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Sunday, April 15, 2018

Musical Hallucinations in People with Psychiatric Problems?

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Musical hallucinations are more often found in people who are older, but several conditions may also be associated with developing this type of problem.  In particular, people who suffer from hearing impairment, brain damage, epilepsy, drug abuse and specific psychiatric disorders such as depression, schizophrenia and obsessive-compulsive disorder are more likely to experience this type of auditory hallucination.


In 1953, Irving Berlin wrote a song for a new musical he had created, Call Me Madam.  The song, You’re Just in Love included the lyrics,
"I hear singing and there's no one there I smell blossoms and the trees are bare"
The lyrics are meant to reflect the state of being in love but for some the experience of hearing music when there isn’t any playing has nothing to do with love.  Musical hallucinations do exist and the research in the area has demonstrated that while no always the case, they do occur at higher rates in psychiatric patients than in the general population.


In 2004, Hermesh and colleagues noticed that subjects in some of their research were reporting musical hallucinations.  Up until then, this symptom was rarely mentioned by psychiatric patients and when it was, it was dismissed as something that wasn’t particularly troubling.  These researchers decided to further explore this symptom in psychiatric patients who had been diagnosed with bipolar disorder, major depressive disorder, obsessive-compulsive disorder, panic disorder, schizophrenia, schizoaffective disorder, and social phobia. They ruled out any individuals who had significant hearing loss or known brain damage.


The researchers determined that there was an increase in prevalence rates of musical hallucinations in these psychiatric populations.  Overall, the prevalence rate of this symptom was 20 percent higher in the psychiatric subjects although there were different rates based on diagnosis.  These hallucinations were experienced by 26 percent of subjects with schizophrenia and 41 percent of those with obsessive-compulsive disorder (OCD). In fact, OCD subjects were found to have experienced musical hallucinations to a much greater degree than had all of the other diagnostic groups combined.  The prevalence rate for the OCD group was 30 higher and for subjects who were diagnosed with OCD and one additional psychiatric disorder the prevalence rate increased to 50 percent.
Later research supported these finding and it has been concluded that while musical hallucinations are rare, among psychiatric patients, especially those with OCD,  they aren’t entirely uncommon.
It is important to note that all cases of musical hallucinations are related to mental disorders.  Research has demonstrated that about .16 percent of people who do not suffer from a psychiatric illness report having experienced musical hallucinations at some time in their life.  A number of brain disorders have also been associated with auditory hallucinations, including temporal lobe epilepsy, delirium, dementia, focal brain lesions, cerebral tumors, Parkinson’s Disease and neurological infections such as encephalitis. Musical hallucinations have  occurred as a side effect of several medications including pentoxifylline, tramadol and Bromocriptina and as the result of liver transplantation. Drug abuse, intoxication and withdrawal from substances such as alcohol, cocaine, and amphetamines have also been associated with these types of hallucinations.


However, how all these disorders, including the psychiatric conditions, may contribute to the development of musical hallucinations or whether there are other factors that may cause both the hallucinations as well as the associated conditions is unclear at this time.  Additional information about this interesting phenomenon can be found in the article, Musical Hallucinations: Blessing & Curse.


References


Baird, A., & Thompson, W. F. (2018). The Impact of Music on the Self in Dementia. Journal of Alzheimer's Disease, 61(3), 827-841.


Bortolon, C., & Raffard, S. (2015). Self-reported psychotic-like experiences in individuals with obsessive-compulsive disorder versus schizophrenia patients: characteristics and moderation role of trait anxiety. Comprehensive psychiatry, 57, 97-105.


Focseneanu, B. E., & Marian, G. (2015). Musical hallucinations–a challenge for psychiatric therapeutical management. Case report. Journal of medicine and life, 8(4), 533.


Hermesh, H., Konas, S., Shiloh, R., Reuven, D., Marom, S., Weizman, A., & Gross-Isseroff, R. (2004). Musical hallucinations: prevalence in psychotic and nonpsychotic outpatients. The Journal of clinical psychiatry.


