Tag: Mood Disorders

Misophonia: Quirk of Human Behaviour or Mental Health Condition?

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Introduction

By analogy with misogyny and misanthropy, misophonia ought to mean hatred of noise.

In fact, it is a recent coinage used to label the phenomenon of strong aversive reactions to sounds originating in other people’s oral or nasal cavities, such as chewing, sniffing, slurping, and lip smacking.

A report of a large series of cases seen in the Netherlands suggests that misophonia is well on its way to becoming a new psychiatric disorder (see below) (Jager et al., 2020).

Some commentators have expressed concern at the creeping medicalisation of quirks of human behaviour (BMJ, 2020).

What is Misophonia?

  • It is also known as Selective Sound Sensitivity Syndrome.
  • Misophonia is a disorder in which certain sounds trigger emotional or physiological responses that some might perceive as unreasonable given the circumstance.
  • Those who have misophonia might describe it as when a sound “drives you crazy.”
  • Their reactions can range from anger and annoyance to panic and the need to flee.

Research Paper Title

Misophonia: Phenomenology, comorbidity and demographics in a large sample.

Objective

Analyse a large sample with detailed clinical data of misophonia subjects in order to determine the psychiatric, somatic and psychological nature of the condition.

Methods

This observational study of 779 subjects with suspected misophonia was conducted from January 2013 to May 2017 at the outpatient-clinic of the Amsterdam University Medical Centres, location AMC, the Netherlands. The researchers examined DSM-IV diagnoses, results of somatic examination (general screening and hearing tests), and 17 psychological questionnaires (e.g. SCL-90-R, WHOQoL).

Results

The diagnosis of misophonia was confirmed in 575 of 779 referred subjects (74%). In the sample of misophonia subjects (mean age, 34.17 [SD = 12.22] years; 399 women [69%]), 148 (26%) subjects had comorbid traits of obsessive-compulsive personality disorder, 58 (10%) mood disorders, 31 (5%) attention-deficit (hyperactivity) disorder, and 14 (3%) autism spectrum conditions. 2% reported tinnitus and 1% hyperacusis. In a random subgroup of 109 subjects the researchers performed audiometry, and found unilateral hearing loss in 3 of them (3%). Clinical neurological examination and additional blood test showed no abnormalities. Psychological tests revealed perfectionism (97% CPQ>25) and neuroticism (stanine 7 NEO-PI-R). Quality of life was heavily impaired and associated with misophonia severity (rs (184) = -.34 p = < .001, p = < .001).

Limitations

This was a single site study, leading to possible selection–and confirmation bias, since AMC-criteria were used.

Conclusions

This study with 575 subjects is the largest misophonia sample ever described.

Based on these results the researchers propose a set of revised criteria useful to diagnose misophonia as a psychiatric disorder.

References

BMJ 2020;369:m1843.

Jager, I., de Koning, P., Bost, T., Denys, D. & Vulink, N. (2020) Misophonia: Phenomenology, comorbidity and demographics in a large sample. PloS One. https://doi.org/10.1371/journal.pone.0231390.

Book: Raising Generation Rx

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Book Title:

Raising Generation Rx – Mothering Kids with Invisible Disabilities in an Age of Inequality.

Author(s): Linda M. Blum.

Year: 2015.

Edition: First (1ed).

Publisher: American Psychiatric Association Publishing.

Type(s): Hardcover, Paperback and Kindle.

Synopsis:

Recent years have seen an explosion in the number of children diagnosed with “invisible disabilities” such as ADHD, mood and conduct disorders, and high-functioning autism spectrum disorders. Whether they are viewed as biological problems in brain wiring or as results of the increasing medicalisation of childhood, the burden of dealing with the day-to-day trials and complex medical and educational decisions falls almost entirely on mothers. Yet few ask how these mothers make sense of their children’s troubles, and to what extent they feel responsibility or blame. Raising Generation Rx offers a groundbreaking study that situates mothers’ experiences within an age of neuroscientific breakthrough, a high-stakes knowledge-based economy, cutbacks in public services and decent jobs, and increased global competition and racialised class and gender inequality.

