![\"\"](\"http:\/\/theamazingworldofpsychiatry.files.wordpress.com\/2009\/12\/untitled.jpeg\" "\\"Reflections\\"")
<\/a><\/p>\nIn September 2009, there was a review of an article on the construction of a diagnosis which is topical given the pending DSM-V and ICD-11. There were also reviews on the Delusional Misidentification Syndromes and one of Winnicott’s articles – on primitive emotional development. There were reviews of a number of articles on both delirium and dementia as well as a review of articles on the impact of technology on healthcare. The last of Betts podcasts on Jungian Analytical psychology at the time was reviewed although having said that another has now been added. Books reviewed covered topics including the effects of exercise on the brain and the relationship between therapy and culture. There was also commentary on the use of twitter in association with the blog. Two big studies published in Nature Genetics were reported in the news, both of which looked at genes strongly associated with Alzheimer’s Disease. There was also a look at a study using a new side-effects checklist for antidepressants. There were also interesting findings on the benefits of reminiscence therapy for memory and on communication of information on medications.<\/p>\n
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Psychology\/Psychotherapy Articles Reviewed<\/strong><\/p>\n Review: Review Article on Cognitive Dysfunction in Multiple\u00a0Sclerosis<\/a><\/p>\n Review: The Delusional Misidentification Syndromes: Strange, Fascinating, and\u00a0Instructive<\/a><\/p>\n Review: Winnicott on Primitive Emotional\u00a0Development<\/a><\/p>\n Review: \u2018Development of Criteria for a Diagnosis\u2019 or \u2018The Pathology of the Midnight\u00a0Snack\u2019<\/a><\/p>\n \n Biological Psychiatry Articles Reviewed<\/strong><\/p>\n Review: Frontal-Subcortical\u00a0Dementias<\/a><\/p>\n Review: MRI Atrophy In Alzheimer\u2019s\u00a0Disease<\/a><\/p>\n Review: Delirium. Sifting Through the\u00a0Confusion<\/a><\/p>\n Review: Clinical Decline and Education in Frontotemporal Lobar\u00a0Degeneration<\/a><\/p>\n \n Social Psychiatry Article Reviews<\/strong><\/p>\n Review: Why Is There Paper In The Paperless\u00a0System?<\/a><\/p>\n Review: Can Wireless Text Messaging Improve Adherence to Preventive Activities? Results of a Randomised Controlled\u00a0Trial<\/a><\/p>\n Review: Dementia and It\u2019s Implications for Public\u00a0Health<\/a><\/p>\n Review: US Public Survey of Mobile Health\u00a0Technology<\/a><\/p>\n Review: Junior Physician\u2019s Use of Web 2.0 for Information Seeking and Medical Education. A Qualitative\u00a0Study<\/a><\/p>\n \n Podcast Reviews<\/strong><\/p>\n Podcast Review: September 2009. 3rd Edition \u2013 August 2009. Nature\u00a0Neuropod.<\/a><\/a><\/p>\n Podcast Review: September 2009 2nd Edition<\/a><\/p>\n Podcast Review: Betts on Jungian Analytic Psychology #27 and #28.\u00a0Individuation<\/a><\/p>\n Betts on Jungian Analytic Psychology #26: Jung on Individuation Part\u00a01<\/a><\/p>\n \n Blogs Reviewed<\/strong><\/p>\n Blog Review: The New Social Workers\u00a0Blog<\/a><\/p>\n Blog Review: Jung\u00a0Currents<\/a><\/p>\n Blog Review: The Differential Biology\u00a0Reader<\/a><\/p>\n Blog Review: Modern\u00a0Psychoanalysis<\/a><\/p>\n \n Books Reviewed<\/strong><\/p>\n Book Review: One Nation Under\u00a0Therapy<\/a><\/p>\n Book Review: 50 Philosophy Ideas You Really Need to\u00a0Know<\/a><\/p>\n Book Review:\u00a0Spark<\/a><\/p>\n Book Review: Jung. On the Nature of the\u00a0Psyche<\/a><\/p>\n \n Miscellaneous<\/strong><\/p>\n Stigma. Worse Than\u00a0Psychosis<\/a><\/p>\n Blog Twittering 8 \u2013 Twitternet\u00a0Addiction<\/a><\/p>\n <\/a>Blog Twittering\u00a07<\/a><\/a><\/p>\n Blog Twittering\u00a06<\/a><\/p>\n <\/a>Blog Twittering\u00a05<\/a><\/p>\n <\/a>Blog Twittering\u00a04<\/a><\/p>\n <\/a>Blog Twittering\u00a03<\/a><\/p>\n <\/a>Blog Twittering\u00a02<\/a><\/p>\n <\/a>Blog Twittering\u00a01<\/a><\/p>\n \n News from September 2009<\/strong><\/p>\n Research in Dementia<\/strong><\/p>\n Three genes associated with Alzheimer\u2019s Disease were identified in 2\u00a0 studies published in Nature Genetics. Amouyel and colleagues conducted a two-part study (Amouyel et al, 2009). In the first part of the study they undertook a Genome-Wide Association Study involving 537,029 single nucleotide polymorphism\u2019s (SNP\u2019s) in a French sample of 2032 people with Alzheimer\u2019s Disease and 5328 controls.As there were multiple comparisons, they needed to control for this (with a Bonferroni correction) and a marker in the CLU gene on chromosome 8 (8p21-p12) showed a statistically significant correlation just above the threshold.<\/p>\n They then attempted a replication in the second stage which involved 3978 probable cases of Alzheimer\u2019s Disease and 3297 controls. This second stage involved subjects from Spain, Belgium and France. They confirmed a statistically significant association of CLU with the probable Alzheimer\u2019s Disease subjects and additionally found a significant correlation with CR1 on chromosome 1 (1q32). The researchers then estimated the contribution of each gene to the risk of Alzheimer\u2019s Disease and estimated that the attributable risk for APOE (a well established risk factor for Alzheimer\u2019s Disease) was 25.5%, for CLU it was 8.9% and for CR1 it was 3.8%. Nevertheless the CR1 did not show up in the first stage of the study.