Psychology

I remarried 5 years ago and moved to my husband’s native country (non english). My 2 sons are grown up and have their own lives in my native country I visit every 2 months. Since living here I have not been able to feel at home. I hate it here and my life has become very insular. I rarely go out, only with my husband and even then I don’t like to. I have been very sad with whole days or weeks of tearfulness. That time has passed and I am now very numb feeling. I have lack of interest in anything and cannot bring myself to do anything. I miss my family very much and cannot wait until my stepson is old enough for us to move to my home country. I am always tired, fed up and disinterested. I have had a lot of health problems, some of which have settled but I still ache and feel very tired all day. My biggest concern is the not wanting to go out. I make all kinds of excuses to myself, I delay, I feel very stressed and anxious if I have to go out. I struggle with the language (I have had lessons but find it difficult) and am always worried that someone will speak to me. Before I moved here I was a kindergarden teacher and had a normal social life. I have told my husband how I feel and he is understanding and sympathetic but there’s really nothing he can do to help. I went to the doctor for a check up and told him how I have been feeling. He said he didn’t think I’m depressed. I’m not so sure, I’ve never been treated for depression so I have no idea myself. He says I ‘have to get out more’ er yes, that IS the problem. I have tried a language group in the area but hated it as they wouldn’t let us speak! The leaders just did all the talking and when a woman approached me to talk to me (in the second language) we were told off! The local language courses are finished now and I have no contact at all with the outside world apart from once a week to the supermarket with my husband and occasional trips out (which I don’t really like). Really, my question is: Could this be depression or maybe Agrophobia? I do not feel suicidal but I must admit to feeling that I just will be glad when life is over naturally. A: You must love your husband very much to have made this move. It sounds like it hasn’t been what you imagined it might be. Please don’t be hard on yourself. It’s a major adjustment to move to an entirely different country and culture. Yes, you certainly could be suffering from a situational depression. Or – it could be an adjustment disorder. Or – it could also be that you are lonely, homesick and grieving the loss of everything that is familiar to you. Talking to a mental health counselor could help you sort it out. I’m so very sorry that the language school was so unhelpful. The whole point of language is to speak! As an educator, I can’t imagine scolding people for trying to do the very thing that is being taught. I’m sorry there doesn’t seem to be another opportunity. That being the case, I do suggest you purchase a language program on CDs or online. Having more vocabulary will help you feel less alien. Although your doctor meant well by telling you to get out more, it is easier said than done. I’m wondering if maybe one way for you to get back into the world is to do some volunteer work with little children. You were a kindergarten teacher so working with children is part of your identity. I wonder if there is a daycare center that could use your help for a few hours a week. Or maybe you could offer to read stories to little ones at the local library or to play with them so their parents can have a few minutes to do their business there. As you know, children aren’t judgmental. Their language is simpler. And you would probably begin to meet some of their mothers. It might be a gentle way for you to venture out. Having a task to do will make it easier to relate to people and will help motivate

Vitamin D and Cholesterol: The Importance of the Sun (2009) by David Grimes, a British doctor, contains more than a hundred graphs and tables. Most of the book is about heart disease.  Grimes argues that a great deal of heart disease is due to too little Vitamin D, usually due to too little sunlight. I recently blogged about other work by Dr. Grimes — about the rise and fall of heart disease. Part of the book is about problems with the cholesterol hypothesis (high cholesterol causes heart disease).  One study found that in men aged 56-65, there was no relationship between death rate and cholesterol level over the next thirty years, during which almost all of them died (Figure 29.2). There is a positive correlation between death rate and cholesterol level for younger men (aged 31-39). The same pattern is seen with women, except that women 60 years or older show the “wrong” correlation: women in the lowest quartile of cholesterol level have by far the highest death rate (Figure 29.5). A female friend of mine in England, who is almost 60, was recently told by her doctor that her cholesterol is dangerously high. The book was inspired by Grimes’ discovery of a correlation between latitude and heart disease: People who lived further north had more heart disease. This association is clear in the UK, for example (Figure 32.4). Controlling for latitude, he found a correlation between hours of sunshine and heart disease rate (Table 32.3): Towns with more sunshine had less heart disease. No doubt you’ve heard that dietary fat causes heart disease. In the famous Seven Countries study, there was indeed a strong correlation between percent calories from fat and heart disease death rate (Figure 30.2). You haven’t heard that in the same study there was a strong correlation between latitude and dietary fat intake (Figure 30.8): People in the north ate more fat than people in the south. The fat-heart disease correlation in that study could easily be due to a connection between latitude and heart disease. The correlation between latitude and heart disease, on the other hand, persists when diet is controlled for. Grimes convinced me that the latitude/sunshine correlation with heart disease reflects something important. It is large, appears in many different contexts, and has resisted explanation via confounds. Maybe sunshine reduces heart disease by increasing Vitamin D, as Grimes argues, or maybe by improving sleep — the more sunshine you get, the deeper (= better) your sleep. Sleep is enormously important in fighting off infection, and a variety of data suggest that heart disease has a microbial aspect. As long-time readers of this blog know, I take Vitamin D3 at a fixed time (8 am) every morning, thereby improving my Vitamin D status and improving my sleep. Grimes and his book illustrate my insider/outsider rule: To make progress, you need to be close enough to the subject (enough of an insider) to have a good understanding but far enough away (enough of an outsider) to be able to speak the truth. As a doctor, Grimes is close to the study of disease etiology. However, he’s a gastroenterologist, not a cardiologist or epidemiologist. This allows him to say whatever he wants about the cause of heart disease. He won’t be punished for heretical ideas.

