Study Of Mental Illness Research Articles

Studies of quality of life in the general population

This article reviews general population studies of quality of life (QOL) in order to provide comparative and normative information against which findings from the more prevalent, but less representative studies of mental illness and mental health can be judged. Electronic, hand and snowball searches generated 1013 publications. The best quality studies of general populations made only a limited contribution to the overall evidence base. Nine of the 24 single sample publications reporting general population data were of a similar and sufficiently high standard to be included in this review. All nine studies were observational and only three reported longitudinal data. The findings of these papers are reviewed and the following conclusions drawn: large proportions of the population are satisfied with their lives in 'general' terms and in domain specific terms; ratings of life quality are frequently highest in family and lowest in finances; personal characteristics and objective circumstances are not a major influence on subjective evaluations of 'general' QOL; domain satisfactions are the best predictors of 'general' life quality; 'general' QOL is more associated with material, social and family concerns than health; depression is related to evaluations of 'general' but not necessarily domain specific QOL; subjective measures of life quality are stable but are also responsive to changes that occur; domain specific indicators are more sensitive than 'general' measures, to objective circumstances, events and changes over time; domain indicators may mediate the relationship between objective events and 'general' QOL; and 'domain importance' is not a major influence in evaluations of subjective QOL.

"Do You Have Anything to Add?" Narrative as Reflection and Commentary on the Social Experience of Mental Illness

This article argues that a phenomenological study of mental illness constructed from first-person subjective narratives can make a substantial contribution to our understanding of illness in terms of ordinary human experience. I suggest that the social experience of mental illness is primarily one of alienation and that this is both an internal and externally imposed experience. I conclude by proposing that the anthropological perspective—seeing the person within his or her wider cultural context, including both spatial and temporal dimensions—has the potential to generate new insights into how we might mitigate the alienating and depersonalizing effects of the mental illness experience. On another level, this article represents my attempt, as a mother, to come to terms with a mental health crisis within my own family.

Neurodevelopmental Approach to the Study of Mental Illness

Neurodevelopmental Approach to the Study of Mental Illness

Neuropsychiatric dynamics: the study of mental illness using functional magnetic resonance imaging

Functional magnetic resonance imaging (fMRI) is poised to make significant contributions to the study of neuropsychiatric illnesses. Whatever neural pathology attends such illnesses has proven subtle at best. By identifying predictable, regionally specific deficits in brain function, fMRI can suggest brain regions for detailed cellular analyses, provide valuable in vivo data regarding effective connectivity, provide a means to model the effects of various drug challenge paradigms, and characterize intermediate phenotypes in the search for the genes underlying mental illness. Nonetheless, as promising as fMRI appears to be in terms of its relative safety, repeatability, ability to generate individual brain maps and widespread availability, it is still subject to a number of unresolved conceptual conundrums inherited from earlier neuroimaging work. For example, functional neuroimaging has not generated any pathognomic findings in mental illness, has not established a clear link between neurophysiology and observable behavior, and has not resolved the potential confounds of medication. In this article, we will review the relevant historical background preceding fMRI, address methodological considerations in fMRI, and summarize recent fMRI findings in psychiatry. Finally, fMRI is being used to simplify the complex genetics of neuropsychiatric illness by generating quantitative and qualitative brain phenotypes.

Evidence of a major psychosis gene in Iceland

Longitudinal studies of mental illness in Iceland indicate that psychosis sometimes segregates into high- and low-rate family branches. Instances are also reported in which the disorder appears to have been derived from one parent. A large family investigation has led to extensive risk data for various classes of relatives, consistent with modified dominant transmission when delusional and affective psychoses are treated as a unit. Some carriers of the proposed psychosis gene are highly gifted, both in terms of artistic production and academic performance. Particularly striking is the number of individuals in families with psychosis who perform brilliantly in mathematics. Attempts to isolate and characterize a psychosis gene seem fully warranted.