<\/p>\n In the second study, Professor Julie Williams<\/a> and colleagues (including Professor Michael Owen<\/a>) undertook another two part study. This involved \u2018up to 19,000 subjects\u2019 in the initial stages of the study, these subjects being recruited from Europe and the United States. Again, this was a Genome Wide Association Study. After quality control measures, they looked at 529,205 autosomal single nucleotide polymorphisms in 3,941 people with Alzheimer\u2019s Disease and 7,848 controls. They identified one marker in CLU (the same gene identified in the study above) and a second in the PICALM gene on chromosome 11. Importantly both of these findings were replicated in the second stage of the study which involved 2,023 people with Alzheimer\u2019s Disease and 2,340 age-matched controls.They then looked further to see if they could identify which areas within the gene were significantly correlated and produces some candidate regions. The team point out that there are other significant genes which wouldn\u2019t have been identified in this analysis.<\/p>\n Thus the three identified genes were CLU, PICALM and CR1.<\/p>\n The CLU gene (Clusterin) which was identified in both studies encodes an apolipoprotein which together with APOE is found in the central nervous system as well as other tissues. There are many suggested pathways for the involvement of CLU in the pathology of Alzheimer\u2019s Disease. Thus CLU is found in the amyloid plaques found in Alzheimer\u2019s Disease and there is evidence also suggesting that it may be involved in the removal of Beta Amyloid from the brain (by forming soluble complexes which can cross the blood brain barrier) and may play a role in inflammation in the brain.<\/p>\n The PICALM gene which was significantly associated with Alzheimer\u2019s Disease in the second study encodes a protein that is involved in endocytosis. Mutations in PICALM (phosphatidylinositol-binding clathrin assembly protein) may therefore interfere with the transport of materials into the neurons and the team suggest that synaptic vesicle cycling may affected (for another study looking at vesicle cycling see the study below which involved a newly discovered protein \u2013 the Flower protein which may be involved in Calcium regulation within the neuron emphasising the importance of endocytosis in neuronal functioning).<\/p>\n The CR1 gene which was significantly associated with Alzheimer\u2019s Disease in the second stage of the first study, encodes a receptor for C3b protein. The C3b protein forms part of the complement cascade and again there is some evidence suggesting that it may be involved in the removal of Beta Amyloid. The CR1 receptor may be involved in the process of phagocytosis\u00a0 \u2013 when material is ingested by the immune cells.<\/p>\n Now that these gene associations have been identified it will be interesting to see further replication studies as well as studies examining the possible roles of these genes in further detail.<\/p>\n The\u00a0N60 region<\/a> of the RanBP9 protein has been associated with an increased production of Beta-Amyloid production using post-mortem and cell culture data and these findings may lead to the development of novel therapeutic interventions for Alzheimer\u2019s Disease. This protein binds to another protein which is involved in the movement of RNA through the pores in the nuclear membrane. RanBP9 interacts with several other proteins also.<\/p>\n Financial Skills and Risk of Dementia<\/strong><\/p>\n Predicting which people with Mild Cognitive Impairment go on to develop dementia is an area of current research interest. There are many studies using different methodologies looking into this question. One predictor is that the size of the Hippocampus (size is inversely correlated with dementia risk) which has a robust evidence base. However, a recent study provides evidence that financial skills may be another marker of risk and this has been widely reported in the media (e.g. here<\/a>, here<\/a> and here<\/a>). A research team, just published in \u2018Neurology\u2019 found that people with Amnestic Mild Cognitive Impairment who scored poorly on the Financial Capacity Instrument were more likely to develop dementia. The sample group were people with Amnestic MCI and are therefore already a select group who have been assessed as having formal difficulties with memory. They were being scored on a tool which measures financial skills. The size of the study is relatively small (n=163) and of these, 25 people with Amnestic MCI went on to develop dementia.<\/p>\n There was found to be a\u00a0significant association<\/a> between a variant in the gene LINGO1 and Parkinson\u2019s Disease and Benign Essential Tremor suggesting that this gene may be involved in both conditions. The gene variant is identified with approximately 5% of people with either condition.