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Mental Health News

Following are the latest news and information resources for the various mental health topics that we cover. We hope you will find the news educational and the links in the resources section useful in helping you to get even more in-depth data.

Too Much Workplace Positivity Might Dampen Employee Motivation

Workers in Google’s offices enjoy an impressive array of perks: subsidized massages, scooters, putting greens, and office video game consoles. In an interview with the New York Times, a Google spokesman explained that the company provides these unusual perks as a way “to create the happiest, most productive workplace in the world.”

But new research suggests that when it climbs too high, a positive mood in the office can actually hurt employee motivation.

Happy employees are more likely to engage in the kind of proactive above-and-beyond behaviors that organizations need to succeed. But a recent study from psychological scientists Chak Fu Lam (Suffolk University), Gretchen Spreitzer (University of Michigan), and Charlotte Fritz (Portland State University) found that when positive mood climbs beyond a certain point, positive behavior at work may actually start to decline.

We might assume that unhappy employees are the ones most likely to feel unmotivated and complacent, but the researchers hypothesized that these feelings might also emerge among particularly happy employees. That is, very upbeat workers could interpret their positive feelings as a sign that everything is going swimmingly at work and that there’s no need for them to try to strive for improvements.

“Positive affect can reach a level such that employees perceive that they are doing well and it is not necessary for them to take initiatives, thereby reducing their proactive behaviors,” Lam and colleagues write in the Journal of Organizational Behavior.

For their study, Lam and colleagues asked 236 workers at a software development firm to rate statements like “I feel alive and vital at work” and “I have energy and spirit at work” as part of a measure for positive affect.

Their supervisors then rated how much each employee engaged in proactive behaviors around the office, including providing encouragement to their colleagues and speaking up about potential issues.

The results revealed that proactive behaviors at work increased with positive affect, but only up to a point. The most engaged employees were the ones who reported a moderately positive mood, while the most positive and least positive employees reported the fewest helpful behaviors.

In a second study, the researchers had 196 staff members from a support services company complete the same survey on positive affect at work. In addition, they also completed measures for their general positive and negative affect.

One month later, 128 supervisors rated each participant for a series of eight proactive behaviors related to addressing customer needs and anticipating potential problems (i.e., he/she tried to fix problems before customers even noticed).

Again, the researchers found that the most proactive employees were those who rated their mood as moderately positive; the least happy and most happy workers both undertook significantly fewer helpful behaviors.

“We find that rather than a simple linear relationship, the relationship seems to be curvilinear such that too much and too little positive affect at work results in lower levels of proactive behaviors,” write Lam and colleagues. “Thus, we offer evidence that challenges the ‘more is better’ assumption commonly associated with positive affect in the workplace.”

The researchers caution, however, that the study sample may have been subject to selection bias, as less proactive people may be less inclined to take part in the study to begin with. Additional studies using different participant recruitment strategies will be needed to confirm these findings.

Despite the apparent downsides of having employees who show particularly positive mood, the researchers emphasize that there is clear value in ensuring that employees are happy on the job. Managers should take steps to establish proper work-life balance, educational opportunities, and room to grow on the job for all employees.

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Your Brain May Want That Bottle Of Soda Because It's Easy To Pick Up

We were intrigued to learn that soda plays a part in a new book called How the Body Knows Its Mind by Sian Beilock, a psychologist at the University of Chicago.

Her book is about the ways in which our bodies affect our brains. To show how, Beilock did a study that sought to answer the question: When you decide whether or not you like an object, might you be making that decision based on how easy it is to pick the object up?

She put two kitchen objects – for example, a spatula and a spoon — in front of 15 undergraduate volunteers. The objects were placed in different positions — say, one with the handle facing the person, one with the handle pointed away.

She asked her volunteers to move the object they liked better into a box. Each person was given 16 tests. Each time, one of the objects was in an easier-to-pick-up position than the other.

You would expect a 50/50 breakdown. But the study, published in the journal Emotion Review, showed that 63 percent of the time people preferred the object that was easiest to grab.

