Science and Research News - 2005 Archive

These reports are provided for your information and resource purposes only, but should not be taken that OCD-UK endorse the research findings or information within these pages.

 

Gene that controls 'fear' discovered

Scientists have discovered a gene that appears to control whether fear reactions to impending danger are appropriate or not.
Mice lacking the gene stathmin appeared fearless in conditions that should instinctively inspire fear.

The gene is present in particularly high levels in a part of the brain, called the amygdala, known to be important in human fear.

The US team told Cell their findings could shed light on anxiety disorders.

The same researchers from the Howard Hughes Medical Institute identified a similar gene a few years ago, called GPR that appeared to be important in the process of "learned fear".

This is where animals, including humans, learn over time that something is a threat or danger, as opposed to the instinctive fear which animals are born with.

GPR appeared to block the action of "circuitry" in the amygdala of the brain which learns fear.

Conversely, the newer gene discovered, stathmin, appears to help this circuitry.

Mice bred to lack stathmin showed abnormally low levels of anxiety in situations that would normally make a mouse very afraid, such as being in large open spaces - innate fear.

They also reacted less to learned fear.

In the study, this was a neutral tone that was played while the animals were delivered a mild electric shock.

The mice showed a decreased memory for the fearful situations and had difficulty recognising dangerous environments.

Their memory for things other than fear was not impaired, however.

Co-researcher Dr Gleb Shumyatsky, from Rutgers University Piscataway, New Jersey, said these mice could be used to study human phobias and anxiety-related disorders such as post-traumatic stress disorder.

"These animal models could be used to develop new anti-anxiety agents," he added.

He said that taken together, their work on genes and anxiety supported clinical data indicating that anxiety is a spectrum of disorders.

He said it was likely that each disorder would have a "unique molecular signature" and therefore require individually tailored drugs for treatment.

Professor Alexander Gardner, a clinical psychologist in Glasgow and member of the British Psychological Association, said: "There is already evidence that the amygdala is involved in fear.

"This is very interesting research indeed."

He said it was important for animals and humans to recognise and respond to fearful situations for survival.

However, he questioned whether fear could be truly innate.

For example, he argued that man was not naturally afraid of fire - man used it to be able to exist in colder climates - but we learn that it can be dangerous and therefore do fear it.

He suggested it might be that certain genes laid down a map in the brain for further acquisition of fear.

 

Web psychotherapy 'just as good'

Therapy delivered via the internet is just as good as face-to-face sessions for treating depression, say Swedish researchers.
Web-based programmes could help counteract the current shortage of skilled therapists, they say.

Cognitive behavioural therapy, the focus of the study, helps a person to change how they think and what they do to improve state of mind.

The research is published in the British Journal of Psychiatry.

In the study, 117 volunteers with mild to moderate depression participated in either a web-based self-help CBT programme plus an internet discussion group, or an internet discussion group alone.

The do-it-yourself CBT programme consisted of 89 pages of text divided into five modules that were estimated to take eight weeks to complete.

Overall, 37% of the patients withdrew from the programme - the main reason given was that it was "too demanding".

However, those that continued with the programme reported significant improvements to their psychological wellbeing.

The success of the web-based self-help programme was the same as that seen in past studies of face-to-face therapy, and was much more effective than the internet group therapy on its own.

The self-help programme resulted in decreased depressive symptoms immediately after treatment and at the six-month follow-up, the researchers found.

Lead researcher Professor Gerhard Andersson, from Linköping University, said: "Benefits were also observed regarding anxiety symptoms and quality of life.

"Self-help treatment of depression is an attractive treatment option."

He said such internet-based therapy options should be pursued further as a complement or alternative to conventional treatment methods.

Dr Peter Haywood, consultant clinical psychologist at the South London and Maudsley NHS Trust said: "Self-help materials can be extremely helpful. Obviously it will not work for everybody.

"There is a shortage of trained CBT therapists so this self-help approach might be useful for some people.

"There are some very well established self-help books that many people have found beneficial, so there are all kinds of ways self-help can be made available."

