mental health

Schizophrenia is a difficult condition for patients and their families to manage. Relapse is a frequent occurrence, particularly if patients decide to discontinue antipsychotic drug treatment because of unwanted side effects. Psychiatrists say over half of patients relapse within two years and over 80 per cent within five years. Relapse is five times more likely to occur among patients who stop their treatment.

Now a phase III study investigating safety and efficacy of a new drug, soon to be available in the US, has shown the risk of relapse in patients getting the treatment over a period of one year compared to those receiving no treatment was reduced by around 75 per cent. Preventing relapse is important because it enables people with schizophrenia to carry on with their lives normally, without disruption to work, education or relationships, and helps avoid the need for hospital admission. Hopes are high that newer treatments will improve on those already available in keeping patients stable.

The drug featured in the study is a new atypical antipsychotic called asenapine, in development by ScheringPlough. It is taken by mouth, and is the first psychotropic medicine to be administered sublingually. The drug is placed under the tongue twice daily and releases slowly from a small reservoir. “The formulation gives a steady distribution of the drug. It also ensures patients under observation are actually taking their medicine and not pretending to swallow a tablet which they later surreptitiously remove,” explained psychiatrist Professor Steven Potkin, of University of California, who has experience of asenapine. “In addition, it makes it difficult for patients to overdose themselves. If they put too much in the mouth the excess is swallowed and rendered inactive in the gut.”

The drug was approved by the FDA in August for treatment of acute schizophrenia in adults and also for acute episodes of mania in bipolar 1 disorder. The first time a psychotropic medicine has been approved for two indications simultaneously. It will shortly be marketed as Saphris in the US. In Europe it is still under review by the European Medicines Evaluation Agency (EMEA). If approved it will be marketed in European countries as Sycrest. Results presented at ECNPResults of the phase III relapseprevention study in schizophrenia were presented this week to psychiatrists at the 22nd annual congress of the European College of Neuropsychopharmacology (ECNP) in Istanbul. They showed that only 12 per cent of patients who received asenapine relapsed over the course of one year compared with 47 per cent of patients who received placebo. The study consisted of a sixmonth open label phase and a sixmonth randomised double blind phase where asenapine was compared against placebo in 386 patients, most of whom suffered from paranoid schizophrenia. Only patients whose disease had stabilised on asenapine were included in the randomised phase. Most of those receiving asenapine took 10mg twice daily

Patients were deemed to have relapsed on a number of assessments including if their score on the standard schizophrenia assessment tool PANSS (Positive and Negative Syndrome Scale) had increased by more than 20 per cent from the time they entered the doubleblind part of the study or if they scored more than 5 on specific items such as hostility or hallucinatory behaviour. Adverse events were monitored throughout the study by formal assessments including ECGs, laboratory tests, and standard rating scales.

Lead author of the study Mary Mackle, a clinical research scientist at Schering Plough in New Jersey, USA, said “The results we saw for asenapine were very good.” The number of patients staying with active treatment was high and the number experiencing a further episode was exceptionally low. Patients were thought to have stayed on treatment because it was effective in controlling symptoms but also because they were not deterred by side effects. “This is a welltolerated drug, obviously, with a good side effect profile. It doesnt cause a lot of weight gain or sedation compared to some other antipsychotics.” In fact, treatmentemergent and treatmentrelated side effects occurred more frequently in the placebo group, she noted.

Another Schering Plough clinical research scientist, Dr John Panagides also commented on how well patients appeared to tolerate treatment “Given the known risk/benefit profiles of current antipsychotic drugs, asenapine is pretty favourable.” It is associated to a much lesser extent with side effects of antipsychotic drug therapy such as raised prolactin, weight gain, metabolic effects, sedation and extrapyramidal system effects (involuntary movements), he explained.

“Asenapines effects on these were very modest,” . The most frequently reported adverse events for both the asenapine and placebo groups were anxiety (8.2 per cent with asenapine vs 10,9 per cent with placebo), increased weight (6.7 per cent for asenapine vs 3.6 per cent for placebo) and insomnia (6.2 per cent with asenapine and 13.5 per cent with placebo.) Clinically significant weight gain (more than 7 per cent of baseline weight amounting to around 4kg affected only 3.7 per cent of asenapinetreated patients.) Four times as many placebotreated patients experienced worsening of schizophrenia as did patients receiving asenapine (4.6 per cent vs 16.1 per cent).Negative symptom improvementOne of the emerging benefits of the new treatment is itseffects on the negative symptoms of schizophrenia, remarked Professor Potkin. Negative symptoms include apathy, loss of drive and lack of motivation or interest, and poor social functioning. “In shortterm studies it showed clear efficacy for negative symptoms and in longer term studies, the effect also seems to be maintained. This is a very important finding because negative symptoms are extremely difficult to treat,” he stressed.

