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Saturday, June 30, 2007

Google storing online medical records?

Google has recruited big names to advise the company on health care. The rumour is that this could be the start of a new service. Google might be working on a way for people to store their medical records online, according to the Wall Street Journal health blog

Friday, June 29, 2007

Psychiatry and movies: David Helfgott, Genius reborn

I use scenes form movies very often when teaching medical students about psychiatry. The benefit of those scenes are that you can see psychiatric symptoms and patients in a very condensed form. Not all movies or scenes can be used. For instance it is hard to use "A beautiful mind" for teaching on Schizophrenia because you'll have to show a very long excerpt of the movie to make your point. Shine is also an example of a movie which you'll need to show at considerable length in order to show the students psychiatric disorder. There is even an entire website about Movies and Mental Illness.
With clear instructions some scenes can be used to demonstrate psychiatric symptoms. "As good as it gets" is one of my favorites. All ready in the beginning of the movie the first scenes paint a clear picture of someone with obsessive compulsive disorder (OCD). Showing "As good as it gets" during a lecture a student asked me if "The Aviator" is also about OCD. I hadn't seen that movie so I purchased the DVD. There are some scenes that clearly shows symptoms of OCD and as such can be used for instructing medical students about psychiatric symptoms. On the other hand seeing the movie also raises the question whether it is OCD or compulsions and obsessions as part of Schizophrenia and that is more difficult to show during a lecture. It requires to show a considerable part of the movie.
Now back to Shine. It is one of the most impelling movies of a psychiatric patient struggling with his illness and overcoming for a great deal his illness. He has also been treated with electro convulsive therapy which can be seen in a short scene. He is doing well these days. In this article in The Japan Times. He is doing a tour in Japan this year."I have tours of New Zealand and Europe this year and again two European tours in 2008, as well as concerts in Australia and Asia, so my itinerary is rather full," he says. "But then I enjoy playing very much. I just play and let the music tell the story."
Good for him
Not only movies but also television shows have psychiatric topics. For instance Brook Shields talking about her post partum depression with Oprah Winfrey. For another comment about psychiatry and movies or television have a look at this article from Lancaster Online: How the media looks at the mind.

Discussed movies:
"A beautiful mind"
"As good as it gets"
"The Aviator"

Thursday, June 28, 2007

Resources on treating depression from finding optimism

Finding optimism is a great blog. A lot of information about depression. I cannot beat that blog. The recent post is 94 resources on treating depression. An excellent collection of links. Also informative links about ECT with one of them I hadn't seen before. Another I did find a while ago

Wednesday, June 27, 2007

Association of Low Bone Mineral Density With Selective Serotonin Reuptake Inhibitor Use by Older Men

In my Google Reader it keeps coming up that elderly men and women have Low Bone Mineral density with Selective Serotonin Reuptake Inhibitor (SSRIs) Use. SSRIs are the most used antidepressants. Other antidepressants such as tricyclic antidepressants (TCAs) do not have this effect according to the abstract of this article in the Archives of Internal Medicine.
The problem is that depression also causes bone density loss, so is it due to the drug or the disease? Other antidepressants such as tricyclic antidepressants do not cause this diminishing of bone density, at least according to this article.Needs to be continued.

Tuesday, June 26, 2007

Med-Source, Blog for medical students

Although it is difficult to see how often this blog is updated it hosts a lot of information for medical students. For instance links to sites with free medical text books, useful websites and reference material.

Monday, June 25, 2007

AMA to Vote on Video Game Addiction

The American Medical Association’s is thinking about recommending the inclusion of “Internet/video game addiction” in the Diagnostic and Statistical Manual of Mental Disorders (a.k.a. DSM), the standard-setting catalog of mental illness.According to an article in the Wall street journal online.
Luckily the final decision will be up to the American Psychiatric Association, which oversees the DSM. To my opinion a lot of research has to be done to proof it even exists. Is there proof of withdrawal symptoms?
You might have guest this author plays a lot of games, on and offline.
Maybe we shlould make a poll which games are played by which medical specialism?

Shock Documentary The eye opening story about one of the most controversial medical treatments in history

The eye opening story about one of the most controversial medical treatments in history.
At this site from the publisher of the film you can view a trailer and buy the DVD. Through candid and intimate interviews with patients, doctors, and other experts, the film explores the myths, mysteries, and realities surrounding electroconvulsive therapy, a medical procedure used, most effectively, in treating severe clinical depression. ECT works by inducing seizures in a patient through electrical impulses to the brain. One of the interviewed is Kitty Dukakis, wife of the three-term Massachusetts governor Michael Dukakis.
I bought the DVD, will review it when I've seen it.

Sunday, June 24, 2007

Bipolar disorder and electroshock (ECT)

ECT for bipolar disorder is underused to my opinion. This article on is an excellent description of the use of ECT with bipolar disorder

Why do we blog, Fuel For Our Fire

A call for vistors to this nice blog to reveal there inspiration for blogging
I hope it grows fast!

Food and Depression, how healthy eating can help

Healthy eating and depression. A publication from the Mental Health Foundation, a UK charity for everyone's mental health. You can also read it online. Research in this area is still underway so it is not possible to draw any firm conclusions but the evidence does suggest that it is worth trying to follow a healthy diet in order to protect our mental health.

