UC Irvine researcher finds biological link between chronic pain, mental illness

It’s understandable that people who are in constant physical pain would experience a high level of stress and fatigue.

But a recent study by researchers at UC Irvine and UCLA shows chronic pain sufferers also are more vulnerable to mental and emotional illnesses such as anxiety and depression and that there’s a biological link between the mental and physical pain.

Catherine Cahill, an associate professor of anesthesiology and perioperative care at UCI, has been working with colleagues at the UCLA Brain Research Institute to study the relationship between chronic pain and mood disorders.

The result? They found that chronic pain causes inflammation in regions of the brain that deal with reward and motivation, causing patients to be more susceptible to mood disorders.

Chronic pain is defined as pain lasting for an extended period, usually more than 12 weeks, according to the National Institutes of Health. More than 100 million Americans are affected by chronic pain, according to a recent report by the Institute of Medicine.

Cahill and the research team studied brain inflammation in rodents and its effect on the neural system. Their paper, published June 3 in The Journal of Neuroscience, shows a link between brain inflammation caused by chronic pain and mood disorders.

“Many studies in depression literature show that one of the causes for the development of mood disorders is a disruption in the dopamine circuitry,” Cahill said, referring to the brain chemical associated with happiness and pleasure. “My study was on the link between the very, very high (co-existence) of anxiety and depression in those patients with chronic pain. This was really never shown before.”

According to the study, the brain inflammation caused by pain triggers the activation of cells called microglia, which hinder the release of dopamine.

Cahill noted that the study has potentially significant implications on how doctors might treat future patients experiencing mood disorders alongside chronic pain. Her research, she added, also sheds light on addiction, an illness that’s affected by the reward and motivation system of the brain.

Cahill said she hopes her research can eventually have clinical impact. She is planning to test an existing drug compound that could restore the flow of dopamine.

“This is a new strategy to try to restore the reward circuitry that has both implications on addiction-like disorders and mood disorders,” she said..
Source:  http://www.ocregister.com/articles/-666693--.html

Mental illness is 'as bad for life expectancy as smoking

Many mental illnesses are as bad for our health as smoking, shocking new research has revealed.

In fact, life expectancy for people with mental health problems is less than for heavy smokers, experts have found.

Serious mental illness can reduce a person's life expectancy by 10 to 20 years, when the average reduction in life expectancy for heavy smokers is eight to 10 years, according to researchers from Oxford University.

Mental illness can reduce a person's life expectancy by between 10 and 20 years

But mental health has not been given the same public health priority as smoking, they said.

The study, published in the journal World Psychiatry, analysed previous research on death risk for a whole range of problems - mental health issues, drug and alcohol abuse, dementia, autistic spectrum disorders, learning disability and childhood behavioural disorders.

The authors examined 20 papers looking at 1.7 million people and over 250,000 deaths.

They found that the average reduction in life expectancy for people with bipolar disorder was between nine and 20 years.

For schizophrenia, life expectancy was 10 to 20 years lower and for those with recurrent depression, it was seven to 11 years lower.

Those who fall victim to drug and alcohol abuse lose between nine and 24 years, the research found, while heavy smokers lost up to a decade. 

'We found that many mental health diagnoses are associated with a drop in life expectancy as great as that associated with smoking 20 or more cigarettes a day,' said Dr Seena Fazel, of the Department of Psychiatry at Oxford University.

'There are likely to be many reasons for this. High-risk behaviours are common in psychiatric patients, especially drug and alcohol abuse, and they are more likely to die by suicide. 

'The stigma surrounding mental health may mean people aren't treated as well for physical health problems when they do see a doctor.

The average reduction in life expectancy in a heavy smoker is eight to 10 years making mental illness more dangerous

'Many causes of mental health problems also have physical consequences and mental illness worsen the prognosis of a range of physical illnesses, especially heart disease, diabetes and cancer. 

'Unfortunately, people with serious mental illnesses may not access healthcare effectively.'

But she added that all of this could be changed.

'That means making sure people have straightforward access to health care, and appropriate jobs and meaningful daytime activities. 

'What we do need is for researchers, care providers and governments to make mental health a much higher priority for research and innovation.'