A ScheringPlough press release in July this year reported on a study investigating asenapines effects on negative symptoms. In the study, asenapine was significantly more effective than olanzapine in the reduction of negative symptoms as assessed using the 16item Negative Symptom Assessment scale (NSA16).”Full results of the trial, including efficacy, safety and tolerability data, will be submitted for presentation at a medical meeting at a later date,” according to the company statement.

All antipsychotic drugs are different, points out Professor Potkin. “There is no one size fits all drug that suits all patients with schizophrenia. Some people wont respond to one but will respond to another. Different sideeffect profiles allow psychiatrists to tailor treatment to suit particular patients, for example, overweight patients would need a drug that avoids excessive weight gain or metabolic syndrome” he suggested. “All antipsychotics are effective at tackling the positive symptoms of schizophrenia but some agents also target different domains that others dont.”

A poster at ECNP led by University of California and Yale University scientists using a primate model suggests asenapine may have potential to treat cognitive impairment in schizophrenia. The researchers concluded from asenapines effects on serotonergic receptors in monkeys that the drug might also improve cognitive impairment in schizophrenia although they stress large scale clinical studies would be needed for confirmation of these effects in patients.

Regarding its other indication, bipolar 1 mania, or mixed symptoms, a poster at ECNP showed asenapine rapidly reduced symptoms within 2 days and improved scores on all 11 items of the YMRS (Young Mania Rating Scale) the standard measure for mania assessment within two weeks.

Although clinical experience with the drug is limited, some professional guidelines, notably those produced by expert bodies concerned with bipolar disease, are already recommending it to psychiatrists on the strength of evidence produced from numerous clinical trials. As further trials are completed and its performance in clinical practice is studied once it becomes widely available, more will be learned about asenapines strengths.

“There is great optimism that other new drugs will be developed in the future that will also help address the current unmet needs in managing patients with schizophrenia and bipolar disorder,” remarked Professor Potkin

Further information
scheringplough.com

Gold medal winning triple jumper Phillips Idowu is calling on the public to take giant strides to end to mental health stigma by taking part in this years Get Moving week (3 to 11 October 2009) a part of the Time to Change campaign to end discrimination. While all eyes are on the athlete at todays Aviva Grand Prix, new research shows only 26 per cent of people would be happy to let their child be coached by someone with a mental health problem.

Sporting heroes like David Beckham, Jonny Wilkinson and Dame Kelly Holmes have all spoken out about their experience of mental distress but the results show that they would not be trusted by the public to coach their kids. The You Gov poll, carried out during the recent IAAF World Championships, found that while 85 per cent think that sportspeople with mental illness set a good example, 48 per cent would only let a sports coach with mental distress teach their children if there were other adults present and a further 13 per cent would rule it out altogether.

Olympian Phillips Idowu said

It is so sad that people with mental health problems are judged and discriminated against, especially when they are living or trying to live normal working lives. These results show that nearly everyone believes that sportspeople with mental illness can be good role models, so I do not understand why so many are opposed to these very same people taking time to pass on their skills to children and encourage them to exercise to improve their physical and mental wellbeing.

Exercise is one of the best ways of improving mental wellbeing but stigma and discrimination mean that many people are unwilling to take part in physical activities involving people with mental health problems. 1 in 10 surveyed admitted they would not want to share gym facilities with someone with mental illness and 1 in 5 would be worried about taking part in a contact sport such as rugby or karate.

Get Moving week will see hundreds of events taking place up and down the country bringing people together with and without experiences of mental distress to break down barriers and combat mental health discrimination. From walking to salsa dancing there is something for everyone and by taking part you can help make life better and fairer for those with experience of mental health problems.

Phillips Idowu will be leading the proceedings at Get Moving and Dance, a festival in Regents Park in London on World Mental Health Day on Saturday 10 October. He will be joined by a host of celebrities at the event where people can try out different styles of dance. Find out more at getmovingweek.org.uk.

Another sporty star giving Get Moving her backing is former Spice Girl Mel C, who herself experienced depression. She said

Im a great believer in the positive effects of exercise on mood and mental wellbeing. Get Moving week is a fantastic way to raise awareness of the proven links between exercise and good mental health and to bring people together all over the country through a range of fun physical activities.

