Computer guided CBT may improve treatment of depression?

Computer guided CBT may improve treatment of depression? - In the United States, depression is the leading cause of disability, but only 21% of patients diagnosed with major depression receive treatment that meets the guidelines of the American Psychiatric Association. 

Of people seeking treatment for depression who would be treated with psychotherapy Live outnumber those who would be treated with drugs three to one, but those who often want to live not a therapy they receive. 

Access to psychotherapy is limited by the number of professionals from the region itself, the cost and logistics - not to mention the stigma. And when people receive the therapy, therapists can not provide care based on evidence.

One way to get high quality psychotherapy to people in need is to automate and computerize the treatment process and provide via websites and applications. This could provide guidelines on the basis of everyone, everywhere, at any time, at a low cost treatment. 

Stand-alone computerized cognitive behavioral therapy (CBT) has been found to be effective for treating depression, and is now available in a few entities. But it remains unclear how much, if anything, CCTB improve the treatment of depression in primary care, so that a group of UK researchers recently tested the benefits of adding CCTB to standard treatment. 

They randomly assigned 691 people with depression in three different groups. One group received standard care, and the others received standard care plus a two CCTB programs online.

CCTB over standard care for depression 

Consequently, the standard treatment of depression in primary care in the UK is pretty good. Citizens are routinely offered antidepressants, psychotherapy, and access to community mental health teams, psychologists, psychiatrists and counselors - a range of both rare resources available in primary care practices in the United States. 

There was a lot of crossover between the study groups. In the group "standard of care", 19% ended up using CBT although they are not specifically assigned to this treatment. Between 77% and 84% of the three groups used to treat depression and drugs "Live" mental health specialists were seen by 17% annually and 24% of the other group CARE. 

In this context - with many participants CCTB groups also receive specialized mental health treatment and 19% of the group receiving the usual practice CBT-- no significant differences in treatment outcomes of depression. However, the United States, the results might have been different, given the limited resources of mental health in most established primary care clinics. 

It would be more interesting and more importantly, know the advantage of using CCTB for patients receiving no more - without drugs and without access to specialists in mental health. It is for these patients that CCTB might be most beneficial.

Challenges to get people to use CCBT to treat depression 

The two sites of the CCBT has been tested in previous clinical trials, and both have proven to be effective treatments - but they are only useful if people use them. Although both independent sites CCTB were designed to be used on 6 or 8 "sessions", most people only used once or twice, although the study provided reminder calls to participants. 

People with depression may experience fatigue, impaired concentration, and feelings of hopelessness. Make websites use systematic CCTB on your own schedule is a challenge - even if these programs could be useful in the end. More structure may be needed to keep people using CCTB.

What is the take home? The biggest challenge is not building a CBT program that works; He built one that people will use. Just as you need to entertain while educating before CBT program must be extremely involving users - and provide immediate value of the first session. 

And while the concept of treatment anywhere, anytime is attractive, confident people to plan CCTB themselves in their own time, in their own homes, can lead to high levels of downhill; after all, you can always get around to it later. 
By: James Cartreine, Phd.

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Adolescents with optimistic friends can have better emotional health

Adolescents with optimistic friends can have better emotional health - Pediatricians and child behavior specialists who work with adolescents know that adolescence is an important time for social growth.

However, these years can be fraught with anxiety for parents of teenagers. How will you know if your teenager Moody is to be with the right people?

What friends could be a bad influence? How can you help your child develop healthy relationships? 

Recent research has addressed some aspects of these issues. A study entitled "Dissemination of healthy humor in social networks of adolescents" published this year in the Proceedings of the Royal Society of London, examined whether a teenager whose friends have a healthy atmosphere is less likely to be depressed.

He also discussed how emotionally healthy friends affect the recovery of adolescent depression. Basically, the researchers wanted to know: is a contagious good mood?

The study involved nearly 3,000 teenagers. Each study volunteers carried out two surveys, six months apart, in which he or she up to five male and five female friends listed. Then each teenager was monitored over time to see how it changes your mood. 

One of the interesting things about this study is that the researchers define depression as a behavior, not necessarily as a disease that we can get. This allowed them to make them slightly different from previous studies looking at the same statistical analysis of things, and discovered the potential power of positive thinking friends. 

The researchers found that have a social network of friends with a healthy atmosphere cut the likelihood of developing depression half of teenagers over a period of 6-12 months. It has also significantly improved the chances of recovery from depression in adolescents who have had it.

Although the data do not show a cause and direct effect, this study suggests that having friends with healthy mood can reduce the risk of depression and make it a little easier to recover from depression if it product.

Surprising findings in the survey on social networks

This study is a good example of a recent trend in epidemiology - the use of data on the social network from person to learn about this person. This research has led to many interesting discoveries, and given really is a whole new area of research.  