\u00a0A\u00a0gene sequencing process<\/a> mrFAST (micro-read Fast Alignment Search Tool) has demonstrated utility in detecting duplicated genome sequences and the researchers have noted an increased number of copy number variants in genes which are located in a segment of the genome which underwent significant duplication in the ape\/human ancestor. The process has implications for detection of diseases in which copy number variants need to be estimated and has also been used in the 1000 Genome Project.<\/p>\n \n Research on Antidepressants<\/strong><\/p>\n The British Journal of Psychiatry featured two interesting studies on antidepressants. The first featured a patient rating scale for antidepressant side-effects \u2013 the Antidepressant Side-Effect Checklist (AEC) which is included in the Appendix for the paper (Uher et al, 2009). The researchers compared this patient rating scale with a clinician rating-scale, the UKU in 811 subjects with depression who were participating in an open-label trial comparing Nortriptylline with Escitalopram. The Nortriptylline was included because of a strong affinity for noradrenergic receptors (it would have been interesting to see whether similar findings would have occurred with Reboxetine). They found that after correcting for the severity of depression, the AEC scores predicted discontinuation of escitalopram (although curiously not the Nortriptylline) and validated the use of the instrument for the purposes of establishing side-effects in antidepressants. In another study, this time qualitative, the researchers explored the emotional side-effects of the SSRI\u2019s. The responses from the participants were grouped into 7 categories and there were many interesting comments from the participants (Price et al, 2009). Both a reduction in \u2018positive\u2019 and \u2018negative\u2019 emotions were reported and there was some supporting evidence from an analysis of comments on several depression related online forums. The authors suggest further quantitative studies to investigate the findings from this study.<\/p>\n Miscellaneous Research<\/strong><\/p>\n A\u00a0new finding<\/a> reported in the journal Cell is that cells are able to move using a newly identified mechanism which involves a folding of the membranes to form filopidia and this involves the use of a protein sRGAP2 which is associated with neurodevelopmental disorders. This may have important implications for the understanding of neurodevelopment.<\/p>\n \n News In Brief<\/strong><\/p>\n In analysis of data<\/a> from the Maastricht Aging Study, 35 healthy older adults without cognitive decline were compared with 30 older adults who displayed cognitive decline (using thresholds on several outcome measures) and in the latter group there was found to be a significant reduction in grey matter volume in the hippocampus, hippocampal gyrus, frontal and cingulate cortices. Some evidence that reminiscence therapy<\/a> can improve memory in the elderly is provided from a review of reminiscence therapy studies that was published in\u00a0Scientific American Mind<\/a> which also looks at other outcome measures. It will be interesting to see the results of a meta-analysis once further studies are available.<\/p>\n A meta-analysis of prospective studies of people with cancer and comorbid depression found that depression was associated with a significant increase in mortality and the paper is freely available here<\/a> at the time of writing as well as being reported on here<\/a>. A PET study<\/a> of 53 people with ADHD compared to 44 healthy controls provided evidence for reduced dopamine receptors in the Nucleus Accumbens.<\/p>\n Two large studies ( n=2978 and n=1760) published at PLOS Medicine<\/a>, looked at how patients make choices regarding medications and amongst the findings, people were best able to understand medication outcome information if this was presented in simple frequencies (e.g. per 100 of the population). Further information on the trials can be found here <\/a>and here<\/a> together with a discussion of shared decision making here<\/a>. An emergency mobile text message system<\/a> for people unable to use their voices in calls is being trialled by a number of UK telecommunication companies.<\/p>\n There is evidence from a small Japanese study<\/a> (n=48) that male teenage young offenders are more likely to misinterpret disgust as anger than male teenage non-offenders. An interesting study<\/a> provided evidence that early stages of the visual perception process were influenced by cue associated emotions and memories. Subjects were presented with faces showing different expressions and the subject\u2019s rating of the emotions in the expressions was correlated with the activation of \u00a0their own facial muscles when the same faces were re-presented after having been modified to exhibit a neutral expression.<\/p>\n A\u00a0comparison<\/a> of longitudinal and retrospective studies provides evidence that people underestimate their experience of mental illnesss retrospectively.\u00a0An American\u00a0study<\/a> of physician-patient interactions in primary care practices in Baltimore found a significant difference in communication-related outcome measures between white and black patients in areas including psychosocial interactions in consultations relating to blood pressure control. The researchers suggest that interventions focusing on doctor-patient communication may influence \u2018racial disparities in the care of patients with high blood pressure\u2019 although such research may have benefits in other areas of health care. The BMA has released a new document on \u2018the effect of alcohol marketing on young people<\/a>\u2018 and there has been wide reporting on this in the media.