The study, published in Annals of Internal Medicine, investigated the prevalence of anxiety disorders in primary care. Researchers at the Regenstrief Institute for Health Care in Indianapolis analyzed the data of 965 primary care patients, ages 18 to 77, between November 2004 and June 2005. The researchers developed a survey for doctors to use to help screen patients for anxiety disorders. Completed surveys and psychiatric interviews were obtained from the participants.

The researchers found that nearly 20 percent of the participants had an anxiety disorder, including posttraumatic stress disorder, generalized anxiety disorder, panic disorder and social anxiety disorder. Many of the participants were diagnosed with more than one type of anxiety disorder. Furthermore, 41 percent of the participants were not being treated for their anxiety disorder.

"Anxiety disorders are prevalent, disabling, and often untreated in primary care," the study authors write. "A 2-item screening test may enhance detection."

REFERENCES:
1. Kroenke K et al. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med 2007 Mar 6;146(5):317-25.

The study, published in The American Journal of Psychiatry, examined whether chronic depression is linked within the family. Researchers at Johns Hopkins Hospital in Baltimore analyzed the data of 638 chronically depressed participants who developed major depression before age 31. The subjects were participants in the Genetics of Recurrent Early-Onset Depression (GenRED) project. The participants were compared with 1,085 of their relatives who had suffered from major depression.

The researchers found that family members were two and a half times more likely to have chronic depression if a parent or sibling had chronic depression. Furthermore, family members were six times more likely to have chronic depression if their parent or sibling had chronic depressing by age 13. "These findings suggest that chronicity of depressive symptoms is familial, especially in preadolescent-onset illness," the study authors write.

The study authors intend to do further studies to determine the genes that may be involved with depression. "Further study using chronicity as a subtype in the genetic analysis of depressive illness is warranted," the study authors write. "Refinement of the definition of chronicity in depressive illness may increase the power of such studies."

REFERENCES:
1. Mondimore FM et al. Familial aggregation of illness chronicity in recurrent, early-onset major depression pedigrees. Am J Psychiatry. 2006 Sep;163(9):1554-60.

But a recent review published in the December issue of the American Journal of Clinical Nutrition did not find significant efficacy when pooling the results of all 12 studies.

Researchers in Britain combined information from 12 recent clinical trials that investigated the power of fish oils rich in omega 3 fatty acids to reduce the symptoms of depression and other depressive disorders.

There was a great degree of variety in the studies pooled into the review. Some studies measured effects in participants with major depression while others looked at the effects fish oils had on bipolar disorder. Most of the studies were small and short term.

It is these reasons and a few others that the authors site as a potenial reason the review was somewhat inconclusive. The authors did not disregard any effect that omega 3 fatty acids may have on depression, but could not definatively say they are effective across the board in a large population.

Omega 3 fatty acids are believed to help ease the symptoms of depression via modulation of the neurotransmitters in the brain, namely serotonin.

The reviewers call for a large scale clinical trial to measure the effect of fish oils as a treatment for depression and depressive disorders such as bipolar disorder.

The study, presented at the August 10-13, 2006 annual meeting of the American Psychological Association in New Orleans, compared the connection between personality and intelligence in both young and older adults. Researchers at York University and Pennsylvania State University administered personality and intelligence tests to 381 healthy adults, ages 19 to 89. The participants were split into three groups including young adults ages 18 to 60, older adults who were intellectually comparable to the younger adults, and older adults who were intellectually superior to the other two groups. Five personality traits including openness, extroversion (friendliness), agreeableness, conscientiousness, and neuroticism, were matched with intelligence test scores.

The researchers found that openness and friendliness were linked to higher intelligence scores in the younger group. However, lack of agreeableness was associated with higher intelligence scores in the intellectually superior older group. Findings also revealed that conscientiousness and openness were linked with strong short term memory and visual and auditory processing in older adults.