So sure, your brain is making the decision, but the decision may be based not on whether you really like, say, a spoon more than a spatula, but simply on whether it looks easy to pick up.

"This means that subtle changes in the placement or packaging of products can have big effects on people's desire to buy them," she observes. And that's where soda bottles come in.

In 2008, Coke redesigned its two-liter bottle a few years ago to make it curvier and thus, "easier to hold and pour," in the words of a Coca-Cola representative. And suddenly, Beilock reports, Coke was selling a lot more of its two-liter sodas than archrival Pepsi.

Does this mean Coke knew all about the way the body influences the mind? Beilock says: "My guess is [in tests] people preferred that bottle."

Based on her research, she believes that the enticing shape of a soda bottle "might push you to buy it even knowing it's not the right decision." (Because after all, soda is not good for you. It falls into the category of what she calls "vice products.")

So the message for soda bottles is that shape matters. Size could matter, too. In December, Coca-Cola introduced a 350-milliter plastic soda bottle — that's a hair under 12 ounces — in parts of Kenya. The goal, according to Coca-Cola, is "to offer our consumers an affordable 'on the go' convenience pack." It's called the kashorty, a colloquial Swahili word that means "the short one."

The kashorty would be especially easy for small hands to pick up. "It could have an effect on kids," says Beilock. And the effect could be: We want soda!

In the developing world, where the invasion of sugary Western products is contributing to a rise in obesity and diseases associated with being overweight, the kashorty could reinforce the soda company's 1950s slogan "What you want is a Coke."

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Getting Rejected Hurts Depressed People For Longer

Rejected by a person you like? Just “shake it off” and move on, as music star Taylor Swift says.

But while that might work for many people, it may not be so easy for those with untreated depression, a new brain study finds.

The pain of social rejection lasts longer for them -- and their brain cells release less of a natural pain and stress-reducing chemical called natural opioids, researchers report in the journal Molecular Psychiatry.

The findings were made in depressed and non-depressed people using specialized brain-scanning technology and a simulated online dating scenario. The research sheds new light on how the brain’s pain-response mechanism, called the opioid system, differs in people with depression.

On the flip side, when someone they’re interested in likes them back, depressed people do feel relatively better -- but only momentarily. This may also be explained by differences in their opioid system compared to non-depressed people, according to the new results.

Further research could lead to a better understanding of how to boost the opioid response in depressed individuals to reduce the exaggerated effect of social stress, and to increase the benefits of positive social interactions.

A team from the University of Michigan Medical School, Stony Brook University and the University of Illinois at Chicago worked together on the study, which builds on previous work about social rejection in non-depressed people.

“Every day we experience positive and negative social interactions. Our findings suggest that a depressed person’s ability to regulate emotions during these interactions is compromised, potentially because of an altered opioid system. This may be one reason for depression’s tendency to linger or return, especially in a negative social environment,” says lead author David Hsu, Ph.D., formerly of U-M and now at Stony Brook. “This builds on our growing understanding that the brain’s opioid system may help an individual feel better after negative social interactions, and sustain good feelings after positive social interactions.”

The researchers focused on the mu-opioid receptor system in the brain – the same system that they have studied for years in relation to response to physical pain. During physical pain, our brains release opioids to dampen pain signals.

The new work shows that this same system is associated with an individual’s ability to withstand social stress – and to positively respond to positive social interactions, says senior author Jon-Kar Zubieta, M.D., Ph.D.

“Social stressors are important factors that precipitate or worsen illnesses such as depression, anxiety and other neuropsychiatric conditions. This study examined mechanisms that are involved in the suppression of those stress responses,” he says. “The findings suggest novel potential targets for medication development that directly or indirectly target these circuits, and biological factors that affect variation between individuals in recovery from this otherwise chronic and disabling illness.” Zubieta is a member of U-M’s Molecular and Behavioral Neuroscience Institute and the U-M Depression Center, and is the Phil F. Jenkins Research Professor of Depression in the Department of Psychiatry.

