Missing DNA Parts Linked to Schizophrenia Risk

Provided by: Associated PressWritten by: Malcolm Ritter, THE ASSOCIATED PRESS Jul. 30, 2008

NEW YORK - Two huge international studies show that people who lack certain chunks of DNA run a dramatically higher risk of getting schizophrenia, a finding that could help open new doors to understanding and diagnosing the disease.

These deletions are rare, each found in less than one per cent of schizophrenia patients. But each one boosts the risk of disease by as much as 15-fold, by one estimate.

Scientists said studying such abnormalities may help them find new medications by shedding light on what causes the disease. And if enough rare aberrations can be found eventually, they may be combined into a test to help in diagnosis, said Kari Stefansson, chief executive officer of deCode Genetics of Reykjavik, Iceland, and an author of one of the studies.

Schizophrenia is currently diagnosed by its symptoms.
The human DNA can be thought of as a very long string of letters - about three billion of them - that sometimes form words (genes). Each newly identified deletion removes a section of about half a million to two million letters.

In the past, scientists have found specific genes and deletions linked to schizophrenia risk. But the new work is notable because two large studies independently identified the same two DNA deletions, and those aberrations have such a big impact on disease risk. Stefansson's paper also reports evidence for a third deletion.

While the DNA deletions are linked to only a tiny fraction of schizophrenia cases, it's not unusual that a very rare cause of a disease provides insights that apply more generally, said Dr. Pamela Sklar of Massachusetts General Hospital, an author of the other paper. She said such knowledge can lead to treatments for many people.

Both papers were published online Wednesday by the journal Nature. Experts not connected with the work praised the results.

"This is tremendous" for basic research into the disease, said Dr. Linda Brzustowicz of Rutgers University. But since the deletions found so far are related to such a small fraction of schizophrenia cases, she said it's too early for companies to offer to test people for them.
Stefansson's paper, which included authors from more than a dozen centres in the United States, Europe and China, reported findings from DNA tests in about 4,700 people with schizophrenia and more than 40,000 healthy people. Sklar's paper, which included scientists from 11 institutes in the United States, Europe and Australia, tested about 3,400 people with schizophrenia and 3,200 others.

Both papers found that while the deletions were rare in schizophrenia patients, they were even rarer in people without the disease. Scientists say the disease results from a combination of genetic predisposition and environmental influences.

The two deletions found by both research groups boost schizophrenia risk 12-fold and 15-fold, Stefansson's group calculated. A third deletion his group found appears to raise risk about threefold.

Sklar said she was "absolutely delighted" that the papers found the two deletions independently, using different methods.

Anne Pulver, a schizophrenia genetics expert at Johns Hopkins University, said the papers represent a welcome shift in focus for finding genetic variants that affect risk of schizophrenia.
Traditionally, that search has centred on relatively common variants, each with little effect on an individual's risk. The new approach seeks rare variants that play a larger role. The new approach should help identify subgroups of patients with different genetic causes for their disease, she said. Eventually that could lead to treatments that are tailored to the differing biological causes, with improved outcomes, she said.
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On the Net:
Nature: http://www.nature.com/nature
Information on schizophrenia: http://www.nimh.nih.gov/health/topics/schizophrenia

A brief overview of Interface Consultation Services current endeavors:

I. Blog Focus - We continue to post weekly on ICS and Counseling Connections.Our posts include mental health research, news and thoughts we feel providers and clients will find valuable.

II. Counseling Connections - Provides Licensed Professional Online and Telephone Mental Health Counseling, Coaching and Services.

III. Telemental Health Triage - We continue our day-to-day service commitment to Riverwood Center to provide professional triage services so their consumers are assured efficient and timely access to mental health services, appropriate level of care assignments and expert telephone crisis triage.

IV. MPRI - Michigan Prisoner Re-entry Initiative for the Mentally Ill - ICS are contracted as the Regional Care Coordinators for the Western Michigan providing services to 18 counties. ICS has hired 5 contracts to assist with this initiative. This program continues to grow at a very fast pace and it the only program of it's kind in the US. This speciality program is designed for mentally ill prisoners who are returning to the community. As Care coordinators we provide funding for housing, psychiatric medications, specialized placements as well as care coordination and consultation on some very difficult cases for the program.