"Agreeableness was found to have a contrary relationship with general knowledge suggesting that a disagreeable nature may go hand in hand with better vocabulary and knowledge retention in older age," says researcher Thomas Baker, of York University, in a news release.

REFERENCES:
1. Study suggests that personality predictors of intelligence change from younger to older adulthood. APA Press Release, August 10, 2006: http://www.apa.org/releases/personality06.html

The report summarized a review of more than 22 clinical trials that researched the effect of various psychological treatments on aspects of chronic low back pain.

Low back pain, especially when chronic, can severly reduce a person's quality of life. Often chronic low back pain is only improved to a certain degree by physical therapy, chiropractic, and massage therapy. Many individuals will become dependant on pain relievers, which also loose effectiveness. It is not uncommon to have overlapping depression in those who suffer from chronic low back pain.

So it seemed natural to assess the efficacy of psychological treatments for chronic low back pain. A variety of treatment modalities were assessed including biofeedback, cognitive-behavioral therapy, hypnosis, and counseling.

Each modality was effective at reducing the severity of low back pain. They also helped the patients cope effectively with pain they do experience, while many reported less of a hinderance on activities of daily living, regardless of pain presence.

Depression and depressive symptoms were also reduced, which was to be expected. Patients reported a better outlook on life, and improved quality of life after psychological treatments.

The authors were pleasantly surprised with their findings, especially evidence that showed psychological treatments (excluding medications) had a direct effect on pain intensity, not just coping skills.

This last year a change was made to the labels for antidepressant medications in terms of their use in children and teens. The label warns of a possible increase in suicidal thoughts and tendencies in youth who are on these types of medications.

Now, the most recent Food and Drug Administration panel discussed placing a warning for adults, especially those under the age of 25. A recent review by a FDA panel found that individuals in this age group who are taking some of the newer antidepressants are twice as likely to have suicidal thoughts or tendencies.

These findings have prompted many consumers to advocate for changes to the current labeling on drugs such as Paxil, Prozac, Cymbalta, Effexor, and Zoloft. Many of those pushing for the change have lost a loved one to suicide while they were being treated for depression with antidepressant medications.

While on the other side of the debate is the pharmaceutical industry and psychiatrists. The manufacturers of the medications say that their research has not shown such an increase in suicide or suicidal thoughts. And the psychiatrists suggest that suicidal thoughts and tendencies may increase if individuals are not given the medications to help treat their depression.

It is a heated debate indeed, with both sides wanting a similar outcome, less harm to the patients.

The FDA is expected to make a decision about the labeling in the near future.

Researchers at the Montefiore Medical Center in New York enrolled one hundred person who were being treated for chronic cough. Each participant underwent standardized testing for depression using the CES-D scale.

The CES-D scale rates a person's mood based on a series of questions. It awards a point value according to answers and defines a cut-off value for depression. Any score above 16 indicates a greater degree of depression or depressive symptoms.

More than half of the participants scored above 16 on the CES-D scale. The mean score was 18.3. After a three month treatment period the average CES-D score dropped to 7.4, a decline that was coorelated with a decline in cough symtpoms.

Based on further analysis the authors concluded that chronic cough is significantly associated with depressive symtpoms. Treatment and alleviation of cough most always results in alleviation of depression.

In some cases the depression may not be due to cough, and as always any depressive symtpoms should not be ignored.

Researchers at Carnegie Mellon University subjected healthy volunteers to personality testing that determined primary personality traits, percieved health, and emotional wellbeing. Then each person was inoculated with a cold or flu virus.

Over the next week volunteers were asked to report their symptoms, if any.

They found that those individuals who were labeled as having a more positive outlook, or as happy individuals were less likely to report symtpoms of illness.

Researchers believe that their may be two mechanisms at play. First is the objective theory that a happy mood may cause the immune system to behave more effectively. Then second, those with a more positive outlook may be less irritated or less likely to report mild symptoms.

When self reported optimism was accounted for, the happy person still had less complaints from the inoculation compared to those with a less positive outlook.