Kobayashi, Y. (2018). A Case of Traumatic Brain Injury Presenting with Musical Hallucinations. Case Reports in Neurology, 10(1), 7-11.


Naskar, S., Victor, R., Nath, K., & Choudhury, H. A. (2017). “Radio inside my head”: A curious case of early onset “stuck song syndrome” or obsessive-compulsive disorder with predominant musical obsession. Indian journal of psychological medicine, 39(3), 373.

Perez, P. A., Garcia-Antelo, M. J., & Rubio-Nazabal, E. (2017). “Doctor, I Hear Music”: A Brief Review About Musical Hallucinations. The open neurology journal, 11, 11.

Friday, April 13, 2018

Early Birds Are Healthier and Live Longer, Study Says

Image result for night owl die sooner than early bird
Maybe you have heard of the dichotomy believed to exist in people where some are more alert and productive in the morning and others in the evening.  This tendency is often presented as a personality characteristic, genetic or physiological predisposition or differences in circadian rhythms. It has also been assumed it is just a preference or style and has no effect on our health or well-being.  
A new study published this week in the journal Chronobiology International, suggests our tendency of being more active in the morning or evening may actually be tied to a number of physical and psychological factors.  The study followed half a million adults for six and a half years and found that people who stated they were “definitely evening types” had a 10% increased risk of mortality compared those who identified as "definite morning types."  This increased risk of death may operate through a number of associated disorders. In particular, night owls were more likely to suffer from diabetes, neurological disorders, psychological disorders, gastrointestinal disorders and respiratory disorders. It is also important to note that night owls were not just displaying a preference for staying up late, their body clocks and circadian rhythms were actually set to later times.
Once explanation for these findings is that our world is generally designed for early morning starts and this is potentially throwing off the circadian rhythms night owls forced to operate on a schedule that is counter to their internal clock.  The results of this study fit with other findings that have demonstrated that people who routinely stay up late are at increased risk of developing diabetes, high blood pressure and certain types of cancer.
The researchers have determined that the problem is not related to a lack of sleep.  Both groups got similar amounts of sleep. Instead, lead researcher Knutson, said,
“I think the problem arises because a night owl is trying to live in a morning lark world.. If the body is expecting you to do something at a certain time like sleep or eat and you're doing it at the quote ‘wrong’ time, then your body's physiology may not be working as well.”
Researchers know the body clock is important.  For example, forcing the body to change time suddenly can be detrimental.  Studies have shown, for example, that switches to and from daylight savings time can increase the  risk of death over the next several days. Other studies show that shift workers forced to routinely take drastically different shifts have multiple increased health risks.
The World Health Organization has even stated that shift work likely contributes to the development of cancer, linking it to breast cancer and other types of cancers.  Shift work has also been associated with diabetes and severe sleep disorders. Forcing people to work shifts that are opposite to their natural circadian rhythm has also been associated with depression and anxiety as well as social isolation and loss of pleasure in normally enjoyable activities.
These studies taken together make an important point.  If you know that you are definitely more active and alert at morning or evening, choose jobs and activities that are consistent with your bodies preference.  It is clear that that working against your body’s natural inclination can be harmful to both your physical and mental health. Some strategies proven to help people who want to switch to an earlier schedule include gradually advancing your bedtime and avoiding the use of technology at night. General sleep hygiene strategies are also helpful.
The researchers were careful to emphasize that it isn’t just circadian rhythm tendencies that put someone at risk. It is a mismatch between your internal clock and society that’s the problem.  Finding creative ways to take care of your needs, participate in the world around you and while being consistent with your our internal clock is not always easy but it can be done.
References
Abbott, S. M., Knutson, K. L., & Zee, P. C. (2018). Health implications of sleep and circadian rhythm research in 2017. The Lancet Neurology, 17(1), 17-18.

