Most would use genetic depression test results to reduce risky behavior, survey shows

ScienceDaily (Aug. 1, 2011) — Eight out of ten Australians would radically change their risky behaviour if tests showed they had a genetic susceptibility to depression, a national study has found.

The study, conducted by researchers at the University of New South Wales (UNSW) and published online in the Journal of Affective Disorders, is the first population-wide analysis of Australian attitudes towards genetic testing for risk of mental illness.

There was overwhelming support for the use of genetic tests to help people take steps to prevent depression before it occurs, especially among those who believe they or their children have a higher than average risk, a randomised phone survey of 1,046 adults found.

The preventive strategies that received support included helping children to be resilient to stress (92%), modifying their own stress (84%), starting therapies (80%) and reducing excessive drug and alcohol use (74%).

The widespread interest in prevention strategies was based on the understanding that while there may be a genetic predisposition to mental illness, environmental factors also played a major role.

The findings suggest there would be widespread community support for genetic screening as a valuable clinical tool for early intervention in high-risk groups.

"There is no certainty depression will manifest in someone with a higher-than-average genetic risk whether they are exposed to stressful life events or not," said study lead-author Dr Alex Wilde, from UNSW's School of Psychiatry.

"Yet most people were still overwhelming prepared to attempt to reduce the possibility of developing a depressive illness by modifying risky behaviours," Dr Wilde said.

Dr Wilde said people could try to change unhealthy aspects of their lives even without a genetic test, but the findings suggest that having test results at hand may act as a powerful motivator for change.

In general, Australians are very interested in knowing their genetic susceptibility to mental illness.

A linked study by the same research team, published this month in the UK-based journal Psychological Medicine, showed there was significant interest in genetic testing for depression, despite ongoing concerns about the tests' validity and that the results could potentially increase social stigma and discrimination.

"The scientific validity is not yet clear for most of the direct-to-consumer genetic tests currently marketed online, including tests for some mental illnesses, which could expose early users to discrimination, stigma and potentially misleading health risks," Dr Wilde said.

This was reflected in the survey result, with those questioned far more likely to support genetic tests carried out by their doctor (63%) than those undertaken through internet-based direct-to-consumer services (40%), Dr Wilde said.

Other study authors were Professor Philip Mitchell and Dusan Hadzi-Pavlovic from UNSW's School of Psychiatry, Associate Professor Bettina Meiser, from the Prince of Wales Clinical School, and Professor Peter Schofield, from Neuroscience Research Australia.

Funding for this study was provided by the Australian National Health and Medical Research Council.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of New South Wales.

Journal Reference:

Alex Wilde, Bettina Meiser, Philip B. Mitchell, Peter R. Schofield. Community attitudes to genetic susceptibility-based mental health interventions for healthy people in a large national sample. Journal of Affective Disorders, 2011; DOI: 10.1016/j.jad.2011.06.023

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Great public desire to seek early diagnosis of Alzheimer's, according to survey

ScienceDaily (July 20, 2011) — Results of an international survey reveal that over 85% of respondents in the five countries surveyed say that if they were exhibiting confusion and memory loss, they would want to see a doctor to determine if the cause of the symptoms was Alzheimer's disease. Over 94% would want the same if a family member were exhibiting the symptoms. The findings were presented July 20 at the Alzheimer's Association International Conference 2011 (AAIC 2011).

The survey of the U.S. and four European countries -- France, Germany, Spain and Poland -- was designed and analysed by Alzheimer Europe and the Harvard School of Public Health.

In four of the five countries, Alzheimer's disease was the second biggest health fear after cancer. The public were asked to choose which disease they were most afraid of getting from a list of seven diseases including cancer, heart disease and stroke. Around a quarter of adults in four of the five countries say they most fear getting Alzheimer's disease.

Fear of Alzheimer's gets worse with age, but even young adults are concerned, with approximately one in seven 18- to 34-year-olds reporting Alzheimer's as the disease they are most afraid of getting from the list provided.

The survey found a large proportion of the public has had some experience with Alzheimer's disease. Majorities in all five countries say that they know or have known someone with Alzheimer's disease, including about seven in ten in France (72%), Germany (73%), Spain (77%), and in the U.S. (73%), and 54% in Poland. In addition, about three in ten have personal experience with a family member with Alzheimer's disease. Experience with a family member ranges from 19% in Poland to 42% in the U.S.

