Articles filed under 'COGNITIVE DISORDERS'
When you hear the term “postpartum depression,” you may immediately think of the extreme sadness that sometimes affects women after childbirth. It may surprise you to learn that while 14% of new mothers are afflicted with the condition, about 10% of fathers can also experience moderate or severe postpartum depression.
A study of 5,000 two-parent families with a child nine months old revealed that depression in new fathers was more than twice as common as in the general male population. The study, published in the August issue of the journal Pediatrics, indicated that depression can start two to three weeks after birth and may last up to a year or longer if untreated.
Fathers with this condition are less likely to interact positively with their child through playing, reading, telling stories or singing songs to their child. In addition, it is difficult for them to be supportive of the child’s mother.
When both mother and father are depressed, their new baby is more apt to be exclusively bottle-fed and put to bed on its stomach instead of on its back, now recommended as a safety measure for infants.
The father’s happy interaction with his new baby is necessary for the child to develop cognitively and emotionally in normal ways. Depressed new fathers are more likely to be irritable, aggressive, and sometimes hostile to the infant and the child’s mother.
The depressed new father may feel burdened or trapped by the financial responsibility of a first or additional child. He may also miss the closeness he previously had with the mother. For some husbands, it may feel as though an intruder has come into the couple’s marital relationship or that his own needs are being neglected.
Talking with a doctor, counselor, psychologist, or social worker can help to make a diagnosis and determine whether depression exists and whether it should to be treated. Severe postpartum depression is not just “baby blues” caused by the fatigue of meeting new demands. In serious cases, it manifests itself in severe sadness or emptiness, withdrawal from family and friends, or a sense of failure. There may even be thoughts of suicide in extreme cases.
If your husband is displaying symptoms of depression, gently approach the subject. You might say, for example, “I believe you have been depressed since our baby was born.” Let him know that it is almost as common for men to suffer postpartum depression as it is for women.
After talking openly about the subject, you may both want to seek help. All of you will benefit in doing so.
Source: WebMD
Technorati Tags: postpartum depression, child birth
August 16th, 2006
What distinguishes the normal memory changes of the aging process from symptoms of Alzheimer’s? Researchers at Rush University Medical Center studied brains from autopsy results of 134 older people who had been involved in a multi-year study in their last years. Most were Caucasians over age 80 who appeared to be mentally normal apart from minor forgetfulness.
Surprisingly, researchers found concentrations of waxy protein clumps typical of patients with full-blown Alzheimer’s in 36% of those who died during the study. None had been diagnosed with Alzheimer’s or even mild cognitive impairment in their final days.
All had performed well on memory examples, although those whose autopsies showed evidence of Alzheimer’s had slightly lower scores in episodic memory. That is, their recall of recently presented information was somewhat impaired. In other words, their brains could not store new information properly in order to recall it.
This recent study appeared in the June issue of Neurology, the scientific journal of the American Academy of Neurology. Scientists attempted to answer the question why some people with brain impairments found in Alzheimer’s patients (at autopsy) appeared to function normally while others become severely debilitated by the mind-robbing disease.
Scientists believe that high levels of education, feelings of social connectedness, and brain-stimulating activity may help individuals to function well despite their reduced brain capacity.
One in 10 persons over age 65 and almost half of persons over age 85 are afflicted with varying degrees of Alzheimer’s disease. Advancing age and family history seem to be risk factors that contribute to the condition. No single comprehensive test can positively diagnose Alzheimer’s while the person is living. A variety of tests and neurological exams are used to diagnose the disease that proves accurate about 90% of the time.
No medical treatment is able to cure or keep Alzheimer’s from progressing, but five FDA-approved drugs are now available to temporarily relieve some of the symptoms of the disease. Other drugs are under development.
According to the Alzheimer’s Association, common symptoms of Alzheimer’s disease include:
• Memory loss that affects job skills
• Difficulty performing familiar tasks
• Problems with language
• Disorientation to time and place
• Poor or decreased judgment
• Problems with abstract thinking
• Placing items in inappropriate places
• Rapid changes in mood or behavior
• Dramatic changes in personality
• Loss of initiative
Normal memory changes in aging:
• Forgetting names or appointments
• Occasionally forgetting reasons for entering a room or the route to your destination
• Sometimes struggling to find the right word
• Forgetting the day or the week
• Temporarily misplacing keys or wallet
• Slight changes in personality
• Feeling weary of work or social obligations
Keeping mentally active through activities such as attempting cross-word puzzles, playing chess, reading books, and attempting new learning experiences may help to stave off the ravages of Alzheimer’s. Appropriate regular exercise is also thought to be helpful, as well.
