Mike Nova's starred items
via Observations by Gary Stix on 5/2/12
Credit: JJ Hall/Wikimedia CommonsWhat prompted the apparent suicide is still unknown. But Seau’s taking of his own life will inevitably raise questions about a possible role of chronic traumatic encephalopathy (CTE), a disorder that results from repeated concussions and that can produce dementia and other forms of cognitive dysfunction.
The NFL has had to contend with a growing incidence of this disorder. Dave Duerson, an NFL safety, committed suicide in 2011 by shooting himself in the chest and directed that his brain be used for research on CTE. Any player in the NFL, and in other contact sports like hockey, probably leaves a long career with some traces of brain injury. But tests will be needed to determine whether Seau merited a clinical diagnosis.
No reports have emerged so far that Seau suffered from dementia-like symptoms. An SUV that Seau was driving in 2010 near his home in Oceanside, Calif., went over a cliff that fronted on a beach, according to The Los Angeles Times. The incident occurred following his arrest that year related to suspicion of domestic violence.
Seau, a 12-time NFL Pro linebacker following a career as an All-American at University of Southern California, registered 13 seasons with the San Diego Chargers, three seasons with the Miami Dolphins and ended his career with the New England Patriots.
See Scientific American’s In-Depth Report—The Science of Concussion and Brain Injury—and the article “The Collision Syndrome” (pay wall) from the February 2012 Scientific American for more on CTE.
via Observations by David Biello on 5/1/12
Banned for indoor use since 2001, the effects of the common insecticide known as chlorpyrifos can still be found in the brains of young children now approaching puberty. A new study used magnetic imaging to reveal that those children exposed to chlorpyrifos in the womb had persistent changes in their brains throughout childhood.The brains of 20 children exposed to higher levels of chlorpyrifos in their mother’s blood (as measured by serum from the umbilical cord) “looked different” compared to those exposed to lower levels of the chemical, says epidemiologist Virginia Rauh of the Mailman School of Public Health at Columbia University, who led the research published online by Proceedings of the National Academy of Sciences on April 30. “During brain development some type of disturbance took place.”
The 6 young boys and 14 little girls, whose mothers were exposed to chlorpyrifos when it was commonly used indoors in bug sprays prior to the ban, ranged in age from seven to nearly 10. All came from Dominican or African American families in the New York City region. Compared to 20 children from the same kinds of New York families who had relatively low levels of chlorpyrifos in umbilical cord blood, the 20 higher dose kids had protuberances in some regions of the cerebral cortex and thinning in other regions. “There were measurable volumetric changes in the cerebral cortex,” Rauh notes.
Though the study did not map specific disorders associated with any of these brain changes, the regions affected are associated with functions like attention, decision-making, language, impulse control and working memory. The “structural anomalies in the brain could be a mechanism, or explain why we found cognitive deficits in children” in previous studies, Rauh notes.
The findings echo similar results with animal studies of the insecticide, which remains widely used in agriculture to kill crop-spoiling insects. Rats exposed to the chemical also experience changes to the brain as well as altered behavior—all at doses below those considered safe by current federal guidelines from the U.S. Environmental Protection Agency (EPA). The change, at least for rats, is irreversible.
Previous studies have linked chlorpyrifos in children to everything from low birth weight to attention problems in both urban and agricultural exposures. And a low, but measurable, dose reaches yet other populations via food—a study that fed children a diet of organic food showed drops in the levels of chlorpyrifos and other organophosphate pesticides that then rebounded when they returned to their regular diet. The insecticide is used on everything from peaches to cilantro. “It’s the fruits and vegetables,” that can carry chlorpyrifos, Rauh notes.
Of course, it remains unclear what, if any, danger such doses pose but it is now apparent that chlorpyrifos exposure in the womb has impacts on brain structure that persist through childhood, at least. And the children in this study were exposed to lower levels of chlorpyrifos than found in a random sampling from a Cincinnati blood bank (which showed levels twice as high as those in the affected children). It also remains unclear whether the brain changes—some of which skew masculine or feminine brain characteristics—will have an impact in puberty. “Whether or not there would be any measurable effects is not clear,” Rauh says. “Hopefully, going forward, we’ll be able to answer some of those questions and determine whether the process of puberty or other aspects of sexual differentiation could be assessed.”
The good news is that washing fruits and vegetables can rinse away lingering chlorpyrifos and, presumably, mitigate any risk. In addition, although chlorpyrifos can persist in indoor environments, it breaks down relatively quickly when exposed to sunlight and other natural elements. And the EPA is now following up its prior ban on indoor use by re-evaluating its policy more broadly. “We have a lot of risky chemicals in our environment,” Rauh says. “We need to determine if the risk persists, if it is reversible and look at the larger regulatory picture for chemicals.”
