New category in the DSM-5 could classify millions of people as mentally ill

It has been announced that the next edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will be adding a new type of somatic symptom disorder.

The new category will eliminate the requirement that somatic symptoms must be “medically unexplained”, and will instead be shifted to focus on “excessive” responses to distressing symptoms, accompanied by “dysfunctional thoughts, feelings or behaviours”. Essentially, it encompasses the distress seen in people who are commonly overly worried about medical problems and often tend to try to diagnose themselves.

However, Allen Frances, Chair of the current (DSM-IV) task force warns that redefining this category may result in inappropriate diagnoses. This concern is supported by a trial study, showing a very high false-positive rate of 7% among healthy people in the general population.

He also explains that this new DSM-5 diagnosis is highly subjective underlying medical conditions that could explain the somatic symptoms will be ignored.

Finally, he suggests that clinicians should ignore this new category to avoid improper diagnosis.

 

 

 

Source: http://www.medicalnewstoday.com/releases/257865.php

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Cortisol and Your Fight-or-Flight Response

You may be familiar with the body’s fight-or-flight response – that “adrenaline rush” that results from your sympathetic nervous system kicking in. It may be that feeling you get right before writing a final exam, or while being chased by an angry dog. Well actually, along with adrenaline, the hypothalamus in the brain controls the release of cortisol, which is also known as the “stress hormone”. Cortisol is released to prepare the body for its fight-or-flight responses – any and all events that can be potential stressors. One of the many roles cortisol has is to increase the amount of glucose available as energy for the major muscles in the body. Furthermore, it narrows the arteries that pump blood to the heart, making the heart work harder and at an increased pace.

Cortisol is vital for the functioning of the fight-or-flight response. The stress-response system in the body is also often well regulated, and cortisol will drop to its normal levels once the perceived stressor has passed. However, when an individual is constantly stressed out, their cortisol levels will remain elevated, keeping the body’s sympathetic nervous system activated and it’s parasympathetic nervous system largely inhibited.

It should be no surprise then, that prolonged periods of stress can have adverse affects on ones physiological health. Specifically speaking, prolonged elevated levels of cortisol will disrupt many body processes. Of these, the ones related to mental health include: sleeping problems and/or insomnia, constant fatigue, depression, and memory impairment. If an individual finds themselves constantly stressed out, it is likely that they are also having trouble sleeping. This makes logical sense, because the body’s sympathetic nervous system is consistently activated through the release of cortisol, without rest. Furthermore, if an individual’s body is invariably in its fight-or-flight mode, they will find it difficult to concentrate and become overwhelmed with fatigue. Most importantly, there have been numerous studies that show possible links between elevated cortisol levels and depression. According to Maes et. al (1994), approximately 50% of individuals with chronic depression are linked with the hyper-secretion of cortisol.

With the above in mind, it is vital to find healthy and effective ways of coping with stress. In this way, we can help ensure that our personal actions do not have detrimental affects on our short or long term mental health.  A few ways stress can be managed in a healthy way include: getting up to stretch for 5 to 10 minutes every hour spent studying, going for a quick jog, or rewarding yourself by spending 30 minutes a day doing something simply for the fact that you want to (ex. watching your favourite TV episode). For more great tips on effective stress management, visit the Stress and Anxiety page on the UBC Live Well Learn Well site.

Sources: http://www.mayoclinic.com/health/stress/SR00001

http://www.todaysdietitian.com/newarchives/111609p38.shtml

http://bjp.rcpsych.org/content/180/2/99.full

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Childhood ADHD may have long-term mental health consequences

Attention-deficit hyperactivity disorder (ADHD) is widely perceived as a problem only in children.  The Canadian Mental Health Association defines it as a disorder that “reduce[s] the child’s ability to pay attention” and outlines the effects of ADHD on children, which can include violent behaviour, low self-esteem, physical pains, and social difficulties.  The Association does not, on its website, mention effects of ADHD on individuals later in life.

Recently, however, studies find that when children with ADHD grow up, they may be more susceptible to mental health issues which may manifest in substance abuse or mental illnesses.  Although they may “outgrow” ADHD, new problems can arise that should not be overlooked.

The journal Pediatrics published a study in which almost 30% of children diagnosed with ADHD never “outgrew” it and 57% of the children with ADHD developed one or more other mental illnesses in adulthood.  These included personality disorders, substance abuse, anxiety, and depression.  In comparison, 35% of children without ADHD developed mental illness in adulthood.

Additionally, children with ADHD were about 8 times as likely as children without ADHD to commit suicide and 3 times as likely to be imprisoned.

The study was conducted on primarily white, middle class children, which may have positively skewed the results.  Therefore, in the general population, childhood ADHD may in fact have even more severe consequences than implicated by the study.

These findings indicate that attitudes towards ADHD need to be shifted and long-term support services for children with ADHD should be provided into their teenage years and adulthood.  Furthermore, well-rounded treatment plans should be created that emphasize educational and mental health support rather than simply medication.

 

SOURCES:

http://www.cmha.ca/mental-health/understanding-mental-illness/attention-deficit-disorders/

http://www.theglobeandmail.com/life/health-and-fitness/health/adhd-not-just-a-childhood-issue-but-a-long-term-condition-study-shows/article9308904/

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Changing Maladaptive Thoughts “Cures” Loneliness

Loneliness has been found to significantly affect ones mental and physical health both in the short and long term.

Three major findings include:
1.Loneliness adversely affects how one behaves and it increases the resistance of blood flow through the cardiovascular system.
2.Loneliness is linked to higher cortisol levels in the morning; altered gene expression in immune cells, poor immune function, high blood pressure and increase in depression.
3.Loneliness leads to difficulty in obtaining deep sleep and it people are at increased risk of developing Alzheimer’s disease at an early age.

Studies have found that lonely people over attend to negative social information and remember more negative events and fewer positive events. This leads to more negative expectations of interacting with others. Therefore potential interventions are aimed at enhancing social support by increasing opportunities for social interaction; changing maladaptive thinking and improving social skills.

By using meta-analysis of 50 loneliness interventions, researchers have found that intervention aimed at changing maladaptive thinking patterns was more effective compared to the other interventions.

Loneliness takes a toll on both physical and mental health and through breaking the negative cycle of maladaptive thinking one can overcome loneliness and enjoy the many health benefits of being socially connected to others.

Source: http://psychcentral.com/blog/archives/2008/09/09/can-loneliness-kill-you/
http://www.psychologytoday.com/blog/the-science-success/201010/the-cureloneliness

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Breast Cancer diagnosis commonly followed by Post-traumatic stress disorder

Researchers at the Herbert Irving Comprehensive Cancer Center (HICCC) at New York-Presbyterian/Columbia University Medical Center have reported that twenty-three percent of women who are newly diagnosed with breast cancer have post-traumatic stress disorder (PTSD).

This PTSD diagnosis is especially seen among African-American and Asian women, as well as women under the age of fifty.

This was the first study to the presence of PTSD symptoms after breast cancer diagnosis. The researchers analyzed telephone call responses of 1,139  women. The surveys showed that during the first two to three months after breast cancer diagnosis, nearly a quarter of the women met the criteria for PTSD. It was also noted, however, that the symptoms declined over the next three months.

The researchers emphasized that the ultimate outcome of their research is to find methods of improving the quality of patient’s lives. If potential risk factors for PTSD can be identified, then early prevention and intervention could be provided post-breast cancer diagnosis to minimize PTSD symptoms.

 

 

Source: http://www.medicalnewstoday.com/articles/257116.php

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