Rodrguez J.J.,Mental Health
International Review of Psychiatry | Year: 2010
This paper summarizes a series of events that were historical milestones in Latin America and the Caribbean in the long road toward restructuring and setting up psychiatric and mental health services to shift from the old and obsolete psychiatric hospital models to other, community-based models. This has been and largely remains the principal challenge that we face. The burden of mental illness is described in terms of morbidity, mortality, and disability. In 1990, it was estimated that psychiatric and neurological disorders accounted for 8.8 of the disability-adjusted life years in Latin America and the Caribbean; in 2004 that burden had grown to 21. However, the treatment gap (sick people who remain untreated) exceeds 60; added to that there is a prevailing gap in funding and resources for the treatment of mental health problems. In response to these problems, the Pan American Health Organization (PAHO/WHO) has continued to strengthen its technical cooperation with the countries. The 49th Directing Council of PAHO/WHO approved the Strategy and Plan of Action on Mental Health for the region of the Americas, which constitutes a major historical landmark; for the first time, the ministries of health in every country in the hemisphere studied and approved a work programme to improve mental health care based on the experiences gained and expressing a technical and political commitment. It is a key priority to continue working to restructure mental health services and strengthen intersectoral initiatives to promote mental health; specific problems, such as care for vulnerable groups, child and adolescent mental health, suicide, alcohol abuse, and violence, also pose a great challenge for mental health programs today. © 2010 Institute of Psychiatry.
Maiera E.,Mental Health
Psychiatria Danubina | Year: 2010
The Numbers of elderly people are gradually increasing in our society, and mood disorders are progressively increasing among older people. Old age depression may also occur after life events: the death of the significant other, economical reasons, health problems (neurological and/or cardiovascular diseases, arthritis, cancer, nutritional deficiency) and can develop into a depressive state. Old age depression is often mistreated, or undertreated, and also underdiagnosed, and this for several reasons: older people reduce their social relations, depression very often presents as a comorbidity with organic diseases (that cover and mask depressive symptoms); finally, the patient may believe that a depressive state is an normal course of life in older people. Recovering from depression is really feasible both in young/adults and in old people, but in older people we can find a higher frequency of admission to hospital, or mortality or suicidality. The depressive symptoms in old age depression is similar to those in adults, however the following aspects require special care, in order to ensure a correct diagnosis despite the presence of comorbidities: - the mood: in contrast with the young and adult, old people often do not complain about their low mood; - the psychotic simptoms: hypocondriacal and psychotic, including hallucinatory symptoms are often present. - the anxiety symptoms: these are often present together with neurosensory symptoms; - the somatic symptoms: the comorbidity with organic diseases can mask and overlap the depressive state; - reduction of congnitive functioning: in these cases, which are quite frequent, it is essential to make a differential diagnosis from "pseudodementia" and "dementia" . In conclusion, several factors contribute to the onset of depression in old age, so that we can assert that it is a really a multifactorial disease. © Medicinska naklada.
The brain circuits responsible for the inability to feel pleasure have now been discovered in rats, a finding that could help researchers better understand the mechanisms underlying depression and schizophrenia. Anhedonia, the inability to feel pleasure from activities that are normally found enjoyable, is a core symptom of several human psychiatric disorders, including depression and schizophrenia. However, little is known about the brain circuits that underlie anhedonia, hindering attempts to develop therapies for it. Previous brain-imaging research suggested that anhedonia might be linked to a part of the brain that sits just behind the forehead known as the medial prefrontal cortex. Prior studies implicated this brain region with thinking about oneself and others, as well as organizing information. [5 Controversial Mental Health Treatments] Now, scientists have conducted experiments on the medial prefrontal cortex of rats. They focused on a series of neurons, or brain circuits, that react to dopamine, a brain chemical linked with responses to rewards such as food, money and social interactions. The rats were genetically modified so that dopamine circuits would activate when the researchers shone pulses of light on their brains. The scientists also used functional magnetic resonance imaging (fMRI) tomonitor brain activity in conscious rats. When the researchers used light to stimulate the medial prefrontal cortex, the rats lost their preference for sugar water over regular water. They also tended to socialize less. Both responses are symptoms of anhedonia. Brain imaging showed that stimulating the medial prefrontal cortex strengthened its connections with certain other regions of the brain, such as the orbital cortex and the ventral striatum, which previous research linked with responses to rewards. In addition, as a result of this stimulation, a few regions became more isolated from the rest of the brain, including areas called the auditory and retrosplenial cortices, which have previously been shown to be related to depression and schizophrenia in humans. "Experimental elevations in excitability of parts of the prefrontal cortex, as can occur in depression and schizophrenia, control the extent to which major basic rewards and drives are compelling in behavior," study author Dr. Karl Deisseroth, a neuroscientist and psychiatrist at Stanford