The new findings have already prompted the team to plan follow-up studies to test individuals who are more sensitive to social stress and vulnerable to disorders such as social anxiety and depression, and to test ways of boosting the opioid response.

“Of course, everyone responds differently to their social environment,” says Hsu. “To help us understand who is most affected by social stressors, we’re planning to investigate the influence of genes, personality, and the environment on the brain’s ability to release opioids during rejection and acceptance.”

Scanning the brain – and finding surprises

The research used an imaging technique called positron emission tomography, or PET. U-M has a PET scanner devoted to research – and a particle accelerator to make the short-lived radioactive elements that enable PET scans to track specific brain activity. The depressed individuals all met criteria for major depressive disorder, and none was taking medication for the condition.

Before having their brains scanned, the 17 depressed participants and 18 similar but non-depressed participants each viewed photos and profiles of hundreds of other adults. Each person selected profiles of people they were most interested in romantically – similar to online dating.

During the brain scan, participants were informed that the individuals they found attractive and interesting were not interested in them. PET scans made during these moments of rejection showed both the amount and location of opioid release, measured by looking at the availability of mu-opioid receptors on brain cells. The depressed individuals showed reduced opioid release in brain regions regulating stress, mood and motivation.

During social acceptance when participants were informed that people liked them back, both depressed and non-depressed individuals reported feeling happy and accepted. This surprised the researchers, says Hsu, because depression’s symptoms often include a dulled response to positive events that should be enjoyable. However, the positive feeling in depressed individuals disappeared quickly after the period of social acceptance had ended, and may be related to altered opioid responses.

But only non-depressed people went on to report feeling motivated to connect socially with other people. That feeling was accompanied by the release of opioids in a brain area called the nucleus accumbens -- a structure involved in reward and positive emotions.

The researchers had actually informed participants ahead of time that the “dating” profiles were not real, and neither was the “rejection” or “acceptance.” Nonetheless, the simulated online dating scenario was enough to cause both an emotional and opioid response. Before the end of the visit, staff gave depressed participants information on treatment resources.

"We enrolled almost all of these subjects in a subsequent treatment study – which allows us to capture additional information about how these opioid changes to acceptance and rejection may relate to success or failure of our standard treatments" says study co-investigator Scott Langenecker, formerly at U-M and now at the University of Illinois at Chicago.

He adds, "We expect work of this type to highlight different subtypes of depression, where distinct brain systems may be affected in different ways, requiring us to measure and target these networks by developing new and innovative treatments.”

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Hidden Gene Gives Hopes For Improving Brain Function

A new study has found the mechanism used by a hidden gene to affect how the brain responds to stressful experiences, in a discovery that could eventually help control anxiety.

University of Queensland scientists, together with colleagues at the University of California Irvine and the Garvan Institute of Medical Research, discovered that Gomafu, a gene recently associated with schizophrenia, causes behaviours that may be key to understanding both schizophrenia and anxiety.

UQ Queensland Brain Institute researcher Dr Timothy Bredy said by looking across the entire genome for genes responsive to fear-related experience, they found that Gomafu was regulated in the adult brain.

“When Gomafu is decreased or turned off, we observe the kind of behavioural changes that are seen in anxiety and schizophrenia,” Dr Bredy said.

The gene, identified as a long non-coding RNA, was found to occur within a section of the genome most commonly associated with “junk” DNA – the 98 per cent of the human genome that, until recently, was thought to have no function.

“Early biologists thought that DNA sequences that do not make protein were remnants of our evolutionary history, but the fact is that these sequences are actually highly dynamic and exert a profound influence on us,” Dr Bredy said.

“We found that non-coding genes such as Gomafu may represent a potent surveillance system that has evolved so that the brain can rapidly respond to changes in the environment.

“A disruption of this network in the brain might contribute to the development of neuropsychiatric disorders.”

These findings will help to resolve the current criticisms surrounding genome-wide association studies, where the majority of gene mutations related to neuropsychiatric disorders are found within non-coding sequences of DNA that were thought to have no biological impact.

