escitalopram, may be useful as a new treatment option for older adults with generalized anxiety disorder, a disabling condition that can also cause muscle tension, insomnia and fatigue.

 “We found improvements not only in anxiety and level of worry but also in functioning,” Dr. Eric Lenze of Washington University School of Medicine in St. Louis, whose study appears in the Journal of the American Medical Association, said in a statement.

 He said many people who took the drug were better able to carry out their daily activities. But for most people, he said, the drug alone is likely not enough.

 “Overall the benefits were fairly modest,” Lenze said in a telephone interview. “It will help some people a lot. Most people will probably need some sort of combination treatment.”

 Lenze’s team did uncover an unexpected benefit: the drug helped people get their blood pressure under control.

 “That suggests there can be some long-term health benefits in treating anxiety in this older age group,” Lenze said.

 While the study looked only at Lexapro, Lenze thinks the benefits would extend to all antidepressants in the class, which are known as selective serotonin reuptake inhibitors or SSRIs.

 Older patients with anxiety typically get no treatment or are given sedatives such as Valium or Xanax. And while these drugs can relieve anxiety, they can also impair thinking ability and can even lead to falls.

 In the study, Lenze and colleagues evaluated 177 people aged 60 or older with generalized anxiety disorder who got either Lexapro or a dummy pill for 12 weeks.

 They found 69 percent of patients got better, compared with 51 percent of those whose symptoms improved simply by taking a placebo. Those who took the drug showed greater improvement in both anxiety symptoms and in social functioning.

 In a more conservative analysis that included people who had dropped out of the study, the drug showed no benefit over the placebo arm. Side effects in the drug arm included fatigue, insomnia and urinary symptoms.

 Lenze is now studying the long-term effects of treatment and is also studying the drug in combination with a goal-oriented type of talk therapy called cognitive behavioral therapy.

 Forest, which faces the loss of patent protection for Lexapro in 2012, supplied drugs for the study. It was funded by the National Institutes of Health.

 (Reporting by Julie Steenhuysen; Editing by Maggie Fox, Richard Chang)

http://www.reuters.com/article/healthNews/idUSTRE50J7GI20090120

Tinnitus causes: Could my antidepressant be the culprit?

Mayo Clinic psychiatrist  Daniel Hall-Flavin, M.D., answers:

Ringing in the ears (tinnitus) can be caused by many medications, including antidepressants such as Zoloft. If your antidepressant causes tinnitus, switching to another medication may alleviate the problem.

Because there are many potential tinnitus causes — including aging, allergies, aspirin, certain infections, and certain autoimmune, neurological and psychiatric disorders — talk to your doctor if you experience ringing in your ears. He or she can help determine whether your antidepressant or another factor is causing your tinnitus.

In addition to managing your medications, other tinnitus treatments may include hearing aids, hearing aid-like devices that deliver low-level sounds to reduce the perception of ringing (masking), cognitive therapy, biofeedback, tinnitus retraining therapy, and treating conditions that are causing your tinnitus.

http://www.mayoclinic.com/health/tinnitus-causes/AN01842

www.mayoclinic.com is an excellent source for health information

Mental Health Care and Foster Children

children-chalk

How Mental Health Care Affects Outcomes For Foster Children

ScienceDaily (Jan. 15, 2009) — Of the approximately half-million children and adolescents in foster care in the U.S., experts estimate that 42 to 60 percent of them have emotional and behavioral problems. Despite the prevalence of mental health problems among foster children, little is known about how pre-existing mental health conditions affect their outcomes in foster care.

A new study co-written by Jung Min Park and Joseph P. Ryan, professors in the School of Social Work at the University of Illinois, followed 5,978 children in foster care in Illinois for several years to determine whether these children’s placement and permanency outcomes were affected by their histories of intensive mental health treatment. The statewide sample included all children and adolescents 3-18 years of age who entered foster care for the first time between 1997 and 2001. They were observed through June 2005.

Based upon child welfare and Medicaid records, the study targeted children who received inpatient psychiatric care, because it was an easily identifiable marker of serious emotional and behavioral problems, and it represented especially high levels of mental health care needs. Five percent (296) of the children had at least one episode of inpatient mental health care prior to being placed in foster care.

“According to my previous study, children who received inpatient psychiatric care ended up in foster care within two years of their first inpatient episode,” Park said.

“Children who receive inpatient psychiatric care have a substantially greater risk for parent-child separation. Our current study shows that when those children enter the child-welfare system, they are more likely to suffer poor outcomes and be left behind in the system.”

The study indicated that children with inpatient psychiatric episodes were at greater risk for frequent placement disruptions and were less likely to reunite with their families of origin or be adopted.

About half of the sample experienced more than three placement changes during their first spell in foster care. Inpatient mental health episodes among white children increased the likelihood of placement instability for them by 75 percent, while such episodes decreased the likelihood of permanence by 24 percent among African-American children.

The study also suggested that there was limited access to and underutilization of mental health services among African-American children.

“Children with a history of inpatient mental health treatment, especially when placed in foster care, benefit from continued follow-up and referrals to community mental health agencies to reduce placement disruptions and facilitate timely permanence,” Park said.

Foster-care placements come at considerable cost to taxpayers: Placement in therapeutic foster care can cost $30,000 or more annually, and placement in residential psychiatric care considerably more.

“Early identification of service needs and related interventions for children and youth with intensive mental health needs can be cost-efficient by helping them achieve placement stability and permanence,” Park said.

During the observation period, about 70 percent of the children in the study achieved permanence by returning to their families or through adoption or guardianship.

The study appears in the Jan. 2009 issue of the journal Research on Social Work Practice.