Friday, June 22, 2007

Beyond Blue

This is a non commercial website with practical information about depression

Beyondblue is a national, independent, not-for-profit organisation working to address issues associated with depression, anxiety and related substance misuse disorders in Australia. Beyondblue is a bipartisan initiative of the Australian, state and territory governments with a key goal of raising community awareness about depression and reducing stigma associated with the illness.

Shrink Rap: L.A. E.R. Tragedy . . . Emergency Mental Health Care

A busy day at work in the ER!
A busy day at work in the ER!,
originally uploaded by kelsana.

Shrink Rap: L.A. E.R. Tragedy . . . Emergency Mental Health Care If this is true, psychiatry in the USA is in a deplorable state.

Wednesday, June 20, 2007

Saturday, June 16, 2007

Sackeims letter to the editor about memory loss due to electroshock

Sure, ranomized controlled trials are better than naturalistic trials, but what we need is better memory tests, study other types of memory (everyday memory and semantic memory), longer follow-up and basic research to the question why some of the patients treated with ECT get memory deficits.
In his letter to the editor Prof Sackeim defends his findings of a naturalistic 7 centre trial to the side effects of ECT. He also used a biographical memory test. These tests are at the least not the best tests to examen retrograde amnesia. We should develop more specific and sensitive test for retrograde amnesia. Last month I made a post about better memory tests especially for retrograde anmesia. W're doing a trial with a new test with ECT for retrograde amnesia. Patients are still incuded in this trial.
Moreover as stated in his letter the impact on every day living of retrograde amnesia is still to be researched. Besides everyday memory, semantic memory is of interest.
Also most research on side effects of ECT have a short follow-up. Randomized controlled trials control for such things as late onset depression and the side effects but with longer follow-up w're able to look at the patients in which the depression is the first symptom of cognitive decline.
We now know a lot about dosage, electrode placement and cognitive side effects of ECT, but what we don't know yet is how do these side effects appear, where do they originate. How can we adapt our techniques and devices to lessen cognitive side effects. More important, which individual factors of the patient makes him more or less prone to these cognitive side effects.

Thursday, June 14, 2007

Dr Sackeims letter to the editor about memory loss due to electroshock

I read this interesting post on will comment on it as sson as possible. Now on vacation in Italy.

Monday, June 11, 2007

Yoga may help treat depression

According to this study and article Yoga may help treat depression and anxiety. Even some data on brain scans and evidence for changes in neurotransmittors after Yoga

Saturday, June 9, 2007

Science, gender and the emergence of depression in American psychiatry 1950-1980

This article by Laura D. Hirshbein is a clear description how depression became a specific disease category with concrete criteria. I thought depression was one of the most clearly described categories in human history. Depression was not a classification in the DSM I (1952). Depression as we know it today became only a diagnostic category in DSM III in 1980. There were certainly descriptions of melancholia in physicians writing throughout human history but the author states that depression as we know it is a twentieth-century phenomenon.
As a psychiatrist working on a depression unit I can most of the time clearly recognize depression. But many patient also present with depressive complaints which are clear depressions in terms of DSM IV criteria but differ from those patients in which a diagnosis of depression can't be missed at least to my opinion.
The author has strong arguments for this 20th century phenomenon.Depression became topic of research in the 1950's. In those days the inpatients mainly consisted of young women.The large number of women in clinical trials for depression in those days appeared to be a reflection of the hospital population of that time. Before the 50' in pre world war 2 period the inpatients of a psychiatric hospital were mainly older men.
In the develoment of DSM III, groups of researchers developed specific diagnostic criteria for depression. They looked at populations of patients in hospitals.Symptoms were counted and analyzed to see which best characterized depression.Patients with drugs or alcohol abuses were excluded as in medication trials. Researchers tested those criteria in hospitalized depressed women. The question whether women were depressed more than men was never raised. The connection between women and depression has been a closed circle. This article gives some food for thought.

Tuesday, June 5, 2007

Forgetting May Be Part of the Process of Remembering - New York Times

Forgetting May Be Part of the Process of Remembering - New York Times
Interesting article in Nature Neuroscience.
In all, this research suggests that memories are more often crowded out than lost. An ideal memory improvement program, Dr. Anderson said, “would include a course on how to impair your memory. Your head is full of a surprising number of things that you don’t need to know.”

Monday, June 4, 2007

Ugo Cerletti

Dr Shock is attending a symposium in Bolzano, Italy about ECT. On one of his days off he was hiking the mountains of the Dolomites in north eastern Italy were he met a 77 years old men Dr Ugo Bebetti. During a pranzo (lunch) in a lovely hotel in Bulla where they met, both on there way to the Alpe di Siusi he told Dr Shock about Dr Ugo Cerletti. The old man met Dr Cerletti during his resedency at the University of Rome.

Saturday, June 2, 2007

Is the dutch kidney reality show a hoax?

Kevin, M.D. posted a link to a press release about the dutch kidney show by the Dutch broadcasting company BNN. The founder of BNN had several kidney transplantations before he died. Read the comment whether it is a hoax or a serious problem in the Netherlands