Sources: MSNBC, Alzheimer’s Association
Technorati Tags: Cognitive Disorders, Alzheimer’s
July 10th, 2006
Recent evidence shows that being overweight in one’s 40s contributes to Alzheimer’s disease and similar brain dementias later in life. Other contributing factors are diabetes and cardiovascular disease, but fat itself appears to play an important role in brain impairment.
This new evidence concerning obesity and brain function was presented in April at the American Academy of Neurology in San Diego, CA. Study author Rachel A. Whitmer, a research scientist at Kaiser Permanente of Northern California, reported on her findings as part of a larger study of 9,000 Kaiser patients who were followed for 30 years.
Study participants submitted to measurements of thickness of skin folds both below the shoulder and at the back of the upper arm. Individuals with the thickest shoulder measurements were found to be almost three times as likely to develop Alzheimer’s disease as those who had less thickness in these areas.
Maria Carrillo of the Alzheimer’s Association suggested that overweight people are often more sedentary. As a result, their arteries can become clogged and restrict blood flow. Healthy eating and exercise can contribute to healthy brain functioning, she indicated.
In 2006, 4.5 million Americans have been diagnosed with Alzheimer’s disease. Risk rises as people age. By 2050, with longevity increasing, the number is expected to increase to 16 million persons with the brain disease.
Sources: MedicineNet.com; Division of Research, Kaiser Permanente of Northern California
April 11th, 2006
An FDA advisory panel debated the issue on whether a “black box” warning should be placed on drugs such as Ritalin, prescribed for hyperactivity and attention deficit disorder. Up to 3.3 million Americans under the age of 20 take ADHD medications such as Ritalin, Adderal and Straterra.
Psychiatrists urged the FDA to carefully consider a previous proposal to include the strongest warnings about heart attack, hallucinations and other potential risks. These adverse events believed to be associated with the drugs are seen in only a small numbers of patients.
Mental health advocates emphasized that leaving conditions untreated in children who need these medications could be equally as risky as the potential cardiovascular and psychiatric risks a few might encounter from their use. The likely outcome is that stronger wordings of potential adverse effects will be included, but a black box warning will be avoided.
Source Article
March 31st, 2006
More Americans than ever are turning to sleep medications to get through the night. Ads promising safe slumber with little or no side effects may be behind this new trend. Many of us lead stressful lives — at the office, in our long commutes, raising children, and caring for older parents. It may be next to impossible to tune it all out at night.
Health experts are concerned that these drugs may be over-prescribed. About 42 million prescriptions for sleeping pills were filled in 2005, up nearly 60 percent since 2000. At least 10 percent of U.S. adults complain of having trouble falling asleep or staying asleep throughout the night. Although the newer drugs may not carry the same risk of dependence as the older ones (usually barbiturates), there is concern that they can sometimes cause strange side effects.
Episodes of sleepwalking or short-term amnesia may be connected to their long term use. In taking sleeping pills, many experience continued sleepiness for several hours after awakening.
Among the most commonly prescribed sleep aids are Ambien and Lunesta. The drug Sonata is shorter acting and may work better for persons who have difficulty falling asleep but who are able to sleep through the night.
Some psychiatrists believe that difficulty sleeping can be a sign of multiple disorders. Among them might be anxiety and depression, problems which are not being addressed.
Developing sleep-promoting habits in the hours just prior to bedtime could solve your insomnia better than taking pills, in the long run. Suggested strategies: Use your bed only for sleep and for sex; take a warm shower to relax; don’t watch violent movies just before bedtime; don’t exercise in the late evening hours; drink a glass of warm milk; avoid caffeine in the evening; gently wind down your conversations; listen to a relaxation tape at bedtime; try to fall asleep in the same general time frame each night.
Labels on sleep medications warn that they should be used only when you can devote a full night to sleeping. If taken in the wee hours of the morning, these drugs could cause sleepiness when driving to work or school or even temporary memory loss.
Newer drugs, such as Rozerem, are coming on the market which may pose fewer long-term risks. This drug acts on the brain’s melatonin receptors, thought to play a role in sleeping and waking cycles.