QBI PhD candidate Ms Paola Spadaro said RNA-directed regulation of these processes had emerged as an important feature of human development, but this was the first time long non-coding RNA activity had been detected in the brain in response to experience.

This finding will enable better prediction of vulnerability and resilience to developing a neuropsychiatric disease, with the primary goal to develop better treatment approaches across the lifespan.

The findings are published in Biological Psychiatry.

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Health And Marriage: The Cortisol Connection

Bad marriages can be sickening. Most people don't have to be convinced of this, but for those who do, several decades of studies offer plenty of proof. Even so, very little is known about exactly how marriage quality affects health. Do strife and rudeness and neglect--and all the other signs of marital unhappiness--somehow get under the skin and trigger physical ailments? Or do warmth and trust and understanding and appreciation follow some biological pathway to wellness? Or both?

Relationship experts have been focusing recently on marital partners' beliefs about their marriage--specifically a partner's belief that the other partner understands and cares for him or her. Whether true or not, this belief--this perception that a partner is responsive, and reciprocates one's love and appreciation--is associated with satisfaction and intimacy in marriages. Could it also be related to physical health?

That's the question that Wayne State University psychological scientist Richard Slatcher has been exploring in his work. Since perceived responsiveness is so important to marital satisfaction, Slatcher and his colleagues wondered if such beliefs might also have a positive impact on health and longevity through some biological pathway. The biological pathway they targeted for study is the hypothalamus-pituitary-adrenal, or HPA, axis, and the hormone cortisol.

Cortisol is ubiquitous. It's present in nearly every cell of the human body, and plays a role in learning, memory and emotion. It also helps regulate the immune system. In a healthy person, cortisol spikes soon after waking, then diminishes all day, bottoming out at bedtime. This is called a steep cortisol slope. A flatter slope--often with a much smaller morning spike--is associated with poorer physical health, including diabetes risk, atherosclerosis and mortality. Aversive childhood experiences and social conflict have been linked to flat cortisol slopes, but the hormone has never been studied in connection with adult romantic relationships.

That's what Slatcher decided to do. He wanted to see if perceived partner responsiveness is linked to steeper--that is healthier--cortisol slopes many years later. He used data from an ongoing longitudinal study called the Midlife in the United States Project, focusing on a group of about 1000 adults, married or cohabiting men and women, who were studied both in 1995-1996 and in 2004-2006. Most stayed with their original partner over the time of the study, though a small group were divorced, separated or widowed, and sometimes remarried.

The scientists assessed the subjects, at both points in time, focusing on their perceptions of theior partners' responsiveness--how much their partners cared about them, understood the way they felt about things, and appreciated them. They also computed a marital risk score for each subject. Was the marriage troubled, at risk of ending? They did this so they could see if partner responsiveness predicted cortisol patterns above and beyond negative aspects of the relationship. They also assessed controlled for other things that might affect the results--how agreeable the subjects were, how depressed, how negative or positive their emotions in general.

Then finally, in 2004-2006, they took saliva samples from subjects, throughout the day over several days, which they tested for cortisol concentration. Would believing in one's partner, early on, affect cortisol, an important health indicator, fully a decade later?

It did, as the scientists report in a forthcoming issue of the journal Psychological Science. Perceived responsiveness was associated with both steeper cortisol slope and higher wakeup cortisol level. Importantly, this link between responsiveness and healthy cortisol was driven, at least in part, by diminishing negative emotions over the decade. In other words, believing that one's partner cares--this perception leads to a decline in negative emotions, which in turn affects cortisol--and ultimately health.

Slatcher wondered if adults who stayed with their original partners fared better or worse than those who moved on. The data say no. There was no evidence that being in a new relationship weakened the association between responsiveness and cortisol. That is, the link between responsiveness and healthy cortisol a decade later was just as strong for those separated and remarried as for those still with their original partner. This suggests a lasting effect of early marital experience, one that carries over even into new relationships. The scientists believe that cortisol could turn out to be the long-sought link between quality marriages and longevity.