V. Passages - ICS is offering Mobile, Intensive, Short-term, Targeted Case Management Services located in Western Michigan will provide case management service option that requires an immediate, flexible, direct-service and mobile response.

This service is designed to provide the intensity of services needed to the non-severely and persistently mentally ill/indigent population that are currently underserviced or are unable to obtain these services at this time through traditional providers.

VI. Utilization Management Opportunities - We continue to provide acute care preauthorization services for Riverwood Center.

VII. College Level Course - ICS owner/partner, Kathlene LaCour is an part-time facility member at Kalamazoo Valley Community College.Please contact us via email by clicking on the link to learn more about how we can service your consulting needs or call (269)929-1292.

Men Drink, Women Ruminate Leading to Anxiety and Depression When Stressed

Women and men tend to have different types of stress-related psychological disorders. Women have greater rates of depression and some types of anxiety disorders than men, while men have greater rates of alcohol-use disorders than women. A new study of emotional and alcohol-craving responses to stress has found that when men become upset, they are more likely than women to want alcohol.

"We know that women and men respond to stress differently," said Tara M. Chaplin, associate research scientist at Yale University School of Medicine and first author of the study. "For example, following a stressful experience, women are more likely than men to say that they feel sad or anxious, which may lead to risk for depression and anxiety disorders. Some studies have found that men are more likely to drink alcohol following stress than women. If this becomes a pattern, it could lead to alcohol-use disorders."

As part of a larger study, the researchers exposed 54 healthy adult social drinkers (27 women, 27 men) to three types of imagery scripts - stressful, alcohol-related, and neutral/relaxing - in separate sessions, on separate days and in random order. Chaplin and her colleagues then assessed participants' subjective emotions, behavioral/bodily responses, cardiovascular arousal as indicated by heart rate and blood pressure, and self-reported alcohol craving.

"After listening to the stressful story, women reported more sadness and anxiety than men," said Chaplin, "as well as greater behavioral arousal. But, for the men ... emotional arousal was linked to increases in alcohol craving. In other words, when men are upset, they are more likely to want alcohol."

These findings - in addition to the fact that the men drank more than the women on average - meant that the men had more experience with alcohol, perhaps leading them to turn to alcohol as a way of coping with distress, added Chaplin. "Men's tendency to crave alcohol when upset may be a learned behavior or may be related to known gender differences in reward pathways in the brain," she said. "And this tendency may contribute to risk for alcohol-use disorders."
There is a greater societal acceptance of "emotionality," particularly sadness and anxiety, in women than in men, noted Chaplin.

"Women are more likely than men to focus on negative emotional aspects of stressful circumstances, for example, they tend to 'ruminate' or think over and over again about their negative emotional state," she said. "Men, in contrast, are more likely to distract themselves from negative emotions, to try not to think about these emotions. Our finding that men had greater blood pressure response to stress, but did not report greater sadness and anxiety, may reflect that they are more likely to try to distract themselves from their physiological arousal, possibly through the use of alcohol."

Chaplin TM, Hong K, Bergquist K, Sinha R. Gender Differences in Response to Emotional Stress: An Assessment Across Subjective, Behavioral, and Physiological Domains and Relations to Alcohol Craving. Alcohol Clin Exp Res. 2008;doi: 10.1111/j.1530-0277.2008.00679.x [Abstract]

Research on Effectiveness of Psychotherapies for Children

The National Instititute of Mental Health has completed en evaluation of research and the effectiveness for mental disorders for children. Please see NIMH site and below..

Reviews of the current research on psychosocial and behavioral therapies, or psychotherapies, for children and adolescents found a number of "well established" and "probably efficacious" treatments for many mental disorders. For example, six were "probably efficacious" for anxiety disorders, and two were "well established" for attention deficit hyperactivity disorder (ADHD), according to scientists funded by NIMH and the National Institute on Drug Abuse, divisions of the National Institutes of Health.

The results were published in a special issue of the Journal of Clinical Child and Adolescent Psychology, and cover the current state of research psychotherapies for children and adolescents with mental disorders. NIMH grantees Wendy Silverman, Ph.D., of Florida International University, Miami, and Stephen Hinshaw, Ph.D., of the University of California, Berkeley, served as guest editors. This special issue provides a 10-year update on the original special issue on psychosocial treatments, published in 1998."