This high level of contact with Alzheimer's disease is likely to have contributed to the wide recognition of common symptoms such as confusion and getting lost, which were recognised by at least 86% and 88%,respectively.

Few people recognised the severity of Alzheimer's disease with approximately 40% knowing that it is a fatal condition (33-61%). In fact, Alzheimer's is the seventh-leading cause of death in high income countries and the only cause of death among the top 10 that cannot be prevented or cured.

Many of the respondents believe there is now an effective medical or pharmaceutical treatment to slow the progression of Alzheimer's disease and make the symptoms less severe (27%-63%). Also, nearly half believe there is a reliable medical test to determine if a person suffering from confusion and memory loss is in the early stages of Alzheimer's disease (38%-59%).

The survey also found public interest in predictive testing. Approximately two thirds of respondents said that, they would get a medical test which would tell them whether they would get Alzheimer's disease before they had symptoms.

Heike von Lützau-Hohlbein, Chairperson of Alzheimer Europe, said: "The results demonstrate the importance of being honest with patients when diagnosing Alzheimer's disease. As a former carer myself, I recognise how valuable it is for people to have first-of-all a name for all the uncertainties of their condition and then have the time to get their affairs in order. It will always be difficult to receive such a diagnosis but doctors need to empower patients and their loved ones to take the appropriate steps. The findings also show there is high awareness of Alzheimer's disease, which is a testament to the success of the many awareness campaigns coordinated by Alzheimer societies."

Dr. Robert Blendon, Professor of Health Policy and Political Analysis from the Harvard School of Public Health said: "Many of the public have high expectations about the possibilities of treatment alternatives and medical testing. It is important for doctors to talk to patients about what treatment and testing options are or are not available."

Florence Lustman, Coordinator of the French Alzheimer Plan, said: "Alzheimer's is a fatal condition that affects most people's lives at some time. One of the key priorities of the French Alzheimer's Plan is early diagnosis, and the survey results support this focus. The findings demonstrate overwhelming public support for receiving diagnosis."

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Harvard School of Public Health.

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Drinking, cannabis use and psychological distress increase in Ontario, Canada, survey finds

ScienceDaily (June 13, 2011) — The latest survey of Ontario adults from the Centre for Addiction and Mental Health (CAMH) shows increasing rates of daily drinking and cannabis use and high levels of psychological distress. The results of the 2009 CAMH Monitor survey, the longest running survey tracking mental health and addiction indicators among adults in Ontario, were published June 13, 2011.

Alcohol

The proportion of adults reporting daily drinking increased from 5.3% in 2002 to over 9% in 2009. The average number of drinks consumed weekly among drinkers has also increased from 3 drinks to 4.6 drinks, and the proportion of adults exceeding low-risk drinking guidelines remains at elevated levels (22%). However, there were also some encouraging findings: there was a significant decline in binge drinking from 12.6% in 2006 to 7.1% in 2009, and the decline was evident especially among young adults, from 24% to 11.5%.

Although driving within an hour of consuming two or more drinks has shown a steady decline in the past years, from 13.1% in 1996 to 6.9% in 2009, there is evidence that this trend has reversed among young adults. Driving after drinking posted a significant increase among 18 to 29 year olds, from 7.7% in 2005 to 12.8% in 2009.

"The data tell us that while the number of people who drink alcohol has not changed, the way they are drinking has -- people are drinking more often and may be consuming more alcohol when they do drink, although there may be fewer binge occasions," said Dr. Robert Mann, CAMH Senior Scientist and lead investigator on the study. "We know that the more access people have to alcohol, the more people will drink, leading to more instances of drinking and driving. Measures such as Random Breath Testing and lowering legal limits to .05% can reduce drunk driving deaths. The implementation of .05% legislation in British Columbia appears to have resulted in a 50% decrease in drinking and driving deaths in that province."

Cannabis

The prevalence of cannabis use has been steadily increasing from 8.7% in 1996 to 13.3% in 2009, for both men and women and among all age groups. Along with this, there was almost a 2-fold increase in cannabis use among those aged 18-29, from 18.3% to 35.8%.