Sunday, March 25, 2018

Remarkable CEO Response to Employee Request for Mental Health Day



Have you ever felt the need to take time off for a mental health difficulty but feared the response from your boss so you just called in sick?  Usually, when we ask for a sick day, it is due to a physical illness, such as a cold or severe allergy.  While mental health issues are often just as serious we are hesitant to ask for the day off because there are usually no sick days for emotional problems.  Even when there are, frequently we still won’t call in and ask to take the day for something mentally health related.

However, the communication of one employee and her boss recently went viral for calling attention to this problem.  The employee asked for a couple of days off, then explained to her team in an email that she was taking the time to "focus on my mental health."  The CEO of the company sent a response which was not what she expected to receive. In it, he thanked the employee for being honest about the reason behind her need for time off.  He further stated that her email reminded him of the importance of mental health time, and helped decrease the stigma associated with mental health needs.

The tweet of a screenshot of the emails, have been “liked” over 35,000 times and retweeted more than 12,000 times.  There was an immediate surge of replies. Many disclosed stories of the negative response they received when attempting to legitimately take mental health days. Some people stated that requests to take a mental health day were refused despite having mental health days included in their benefits.  

The employee summed up the reason she felt it was important to be open about the reason she was taking two days off.

"I'm specific to be an example so my team knows that they can feel comfortable taking sick leave for mental health, even if they don't say it."

Monday, March 19, 2018

Your Stress is Hurting My Brain

Image result for stress contagion effect

It has been known for some time that stress and emotions can be contagious, especially when they occur in people we are particularly close to and care about.  When someone is stressed out, those around them can feel the stress and come to experience it themselves. Similarly with emotions. When we are constantly around people experiencing negative emotions we begin to feel the same way.  One of the most researched area looking at these types of associations has shown that living with someone who is depressed or anxious can lead us to become depressed or anxious. The effects of stress has been shown to not just be emotional in nature.  Stress has been shown to permanently alter our brains in terms of brain chemistry, structure and function.


Now, a new study suggest that we should be more concerned about second hand
stress.  The study, conducted by a team at the Cumming School of Medicine's
Hotchkiss Brain Institute (HBI), at the University of Calgary suggests that stress in
one person can alter the brain of another person the same way that real stress does.  
Using a mouse model, the study also indicated that the effects of stress on the brain
were reversed in female mice after a social interaction. However, this was not the case
for the male mice.


Using pairs of mice, one mouse from the pair was exposed to a stressor then returned
to its partner who had not been exposed.  They responses of CRH neurons which
control the brain’s reaction to stress were then examined in both mice. It was found
that the brains of both mice were affected in exactly the same way.


This study was found to be particularly important because brain changes associated
with stress are thought to underlie  many mental disorders including PTSD, depression
and anxiety disorders. It is not known at this time whether stress experienced through
contagion has lasting or permanent effects on the brain.  
Jaideep Bains, the lead researcher for the study said,  "We readily communicate our stress to others, sometimes without even knowing it. There is even evidence that some symptoms of stress can persist in family and loved ones of individuals who suffer from PTSD. On the flip side, the ability to sense another's emotional state is a key part of creating and building social bonds."
This study demonstrates that stress and social interactions are closely connected. The
outcomes of these relationships can be long-lasting.  They may alter our emotions,
physiology, neurology and behaviors over a lengthy period or the effects may resurface
at a later time. The degree to which the changes may be irreversible is unclear and the
question needs further study. 
Resources
Toni-Lee Sterley, Dinara Baimoukhametova, Tamás Füzesi, Agnieszka A. Zurek,
Nuria Daviu, Neilen P. Rasiah, David Rosenegger, Jaideep S. Bains (2018). Social
transmission and buffering of synaptic changes after stress. Nature Neuroscience.
DOI: 10.1038/s41593-017-0044-6

Sunday, March 4, 2018

Study Shows That Holding Hand Can Decrease Pain


A new study suggests that holding hands with someone we love leads not only to a
sense of connection but that it can cause our breathing, brain waves and heart rates
to sync  and can even decrease physical pain.  Couples who had been together for
at least a year were put in different situations involving being in the room together or
not in the same room and touching or not touching.  Woman were exposed to mild
heat related pain. When both were in the same room, regardless of whether or not
they were touching, synchronicity of brain waves occurred, especially for wavelengths
associated with sustained attention.


