Lifeline Anxiety Disorder Newsletter

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February 4th - A new study shows that by age 30, more than three-quarters of girls diagnosed with attention deficit hyperactivity disorder (ADHD) have had anxiety disorder symptoms. This compares to just over half of girls without ADHD. Nearly two-thirds have had problems with drugs or alcohol compared to one-quarter of those without ADHD. Dr. Joseph Biederman of Massachusetts General Hospital in Boston followed the progress of 96 girls with ADHD and 91 without the disorder in a control group. The participants completed standard diagnostic interviews for psychiatric disorders at the beginning of the study, then five, then 11 years later. The reasons for the association with other psychiatric disorders is not known. A genetic predisposition could be involved or there may be environmental causes. Parents should be aware of the risks and watch for symptoms.

An odd, but possibly effective treatment for social phobia is found in the Japanese self-help DVDs, Miteru Dake for Men and the recently released follow-up Miteru Dake for Lady. The programs feature multiple minute-long segments in which a man or woman stares at you. In Miteru Dake for Lady, each of the segments ends with the man smiling and commenting positively. The objective is to make it easier over time to make eye contact with members of the opposite sex. "Miteru Dake" means "only looking".

February 2nd - The Ontario Ministry of Education has released its revised health and physical education curriculum for Grade 1-8 programs beginning in September 2010, bringing a new approach to healthy living. Students will be helped to use health concepts they understand to make healthy choices and to understand the connection between personal health and well-being. Mental health concepts are included within all content areas with a focus on promoting and maintaining mental health, building an understanding of mental illness and reducing stigma and stereotypes. By Grade 6, they will know how to assess the effects of stereotyping, including assumptions about mental health, on self-concept, social inclusion and relationships with others and will be able to propose appropriate ways of responding to and changing assumptions and stereotypes. By the end of Grade 7, they will be able to demonstrate an understanding of linkages between mental illness and problematic substance use and to identify school and community resources that can provide support for mental health concerns relating to substance use, addictions and related behaviours. By the end of Grade 8, they will have the capacity to identify the warning signs of substance misuse or abuse and addictions and related behaviours and discuss the consequences. The revised curriculum document is available at www.edu.gov.on.ca.

If you're in the UK, BBC One has a documentary, My Child Won't Speak on at 10:35pm tonight. It three young girls with selective mutism, as they struggle to overcome their phobia and speak to people other than their parents. Eight-year-old Red has a set of rules about who she can and can't talk to, ten-year-old Megan will talk freely at home, but never utters a word at school and 15-year old Danielle started speaking in public for the first time just a year ago. The program follows the girls as they try to confront the personal fears and anxieties they have about using their voices. See www.bbc.co.uk/headroom for more information. Hopefully the North American BBC stations will bring it to Canadian and American audiences soon.

January 28th - A wireless-enabled finger-ring device that measures skin temperature coupled with a web-enabled system has the capacity to provide a channel of communication between patients with panic and anxiety disorders and health care workers. The International Journal of Business Intelligence and Data Mining reports that the system is being developed in Taiwan. It will enable patients to upload physiological data and their self-assessment to the database, allow hospital staff to answer patients' questions and for pertinent information to be downloaded. The ring continuously monitors and records the patient’s finger skin temperature providing an indicator of his/her emotional state. Patients are taught to observe the effects of muscle and mental relaxation exercises on their skin temperature, biofeedback that can also be monitored by the health care worker. After learning this, ten patients in a pilot study were able to apply the methods and cues to relieve their panic disorder symptoms experiencing fewer panic attacks and showing improvement measured on the Panic Disorder Severity Scale. A large multi-center clinical trial is now taking place. The next step will be to develop a system for mobile devices.

Elizabeth Baker, owner of Thames Centre Service Dogs in London, Ontario, takes abandoned and surrendered dogs with good personalities and trains them to help their owners deal with panic attacks. They can cut down on the owner's need for medication, reducing the costs of health care for people with autism and anxiety disorders and veterans with post-traumatic stress disorder (PTSD). Baker is proposing that Veterans Affairs help with the cost of service dogs for some of the 6 per cent of Canada's Afghanistan veterans who have PTSD. Trained dogs cost about $6,000 each. In one case, a Legion branch in Ontario has purchased a dog for one of its members and would like to do so for other members but Legion branches have limited resources. Baker says she intends to keep working on Veterans Affairs to provide funding.