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The Vitamin D And Serotonin Connection

For years, doctors have recommended vitamin D and calcium supplements to maintain healthy bones, but research taking place at Children's Hospital & Research Center Oakland is showing that vitamin D may be related to healthy brain development. Rhonda P. Patrick PhD, a postdoctoral fellow at Children’s Hospital Oakland Research Institute, is studying what role vitamin D has in serotonin production because a growing body of evidence suggests that vitamin D — present in some foods and produced naturally when skin is exposed to sunlight — regulates the enzyme that converts the amino acid tryptophan into serotonin, a neurotransmitter believed to help regulate moods and direct brain development while in the womb.

Patrick, a postdoctoral fellow at Children’s Hospital Oakland Research Institute in Oakland, CA., said the degree to which vitamin D regulates serotonin isn’t yet clear. But psychologists and neuroscientists have established the effects of low serotonin by restricting tryptophan entering the brains of human test subjects, she said.

“What happens is their long-term decision making shuts down,” she said. “They become impulsive and aggressive, angry, unhappy. They have difficult time interpreting people’s facial expressions.”

‘Why do we feel better when we go out in the sun? Sun makes vitamin D in your skin.’

Vitamin D is naturally present in some foods, including fatty fish such as mackerel, salmon, and tuna, and in small amounts in cheese, egg yolks, and beef liver, according to the National Institutes of Health. But most vitamin D in the human diet comes from its addition to foods such as milk, orange juice, and breakfast cereals.

Because vitamin D regulates about 1,000 different types of genes in the body — roughly 5 percent of the human genome — Patrick and her mentor, Bruce N. Ames, a senior scientist at Children’s Hospital Oakland Research Institute, believes the nutrient may play a much larger role in our health than previously realized.

Dr. Walter Willett, chairman of the nutrition department at the Harvard School of Public Health, said that the hypothesis suggests many avenues for further research.

“This work by Ames and Patrick is significant because it describes a potential pathway linking vitamin D with serious mental conditions, and may explain some of the features of these diseases,” Willett said in an e-mail.

Researchers are working to confirm Ames and Patrick’s hypothesis in the lab. Mark R. Haussler, a professor at the University of Arizona College of Medicine — Phoenix, and Peter Jurutka, an associate professor at Arizona State University, have conducted experiments that support the hypothesis, Haussler said.

In successive experiments using synthesized DNA, then cells from human kidneys, then cells from the brains of rats and of humans, Haussler and Jurutka established that vitamin D produced effects consistent with Patrick and Ames’s hypothesis: It enhanced the ability of the brain cells to produce serotonin by anywhere from double to 30 times as much, Haussler said.

Haussler said a better understanding of how to regulate serotonin production could have a “huge impact, and all the way across the life span.” Haussler speculated that regulating serotonin in developing brains could potentially affect the development of autism or attention deficit hyperactivity disorder.

Some benefits of vitamin D have been known for generations, Haussler said, though they might have been described in different terms.

“When I was young, my mother would say, ‘Mark, go out in the sun; you’ll feel better,’ ” Haussler said. “Well, you know, I usually did, and that’s a common-sense-type thing, but why? Why do we feel better when we go out in the sun? Sun makes vitamin D in your skin.”

But too much sun can also lead to skin cancer, he cautioned, and not all sun exposure will help produce vitamin D. In New England during the winter, the sun is too low on the horizon to help generate the production of vitamin D.

Doctors and researchers said that in this region and many others, it is beneficial to take a vitamin D supplement, at least during winter months, but controversies have arisen in recent years about the use of vitamin supplements and the tools for measuring vitamin D deficiency.

Late last year, a widely discussed editorial in the Annals of Internal Medicine encouraged the public to “stop wasting money” on vitamin and mineral supplements that had not been proved to prevent or slow the development of chronic diseases.

That editorial included a caveat that vitamin D supplementation remained “an open area of investigation, particularly in deficient persons” but nevertheless concluded that “current widespread use [of vitamin D supplements] is not based on solid evidence that benefits outweigh harms.”

