St Anthony’s Fire

The gangrenous and convulsive ergot syndromes that can follow the ingestion of C. purpurea have long been known. Art depicts the classic signs and symptoms of poisoning, such as the strange dancing syndrome shown in woodcuts from the middle ages in Germany and Poland.

The Temptation of St Anthony, a famous painting by the German artist Matthias Gr√ºnewald, depicts people with gangrenous digits, lurid rashes, ulcerations and dystonic postures. At the time of the painting, circa 1500 AD in the middle ages, this condition was known as St Anthony’s Fire.

From Mike Schachter’s chapter in Ergot-derived Drugs: A Cross Therapy Evidence-based Review (ISBN 1853156140).

Albert Hoffman discovered LSD when researching ergot, and LSD is still synthesised from ergot today.

Perfect breast formula = nonsense + sell out

Dr Petra Boyton has spotted another psychologist who seems to have sold out his good name by pushing a Cliff Arnall-like nonsense formula: this time for the ‘perfect breast’.

It all seems to be part of a promotion for a UK Men’s magazine which, in a press release, “reveals the formula for the perfect breast” developed by “University Psychologist Dr. David Holmes”.

I’ve emailed a possible culprit to confirm who it might be and am currently waiting for a response.

Needless to say, the formula itself is complete rubbish. Quite predictably, and rather insultingly, it gets described as ‘science’ in the press release.

There’s more analysis in Petra Boyton’s post if you want the full gory details.

Link to analysis from Petra Boyton.

Sex, drugs and pharmacology

The eDrugSearch blog has noted that Mia Heaston, the current Miss Illinois and one of the 2007 Miss USA hopefuls, is also a pharmaceutical industry representative.

If this link seems a bit too tenuous to be newsworthy, the blog also identifies two of last year’s Miss USA contestants who were drug reps and identified no less than 16 professional cheerleaders who also work as reps for the pharmaceutical industry.

If you’ve ever met a drug rep, you’ll know they tend to be charming, aesthetically pleasing young people with free gifts and selected scientific publications to hand, which of course, suggest that the company’s medication is the best treatment for any number of mental illnesses or assorted disorders.

In a classic 1983 paper Webster and Driskell reported that attractive people are generally thought to be more intelligent and more competent, including when judged on their likely performance on tasks completely unrelated to good looks, such as ‘ability to pilot a plane’.

The use and perceived credibility of information provided by drug reps to doctors has been found to correlate with prescribing.

In other words, even apart from the sex appeal, attractive drug reps are likely to make the marketing information seem more convincing, which in turn leads leads to more doctors using the drugs.

So it’s no surprise that one of the biggest industries on the planet is selectively recruiting some of the most attractive people to promote both their product and their product-supporting research.

No Free Lunch has an extensive list of peer-reviewed research on drug marketing that is an essential antidote and will help you judge their information more effectively.

Link to eDrugSearch blog on Miss USA drug reps (via Furious Seasons).
Link to eDrugSearch blog on cheerleader drug reps.
Link to first page of classic Webster and Driskell paper.

A child psychiatrist in Iraq

BBC News has a brief news story on its front page that relates the experiences of Dr Haidr al-Maliki, a child psychiatrist in Iraq.

From what Dr al-Maliki says, it seems most psychiatrists have left the country and he himself is having to work with severely traumatised children despite not having the proper training.

He has also been shot and threatened, and lives in fear of his life.

About a year ago, during Ramadan, four boys aged about 15 to 20 came into my private clinic, in front of my patient.

They asked “Are you Dr Haidr?” I said yes. And they shot me several times.

One bullet went into my right shoulder, another into my right arm. I am left with nerve injury and muscle atrophy.

Afterwards they told me I couldn’t go to my clinic and that I had to leave the country. They didn’t say why.

Link to BBC News article ‘My Iraq: Child psychiatrist’.

Neither fools nor rogues

A quote from a recent paper by psychiatrist Dr Paul Mullen on the difficulties with diagnostic manuals for mental illness, such as the DSM and ICD.

Mullen argues that the definitions of mental illnesses are designed in an open-minded way to aid diagnosis and stimulate debate but end up trapping us into a narrow definition of mental distress:

Those who create these manuals are neither fools nor rogues. They know that classificatory systems grow and develop. They welcome research, debate, and change. They are often painfully aware of the compromises and hopeful approximations which go to create the final authoritative text.

But this intellectual honesty does not translate into the practices and ideologies which DSM and ICD sustain in the cities of psychiatry and psychology. In today’s field of mental health if you seek research funding or publication, you are forced into the languages of DSM or ICD.