A 2007 study in the New England Journal of Medicine was one of the first of its kind. It has been shown that obese people who had friends and relatives were themselves more likely to be obese. 

Since then, additional research has studied how social networks influence the risk of developing the individual (or avoid) specific health conditions such as obesity, smoking and depression.

The results of these studies are sometimes surprising, giving valuable information to the new medical community. For example, I conducted a study in 2011 called me "The influence of social networks on patients' attitudes towards the type II diabetes." When I began this research, it is assumed that patients are less concerned about having diabetes, if several friends and family members had diabetes. 

I had imagined that these patients might have become so used to the idea that diabetes disease seems common and almost normal. But in fact, my team found the opposite! patients with a higher prevalence of diabetes within their social networks worried over their disease. This unexpected result gave me information that helped me take better care of my patients.

Using network data to improve the mental health of your child

This type of research is not only useful for doctors, but also provides important for anyone trying to improve their own health or that of informing the family of one. 

The study on the positive mood in the social networks of adolescents suggests that parents may be able to reduce their chances of developing adolescent depression - or improve your mood or depression if she has - just promote and support emotionally healthy friendships with their peers.

With much controversy over the use of antidepressants in adolescents, the results are, as they can give parents a simple way to promote the emotional health and well-being in their teens - no drugs involved.
By: Nandini Mani, MD

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Nutritional Psychiatry: Your Brain on Food

Nutritional Psychiatry: Your Brain on Food - Think of. Your brain is always "on". Watch your thoughts and movements, breathing and heartbeat, his senses - he works hard 24/7, even while you sleep.  

This means that your brain needs a constant supply of fuel. The "fuel" comes from the food you eat - and what is the fuel that makes all the difference. In short, what you eat directly affects the structure and function of the brain and ultimately your mood.
 
As a luxury car, your brain works better when the Premium fuel is achieved only. The consumption of high quality foods that contain lots of vitamins, minerals, and antioxidants nourishes and protects the brain against oxidative stress - the "waste" (free radicals) occurs when the body uses oxygen, which can damage cells.

Unfortunately, as a luxury car, the brain can be damaged in case of ingestion of premium fuel than anything. If fuel substances "low premium" (obtained from processed or refined foods) reach the brain, has little ability to get rid of them.  

Diets high in refined sugars, for example, are harmful to the brain. In addition to worsening insulin regulator also promote inflammation and oxidative stress. Multiple studies have found a correlation between a diet high in refined sugars and impaired brain function - and even worsening disorder mood symptoms such as depression.

That makes sense. If your brain is deprived of the quality of nutrition, or free radicals or harmful inflammatory cells circulating in the closed area of the brain, contributing to brain tissue damage, the consequences are to be expected. What is interesting is that, for many years, the medical field is not fully recognized the relationship between mood and food.

Today, fortunately, the growing field of nutritional psychiatry is to find that there are many consequences and correlations of not only what you eat, how you feel and how they behave in the end, but also the types of bacteria that live in your gut.

How the food you eat affects how you feel 

Serotonin is a neurotransmitter that helps regulate sleep and appetite, moods mediation, and inhibit pain. For about 95% of serotonin is produced in the gastrointestinal tract and the gastrointestinal tract is filled with a hundred billion nerve cells, or neurons, it is logical that the workings of your digestive system not only help digest food, but also guide their emotions. 

In addition, the function of these neurons - and the production of neurotransmitters such as serotonin - is strongly influenced by the billions of "good" bacteria that make up your gut microbiome. These bacteria play an essential role in your health.  

They protect the lining of the intestine and to ensure they provide a strong barrier against toxins and "bad" bacteria; the limited inflammation; improve the way you absorb nutrients from food; and activate the nerve paths traveling directly between the gut and brain.

Studies have shown that when people take supplements containing probiotics (good bacteria), their levels of anxiety, perceived stress, and improve mental outlook, compared to people not taking probiotics. 

Other studies have compared the "traditional" diets such as the Mediterranean diet and the traditional Japanese diet, a typical diet "Western" and showed that the risk of depression is 25% to 35% lower in those who eat a traditional diet. Scientists explain this difference because these traditional diets tend to be rich in vegetables, fruits, unprocessed grains and seafood, and contain only small amounts of lean meats and dairy products.  

They are also vacuum processed and refined foods and sugars, which are diet staples style "Western". In addition, many of these unprocessed food ferment, and thus act as natural probiotics. Fermentation using yeasts and bacteria to convert sugar in foodstuffs to carbon dioxide, lactic acid and alcohol. It is used to protect food from spoiling and can add a nice flavor and texture. 

This may seem unlikely, but the idea that the good bacteria not only influence what their intestinal digestion and absorbs, but also on the degree of inflammation throughout the body as well as their level of mood and energy, it gaining ground among scholars. The results so far have been pretty amazing.

What does this mean for you? 

