Psychotherapy shows more promise

Washington. Long term psychodynamic psychotherapy (LTPP), which stresses psychological support and intervention for patients based on their specific needs, seems more effective in treating complex psychiatric problems than short-term treatments that focus more on medications, a meta-analysis found.

“In this meta-analysis, LTPP was significantly superior to shorter-term methods of psychotherapy with regard to overall outcome, target problems, and personality functioning,” said lead researcher Falk Leichsenring of the University of Giessen, Geramany.

The meta-analysis published in the Journal of the American Medical Association included 11 randomized controlled trials and 12 observational studies, involving a total of 1053 patients receiving LTPP. “(LTPP) yielded large and stable effect sizes in the treatment of patients with personality disorders, multiple mental disorders, and chronic mental disorders. The effect sizes for overall outcome increased significantly between end of therapy and follow-up,” Leichsenring stressed.

Patients undergoing LTPP on average saw better results 96 percent of the time than patients who received short-term intensive medication therapies.“Evidence indicates that short-term psychodynamic psychotherapy is insufficient for a considerable proportion of patients with complex mental disorders, i.e., patients with multiple or chronic mental disorders or personality disorders,” the authors said. “Some studies suggest that (LTPP) may be helpful for these patients, according to background information in the article,” they added.

*Source : Medical Observer, year 17, issue 10, Nov-Dec. 2008

Gulf War Syndrome alert!

Nearly two decades after the Gulf War, US veterans felt vindicated as congress has finally conferred them the medical recognition of the Gulf War Syndrome.
After coming home from the dusty battlefront terrains of the Middle East during 1991 conflict, more than a quarter of the 700,000 Gulf War troops reported persistent headaches, memory and concentration problems, unexplained fatigue and widespread pain. Some even included skin rashes, respiratory symptoms, and digestive problems. Turning their health concerns over to the medical community, Gulf War Veterans often find themselves in a position where their complaints are met with cynicism and suspicion.
Because of the complaints that these soldiers were not receiving adequate health care from the state, Washington, then, chartered the Research Advisory Committee on Gulf War Veteran’s illnesses to investigate on the nature of the said illness.
Last November 2008, the panel has finally release its verdict. The committee confirmed the legitimacy of their claims. The 450 page-report concluded that Gulf War Syndrome is real and is caused by exposure to neurotoxic chemicals including pesticides and pyridostigmine bromide. The committee’s director, Roberta white of Boston University School of Public Health said that there is compelling evidences that substantiate veteran’s complains and their findings also support veteran’s belief that exposures to the toxic chemical during the Gulf War is related to their health problems.

Good Autism Practice Developing a Curriculum for Life

The Center for Autism and Related Disorder, Philippines (CARD,Phils) and Professionals for Autism Foundation Inc. (PAF) is holding a seminar on the 29-31 January 2009. World Expert on Autism, Ms. Rita R. Jordan shares her knowledge and insight on Autism. The seminar Good Autism Practice Developing a Curriculum for Life will be held on Every Nation – Leadership Institute, 32^nd street corner, University Parkway, Bonifacio Global City, Makati City.

For more information, check out their website www.cardphils.org or call (632) 820-8719

Lilly schizophrenia drug has risk of deep sedation

Update to those who are psycho serious about psychopharmacology.


Lilly schizophrenia drug has risk of deep sedation
by Jennifer Corbett Dooren

Washington- the U.S. Food and Drug administration said yesterday that a long-acting, injectable form of Eli Lilly & Co.'s top-selling drug Zypreexa was effective at treating schizophrenia, but caused "profound sedation" in certain patients.

A memo written by Thomas Laughren, the FDA's psychiatry products division director, and posted on the agency's Web site yesterday, said clinical studies of the drug showed 24 out of 1915 patients exposed to the long-acting form of Zyprexa suffered from profound sedation after receiving the injection. The FDA said the sedation typically lasted about one to three hours.

The long-acting form of Zyprexa faces a review by an FDA panel of outside medical experts tomorrow. The panel will be asked if that form of Zyprexa has been shown to be "acceptably safe" and effective for the treatment of schizophrenia. The panel's decision will amount to a recommendation about whether the FDA should approve the product. The FDA usually follows its panel's advice but isn't required to.

Zyprexia is currently approved as an oral, once-daily medication to ttreat schizophrenia and bipolar disorder. The drug had $4.8 billion in sales last year. There is also a short-acting injectable form of Zyprexa that is used to treat agitated, noncooperative patients with schizophrenia or bipolar mania, usually in an emergency setting.

Lilly is seeking FDA approval of the long-acting form of Zyprexa for the treatment of schizophrenia, which could be injected every two or four weeks. The product would be administered in a doctor's office.

Schizophrenia is a severe, disabling brain disorder that affects the way people think and afflicts about 1% of Americans. According to the National Institute of Mental Health, people with schizophrenia may hear voices other people don't hear of they may believe that others are reading their minds, controlling their thoughts or plotting to harm them. The disorder is typically diagnosed in a person's latge teens or 20s.