January 22nd - A new one minute test which can diagnose post-traumatic stress disorder (PTSD) with 90% accuracy has been developed at the University of Minnesota. The test uses magnetoencephalographic (MEG) recordings to measure the magnetic fields produced by electrical activity in the brain, specifically the tiny magnetic fluctuations that occur as groups of neurons fire. The controlled study involved seventy-four military veterans, diagnosed with PTSD, and 250 healthy volunteers. Participants were placed within an electromagnetically shielded chamber and told to look at a spot 65 cm in front of them for one minute to allow researchers to monitor the subjects brain while at rest. MEG scans record how nerves in the brain interact faster than both magnetic resonance imaging (MRI) and Computerized Axial Tomography (CT) scans. The PTSD patients proved to have different brain patterns to the healthy volunteers and the scans also show the severity of the disorder in each individual. More information is available at the website of the Journal of Neural Engineering.

While painkiller injections don't guarantee the prevention of PTSD, researchers at the Naval Health Research Center in San Diego are finding that they do appear to impact on the psychic strain of combat. Whether this is due to reduction of pain or to morphine affecting the consolidation of memory immediately after a traumatic event or a compination of both is not known. However, a study of Army, Navy and Marine Corps personnel wounded in Iraq between 2004 and 2006 shows that 76 percent of those who did not develop PTSD had been given morphine. This compares to 61 percent of those who had been given morphine who did develop PTSD. The researchers are now looking at the effect of other opiates and anti-anxiety medications.

January 19th - Great West Life's Centre for Mental Health is providing a free webinar on managing mental health in the workplace. The two-hour web-based presentation is entitled Issues and Solutions: Managing Mental Health in the Workplace, and is available until June 30th at www.mentalhealthworks.ca. The presentation provides tips on identifying and addressing workplace mental health issues as well as resources for effective performance management. It is endorsed by the Mental Health Commission of Canada.

BrainStorm, the eighth Northern Initiative for Social Action (NISA) poetry contest is accepting entries until March 19th from consumers and survivors of mental health services. This is an international competition and the topic is open. Three prizes are awarded with publication in NISA's Open Minds Quarterly. NISA is a Sudbury, Ontario-based, non-profit agency working with mental health services consumers. For more information, go to www.nisa.on.ca.

Passengers who were on Air Transat Flight 236 which almost crashed into the Atlantic Ocean in 2001 are invited to participate in a study funded by the National Institute of Mental Health and the Canadian Institutes of Health Research. The study, led by the world-renowned Baycrest's Rotman Research Institute in partnership with the University of Toronto and McMaster University, is the first to investigate the differences in how individuals are affected differently by the same experience in a large group of people who all experienced the same traumatic event under the same conditions. One of the researchers, Dr. Margaret McKinnon, assistant professor of Psychiatry and Behavioural Neurosciences at McMaster University, was a passenger on the flight. It is hoped that 50 of the passengers see the study as an opportunity to turn their experience into a positive contribution to better understanding of the brain circuitry involved in emotion, attention and memory and why some people are more vulnerable than others to post-traumatic stress. Those interested should contact Baycrest's Rotman Research Institute in Toronto at 416-785-2500, ext. 3084, for further information.

January 17th - I just found out about the death of Jerilyn Ross from cancer on January 7th. A victim of anxiety disorders herself, Jerilyn was a psychotherapist and founder of the Anxiety Disorders Association of America (ADAA) which she cofounded in 1979 after gaining control of her own panic, fears and phobia. She became a well-known advocate of improved treatment, anxiety disorder research and the training of health professionals. Through her practice in Washington, D.C., her weekly radio talk show, the ADAA website, annual ADAA conferences and her books Triumph Over Fear: A Book of Help and Hope for People with Anxiety, Panic Attacks, and Phobias, she had helped many thousands of people and families facing anxiety disorders. Her new book, co-authored with Robin Cantor-Cooke, One Less Thing to Worry About: Uncommon Wisdom for Coping with Common Anxieties was published last year. Jerilyn's funeral was held January 11th at Washington Hebrew Congregation in Washington, D.C. The family requested memorial donations be made to ADAA, 8730 Georgia Ave., Silver Spring, MD 20910. Rest in Peace, Jerilyn. You will be sadly missed.

January 12th - The gene identified as making animals susceptible to canine compulsive disorder may help scientists find out more about obsessive compulsive disorder (OCD) in humans. The Boston Globe reports that, after scientists at the Broad Institute in Cambridge announced that the gene is a common link in 92 Doberman pinschers with compulsive behaviour including obsessively chasing their tails, licking their legs, pacing and circling, the DNA of more than 300 people with OCD and about 400 of their relatives will be studied. If it proves to be a short cut to finding the gene in humans, by narrowing down where it is likely to be located in human DNA, it fast track the development of effective treatment of the disorder.

