subtypes of alcoholism

June 30, 2007

New study shows five subtypes of alcoholics: young adult, young antisocial, functional, intermediate familial, chronic severe.  This seems to be getting a fair bit of media attention.

Here’s a 1983 study with six subtypes.  Here’s a 2006 review finding as many as four subtypes.  Here’s a 2004 study with four subtypes.  There’s also a type 1/type 2 distinction from 1988, and a type A/type B distinctions.  This is just from a quick google search and a non-exhaustive search on PubMed.

Ahistorical science news is pretty common – everything’s a big new finding, a new development, the first of its kind.  I’m not sure how much this has to do with science writers not having much background, how much it has to do with news not selling unless it’s new, and how much it has to do with the fact that if you don’t have to give people historical perspective it makes you able to do your job – writing stories people will want to read – much more efficiently.

I still wish that science news would come with more information on what this has to offer over similar previous findings, and more information on how those previous findings (for work with applied implications) were useful or not useful.  Is this really a shiny new finding, or just another variation?  That kind of thing.  (At least it’s not yet to the point where people are still reporting it as news months from now.)

I’m agnostic about whether this specific study in a shiny new finding or not – it may be a useful improvement on previous studies, it may not; I don’t know enough about that area of research to tell.   The point I want to make, though, is that a lot of science-related stuff hyped as news isn’t, and it often gets oversold because it’s presented without the research context.

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a peek into the future

June 29, 2007

I’m probably going to switch to posting longer, higher-quality stuff once a week or so, and post news stories or tidbits the other days of the week.  Attempting to do topics justice while still posting frequently doesn’t go so hot with a full-time job.  (I’m having a lot of fun, though.  Here and at the job.  But not, you know, too much fun.)

Here is a sampling of topics I’d like to write about at some point (not in any order).  If anyone votes for anything, I’ll bump it up in the schedule.  If anyone wants to propose a topic, I’ll drop it in the list as long as it’s vaguely appropriate.

  • medication for youth (this has a vote already)
  • antipsychotics for youth
  • worries about personality and perceptions of self with regards to medication
  • relapse rates in bipolar
  • kindling
  • violence rates/types (both by and against the mentally ill)
  • creativity and medication
  • firearms (second amendment, deaths by suicide)
  • transient mental disorders (like hysterical fugue, that was once popular and is now almost gone)
  • more on culture and mental disorders because I ❤ culture
  • evolutionary psychology/biology of mental disorders (because I ❤ evolution)
  • culture and evolution with regards to mental disorders (because I ❤ the interrelationship of culture and evolution more than almost any academic topic)
  • approaches to decreasing stigma and stereotypes
  • weird crap I find on the internet
  • multiple personality disorder, soulbonds, and theory of mind (i.e., lots of speculation)
  • otherkin, and fringe religious beliefs: I don’t believe you’re really an iridescent winged fox like you think you are, but I don’t think you’re mentally ill, either
  • these weird things you have to get differentially diagnosed with and that almost no one has (like cycloid psychosis and brief psychotic disorder): what the hell are they?
  • inaccuracies in science reporting
  • symptom clusters in unipolar depression: withdrawal vs. support-seeking
  • Munchausen’s (people faking disorders including mental illness for personal gain)
  • dumb things people say – not the standard dumb things like”depression means you’re weak” but new fun wacky stuff
  • Is schizoaffective disorder a form of schizophrenia, a form of bipolar, its own thing, or something else?
  • spectrum disorders, public perception, and identity politics
  • other identity politics stuff
  • legal stuff (I don’t know enough about this yet to break it down into subcategories)


misc

June 28, 2007

I was in the second of two all-day meetings today.  The first I got through by being actively interested plus taking adderall, but by today I was so tired of paying attention that the adderall wasn’t much help. (It doesn’t fix not wanting to pay attention, luckily; the first add medication I tried caused me to pay attention to everything anybody said no matter what even if I really wanted to think about something else.)  So tonight is Random Facts From Goodwin & Jamison (2007) Night, instead of semi-coherent post on something substantive night.

  • People first developing bipolar disorder are, on average, 22.2 years old.  In 1990 that figure was six years higher for studies with similar inclusion/exclusion criteria.  Why? They mention a couple hypotheses: more people are being diagnosed bipolar instead of schizophrenic (and psychotic features appear to show up earlier), and antidepressants and stimulants are kicking off episodes earlier than they would naturally have occurred.
  • A few entries from a long list of conditions and drugs reported to precipitate manic episodes: influenza, Syndenham’s chorea (movement disorder caused by infection), bromide (a sedative used in the late 19th and early 20th centuries), and Q fever.
  • Apparently lithium during pregnancy isn’t anywhere near as likely to lead to a heart defect as we used to believe.  (But you still shouldn’t breastfeed on it.)