"These increases are of concern to us," stated Dr. Mann. "We know that cannabis use may increase the risk of psychosis for people who are predisposed to schizophrenia, and may worsen the symptoms of other mental illnesses." Another noticeable change was the large increase in use of cannabis among older adults. Use by those aged 50 years and older increased more than 3-fold from 1.4% to 4.7% between 1996 and 2009 and, among past year cannabis users, the proportion of users aged 50 years and older increased from 1.9% to 13.9% during the same time period.

Tobacco

Some positive findings are that the percentage of adult Ontarians reporting smoking cigarettes declined from 19.7% in 2008 to 18.6% in 2009. Though 14% of Ontarians still report daily smoking, it is a positive sign that cigarette smoking has steadily declined since 1996, from 26.8% to 18.6% in 2009. Dr. Mann notes that the provincial government's commitment to anti- smoking legislation through smoke-free Ontario probably played an important role in the decrease in smoking rates.

Mental Health

One in seven Ontario adults (14.7%), representing 1,400,000 people, reported symptoms of elevated psychological distress, and almost 6% reported that their overall mental health was poor. Those aged 30-39 were the most likely to report poor mental health, and those over age 65 reported the lowest rates of poor mental health. Mental health was strongly correlated with education. Those who had not graduated high school reported higher levels of poor mental health, and those who had graduated from university reported lower rates. "These results suggest that the social determinants of health, such as income, play as important a role in mental health as they do in physical health," said Mann.

The use of anti-anxiety medication has remained stable over the past few years, but trend data shows that over the past 10 years, use of these medications has risen from 4.5% to nearly 7% of Ontario adults. The same pattern can also be seen in the use of antidepressant medication, which has trended upward from 3.6% in 1999 to the current rate of 6.6%. Added Dr. Mann, "Though these are marked increases, they may also be showing that more people experiencing mental health problems are seeking and receiving help, which is a positive step."

Despite several differences, there was no strong dominant pattern in regional differences. Those from Northern Ontario were the most likely to be current smokers and to smoke daily; those from Toronto were the least likely to drink alcohol; those from the South West region of the province reported the highest average number of drinks consumed per week; and driving after drinking was most likely in the South West and in the Central South regions.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Centre for Addiction and Mental Health.

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Eight-question survey can help predict post-traumatic stress disorder

ScienceDaily (July 18, 2011) — A simple eight-question survey administered soon after injury can help predict which of the 30 million Americans seeking hospital treatment for injuries each year may develop depression or post-traumatic stress, report Therese S. Richmond, PhD, CRNP, associate professor at the University of Pennsylvania School of Nursing, and her colleagues in General Hospital Psychiatry.

"Depression and PTSD exert a significant, independent, and persistent effect on general health, work status, somatic symptoms, adjustment to illness, and function after injury," the authors wrote, also emphasizing that even minor injuries can lead to traumatic stress responses. The findings allow healthcare providers to identify patients at highest risk for developing these disorders and to target appropriate resources to this vulnerable group.

This screening tool -- reportedly one of the first of its kind for adults in the U.S. -- could have a great impact on the judicious allocation of costly mental health resources.

Using an eight-question survey, all injured patients can be rapidly assessed for risk in the hospital. Healthcare providers can then provide patients classed as high-risk for developing depression or PTSD with information about symptoms to look for and advise them to contact their primary care provider should symptoms surface. This intervention can facilitate early diagnosis of these disabling disorders.

The study reported nearly 100 percent accuracy in negative results. Only five percent of injured patients who tested negative for risk of depression on the screening survey developed depression and no patients who tested negative for PTSD risk developed PTSD. At the same time, not all patients who screen positive will develop these disorders. The researchers do not suggest that all patients who screen positive receive mental health services, but rather that this finding prompt systematic provision of information and additional follow-up.

The authors caution that while the findings of this initial study are most promising, they need to be replicated in an independent sample.

With Dr. Richmond, the study authors are: Josef Ruzek, PhD; Theimann Ackerson, MSSW; Douglas J. Wiebe, PhD; Flaura Winston, MD, PhD; Nancy Kassam-Adams, PhD.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Pennsylvania School of Nursing, via EurekAlert!, a service of AAAS.

Journal Reference:

Therese S. Richmond, Josef Ruzek, Theimann Ackerson, Douglas J. Wiebe, Flaura Winston, Nancy Kassam-Adams. Predicting the future development of depression or PTSD after injury. General Hospital Psychiatry, 2011; DOI: 10.1016/j.genhosppsych.2011.05.003

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here