Even for the most effective interventions, there is substantial individual variability in treatment response," said Benedetto Vitiello, chief of NIMH's Child and Adolescent Treatment and Preventive Intervention Research Branch. "Further research is needed to understand the factors accounting for treatment effects and to identify predictors of response, in order to eventually arrive at more targeted and specific intervention strategies."

Overall, the 10 articles in the special issue reveal considerable advances over the past decade in the quality and quantity of research on psychosocial treatments for children with mental disorders.

Among notable findings:A review of 32 studies by Silverman and her colleagues concluded that six therapies for anxiety disorders have substantial research support and met the criteria for "probably efficacious" and may be helpful for treating children and adolescents with anxiety disorders. These treatments are:
Individual cognitive behavioral therapy.
Group cognitive behavioral therapy (GCBT).
GCBT with parents.GCBT for social phobia.

Social effectiveness training for children with social phobia.Few large-scale trials on anxiety disorders have compared specific psychosocial therapies with credible control conditions. As a result, to date, no specific psychotherapies met the most stringent criteria for "well-established treatments" used for this article. However, the second-highest ranking of "probably efficacious" denotes considerable research evidence supporting a treatment's usefulness, so mental health care providers can be confident in using the therapies listed, Silverman says.

A review of 46 studies by William Pelham, Jr., Ph.D., and Gregory Fabiano, Ph.D., both of the State University of New York at Buffalo, found that two psychosocial treatments are "well-established" for treating ADHD in children and adolescents:

Behavioral parent training.
Behavioral classroom management.

The authors also found a third type of well-established behavioral intervention called the Summer Treatment Program (STP), which focuses on peer relationships and is often given in recreational, summer camp-like settings. Children in STP typically receive more hours of treatment in a week compared to other weekly forms of psychotherapy, but STP is more expensive, and harder to provide in the community, and harder to find than behavioral parent training and behavioral classroom management.

In addition to anxiety and ADHD, the special issue also evaluates evidence-based psychosocial treatments for autism, eating disorders, depression, obsessive-compulsive disorder, exposure to traumatic events, disruptive behavior, and substance abuse. In addition, one of the articles focused on psychotherapies and treatment approaches specific to different ethnic and cultural backgrounds.

Mental disorders are generally treated with psychotherapy, medications, or a combination of the two. As scientists find out more about how mental disorders affect the brain and behavior, they also better understand what makes a treatment work for certain disorders or certain people. This can sometimes lead to new medications or therapies, or new uses for existing treatments. However, such treatments may not be proven by research (evidence-based).

The special issue helps address knowledge gaps by reporting on the current state of evidence-based psychosocial treatments in children and adolescents. For each article, scientists provided a review of the research literature in their field of expertise. The articles also:Identify the most effective psychosocial treatments, using and building on guidelines developed in 1995 by the American Psychological Association Task Force on Promotion and Dissemination of Psychological Procedures.

Discuss factors that may affect a child's response to treatment.Suggest directions for future research.Each article also discusses practice recommendations based on available research for doctors and other mental health care providers. However, these recommendations are intended more as a guide to current treatments and are not a requirement or prescription for best care."

We can only hope that the current generation of child and adolescent psychosocial treatment researchers will heed the call expressed in these articles for even more sophisticated, more rigorous, and more statistically powerful studies," said Drs. Silverman and Hinshaw.

Reference
Silverman WK, Hinshaw SP. The Second Special Issue on Evidence-Based Psychosocial Treatments for Children and Adolescents: A Ten-Year Update. J Clin Child Adolesc Psychol. 2008 Jan-Mar;37(1)

Our Deepest Fear.......MLK Day!

Our deepest fear is not that we are inadequate.
Our deepest fear is that we are powerful beyond measure.
We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous?
Actually, who are you not to be?
We were born to make manifest the glory of God that is within us.
And as we let our own light shine, we unconsciously give other people permission to do the same.

-Martin Luther King, Jr.

Teen Brain Still Maturing

Provided by: Associated Press
Written by: Malcolm Ritter, THE ASSOCIATED PRESS Dec. 2, 2007
NEW YORK - The teenage brain, Laurence Steinberg says, is like a car with a good accelerator but a weak brake. With powerful impulses under poor control, the likely result is a crash.