Richard Brook, chief executive of Mind, said: "Computer-delivered CBT is an important addition to the range of treatment options available for people experiencing depression.

"This method of delivery is useful for people who might not be able to access CBT easily because of their remote location, or for people who find it difficult to speak 'one-to-one' about their depression.

"With the current shortage of therapists, people can sometimes wait up to a year for treatment on the NHS.

"However, online CBT will not suit everyone. It should not be used as a reason to evade training enough therapists so that people experiencing mental health problems can access the treatments they need when they need them."

 

Medication Eases OCD Symptoms

A medication used to ease symptoms of amyotrophic lateral sclerosis, or Lou Gehrig's disease, also is helpful in treating people with treatment-resistant obsessive-compulsive disorder (OCD), according to a pilot study at the Yale School of Medicine.

Although the study included just 13 patients, the preliminary results showed promise for persons who have found no relief using other medications and cognitive behavioral therapy, said Vladimir Coric, MD, assistant clinical professor in the Department of Psychiatry and director of the Yale OCD clinic.

Coric and colleagues tested riluzole, a glutamate modulating agent, on patients with OCD. Glutamate is the most abundant excitatory neurotransmitter in the brain, but when in excess may cause neurotoxicity. Seven of the patients treated with riluzole experienced a 35-percent reduction in symptoms and five were categorized as responsive to the treatment. "Riluzole appears to have significant antiobsessional, antidepressant, and antianxiety properties," concluded Coric.

 

Seroxat Suicide Warnings

Further concerns have been raised about potential suicidal side effects of a commonly used antidepressant.
The drug Seroxat (paroxetine) is already banned from use by adolescents because of an increased risk of suicidal thoughts.

In Psychiatry, a Biomed Central journal, University of Oslo scientists said existing studies indicated these warnings should be extended to adults.

GlaxoSmithKline, which makes the drug, said it had helped millions.

Paroxetine is one in a class of drugs known as Selective Serotonin Re-uptake Inhibitors (SSRIs).

In 2003, around 19 million prescriptions for SSRIs were handed out in England for the treatment of depression and anxiety.

Concerns over suicidal side effects for those taking paroxetine were first raised by the BBC's Panorama programme in 2002.

Last year the Medicines and Healthcare products Regulatory Agency's (MHRA) Committee on Safety of Medicines concluded that a modest increase in the risk of suicidal thoughts and self-harm for SSRIs could not be ruled out, but the benefits for adults outweighed the risks.

The Norwegian researchers, whose study was triggered by a journalist from the Norwegian Broadcasting Corporation working on a medical information programme, analysed the results of 16 trials involving the drug.

The studies were presented to drug regulatory agencies in 1989, prior to the drug being licensed for use by doctors in the early 1990s.

In each, patients had either been given paroxetine or a placebo (dummy pill).

The researchers carried out a statistical analysis of all the results, taking into account the length of time patients were on the drugs.

The studies included 916 patients on paroxetine and 550 patients on placebo.

There were no actual suicides in any of the studies. However, there were seven suicide attempts in the group on paroxetine, and only one in the placebo group.

Writing in Biomed Central, the team led by Dr Ivor Aursenes, said: "Patients and doctors should be warned that the increased suicidal activity observed in children and adolescents taking certain antidepressant drugs may well be present also in adults.

"We also conclude that the recommendation of restrictions in the use of paroxetine in children and adolescents conveyed by regulatory agencies lately should include usage in adults."

A spokesman for GlaxoSmithKline: "We take the safety of all our medicines extremely seriously and will, of course, review this study carefully when it becomes available."

He added: "At this stage, it's not clear what method the researchers have used to arrive at these numbers or which clinical trials they have selected.

"However, we can say that these conclusions in no way reflect the picture that has been built up about the benefits and risks of paroxetine in adults through an extensive clinical trials programme involving 24,000 patients or through the use of this medicine in tens of millions of people around the world."

An MHRA spokeswoman said it kept the safety of all SSRIs under close review and all new evidence was carefully reviewed and considered to see if new advice was needed.