The best strategy, if possible, is to avoid taking pills to sleep each night. Reducing the stress in your life, developing good sleep preparation habits, or addressing any psychological problems with your doctor may be the wisest course.
Sources: New York Times (date?) (www.nytimes.com); Dr. Dean Edell, ABC daily broadcasts (www.healthcentral.com)
March 29th, 2006
Phones are ringing constantly in many psychiatrists’ offices. Patients are worried about their own or their child’s treatments for attention-deficit disorder with a stimulant such as Ritalin. Since an FDA panel voted 8-7 recently to put a block-box warning label on each prescription bottle, patients on stimulants are exhibiting high anxiety.
Most doctors who treat patients with stimulants such as Ritalin or Adderall say the risk for cardiac problems is “remote.” Out of the 2.5 million children and 1.5 million adults on stimulants, it is estimated that a handful of them will die suddenly each year, whether taking the drugs or not.
Psychiatrists and cardiologists agree, however, that people with high blood pressure, heart murmurs, or other cardiovascular problems should be cautious in using these drugs. If their physician feels there is sufficient risk, they should taper off the drugs or reduce their dosage.
Patients should ideally be screened for potential problems before receiving prescriptions for these drugs, according Dr. James Waxmonsky, a psychiatrist at the University at Buffalo, New York.
Adults with high blood pressure, high cholesterol, a family history of heart disease, and those who smoke should be concerned about being on stimulants. If these risk factors can be eliminated or stabilized, using ADD medications would be more advisable. Certainly, patients with these medical problems should be closely monitored while taking stimulants.
William Pelham, a psychiatrist at the University at Buffalo who studies psychosocial treatments for attention-deficit disorder, points out that some children would benefit more from an intensive summer-long course of behavior modification. He indicates that most parents don’t even hear of these alternatives to medications.
Many adults feel that stimulants help them to lead a more normal and productive life. These individuals plan to continue on the drugs, despite any small risks they might be taking.
Source: New York Times (2/21/06); Benedict Carey, reporter
March 24th, 2006
If your child has been labeled “hyperactive” by a teacher, you might think twice before resorting to a drug such as Ritalin to improve performance in class. Stimulants such as Ritalin, Concerta and Adderall are the most widely prescribed medications for childhood behavioral problems. Some 2.5 million children and 1.5 million adults are taking them for hyperactivity or attention deficit disorder (ADD or ADHD).
An FDA panel recently voted 8-7 to recommend written guides to patients and to require that prominent, “black box” warnings be placed on drug labels. Dr. Steven Nissen, a cardiologist at the Cleveland Clinic and member of the panel voiced “grave concerns” about the harm these drugs may cause. The vote took place after FDA medical officers described reports of 25 sudden deaths, mostly children, among those taking these stimulants.
A biostatistician on the panel went so far as to say that stimulants might be more dangerous to the heart than the painkiller Vioxx, withdrawn from the market in recent years. Some physicians believe the drugs may increase risks of strokes and serious arrhythmias in children and adults, although the risk of heart disease is small in childhood. All panel members agreed that parents of children with known heart conditions should consult their physicians about the use of such drugs.
Ritalin has been marketed since 1955. Dozens of studies have shown it to be safe and effective, although these studies may not have continued long enough to determine risks of long-term use. The soaring popularity of these medications warrants close study as to their potential risks to the heart. Preliminary analysis suggests that heart risks may increase two-fold. With the increasing use of these medications in adults, this data may be more significant for them.
Panel members were deeply divided as to relative risks and benefits of stimulants. Psychiatrists and psychologists who treat patients with attention deficit disorder and hyperactivity disagreed on whether a strongly worded warning was warranted. The director of the Center for Children and Families at the State University of New York voiced the idea that a black-box warning might prompt families to explore behavioral treatments as alternatives to drugs – “a very good outcome for kids with ADHD and their families.” Other FDA officials expressed concern about scaring away many from needed treatment and minimizing the benefits of these drugs. They were unwilling to “sensationalize what is a very low-probability event.”
In March, the FDA will convene a committee made up primarily of pediatricians and psychiatrists on these issues. These clinicians are expected to voice support for continued use of stimulants and be reluctant to frighten patients with black box warnings. Pharmaceutical company representatives agreed to cooperate with the FDA on any label changes.
Sources: San Francisco Chronicle, 2/10/06, Gardiner Harris, New York Times reporter; New York Times editorial (2/12/06)
March 19th, 2006
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