The Children's Hospital of Philadelphia has published research into stress disorder and post traumatic stress disorder (PTSD) in parents of child accident victims. The research, published in the Journal of Traumatic Stress, shows that 27 percent of parents had acute stress disorder or traumatic stress symptoms six months afterwards, with 15% of them developing symptoms of PTSD. Symptoms included re-experiencing the incident, avoiding reminders of the incident, general anxiety and being easily startled. Because the health of parents is so important to the recovery of the child, they have created a website at www.AfterTheInjury.org to help families deal with their reactions. When traumatic stress reactions go on for longer than a month, it is important that parents to seek support for themselves.

January 9th - A trend to psychiatrists prescribing more than one drug at a time, often with little or no scientific basis, puts patients at increased risk of drug interactions U.S. researchers at Johns Hopkins University and Columbia University reported in the January issue of Archives of General Psychiatry. 60% of patients whose visits to a psychiatrist resulted in a drug prescription were given at least two medications and 33% three or more according to 2005-2006 government survey data the researchers analyzed, up from 43% amd 17% respectively less than ten years earlier. Medications studied were antidepressants, antipsychotics, mood stabilizers and sedative-hypnotic drugs including benzodiazapines prescribed for anxiety disorders. Prescriptions for two or more antidepressants or antipsychotics and combinations of antipsychotics and antidepressants were the most significant. The combinations of antidepressants and antipsychotic drugs involved are supported by clinical trials, but many are unproven in terms of efficacy and, while there is evidence that combining different antidepressants can improve the efficacy, they also raise the risk of adverse effects. 10% of visits involving antidepressants and antipsychotic combinations increased to 16% and adding a second or third antidepressant to antidepressant treatment doubled in frequency. The odds ratio for multiple drug prescriptions for anxiety was 1.57 compared to patients with other diagnoses. Single diagnoses of anxiety disorder, along with those for major depression, bipolar disorder and schizophrenia were significantly associated with multiple prescriptions as were older patients compared to younger and females compared to males. The researchers are concerned about the dangers of these trends and call for increased education and restrictions on drug formularies particularly especially in the Medicare and Medicaid programs where odds ratios of patients receiving multiple prescriptions are significantly higher compared those with private insurance.

January 6th - Psychological debriefing, involving the reliving of the trauma, may be doing more harm than good according to a commentary in the Canadian Medical Association Journal. It has not been shown to prevent post-traumatic stress disorder (PTSD) in adults and, in some cases, appears to actually increase risk of the disorder. In the face of this evidence, Dalhousie University researchers are urging that psychological debriefing not be performed after traumatic incidents in schools. More research is needed to assess psychological and mental health interventions in schools after traumatic events such as violence, suicides and accidental death. Promoting a sense of safety and calmness, as well as connectedness and hope at school, is more beneficial and there are two evidence-based programs, Psychological First Aid and Cognitive Behavioral Intervention for Trauma in Schools that they feel may benefit students after a traumatic event. The focus should be on the children who may be at risk including the friends of the student involved in the trauma and children with preexisting mental health problems and on the provision of psychological resources if students or parents request them.

January 4th - The United Kingdom's new plan for mental health is explained in New Horizons: A Shared Vision for Mental Health which lays out 120 steps for government and non-governmental groups to achieving the vision of improving mental health and the quality and accessibility of mental health services. The objective is for people with mental health problems to be able to structure their own lives, participate in the community and work to earn a living with the participation of all levels of government in partnership with non-governmental organizations and the community at large. Stigma and discrimination and better access to employment and housing are addressed as well as the impact of environment, climate change, violence and abuse on mental health. More information at at newhorizons.dh.gov.uk.

To God Be the Glory is an autobiographical account of the author's service during World War II and its psychological impact. American military veteran, J. D. Williams struggled with post-traumatic stress disorder (PTSD) after being severely wounded and trapped for 48 hours without access to medical care during a battle on the island of Okinawa. He hopes that, by explaining how he addressed his PTSD through prayer, keeping busy, refraining from consuming drugs or alcohol and in my elder years receiving counseling at the veteran center, he can inform and motivate others in similar circumstances. Many World War II veterans have spent over sixty years with untreated PTSD and this is a book, which through its content on Williams's experiences in the Pacific and his later life as a customs orricer, should attract the attention of these men who need to be made aware of the benefits of treating their PTSD.

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