Universities Miss Chance to Identify Depressed Students, Study Finds

ScienceDaily


One out of every four or five students who visits a university health center for a routine cold or sore throat turns out to be depressed, but most centers miss the opportunity to identify these students because they don’t screen for depression, according to new Northwestern Medicine research.

About 2 to 3 percent of these depressed students have had suicidal thoughts or are considering suicide, the study found.

“Depression screening is easy to do, we know it works, and it can save lives,” said Michael Fleming, professor of family and community medicine at Northwestern University Feinberg School of Medicine. “It should be done for every student who walks into a health center.”

The consequences of not finding and treating these students can be can be serious and even deadly. “These kids might drop out of school because they are so sad or hurt or kill themselves by drinking too much or taking drugs,” Fleming said.

“Things continually happen to students — a low grade or problems with a boyfriend or girlfriend — that can trigger depression,” Fleming said. “If you don’t take the opportunity to screen at every visit, you are going to miss these kids.”

Fleming, who joined Feinberg in the fall of 2010, is lead author of a paper on the findings in the January issue of the American Journal of Orthopsychiatry. He conducted the research when he was a faculty member at the University of Wisconsin.

The study is the first to screen for depression in a large population of students who are coming to campus health centers for routine care. Prior depression studies have been conducted by surveying general college samples or students in counseling centers. The frequency of depression and suicidal thoughts among campus health clinic users was nearly twice as high as rates reported in general college samples.

Depressed students need treatment, which may include counseling and medication. These students are more likely to drink, smoke and be involved in intimate partner violence, the study found.

With new technology, screening students is simple, Fleming noted. While waiting for an appointment at the health center, the student could answer seven simple questions — a depression screening tool that that could be immediately entered into his electronic health record. “They can answer those seven questions in a minute,” Fleming said.

When the doctor or nurse sees the student, she then could address the student’s sadness or depression.

Universities typically separate mental health treatment from primary care treatment. If a student comes to a campus health center and complains about depression, he is referred to a counseling center.

“But students don’t necessarily get there unless they are pretty depressed,” Fleming said. “If we screen, we can try to find every student that is depressed.”

Historical perceptions and biases against preventive screenings are that kids who need treatment the most don’t go to campus health centers, and they won’t tell the truth about their depression.

That’s wrong. “Students will tell you the truth,” Fleming said. “If they are sad and depressed, they will tell you that. And, kids who are drinking too much or who are suicidal do go to the campus health centers.”

The study also found that students who exercise frequently are not as depressed. “That’s the one thing that seemed to be protective,” Fleming said.

The study surveyed 1,622 college students at college campuses including the University of Wisconsin, the University of Washington and the University of British Columbia.

 

Web Source: http://www.sciencedaily.com/releases/2011/01/110110154647.htm

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Northwestern University, via EurekAlert!, a service of AAAS.


Journal Reference:

  1. Sara Mackenzie, Jennifer R. Wiegel, Marlon Mundt, David Brown, Elizabeth Saewyc, Eric Heiligenstein, Brian Harahan, Michael Fleming. Depression and Suicide Ideation Among Students Accessing Campus Health Care. American Journal of Orthopsychiatry, 2011; 81 (1): 101 DOI: 10.1111/j.1939-0025.2010.01077.x

LOW VITAMIN D LINKED TO SCHIZOPHRENIA

There may be a link between sunlight, vitamin D and children’s brain development.
Content provided by Timothy McDonald, ABC Science

THE GIST

  • Babies born with low vitamin D levels are shown to be twice as likely to develop schizophrenia.
  • The finding may mean there could be a way to prevent cases of the disease.
  • Scientists caution more research needs to be done to confirm the link.

Babies born with low vitamin D levels are twice as likely to develop schizophrenia later in life, researchers from the Queensland Brain Institute have found.

But the researchers say the good news from the study is that it suggests it may be possible to prevent schizophrenia.

John McGrath from the Queensland Brain Institute says there have been suggestions for some time that there may be a link between sunlight, vitamin D and brain development. He says it is increasingly clear children with low vitamin D levels are more likely to develop schizophrenia.

“For the babies who had very low vitamin D, their risk was about twice as high as those babies who had optimal vitamin D,” said McGrath.

“But the amazing thing was that the study that was based in Denmark, where low vitamin D is quite common, we found that if vitamin D is linked to schizophrenia our statistics suggest that it could explain about 40 percent of all schizophrenias. That’s a much bigger effect than we’re used to seeing in schizophrenia research.”

While the simplest way to get enough vitamin D is to spend more time in the sun, it remains unclear whether there are fewer cases of schizophrenia in a country like Australia which sees a lot more sunlight.

“We don’t have high-quality data on that, but some statistics suggest we do have slightly lower incidences and prevalence of schizophrenia,” said McGrath.

“Like many other diseases, like multiple sclerosis, schizophrenia tends to be more common in places further away from the equator. And if you’re born in winter and spring you tend to have a slightly increased risk of schizophrenia also, and that was one of the original pieces of the jigsaw puzzle that led us to wonder maybe vitamin D could be implicated.”

Ian Hickie from the Brain and Mind Research Institute in Sydney says he is not surprised by the results, however he says more research is needed.

“So the real acid test is going to be trying to lift vitamin D levels in pregnant women and newborns and see whether there’s an effect on later schizophrenia,” said Hickie. “Or even in fact, looking at providing higher levels of vitamin D by vitamin D supplementation in other ways later in life and particularly childhood and the teenage years, to see whether you might reduce the risk of onset of schizophrenia.”