Start paying attention to how you eat different foods makes you feel - not just in the moment, but the next day. Try eating a "clean" diet for two to three weeks - which means cutting out all processed foods and sugar.  

Add fermented foods like kimchi, miso, sauerkraut, pickles, food or Kombucha. You can also try going without milk - and some people even believe they feel better when their diets are not the point. See how it feels. Then slowly introduce foods into your diet, one by one, and see how it feels.When my patients "own will", who can not believe how good they feel both physically and emotionally, and how much worse then they feel when they enter the foods known to increase inflammation. Give it a try! 
By: Eva Selhub MD  

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Many infants and young children using mobile devices every day

Many infants and young children using mobile devices every day - This is probably no surprise to anyone who has paid attention to the world around them, but a study just published in the journal Pediatrics indicates that 44% of children under 1 using mobile devices every day. At the age of 2, which passes 77%.

At 4 years, half of the children in the study had their own TV - and three-quarters had their own mobile device. And it was not rich nor children; the study was conducted in low-income urban practice in Philadelphia.

When the researchers asked parents about the different situations in which they let their children use the devices, this is what they said:

   *  70% allow children to use for tasks they could do  
   *  65% use them to keep the child calm in a public place  
   *  58% have used them during the races  
   *  29% of them used to put their children to sleep
 
Now, as a parent, I see quite how to have a smartphone can make all the difference when you are unexpectedly trapped in a boring place with a child who must be calm and quiet. And it is quite possible that some of these children are doing on their devices educational activities that help them learn, or using Skype or Face Time with a friend or relative.

But again, this is worrying. Dr. Dimitri Christakis like, a pediatrician at the University of Washington to study the effect of media on young children, he said in a recent New York Times, "Children need more rounds of applications." We've all been in situations where people interact with their phones and not the other. Radesky Dr. Jenny did a study where we observed families in fast-food restaurants and an alarming number of parents was found to pay . more attention to your phone for your child's interaction with adults is essential for brain development of children -. and build strong relationships Interaction with devices simply can not replace. 

When my children were young, so we went wherever they might need to be calm and patient, who was always ready - with books, small toys, pencils and paper, and some games to play (I Spy, Guess what I am I thought, etc.) do not see too many parents who do. What I see is that parents give their children a tablet or smartphone.

Only time will tell what effect this will have on the children; we will need years to understand if and how it affects their brains and their relationships. While we wait, we must try to do what we know works well for both. So, parents - with the smartphone, pack of crayons. And keep in mind, before turning on the iPad, put your child on your lap and play I Spy.  
By: Claire McCarthy, MD 

 

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Healing through Music

Healing through Music - The last time I had a mammogram, I have a big surprise - and it was good.  

A string quartet played just outside the gates of breast imaging center, and immediately changed my thoughts "What will they find mammography?" A "Do Schubert or Beethoven?" For when my name was called, he had almost forgotten why I'm here.

The concert was an unexpected work Chartrand and Holly Lorrie Kubicek, therapists and co-coordinator of the Environmental Music in Massachusetts General Hospital. But bring music into hospital rooms is a complementary activity for music therapists. Most of his time is devoted to the use of music to help patients to achieve specific objectives, such as the recovery of their speech after a stroke and reduce the stress of chemotherapy.

Chartrand is a singer and a graduate of the Berklee College of Music. He decided to become a therapist to music when he realized he could use music to help others as he had supported all his life. "The favorite part of my job is to see how big an impact music can have on someone who is not feeling well," she said.

What is music therapy?

Music therapy is a growing field. These certificates are therapists are accomplished musicians who have a deep understanding of how music can evoke emotional responses to relax or stimulate people, or help them heal. Combine this knowledge with his familiarity with a wide variety of musical styles to find the specific type that you can get through a difficult physical rehabilitation session or will guide you in meditation. And they can find their favorite music style, or electro pop and grand opera.

Music therapists know few limits. They can play music for you or with you, or even teach you how to play an instrument. On any given day, the tank can Chartrand carrying a drum, a ukulele or iPad and speakers in the room of a patient. "Technology gives us both access to all types of music that can find and read almost any type of music you like," she said.

Proof of music therapy

A growing body of research shows that music therapy is most appreciated. It can improve the performance and quality of life health in a variety of ways. Here is an example:

Improved invasive procedures. In controlled clinical trials of people with colonoscopies, cardiac angiography and knee surgery, listening to music before your procedure had reduced anxiety and a reduced need for sedatives. Those who listened to music in the operating room reported less discomfort during the procedure. Listening to music in the recovery room under the use of opioid analgesics.

Restore lost his speech. Music therapy can help people who are recovering from a stroke or head trauma that damaged the left area of ​​the brain responsible for speech. Because singing ability comes from the right side of the brain, people can avoid the injury on the left side of his brain thought of singing first and then gradually release the melody.  