Also last year, a study from Massachusetts General Hospital found that many of the 70 percent to 90 percent of African-Americans diagnosed as vitamin D deficient may actually have healthy levels of the vitamin — and are not deficient — because they are genetically disposed to carry more of the “free” form of the nutrient.

Willett, of the Harvard School of Public Health, said the anti-supplement editorial “was unhelpful as it lumped together a very wide range of doses and conditions.”

Willett said many Americans do not get enough vitamin D from diet and sun exposure and should take a supplement. His recommendation included African-American adults because, he said, science has not yet determined which forms of vitamin D benefit specific organs, and the “free” form may not be helpful in all instances.

There is no universal agreement about the proper dosage, but Willett recommends 1,000 international units per day for most adults. Patrick said that before taking a supplement, people should get tested and consult their physicians.

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Aging Affects Sleep Quality

Getting a good night’s sleep can be challenging, especially as we age. About half of all older adults report sleeping difficulties. This can make them more likely to experience physical or mental health conditions, memory problems, and falls, due to poor balance.

Older adults also have less deep sleep than younger people and their sleep is more easily interrupted.

As we age, our body clock or “circadian rhythms” change. We have a less consistent pattern of feeling sleepy and awake. We also feel sleepy earlier in the evenings and wake up earlier in the mornings. Medical conditions commonly experienced in later life, and the medication used to treat them can also interfere with sleep.

Treatments for sleeping difficulties include medication for short-term relief and psychological treatments such as cognitive behavior therapy (CBT). CBT helps people to change unhelpful thoughts and behaviors that contribute to poor sleep.

While CBT is very effective for clinically diagnosed insomnia, not everyone with milder sleeping difficulties needs such an intensive treatment. For some people, sleep quality can be improved by learning relaxation to reduce physical tension and worry.

Another approach that is showing promise for improving sleep is to learn mindfulness.

What is mindfulness?

Mindfulness involves deliberately focusing on what we are experiencing, thinking or feeling in the present moment, without negatively judging our experiences. We can learn mindfulness by becoming more aware of where we are focusing our attention.

Mindfulness is the opposite to absentmindedness or being on “auto pilot”, like when you read a book and realize you haven’t paid attention to what was written on the last few pages because you were distracted by planning tomorrow’s activities.

Mindfulness also involves deliberately focusing on things we don’t normally pay much attention to. You may have experienced mindfulness when you’ve listened intently to a favorite piece of music and deliberately turned your attention to the sound of just one instrument.

How can mindfulness help sleep?

The findings of a recently published research study, led by David Black from the University of Southern California, suggest that practicing mindfulness might be particularly helpful for improving sleep quality in adults aged 55 years or older with mild sleeping difficulties.

The mindfulness program involved taking part in six two-hour group classes and between five and 20 minutes a day of home practice.

The researchers found that adults who completed a structured mindfulness program showed greater improvements in sleep quality than adults who completed a program that taught them good “sleep hygiene” habits.

Counter-intuitively, the way that mindfulness may influence sleep is not directly through relaxation, because mindfulness is about waking the body up and becoming more aware. By learning to become more aware of present-moment experiences, we learn not to react to thoughts and worries that can interfere with sleep.

We still don’t know exactly how much and what type of mindfulness practice is needed before a person notices improvements to their sleep. But research suggests that regular practice activates the parts of the brain that help us experience our environment through our senses rather than through thoughts and worries.

Tips for practicing mindfulness

Practice mindfulness regularly, in a quiet place where you won’t be interrupted. It’s best to learn mindfulness outside of the bedroom because to learn the skill, you first need to learn to pay more attention to your present-moment experiences rather than to go to sleep.

There are a number of ways to start to practicing mindfulness:

>Listen to a mindfulness meditation CD, MP4 audio or a mindfulness app

>Take part in activities that encourage mindfulness, such as yoga, pilates, walking, tai chi or running

>Undertake daily activities, such as cleaning your teeth or washing the dishes, in a mindful way by focusing on the experience of doing the activity

>Enjoy the experience of eating in a mindful way by using all of your senses and keeping your attention on the food.