The mental health of ethnic minorities

Clinical studies have suggested that men of Caribbean origin living in Britain had much higher rates of psychosis than their white counterparts; while adults of South Asian origin have been found to have lower rates of depression. These findings have been controversial, both because of the inherent difficulty of diagnosing mental illness, and because of the possibility of cultural bias in the definition and measurement of these conditions. This article summarises the findings of the most substantial population‐based study of mental illness ever undertaken among ethnic minorities in Britain. A sample of 5,106 members of minority groups, and 2,867 white people, were screened for indicators of mental illness in the course of a national survey. Those who screened positive were then re‐interviewed to validate the initial diagnosis. The results carry some resonance with the findings of clinical studies, without replicating them exactly. Some doubts are shed on the appropriateness of standard measures of mental health for migrants from South Africa.

Linking mind and brain in the study of mental illnesses: a project for a scientific psychopathology.

Brain research on mental illnesses has made substantial advances in recent years, supported by conceptual and technological developments in cognitive neuroscience. Brain-based cognitive models of illnesses such as schizophrenia and depression have been tested with a variety of techniques, including the lesion method, tract tracing, neuroimaging, animal modeling, single-cell recording, electrophysiology, neuropsychology, and experimental cognitive psychology. A relatively sophisticated picture is emerging that conceptualizes mental illnesses as disorders of mind arising in the brain. Convergent data using multiple neuroscience techniques indicate that the neural mechanisms of mental illnesses can be understood as dysfunctions in specific neural circuits and that their functions and dysfunctions can be influenced or altered by a variety of cognitive and pharmacological factors.

The validity of two versions of the GHQ in the WHO study of mental illness in general health care.

In recent years the 12-item General Health Questionnaire (GHQ-12) has been extensively used as a short screening instrument, producing results that are comparable to longer versions of the GHQ. The validity of the GHQ-12 was compared with the GHQ-28 in a World Health organization study of psychological disorders in general health care. Results are presented for 5438 patients interviewed in 15 centres using the primary care version of the Composite International Diagnostic Instrument, or CIDI-PC. Results were uniformly good, with the average area under the ROC curve 88, range from 83 to 95. Minor variations in the criteria used for defining a case made little difference to the validity of the GHQ, and complex scoring methods offered no advantages over simpler ones. The GHQ was translated into 10 other languages for the purposes of this study, and validity coefficients were almost as high as in the original language. There was no tendency for the GHQ to work less efficiently in developing countries. Finally gender, age and educational level are shown to have no significant effect on the validity of the GHQ. If investigators wish to use a screening instrument as a case detector, the shorter GHQ is remarkably robust and works as well as the longer instrument. The latter should only be preferred if there is an interest in the scaled scores provided in addition to the total score.

Cerebral blood flow changes in limbic regions induced by unsolvable anagram tasks

The study addressed the question of whether unsolvable as opposed to solvable cognitive problems activate discrete neuronal systems in the human brain. Twelve healthy humans tried to solve unsolvable anagrams. Solvable anagrams and a resting baseline after each anagram task served as control conditions in a within-subject design. Activation was measured with the equilibrium infusion method by using 15O-labeled water and positron emission tomography, with absolute quantitation of anatomically defined regional cerebral blood flow (CBF). Compared to rest, both anagram tasks increased activity in frontal and temporal regions. The soluble task condition increased hippocampal activation and decreased mammillary bodies activity, while unsolvable anagrams were associated with increased CBF to the mamillary bodies and amygdala and decreased hippocampal activity. A limbic network integrating negative emotion and cognition seems reflected in reciprocal diencephalic and limbic activation with solvable and unsolvable anagrams. Since unsolvable anagrams have been used to induce learned helplessness in humans, this finding may provide an initial step toward clarifying its neural substrate.

The Economic Consequences of not Treating Depression

A conceptual framework is described for a broad cost-benefit evaluation of improved financial access to treatment of untreated affective disorders. The analysis provides an estimate of the value of resources needed to provide improved access to treatment, and it compares these resources to the value of resources the improved access to treatment might save. The cost-benefit analyses based on recent cost of mental illness studies provide some evidence that appropriately treating people with untreated affective disorders is cost-beneficial. Patients, providers and buyers of health care should be further encouraged to pay more attention and to commit more financial resources to the treatment of affective disorders.