Sue Baker, Director of Time to Change said

By getting people with different experiences of mental health together, we can help everyone to understand more about mental health. The prevailing stigma is society is vastly due to public misunderstanding and Get Moving week is a great way to break these myths. Plus, it gives people the chance to do something active, lifting their mood and benefiting their mental and physical wellbeing.

The Time to Change campaign is Englands biggest and most ambitious programme to end mental health discrimination. The campaign is run by leading mental health charities Mind and Rethink, and backed by £16 million from the Big Lottery Fund and £4 million from Comic Relief.

Notes

All figures are from YouGov Plc. Total sample size was 2082 adults. Fieldwork was undertaken between 17 and 19 August. The figures have been weighted and are representative of all GB adults (aged 18+).

Time to Change is Englands most ambitious programme to end the discrimination faced by people with mental health problems, and improve the nations wellbeing. Mind and Rethink are leading the programme, funded with £16m from the Big Lottery Fund and £4m from Comic Relief, and evaluated by the Institute of Psychiatry at Kings College, London. For further information go to timetochange.org.uk

The Big Lottery Funds support for Time to Change comes from its £165m Wellbeing programme. The Big Lottery Fund has been rolling out grants to health, education, environment and charitable causes across the UK since its inception in June 2004. It was established by Parliament on 1 December 2006. Full details of the work of the Big Lottery Fund, its programmes and awards are available on the website biglotteryfund.org.uk

Commenting on the final biennial report from the Mental Health Act Commission released by the Care Quality Commission, Mental Health Network director Steve Shrubb said

“While the Commission rightly acknowledges that often very vulnerable people are looked after effectively and with care, we know there is more to do to make this the norm across all services.

“The commission is also right to highlight the high number of community treatment orders and we agree that we need a more detailed understanding of how they are being used.

“The Mental Health Network has been calling for some time for the mandatory training and accreditation scheme for all staff who may be engaged in restraint practices to be set up as soon as possible.

“We are also working with the department of health among others to develop an acute pathway declaration which will set out the kind of support people can expect along with a national plan to implement it.”

Notes

The Mental Health Network represents the majority of mental health trusts. It was launched in spring 2007 to provide a distinct voice for providers of NHS mental health services.

Source

As the Government sets out proposals to reform social care, leading mental health charity Mind welcomes the move to simplify the process and create a fairer system for the many thousands of people with mental health problems who currently pay for social care services.

Minds Director of External Relations Sophie Corlett said

“Health and social care are two sides of the same coin, yet the division between the two services and how they are paid for and accessed has long been a problem for people with experience of mental distress, whose needs can span both categories.

“Having a mental health problem isnt just a medical issue it can affect every aspect of daily living, from holding down jobs and relationships, to domestic duties such as getting round to cooking and paying the bills. A lack of funding in the social care system has meant that people with enduring mental health needs have been missing out on simple but life changing services, including support in managing day to day tasks that will help them get back on their feet and live independent lives. People are being left isolated and unable to access the things in life that most people take for granted.

“The Governments commitment to a National Care Service should help to address some of these problems by finally bringing social care in step with NHS services. We must ensure that any future Governments sign up to this radical reform which will create a fairer playing field for people with experience of mental distress.”

Patients will continue to be unprotected if statutory independent regulation is not extended to counsellors and psychotherapists, according to leading national charities Mind and WITNESS. On the day that psychologists are to be regulated by the Health Professions Council (HPC), the charities welcome the advancement and urge counsellors and psychotherapists to follow suit.

Psychological therapies remain one of the least regulated areas of mental health practice in the UK, currently anyone can set themselves up as a counsellor or psychotherapist, without formal training or need to join a professional organisation. There is no single body to monitor malpractice and numerous complex complaints systems make it difficult for patients to take up claims. The Government has promised HPC regulation for psychotherapists and counsellors by 2011 but there remains some professional opposition to the plans.

Paul Farmer, Chief Executive of the mental health charity Mind, said

“People go to see a counsellor or psychotherapist when they are in distress and it is unacceptable that at their most vulnerable they are not being properly protected. Now that psychologists are to be regulated by the HPC it makes sense for counsellors and psychotherapists to follow suit. We need a robust system of regulation that ensures health professionals meet set standards and patients are offered a central and fair system for making complaints. It is clear that selfregulation is not working and the Government must press ahead with its plans to overhaul the system.”

WITNESS Chief Executive Jonathan Coe said

“It can be very hard for clients to complain. Not only does it require a great deal of strength of character to report abuse but people have to face over 100 different codes of conduct and organisational complaints procedures, may have to meet their own costs, prepare their own cases and represent themselves at panels made up exclusively of professionals.”