Sophie Corlett, director of policy at the mental health charity Mind, said: "This study would seem to be an extremely worrying addition to growing evidence raising serious concerns over the safety of paroxetine.

"It confirms what Mind service users have long been telling us anecdotally.

"By ignoring what mental health service users themselves have said about the medication and its effects, the drugs regulators may well have caused lives to be lost."

Margaret Edwards, of the mental health charity Sane, said: "Seventy per cent of those being treated with the new anti-depressants respond well, and the risks of suicide from untreated depression must be borne in mind in balancing the risks and benefits."

 

Antipsychotics Suppress OCD Symptoms Study

People suffering with obsessive-compulsive disorder (OCD) who do not respond adequately to antidepressant therapy may benefit from the addition of an antipsychotic agent, results of a study hint.

While antidepressants are commonly used to treat OCD, approximately half of patients do not respond to these drugs when used alone, study investigators explain in a report in the Journal of Clinical Psychiatry

Dr. Xiaohua Li, from the University of Alabama at Birmingham, and associates tested whether adding an antipsychotic might help these non-responders.

They had 12 patients with severe OCD on "stable-dose" antidepressant therapy add risperidone (1 milligram daily), haloperidol (2 milligrams daily) or placebo for 2 weeks each in a crossover fashion, with a 2-week placebo washout period between treatments.

Li and colleagues report that both antipsychotics led to a rapid and significant reduction in OCD behavior compared with placebo.

Considering that the patients had severe lingering OCD symptoms during antidepressant treatment only, "a significant reduction in obsession within 2 weeks of treatment initiation with each drug is notable," the authors comment.

Both drugs also significantly reduced anxiety among the patients and risperidone, but not haloperidol, also improved depressed mood and enhanced overall well-being, the authors report.

Five subjects discontinued haloperidol before the 2-week phase was complete due to side effects such as lethargy (sluggishness) or dystonia (prolonged, repetitive muscle contractions), whereas all of the participants completed the risperidone phase.

This study, say the authors, suggests that adding an antipsychotic to an antidepressant may be of benefit in OCD patients who do not respond to antidepressant therapy alone.

 

Throat Infection Tourette's Link

There is growing evidence that a common childhood throat infection increases the risk of neurological disorders such as Tourette's syndrome.
Scientists found children with such disorders were twice as likely to have had recent streptococcal infections than their healthy peers.

Researchers at Seattle's Center for Health Studies suggest the body's response to the infection may be key.

But they tell the journal Pediatrics that it is just one potential trigger.

OCD is more commonly associated with adults, but the researchers say it affects around 1 to 2% of school-age children - and transient tics can affect 10 to 25% of primary school age children.

Tourette's - a neurological disorder characterized by tics, involuntary vocalization, and, in some cases, the compulsive utterance of obscenities - affects around one in every 100 children to some degree.

Scientists had suspected there may be a link between the streptococcal infection and neurological disorders.

It has been suggested that the body's natural response to infection, where particular antibodies are produced and directed to parts of the brain, might be linked in some way to these disorders.

However, it is not clear why most of the millions of children who have bacterial throat infections each year do not develop such disorders.

The team from the Group Health Center for Health Studies in Seattle aimed to assess the strength of the link between strep infections and the incidence of neurological disorders.

They looked at 200 children aged four to 13 diagnosed with a neurological disorder between 1992 and 1999, and compared them with healthy children in the same age group.

Children with Tourette's, OCD or a tic disorder were more than twice as likely to have had at least one streptococcal infection in the three months before symptoms of their disease emerged.

And incidence of the disorders was more than three times as common among patients who had had two or more streptococcal infections in the year before the onset of their disease.

Dr Robert Davis, who led the study, said: "There are likely a number of different causes for these conditions, which often show up first in childhood or adolescence.

"Following a number of different leads from past research, we've found more tantalising clues about possible connections between childhood infections and certain disorders.

"However, our findings certainly don't suggest that there is any immediate need for a change in medical - or parental - practice."