And, perhaps, a crime.

Steinberg, a Temple University psychology professor, helped draft an American Psychological Association brief for a 2005 case in which the U.S. Supreme Court outlawed the death penalty for crimes committed before age 18.

That ruling relies on the most recent research on the adolescent brain, which indicates the juvenile brain is still maturing in the teen years and reasoning and judgment are developing well into the early to mid 20s. It is often cited as state legislators consider scaling back punitive juvenile justice laws passed during the 1990s.

"As any parent knows," wrote Justice Anthony Kennedy for the 5-4 majority, youths are more likely to show "a lack of maturity and an underdeveloped sense of responsibility" than adults. "These qualities often result in impetuous and ill-considered actions and decisions."

He also noted that "juveniles are more vulnerable or susceptible to negative influences and outside pressures, including peer pressure," causing them to have less control over their environment.

Some child advocates have pointed to the Supreme Court decision and the research as evidence that teens - even those accused of serious crimes - should not be regarded in the same way as adults in the criminal justice system.

Dr. David Fassler, a psychiatry professor at the University of Vermont College of Medicine who has testified before legislative committees on brain development, says the research doesn't absolve teens but offers some explanation for their behavior.

"It doesn't mean adolescents can't make a rational decision or appreciate the difference between right and wrong," he said. "It does mean, particularly when confronted with stressful or emotional decisions, they are more likely to act impulsively, on instinct, without fully understanding or analyzing the consequences of their actions."

Experts say that even at ages 16 and 17, when compared to adults, juveniles on average are more:
-impulsive.
-aggressive.
-emotionally volatile.
-likely to take risks.
-reactive to stress.
-vulnerable to peer pressure.
-prone to focus on and overestimate short-term payoffs and underplay longer-term consequences of what they do.
-likely to overlook alternative courses of action.

Violence toward others also tends to peak in adolescent years, says psychiatrist Dr. Peter Ash of Emory University. It's mostly likely to start around age 16, and people who haven't committed a violent crime by age 19 only rarely start doing it later, he said.

The good news here, he said, is that a violent adolescent doesn't necessarily become a violent adult. Some two-thirds to three-quarters of violent youth grow out of it, he said. "They get more self-controlled."

Some of the changes found in behavioral studies are paralleled by changes in the brain itself as youths become adults.

In fact, in just the past few years, Steinberg said, brain scans have given biological backing to commonsense notions about teen behavior, like their impulsiveness and vulnerability to peer pressure.

It's one thing to say teens don't control their impulses as well as adults, but another to show that they can't, he said. As for peer pressure, the new brain research "gives credence to the idea that this isn't a choice that kids are making to give in to their friends, that biologically, they're more vulnerable to that," he said.

Consider the lobes at the front of the brain. The nerve circuitry here ties together inputs from other parts of the brain, said Dr. Jay Giedd of the National Institute of Mental Health.

This circuitry weighs how much priority to give incoming messages like "Do this now" versus "Wait! What about the consequences?" In short, the frontal lobes are key for making good decisions and controlling impulses.

Brain scans show that the frontal lobes don't mature until age 25, and their connections to other parts of the brain continue to improve to at least that age, Giedd said.

The inexplicable behavior and poor judgments teens are known for almost always happen when teens are feeling high emotion or intense peer pressure, conditions that overwhelm the still-maturing circuitry in the front part of brain, Giedd said.

Personal Care, Restaurant Industries Have Highest Depression Rates

Provided by: Associated PressWritten by: Kevin Freking, THE ASSOCIATED PRESS Oct. 13, 2007 and Conoe News

WASHINGTON - People who tend to the elderly, change diapers and serve up food and drinks have the highest rates of depression among U.S. workers.
Overall, seven per cent of full-time workers battled depression in the past year, according to a government report available Saturday.

Women were more likely than men to have had a major bout of depression, and younger workers had higher rates of depression than their older colleagues.

Almost 11 per cent of personal care workers - which includes child care and helping the elderly and severely disabled with their daily needs - reported depression lasting two weeks or longer.