“The existing system is open to abuse. It allows therapists to continue using the same titles, even after they are removed from their own register. HPC regulation cant end abuse but it can provide a single, unified and unbiased channel for complaints, and if a practitioner is struck off they are then legally barred from operating under that title.”

Professional boundaries charity WITNESS is approached every month by individuals who have been abused by therapists. People like Ed whose psychologist broke patient confidentiality when she divulged to third parties sensitive details of their session. He has attempted to make complaints but has been unsuccessful as it is his word against that of the psychologist, who denies wrongdoing.

Ed said

A quarter of us will experience at least one mental health problem in any one year, and yet stigma and prejudice are still widespread.

In recognition of this hidden health crisis, The Royal Society for Public Health (RSPH rsph.org.uk ) has today accredited the Mental Health First Aid (MHFA) training programme in England, developed to establish a network of people with the skills and knowledge to take this essential first aid training into the community.

Mental health problems can affect people at any time, in different ways, and many suffer in silence for a long time before eventually seeking help. The MHFA course trains people to recognise the symptoms of mental health problems, shows how to offer initial help to those affected, and provides information about professional support.

MHFA supports the governments wellbeing agenda which highlights the importance of early intervention. Trainees on mental health first aid courses work in many different settings, including commercial organisations, teaching, police and prison services.

Fionuala Bonnar, programme director for Mental Health Services and Improvement, London Development Centre, part of Commissioning Support for London, said “The MHFA course instructors are a vital link in our work to promote awareness of mental health problems. RSPH accreditation for our instructors programme shows that our courses are delivered to the RSPHs very high standards, giving additional confidence to instructors, trainees and the public.”

RSPH chief executive professor Richard Parish comments “Many people are familiar with first aid for physical health, but there is a much more limited understanding of first aid for mental health. Early recognition of mental health problems can make all the difference to the outcome for individuals and their families, and the mental health first aid course gives trainees the practical knowledge to help identify anyone who may need professional help. Excellent training for these instructors is essential to the success of this much needed work. RSPH accreditation confirms the high quality of the instructor training programme and I congratulate all those involved in achieving this recognition.”

Notes

1. The National Mental Health Development Unit (NMHDU)

MHFA was originally developed in Australia and has been adapted for use in England by NMHDU. More than 100 MHFA instructors have now been trained.

Psychology is the science of the mind and behavior. The word “psychology” comes from the Greek word psyche meaning “breath, spirit, soul”, and the Greek word logia meaning the study of something. According to Medilexicons medical dictionary, psychology is “The profession (clinical psychology), scholarly discipline (academic psychology), and science (research psychology) concerned with the behavior of humans and animals, and related mental and physiologic processes.” Although psychology may also include the study of the mind and behavior of animals, in this article psychology refers mainly to humans.How do psychologists study the mind? The mind is highly complex and enigmatic. Many wonder how psychologists can study such an intricate, seemingly abstract and extremely sophisticated thing. Even if scientists look inside the brain, as in an autopsy or during a surgical operation, all they see is gray matter (the brain). Thoughts, cognition, emotions, memories, dreams, perceptions, etc. cannot be seen physically, like a skin rash or heart defect.

Experts say that the approach to psychology is not that different to other sciences. As in other sciences, experiments are devised to confirm or disprove theories or expectations. For a physicist, the raw data during the experiments may be atoms, electrons, the application or withdrawal of heat, while for the psychologist human behavior is the raw data.

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For a psychologist, human behavior is used as evidence or at least an indication of how the mind functions. We are unable to observe the mind directly; however, virtually all our actions, feelings and thoughts are influenced by the functioning of our minds. That is why human behavior is used as raw data for testing psychological theories on how the mind functions.Where does psychology lie compared to other sciences? Many say that psychology lies at the crossroads of other disciplines, such as medicine, linguistics, sociology, biology, artificial intelligence, anthropology, sociology, and even history. For example, neuropsychology which looks at how different brain areas are involved in memory, language, emotions, etc. overlaps with biology and medicine.How many branches of psychology are there? There are many branches of psychology; how you split them up will usually depend on which part of the world you are, even which university or institution you were trained at. The following are seen as the main branches of psychologyClinical psychology integrates science, theory, and practice in order to understand, predict and relieve maladjustment, disability, and discomfort. Clinical psychology also promotes adaption, adjustment and personal development. A clinical psychologist concentrates on the intellectual, emotional, biological, psychological, social, and behavioral aspects of human performance throughout a persons life, across varying cultures and socioeconomic levels. In other words, clinical psychology is the scientific study and application of psychology in order to understand, prevent, and alleviate psychologicallycaused distress or dysfunction (disability) and promote the patients wellbeing and personal development.

