Problematic Psychiatric Diagnosis

 As both a psychiatrist and a patient, I know how slippery a diagnosis can be

At the outset I must make this perfectly clear. Psychiatric disorders exist, have as yet an undiscovered physical substrate which may have a genetic and environmental components, typically a result of the gene and environmental interaction. Psychiatric drugs have made huge improvements to society and individuals. My focus on this post is where psychiatry and psychology needs to change. 

 The controversies surrounding psychiatric diagnosis are decades old. Thomas Szasz is the seminal figure on the issue and his work, "The Myth of Mental Illness"(1961), began a debate that continues today. Today the problem is worse. The above article is another example of how psychiatry as a profession and our culture needs to seriously reevaluate how psychiatric diagnoses are made and how psychiatric conditions are treated. 

Evolution is Depressing.

 

New Antidepressants Can Lift Depression and Suicidal Thoughts Fast, but Don’t Expect Magic Cures

Ketamine is an NMDA antagonist. I've long had concerns about using it for depression treatment because the NMDA receptors play a cardinal role in activating the CREB pathway which in turns is important for synaptic consolidation. So the long term use of ketamine, which will be required because the effect only lasts a few days, raises troubling questions about synaptic density. 

Motorcycling Macho Millennials

A Youtube channel I occasional watch is Max Wrist. The name says it all. He is a motorcyclist who likes to twist the throttle to the red line. Max Wrist is an excellent rider but he takes some dangerous risks. So it was inevitable that his recent video has been posted. He's lucky though, while his leg is smashed up the other riders involved in the accident have fared much worse, one with dangerous brain swelling that will most probably result in brain damage. 

The Removal of Dead Neurons

A remarkable video of how dead neurons are removed from the brain.

For The First Time, Scientists Have Captured Video of Brains Clearing Out Dead Neurons

A Mix of Antioxidants is Best for the Brain.

Antioxidant cocktail key to preventing Alzheimer's

No surprises here and the study linked below provides good details on how to optimise our nutrient and especially antioxidant intake to protect the brain. If it protects the brain it will confer benefits to the whole body. 

Full Text at link:

Role of antioxidants and a nutrient rich diet in Alzheimer's disease

Transcend

Transcend: The New Science of Self-Actualization  By Scott Barry Kaufman

SBK was a Facebook friend. I have long left Facebook. SBK was at Pennsylvania University where he lectured in Positive Psychology. He was also the founder of the Imagination Institute. So it is not surprising he is still firmly in the humanistic psychology tradition because Positive Psychology is the logical extension of many themes in humanistic psychology. 

Scott Barry Kaufman is the dream psychologist for left wingers. Jordan Peterson is the dream psychologist for right wingers. Both have enjoyed huge popular support and are regarded by their respective fans are supremely intelligent and world leading psychologists. Fans are often stupid like that. 

Free Speech is a Double Edged Sword

Singleton High School teacher apologises after racist classroom rant

The two disturbing words in this headline are "apologises" and "racist". 

It's alleged the teacher made comments about Indigenous Australians living in state housing and taking money from the government.

In this sentence the word "alleged" is used probably to protect the publisher but it is incongruous with the use of the word "racist" in the headline. If you're going to call someone a racist I can't see why the qualification "alleged" is necessary.  

"Then the teacher's turned around and said the best thing to happen to Aboriginal people is the European colonisation," Ms Franks said.

Exercise and the Endocannabinoid Network

Waking up at 3.15am and realising trying to get back to sleep is a dream I wake up and decide to see if I can wake up the brain. It woke me up with this strange idea: exercise elevates the endocannabinoid network which is one avenue by which exercise inhibits inflammation. So off to pubmed and the available data supports my intuition but the data is very limited. Only in recent years has there been renewed interest in the endocannabinoid network. Because of government prohibitions and the typical knee jerk response to anything associated with marijuana until recently the research community has been prevented from deeper investigations; the result being we have neglected one of most important networks in modulating inflammation associated with aging and especially in the brain. That is now changing but in my country Australia the government persists with a perspective that based on ignorance and arrogance. Too many stupid politicians in Australia but of course on that matter the country is not exceptional.   

Land of Fire and Ice

The Arctic is on fire: Siberian heat wave alarms scientists

Iceland has been referred to as the land of fire and ice. Looks like that appellation needs to be more broadly geographically based. 

Does Toxicology Testing Need Improvement?

Effects from low-level concentrations of harmful chemicals preserved in three generations of fish

I've seen related findings going back many years but all too often we rely on short term high concentration toxicology testing. Increasing evidence is finding that persistent low level exposure to various chemicals can have important health consequences for the individual. This study finds that it is not only the individual that is affected but also the following generations. It is about endocrine disruptors, molecules which impact on hormonal functions. So the result isn't that surprising because hormones are very powerful molecules which are produced in relatively small quantities. 

