Mood disorder

Family History Of Suicide: Parent’s Suicidal Behavior Could Influence Child’s.

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Suicide

Parent’s suicidal behavior may influence their child’s suicidal behavior. 

It is well known that a family history of suicide increases a young person’s risk for suicidal behavior. However, very little is known about what mechanisms and pathways lead to familial transmission of suicidal behavior. A recent study published in JAMA Psychiatry has found that having a parent who attempted suicide means a child with a mood disorder could be five times more likely to exhibit suicidal behavior.

According to the National Institute of Mental Health, approximately 38,000 people die by suicide each year in the United States. Some of the most common risk factors for suicide include a family history of suicide, a family history of mental disorder or substance abuse, and family violence, including physical or sexual abuse. While tragic, suicide is often preventable, and the best method of prevention is knowing the signs and getting help.

“Impulsive aggression played an important role in increasing the likelihood of an offspring suicide attempt, but it did so by increasing the risk of the subsequent development of a mood disorder, which in turn increased the risk of an attempt,” the research team explained. “The transition from impulsive aggression to mood disorder may be particularly salient to understanding recurrent suicidal behavior because this pathway from offspring suicide attempt at baseline to an attempt at follow-up was mediated by offspring impulsive aggression and mood disorder.”

The research team, led by Dr. David A. Brent from the University of Pittsburgh Medical Center, recruited 701 children between the ages of 10 and 50, as well as 334 parents suffering from mood disorder, 191 of which had attempted suicide. Both children and parents were followed for a period of 5.6 years. At the beginning of the study, which took place between July 1997 and June 2012, participants underwent a complete psychiatric assessment as well as self-reported questionnaires.

Out of 701 children, 44 admitted to attempting suicide prior to the study and 29 made a suicide attempt during the study’s follow-up, 19 of which were first-time suicide attempts. Incidence of depression among children in the study increased from 29.6 percent in the first 1-2 years to 48.2 percent by the end of the study. After accounting for previous suicide attempts and familial transmission of a mood disorder, results indicated that children with a parent who attempted suicide were nearly five times more likely to attempt suicide.

“Parental history of a suicide attempt conveys a nearly five-fold increased odds of suicide attempt in offspring at risk for mood disorder, even after adjusting for the familial transmission of mood disorder,” the research team concluded. “Interventions that target mood disorder and impulsive aggression in high-risk offspring may attenuate the familial transmission of suicidal behavior.”

Source: Oquendo M, Melhem N, Brent D, et al. Familial Pathways to Early-Onset Suicide AttemptA 5.6-Year Prospective Study. JAMA Psychiatry. 2014.

Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis..

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Background

Cancer survival has improved in the past 20 years, affecting the long-term risk of mood disorders. We assessed whether depression and anxiety are more common in long-term survivors of cancer compared with their spouses and with healthy controls.

Methods

We systematically searched Medline, PsycINFO, Embase, Science Direct, Ingenta Select, Ovid, and Wiley Interscience for reports about the prevalence of mood disorders in patients diagnosed with cancer at least 2 years previously. We also searched the records of the International Psycho-oncology Society and for reports that cited relevant references. Three investigators independently extracted primary data. We did a random-effects meta-analysis of the prevalences of depression and anxiety in cancer patients compared with spouses and healthy controls.

Findings

Our search returned 144 results, 43 were included in the main analysis: for comparisons with healthy controls, 16 assessed depression and ten assessed anxiety; of the comparisons with spouses, 12 assessed depression and five assessed anxiety. The prevalence of depression was 11·6% (95% CI 7·7—16·2) in the pooled sample of 51 381 cancer survivors and 10·2% (8·0—12·6) in 217 630 healthy controls (pooled relative risk [RR] 1·11, 95% CI 0·96—1·27; p=0·17). The prevalence of anxiety was 17·9% (95% CI 12·8—23·6) in 48 964 cancer survivors and 13·9% (9·8—18·5) in 226 467 healthy controls (RR 1·27, 95% CI 1·08—1·50; p=0·0039). Neither the prevalence of depression (26·7% vs 26·3%; RR 1·01, 95% CI 0·86—1·20; p=0·88) nor the prevalence of anxiety (28·0% vs 40·1%; RR 0·71, 95% CI 0·44—1·14; p=0·16) differed significantly between cancer patients and their spouses.

Interpretation

Our findings suggest that anxiety, rather than depression, is most likely to be a problem in long-term cancer survivors and spouses compared with healthy controls. Efforts should be made to improve recognition and treatment of anxiety in long-term cancer survivors and their spouses.

Source: Lancet

When does your mental health become a problem?

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One in four people are expected to experience a mental health problem, yet stigma and discrimination are still very common. Myths such as assuming mental illness is somehow down to a ‘personal weakness’ still exist.

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How do we define mental health?

A person who is considered ‘mentally healthy‘ is someone who can cope with the normal stresses of life and carry out the usual activities they need to in order to look after themselves; can realise their potential; and make a contribution to their community. However, your mental health or sense of ‘wellbeing’ doesn’t always stay the same and can change in response to circumstances and stages of life.