The authors concluded that "positive emotions have a big effect" on one's health and well being, possibly to a greater degree than we currently understand.

The study, published in Biological Psychiatry, compared the effect of usual treatment to VNS plus usual treatment in patients with treatment-resistant depression. Researchers at the Medical University of South Carolina in Charleston, analyzed the data of 124 participants with treatment-resistant depression receiving usual depression treatment and 205 participants with treatment-resistant depression receiving VNS plus usual depression treatment, for 12 months. The participants had similar baseline demographic, psychiatric and treatment histories, and treatment resistance.

Researchers found that 27 percent of the VNS group had an improvement in depression symptoms, as compared to 13 percent of the usual treatment group. The two groups were administered similar treatment, including drugs and electroconvulsive therapy, during follow-up.

"This comparison of two similar but nonrandomized treatment-resistant depression groups showed that VNS plus treatment as usual was associated with a greater antidepressant benefit over 12 months," the study authors conclude.

REFERENCES:
1. George MS et al. A one-year comparison of vagus nerve stimulation with treatment as usual for treatment-resistant depression. Biol Psychiatry 2005 Sep 1;58(5):364-73.

Recognizing the warning signs of infidelity can help prevent extramarital affairs. Experts identify the following red flags of infidelity:

1. Your partner tells you the marriage has problems-

2. Your partner changes their appearance-

3. Your partner is hypercritical-

4. Your partner is giving you lavish gifts out of guilt-

5. Your partner's colleagues give you the cold shoulder-

6. Your partner is secretive-

7. Your partner has a history of infidelity-

Once you recognize your partner's warning sign(s), you'll need to take action to save your marriage from infidelity. Experts suggest that you directly address your partner's behavior. If you're unable to open up a dialogue, suggest couples therapy. Addressing the potential problem early will help save the relationship. However, infidelity and marital problems don't necessarily mean a marriage is over. With treatment, healing, forgiveness, and recovery, the marriage can become stronger with developed trust, commitment and empathy.

REFERENCES:
1. Glass SP. AAMFT Consumer Update: Infidelity. AAMFT.org:
http://www.aamft.org/families/consumer_updates/infidelity.asp

The study, presented at the June 10-11, 2006 meeting of the American Diabetes Association in Washington, DC, investigated whether antidepressant drugs are associated with the risk of developing type 2 diabetes. Researchers at the Johns Hopkins Medical Institutions in Baltimore, Maryland analyzed the data of 3,187 overweight participants with impaired glucose tolerance (IGT), as part of the Diabetes Prevention Program (DPP), for three years. At the beginning of the study, 5.7% of participants were taking antidepressants and 13.6% had previously taken antidepressants. Seventy-eight percent of those using antidepressants were taking selective serotonin reuptake inhibitors (SSRI), serotonin norepinephrine reuptake inhibitors, or serotonin modulators. The participants' symptoms of depression were measured on the Beck Depression Inventory.

The researchers found that there was a two- to three-times greater risk of developing type 2 diabetes for participants who took antidepressants. Findings also revealed that participants with symptoms of depression at the beginning of the study, but were not taking antidepressants, did not have an increased risk for type 2 diabetes. These results were found after controlling for demographic factors and weight changes.

The study results don't explain how antidepressant drugs increase the risk for type 2 diabetes, or which antidepressants may be linked with the greatest risk.

REFERENCES:
1. Rubin RR et al. "Depression Symptoms, Antidepressant Medicine Use and Risk of Developing Diabetes in Diabetes Prevention Program Participants." Abstract 869-P, presented at the June 10-11, 2006 meeting of the American Diabetes Association in Washington, DC

The study, published in the American Journal of Psychiatry, reviewed studies on omega 3 fatty acids and its role as a cause and natural treatment of mood disorders. Studies suggest an association between low fish intake and higher rates of mood disorders, such as depression and bipolar disorder. Other studies indicate that omega 3 supplementation may offer therapeutic benefits, including mood-stabilizing and antidepressant effects.