Therapeutic Uses of Gastrointestinal Peptides

The GI tract is one of nature's great pharmacies. Most, if not all, biologically active peptides can be found there, and it is quite likely that others remain to be discovered. Our ability to exploit this resource has expanded considerably over the past two decades. Advances in analytical techniques have allowed investigators to rapidly isolate and purify new compounds from tissue extracts. Sequencing and de novo synthesis of newly discovered peptides are now routine, and the structural modifications required to alter activity and tailor a compound to a particular use are easily made. A number of gastrointestinal peptides or their analogues for use in clinical studies are available from commercial sources (see Table 7). Somatostatin is the first gut peptide to successfully complete development and yield a pharmaceutical compound with a broad range of action. Several of the peptides discussed in this article have similar potential. TRH stands out as a candidate because of its effectiveness in the treatment of experimental spinal cord injury and a variety of shock states. Such a broad range of action in critical fields may justify the intensive development required to yield potent, long-acting, and highly specific analogues. Similarly, the antimetastatic and immunostimulant properties of the enkephalins offer promise for new therapies in the treatment of AIDS, ARC, and cancer. Studies with amylin may lead to new and more precise regimens of blood sugar control in insulin-dependent diabetics and could in turn, prevent some of the worst long-term effects of the disease. The development of effective intranasal forms of GHRH could spare children with GH-GHRH deficiency the distress of repeated injections and help to prevent excessive GH blood levels. Secretin, glucagon, or CGRP might be used one day in cardiovascular emergencies, and VIP or its analogues could prove effective in the treatment of asthma. Although preliminary results with many of these peptides are encouraging, further progress will require the development of standardized experimental models and a more rigorous approach to experimental design. Many of the studies reported here suffered from small patient numbers, a narrow or nonexistent range of doses, or the use of only one or two dosing regimens. Lack of objective criteria for determining the level of response, e.g., in studies of mental illness or degenerative diseases, and the ethical problems of withholding treatment from some patients to establish proper controls further hamper research in this area. If the questions of efficacy and safety are to be resolved, thorough, well-planned trials will be required.

Space in its place: Developing the link in medical geography

This paper argues that a re-examination of the interrelationship between constructs of place and space is crucial to geography's involvement in the broader endeavour of health research. Place has re-emerged as nexus of ascribed meaning within contemporary social theory. Places, however, are related in space, by distance or proximity. The distinction needs to be made between this orthodox (geometric) view of space and two types of social space: the (experienced) space described by humanist geographers; and the more recent (socio-spatial) conceptualization which is both experienced and (re)produced by societal structures and advocated by social theorists in geography. We argue that advancing a recursive understanding of space and place is an appropriate direction in medical geography. This direction will include both an understanding of the ways in which space shapes the character of places and how the particularities of places resist or set in motion (orthodox) spatial processes. Illustrations are drawn from studies of mental illness and mental health care and primary health care in a remote area of New Zealand.

Medical Sociology Goes Global: An Introduction to This Special Issue: Health and Health Care in Developing Countries

In the United States, medical sociology has established its usefulness for inves tigating all manner of health phenomena ? the role of social factors and socioenvi ronmental hazards in causing disease; the behavior, values, and decision-making propensities of physicians, hospitals, and other provider entities; the help-seeking be havior of actual and potential patients; the measurement of health status, stress, and patient satisfaction; and, more recently, the quality of life under the impact of various forms of illness and treatment. The questions that medical sociologists study imply, not surprisingly, a social perspective on disease: an awareness that accepts biomedical knowledge but adds to it. Thus, even diseases with known bacteriological sources, e.g., tuberculosis or cholera, are massively affected in their occurrence by socially-determined life-chances of individuals and groups in society. Medical sociologists have studied many variations on this general theme ? differential access to safe and salutary conditions of daily life; to preventive services; to treatment resources; to modalities for rehabilitation and chronic care; and to competent, concerned professionals. Medical sociology in the United States came of age during the 1950's and 60s with financial stimulation from the federal government. The then-recently formed National Institute of Mental Health (NIMH) commissioned epidemiological studies of mental illness, the mental hospital as a care/treatment/custodial site, and public attitudes toward mental illness. NIMH also underwrote pioneering medical school curricula that gave wholly novel attention to the social factors in disease, doctor patient relationships, and problems of access to medical care. Medical sociology also made its way into the academic teaching of sociology, first at the graduate level and then the undergraduate. In this arena of growth, it was under less pressure to prove its relevance than in the biomedical research and medical education venues. Medical

Molecular genetics, reductionism, and disease concepts in psychiatry.