To claim rebates for clinical work or to present expert testimony to courts and tribunals, increasingly, the language of these diagnostic manuals is imposed upon you. To even contribute to the professional debates on nosology you are constrained within the premises which sustain the manuals.

Link to PubMed entry for paper.

2007-03-23 Spike activity

Quick links from the past week in mind and brain news:

A man with a sleep disorder that causes him to have violent outbursts in his sleep is discussed by BBC News.

Cognitive Daily asks whether “racing” video games cause reckless driving.

A computer that ‘tunes in’ to the user’s mood and reacts emotionally is covered by New Scientist (with video).

Blog Around the Clock has choice selection of recent Science Daily mind and brain stories.

BBC News on a study suggesting the attractiveness of the accused affects the judgement of the jury.

Strange loops, alpha oscillations and consciousness. Developing Intelligence investigates.

PBS reports on a brain surgeon who has developed brain cancer and has to make critical decisions he usually reserves for his patients.

Neurophilosopher reports that people with damage to areas of the frontal lobes can make moral decisions based on the greater good of the community, unclouded by concerns over harming an individual.

Doubt cast on definition of PTSD

New Scientist is reporting on a new study that questions the definition of post-traumatic stress disorder, based on the fact that a group of severely depressed patients seem to experience PTSD symptoms despite never having suffered a significant trauma.

PTSD is one of the only psychiatric disorders that includes a specific cause in its definition: a traumatic experience that involved likely death or injury to self or others, which was strong enough to cause fear, helplessness or horror.

If this experience results in intrusive memories of the event, persistent arousal and avoidance or dissociation, a person can be diagnosed with PTSD.

This new study, led by psychiatrist Prof Alexander Bodkin, found that almost 80% of a group of severely depressed patients experienced enough symptoms to be diagnosed with PTSD, despite never having been in a traumatic incident.

This suggests that the mental disorder thought to be specific to PTSD may, in fact, not be specific to trauma.

This is not the first time that the validity of PTSD has been questioned. Indeed, it has been a controversial diagnosis since it was first introduced.

As described by some excellent histories of military psychiatry, the acceptance of PTSD as a psychiatric diagnosis was in no small part due to pressure from Vietnam war veterans’ groups who wanted the military and state to provide treatment for the effects of traumatic combat stress.

Although PTSD is often described as the modern diagnosis of what used to be called ‘shell shock’, records from Word War I show ‘shell shock’ to be quite different in many respects, more closely resembling conversion disorder – a condition where emotional trauma can be expressed as physical symptoms such as paralysis and convulsions.

Before ‘shell shock’, combat stress was often diagnosed as ‘soldiers heart’. It’s interesting to note how the concept of combat stress has become more psychological and less physical as time has progressed.

However, most diagnoses of combat stress, in whatever form they have taken, have usually been strongly opposed by the military – who see it as taking soldiers away from the front line, and the government – who are reluctant to compensate soldiers for the inevitable consequences of life-threatening missions.

Many clinicians will, perhaps, not be concerned on a day-to-day basis if the symptoms of PTSD are found not to be specific to the disorder, as they can still treat the symptoms, regardless of how they are classified.

Nevertheless, the implications for research and health care provision (which often relies on confirming a specific diagnosis) could be more profound, particularly if the definition is changed or rejected as a result.

However, this is not likely to happen in the near future, although no one really knows what modifications to the definition of many mental disorders are due in the next edition of the DSM diagnostic manual.

Link to NewSci article ‘Doubt cast on definition of PTSD’.
Link to study abstract.
Link to excellent review of Shephard’s book War of Nerves.

Brain damage and the social chameleon

The BPS Research Digest has picked up on a curious case study of a brain injured man whose identity appears dependent on the environment he is in, owing to severe memory problems.

The case was published in the neurological journal Neurocase by psychologist Giovannina Conchiglia and colleagues.

The patient was investigated by the team after he suffered left-focused damage to the frontal and temporal lobes after the oxygen supply to the brain was cut off during a heart attack.

Unfortunately, the full paper isn’t available online, but it’s well worth reading if you do have access to the journal.

The researchers put the patient, named AD, in various environments, such as a bar or kitchen, where he assumed the identity of a barmen and chef.