Psychological assessment and psychotherapy are central to the practice of clinical psychology. However, clinical psychologists are often also involved in research, training, forensic testimony, and other areas.
Cognitive psychology this branch investigates internal mental processes, such as problem solving, memory, learning, and language (how people think, perceive, communicate, remember and learn). This branch of psychology is closely related to other disciplines, such as neuroscience, philosophy and linguistics.

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What is mental health? What is mental disorder?

What is schizophrenia?At the center of cognitive psychology is how people acquire, process and store information. Many say that cognitive psychology is the study of intelligence. Practical applications for cognitive research may include how to improve memory, increase the accuracy of decisionmaking, or how to set up educational programs to boost learning.
Developmental psychology this is the scientific study of systematic psychological changes that a person experiences over the course of his/her life span. Developmental psychology is often referred to as human development. It used to just focus on infants and young children, but also includes teenagers and adults today the whole human life span. Developmental psychology includes any psychological factor that is studied over the life of a person, including motor skills, problem solving, moral understanding, acquiring language, emotions, personality, selfconcept and identity formation.

Developmental psychology also looks and compares innate mental structures against learning through experience. For example, babies are thought to be born with an LAD (language acquisition device) an inbuilt ability to acquire language. A developmental psychologist will be interested in how the LAD works compared to the babys development through experience, and how the two interplay. A developmental psychologist will be interested in how a persons characteristics interact with environmental factors and how development is impacted. Developmental psychology overlaps with several other branches of psychology, as well as other disciplines, such as linguistics.
Evolutionary psychology this looks at how human behavior has been affected by psychological adjustments during evolution. Just as biologists talk about natural selection or sexual selection during evolution, this branch of psychology applies psychology to the same way of thinking. An evolutionary psychologist believes, for example, that language or memory perception are functional products of natural selection.

Some evolutionary psychologists hypothesize that language learning is a capacity we are born with, making language learning a virtually automatic process but not reading or writing. In other words, they believe our ability to learn language is inherited while our ability to read and write is not (language learning will happen automatically, while reading and writing has to be taught). A person who is born in a town that speaks French will speak French by the time he is 20. However, if he is not taught to read he will be illiterate language is acquired automatically if it exists around you, while reading and writing are not.

An evolutionary psychologist believes that our human psychological traits are adaptations for survival in the everyday environment of our ancestors.
Forensic psychology this involves applying psychology to criminal investigation and the law. A forensic psychologist practices psychology as a science within the criminal justice system and civil courts. Forensic psychology involves understanding criminal law in the relevant jurisdictions in order to interact with judges, lawyers and other professionals of the legal system. Forensic psychology involves the ability to testify in court, to present psychological findings in legal language to the courtroom, and to provide data to legal professionals in a clear way.

A forensic psychologist needs to understand the rules, standards, and philosophy of his/her countrys judicial system.
Health psychology also called behavioral medicine or medical psychology. This branch observes how behavior, biology and social context influence illness and health. While a doctor treats the illness, the health psychologist will focus more on the person who has the illness, by finding out about their socioeconomic status and background, behaviors that may have an impact on the disease (such as medication compliance), plus the biological reasons for the illness. The aim of the health psychologist is to improve the patients overall health by analyzing disease in the context of biopsychosocial factors. Biopsychosocial refers to the biological, psychological, and social aspects in contrast to the strictly biomedical aspects of disease.

Health psychologists generally work alongside other medical professionals in clinical settings.
Neuropsychology studies the structure and function of the brain in relation to clear behaviors and psychological processes. Neuropsychology is also involved in lesion studies in the brain, as well as recording electrical activity from cells and groups of cells in higher primates, including some human studies.

A neuropsychologist will use a Neuropsychological Evaluation a systematic assessment procedure to determine the degree of any possible behavioral problems following suspected or diagnosed brain injury in a patient. When diagnosis is made, some patients are treated with an individualized cognitive remediation protocol a treatment that helps the patient overcome his/her cognitive deficits.
Occupational psychology (also known as industrialorganizational psychology, IO psychology, work psychology, organizational psychology, work and organizational psychology, occupational psychology, personnel psychology or talent assessment) studies the performance of people at work and in training, develops an understanding of how organizations function and how people and groups behave at work. The occupational psychologist aims to increase effectiveness, efficiency, and satisfaction at work.