The synchronization was strongest when when the pair was holding hands and the
woman was in pain.  It was concluded that touch is an important part of easing pain,
just being together isn’t enough.  It was further concluded that pain interrupts the
interpersonal synchronization that is experienced normally by couples and that touch
re-establishes it.  


Results also showed that when the woman’s male partner felt empathetic toward
her, brain wave synchronization increased and pain decreased even more.  It was
hypothesized that when we sense that someone else feels our pain it helps us to
better manage it.  This study expands upon the first one published from this
research which showed touch led to a similar decrease in pain and an increase in
synchronization in heart rate and breathing rate between partners.  The two studies
showed that the intensity of pain averaged a 34% reduction for individuals  when
holding hands.   It’s important to note, however, that this research did not explore
the effect in homosexual couples or non-romantic partners.


References


Goldstein, P., Weissman-Fogel, I., & Shamay-Tsoory, S. G. (2017). The role of touch
in regulating inter-partner physiological coupling during empathy for pain. Scientific
Reports, 7(1), 3252.

Peled-Avron, L., Goldstein, P., Yellinek, S., Weissman-Fogel, I., & Shamay-Tsoory, S. G. (2017). Empathy during consoling touch is modulated by mu-rhythm: An EEG study. Neuropsychologia.

Wednesday, February 28, 2018

Anxiety Can Help You Remember



A new study conducted at the University of Waterloo has determined that manageable levels of anxiety can actually help your ability to remember details of events. It was also found that when anxiety levels increase to an unmanageable level or when anxiety turns into fear, it could lead to people remembering primarily what is associated with the negative mood state.  Also, they are likely to interpret neutral aspects of their experiences as being associated with the anxiety or fear as well as with thoughts, beliefs and interpretations related to their high anxiety level.
The study showed that participants who were high in anxiety displayed a heightened sensitivity to the effects of emotional context on their memory. Neutral details were interpreted according to the emotion experienced while encoding the information. This means that thinking about highly emotional events or negative events could cause you to develop a negative mindset that alters the way you perceive your environment.  
It is important for us to be aware of how our mood states might be affecting how we view and interact with the world.  This may not be possible to do when in the actual mood state.  Instead, trying to think about this relationship when not in the fearful or anxious state of mind might better enable us to see how our views were changed when experiencing the negative mood and better understand the connection.  The more we are aware of this relationship the better we will be at perceiving it during negative mood states as well.
The ability to manage your anxiety however, can lead to positive outcomes.  When we perceive our anxiety as controllable we do not experience it as severely as when we believe it to be out of our control. When it is manageable it doesn’t become the primary focus of our lives because we know we can always do something about it should it become necessary.  
Unmanageable or uncontrollable anxiety, on the other hand, leads to distress and a constant focus on the mood state since we feel overwhelmed by the anxiety and constantly worry it will get worse.  This attention to the anxiety makes it the center of our world and thus, everything becomes colored by it.  The moral of this study is that it is important to work on learning as many coping strategies for managing anxiety as possible. While we can’t get rid of all the anxiety and stress in our world, by learning how to control it and decrease it, we will be more likely to experience the positive effects of anxiety on our memory.
It is also important for educator to be aware that there could be anxiety related factors that influence student ability to remember the material they are being taught. Lightening the mood while teaching could be beneficial for students, especially those who experience high levels of school and performance related anxiety.  
References
Lee, C., & Fernandes, M., (2017).. Emotional Encoding Context Leads to Memory Bias in Individuals with High Anxiety. Brain Sciences, 8 (2): 6 DOI: 10.3390/brainsci8010006