He stressed that much more research was needed before advice could be given to parents and doctors in a bid to reduce the occurrence of childhood neurological disorders.

But he added: "Right now, this is all still in the research stage.

"We still don't know if treatment with common antibiotics helps prevent these neurological conditions that might follow strep throat, or reduce their severity, or shorten their duration if they do occur."

The researchers say a person's genes may play a critical role, with infection acting as a trigger.

The UK's Obsessive Compulsive Disorder Centre says streptococcal infection is one of several suggested causes for the condition, because of the potential damage caused by antibodies to neurotransmitters in the brain.

It adds: "Investigations into the impact of throat infection on the malfunctioning area of the brain identified with OCD are looking promising but are, as yet, inconclusive."

 

Pacemakers to Treat Depression

Scientists have succeeded in treating severe depression by fitting patients with brain pacemakers which shock neural circuits in the brain
The patients agreed to test the technique after conventional drug treatment failed to lift their depression. Of the six patients to be fitted with the device, four experienced a dramatic improvement. Another two underwent the procedure in recent months and their progress is being monitored.

The technique, called deep brain stimulation, was developed to treat tremors in people with Parkinson's disease.

But Helen Mayberg, a neurologist at Emory University's school of medicine in Atlanta, decided to test it on severely depressed people after identifying a region of the brain which became overactive in depressed people. The area, known as the subgenual cingulate region (SCR), was pinpointed from 10 years of brain scan images.
During the procedure, patients received a local anaesthetic before a hole the size of a five pence coin was bored into their skull. Two wires, each thinner than a human hair, were inserted into the brain deep enough to reach either side of the SCR, which lies just above eye level.

Because the patients were conscious throughout the procedure, they could tell the medical staff how different electric pulses made them feel.

According to Dr Mayberg, when the electrodes were in the right spot, patients often experienced a sudden improvement in their mood.

"Patients would say 'what did you just do? I suddenly have a sense of intense calm'," she said. "We had no reason to suspect there was a switch for depression we could turn off."

After finding the right position for the electrodes, the patients were given a general anaesthetic and a further operation to run the wires beneath the skin on the skull, down the neck and into a matchbox-sized pacemaker.

Dr Mayberg said the researchers had yet to fully understand why the technique worked, but believed that the shocks blocked the overactivity of the SCR, which in turn allowed normal activity to return to the rest of the brain.

Dr Mayberg said no detrimental side effects had been detected but the patients would have to be monitored for years to rule out any long term effects, such as whether the continuous pulses eventually damaged brain cells. David Nutt, the head of psychopharmacology at Bristol University said the technique could be used to treat about 5,000 of the most severely depressed people in Britain. "It is the most exciting new development in terms of the treatment of depression in 10 years," he said.

Other scientists believe the technique might be useful for treating obsessive compulsive disorder (OCD) which can lead to a spectrum of disruptive behaviour, including a constant urge to wash. Preliminary trials have had limited success in treating OCD but Naomi Fineburg, a psychiatrist at Queen Elizabeth II hospital in Welwyn Garden City, hopes to begin a British trial shortly with the University of Dundee.

 

Estrogen Affects Obsessive-Compulsive Disorder

Researchers say there may be a link between estrogen deficiency and obsessive-compulsive disorder obsessive-compulsive disorder (OCD) in men.

More than 3 million U.S. adults have OCD, says the National Institute of Mental Health. The disorder involves recurrent, unwanted thoughts or rituals such as counting, checking, cleaning, or washing the hands, which people feel they cannot control.

People with OCD can suffer intensely, but treatment is available. It's important to get help as soon as possible to improve quality of life.

OCD Behaviors Resolve With Estrogen The findings are based on experiments with lab mice, not people.

Some of the mice in the study had a normal set of genes. Others were bred not to make an enzyme called aromatase, which converts male sex hormones to the female sex hormone estrogen. Because the genetically altered mice couldn't make aromatase, they had less estrogen than normal mice.