A violent attack by someone who is mentally ill quickly grabs the headlines. And it’s usually implied that mental illnesses are a preventable cause of violent crime. Tackle that and we can all sleep safer in our beds. But by pressuring mental health services to focus on the risk of violence we are in danger of actually increasing it. Most of the debate around risk and offending has centred around schizophrenia – the bread and butter of community psychiatry. But what is the evidence relating to the risk of violence in those diagnosed with schizophrenia? It’s tricky because schizophrenia varies so much in character and severity. And other factors known to have an association with violent crime, like migration and social disadvantage, are often also implicated as a part of the cause or consequence of schizophrenia.... Fazel, S. (2009) Schizophrenia, Substance Abuse, and Violent Crime. JAMA: The Journal of the American Medical Association, 301(19), 2016. DOI: 10.1001/jama.2009.675 Schizophrenia, Substance Abuse, and Violent Crime Short, T., Thomas, S., Mullen, P., & Ogloff, J. (2013) Comparing violence in schizophrenia patients with and without comorbid substance-use disorders to community controls. Acta Psychiatrica Scandinavica. DOI: 10.1111/acps.12066 Comparing violence in schizophrenia patients with and without comorbid substance-use disorders to community controls

Academics earn street cred with TED Talks but no points from peershttp://www.psypost.org/2013/06/academics-earn-street-cred-with-ted-talks-but-no-points-from-peers-18527Sent via Flipboard

Experts suggest that when diagnosing depression, professionals should look to recurrence rates of symptoms for accuracy, rather than simply presence of symptoms...

Andrea Schneider, LCSW - If you've been devalued and discarded by someone with narcissistic behavior, one of the best things you can do after is avoid all contact....

by Danielle D. DeSouza, Massieh Moayedi, David Q. Chen, Karen D. Davis, Mojgan Hodaie Objective Idiopathic trigeminal neuralgia (TN) is characterized by paroxysms of severe facial pain but without the major sensory loss that commonly accompanies neuropathic pain. Since neurovascular compression of the trigeminal nerve root entry zone does not fully explain the pathogenesis of TN, we determined whether there were brain gray matter abnormalities in a cohort of idiopathic TN patients. We used structural MRI to test the hypothesis that TN is associated with altered gray matter (GM) in brain areas involved in the sensory and affective aspects of pain, pain modulation, and motor function. We further determined the contribution of long-term TN on GM plasticity. Methods Cortical thickness and subcortical GM volume were measured from high-resolution 3T T1-weighted MRI scans in 24 patients with right-sided TN and 24 healthy control participants. Results TN patients had increased GM volume in the sensory thalamus, amygdala, periaqueductal gray, and basal ganglia (putamen, caudate, nucleus accumbens) compared to healthy controls. The patients also had greater cortical thickness in the contralateral primary somatosensory cortex and frontal pole compared to controls. In contrast, patients had thinner cortex in the pregenual anterior cingulate cortex, the insula and the orbitofrontal cortex. No relationship was observed between GM abnormalities and TN pain duration. Conclusions TN is associated with GM abnormalities in areas involved in pain perception, pain modulation and motor function. These findings may reflect increased nociceptive input to the brain, an impaired descending modulation system that does not adequately inhibit pain, and increased motor output to control facial movements to limit pain attacks.