<\/p>\n A new gene association<\/a> with deafness has been identified. Loxhd1 mutations impair functioning of hair cells and subsequently with hearing. Mutations of this gene were found in some families with deafness \u00a0(in a genetic database with genetic samples from hundreds of families with deafness).\u00a0A protein \u2013 called the Flower protein \u2013 has been\u00a0recently identified<\/a> and found to play a role in the processes of endo and exocytosis whereby neurotransmitters are packaged into vesicles, released from the neuron and the membrane resorbed. Aggregates of the protein form channels which allow the entry of calcium into the cell and the research team suggest that this protein could be responsible for the close and necessary coupling of endocytosis and exocytosis.<\/p>\n \n Evolutionary Psychiatry<\/strong><\/p>\n Evidence<\/a> has been found that a species of New World Monkey \u2013 the Cotton Topped Tamarin are able to distinguish between \u2018affiliate\u2019 and \u2018fear\u2019 music produced by other monkeys. Such studies are useful for debates in Evolutionary Psychology. In a fascinating anthropological study<\/a> of the fairy tales Little Red Riding Hood shows that this fairy tale probably has a very ancient origin. There were subtle differences across the world \u2013 for instance in China the wolf is replaced with a tiger. The most closely related versions to the modern European were those from Nigeria and Iran. There are many forms of analysis of fairy tales including psychoanalysis (see here<\/a>, here <\/a>and here<\/a> for instance.\u00a0A study<\/a> published in Science (n-192) and using a public goods game paradigm (used in the study of group behaviour) provided evidence that using a reward strategy for \u2018good behaviour\u2019 produced better outcome (e.g. contributions to the group) than with the use of punishment for \u2018bad behaviour\u2019. A team looking into the extinction of Neanderthals have found the remains of late ice age animals <\/a>in a cave in Torquay and the remains include what could be a 25,000 year old Hyena.<\/p>\n \n Psychiatry 2.0<\/strong><\/p>\n An application –\u00a0healthii <\/a>– has been developed with the intention of improving the well-being of people engaged in social networking online. A recent trial on Twitter at the end of August and the findings should be reported in the near future.\u00a0A Twestival Local (a local festival on twitter) is taking place (see the site here<\/a>) to raise money for charity. There are two types of festival \u2013 one is global and the other involves individual cities which are identified on the map here<\/a>. This shows one of the many extraordinairy ways in which Twitter is impacting on society globally. A study<\/a> looking at twitter provided evidence that 20% of twitters\u00a0 involve exchanging information about \u2018products\u2019. Epi Collect Software<\/a> on mobile devices has been piloted which enables \u2018citizen scientists\u2019 to gather data for science projects incorporating their location within the data.<\/p>\n \n Twitter<\/strong><\/p>\n You can follow \u2018The Amazing World of Psychiatry\u2019 Twitter by clicking on this\u00a0link<\/a><\/p>\n Podcast<\/strong><\/p>\n You can listen to this post on Odiogo by clicking on this\u00a0link<\/a> (there may be a small delay between publishing of the blog article and the availability of the podcast).<\/p>\n TAWOP Channel<\/strong><\/p>\n You can follow the TAWOP Channel on YouTube by clicking on this link<\/a><\/p>\n Responses<\/strong><\/p>\n If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk<\/p>\n Disclaimer<\/strong><\/p>\n The comments made here represent the opinions of the author and do not represent the profession or any body\/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.<\/p>\n In September 2009, there was a review of an article on the construction of a diagnosis which is topical given the pending DSM-V and ICD-11. There were also reviews on the Delusional Misidentification Syndromes and one of Winnicott’s articles – on primitive emotional development. There were reviews of a number of articles on both delirium […]<\/p>\n","protected":false},"author":693,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-109397","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/109397","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/users\/693"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/comments?post=109397"}],"version-history":[{"count":0,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/109397\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/media?parent=109397"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/categories?post=109397"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/tags?post=109397"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}<\/p>\n","protected":false},"excerpt":{"rendered":"