The estrogen-deficient male mice stood out from the other mice in three ways:

They ran "excessively" on their running wheels. They spent twice as long grooming themselves after being misted with water, compared with the other male mice. They had lower levels of a brain chemical called COMT (catechol-O-methyl transferase).
The extreme grooming and running patterns are two indicators of OCD in mice, and low COMT levels have been found in obsessive-compulsive men, say the researchers.

Treatment with estrogen reversed the excessive running and grooming behavior as well as raised COMT levels.

Estrogen-deficient female mice did not show the same patterns. That provides "further evidence" that estrogen affects the brains of males and females differently, say the researchers.

 

Therapy better than meds for kids, teens with OCD

While both psychotherapy and medication can be effective for children and adolescents with obsessive-compulsive disorder, therapy may be the best choice, according to a review of studies on the topic.

Such non-drug treatment, specifically a process involving exposure and response prevention (ERP), is not as widely available as medication, but it appears to be associated with fewer residual symptoms, a team of Mayo Clinic researchers report.

"(ERP) is more effective in the short term and it lasts longer" than medication, stud Dr. Jonathan S. Abramowitz told Reuters Health. He explained that "ERP gives kids with OCD skills that no one can ever take away from them for life, whereas with medication they're relying on the pill."

Obsessive-compulsive disorder affects about 1 percent of all children and adolescents and up to 3 percent of adults. In fact, researchers have found that when symptoms go untreated during the early years they usually persist throughout adulthood.

The cause of the condition is unknown. Symptoms such as frequent handwashing and fear of germs or frequent checking (of locked doors, for example) and fear of mistakes or disasters can appear at any age, but are not usually recognized until around age 5.

Cognitive-behavioral therapy involving exposure and response prevention (ERP) is the preferred treatment for children and adolescents, according to 1997 Expert Consensus Guidelines, but few therapists are trained in its use.

Individuals treated with ERP are taught to face their fears by engaging in repeated and prolonged confrontation with whatever stimuli evokes their obsession, and refraining from responding with compulsive behavior.

For example, those who frequently wash their hands after opening doors -- because of their fear of germs would practice touching doorknobs without washing their hands afterwards. Or, those with an irrational fear of bad luck associated with the number 13 may repeatedly be taken to the 13th floor of a building.

Medication, on the other hand, most commonly serotonin reuptake inhibitors (SRIs) such as fluoxetine, is the more widely available treatment for OCD. Patients may experience relapse upon discontinuation of their medication, however, so SRI treatment is typically long-term.

Abramowitz and his colleagues reviewed 18 studies that examined either SRI or ERP treatment for patients aged 13 to 15 years who were diagnosed with obsessive-compulsive disorder. Patients treated with the ERP psychotherapy met daily or weekly and their treatment included parental assistance and homework.

In each study, after undergoing treatment for anywhere from 10 to 14 weeks, the teenagers reported substantial improvement in their OCD symptoms. Both ERP psychotherapy and the SRI medication were effective, but there were fewer residual symptoms among those treated with psychotherapy, the report indicates.

"If you roll the dice, you are more likely to have less symptoms after an ERP trial than after a medication trial," Abramowitz said.
He and his colleagues concluded that the results of their analysis their "generally support the clinical recommendations of the OCD Expert Consensus Guidelines that ERP is the first-line treatment approach for children and adolescents with this disorder."

ERP psychotherapy does not cure obsessive-compulsive disorder, however. Also, some parents may be reluctant to allow their children to undergo the difficult process involved in facing their fears, and even when they are willing to do so, they may find it much more difficult to locate an ERP specialist than it is to find a physician.

Thus, when ERP therapy is unavailable, refused, or does not have the intended effect, "SRIs represent a viable treatment strategy," Abramowitz and his team note.

What's the bottom line? "If you have OCD (or) if your kid has OCD, there's help," Abramowitz said.

 

 

Some Suspect OCD Link to Strep in Kids

Doctors Say Obsessive Compulsive Symptoms Can Appear After Strep Infection

What started out as a sore throat for Maury Cronauer two years ago developed into a frightening cascade of symptoms.