Interestingly, this didn’t happen in all cases:

During the first two experiments A.D was attracted by social and environmental stimuli, and did not in fact hesitate after a short while to interpret the role expected of him, and to “take on” the personality of the barman and chef, respectively. It is to be emphasised that in none of the experiments proposed did A.D. imitate the characters interpreted by the actors/experimenters, but rather assumed his own role in keeping with the context. In the last experiment, however, the patient manifested a different form of behaviour, in that he did not assume any role, as he considered that specific context inadequate…

His refusal to take on the role of laundryman in Experiment 3 is relevant since it is unlikely to be suited to him. The roles he adopts, therefore, must in some way correspond to certain traits of his personality structure or his social prerogatives, however versatile these may be.

There is now a growing recognition that symptoms caused by brain injury might be influenced not only by physical damage, but also by the wishes and desires of the patient.

Recent research has looked at this effect in both confabulations and delusions and found a strong interaction between unusual neurological conditions and the motivations of the patient.

This suggests that symptoms are influenced as much by the remaining intact brain areas, as the damaged ones.

Link to BPSRD article ‘Brain damage turns man into human chameleon’.
Link to abstract of Neurocase paper.

Carrying a lethal gene

The New York Times has a fantastic article and video documentary on people who have decided to find out whether they carry the gene for the degenerative brain disorder Huntingdon’s disease, even before it’s started to causes any symptoms.

The disorder is caused by a single gene which, if inherited, causes a progressive deterioration in areas of the basal ganglia and frontal lobe which are eventually lethal.

The symptoms usually only appear in middle age and include, most visibly, uncontrolled movements of the body.

However, cognitive problems (such as impairments in memory, concentration, perception and strategic thinking), and the development of mood disorders and psychosis are also possible.

Because the disorder only takes hold in later years, many people with parents or grandparents with the disorder have to decide whether to get tested, and discover whether they have the gene and are fated to develop Huntingdon’s later in life.

The NYT article reports on how one young woman, who has taken the test and found out that she will develop the disorder, deals with the knowledge of her neurological fate.

Ms. Moser is still part of a distinct minority. But some researchers say her attitude is increasingly common among young people who know they may develop Huntington’s.

More informed about the genetics of the disease than any previous generation, they are convinced that they would rather know how many healthy years they have left than wake up one day to find the illness upon them. They are confident that new reproductive technologies can allow them to have children without transmitting the disease and are eager to be first in line should a treatment become available.

“We’re seeing a shift,” said Dr. Michael Hayden, a professor of human genetics at the University of British Columbia in Vancouver who has been providing various tests for Huntington’s for 20 years. “Younger people are coming for testing now, people in their 20s and early 30s; before, that was very rare. I’ve counseled some of them. They feel it is part of their heritage and that it is possible to lead a life that’s not defined by this gene.”

As well as showing some of the striking and distinctive movements associated with the disorder, the videos also relate some insightful reflections from Katie Moser, the subject of the article.

It’s common for there to be no cure for neurological illness, but usually there are some treatments which can slow down the symptoms.

Unlike some other disorders, there are remarkably few of these treatments for Huntingdon’s disease, although research is currently being undertaken to try and improve the situation.

Link to NYT article ‘Facing Life With a Lethal Gene’.
Link to Wikipedia page on Huntingdon’s.

At the 15th European Congress of Psychiatry

I’ve spent the day at the 15th European Congress of Psychiatry and have been catching up with some of the latest developments in the field.

As is common with these sorts of things, the exhibition hall is largely an exercise for drug companies to promote their products using giveaways and selective education.

My favourite tagline was on the stand for the antidepressant drug tianeptine: ‘Treating Depression Beyond the Symptoms’.

I can’t quite picture what this refers to. Maybe they send a drug rep round to improve people’s housing, finances and difficult family situation?

In terms of antipsychotic promotion, the big selling point seems to be avoiding weight gain.

Many of the companies are advertising that there drug causes less weight gain, or are promoting ways of using their drug to minimise strain on the cardiovascular system.

In terms of research being presented, there’s a fantastic selection from across Europe. Here’s just a few that have caught my eye.

A study by Esmina Avdibegović and colleagues from University Clinical Centre of Tuzla in Bosnia and Herzegovina found that the suicide rate dropped during the Bosnian war, and that even after the war, less people committed suicide than before.

Another study from the Tuzla Clinic by Izet Pajevic and colleagues looked at religiosity in war veterans from the same conflict, and found that religious practice was associated with better mental health and less risky, agressive and psychopathic behaviour.

In fact, there’s a lot of interesting research here from Bosnia and Herzegovina and I look forward to hearing more.

An elegant study by Krzystof Krstya and colleagues from the Silesian Medical Academy in Poland looked at improvements in cognitive function during treatment for anxiety disorders, and found that combined drug therapy and psychotherapy had the most significant benefit for short-term memory and attention.