The British Psychological Society says occupational psychology “is concerned with the performance of people at work in training, how organizations function and how individuals and small groups behave at work. The aim is to increase the effectiveness of the organization, and to improve the job satisfaction of the individual.”
Social psychology uses scientific methods to understand and explain how feeling, behavior and thoughts of people are influenced by the actual, imagined or implied presence of other people. A social psychologist will look at group behavior, social perception, nonverbal behavior, conformity, aggression, prejudice, and leadership. Social perception and social interaction are seen as key to understanding social behavior.

Put simply, social psychology studies the impact of social influences on human behavior. A short history of psychologyIn a philosophical context psychology was around thousands of years ago in ancient Greece, Egypt, India, Persia and China. Medieval Muslim psychologists and doctors had a more clinical and experimental approach to psychology they were the first to have psychiatric hospitals.

Pierre Cabanis (France) created biological psychology in 1802. A physiologist, Cabanis wrote a well known essay called “Relations between the physical and moral aspects of man” (”Rapports du physique et du moral de lhomme”). He interpreted the mind according to his previous studies of biology. He believed that sensibility and soul were parts of the nervous system.

1979, the birthdate of psychology In 1979 Wilhelm Wundt, Germany, founded psychology as a truly independent experimental field of study. He set up the first laboratory that carried out psychological research exclusively at Leipzig University. Wundt is known today as the father of psychology.

Principles of Psychology, published by William James, an American philosopher in 1980, was discussed by psychologists worldwide for many decades.

Hermann Abbingaus (18501909), University of Berlin, was the first psychologist to study memory extensively. Ivan Pavlov (18491936), famous today even among lay people for the term Pavlovs dog, researched the learning process called “classical conditioning”.Psychoanalysis Sigmund Freud (18561939), Austria, developed psychoanalysis a method of psychotherapy. His understanding of the mind was mainly based on interpretive methods, introspection and clinical observations. He focused on resolving unconscious conflict, mental distress and psychopathology. Freuds theories on sexuality and the unconscious mind became famous; probably because sexuality was a taboo subject at the time. The main principle of Freuds theory was that the unconscious is responsible for most thought and behavior in everybody and the disorders of the mentally ill. Freud had a considerable influence in psychiatrist Carl Jung (Switzerland).
Structuralism vs. Functionalism E. B Titchener (USA), a student of Wundt, strongly believed in structuralism. William James and John Dewey were strong believers in functionalism. Structuralism is interested in what is consciousness? while functionalism is interested in what is consciousness for? What are the purposes or functions of consciousness and basic mental processes?

Structuralists and functionalists disagreed with each other passionately. Most agree there was never a clear winner in the debate but their discussion did lead to a rapid spread of psychology in the USA, as well as some other parts of the world. Stanley Hall set up the first psychology lab in the United States at Johns Hopkins University.
Behaviorism in 1913 an American psychologist, John B. Watson, founded a new movement that altered the focus of psychology. Watson believed that structuralists and functionalists deviated too much from objective science. Put simply, Watson said that psychology should focus on the study of behavior because he believed that behavior was not the result of internal mental processes, but rather the result of how we respond to stimuli from the environment. Behaviorism focused on how people learn new behavior from the environment. Behaviorism became very popular in the USA. B. F Skinner followed in Watsons footsteps.
Humanism some psychologists viewed behaviorism and psychoanalytic theory as too dehumanizing. Rather than being victims of the environment or the unconscious, humanists said that humans are innately good and that our own mental processes played an active role in our behavior. The humanist movement valued highly our emotions, free will, and a subjective view of experience.
Cognitive Theory this started in the 1970s and is seen as the most recent school of thought in psychology. Cognitive perspective is much more objective and calculating than humanism. However, it differs from behaviorism in that it focuses on mental processes extensively. Cognitive theorists believe that we take in information from our environment through our senses and then process the data mentally by organizing it, manipulating it, remembering it, and relating it to information we had stored previously. Cognitive theory is applied to language, memory, learning, perceptual systems, mental disorders and dreams.
Today dominant movements do not really exist today in the way they used to. Behaviorism, psychoanalytic theory, humanism, and cognitive perspective are all studied currently by psychologists. Psychology has become much more eclectic (selecting what appears to be best from every doctrine, movement or school of thought).

Mental Health America tomorrow will honor journalists, producers and writers for outstanding coverage of mental health issues at a Media Awards luncheon being held during its Centennial Conference in Washington, D.C.