Try not to pressure yourself to get the hang of mindfulness straight away. The goal of mindfulness it to not judge your experiences. If you notice your attention straying you can gently bring your attention to what you are focusing on, such as your breath.

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Study: Diagnosed Depression Linked To Violent Crime

People diagnosed with depression are roughly three times more likely than the general population to commit violent crimes such as robbery, sexual offences and assault, according to psychiatric experts.

A study based on more than 47,000 people in Sweden, emphasized that the overwhelming majority of depressed people are neither violent nor criminal and should not be stigmatized.

“One important finding was that the vast majority of depressed people were not convicted of violent crimes, and that the rates ... are below those for schizophrenia and bipolar disorder, and considerably lower than for alcohol or drug abuse,” said Seena Fazel, who led the study at University of Oxford’s psychiatry department.

The researchers found that 3.7% of men and 0.5% of women committed a violent crime after being identified as clinically depressed. This compared with 1.2% of men and 0.2% of women in the general population.

The study tracked the medical records and conviction rates of 47,158 people diagnosed with depression over a period of about three years. It then compared th e data with the records of 898,454 people with no history of diagnosed depression.

Violent crime was defined as a conviction for any of the following: homicide or attempted homicide, aggravated or common assault, robbery, arson and sexual offences (including indecent exposure, and illegal threats or intimidation).

When the researchers took account of previous histories of violence, self-harm, psychosis and substance misuse, they still found a link between depression and violent crime. Marjorie Wallace, chief executive of the mental health charity Sane, said: “The majority of people with depression are never violent, yet people receiving a diagnosis can feel frustrated, angry and initially desperate.

“It is also very rare for anyone with depression to commit crime. This study does, however, show how important it is for professionals not to ignore those strong feelings and make clear people can come to terms with how they feel and recover.”

Depression is one of the most common forms of mental illness, affecting more than 350 million people worldwide. Treatment usually involves either medication or psychotherapy, or a combination of both.

Andrea Cipriani, a clinical researcher and consultant psychiatrist at Oxford who was not directly involved in the study, said the results show the importance of talking to depressed patients about how violent thoughts and behaviour can be part of their illness. “It’s relieving for patients to talk about what they feel,” he said. “It’s relieving to know there’s a way out and it’s treatable.”

Fazel noted that in guidelines for doctors treating major depression, there is considerable focus on whether a patient is likely to self-harm or attempt suicide, yet little attention is given to violence.

“Quite understandably, there is considerable concern about self-harm and suicide in depression. We demonstrate that the rates of violent crime are at least as high, but they don’t receive the same level of attention in clinical guidelines or mainstream clinical practice.” He added that the next step in the research would be to examine the links between depression and violence.

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Depression Taking A Bigger Economic Toll On US

The economic costs from the psychological affliction of depression have gotten significantly larger in recent years—and people suffering from that condition were hit particularly hard by the 2008 financial crisis, a new study has found.

Annual costs related to major depressive disorder rose to $210.5 billion in 2010, according to the study published Wednesday in the Journal of Clinical Psychology. That represents a 21 percent increase over the $173.3 billion in overall annual economic fallout linked to sufferers of the disorder as of 2005, the report noted.

"The current study adds to our understanding of MDD as a source of significant economic burden," the report's authors wrote.

The report, which drew on data from insurance claims in the OptumHealth Reporting and Insights database, leads off with the observation that in the U.S., depression "is the leading cause of disability for people aged 15-44, resulting in almost 400 million disability days per year, substantially more than more other physical and mental conditions."

And more people were suffering from that affliction in 2010 compared to 2005, the report said.

During that five-year time span, the number of people suffering from depression grew from 13.8 million to 15.4 million, with the fastest rate of increase seen among people older than the age 50.