The study of mental illness by the methods of molecular genetics is still in its infancy, but the use of genetic markers in psychiatry may potentially lead to a Virchowian revolution in the conception of mental illness. Genetic markers may define novel clusters of patients having diverse clinical presentations but sharing a common genetic and mechanistic basis. Such clusters may differ radically from the conventional classification schemes of psychiatric illness. However, the reduction of even relatively simple Mendelian phenomena to molecular genetics has been shown to be a surprisingly complex and problematic enterprise. Mental illnesses exist at many levels of including social, environmental, and developmental interactions. Reductionistic shifts in the classification of such a disease entity will have to address the interlevel dynamics that take place within the structure of theories of mental illness. The question of how molecular analysis of psychiatric disease will impact on the structure of existing theories and classification systems is the central topic of this paper.

Chromatographic methods for the analysis of basic neurotransmitters and their acidic metabolites

Chromatographic techniques for the determination of trace amounts of neurotransmitters were reviewed. The two techniques found to be most useful were GC-MS and the reversed-phase mode of HPLC with an electrochemical or fluorescent detector. For structure determination or unequivocal peak identification, GC-MS is the method of choice. In addition the limits of detection of GC-MS were better than those obtained by HPLC. However for routine analyses, HPLC is now being used in studies of mental illness and other diseases. Good resolution, reproducibility and sensitivity can be obtained without the derivatisation steps required for GC-MS, and catecholamines, serotonin, and their acidic metabolites can be concomitantly determined in one analysis.

Psychiatry: mindless or brainless, both or neither?

After a period marked by one-sided emphasis on psychodynamics and social issues, or what could be called "brainless" psychiatry on account of its relative neglect of cerebral processes, we are witnessing an opposite trend towards extreme biologism or "mindless" psychiatry. The pendulum has swung periodically from one to the other of these reductionistic positions throughout the history of psychiatry. The author argues that neither brainless nor mindless psychiatry can do justice to the complexity of mental illness and to the treatment of patients. Psychiatry's distinguishing feature as a clinical discipline is its equal concern with subjective experience, or the mind, and with the body, including brain function, which together constitute a person, a psychiatrist's proper focus of inquiry and intervention. Moreover, a person, viewed as a mindbody complex, is in constant interaction with the environment. It follows that both study of mental illness and clinical practice need to take into account the psychological, the biological and the social aspects. These three aspects are not mutually reducible and are indispensable for the understanding and treatment of the individual patient. Such a comprehensive, biopsychosocial approach provides an antithesis to the reductionistic viewpoints and, in the writer's opinion, is both practically and theoretically most satisfying.

Is biochemistry irreducible to chemistry?

Is biochemistry irreducible to chemistry?

Comparison of mania and depression after brain injury: causal factors.

Patients who developed secondary mania after brain injury (N = 17) had a significantly greater frequency of injury to right hemisphere areas connected with the limbic system than poststroke patients with major depression (N = 31), who had injury primarily in the left frontal cortex and basal ganglia. For patients without mood disturbance after brain injury (N = 28), the location of the lesion was not significant. Secondary mania patients also had a significantly greater frequency of family history of affective disorder than did the other two groups. These results suggest that an interaction between injury to certain areas of the right hemisphere and genetic factors or other neuropathological conditions produces secondary mania.

The Female Malady: Women, Madness and English Culture, 1830-1980

In this informative, timely and often harrowing study, Elaine Showalter demonstrates how cultural ideas about 'proper' feminine behaviour have shaped the definition and treatment of female insanity for 150 years, and given mental disorder in women specifically sexual connotations. Along with vivid portraits of the men who dominated psychiatry, and descriptions of the therapeutic practices that were used to bring women 'to their senses', she draws on diaries and narratives by inmates, and fiction from Mary Wollstonecraft to Doris Lessing, to supply a cultural perspective usually missing from studies of mental illness. Highly original and beautifully written, The Female Malady is a vital counter-interpretation of madness in women, showing how it is a consequence of, rather than a deviation from, the traditional female role.

High-risk studies of mental illness

High-risk studies of mental illness