New Study Identifies 44 Genes Linked to Depression

There has always been a question about why all of the different antidepressants, with a few
exceptions, have been found to work more or less well in treating Major Depressive Disorder.
While some studies have suggested that different medications are significantly more effective, all
of these medications were better than placebo and differences in clinical significance as opposed
to statistical significance have resulted in similar findings. While some classes or individual
medications work better with some individual people, there has been no clear explanation for
similar effectiveness rates found despite different classes working on different systems. This
question has underscored just how much variance exists in depression.  

Now, new cutting edge research examining the genetic foundations of depression in detail has
increased the hope of identifying better effective treatments for this mental difficulty. Researchers
have identified no fewer than 44 gene variations that have been associated with an increased risk
of developing depression.  Of the variations identified, 30 have never been associated with the
condition previously. At the same time, it has been reiterated that there are thousands of genes
related to depression, each with a very small effect on the actual development of the disorder. This
research provides additional information on other genes that may be more significantly related to
the disorder or that may affect groups of other genes to increase or decrease the risk.

This research has tripled the number of genetic regions that have been linked to major depression.
In addition to providing new targets for possible treatment, these findings may help explain why
some people are affected by the disorder and others aren’t, even when they have similar life
experiences.   This research may also help explain broader depression related phenomena. For
example, it might help determine whether when genetic predispositions to the disorder are low this
indicates a greater ability to resist the effects of life stress.

Investigations into different contributors to depression have indicated that genetic factors account for
about 40 percent of the risk factor while other biological factors, environment and life experiences
account for the remaining 60 percent.  This emphasizes the importance of remembering that there are
a number of areas that can be targeted when treating depression. While genetics appears to contribute
a great deal to the development of depression, life experiences and environmental influences contributing
to and maintaining the disorder cannot be ignored.

References

Cipriani, A., Furukawa, T. A., Salanti, G., Chaimani, A., Atkinson, L. Z., Ogawa, Y., & Egger, M.
(2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of
adults with major depressive disorder: a systematic review and network meta-analysis. The Lancet.

Corfield, E. C., Yang, Y., Martin, N. G., & Nyholt, D. R. (2017). A continuum of genetic liability for
minor and major depression. Translational psychiatry, 7(5), e1131.

Harris, J. D., Brand, J. C., Cote, M. P., Faucett, S. C., & Dhawan, A. (2017). Research pearls: The
significance of statistics and perils of pooling. Part 1: Clinical versus statistical significance. Arthroscopy,
33(6), 1102-1112.

Monden, R., Roest, A. M., van Ravenzwaaij, D., Wagenmakers, E. J., Morey, R., Wardenaar, K. J.,
& de Jonge, P. (2018). The Comparative Evidence Basis for the Efficacy of Second-Generation
Antidepressants in the Treatment of Depression in the US: A Bayesian Meta-Analysis of Food and
Drug Administration Reviews. Journal of affective disorders.

Wray, N. R., & Sullivan, P. F. (2017). Genome-wide association analyses identify 44 risk variants and
refine the genetic architecture of major depression. bioRxiv, 167577.

Is Perspective Taking Always a Good Thing?

We are often told that in order to better understand others we should put ourselves in their shoes.  

The ability to take another’s perspective is associated with empathy and both empathy and taking

others points of view are thought to be important skills for human relationships.  It is generally

believed that perspective taking develops in childhood and those who are not able to see things

from others points of view are thought of as narcissistic or worse. Yet new research suggests that

perhaps taking other people’s perspectives isn’t always good advice.

A new paper, examines 25 studies that look at what happens when people are told to take another’s

perspective compared to when they are no asked to do so. Fifteen of the studies explored people’s

judgments about strangers. Eleven of these asked people to determine the mood of pictures of people

from their facial expression, posture, or their eyes. Three studies asked people to rate whether people’s

smiles were genuine and fake smiles on videos. The last study had people listen to a story told by

strangers about their memories and to determine whether the person was telling the truth or lying.

Participants for these studies were recruited from many different populations including universities

in the U.S. and other countries and online samples.  Analysis of these studies showed that there was

a tendency for those told to take others perspectives to be less accurate than those not told to do so.

In the other ten studies, participants were told to make judgments about the attitudes and beliefs of

either their romantic partner or strangers they had just met. The studies asked people to judge whether

the other individual liked specific activities, jokes, videos, or art or whether they were likely to hold

certain opinions.  Again, people told to take the other person’s perspective did slightly worse on the

task than people in the control condition. Minimally, the findings from these 25 studies suggest that

when making judgments about others, taking their perspective doesn’t seem to help.

While this paper states it examines perspective taking the experiments included largely require snap

judgments of pictures or videos of strangers.  Simply instructing someone to take the perspective of

others when judging certain characteristics does not they did so or even that they knew how to do so,

and the conditions did not provide the opportunity to be able to do this.  While there are different types

of perspective taking, some more complex than others, this article was about social judgments and thus,

should have included social perspective takings. This however, would require some type of relationship

that existed before the participant could possibly take another person’s perspective.

Therefore the conclusion reached in this research, specifically that perspective taking does not help us

when making judgments or interpreting emotions or social attitudes about others is not well founded.  

The ability to see things from another person’s perspective allows us to bond with and relate to each

other and to share positive and negative emotions and experiences. These are aspects that make us

human and that enable us to fully appreciate and enjoy life, our world and those who are in it.

Reference

Eyal, T., Steffel, M., & Epley, N. (2018). Perspective mistaking: Accurately understanding the mind of another requires getting perspective, not taking perspective. Journal of Personality and Social Psychology, 114(4), 547-571.

Musical Hallucinations in People with Psychiatric Problems

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.

Early Birds Are Healthier and Live Longer, Study Says

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.