During such episodes there is loss of interest and pleasure, and at least four other symptoms surface, including problems with sleep, eating, energy, concentration and self-image.
Workers who prepare and serve food - cooks, bartenders, waiters and waitresses - had the second highest rate of depression among full-time employees at 10.3 per cent.
In a tie for third were health care workers and social workers at 9.6 per cent.
The lowest rate of depression, 4.3 per cent, occurred in the job category that covers engineers, architects and surveyors.

Government officials tracked depression within 21 major occupational categories. They combined data from 2004 through 2006 to estimate episodes of depression within the past year. That information came from the National Survey on Drug Use and Health, which registers lifetime and past-year depression bouts.

Depression leads to $30 billion to $44 billion in lost productivity annually, said the report from the Substance Abuse and Mental Health Services Administration.

The report was available Saturday on the agency's website at http://oas.samhsa.gov/

The various job categories tracked could be quite broad, with employees grouped in the same category seemingly having little in common.

For example, one category included workers in the arts, media, entertainment and sports. In the personal care category, a worker caring for toddlers at a daycare centre would have quite a different job from a nursing aide who helps an older person live at home rather than in a nursing home.

Just working full-time would appear to be beneficial in preventing depression. The overall rate of depression for full-time workers, seven per cent, compares with the 12.7 per cent rate registered by those who are unemployed.

The percentage of full-time workers age 18 to 64 reporting depression lasting two weeks or longer, by categories of occupation, as provided by the National Survey on Drug Use and Health using 2004 through 2006 data:

-Personal care and service: 10.8
-Food preparation and serving related: 10.3
-Community and social services: 9.6
-Health care practitioners and technical: 9.6
-Arts, design, entertainment, sports and media: 9.1
-Education, training and library: 8.7
-Office and administrative support: 8.1
-Building and grounds cleaning and maintenance: 7.3
-Financial: 6.7
-Sales and related: 6.7
-Legal: 6.4
-Transportation and material moving: 6.4
-Mathematical and computer scientists: 6.2
-Production: 5.9
-Management: 5.8
-Farming, fishing and forestry: 5.6
-Protective service: 5.5
-Construction and extraction: 4.8
-Installation, maintenance and repair: 4.4
-Life, physical and social science: 4.4
-Engineering, architecture and surveyors: 4.3

Source: Substance Abuse and Mental Health Services Administration.

Late Night Teen Cell Phone Use Threat to Sleep and Functioning

Psychiatric Times
Judith GrochReviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.

Explain to interested patients that teenage use of cell phones for calling and text messaging is common after bedtime, leaving adolescents sleep-deprived and tired.

LEUVEN, Belgium, Sept. 4 -- Just because adolescents go to bed, that doesn't mean they stop calling and texting their friends, and that may leave them bleary-eyed in the morning, researchers here reported.

Adolescents who use their mobile phones for calling friends and sending and receiving text messages after bedtime awaken sleep-deprived and tired, Jan Van den Bulck, Ph.D., of Katholieke Universiteit Leuven here, reported in the Sept. 1 issue of Sleep.
Heavy use of TV, internet, and computer games in the bedroom has been linked to reduced time in bed and to sleep disturbances, although adolescents often claim they need these media as "sleep aids."

Much of the teen use of cell phones involves the simple pleasure of being permanently connected, day and night, to a group of friends, Dr. Van den Bulck said. However, he added, little has been known about the impact of cell phone use on sleep.

To assess the prevalence of night-time mobile phone use and its relationship to tiredness with a one-year follow-up, Dr. Van den Bulck studied 1,656 second-year and fifth-year secondary school children in 15 schools in Flanders.

Baseline data were collected in February 2003 with a follow-up in 2004 and another in 2005.
Of the children (52.1% boys), the average age was 13.7 years in the youngest group and 16.9 years in the oldest group at baseline. Tiredness was self-reported.

Only 38% of the participants never used their mobile phone after lights out. Overall 35% of the cases of being very tired were attributed to the use of the mobile phone.
Multinomial logistic regression showed that after a year:

Using the mobile phone less often than once a month increased the odds of being very tired by 1.8 (95% CI 1.2 - 2.8);
Using the phone less than once a week more than doubled the tiredness odds (OR 2.2, 95% CI 1.4 - 3.5);
Using it about once a week tripled the odds (OR 3.3, CI 1.9 - 5.7);
Using it several times a week yielded a five-fold increase in the odds of being very tired (OR 5.1, CI 2.5 - 10.4).

