Providentia

NHS Introduces Postpartum Depression Treatment Guidelines

Although experts warn that one women in seven experiences significant mental health problems during or after pregnancy, family doctors often miss essential warning signs of mental problems in their female patients.  To combat the detrimental effects of postpartum depression on women and their children, the U.K. National Health Service has implemented new clinical guidelines for use by family doctors.  The guidelines involve asking a series of screening questions of all new mothers to spot symptoms of clinical depression or other emotional issues including eating disorders, anxiety, and psychosis.   Although postpartum depression has long been recognized as a significant health risk, standards of medical care and diagnosis have been found to vary significantly across different regions of the country.   By focusing on new mothers in the months following giving birth, it is hoped to provide suitable treatment options including counseling or medication.   

More details on this story can be found here. 

Despite Partial Victory, Loftus Lawsuit to Proceed

In a unanimous decision by the California Supreme Court, all but one of the claims brought against Dr. Elizabeth Loftus in the "Jane Doe" defamation trial have been dismissed.  The court also ruled that the trial can proceed on a single claim of misrepresentation.  Dr. Loftus, a prominent memory researcher and professor at the University of California, Irvine and the University of Washington, has been a longstanding opponent of recovered memory allegations.  In an article which Dr. Loftus and a colleague published in the Skeptical Inquirer in 2002, the authors provided a comprehensive critique of the "Jane Doe" case which had been lauded as a landmark study in recovered memory.  In the case, Jane Doe alleged "recovering" memories of childhood abuse at the hands of her mother who has consistently denied the allegations.  Through extensive research including interviews of Jane Doe's foster mother and other principals of the case, Dr. Loftus and her colleague concluded that the allegations were false and that the abuse never occurred.  While Jane Doe's identity was not revealed in the article, Nicole Taus made her identity public in 2003 and filed a lawsuit against Dr. Loftus and the University of Washington  citing multiple claims of invasion of privacy, misrepresentation, defamation, and misuse of public records.  Although Dr. Loftus has denied misrepresenting herself to Nicole Taus' foster mother, the trial is scheduled to proceed on this basis.  Despite disappointment in failing to overturn all of the claims of the case, Dr. Loftus' attorney has described the decision as a victory for academic researchers. 

More details on the case can be found here

Is Steroid Use Linked to Criminal Offending?

The results of a study examining the possible role of anabolic steroid use  in criminal offending are presented in the November, 2006 issue of Archives of General Psychiatry.  A team of researchers led by Fia Klötz of  Uppsala University, Sweden examined 1,440 Swedish respondents tested for steroid use between 1995 and 2001.  The 241 respondents who tested positive for steroid use were found to be significanly more likely to have been convicted of a weapons or fraud offense than the 1,199 respondents in the control group.  No significant difference was found between the two groups for violent or property offenses. The link between weapons offenses and steroid use was found to persist even when substance abuse history was ruled out. While steroid use had been previously implicated in impulsive violence, the study findings suggest that it may be linked to other aspects of antisocial behaviour.

The study abstract can be found here.  The full-length article is also available.

Dying for the Truth?

Dr Vladimir Bekhterev was unquestionably one of the eariy pioneers in Russian medicine.  Born in 1857, he was a prominent neurophysiologist and psychiatrist who founded the Psychoneurological Institute, did important work in adapting Pavlov's research to human patients (he was later viewed as a founder of psycho-reflexology), and gave his name to Bekhterev's disease (now more commonly known as ankylosing spondylitis) as well as numerous other diseases and anatomical structures.  Given his stature as a researcher and physician, it was little wonder that Joseph Stalin summoned him in 1927 in order to treat his symptoms of depression (Dr. Bekhterev had also treated Lenin).  What happened as a result of the examination is cause for speculation.  Some sources suggest that the psychiatrist diagnosed Stalin as suffering from severe paranoia and advised him to resign (he had a reputation for being outspoken).  What is not in dispute is that Stalin disagreed rather strenuously with the diagnosis. While there is no direct evidence that he had ordered Dr. Bekhterev's death, it occurred that same day and no postmortem was held.  The body was cremated, presumably in accordance with Dr. Bekhterev's wishes. 

Regardless of the actual diagnosis, there is little question now that Stalin was driven by paranoia.  The purges that continued until his death in 1953 claimed countless lives (including Dr. Bekhterev's son, Pyotr).  Did he order Dr. Bekhterev's death?  It was certainly in character for him although the physician's eminence might have prevented him from acting openly.   Was it foolish for Dr. Bekhterev to be so candid given that he was dealing with a monster?  Perhaps, but he has my deepest respect for doing so. 

P.S., Natalya Bekhtereva, granddaughter of Vladimir, is continuing the family tradition as an eminent neuroscientist.  By all accounts,she is maintaining the family tradition for feistiness as well.      