Dr John Williams, head of neuroscience and mental health at the Wellcome Trust, which funded the study, added: 'We now have strong evidence that mental illness is just as threatening to life expectancy as other public health threats such as smoking.

Mark Winstanley, chief executive of Rethink Mental Illness, said: 'Our Lethal Discrimination report showed that more than 30,000 people with mental illness are dying needlessly every year - that's more than one avoidable death every 20 minutes.

'Signs of heart disease, diabetes and cancer are being missed because people aren't getting the right health checks.

'Obesity and smoking are also huge problems - 40 per cent or all tobacco consumption is by people with mental illness, yet they aren't getting the support with lifestyle changes that other people expect and receive.'

Source: http://www.dailymail.co.uk/health/article-2637319/Mental-illness-bad-life-expectancy-smoking.html

Depression 'over-diagnosed' with drugs dished out to patients who are simply sad or unable to sleep, warns expert

Million of patients are being wrongly diagnosed with depression when they are simply sad, according to a new report.
Anti-depressants are being dished out to people grieving loved ones, suffering sexual problems or even unable to sleep, claims a newly-published scientific paper published by academics at Liverpool Unversity.
The number of people diagnosed with mental illnesses like depression has doubled since 2002. It is believed more than five million people are now labelled depressed or suffering anxiety in the UK.
Liverpool University's Professor of Primary Medical Care, Chris Dowrick, claims in a new report that up to half of these patients have been misdiagnosed.
Writing in the British Medical Journal, the academic, who also works as a GP, said: 'Over-diagnosis is now more common than under diagnosis.'
He has called for guidelines on diagnosing depression to be tightened and for pharmaceutical companies to be banned from marketing their drugs to GPs.
'Over recent decades there has been an increasing tendency, especially in primary care, to diagnose depression in patients presenting with sadness or distress and offer them anti-depressant medication,' he wrote.
'For GPs a diagnosis of depression may be an attractive instrument for managing uncertainty in the consulting room, especially as its commonest treatment comes in the form of a once-daily pill and is encouraged by clinical guidelines and indicators.
'But these pills won't work for people with mild depression, or who are sad, but they have side effects and we are seeing patients becoming reliant on drugs they do not need.'

He added the problems began back in the 1980s, when qualifying symptoms for depression were lowered to include feeling sad, blue or down in the dumps for two weeks, or appetite change, sleep disturbance, drop in libido and tiredness.
Dr Dowrick went on to explain that these symptoms were so common that most people would have them at some point in their lives.

Professor Chris Dowrick, who also works as a GP, said that over-diagnosis is more common than under-diagnosis and called for guidelines on diagnosing depression to be tightened (file photo)

Despite extensive research and calls from health professionals for the classification system to be revised, though, the worldwide boom in the prescription of anti-depressants has soared. In the UK, sales of anti-depressants have increased at a rate of 10per cent every year.
Dr Dowrick and his team said drug companies had a part to play in the problem of over-diagnosis. He criticised their strategies of marketing drugs for mild depression and anxiety, making them be seen as conditions that required medication.
He said: 'Often doctors do not know how effective the drugs are because they do not have full and accurate information on the research carried out by the pharmaceutical companies.
'Drug companies should be stopped from marketing antidepressant medication to physicians,' he wrote.
However, mental health charities last night rejected his calls that depression is over-diagnosed.

Jenny Edwards CBE, Chief Executive of the Mental Health Foundation, said: 'There is an increase in depression and anxiety that GPs are seeing because of the pressures people are facing from debt, unemployment and their effects on people's relationships.
'Diagnosing this as mental illness can be a crucial first step to help people get help.
'However it is vital that more is done to support GPs to offer a wider choice than just medication.
'Talking therapies can be reallyhelpful but the waiting times need to be slashed.'
On Friday, it was revealed that drugs companies routinely withhold results of clinical trials from doctors, leaving them poorly informed about how to treat patients.
The public accounts committee said it had 'extreme concern' that pharmaceutical companies only published around half of completed trial results and are more likely to hide unfavourable results.

It called on the Government to make sure that full methods and results of all trials are opened up to wider scrutiny by doctors and researchers.

Read more: http://www.dailymail.co.uk/health/article-2534408/Depression-diagnosed-drugs-dished-patients-simply-sad-unable-sleep-warns-expert.html#ixzz2pcqhawRx
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