This section contains a variety of very general topics that don't fit under a single heading and for which I don't have enough articles to make separate sections.
One-third of Children have Psychiatric Difficulties: 1420 children aged 9 to 13 years at intake were assessed annually for DSM-IV disorders until age 16 years. RESULTS: Although 3-month prevalence of any disorder averaged 13.3% (95% confidence interval [CI], 11.7%-15.0%), during the study period 36.7% of participants (31% of girls and 42% of boys) had at least 1 psychiatric disorder. Some disorders (social anxiety, panic, depression, and substance abuse) increased in prevalence, whereas others, including separation anxiety disorder and attention-deficit/hyperactivity disorder (ADHD), decreased. Duke. Prevalence and development of psychiatric disorders in childhood and adolescence. Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Arch Gen Psychiatry. 2003 Aug;60(8):837-44. Ed: This study doesn't mean that one-third of children will benefit from mental health services. Matter of fact, sometimes we over-medicate and over-counsel children and their parents or provide care that is too expensive for the value gained. Still, some children with benefit from medication and/or counseling.
Psychiatric Illness Very Common in General Medical Practice: A study of 86 general practices in Belgium randomly selected 2316 patients. Only 5.4% of all patients consulted for a psychiatric reason, but a psychiatric disorder was detected in 42.5% of all patients. Most commonly detected disorders were mood disorders in 31.0% (major depressive disorder, 13.9% and dysthymia, 12.6%), anxiety disorders in 19.0% (generalized anxiety disorder, 10.3%), somatoform disorders in 18.0% and probable alcohol abuse/dependence in 10.1%. High prevalence of mental disorders in primary care. Ansseau M, Dierick M, Buntinkx F, Cnockaert P, De Smedt J, Van Den Haute M, Vander Mijnsbrugge D. J Affect Disord. 2004 Jan;78(1):49-55
Lie Detection: Voice-Stress Analysis Worthless: Voice-stress analysis, an alternative to the polygraph as a method for lie detection, is widely used in police and insurance fraud investigations. It is being touted as a powerful and effective tool for an array of new applications -- everything from the screening of potential terrorists in the nation's airports to catching wayward spouses in messy marital disputes. Despite its booming popularity, a number of federally sponsored studies have found little or no scientific evidence to support the notion that existing voice-stress technologies are capable of consistently detecting lies and deceptions. "We tested one of the more popular voice-stress lie detection technologies and got dismal results, both in the system's ability to detect people actually engaged in deception and in its ability to exclude those not attempting to be deceptive," said Mitchell S. Sommers, an associate professor of psychology in Arts & Sciences at Washington University in St. Louis. "In our evaluation, voice-stress analysis detected some instances of deception, but its ability to do so was consistently less than chance -- you could have gotten better results by flipping a coin." Funding by the Department of Defense Polygraph Institute. Presented at the World Congress of International Conference of Psychophysiology in July 2002. Ed: Lie detectors are all highly unreliable. It is a large industry which has made money at the expense of destroying thousands of lives by falsely accusing people of lying. The use of lie detectors for any reasons whatsoever should be illegal by government or private industry until solid research shows a high degree of reliability. It is very unlikely that this could ever be done.
Blinding in Double-Blind Research Rarely Measured and Often Not Successful: In an analysis of 191 DB PC studies, researchers report that only seven of the 97 (7%) general medicine trials provided evidence on the success of blinding, with five reporting that the success of blinding was imperfect. In trials from psychiatric journals, the success of blinding was reported in eight of the 94 trials, with four reporting that the blinding was imperfect. Overall, only four of the 191 (2%) trials assessed blinding in the participants and either the outcome assessors or the investigators. Turning a blind eye: the success of blinding reported in a random sample of randomised, placebo controlled trials. Dean Fergusson, Kathleen Cranley Glass, Duff Waring, Stan Shapiro
Neurotransmitters: There are many different neurotransmitters and receptors in the brain, but only a few of these are targeted for the treatment of psychiatric difficulties. Only about 10,000 of the brain's 100 billion neurons produce dopamine, the primary target for anti-psychotic medications. Serotonin circuits are confined mainly to the midbrain. Drugs increasing action on the serotonin receptors are used to treat depression. The most common type of receptor in the brain is the direct gated or ionotropic glutamate receptor. Binding of this receptor opens the gate allowing ions to rush into the nerve cell. The metabotropic glutamate receptor (mGluR), when bound by a neurotransmitter, releases a second messenger within the cell which goes to the ionotropic glutamate receptor and influences its action.
Recycling Endosomes Put Neurotransmitter Receptors Back on the Surface: Neurotransmitter receptors inside the neuron are carried to the surface from sac-like carriers called endosomes and vesicles, which enclose and transport various molecular cargos in the cell. Depending on the type of carrier, the cargo may be destroyed, or recycled back to the cell surface. The movement of AMPA receptors studied had to be regulated by activation by NMDA receptors, which are known to trigger long term potentiation in neurons. "Recycling endosomes" transport "used" receptors back to the neuronal surface after they have been drawn into the neuron. Triggering LTP not only affected insertion of AMPA receptors, but the generalized recycling of molecular cargo to the dendritic surface. Aging and neurodegeneration has been associated with enlarged and expanded endosomes in neuronal dendrites. There is an association of aging and neurodegeneration with altered synaptic function and plasticity. Michael Ehlers, Duke Univ., Julie Kauer Brown Univ. 9/24/2004, Science.
Metabotropic Glutamate Receptors: There are eight different types of mGluRs in the brain which have been discovered to date. The mGlu2 receptor may be able to be affected to treat anxiety and addiction. Unfortunately, a drug designed to reduce anxiety was in the late stages of human testing when it was discovered to have a problem of causing seizures too frequently. Cocaine causes long-term changes to mGluR2 is the prefrontal cortex and nucleus accumbes. Activating mGluR2 may lessen symptoms of addiction. mGlu4 is involved in Parkinson's disease and found primarily in the basal ganglia. In Parkinson's disease, dopamine is deficient causing glutamate-producing neurons in the basal ganglia to become overactive. Blocking the mGlu4 neurons may help correct this problem. An mGluR5 antagonist is being researched for pain and anxiety management. Mice lacking mGlu5 or who have it blocked by a medication are not interested in cocaine. This receptor is also being studied for schizophrenia. In mice, knocking out the mGluR8 gene makes the mice more susceptible to stress. Knocking out the mGluR7 receptor modifies the fear reaction. New Scientist 3/6/04