As of now, however, the use of chlorpyrifos remains widespread in conventional agriculture. “Eating organic is a great idea, however, it is very expensive and out of reach for many average families,” such as the ones in this study, Rauh notes. It’s a “better idea to wash your apples. That would eliminate a whole variety of problems.”
Image: © iStockphoto.com / Federico Rostagno
via Observations by Katherine Harmon on 4/27/12
Image courtesy of iStockphoto/kali9Thus, for those who work in an industry where a simple error can lead to injury or death, missing out on sleep can be seriously dangerous. Moreover, according to a new survey, workers in industries with heavy equipment are among the least likely to be well rested.
A study of more than 15,000 employed U.S. adults shows that 30 percent of all workers reported getting fewer than six hours of sleep every day. That’s some 28.3 million workers who are operating (themselves and often machinery) with far less sleep than recommended. The findings were published online April 27 by the U.S. Centers for Disease Control and Prevention (CDC).
Night shift workers were, predictably, the most likely to be getting less z’s, with 44 percent—some 2.2 million people—getting fewer than six hours a day. (Trying to sleep during daylight hours can be a challenge because the body’s circadian rhythms are more likely to be sending stay-awake hormonal signals.)
Of people who work in transportation and warehousing on overnight shifts, almost 70 percent are getting fewer than six hours of sleep a day. This is of particular concern considering that at least one in five vehicle accidents is the result of a fatigued driver.
More than half (about 52 percent) of those working overnight in health care and other assistance industries reported fewer than six hours of sleep. Fatigue in the medical field has been shown to increase both errors and injuries. A 2007 study found that medical trainees who were sleep-deprived were three times as likely to accidentally stick themselves with a needle.
Other sectors that were likely to be getting little sleep (for any shift) were mining (at about 42 percent), utilities workers (at 38 percent) and manufacturing (about 34 percent).
“Short sleep duration is associated with various adverse health effects (e.g., cardiovascular disease or obesity), decreased workplace and public safety, and impaired job performance,” wrote the report authors, led by Sara Luckhaupt, of the CDC’s National Institute for Occupational Safety and Health.
Workplace safety might sound like the lame stuff of training videos and OSHA (Occupational Safety and Health Administration) posters. But in the U.S., thousands of workers still die from on-the-job injuries every year. And some 2.7 million workers had to go to the emergency room after sustaining an injury on the job in 2010 alone. Personal safety aside, these accidents are expensive. Fatal injuries on the job cost the U.S. some $6 billion annually, and nonfatal workplace injuries drain some $186 billion, according to the CDC. The agency points out that April 28 is the other Memorial Day: Workers Memorial Day, to recognize “those workers who have died or sustained work-related injuries or illnesses.” Presumably those insults are more substantial than the familiar paper cut.
Aside from individual attention to sleep habits and health, sleeping times can also be boosted by better policies. One way employers could help those with variable shifts, for example, is by “rotating workers forward from evening to night shifts rather than backward from night to evening shifts,” which “makes it easier for circadian rhythms to adjust so that workers can sleep during their rest times,” Luckhaupt noted.
And not everyone who is burning the midnight oil is missing out on sleep. Those who work nights in the “arts, entertainment and recreation” fields seem to be doing just fine sleeping in. Less than 10 percent of them reported getting fewer than six hours of sleep.
via Observations by Ferris Jabr on 5/3/12
I have this slim silver book on my desk called the “Quick Reference to the Diagnostic Criteria From DSM-IV-TR.” Page 153 reads:
Schizophrenia
A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):
(1) delusions
(2) hallucinations
(3) disorganized speech (e.g., frequent derailment or incoherence)
(4) grossly disorganized or catatonic behavior
(5) negative symptoms, i.e., affective flattening, alogia, or avolition
Throughout the book, similarly organized lists of symptoms follow the names of every officially recognized mental disorder—bipolar disorder, autistic disorder, generalized anxiety disorder and so on. My slim silver volume is an abridged version of the Diagnostic and Statistical Manual for Mental Disorders IV-TR (DSM-IV-TR), the most current edition of the standard reference guide for psychiatrists. It’s the book that many psychiatrists consult when deciding what ails their patients.
For the past 11 years, the American Psychiatric Association (APA), which publishes the DSM, has been working on a brand new version of the manual, the DSM-5 (no more Roman numerals, now that we have fully entered the age of digital publishing). Psychiatry’s new “bible” is slated for publication in May, 2013.
The APA has overhauled the DSM several times in the past—always a laborious and controversial process. This time, the association is doing things a little differently. Psychiatrists within and outside the APA have long criticized the revision process for its opacity. So the APA has made drafts of the new DSM-5 available on their website for public comment and has amended the drafts based on feedback from the psychiatrists, psychologists and the general public.