"Worsening economic conditions after the 2008 downturn took a particularly heavy toll" on those people, noted the report, whose lead author, Paul Greenberg, is a managing principal at the Boston-based economic consulting firm Analysis Group.

Among sufferers of major depressive disorder, there was a 6.2 percentage point increase in the rate of people who were either unemployed or not looking for work, the report noted. In contrast, people without MDD saw just a 3.8 percentage point increase, study found.

Breaking down the costs

The report breaks out three areas that contribute to the $210.5 billion tally it arrives at: workplace costs, direct costs and suicide-related costs.

Workplace costs, which included missed days and reduced productivity, were responsible for half of all the costs related to sufferers of depression. The next biggest contributor, at 45 percent of total costs, came from direct costs, which included medical claims and pharmaceutical costs.

The remaining 5 percent came from suicide-related costs, which include the loss of earnings.

Only a minority of the economic costs from MDD patients identified by the study—38 percent—were due to major depression itself the report found.

The biggest share of the costs associated with those people came from so-called comorbidities, or conditions that were occurring for them at the same time as their depression, such as anxiety and post-traumatic stress disorder, and physical ailments like back pain, sleep disorders and migraine headaches.

Given that fact, the report authors wrote, "Further research should focus on the relative importance of these different factors and analyze further the comorbidities associated with MDD that account for the largest portion of the total economic burden of the disease."

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Mistargeted Messages Could Spur Help-Seeking For Depression

From decades of research, scientists have developed effective, empirically-validated interventions for treating major depression and, yet, many people suffering from depression don’t receive these treatments. While there can be many reasons why a depressed person might not seek help, one major barrier seems to emerge from the disorder itself:

“Unlike many physical illnesses in which help-seeking increases as severity intensifies, the more depressed people become, the less likely they are to seek help from family, friends, and mental-health professionals,” psychology researcher Jason T. Siegel and colleagues at Claremont Graduate University write in Clinical Psychological Science.

Researchers and practitioners have tried to harness mass communication as one tool for encouraging help-seeking, and yet some research suggests that these efforts can backfire. Indeed, studies have shown that messages that directly target people with depression can, for example, increase feelings of self-stigma and reinforce beliefs about the link between depression and suicide.

Siegel and colleagues wondered whether mistargeted communication — messages that are directed at a target individual but are ostensibly directed at someone else — might avoid the potential for backfire.

In an online study, the researchers asked 335 participants in the United States to complete a widely used measure of clinical depression, the Beck Depression Inventory-II, to gauge their symptoms of depression over the last 2 weeks. Some of the participants then saw a direct message (e.g., “Are you feeling distressed? Feeling hopeless?”), while others saw a mistargeted message (“Do you know someone who is distressed? Feeling hopeless?”).

The results were clear: While higher depression scores were generally linked with lower intentions to seek help from a romantic partner, a close friend, or family members among participants who received the direct message, there was no such relationship for the participants who received a mistargeted message.

According to the researchers, these findings indicate that the mistargeted message was more effective at promoting help-seeking than the direct message was. And a second online study confirmed this pattern of results.

The researchers gave 1152 participants in the U.S. the same depression inventory and then presented them, by video, with either a direct message, a mistargeted message, or a control video featuring falling leaves.

Again, there was a generally negative relationship between depression scores and attitudes toward help-seeking, intentions to seek help, and expectations about the outcomes of seeking help. But these associations tended to be less negative for the participants who had received the mistargeted message compared to those who received the direct message or no message.

“This set of studies adds to the literature by providing a clear pathway for improving outreach efforts that target people with depression,” Siegel and colleagues write. “Simply put, although a poorly developed [depression public service announcement] can cause harm, a well-developed message can possibly save lives.”

The researchers note that further research should explore the specific mechanisms that lead some direct messages to backfire and should also seek to identify the help-seeking attitudes that are most amenable to change.

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Did You Know?

Mental ill health accounts for some 15 per cent of the disease burden in developed countries – and people who are seriously mentally ill typically die 20 years earlier than would otherwise be expected


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