Vitamin D supplements may prove an effective way to prevent schizophrenia. But McGrath agrees there is only a statistical link at the moment and that does not prove vitamin D deficiencies are to blame for schizophrenia.

“Because the treatment and the outcome can be separated by about 20, 30 years, we need to treat pregnant women and then wait for their offspring to develop schizophrenia,” he said. “It will be a very challenging study to do.”

It could be decades before scientists know for sure.

“But medical research tends to move at a steady pace. I think the other thing is that there are many other studies suggesting that vitamin D is good for baby’s bone health,” McGrath said.

“So it may well be that recommendations will be made to women to increase their vitamin D status for more obvious outcomes, like baby’s rickets for example. If that happened then it may well be that schizophrenia would start to fall in decades to come.”

But Hickie warns against spending too much time in the sun to get more vitamin D because that could increase the risk of skin cancer.

“Rates of melanoma and skin cancer are obviously very high in our country and directly related to sun exposure, particularly in childhood,” he said.

“So on the one hand we need to be careful about over exposure to sunlight, on the other hand it may well be that in some places, or in some individuals, low levels of vitamin D may constitute a risk factor, particularly in pregnancy and therefore affecting the rates of vitamin D in newborn children.”

“So this is one of the issues that we’re going to need to look at clearly. I don’t think it means that everyone should be rushing out into the sun and necessarily putting themselves at risk of other sun-related cancers.”

Even if vitamin D does make a difference, there are several other factors that may play a part.

A predisposition to the illness can run in families, chemical imbalances in the brain may be responsible and stressful events are often thought to play a role in the onset of the schizophrenia.

This article was originally posted at Discovery.com: http://news.discovery.com/human/vitamin-d-schizophrenia.html#mkcpgn=hknws1

Hurts So Good – Neural Clues to the Calming Effects of Self-Harm

Cutting
Cutting

The notion that cutting or burning oneself could provide relief from emotional distress is difficult to understand for most people, but it is an experience reported commonly among people who compulsively hurt themselves.

Individuals with borderline personality disorder experience intense emotions and often show a deficiency of emotion regulation skills. This group of people also displays high prevalence rates of self-injurious behavior, which may help them to reduce negative emotional states.

Niedtfeld and colleagues studied the effects of emotional stimuli and a thermal stimulus in people either with or without borderline personality disorder. They conducted an imaging study using picture stimuli to induce negative, positive, or neutral affect and thermal stimuli to induce heat pain or warmth perception. The painful heat stimuli were administered at an individually-set temperature threshold for each subject.

In patients with borderline personality disorder, they found evidence of heightened activation of limbic circuitry in response to pictures evocative of positive and negative emotions, consistent with their reported emotion regulation problems. Amygdala activation also correlated with self-reported deficits in emotion regulation. However, the thermal stimuli inhibited the activation of the amygdala in these patients and also in healthy controls, presumably suppressing emotional reactivity.

Dr. John Krystal, Editor of Biological Psychiatry, commented, “These data are consistent with the hypothesis that physically painful stimuli provide some relief from emotional distress for some patients with borderline personality disorder because they paradoxically inhibit brain regions involved in emotion. This process may help them to compensate for deficient emotional regulation mechanisms.”

The authors note that these results are in line with previous findings on emotional hyperactivity in borderline personality disorder and suggest that these individuals process pain stimuli differently depending on their arousal status.

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Elsevier: http://www.elsevier.com/wps/find/authored_newsitem.cws_home/companynews05_01647

New Online CEUs Added


Dissociative Identity Disorder
Standard CEUs/NBCC CEUs:  8
Course Cost: $24

Considerable progress has been made in the diagnosis, assessment, and treatment of dissociative identity disorders (DID) during the past decades, as reflected by increased clinical recognition of dissociative conditions, the publication of numerous research and scholarly works on the subject, and the development of specialized diagnostic instruments.  Treating Dissociative Disorders in Adults is a course that was developed using guidelines from the Journal of Trauma and Dissociation, which summarizes expert consensus concerning safe and effective treatment for DID patients.  The course material offers a practical guide for the management of these patients and would be appropriate for any professionals who may encounter these clients or for anyone interested in gaining further knowledge about Dissociative Identity Disorder.


Managing Depressive Symptoms in Substance Abusing Clients

Standard CEUs: 12  Cost: $36
NBCC CEUs:  14     Cost: $42

This informative course was developed using material from the Treatment Improvement Protocol,  Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery, developed by the US Department of Health and Human Services Center for Substance Abuse Treatment. The material was designed for use by substance abuse treatment counselors and other professionals who work with clients who have substance abuse issues and depressive symptoms. When depressive symptoms occur in substance abuse treatment, they can interfere with the clients’ recovery and ability to participate in treatment. This course will help professionals gain the skills necessary to assist clients who are struggling with depressive symptoms, particularly in the first year of treatment.  The course also includes several vignettes which provide specific examples of how to work with clients facing substance abuse and depressive symptoms.


Veterans and Substance Abuse

Standard CEUs: 2  Cost: $6
NBCC CEUs: 1     Cost: $3

Numerous studies show that rates of alcohol and other drug use disorders are high among veterans within the Veterans Health Administration (VHA) health care system. This course gives a brief overview of clinical considerations in the treatment of veterans with substance use disorders and other co-occurring mental health issues.  This is an excellent course for any professional who may come in contact with this population or for anyone who is interested in gaining knowledge in this subject area.