Monica Sigaudo and colleagues from the University of Turin Medical School reported that an inert pill could actually increase pain perception when given with the suggestion that it raised sensitivity – something known as the ‘nocebo effect‘.

Finally, a neuroimaguing study by Jan Prasko and colleagues from the Prague Psychiatric Centre found that in the treatment of panic disorder, both cognitive behavioural therapy and antidepressants were equally as effective, and interestingly, had a similar effect on the brain.

Anyway, just time to grab something to eat and prepare for my own talk…

On not drowning in a teaspoon of water

The Stanford Magazine has an article an the work of psychologist Prof Carole Dweck who argues that the key to success lies in how you deal with failure.

Dweck’s research was recently the subject of a great deal of interest after it was discussed in a widely read New York Magazine article on the sometimes paradoxical effects of praising children in certain ways.

In the Stanford Magazine article, Dweck discusses how her findings have been applied to achievement in general, and how we attribute or give credit for success has a significant impact on our future successes.

A 60-year-old academic psychologist might seem an unlikely sports motivation guru. But Dweck’s expertise ‚Äî and her recent book, Mindset: The New Psychology of Success ‚Äî bear directly on the sort of problem facing the Rovers. Through more than three decades of systematic research, she has been figuring out answers to why some people achieve their potential while equally talented others don’t ‚Äî why some become Muhammad Ali and others Mike Tyson. The key, she found, isn’t ability; it’s whether you look at ability as something inherent that needs to be demonstrated or as something that can be developed.

Link to Stanford Magazine article ‘The Effort Effect’.
Link to details on Dweck’s book Mindset.

Vote for the greatest discovery in psychology

PsyBlog has just published the last of its articles on the top ten psychology studies, so you can now read through and vote for your favourite.

The list is wide ranging and comprehensive, covering developmental psychology, perception, false memory, conformity, psychotherapy, personality and several other keys discoveries in the history of psychology.

Head on over for the complete list and cast your vote to support your personal choice for the most influential study in of all time.

Link to PsyBlog’s ‘Top Ten Psychology Studies’.

Madrid, Dublin and a prior warning

Just a quick note to say posting may be a bit irregular over the next week or so, as I’m going to be travelling.

I’m off to Madrid at the weekend to attend the European Congress of Psychiatry, where I’ve kindly been invited to speak at the Monday afternoon ‘Fringes of Psychosis’ symposium organised by Andrea Raballo.

I’m then off to the fair city of Dublin to find somewhere to live!

I’m going to be there for four months from the beginning of April working with children and adults with neurodevelopmental disorders and learning disabilities.

Which brings me to a request…

If you know anyone that has a room to rent in Dublin from April to July, do get in touch!

Artists look differently at visual scenes

Cognitive Daily has a fantastic piece on a eye-tracking study looking at how artists and non-artists look differently at visual scenes.

The study concluded that artists spend more time looking at areas of the visual scene that the rest of us pass over as less important.

So why do artists look at pictures — especially non-abstract pictures — differently from non-artists? Vogt and Magnussen argue that it comes down to training: artists have learned to identify the real details of a picture, not just the ones that are immediately most salient to the perceptual system, which is naturally disposed to focusing on objects and faces.

The study is reminiscent of research completed in collaboration with artist Humphrey Ocean, whose eye movements were similarly recorded by eye-tracking technology when completing various drawings.

Ocean was also put in a fMRI scanner while he drew, and his brain activation was compared to a non-artist. The study reported that Ocean had much greater activation in the parietal lobe – an area heavily implicated in visual and spatial abilities.

Link to CogDaily article ‘Artists look different’.

2007-03-16 Spike activity

Quick links from the past week in mind and brain news:

Esquire Magazine has an article on pioneering neurosurgery on Iraq vets to reconstruct large areas of damaged skull.

Cognitive Daily looks at research suggesting that judges may be biased in their belief in the truth of videotaped confessions – depending on the angle of the camera.

Technology Review reviews Marvin Minksy’s new book on emotion and the future of AI.

Developing Intelligence asks whether visual binding is an automatic process.

Science and Consciousness Review has a feature article / extended book review on the science of consciousness – where it is and where it should be.

Steven Pinker has been speaking recently on the ‘decline of violence’.

Subliminal messages in video games to treat addiction? OmniBrain investigates.

Deric Bownds discusses a study finding that the brain’s response to threat is reduced by hand holding.

The Neurophilosopher dissects a notoriously flawed study from 1906 that tried to argue for differences in the ‘negro brain’.

Can we wear out self-control? Frontal Cortex examines research that suggests that it might be a resource we can deplete.