Goodwin and Jamison

June 27, 2007

A book I’ve been mentioning (and will continue to use in my entries) is:

Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression by Frederick K. Goodwin and Kay Redfield Jamison (Hardcover – Mar 9, 2007)

If you like research on bipolar disorder and/or recurrent depression, this is the freaking awesomest book ever – a huge collection and summary of available research on every aspect, with commentary. If you like it enough to consider getting it, I encourage you to get it through the link above, which will benefit crazyboards, the support and education boards that I help moderate and that have helped me a whole hell of a lot.

If you can’t afford the price tag, you may be able to get it through inter-library loan. The current one is the second edition.


why bipolar ups suck more than people often think

June 27, 2007

Some terminology used for states in bipolar disorder:

mania: euphoria and/or irritability.  People who don’t know much about it sometimes think it’s the same thing as being extra-super-happy, and would like to have it.

hypomania: somewhat less euphoria and/or irritability.  People who don’t know much about it usually don’t know that it’s mania to a lesser degree, and therefore not as destructive, but if they did, they’d probably pick hypomania out as the fun mood state to be in, and pay more for this than mania.  (I’d sure pay a lot personally to trade out what I actually get for these happy, productive hypomanias.)

mixed state: a lot of people know something more about bipolar disorder aren’t familiar with this term.  It involves having symptoms of mania and depression at the same time.  Anybody who paid for this would want a refund.

dysphoric mania: Not a DSM term, and as far as I can tell, accounted for by the fact that even euphoric mania can suck, and the fact that mania with depression mixed in gets termed a mixed state.  Maybe someone will rescue it but I think this might be a red-headed stepchild.

depression: real depression (as opposed to fake-ass glamorous depression) is probably not worth much to anyone who isn’t in a mixed state.

First, mania and hypomania
I’m going to leave out all the objectively bad things for you that can happen during hypomania/mania – damaging relationships, losing jobs, spending yourself into debt, etc. – and instead concentrate on the subjective-type-stuff that happens during mania (data from table in Goodwin and Jamison):

percentage and symptom

76% flight of ideas / racing thoughts

75% Distractibility / poor concentration

29% confusion

54% delusions
29% persecutory/paranoid delusions

Hallucinations: 18% auditory, 12% visual, 15% olfactory

19% thought disorder

By definition you can’t get delusions or hallucinations in hypomania (if you do, it’s considered mania instead), but you can certainly get racing thoughts and crappy concentration (I don’t know how common confusion is, but I’ve seen the first two mentioned a lot).

I have no doubt that some people with bipolar disorder get the euphoric kind of mania without the subjectively unpleasant stuff, and that some get the euphoric kind of hypomania that is also useful and productive and doesn’t even screw up their life and people write books on it about how hypomania is great and how to prolong and maintain it.

But man, let’s have a little recognition of those of us who can barely read through a paragraph or write an email while we’re so pointlessly overenergized, and who can’t sleep or calm down or do anything because we can’t slow down or stop our speeding thoughts, etc.  All bipolar disorder sucks ass, but things suck especial ass when there’s a perception that there’s a good side for you that helps make up for the bad side, when it’s mostly just different kinds and degrees of painful.

And that’s mania and hypomania, the more positive side of bipolar disorder.  Later I’ll write about mixed states, which were what I actually wanted to write about, since there is some damn nifty research and theory on them.  And since they are also under-recognized, particularly popularly.


Social skills programs for children with autism largely ineffective (meta-analysis)

June 26, 2007

A meta-analysis of 55 published research studies found that social skills programs for autistic kids were poor overall, though better if the programs were held in the normal classroom setting rather than a pull-out one. They were more likely to use and to maintain the new skills, and more likely to use them in other settings. The researchers recommend greater amounts of programming, targeting programs towards kids’ skill deficits, and checking to see whether the program was actually carried out as designed.

No commentary on this one – just general surprise that they were found so solidly poor.


manic mice? and circadian rhythms

June 25, 2007

Manic mice

Mice engineered to lack a specific gene showed behaviors similar to human mania in a study funded in part by NIMH; they were hyperactive, slept less, appeared less depressed and anxious, and craved sugar, cocaine and pleasure stimulation. The rodents’ behavior was more normal after lithium treatment or restoration of a functioning CLOCK protein, which the knocked-out gene codes for.

The article says this is similar to human mania, and it sounds like it’s similar enough to tell us useful stuff, although the mice don’t sound bipolar, just, as they say, behaving similarly to some aspects of manic humans.

The CLOCK protein is involved in circadian rhythms. And so here is some interesting stuff on circadian rhythms in bipolar disorder, and on how lithium works, from one of my favorite bipolar disorder sites, Jim Phelps’ Psych Education. Lots of science, lots of high-level information that isn’t very widely spread, and an excellent site for info on bipolar II in general and on anxiety in bipolar.