Everyone will go through periods when they feel emotions such as stress and grief, but symptoms of mental illnesses last longer than normal and are often not a reaction to daily events. When these symptoms become severe enough to interfere with a person’s ability to function, they may be considered to have a significant psychological or mental illness.

Someone with clinical depression, for example, will feel persistent and intense sadness, making them withdrawn and unmotivated. These symptoms usually develop over several weeks or months, although occasionally can come on much more rapidly.

Mental health problems are defined and classified to help experts refer people for the right care and treatment. The symptoms are grouped in two broad categories – neurotic and psychotic.

Neurotic conditions are extreme forms of ‘normal’ emotional experiences such as depression, anxiety or obsessive compulsive disorder (OCD). Around one person in 10 experiences these mood disorders at any one time. Psychotic symptoms affect around one in 100 and these interfere with a person’s perception of reality, impairing their thoughts and judgments. Conditions include schizophrenia and bipolar disorder.

Mental illness is common but fortunately most people recover or learn to live with the problem, especially if diagnosed early.

What causes mental illness?

How common are mental illnesses in the UK?

  • Anxiety will affect 10% of the population
  • Bipolar disorder will affect one in 100
  • One in every 150 15-year-old girls will get anorexia, and one in every 1000 15-year-old boys
  • 20% of people will become depressed at some point in their lives
  • OCD will affect 2%
  • Personality disorder will affect one in 10, though for some it won’t be severe
  • Schizophrenia will affect one in 100

Source: Royal College of Psychiatrists

The exact cause of most mental illnesses is not known but a combination of physical, psychological and environmental factors are thought to play a role.

Many mental illnesses such as bipolar disorder can run in families, which suggests a genetic link. Experts believe many mental illnesses are linked to abnormalities in several genes that predispose people to problems, but don’t on their own directly cause them. So a person can inherit a susceptibility to a condition but may not go on to develop it.

Psychological risk factors that make a person more vulnerable include suffering, neglect, loss of a parent, or experiencing abuse.

Difficult life events can then trigger a mental illness in a person who is susceptible. These stressors include illness, divorce, death of a loved one, losing a job, substance abuse, social expectations and a dysfunctional family life.

When is someone thought to be mentally ill?

A mental illness can not be ‘tested’ by checking blood or body fluids. Instead it is diagnosed, usually by an experienced psychiatrist or clinical psychologist, after studying a patient’s symptoms and monitoring them over a period of time.

How ICD-10 classifies bipolar affective disorder:

‘A disorder characterized by two or more episodes in which the patient’s mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression). ‘

Many different mental illnesses can have overlapping symptoms, so it can be difficult to tell the conditions apart.

To diagnose a mental health condition, psychiatrists in the UK may refer to the World Health Organisation’s International Classification of Diseases (ICD) system. This lists known mental health problems and their symptoms under various sub-categories. It is updated around every 15 years.

Some experts argue that the current system relies too strongly on medical approaches for mental health problems. They say it implies the roots of emotional distress are simply in brain abnormalities and underplay the social and psychological causes of distress.

They argue that this leads to a reliance on anti-depressants and anti-psychotic drugs despite known significant side-effects and poor evidence of their effectiveness.

Source: BBC

When does your mental health become a problem?.

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One in four people are expected to experience a mental health problem, yet stigma and discrimination are still very common. Myths such as assuming mental illness is somehow down to a ‘personal weakness’ still exist.

How do we define mental health?

_67120046_mentalhealth74879048

A person who is considered ‘mentally healthy‘ is someone who can cope with the normal stresses of life and carry out the usual activities they need to in order to look after themselves; can realise their potential; and make a contribution to their community. However, your mental health or sense of ‘wellbeing’ doesn’t always stay the same and can change in response to circumstances and stages of life.

Everyone will go through periods when they feel emotions such as stress and grief, but symptoms of mental illnesses last longer than normal and are often not a reaction to daily events. When these symptoms become severe enough to interfere with a person’s ability to function, they may be considered to have a significant psychological or mental illness.

Someone with clinical depression, for example, will feel persistent and intense sadness, making them withdrawn and unmotivated. These symptoms usually develop over several weeks or months, although occasionally can come on much more rapidly.

Mental health problems are defined and classified to help experts refer people for the right care and treatment. The symptoms are grouped in two broad categories – neurotic and psychotic.

Neurotic conditions are extreme forms of ‘normal’ emotional experiences such as depression, anxiety or obsessive compulsive disorder (OCD). Around one person in 10 experiences these mood disorders at any one time. Psychotic symptoms affect around one in 100 and these interfere with a person’s perception of reality, impairing their thoughts and judgments. Conditions include schizophrenia and bipolar disorder.

Mental illness is common but fortunately most people recover or learn to live with the problem, especially if diagnosed early.

How common are mental illnesses in the UK?