Former Congresswoman Gabby Giffords uses this technique so that you can testify before a congressional committee two years after a gunshot wound in his brain destroyed his ability to speak.

Reducing side effects of cancer therapy. Music reduces anxiety associated with chemotherapy and radiotherapy. You can also relieve nausea and vomiting in patients receiving chemotherapy.

AIDS pain relief. Music therapy has been tested on patients from those suffering from severe acute pain in people with chronic pain of arthritis. In general, music therapy reduces the perception of pain, reduces the amount of necessary drugs against pain, helps relieve depression, and gives people a greater sense of control over their pain. 

Improving the quality of life for dementia patients. Because of the ability to interact with the music it remains intact until the disease process, music therapy can help you remember the memories, reduce agitation, communication aid, and improve physical coordination.
 
How to find a music therapist

If you face a procedure or disease, or just want relief from stress of everyday life and helps to stick to an exercise program of a music therapist may be able to help. You can find one on the website of the American Music Therapy Association. 
By: Beverly Merz 
 

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Challenge your mind and body to hone their thinking skills

Challenge your mind and body to hone their thinking skills - My friend Betty is one of the most impressive elders that I met him. At 88, her voice is strong and his heart is young, and it seems to have so much energy and enthusiasm as he did in 1982 when I met her. It exercises, friends, gardens, to pay their own bills, follow the news, and is constantly reading and ask questions. How do you stay so strong? "I guess I'm just a curious person, boy," he laughs.

But living there how Betty - always learn new things, and keep busy with friends and favorite activities - is exactly what experts say can help keep our skills sharp thinking. "Cognitive and social commitment demonstrated a protective effect against cognitive decline, while the loss, depression and social isolation of hearing is associated with cognitive impairment," says Dr. Kathryn Papp, a neuropsychologist and professor of neurology at Harvard Medical School.

How it works?
Dr. Papp said he does not know the exact reasons for the mental and social engagement, protecting our thinking abilities, but we have some ideas. "Until the 1990s, we thought that people are born with however many brain cells die with now know that new cell growth. - A process called neurogenesis - occurs throughout life, even in Does old age, "says.

It turns out that the human brain has great potential for something called neuroplasticity, or in other words, being very malleable. It seems to challenge our brain - for example, by learning a new skill - leading to real changes in the adult brain. "You can create new connections between brain cells by altering the balance of neurotransmitters available and change how to make connections," says Dr. Papp.

Being socially engaged can help repel social isolation and depression, both of which have been linked to decreased cognitive functioning in the future. Having good social support also reduces stress, another thing that we know that this has a negative impact on thinking skills.

Other factors 
A healthy lifestyle is also associated with neurogenesis, including getting enough sleep, avoid overeating, and the big boss of all: exercise. "The researchers found that physical exercise leads to the release of cellular growth factors that are important to neurogenesis," says Dr. Papp.And this combination of growth and new brain cells factors that come from a healthy, stimulating the brain, and stay connected socially in a meaningful way can actually help protect the brain and keep it more resistant to changes that cause dementia.

Start your engine 
What is the best way to speed up your thinking skills? Start with mini-challenges for the brain:

 *   Brush your teeth with the hand not commonly used.
 *   Take a different route or shop work.
 *   Eat a piece or two dinner with eyes closed.
 *   Listen to a new type of music.
 *   Do jumps 60 seconds (or any physical activity).
 *   Sit in a different place in your home or at a favorite restaurant."This requires the brain to do a job because it clashes with something you have not experienced before," says Dr. Papp.

You can also search for activities that integrate brain stimulation, physical activity, and social commitment, such as:

*   learn to play a sport or game (tennis, table tennis, golf)
*   learn to dance (try the cha-cha, rumba and merengue)
*   take a class by planting flowers or vegetables
*   learning tai chi, which has been shown to increase thinking skills.

If physical activity is not possible, consider taking a class in

*   painting (watercolors start, then switch to oils)
*   piano, flute, guitar or
*   write stories (or memories)
*   Computers
*   flower arrangement
*   hosiery (useful for Christmas presents!)
*   a new language.

Or you can participate in any new activities that you find interesting, such as:

 *   Volunteer at a local charity
 *    explore a new city
 *    join a book club
 *    try a new restaurant or new types of foods
 *    become a museum of education
 *    helping at a local school or daycare
 *    join a club collector (Dolls, stamps, souvenirs). 

"The best activities are those that are nice," says Dr. Papp. And just as it is important to stick to a diet medications or exercise, should take a model to always learn, as my friend Betty, to reap the benefits. "I like to ask questions and hear the stories of people," he said. "I never want to stop learning."

She would have made a great reporter, that one. But I'm glad I can be the one to share the news flash here, which is that staying mentally sharp decline in the use of your brain and your body, whatever your age.
By: Heidi Godman

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