Church of Scientology Sponsors Psychiatric Whistleblowers Awards

The Citizens' Committee on Human Rights (CCHR), an advocacy group dedicated to exposing human rights abuses by mental health professionals,  held its annual awards banquet on February 17 in Los Angeles to honour mental health industry whistleblowers.  CCHR was founded in 1969 by the Church of Scientology and Dr. Thomas Szasz to document cases of psychiatric medication abuse.  Despite controversy relating to its activities and its relationship with the Church of Scientology. CCHR remains active with campaigns against forced medication and perceived abuses relating to medication of children.

At the awards banquet, celebrities including Kirsty Alley and Kelly Preston honoured a number of recipients featuring prominent psychiatrists and neurologists.  Click here for a complete description and list of awards recipients. 

Violence and Abuse in African HIV-Infected Women and Children

A qualitative research study investigating the mental health issues of a sample of HIV-infected women and children in Zambia has indicated a considerable overlap between incidence of domestic violence and HIV status.  The researchers identifed domestic violence, depression, and alcohol abuse as being major problems for women respondents. In children, defilement, domestic violence, and behaviour problems were found to be prominent.  In particular, domestic violence and sexual abuse were found to be closely linked to HIV and alcohol abuse. The study researchers discuss the findings in terms of the role of cultural influences and the stigma that plagues African HIV-positive women and children. 

The abstract for this study can be found here.  The full-text of the study is also available.

Street Children Targets for Sexual Abuse

Despite active intervention by non-governmental organizations and support agencies, an estimated 50% of the 12,000 to 14,000 street children living in Karachi, Pakistan become involved in the commercial sex trade.  Data provided by the Azad Foundation, an aid organization dedicated to assisting street children indicates that the number of street children is increasing.  The children are mostly males, ranging in age from 7 to 11 and are often abandoned by their families for economic reasons. Their numbers are bolstered by the thousands of refugees entering Pakistan from neighbouring Afghanistan and Bangladesh. Their vulnerability makes them natural targets for sexual predators and many of the children resort to "survival sex" to support themselves on the streets.  The Azad Foundation maintains drop-in centres, a night shelter, and a mobile dispensary to provide medical assistance and to educate children on sexual health issues, including the prevention of HIV-AIDS and other sexually transmitted diseases. Psychological counseling is also provided to help former street-children deal with issues relating to trauma and other emotional issues.

More information on the Azad Foundation and its work with street children in Pakistan can be found here. 

Underdiagnosed ADHD in Adults

Based on an analysis of the results of the National Comorbid Survey Replication, in which a subsample included a screen for adult attention-deficit hyperactivity disorder (ADHD),  it was estimated that the current prevalence of adult ADHD was 4.4 per cent.  The subsample consistend of 3,199 respondents who were in the 18-44 age range with clinical follow-up interviews of 154 respondents.  Adult ADHD was found to be linked to a range of other psychiatric and substance abuse disorders that were also assessed in the survey as weil as imparments in social and occupational functioning.  Most of the respondents who were found to have adult ADHD had never been previously diagnosed or received treatment.

The study abstract can be found in the April, 2006 issue of the American Journal of Psychiatry.  The full-text version of the study is also available.

Romanian Exorcist Sentenced

A Romanian Orthodox priest was sentenced to 14 years imprisonment for his role in the exorcism death of a 23-year old nun.  Daniel Petru Corogeanu was sentenced along with three nuns who had participated in the exorcism.  Maricica Irina Cornici, a 23-year old nun, was killed in 2005 following an exorcism ceremony at an isolated monastery in which she was chained to a cross without food and water for days.  She eventually died of suffocation, dehydration, and exhaustion.  She had been previously treated for schizophrenia following claims that the "Devil was talking to her" but had relapsed.  Although the Orthodox Church has condemned the ritual death as "abominable", Corogeanu's numerous followers thronged the courtroom and wept at his sentence.  An appeal is planned. 

More details of the story can be found here.

Report Finds Psychiatrist's Killer Not Criminally Responsible

A court-ordered psychiatric report has found 19-year old Vitali Davydov not criminally responsible in the September 3, 2006 murder of prominent psychiatrist, Wayne S. Fenton.  The report was completed during Davydov's stay at the Clifton T. Perkins Hospital Center, a maximum security psychiatric facility in Maryland.  Dr. Fenton, an authority on treating schizophrenics was killed by Davydov during an emergency assessment held in his office.  The weekend assessment was requested by one of Dr. Fenton's colleagues due to concerns over Davydov's refusal to take appropriate medication (he was not on medication at the time of the murder).  Based on evidence presented at the trial, Davydov became agitated and began beating on Dr. Fenton with his hands.  The murder came to light when Davydov's father noticed blood on his son's hands and shirt afterwards and contacted police.  Dr. Fenton was later declared dead at the scene. 

In the report, Davydov was also found competent to stand trial while on medication and the trial is proceeding.  More details on the story can be found here.