She began to exhibit bizarre behavior — blurting out disturbing thoughts, obsessively washing her hands until her skin was raw. Her parents were completely baffled — and frightened.

"When she would wake up in the morning we weren't sure what Maury we were going to get," said her mother, Michelle Cronauer.

A Surprising Diagnosis

Obsessive compulsive disorder afflicts millions of Americans, creating in them irrational fears and obsessions, such as fear of germs, fear of plastic utensils, or a constant need to wash one's hands.

It also affects approximately 1 percent of children, including Maury, now 6 years old.

What was most surprising to the Cronauers was that doctors linked Maury's obsessive compulsive behavior to a common ailment in children — strep throat.

The theory is not yet widely accepted in the medical community, but it has been gaining more support.

The likely relationship, which is the subject of a New York Times Magazine cover story this Sunday, has been coined PANDAS, or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.

While experts believe the condition is relatively rare — striking about one in 1,000 children — it could explain unusual symptoms in some kids following strep throat.

"We think that the strep causes obsessive compulsive disorder by creating antibodies that get mixed up and attack the child's own brain," said Dr. Susan Swedo of the National Institutes of Mental Health.

Antibiotic Treatment Helps Many

Dr. Christina Johns, an emergency room physician Children's National Medical Center in Washington, D.C., said doctors are seeing an association between strep and OCD in children but says that the link needs more study.

Johns said parents shouldn't panic but should be watchful if their child suffers from an infection and then begins exhibiting strange behavior.

"If you see your child taking more time getting ready for school or showing odd behavior, talk to your doctor," she said.

In the meantime, doctors say many children show marked improvement in OCD symptoms after antibiotic treatment.

Maury has been on antibiotics for two years now, and her obessive compulsive symptoms are gone.

Michelle Cronauer says the change is dramatic.

"We have our daughter back," she said. "She's always laughing, always playing."

 

 

Therapy Helps Children with Obsessive-Compulsive Disorder

Psychological treatment that teaches children to face their fears is the most effective treatment for pediatric obsessive-compulsive disorder (OCD), according to a new Mayo Clinic analysis of previously published research.

The treatment, a form of cognitive-behavioral therapy (CBT) called exposure and response prevention, produces almost twice as much benefit compared with medications used for childhood OCD, says Jonathan Abramowitz, Ph.D., Mayo Clinic psychologist and lead researcher on the study. The study is published in the spring issue of Behaviour Therapy, and is the first meta-analysis (a quantitative approach to combining the results of previous studies) to focus on children with OCD.

OCD is an anxiety disorder that affects about 1 percent of children and adolescents, and 2 to 3 percent of adults.

Just like adults with OCD, children with OCD are plagued with persistent, distressing and illogical fears. These obsessions, such as fear of dirt or germs, compel the child to perform repetitive behaviours, such as excessive hand washing. The obsession and compulsive Behaviour can interfere with school, friends and family life.

Dr. Abramowitz and his colleagues reviewed 18 studies on OCD treatment published from 1983 to 2004. The studies examined the effectiveness of CBT or medication therapy.

Both CBT and antidepressant medications such as fluoxetine (Prozac) and clomipramine (Anafranil) are considered standard treatment for OCD. And many children with OCD are able to benefit from either form of treatment, or their combination.

Dr. Abramowitz and his colleagues compared the results from 10 studies of CBT and 11 studies of medication treatment to determine whether either treatment has an advantage.

“Because very few studies have directly compared the effects of medication versus CBT for treating children, our results give parents and health care providers more insight as they choose treatment,” says Dr. Abramowitz.

Exposure and Response Prevention

In exposure and response prevention, children learn strategies to manage obsessional fears and compulsive urges by gradually facing their fears. For example, a child who is afraid of getting sick if she touches her shoe would practice touching her shoe without washing her hands. A youngster with a fear that the number 13 will cause bad luck might go to the 13th floor of a building to get exposure to this number. Exposure and response prevention teaches children how to reduce their fears and rituals by thinking and acting in more healthy ways. The children learn that their fears and rituals are unnecessary.