Time of calling, ranging from right after bedtime to any time of the night, also made a difference in the one-year tiredness measure. In most cases calling happened right after lights out. Yet a considerable amount occurred before 3 AM, and about a fifth of the adolescents reported that sending or calling could happen at any time of night.

Use of the phone right after lights out increased the odds of being very tired by 2.2 (CI 1.4 - 3.4); between lights out and 3 AM, the odds were 3.9 times higher (CI 2.1 - 7.1), and for those who used it at any time of the night the odds were 3.3 times higher (CI 1.8 - 6.0).
Among the study's limitations was the use of self-reports. Usually giving socially desirable replies, a potential source of bias in such studies, would not seem to have occurred here, as it is unlikely that students believe that underestimating this behavior is socially desirable.

It is also customary to warn readers about drawing causal conclusions from this sort of research, Dr. Van den Bulck said. However, the idea that adolescents use their phones because they can't sleep does not hold here because of the two-way communication involved. It would apply to outgoing calls, but not to incoming calls.

Unless there were clusters of sleepless adolescents, it is more likely that communicating children keep each other awake, Dr. Van den Bulck wrote.

Mobile-phone use after lights out is widespread, he said. The risk ratios suggest that there is no safe dose. Even moderate use doubles the risk of long term tiredness, nor is there is a safe time to send or receive calls or messages.

There is growing awareness of the importance of studying the impact of the modern electronic media on several aspects of adolescent health in general and sleep in particular, Dr. Van den Bulck said.

The American Academy of Pediatrics has suggested that children's bedrooms ought to be "electronic media-free." However, the Academy appeared to be thinking mainly of media such as TV and video games, he said.

However, the present study suggests that there are many more threats to adolescent sleep in the bedroom. As mobile phones become ever more complex (integrating radio, television, and MP3 technologies), the attraction to use them after lights out is likely to increase further, Dr. Van den Bulck concluded.

Dr. Van den Bulck reported no conflicts of interest. This study received support from the Fund for Scientific Research (Flanders) and the Ministry of Welfare of the Flemish Government of Belgium.

Computers, Internet and Psychotherapy

The demand of psychotherapy often exceeds the availability of therapists. Two studies published in the journal Psychotherapy and Psychosomatics review how modern computer and communication technologies can provide novel opportunities for the provision of stepped care for patients with mental disorders.
In a review and an accompanying editorial by Prof. Isaac Marks and collaborators point out that therapist time is not saved by conducting cognitive behavior therapies (CBT) via e-mail, telephone or video-conference exchanges between patient and therapist in real time. However, time can be saved when treatment tasks are delegated to patient-computer interactions.

Many patients may also prefer to access CBT at home by computer for reasons of greater confidentiality, lessening of stigma and reduction of time needed to travel to a therapist.

This concept was explored by Indra Tumur and colleges in a analysis of 4 studies to compare the effectiveness of a computerized cognitive behavior therapy (CCBT) program, BTSteps, for the treatment for obsessive-compulsive disorder (OCD) against the traditional therapist-led cognitive behaviour therapy (TCBT) and relaxation.

They found that CCBT was as good as TCBT for reducing time spent in rituals and obsessions and and was superior to RLX treatment. Improvement of OCD persisted beyond the end of the CCBT treatment. Therapist guided CBT was more effective than CCBT for all patients overall though not in those who went on to start self-exposure.

In the third study, University of Heidelberg researchers investigated the effectiveness of group therapy delivered through an Internet chat room following inpatient treatment.The main goal of the program was to reduce the risk of losing the therapeutic benefits gained during the inpatient treatment. 114 patients participated in one of two parallel groups of 8-10 patients that met with a group therapist in an Internet chat room.

The groups met weekly for 12-15 weeks for 90 min. Controls were 114 patients who did not participate in the chat groups and were matched by application of propensity score methods.The main criterion was derived from comprehensive assessments of changes in health status comprising the psychological and physical condition of the patients.

Assessments were conducted at admission, discharge and 12 months after discharge. 12 months after discharge, chat participants showed a substantially lower risk (24.7%) for negative outcome than controls (38.5%). Furthermore, a low dropout rate and the high session attendance suggest this novel offer met patients' needs, and thus, opens new avenues for optimizing care for patients with mental disorders.