by Katharina Bottermann, Michael Reinartz, Marian Barsoum, Sebastian Kötter, Axel Gödecke AKT2 is one of the three isoforms of the protein kinase AKT being involved in the modulation of cellular metabolism. Since protein-protein interactions are one possibility to convey specificity in signal transduction, we performed AKT2-protein interaction analysis to elucidate their relevance for AKT2-dependent cellular functions. We identified heat shock protein 90 kDa (HSP90), Cdc37, heat shock protein 70 kDa (HSP70), 78 kDa glucose regulated protein (GRP78), tubulin, GAPDH, ?-enolase and elongation factor 2 (EF2) as AKT2-interacting proteins by a combination of tandem affinity purification and mass spectrometry in HEK293T cells. Quantitative MS-analysis using stable isotope labeling by amino acids in cell culture (SILAC) revealed that only HSP90 and Cdc37 interact stably with AKT2, whereas the other proteins interact with low affinity with AKT2. The interactions of AKT2 with ?-enolase and EF2 were further analyzed in order to uncover the functional relevance of these newly discovered binding partners. Despite the interaction of AKT2 and ?-enolase, which was additionally validated by proximity ligation assay (PLA), no significant impact of AKT on ?-enolase activity was detected in activity measurements. AKT stimulation via insulin and/or inhibition with the ATP-competitive inhibitor CCT128930 did not alter enzymatic activity of ?-enolase. Interestingly, the direct interaction of AKT2 and EF2 was found to be dynamically regulated in embryonic rat cardiomyocytes. Treatment with the PI3-kinase inhibitor LY294002 before stimulation with several hormones stabilized the complex, whereas stimulation alone led to complex dissociation which was analyzed in situ with PLA. Taken together, these findings point to new aspects of AKT2-mediated signal transduction in protein synthesis and glucose metabolism.

by Kristina Schee, Susanne Lorenz, Merete Molton Worren, Clara-Cecilie Günther, Marit Holden, Eivind Hovig, Øystein Fodstad, Leonardo A. Meza-Zepeda, Kjersti Flatmark Colorectal cancer (CRC) is one of the leading causes of cancer related deaths and the search for prognostic biomarkers that might improve treatment decisions is warranted. MicroRNAs (miRNAs) are short non-coding RNA molecules involved in regulating gene expression and have been proposed as possible biomarkers in CRC. In order to characterize the miRNA transcriptome, a large cohort including 88 CRC tumors with long-term follow-up was deep sequenced. 523 mature miRNAs were expressed in our cohort, and they exhibited largely uniform expression patterns across tumor samples. Few associations were found between clinical parameters and miRNA expression, among them, low expression of miR-592 and high expression of miR-10b-5p and miR-615-3p were associated with tumors located in the right colon relative to the left colon and rectum. High expression of miR-615-3p was also associated with poorly differentiated tumors. No prognostic biomarker candidates for overall and metastasis-free survival were identified by applying the LASSO method in a Cox proportional hazards model or univariate Cox. Examination of the five most abundantly expressed miRNAs in the cohort (miR-10a-5p, miR-21-5p, miR-22-3p, miR-143-3p and miR-192-5p) revealed that their collective expression represented 54% of the detected miRNA sequences. Pathway analysis of the target genes regulated by the five most highly expressed miRNAs uncovered a significant number of genes involved in the CRC pathway, including APC, TGF? and PI3K, thus suggesting that these miRNAs are relevant in CRC.

by L. Charles Bailey, David E. Milov, Kelly Kelleher, Michael G. Kahn, Mark Del Beccaro, Feliciano Yu, Thomas Richards, Christopher B. Forrest Objective To evaluate the validity of multi-institutional electronic health record (EHR) data sharing for surveillance and study of childhood obesity. Methods We conducted a non-concurrent cohort study of 528,340 children with outpatient visits to six pediatric academic medical centers during 2007–08, with sufficient data in the EHR for body mass index (BMI) assessment. EHR data were compared with data from the 2007–08 National Health and Nutrition Examination Survey (NHANES). Results Among children 2–17 years, BMI was evaluable for 1,398,655 visits (56%). The EHR dataset contained over 6,000 BMI measurements per month of age up to 16 years, yielding precise estimates of BMI. In the EHR dataset, 18% of children were obese versus 18% in NHANES, while 35% were obese or overweight versus 34% in NHANES. BMI for an individual was highly reliable over time (intraclass correlation coefficient 0.90 for obese children and 0.97 for all children). Only 14% of visits with measured obesity (BMI ?95%) had a diagnosis of obesity recorded, and only 20% of children with measured obesity had the diagnosis documented during the study period. Obese children had higher primary care (4.8 versus 4.0 visits, p Conclusions Multi-institutional EHR data sharing is a promising, feasible, and valid approach for population health surveillance. It provides a valuable complement to more resource-intensive national surveys, particularly for iterative surveillance and quality improvement. Low rates of obesity diagnosis present a significant obstacle to surveillance and quality improvement for care of children with obesity.