And treatment is short term. At the Mayo Clinic OCD program, treatment typically lasts from one to four months.

“Most importantly, the improvements that children make appear to last after therapy ends,” says Stephen Whiteside, Ph.D., Mayo Clinic child psychologist and coauthor of the study. “That’s because children learn skills in therapy that no one can ever take away from them.”

Not all families have access to this type of treatment. Dr.Whiteside notes that effective therapy requires a mental health care provider who has specific training or experience in exposure and response prevention therapy.

Medication Therapy

Medication therapy also reduces symptoms of obsessive-compulsive disorder, though doctors aren’t sure why. OCD symptoms usually return when children stop taking medication.

“Medication therapy is based on the idea that OCD has something to do with serotonin, which is a neurotransmitter,” says Dr. Abramowitz. “But experts remain unsure of exactly how medications work.” Also puzzling, the researchers noted a placebo effect. The analyses suggested that some children benefited from receiving a placebo instead of the real drug.

“The study supports clinical impressions that both antidepressant medication and exposure and response prevention therapy can reduce symptoms for children with OCD,” says Dr. Abramowitz. “But neither approach cures the disorder.”

Dr. Abramowitz says that more studies are needed to evaluate if the exposure and response prevention therapy could be used together, or in sequence with medication, to reduce symptoms more effectively.

 

Scientists reveal anxiety 'all in genes'

IT MAY provide the answer to why manic Basil Fawlty and dizzy singleton Bridget Jones let worries plague their lives.

Scientists at the European Molecular Biology Laboratory in Monterotondo, Italy, have found a key gene that can make patients prone to anxiety.

Researchers believe faults in the gene, which helps to produce the so-called ‘happy hormone’ serotonin, leaves sufferers more vulnerable to anxiety disorders.

Scientists now hope research into the gene will enable them to identify people most at risk. Dr Cornelius Gross, who led the research group, said:

"Such research is important as the knowledge could allow susceptible individuals to be identified early and provided with appropriate interventions.

"By intervention I mean mostly psychological intervention aimed at reducing the impact of adverse life events. This could be something as simple as making people aware of the increased risk, but could also include family counselling.

"In addition, the identification of genes involved in these diseases could suggest novel targets for the development of pharmacological therapies.

"Drugs, particularly in children, would only be a last resort and would have to be weighed up against their psychological and medical side-effects."

Gross’s research on mice has found specific mutations in a gene involved in synthesising serotonin can make them more anxious than normal. He believes faults in the gene, called Tph2, leave them more prone to the adverse effects of factors such as early family environment.

In both mice and humans, low levels of maternal care have been found to increase the risk of depression and anti-social behaviour. However, Gross found that those with the faulty Tph2 genes produced higher levels of anxiety when exposed to low levels of maternity care.

Also, the mice with the mutated gene showed severe anxiety with high levels of attention from their mothers.

Gross said: "The incidence of adverse early environment is extremely high and is associated with enormous social costs. Among those persons regularly visiting hospitals for chronic disorders, a large fraction report early adverse childhood events, suggesting that such persons account for an excessively large part of society's medical burden.

"If this is the case, then even a small intervention could have a significant economic benefit, not to mention social benefits."

Experts estimate that as much as 4% of the population suffer from generalised anxiety disorders. Often the condition can lead to panic attacks, depression, obsessive compulsive disorders and even physical problems like headaches, trembling and sleep loss.

Hollywood director Woody Allen is famous for his portrayal of neurotic and angst-ridden men in his films like Annie Hall and Manhattan. The bespectacled actor has said he used his films as a distraction from his own problems. "My whole life I am constantly fighting all kinds of depression and terror and anxiety and I find that, like a mental patient in an institution, if they keep the patient busy finger-painting then they are more relaxed," said Allen.

But research into the role that genes play may now help doctors target their therapies more accurately and even help vulnerable people before they develop symptoms.

Dr Andrew McCulloch, chief executive of the Mental Health Foundation, says: "Around one in ten will experience severe anxiety at some point.

Phobias, panic attacks and obsessive compulsive disorder are caused by abnormal levels of anxiety and can be debilitating.