Baer L, Greist J, Marks IM. Computer-Aided Cognitive Behaviour Therapy Psychother Psychosom 2007;76:193-195 (no abstract)
Tumur I, Kaltenthaler E, Ferriter M, et al. Computerised Cognitive Behaviour Therapy for Obsessive-Compulsive Disorder: A Systematic Review Psychother Psychosom 2007;76:196-202 [Abstract]
Golkaramnay V, Bauer S, Haug S, et al. The Exploration of the Effectiveness of Group Therapy through an Internet Chat as Aftercare: A Controlled Naturalistic Study Psychother Psychosom 2007;76:219-225 [Abstract]

Interface Consultation Services Update

A brief overview of Interface Consultation Services current endeavors:

I. Blog Focus - We continue to post weekly on ICS and Counseling Connections.Our posts include mental health research, news and thoughts we feel providers and clients will find valuable.

II. Counseling Connections - Provides Licensed Professional Online and Telephone Mental Health Counseling, Coaching and Services.

III. PESI Seminars by ICS:

High Risk Callers: Responding to Psychiatric Emergencies Over the Phone. New and exciting sorely needed seminar designed specifically for clinicians, call centers, triage nurses who provide efficient assessment and treatment over the phone. Psychiatric Emergencies over the phone line are DIFFICULT and extremely anxiety provoking. General Medical Clinics are seeing more psychiatric patients. Learn the skills you didn't learn in school to assist these patients.

IV. Telemental Health Triage - We continue our day-to-day service commitment to Riverwood Center to provide professional triage services so their consumers are assured efficient and timely access to mental health services, appropriate level of care assignments and expert telephone crisis triage.

V. MPRI - Michigan Prisoner Re-entry Initiative for the Mentally Ill - ICS are contracted as the Regional Care Coordinators for the Western Michigan providing services to 17 counties. ICS has hired Lee Burdick March 2007 to assist with this initiative. This program continues to grow at a very fast pace and it the only program of it's kind in the US. This speciality program is designed for mentally ill prisoners who are returning to the community. As Care coordinators we provide funding for housing, psychiatric medications, specialized placements as well as care coordination and consultation on some very difficult cases for the program.

VI. Utilization Management Opportunities - We continue to provide acute care preauthorization services for Riverwood Center.

VII. College Level Course - ICS partner, Kathlene LaCour is an part-time facility member at Kalamazoo Valley Community College.

We are seeking other opportunities to expand these kinds of services to other agencies. Please contact us via email by clicking on the link to learn more about how we can service your consulting needs or call (269)929-1292.

"What we are today comes from our thoughts of yesterday and our present thoughts build our life tomorrow. Our life is the creation of our mind." -- Siddhartha Buddha

Death.. One Man's Thoughts....

Checkout this Vlog site by Josh Leo.

He expresses some of his thoughts about death and dying.

Discovering Our True Nature - Online Radio Show

Discovering Our True Nature - Online Radio Show with Host Branden Cohen (click on link to listen to recent shows...

Join Branden for his weekly internet radio show on Tuesday at 1pm or go to link above for live or achived shows. Each begins with a guided meditation and Branden welcomes guests and callers to share their personal experiences and ask questions. The show explores a variety of psychological and spiritual topics.

Branden Cohen is a MA Clinical Psychologist. email him at brandencohen@hughes.net

This week show and guest talk about addiction and ways to heal the most difficult of addictions and the heart.

contact us at... interface_consultation@comcast.net

Today is the Day!

Today is your opportunity to make a real positive difference in your life.

Live this very day with respect and responsibility for yourself and the treasure of today will be with you always.

-Kenn

May Mental Health Month

Welcome to Mental Health Month 2007! The theme for this year's observance is MIND Your Health. For more than fifty years, our country has celebrated May as Mental Health Month to raise awareness about mental illnesses and the importance of mental wellness for all. Mental Health America invites you to join us in this important observance.

Contact Us..

Work related suicide, Mental Illness Increase in Japan

Provided by: Associated PressMay. 17, 2007

TOKYO (AP) - The number of Japanese who killed themselves because of work jumped by 52 per cent last year, while work-induced mental illness also hit a record high, a health official said Thursday.