In addition to awards in print and broadcast categories, Mental Health America will present a special award, The Bell Award for Significant Contributions to Mental Health Journalism, to Steve Lopez of the Los Angeles Times. Lopez is the author of “The Soloist,” which inspired the film of the same name. He won a Mental Health America Media Award in 2006 for a series of columns that first chronicled the life and struggles of “The Soloist,” Nathaniel Anthony Ayers.

“The Media Awards bring together the very best mental health stories in print and broadcast media during 2008,” said David L. Shern, Ph.D., president and CEO of Mental Health America “Informative and thoughtprovoking journalism is a powerful form of education and we applaud these journalists for helping shape public understanding of these critical issues.”

Mental Health America will present 2009 Media Awards in the following categories

Advocacy

Jane Howard, Wisconsin United for Mental Health, “Open Doors, Open Minds A Guide for Reporting”

Local Television

Robert L. Arnold and John Barone, KPRC (Houston, TX), “”Mental Health Crisis”

National Radio

Alix Spiegel, NPR, “Two Families Grapple with Sons Gender Preferences”

Local Radio

Bryan Thompson, Kansas Public Radio, “Greensburgs Long Road to Recovery”

National Television

Larkin McPhee, PBS, “Depression Out of the Shadows”

Documentary

Ben Selkow, Sundance Channel/Indie Pix Films, “A Summer in the Cage”

Series

Sharon Salyer and Alejandro Dominguez, The Herald (Everett, Washington), “Alone Among Us”

Newspapers with a Circulation Below 100,000

James Carlson, Topeka CapitalJournal, “The Bob Owen Story”

Newspapers with a Circulation Above 100,000

Elizabeth Bernstein and Nathan Koppel, The Wall Street Journal, “A Death in the Family”
Amy Upshaw, Arkansas DemocratGazette, “The Long Way Home”

National Magazines

Mary Carmichael, Newsweek, Growing Up Bipolar”

Coverage of Mental Health Research

Yudhijit Bhattacharjee, Science, “Shell Shock Revisited”

Local/Regional Magazines

Ray Ring, High Country News, “My Crazy Brother”
Chandra R. Thomas, Atlanta, “Suicide Mission”

A volunteer judging panel of media professionals selected the winning entries for their educational value, outstanding quality, comprehensiveness and creativity in addressing timely issues in mental health. Members of this years panel included Sarah Baldauf of U.S. News & World Repor; David Brown, The Washington Post; Kelly Kennedy, Times News Service; Anita Manning, Freelance; and Kim Sedmak, AARP TV.

Get Ready for the 2010 Media Awards!

The Mental Health America 2010 Media Awards competition will honor reporting and portrayals of mental health issues in news and features stories, on national, state local and student levels and in print, online and broadcast media. Mental Health America will distribute nomination guides in early 2009. To sign up for our mailing list, please email mediaawards@mentalhealthamerica.net.

As many as half of all men taking the antidepressant medication paroxetine (trade names Seroxat, Paxil) may have increased sperm DNA fragmentation a predictor of compromised fertility. Research led by NewYorkPresbyterian Hospital/Weill Cornell Medical Center also found that the changes are reversible with normal levels of sperm returning after discontinuation of the drug.

The study is currently published in the online edition of the journal Fertility & Sterility, and represents one of the first scientific investigations into the effect of antidepressants on sperm quality.

“Its fairly well known that SSRI antidepressants negatively impact erectile function and ejaculation. This study goes one step further, demonstrating that they can cause a major increase in genetic damage to sperm,” says Dr. Peter Schlegel, the studys senior author. “Although this study doesnt look directly at fertility, we can infer that as many as half of men taking SSRIs have a reduced ability to conceive. These men should talk with their physician about their treatment options, including nonSSRI depression medications.”

Dr. Schlegel is chairman of the Department of Urology and professor of reproductive medicine at Weill Cornell Medical College, and urologistinchief at NewYorkPresbyterian Hospital/Weill Cornell Medical Center.

The study followed 35 healthy male volunteers who were given paroxetine, a selective serotonin reuptake inhibitor (SSRI), for five weeks. The drug was used because of its relatively short halflife and because it has previously shown to exert the strongest effect in delaying ejaculation. DNA fragmentation, defined as missing pieces of genetic code in the sperm DNA, was measured using an assay called deoxyuride50triphosphate biotin nick end labeling (TUNEL).

Results showed that the percent of participants with abnormal DNA fragmentation rose from less than 10 percent to 50 percent while taking the drug. DNA fragmentation, the authors note, is known to correlate with poorer fertility and pregnancy outcomes, even when techniques such as in vitro fertilization and intracytoplasmic sperm injection are applied. It has also been linked with an increased risk for birth defects.