Adapted from materials provided by University of Illinois at Urbana-Champaign.

Newer Antipsychotics Pose Cardiac Risk

Patients advised to avoid the drugs in some cases

WEDNESDAY, Jan. 14 (HealthDay News) – A new study warns that the second generation of antipsychotic drugs, used to treat conditions ranging from schizophrenia to anxiety, put patients at higher risk of sudden death due to cardiac arrest.

The odds of a heart problem are low, and specialists said that the drugs are appropriate for certain patients. Still, doctors, families and patients should be cautious, said study lead author Wayne Ray, director of the Vanderbilt University School of Medicine’s Division of Pharmacoepidemiology.

“If they’re being used for schizophrenia, consider a cardiology evaluation. If you’re considering using them for bipolar disorder, think about using another alternative drug first,” Ray said.

And patients should rarely, if ever, take the drugs to treat other conditions, he said.

At issue are newer antipsychotic drugs — clozapine (Clozaril), quetiapine (Seroquel), olanzapine (Zyprexa) and risperidone (Risperdal).

Federal health officials have approved the use of the drugs to treat schizophrenia and bipolar disorder, Ray said.

Doctors also prescribe them for so-called “off-label” uses to treat conditions such as anxiety, attention deficit disorder in children and dementia in the elderly.

“For schizophrenics, they work pretty well. They’re pretty much the only alternative,” Ray said. But other drugs offer alternatives for bipolar patients, he said.

For the new study, published in the Jan. 15 issue of the New England Journal of Medicine, Ray and his colleagues expanded on earlier research that suggested the newer drugs disrupt the heart’s rhythm. The researchers examined the medical records of 44,218 patients who used the older antipsychotic drugs and 46,089 patients who used the newer ones. All the patients lived in Tennessee and were recipients of Medicaid, the government-sponsored insurance program that serves low-income people.

The researchers also looked at the records of 186,600 people who didn’t use antipsychotic drugs.

They found that users of the newer drugs were 2.26 times more likely to suffer from sudden cardiac death than those not on the medications. Those who used the older drugs were 1.99 times more likely to die versus those not taking the medications.

Patients who took the highest doses were at the highest risk. Overall, the patients had a three-in-1,000 risk of sudden cardiac death a year, Ray said.

The numbers may seem low, but they’re significant, Ray said. “If I were talking to a friend or family member, I’d advise them to avoid [the drugs] if possible.”

The drugs appear to cause problems by disrupting potassium in the heart, causing its electrical rhythm to fail, Ray said.

Dr. Sebastian Schneeweiss, an associate professor of medicine and epidemiology at the Harvard School of Public Health, co-wrote an accompanying commentary in the journal. He said that, considering the risk and lack of evidence that the drugs are useful beyond limited cases, doctors should “sharply” reduce their use to treat conditions other than acute psychosis and schizophrenia.

http://www.nlm.nih.gov/medlineplus/news/fullstory_73829.html

No Link With Asthma Med and Suicide

FDA says Singulair data do not suggest suicide link

By Ransdell Pierson

 NEW YORK (Reuters) – Jan. 13, 2008 – U.S. regulators on Tuesday said their review of clinical trials does not suggest Merck & Co’s Singulair asthma drug or similar medicines cause suicide or suicidal thought, although the data were inadequate to draw a firm conclusion.

 However, the U.S. Food and Drug Administration said it was continuing to review the data to determine if the class of drugs cause other psychiatric problems, including mood and behavioral changes. The agency noted it may take months to conclude that analysis and report its findings.

 “If the FDA safety review leads to a stern warning about behavioral changes in the Singulair label, this could frighten users of the drug or their parents and give Merck’s competitors ammunition to attack the brand,” Sanford Bernstein analyst Tim Anderson said in a research note.

 The FDA last March said it would conduct a 9-month review of safety data that raised concerns that Singulair (montelukast) might be linked to suicidal thought, suicide and behavioral and mood side effects.

 The agency also studied trials involving two other medicines that work by blocking inflammation-causing proteins called leukotrienes, AstraZeneca Pls’s Accolate (zafirlukast) and Zyflo (zileuton) sold by Cornerstone Therapeutics Inc.

 “Although these data do not suggest that montelukast, zafirlukast or zileuton are associated with suicide or suicidal behavior, these clinical trials were not designed specifically to examine neuropsychiatric events,” the FDA said. “As a result, some events may not have been reported.”

Concerns about a possible suicidal link have arrested sales growth of Singulair, Merck’s biggest product with annual sales of almost $4.5 billion.

 Singulair’s package insert label was changed in late 2007 to include a warning about such a possible association, based on reports of a few suicides among patients that have taken the medicine during its years on the market, Merck said.

“At the time we did not believe, and we still don’t think a link has been established” between Singulair and the suicides, Scott Korn, a senior safety surveillance executive for Merck, said on Tuesday after the FDA issued its partial findings.

 The FDA said it had reviewed results of 41 placebo-controlled trials involving Singulair conducted among patients 6 years of age and older.

 “One adult patient out of 9929 patients treated with (Singulair) had suicidal ideation and there were no completed suicides,” the agency said. It said no patients taking placebos in the Singulair trials had suicidal thoughts or committed suicide.

 No patients taking Accolate in 45 trials had suicidal thoughts or completed suicide, while one patient taking a placebo in the trials tried suicide and another had suicidal thoughts, the FDA said.

 No patients in 11 Zyflo trials, either those taking the drug or a placebo, had suicidal thoughts or completed suicide, the FDA said.

 (Additional reporting by Lisa Richwine in Washington; Editing by Bernard Orr)

http://www.reuters.com/article/healthNews/idUSTRE50C7MS20090113