University, told Live Science. "We need to continue developing this understanding of how the brain works all together as a coordinated dynamical system." The scientists detailed their findings in the Jan. 1 issue of the journal Science. Follow Charles Q. Choi on Twitter @cqchoi. Follow us @livescience, Facebook & Google+. Original article on Live Science. Copyright 2016 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Below are posts I’ve written on efforts to understand and treat mental illnesses and disorders, from depression to alcoholism. Please let me know about missing stories, broken links or other problems. See also my books The Undiscovered Mind and Rational Mysticism. Psychiatry in Crisis: Mental Health Director Rejects Psychiatric Bible and Replaces With… Nothing. Are Antidepressants Just Placebos with Side Effects? Psychiatrists, Instead of Being Embarrassed by Placebo Effect, Should Embrace It. Why Screening Teens for Mental Illness Is a Terrible Idea. Bipolar Writer Comments on Debate Over “Crisis in Psychiatry.” What 60 Minutes Gets Wrong in Report on Mental Illness and Violence. Cybertherapy, placebos and the dodo effect: Why psychotherapies never get better. Alcoholics Anonymous Ain’t Perfect, But At Least It’s Free. Programs for Troubled Vets Don’t Work, So How About Ending War? Neuroscientists Don’t Believe in Souls—But That Doesn’t Mean They Can’t Sell Theirs. Who Wants to be a Psychopath? Why Optogenetic Methods for Manipulating Brains Don’t Light Me Up. Why Optogenetics Doesn’t Light Me Up: The Sequel. Research on TM and Other Forms of Meditation Stinks. Do All Cults, Like All Psychotherapies, Exploit the Placebo Effect? Why Buddha Isn't Dead--and Psychology Still Isn't Really a Science. DMT is in your head, but it may be too weird for psychedelic renaissance. What Should We Do With Our Visions of Heaven—and Hell? If religion is a side effect of sex, does that mean God doesn't exist? Can a Hole in Your Head Get You High? An Appreciation of Oliver Sacks, Anti-Theorist of the Mind. Oliver Sacks and the Binding Power of Rhythm.
News Article | March 25, 2016
Lots of students have roommates. Lauren Dwyer, a grad student at Ryerson University in Toronto, shares her space with BB-8, the rolling bot from Star Wars: The Force Awakens. Dwyer has been living alongside BB-8, and studying it, for the past two months. Made by Colorado-based tech company Sphero, it’s only slightly larger than the palm of my hand. It zips wirelessly around the room, controlled by a mobile app, and responds to requests for it to “look around!” and “go to sleep!” The app can also record video messages for BB-8 to play back. Watch through your phone, and it will appear as if the messages are being projected by the droid like in the Star Wars movies. Sphero calls BB-8 a “companion,” not a toy, and it has become the new BFF to hordes of wannabe Jedis since hitting the market in late 2015. Befriending a real-life BB-8 is more than just obsessive Star Wars fandom. At Ryerson, the Faculty of Communication and Design is studying the BB-8 replica to determine whether robots can help treat anxiety, which affects 5 percent of the country’s population and is especially prevalent among young people, according to the Canadian Mental Health Association. Dwyer is interested in BB-8’s modes of communication. She’s been keeping track of the ways in which the robot employs beeps and gestures to express human emotions, like curiosity and frustration. This collection of beeps and squeals, she believes, is one reason why it might be more comforting than an opinionated friend or a stone-cold therapist. “Words can trigger anxiety,” Dwyer said. “A word that feels calming to one person might be upsetting to another.” Since the robot interacts using abstract noises, there aren’t any pre-programmed phrases to worry about, which could provoke negative feelings. Combined with BB-8’s cute factor, the user’s ability to manipulate the bot’s emotions through a command menu that includes “joy” and “affirmation,” is what could cause the robot to comfort those with anxiety, Dwyer told me. “Users can control BB-8’s emotions to respond to their personal feelings, which will help them feel calm and level.” Unlike consolation from another human, whether it’s a doctor or a friend, the bot’s responses are predictable and simple. “Sometimes when you’re suffering from anxiety, you can’t be around people," Dwyer said. "That’s when the robot would come in handy.” Other studies have looked at robots as a coping method for people with mental health issues. In 2003, Japanese researchers introduced PARO, a plushie-like mechanical seal whose cuddly, interactive features are designed to help people cope with dementia and Alzheimer’s. Next there was Popchilla, a huggable blue alien that teaches children with autism how to read the emotional cues of others. Past studies suggest these robots are working. In a 2013 study at a nursing home in Indiana, elderly patients with dementia engaged more frequently with other residents after regularly interacting with PARO. Robots are expensive, but so are private therapy sessions in Canada, where they aren’t always publicly paid for. BB-8 and Popchilla cost about as much as a single session, which can run up to $150 (and must often be booked a year in advance). Both therapy and a helper robot are a steep expense for the many low-income families affected by anxiety disorders. PARO is even pricier than the others: the friendly sea mammal is about a $6,000 setback. BB-8’s capacity to treat anxiety has not yet been tested on humans, Dwyer said. She will be evaluating other robots, including the soccer-playing, human-shaped NAO robot, before using the data to develop her own therapy android in the next few years. She cautioned that neither BB-8, nor any robot, should be a person’s sole coping tactic. “This isn’t meant to be the substitution for a caregiver, therapy, or medication,” she said. “It’s meant to act as a supplement that can assist with a person’s day-to-day life.” That will come as good news to any mental health care worker who might worry that his or her job will eventually be replaced by a friendly bot.