The study also confirmed the effect of SSRIs on sexual function, with more than a third of study participants reporting significant changes in erectile function and almost half reporting ejaculatory difficulties.

Normal levels of both sexual function and DNA fragmentation returned one month after discontinuation of the drug.

Sperm volume, concentration, motility and morphology were not significantly changed by SSRI therapy although previous research by the NewYorkPresbyterian/Weill Cornell team has shown SSRIs to affect these measures in some men.

What accounts for these findings more specifically, how does the drug affect the sperm?

Lead author Dr. Cigdem (Cori) Tanrikut explains that while the exact mechanism isnt understood, the evidence points to the drug slowing sperm as it travels through the male reproductive tract from the testis to the ejaculatory ducts. Sperm gets “hung up,” she says, allowing it to get old and its DNA damaged.

“Our main clue is that DNA integrity was quickly restored once the study participants stopped taking the drug. This would have taken much longer had sperm production been affected,” says Dr. Tanrikut, who is affiliated with Massachusetts General Hospital and Harvard Medical School, and led the study while completing a fellowship in male reproductive medicine and microsurgery at NewYorkPresbyterian/Weill Cornell. She is currently adjunct assistant professor of urology and reproductive medicine at Weill Cornell Medical College.

“This is a new concept for how drugs can affect fertility and sperm,” notes Dr. Schlegel. “In most cases, it was previously assumed that a drug damaged sperm production, so the concept that sperm transport could be affected is novel.”

“An estimated half of all infertility is related to problems on the mans side,” continues Dr. Schlegel. “It is our hope that this research can improve couples chances for conception, and potentially better our ability to create drugs that wont get in the way.”

Coauthors included Drs. Margaret Altemus and Darius A. Paduch of NewYorkPresbyterian/Weill Cornell; and Dr. Adam S. Feldman of Massachusetts General Hospital and Harvard Medical School.

The study was supported with help from the Frederick and Theresa Dow Wallace Fund of the New York Community Trust.

Depression affects approximately 10 percent of American men over their lifetimes. Antidepressant medications are the most common form of treatment, with almost 233 million prescriptions written in 2007. The most common drug therapy used are selective serotonin reuptake inhibitors (SSRIs). While the current study looked at healthy, nondepressed individuals, it is known that untreated depression or anxiety alone can affect fertility. Recent research has shown that for both pregnant women with untreated major depression and for those who were taking SSRIs throughout their pregnancy, more than 20 percent of infants were delivered preterm.

Mental health care must improve to halt the staggering number of suicides occurring in prisons, new research has revealed.

In 2008, there were 91 suicides per 100,000 per year in England and Wales in the prison population, compared with 8.5 per 100,000 in the general population. Now a new three year study has found that a large proportion of those entering prison are already vulnerable with self harm, alcohol misuse and psychiatric issues.

The National CaseControl Study of Selfinflicted Death in Prisons in England and Wales collected data based on 220 prisoner records and feedback from prison and healthcare staff.

Men accounted for 95 per cent of the deaths, the research conducted by Professor Jenny Shaw, at Northwest Forensic Academic Network and The University of Manchester and colleagues found. Professor Shaw presented the research findings today at the Annual Meeting of the Royal College of Psychiatrists in Liverpool.

Hanging was chosen as the method of death by 90%. Alarmingly, over a third (35%) of deaths happened within the first month in prison and departed prisoners were three times more likely to have had no visits during the prison term.

They were also six times more likely to have a history of selfharm and twice as likely to have a history of alcohol misuse problems.

The findings have prompted calls for multiagency working between prison officers, doctors and mental health professionals. According to Professor Shaw imported vulnerability where prisoners enter the system with psychiatric diagnosis, self harm history, alcohol misuse problems and mental health contact is very common in the general prison population.

“To reduce the risk we need to improve the general mental health care of all prisoners,” Professor Shaw said. “We need to include the kinds of methods we have in the community but adapted for prisons. Because of the nature of the place you have to adjust what you do and address the fact they are locked up for most of the day and are in a custodial regime. We need models that work for the socially excluded people at a primary care level, including prison officers in training.”

Professor Shaw also urged better exchange of information between the prison service and outside agencies and called for an improvement in the assessment and monitoring procedures for those at risk. Extra care should also be provided at time of key risk, Professor Shaw said.

Reference
Annual Meeting of the Royal College of Psychiatrists, BT Convention Centre, Liverpool, 2 5 June 2009