  • Anxiety will affect 10% of the population
  • Bipolar disorder will affect one in 100
  • One in every 150 15-year-old girls will get anorexia, and one in every 1000 15-year-old boys
  • 20% of people will become depressed at some point in their lives
  • OCD will affect 2%
  • Personality disorder will affect one in 10, though for some it won’t be severe
  • Schizophrenia will affect one in 100

Source: Royal College of Psychiatrists

What causes mental illness?

The exact cause of most mental illnesses is not known but a combination of physical, psychological and environmental factors are thought to play a role.

Many mental illnesses such as bipolar disorder can run in families, which suggests a genetic link. Experts believe many mental illnesses are linked to abnormalities in several genes that predispose people to problems, but don’t on their own directly cause them. So a person can inherit a susceptibility to a condition but may not go on to develop it.

Psychological risk factors that make a person more vulnerable include suffering, neglect, loss of a parent, or experiencing abuse.

Difficult life events can then trigger a mental illness in a person who is susceptible. These stressors include illness, divorce, death of a loved one, losing a job, substance abuse, social expectations and a dysfunctional family life.

When is someone thought to be mentally ill?

A mental illness can not be ‘tested’ by checking blood or body fluids. Instead it is diagnosed, usually by an experienced psychiatrist or clinical psychologist, after studying a patient’s symptoms and monitoring them over a period of time.

Many different mental illnesses can have overlapping symptoms, so it can be difficult to tell the conditions apart.

To diagnose a mental health condition, psychiatrists in the UK may refer to the World Health Organisation’s International Classification of Diseases (ICD) system. This lists known mental health problems and their symptoms under various sub-categories. It is updated around every 15 years.

Some experts argue that the current system relies too strongly on medical approaches for mental health problems. They say it implies the roots of emotional distress are simply in brain abnormalities and underplay the social and psychological causes of distress.

They argue that this leads to a reliance on anti-depressants and anti-psychotic drugs despite known significant side-effects and poor evidence of their effectiveness.

How ICD-10 classifies bipolar affective disorder:

‘A disorder characterized by two or more episodes in which the patient’s mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression). ‘

Source: BBC

Prolonged, Disabling Fatigue in Teens Common, Undertreated.

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Extreme, persistent fatigue in US adolescents is common, highly disabling, and often coexists with mood disorders, new research shows.

A survey conducted by investigators from the National Institute of Mental Health showed that prolonged fatigue, defined as lasting 3 months or longer, was reported in 3% of teens aged 13 to 18 years, and more than half of these youth reported severe or very severe difficulties in school, family, or social situations.

Among teens with prolonged fatigue, 1.4% had prolonged fatigue alone, and 1.6% had prolonged fatigue with comorbid depression or anxiety.

“Many parents complain their adolescents are ‘lazy’ because they tend to sleep late on weekends and do not seem to have much energy. Our data suggest that fatigue may be an indicator of either physical or mental disorders that should be followed up by their physician,” Kathleen Merikangas, PhD, from the National Institute of Mental Health, told Medscape Medical News.

The study is published in the May issue of the American Journal of Psychiatry.

The investigators studied the prevalence and correlates of prolonged fatigue in a representative sample of 10,123 US adolescents aged 13 to 18 years. They defined prolonged fatigue as extreme fatigue with at least 1 associated symptom, including pain, dizziness, headache, sleep disturbance, inability to relax, and irritability, that does not resolve by rest or relaxation and lasts at least 3 months.

Dr. Merikangas said what she found most interesting was “the extent to which persistent fatigue alone, without comorbid anxiety or depression, was associated with disability in adolescents from the general population.”

Nearly 60% of the adolescents with prolonged fatigue only had severe or very severe disability, and their rates of poor physical and mental health were on par with those of adolescents with mood or anxiety disorders, the investigators say.

Adolescents with prolonged fatigue plus a mood or anxiety disorder had significantly greater disability, poorer mental health, and more health service use than those with either condition alone.

“Extreme fatigue that continues even after rest and interferes with adolescents’ ability to participate academically, socially, or at home is a pathological condition, yet it’s not being recognized and treated,” Dr. Merikangas commented in a statement. “Also, teens with a depressive or anxiety disorder plus persistent fatigue appear to be sicker than those without fatigue.”

“Fatigue should be routinely assessed by healthcare providers. Among youth with mood or anxiety disorders, fatigue may be an important indicator of negative health behaviors (eg, smoking, drug use) and disability,” she said.

In an accompanying editorial, Gijs Bleijenberg, PhD, and Hans Knoop, PhD, of Radboud University Nijmegan Medical Centre, the Netherlands, write that the prevalence of persistent fatigue without anxiety or depression was “surprisingly high.”

Perhaps of even greater concern was that 60% of this group had disabling fatigue, yet most did not seek medical help.

They note that is not unusual for adolescents to engage in extreme behavior and exhaust themselves. However, fatigue that does not resolve when teens modify their behavior has significant health implications for social, emotional, and intellectual development and warrants medical attention.

Source: medscape.com