The latest drafts of the DSM-5 are now available online and open to comment for the next six weeks. Here are the most significant updates:
-The APA is no longer considering “Attenuated Psychosis Syndrome” as a new official disorder in the DSM-5. The proposed diagnosis was supposed to help identify children at risk for developing a psychotic disorder, but research has shown that 2/3 of children who qualify as “at risk” never progress to true psychosis.
-The APA is no longer considering “Mixed Anxiety Depressive Disorder” as a new official disorder in the DSM-5. Many psychiatrists worried that the new diagnosis was too vague and that too many people would qualify.
-The APA has added a footnote to the Major Depressive Disorder criteria “to clarify the difference between normal bereavement associated with a significant loss and a diagnosis of a mental disorder.” Previous changes to the depression criteria reframed grief that lasted longer than 2 months as a sign of depression, even if someone had recently lost a loved one—a mistake that drew intense criticism.
Over at Time magazine, Maia Szalavitz has a great discussion of the newest changes. She also points to Allen Frances’s critical analysis at Psychology Today.
This year, the APA is holding its annual meeting from May 5 to 9 in Philadelphia, where much of the discussion will focus on the drafts of the DSM-5 and the results of “Field Trials”—dry runs of the new diagnostic criteria in clinical settings. I am attending the conference to learn more and, next week, my colleague Ingrid Wickelgren at Scientific American MIND and I will bring you a series of blogs about the DSM-5 authored by ourselves and some well-known researchers and psychiatrists. For the duration of next week, we will also publish my feature article about DSM-5 in its entirety on our website. After next week, you can still read the feature in the May/June issue of MIND. Stay tuned!
Schizophrenia
A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):
(1) delusions
(2) hallucinations
(3) disorganized speech (e.g., frequent derailment or incoherence)
(4) grossly disorganized or catatonic behavior
(5) negative symptoms, i.e., affective flattening, alogia, or avolition
Throughout the book, similarly organized lists of symptoms follow the names of every officially recognized mental disorder—bipolar disorder, autistic disorder, generalized anxiety disorder and so on. My slim silver volume is an abridged version of the Diagnostic and Statistical Manual for Mental Disorders IV-TR (DSM-IV-TR), the most current edition of the standard reference guide for psychiatrists. It’s the book that many psychiatrists consult when deciding what ails their patients.
For the past 11 years, the American Psychiatric Association (APA), which publishes the DSM, has been working on a brand new version of the manual, the DSM-5 (no more Roman numerals, now that we have fully entered the age of digital publishing). Psychiatry’s new “bible” is slated for publication in May, 2013.
The APA has overhauled the DSM several times in the past—always a laborious and controversial process. This time, the association is doing things a little differently. Psychiatrists within and outside the APA have long criticized the revision process for its opacity. So the APA has made drafts of the new DSM-5 available on their website for public comment and has amended the drafts based on feedback from the psychiatrists, psychologists and the general public.
The latest drafts of the DSM-5 are now available online and open to comment for the next six weeks. Here are the most significant updates:
-The APA is no longer considering “Attenuated Psychosis Syndrome” as a new official disorder in the DSM-5. The proposed diagnosis was supposed to help identify children at risk for developing a psychotic disorder, but research has shown that 2/3 of children who qualify as “at risk” never progress to true psychosis.
-The APA is no longer considering “Mixed Anxiety Depressive Disorder” as a new official disorder in the DSM-5. Many psychiatrists worried that the new diagnosis was too vague and that too many people would qualify.
-The APA has added a footnote to the Major Depressive Disorder criteria “to clarify the difference between normal bereavement associated with a significant loss and a diagnosis of a mental disorder.” Previous changes to the depression criteria reframed grief that lasted longer than 2 months as a sign of depression, even if someone had recently lost a loved one—a mistake that drew intense criticism.
Over at Time magazine, Maia Szalavitz has a great discussion of the newest changes. She also points to Allen Frances’s critical analysis at Psychology Today.
This year, the APA is holding its annual meeting from May 5 to 9 in Philadelphia, where much of the discussion will focus on the drafts of the DSM-5 and the results of “Field Trials”—dry runs of the new diagnostic criteria in clinical settings. I am attending the conference to learn more and, next week, my colleague Ingrid Wickelgren at Scientific American MIND and I will bring you a series of blogs about the DSM-5 authored by ourselves and some well-known researchers and psychiatrists. For the duration of next week, we will also publish my feature article about DSM-5 in its entirety on our website. After next week, you can still read the feature in the May/June issue of MIND. Stay tuned!
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