A Promising Breakthrough for Treating Parkinson's Disease?

One-time treatment generates new neurons, eliminates Parkinson's disease in mice

Because Parkinson's disease is very much about the loss of dopamine producing neurons the great hope has always been stem cells to create neurons which produce dopamine. In a classic example of a accidental discovery this breakthrough found that many cell types will become dopamine producing neurons. 

In this serendipitous way, the team discovered that inhibiting or deleting just a single gene, the gene that encodes PTB, transforms several types of mouse cells directly into neurons. 

The abstract:

 Reversing a model of Parkinson’s disease with in situ converted nigral neurons

Nature volume 582, pages550–556(2020)

Parkinson’s disease is characterized by loss of dopamine neurons in the substantia nigra1. Similar to other major neurodegenerative disorders, there are no disease-modifying treatments for Parkinson’s disease. While most treatment strategies aim to prevent neuronal loss or protect vulnerable neuronal circuits, a potential alternative is to replace lost neurons to reconstruct disrupted circuits2. Here we report an efficient one-step conversion of isolated mouse and human astrocytes to functional neurons by depleting the RNA-binding protein PTB (also known as PTBP1). Applying this approach to the mouse brain, we demonstrate progressive conversion of astrocytes to new neurons that innervate into and repopulate endogenous neural circuits. Astrocytes from different brain regions are converted to different neuronal subtypes. Using a chemically induced model of Parkinson’s disease in mouse, we show conversion of midbrain astrocytes to dopaminergic neurons, which provide axons to reconstruct the nigrostriatal circuit. Notably, re-innervation of striatum is accompanied by restoration of dopamine levels and rescue of motor deficits. A similar reversal of disease phenotype is also accomplished by converting astrocytes to neurons using antisense oligonucleotides to transiently suppress PTB. These findings identify a potentially powerful and clinically feasible approach to treating neurodegeneration by replacing lost neurons.

Prenatal stress can cause long-term behavioral deficits in mice

Prenatal stress, especially maternal immune activation has long been strongly associated with behavioral changes in the offspring. Maternal immune activation is not just about a mild infection it typically involves a severe and persistent infection. It is a leading risk marker for schizophrenia and autism. This study goes one step further and finds that by simply blocking one molecule, CCL2, they could prevent the behavioral changes in the offspring. I'm a little suspicious of that and obviously that can't be extrapolated to human beings. Blocking CCL 2 might seem like a good idea for pregnant women experiencing stress but biological molecules typically have many different effects and we don't know what the consequences of blocking that molecule will have for the overall health of the women and the developing fetus. 

The findings suggest that the maternal microbiome or immune system could be good targets for developing preventive treatments for women who experience stress during pregnancy.

The problem though is that maternal immune activation is not enough, there is a genetic component to the emergence of these conditions. The genetic component involves some immune related genes but also involves genes relating to brain development. 

Nonetheless as a preventive strategy pregnant women should avoid potentially dangerous infections and generally manage their stress. This is one reason why I have concerns about pregnant women working in some roles where the risk of infection and high levels of psychological stress exist. I think our society has over stepped the mark on this matter and as research accumulates I hope more pregnant women, socioeconomic circumstances notwithstanding, are able to adopt the traditional approach of being nurtured through their pregnancy rather than being expected to perform as everyone else.

 

Is the USA a failing state?

Is America a ‘failing state’? How a superpower has been brought to the brink

At present it isn't a healthy state but it is hyperbolic to suggest it is a failing state. Nations go through periods of turmoil but democratic nations typically survive and adjust to the new realities. The problem for the USA is that it has a president promoting division, has handled the coronavirus pandemic in a poor fashion, and has threatened to send in the military to contain the street violence. 

The USA has a growing problem with economic inequality. The recent tax cuts only exacerbate that trend because those tax cuts support the top of the economic food chain. While unemployment is at record lows that doesn't appear to be addressing the economic inequality situation, possibly because most of those jobs are minimum wage jobs. There is some reason for optimism because wages have increased but that might be a function of various states raising the minimum wage. 

I don't think the USA is becoming a failing state but it would certainly help if the leadership adopting a more creative approach to reducing the street violence rather than just threatening to call in the military. The protestors have gone too far and at both the federal and state levels the authorities seem incapable to quell the unrest. 

Sweden's Coronavirus Strategy Failure

Public support for Sweden's controversial coronavirus strategy is plummeting

Sweden coronavirus strategy struck many as being unusual and dangerous. Initially conservatives praised Sweden for not falling prey to alarmism and sacrificing their economy to the boogeyman. Conservatives are quiet now because Sweden has paid a heavy price. It is worth noting that the Swedish government may have had no choice because the Swedish constitution doesn't allow the government to impose such onerous restrictions on personal behaviour as was adopted in many other advanced nations.