Tuesday, January 23, 2018

Curcumin May Improve Memory and Mood According to New Study



Now there’s even more reason to love Indian food. The substance that gives curry its bright yellow color is curcumin. New research has shown that certain forms of curcumin can help improve memory and mood individuals with age related memory loss.  Curcumin, found in turmeric, has long been shown to have anti-inflammatory and antioxidant properties. It also has been hypothesized that curcumin as a dietary supplement could contribute to the low prevalence rate of Alzheimer's disease and better cognitive performance in India.
The research, published online Jan. 19 2018 in the American Journal of Geriatric Psychiatry, examined the effects of an curcumin supplement on memory performance in individuals without dementia.  Also studied, was the possible impact of curcumin’s on the plaques and tangles which are hallmark brain symptoms of those with the brains of people with Alzheimer's disease.  Results of the study indicated that those who took curcumin demonstrated significant improvements in their memory and attention, while the subjects who received placebo did not improve in either area. Those taking curcumin showed improvements of 28 percent on memory tests over 18 months and showed improvements in mood.  
"Exactly how curcumin exerts its effects is not certain, but it may be due to its ability to reduce brain inflammation, which has been linked to both Alzheimer's disease and major depression," said Dr. Gary Small, director of geriatric psychiatry at UCLA's Longevity Center and of the geriatric psychiatry division at the Semel Institute for Neuroscience and Human Behavior at UCLA, and the study's first author." “These results suggest that taking this relatively safe form of curcumin could provide meaningful cognitive benefits over the years.”, UCLA's Parlow-Solomon Professor on Aging.

Reference


Gary W. Small, Prabha Siddarth, Zhaoping Li, Karen J. Miller, Linda Ercoli, Natacha D. Emerson, Jacqueline Martinez, Koon-Pong Wong, Jie Liu, David A. Merrill, Stephen T. Chen, Susanne M. Henning, Nagichettiar Satyamurthy, Sung-Cheng Huang, David Heber, Jorge R. Barrio. Memory and Brain Amyloid and Tau Effects of a Bioavailable Form of Curcumin in Non-Demented Adults: A Double-Blind, Placebo-Controlled 18-Month Trial. The American Journal of Geriatric Psychiatry, 2017; DOI: 10.1016/j.jagp.2017.10.010

Thursday, January 11, 2018

Health Care Provider Fined Millions for Failure to Protect Health Records

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has settled a lawsuit with 21st Century Oncology, Inc. (21CO) involving their failure to protect health care records of millions of people.  The settlement includes a has $2.3 million fine which has been agreed to instead of possible civil money penalties which could have amounted to much more.  21CO has also agreed to put into place a complete corrective action plan to remediate current problems and prevent future violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules.
The case was initiated by the Federal Bureau of Investigation (FBI) who informed 21CO that they had determined that patient information had been illegally accessed by an unauthorized third party. They provided 21CO with patient files that an FBI informant had illegally bought. 21CO conducted an internal investigation, through an outside forensic auditing firm.  It was determined that the attacker accessed health care records through a Remote Desktop Protocol from an Server housed within 21CO’s internal network. The company learned that more than 2.2 million people had their medical information illegally accessed.  Information obtained by the attacker included patient names, social security numbers, physicians’ names, diagnoses, treatment and insurance information.

The HHS subsequent investigation determined that 21CO engaged in the following illegal activities:
  • Unauthorized disclosure of Personal Health Information (PHI)
  • Failure to thoroughly evaluate possible risks to confidentiality of PHI
  • Failure to impose security measure that were effective in reducing the risk to PHI and to comply with HHS requirements
  • Failure to hold regular review of system information activity including audit logs, access reports, and security incident tracking reports
  • Disclosed information to individuals and entities it allowed to act as business associates without written business associate agreements

21CO provides cancer care and oncological radiation services. While their headquarters is located in Fort Myers, Florida, the company has 179 treatment centers which operate in 17 states and seven countries in Latin America.  Filing for Chapter 11 bankruptcy protection in May 2017, 21CO received permission from the bankruptcy court to agree to the settlement agreement.