"It can be very distressing but there is lots of help available. Knowing if someone is vulnerable could enable people to help themselves with regular exercise or following a healthy diet.

"Exercise triggers brain chemicals that improves mood and distracts people from their worries while eating healthily and cutting down on caffeine and alcohol will help lower anxiety levels."

Dr David Balfour, a psychologist at Dundee University, said researchers had long suspected genes might play a role in disorders like anxiety, but few have ever been identified.

He said: "There are a range of different genes involved in the serotonin pathway. The argument seems to be during early development these parts of the pathway are still developing too right into adolescence.

 

Morphine May Help Treatment Resistant Sufferers

For people with obsessive-compulsive disorder (OCD) who have not been helped by standard drug treatments, a weekly dose of oral morphine may ease their symptoms, according to a small pilot study.

The newer class of antidepressants known as SRIs is approved for treating OCD, but up to 40 percent of patients fail to respond to two or more of these drugs, Dr. Lorrin M. Koran and his associates explain in the Journal of Clinical Psychiatry.

Quite why morphine can be effective is not known, but other small studies have suggested a role for drugs that interact with opioid receptors because there is a high concentration of opioid receptors in an area of the brain thought to be involved in OCD.

For their trial, Koran's group enrolled 23 subjects with OCD who had tried anywhere from two to six different SRIs. The participants were assigned to once-weekly oral morphine, the anti-anxiety drug lorazepam, or an inactive placebo, in random order for two weeks each.

Average scores on a standard OCD scale declined from 29 to 25 while the subjects were taking morphine, and to 27 in the lorazepam phase.

Seven of the 23 subjects were deemed to be responders to morphine based on score decreases of 25 percent or more. There were four subjects who responded to lorazepam.

Among those responding to morphine, the most noticeable effect began the day after taking the drug and lasted for two to five days. These individuals reported decreased frequency and persistence of obsessions and anxiety, as well as an increased ability to resist their compulsions.

The researchers saw no euphoric effects from taking the drugs -- although one subject later admitted to having abused hydrocodone for several years, which he said reduced his OCD symptoms.

"The response seen, its rapidity, and the relative tolerability of the treatment are encouraging and warrant larger and longer term studies" of morphine or other opiate drugs for treatment-resistant OCD, the team concludes.

Those with Obsessive-Compulsive behaviours at higher risk for developing an eating disorder

 

Dietary Supplement Research

A researcher at the Nathan Kline Institute for Psychiatric Research has been awarded a grant for an experiment to see if a dietary supplement can help treat symptoms of obsessive-compulsive disorder.

Dr. William Greenberg, a psychiatrist who serves as the director of outpatient research at the state-run research institute in Orangeburg, was awarded $30,000 from the OC Foundation, a nonprofit organization based in New Haven, Conn.

"We don't know exactly what the problem is that causes people to have obsessive-compulsive disorder," Greenberg said. "But there are a couple of hints."

One of the hints has led him to explore the role that glycine, an amino acid found in many foods, may play in reducing OCD's symptoms.

Researchers already know that the disorder, a condition in which people are gripped by irrational obsession that leads them to perform rituals such as excessive hand-washing to get rid of anxiety, is caused by a misfiring of neurotransmitters in the brain.

Greenberg and other scientists are especially interested in the role played by glutamate, a major brain neurotransmitter.

In the research study that he is conducting at the Kline Institute, Greenberg will give high doses of a powdered form of glycine half of the participants to see if it has an effect on their symptoms.

People who take part in the study will still take their regular medication while participating.

Obsessive-compulsive disorder is often treated by behavioural therapy or antidepressants.

"The current treatment for OCD leaves a lot of room for improvement," said Greenberg, who has a private psychiatric practice in Ridgewood, N.J. He is also president of the New Jersey Psychiatric Association.

One person in 50 suffers from some form of the disorder, scientists estimate.

"OCD takes a terrible toll on people," Greenberg said. "A lot of people still suffer from symptoms no matter how high a dose of antidepressants they take."

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