The FDA said the panel also will be asked to make recommendations about whether long-acting Zyprexa should carry a "blackbox" warning- the FDA's toughest drug precaution, which appears at the top of a product's label- or if the agency should consider approving the product for so called second line use after other drugs fail.

In documents also posted on the FDA's web site, Lilly said schizophrenia is a "chronic and devastating mental illness" and noted that "nonadherence with medication is common." The company said the injectable form of Zyprexa gives patients another treatment option.

Lilly said it believes the profound sedation associated with the long acting, injectable form of Zyprexa can be safely managed and said patients and health-care providers can be adequately warned of the risk.

The FDA said the sedation seen witht he long-acting form of Zyprexa appears unique to the injectable form of the drug and likely results from the rapid release of the drug into a patient's body after being injected.


source: The Wall Street Journal, Feb. 5, 2008 p. 6

Norepinephrine

There is this interesting article i read. It is about the brain chemical that makes bad memories stay. Here is the copy of the article.

We bank on our memory to help us recall things in our daily lives. We welcome good memories, but bad memories are just sometimes here to stay no matter how much we want to forget them. A group of scientists may hold the answer to this mystery.

Researchers theorized that stress hormone called Norepinephrine aids in the release of a chemical receptor in the brain called GluR1. This helps the brain to make memories easier, allowing the brain to remember what happened to avoid a certain stressful event from recurring.

Hailan Hu, PhD and Roberto Manilow, MD,PhD, from the Cold Spring Harbor Laboratory in New York, tested this theory in mice. They injected a group of mice with epinephrine (which boosts norephinephrine), and another group with salt water (which does not affect norepinephrine).

On the first day of the test, the mice were put in a cafe and were allowed to explore for awhile. The next day, the mice got a mild electrical shock as soon as they were placed in the same cage. Scientists then videotaped the mice on the last day of the experiment to see which group of mice stood still longer after being put back in the cage. The epinephrine group was shown to have stood still longer compared to the salt water group. The scientists took that as a sign of "fear-based learning".

Additional tests found that GluR1 played a crucial role in that experiment. Although scientists believe that other chemical chain reactions in the brain may have also been involved. STudy results were purblished in the journal Cell.


Source: Health & Lifestyle, adding life to living. (nov-dec. 2007, p8)

painful+memories=forget

Learn to Forget:
How the mind blocks painful memories
by IAN SAMPLE


Brain scans showing how the mind buries painful memories could lead to revolutionary therapies for emotional problems such as anxiety, depression and post-traumatic stress disorder, psychologists said.

The ability to suppress memories has long been a controversial issue in psychology, but researchers at the University of Colorado found that with practice, volunteers could learn to forget, a skill they used to block out images that were chosen to cause them distress.

Scans of the volunteers' brains revealed that key neural circuits switched on when their minds were trying to banish painful memories, giving scientists a new level of understanding into how the brain works, and raising hopes that it may be possible to design drugs to help troublesome memories fade away.

"We think we now have a grasp of the neural mechanisms at work, and hope the new findings and future research will lead to new therapeutic and pharmacological approaches to treating a variety of emotional disorders." said Brendan Depue, lead schientist on the study at he University of Colorado at Boulder.

Volunteers were asked to memorise 40 different pairs of pictures.

Each pair consisted of an emotionally neutral human face linked to a disturbing image, such as a car crash, an injured person or an electric chair.

The participants were then placed in a magnetic resonance imaging brain scanner and shown only the facial images.

THE COST OF PERFECTION

I've read this interesting article. Hope to share it with you.....


Do you see issues in black and white or shades of gray? The way you handle conflict at work colors not only your feelings about your job, but also your health.

People who think in rigid, evaluative "absolutist" (AB) terms--like perfectionists and control freaks--are more susceptible to emotional and physical problems than those who are open-minded and flexible, or "non-absolutist", says Alistair Ostell, lecturer in psychology at the University of Bradford ManagementCenter in England.

AB thinkers get upset if things don't go their way, which impedes their problem-solving and coping skilss, he explains. This may translate into health complications such as insomnia, heart palpitations, chronic fatigue and high blood pressure. Also, says Ostell, "when people are angry, they increase secretion of the (stress) hormone cortisol, which tends to suppress the immune system, making them vulnerable to infection."

In Ostell's study, published in the British Journal of Medical Psychology,British "headteachers", or school principals, deemed non-absolutist were in better health, were less stressed and enjoyed their jobs more than absolutist principals. Though the study took place in the classroom, Ostell warns that AB thinking occurs across jobs and personality types.

People with AB attitude may find it hard to change their mind-set, says Ostell. But he suggests they consider the link between their attitude and its ill effects--and then try to go with the flow whenever possible.


Source: Psychology Today, Feb. 2000 (p.16)