Tuesday, January 2, 2018

New Study Suggests Diabetes Drug May Help Reverse Symptoms of Alzheimer’s Disease



A new study carried out at Lancaster University in England indicates that a drug used to treat diabetes significantly reverses memory loss and brain degeneration in mice.  This research utilized mice who had been bred to express genes indicated in Alzheimer’s disease in humans effectively creating a rodent version of the disease.
The diabetes drug, called a triple receptor, combines three molecules known as growth factors.  The drug was used to treat mice who had been allowed to age which gave the disease time to develop fully and damage the animal’s brain. After administering the drug, the mice underwent a maze test which measured memory.
Results showed that the drug was associated with improved learning and memory skills in the mice. There were also physiological change including a reduced amounts of plaque buildup in the brain, which is a primary characteristic of Alzheimer’s disease.  The mice who were given the drug also were found to have reduced levels of chronic inflammation in their brains, slower rates of brain nerve cell loss, and increased brain nerve cell protection. Additionally, the diabetes drug appeared to prevent and even reversed the brain growth impairment that leads to nerve cells losing function ultimately results in some of the classic symptoms of Alzheimer’s disease. 
The growth factors in this drug specifically affected growth in the animals' brains.  This is important as the brains of Alzheimer’s patients are shown to display growth impairment. This impairment has been associated with the cognitive decline that occurs in those with the condition.
It is hoped that the same results will be found when human testing occurs leading to an effective treatment for Alzheimer’s disease and other memory-related illnesses.  According to the lead study researcher Christian Holscher of Lancaster University, the results of this study suggest that the drug in question, "has a clear promise of being developed into a new treatment for chronic neurodegenerative disorders such as Alzheimer's disease."  These findings and the associated indications for the development of future treatment options is particularly exciting, as it has been 15 years since a new Alzheimer’s drug has become available. 
Reference
Tai, J., Liu, W., Li, Y., Li, L., & Hölscher, C. (2018). Neuroprotective effects of a triple GLP-1/GIP/glucagon receptor agonist in the APP/PS1 transgenic mouse model of Alzheimer's disease. Brain research, 1678, 64-74.

Sunday, December 17, 2017

New Study Suggests Non-Invasive Treatment for Autism

Following the report of the results of a new research study, scientists are looking at the possibility of treating children with autism with neuromodulation to help correct social deficits.

Research has long established that there are specific areas of the brain responsible for problem behaviors in people with autism.  There has been a great deal of controversy over what implications this information might have for treatment.  Electrical stimulation has been proposed but this has been resisted because treatment should be conducted as early as possible, meaning many of the individuals you would be treating would be children.  Other opposition to such treatment comes from the fact that the primary areas that would be targeted lie deep within the brain and cannot be reliably reached. 

New research from the O'Donnell Brain Institute has demonstrated that a specific part of the cerebellum that has been believed to contribute coordinating movement is actually important for social behaviors in people with autism. This groundbreaking research not only establishes a more accessible target for brain stimulation but it also can help correct social impairments, one of the major areas of difficulties for those with autism.  

While some say this treatment would only be effective with those treated at the very earliest ages, the researchers don’t agree. Using a mouse model, they conducted additional research which seemed to indicate that neuromodulation restored social behaviors even in adult mice. This result suggests individuals with autism still might benefit from brain stimulation intervention  even if treatment is not provided until later in life.

Dr. Peter Tsai, the director of the research study, said, "This is potentially quite a powerful finding,  From a therapeutic standpoint, this part of the cerebellum is an enticing target. And although neuromodulation would not cure the underlying genetic cause of a person's autism, improving social deficits in children with autism could make a huge impact on their quality of life."

References

Stoodley, C. J., D’Mello, A. M., Ellegood, J., Jakkamsetti, V., Liu, P., Nebel, M. B., Gibson,J. M., Kelly, E., Meng, F.. Cano, C. A., Pascual, J. M., Mostofsky, S. H.. Lerch, J. P. & Tsai, P. T., (2017).  Altered cerebellar connectivity in autism and cerebellar-mediated rescue of autism-related behaviors in mice. Nature Neuroscience, 20 (12): 1744.