However, it remains unclear if omega 3 supplementation alone has antidepressant effects or whether it should augment antidepressant drugs. Furthermore, more studies need to be done to determine which omega 3 fatty acid (EPA or DHA) has the greatest benefit and in what dose. The study authors believe that changes in the western diet over the past 150 years have decreased omega 3 levels in the body.

"Deficits in omega-3 fatty acids have been identified as a contributing factor to mood disorders and offer a potential rational treatment approach," the study authors write. "This review identifies a number of hypotheses and studies for consideration. In particular, the authors argue for studies clarifying the efficacy of omega-3 supplementation for unipolar and bipolar depressive disorders, both as individual and augmentation treatment strategies, and for studies pursuing which omega-3 fatty acid, eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA), is likely to provide the greatest benefit. "

REFERENCES:
1. Parker G et al. Omega-3 Fatty Acids and Mood Disorders. Amer J Psych 2006 Jun;163(6):969-978.

2. Unhealthy change in Western diet. Black Dog Institute News Release, June 22, 2006:
http://www.blackdoginstitute.org.au/media/newsreleases/documents/
Omega-3papernewsrelease.pdf

Some experts believe that certain types of mental disorders and addictions may even be a single disease. One indication is that studies have found similarities within the brain chemistry of certain mental illnesses and addiction. Other research has found that when one of the conditions deteriorates, the other condition will also deteriorate. This is often seen in bipolar disorder and substance abuse problems.

Bipolar disorder (also called manic-depressive disorder) is characterized by extreme mood swings, ranging between episodes of high elation (mania) and deep depression. Studies show that bipolar disorder patients have a very high rate of alcohol addiction. Bipolar patients have a seven times greater incidence of alcoholism than that of the general population, including those with other types of mental disorders.

Experts agree that both the mental health problem and substance abuse problem need to be treated simultaneously. A dual treatment program that integrates addictive substances detoxification with mental health care can effectively get both problems under control. Furthermore, a good therapeutic alliance between doctor and patient will help prevent relapses of both problems.

To assess cognitive function each participant was given a battery of standard tests which assessed memory, attention, and learning ability. The same tests were given five years later. The researchers also took measurements of height and weight and determined BMI during each of the testing periods. The change in cognitive function was compared to the change in BMI over the study period.

In general participants with a higher BMI scored lower on the tests after accounting for age, sex, and educational differences. Then after the five year period, the rate of cognitive decline was more in those who had a higher BMI, or those who gained more weight during that period.

The researchers believe that non-diagnosed conditions such as heart disease, high blood pressure, and diabetes could effect mental function via damage to blood vessels. But they also discussed the effect of leptin, a hormone made by fat cells, on mental function. Leptin may affect key aspects of learning and memory, which could help explain the effect on cognitive function.

Still the authors state that this study provides another reason for individuals to maintain a healthy weight. Obesity is an epidemic in the US and contributes to a variety of chronic diseases and this new study adds mental decline to the list.

The small pilot study, published in Dermatologic Surgery, investigated the effect of botox treatment on patients with major depression. Researchers at the Saint Dermatology and Cosmetic Surgery Associates in Greenbelt, Maryland administered five botox injections into the frown muscles of 10 depressed patients, for two months. The participants were evaluated for depression with the Beck Depression Inventory II (BDI-II) before and after treatment. The patients had previously been treated with antidepressants and psychotherapy.

Researchers found that 9 out of 10 of the participants were no longer depressed, and did not meet the clinical standards for depression. Furthermore, the tenth participant was still depressed, but reported an improved mood.

"To our knowledge, these are the first reported cases of depression treated with botulinum toxin A," write the study authors.

Due to the small size of the study and lack of comparison group, some experts question the study's findings. They suggest that definitive results will require further study in larger clinical trials.

REFERENCES:
1. Finzi E and Wasserman E. Treatment of depression with botulinum toxin A: a case series. Dermatol Surg 2006 May;32(5):645-9; discussion 649-50.