Compensation paid to the families of workers who committed suicide due to work-related stress was paid out in a record 65 cases in 2006, compared with 42 the previous year, said Health Ministry official Junichiro Kurashige.
The number of workers who received compensation for work-induced mental illness hit 205, up 61 per cent from a year earlier, Kurashige said, citing a recent government report.

Efforts by the government to encourage workers to apply for compensation were partly behind the rise, said Kurashige.

Japan's suicide rate is among the highest in the industrialized world. More than 32,000 Japanese took their own lives in 2004, the bulk of them older Japanese suffering financial woes as the country struggled through a decade of economic stagnation.

The Japanese government has earmarked a substantial budget for programs to help those with depression and other mental illnesses.

See C-Health for more mental health news...

Spirituality, Suicide and Mental Health

Canoe Health Reports....An Canadian conference is drawing attention to the key role spirituality plays in mental health and even for suicidal patients.

Medical schools have started to raise awareness about spirituality, so students entering the health-care field will inquire about their patients' belief systems to better understand their attitudes toward life and death.

To shed more light, the University of Ottawa's department of psychiatry, the Ontario Multifaith Council on Spiritual and Religious Care and Saint Paul University are hosting the third annual international conference on Spirituality and Mental Health today and tomorrow.

Developing a greater understanding of the link between mental health and spirituality is necessary for health-care workers who truly want to help their patients, said Dr. Andre Gagnon, chairman of the conference organizing committee. The same can be said of workers dealing with suicidal patients.

Suicidality has been VIEWED AS AMORAL.
Historically, suicidal thoughts were viewed by religions as amoral and people who suffered from them could be forbidden access to a place of worship and even burial rights, said Gagnon.Over time, religions have grown more accepting of the reality that these people need help.

Researching links between suicide rates and spirituality poses difficulties due to the many other variables associated with suicide.Gagnon said that even the awareness of spirituality in suicide can aid health providers in providing appropriate care."A lot of people at first want to stop the suffering they are in, they don't wish to die as much as to stop feeling so badly," he said.

We are all spiritual beings and to neglect this part of a person in who is experiencing significant distress and psychiatric pain can delay a person's recovery. Treating people as whole beings - mental, physical, spiritual and emotional is key.

Binge Eating/Compulsive Eating Disorder

Psychiatric Times indicates that this disorder is more common than anorexia and bulimia combined, according to a national survey.In DSM- IV this disorder was being reviewed and was indicated to require more research and study to determine if it would be appropriate for admission into the DSM (Diagnostic and Statistical Manual for Mental Disorders).

Most physicians, however, aren't aware of the problem, says James Hudson, MD, director of the Psychiatric Epidemiology Research Program at McLean Hospital and a professor of psychiatry at Harvard."Doctors have a reasonable degree of awareness about anorexia and bulimia, but they're not tuned into binge eating. It's just not as well known," says Hudson, lead author of "The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication". The study, published Feb. 1 in Biological Psychiatry, found that 2.8 percent of the general population has binge-eating disorder -- more than bulimia (1 percent prevalence) and anorexia (0.6 percent) combined.

Treatment for this disorder experts recommend a comprehensive eating disorders program. The programs take a multidisciplinary approach that typically includes nutrition counseling; a behavioral weight control plan with healthy meals spaced throughout the day; medication in some cases; and a strong foundation in cognitive behavioral therapy (CBT) -- considered the gold standard for treating the disorder.

Due to this disorder not being an official diagnosis many insurances will not pay for treatment. Self help programs include reading books with CBT focus and drug treatment with SSRI, appetite suppressants and mood stabilizers. See Psychiatric Times for more information

Who Are You?

A father, mother, wife, husband, sister, brother, boss, employee, devotee, coach, player, student, teacher, etc.

You are not your relations. The core of who you are is not defined by your relationship to friends, family, god or others in general. These are power parts of our being and living in this world.

Is here a you without relationship to others?

So truly, who are you when you look in the mirror and see more than your physical self looking back at you?

Food for Thought....

Yesterday, Today and Tomorrow....

Yesterday is but today's memory, tomorrow is today's dream.

- Kahlil Gibran