Through in-depth interviews, observations of parents’ meetings, and analyses of popular advice, Linda Blum examines the experiences of diverse mothers coping with the challenges of their children’s “invisible disabilities” in the face of daunting social, economic, and political realities. She reveals how mothers in widely varied households learn to advocate for their children in the dense bureaucracies of the educational and medical systems; wrestle with anguishing decisions about the use of psychoactive medications; and live with the inescapable blame and stigma in their communities.

What Impact does Motivational Dispositions have on Mood Symptoms & Emotional Regulation?

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Research Paper Title

Psychopathological Correlates and Emotion Regulation as Mediators of Approach and Avoidance Motivation in a Chinese Military Sample.

Background

Approach and avoidance motivation have been thoroughly studied in common mental disorders, which are prevalent in the military context.

Approach/avoidance motivational dispositions underlie emotion responses and are thought to influence emotion dysregulation.

However, studies on the mediating role of emotion regulation (ER) between motivational dispositions and mental disorders have been insufficient.

The researchers examined the psychopathological correlates of motivational dispositions and explored the mediating role of ER.

Methods

The Behavioural Inhibition System and Behavioural Activation System (BIS/BAS) scales and measures of mood disorders (depression, anxiety, OCD, and PTSD) were administered to a nonclinical sample of 3,146 Chinese military service members.

The Emotion Regulation Questionnaire for Army men (ERQ-A) (Chinese version) was used to measure ER styles.

They examined the reliability and construct validity of the BIS/BAS scales.

Approach/avoidance motivations were correlated with symptoms of mood disorders.

Mediation analysis was conducted to confirm the mediating role of ER between motivation and mood disorders.

Results

The results showed acceptable internal reliability and construct validity of the BIS/BAS scales. Gender (female), family status (single-parent family), and social relationships (having fewer good friends) were significant predictors of high BIS sensitivity.

More years of education, an older age, being an only child and being in a single-parent family all significantly predicted high BAS sensitivity.

The BIS/BAS scales were predictive of various DSM-V-based mental disorders (depression, anxiety, OCD, and PTSD).

Immersion exacerbated the impact of BAS/BIS sensitivities on depressive/PTSD symptoms, while reinterpretation and talking out alleviated the impact of BAS/BIS sensitivities on these symptoms.

Conclusions

Motivational dispositions have an impact on mood symptoms under specific conditions.

ER strategies (immersion, reinterpretation, and talking out) were shown to be partial mediators between approach/avoidance motivation and mood disorders.

These findings highlight the importance of ER in altering the impact of motivational dispositions on mood disorders and as a promising target of psychotherapies.

Reference

Wang, X., Zhang, R., Chen, X., Liu, K., Wang, L., Zhang, J., Liu, X. & Feng, Z. (2019) Psychopathological Correlates and Emotion Regulation as Mediators of Approach and Avoidance Motivation in a Chinese Military Sample. Frontiers in Psychiatry. 10:149. doi: 10.3389/fpsyt.2019.00149. eCollection 2019.

MedSupport: Patient Perceptions & Perceived Support

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Research Paper Title

Enabling patients to cope with psychotropic medication in mental health care: Evaluation and reports of the new inventory MedSupport.

Background

This cross sectional study examined patients’ perceptions of professional support regarding use of psychotropic medication in a specialist mental health care setting.

The aims were to evaluate reliability and validity of the MedSupport inventory, and investigate possible associations between MedSupport scores and patient characteristics.

Methods

A cross-sectional study was performed. The patients completed the MedSupport, a newly developed self-reported 6 item questionnaire on a Likert scale ranged 1 to 5 (1 = strongly disagree to 5 = strongly agree), and the Beliefs about Medicines Questionnaire.

Diagnosis and treatment information were obtained at the clinical visits and from patient records.

Among the 992 patients recruited, 567 patients (57%) used psychotropic medications, and 514 (91%) of these completed the MedSupport and were included in the study.

Results

The MedSupport showed an adequate internal consistency (Cronbach alpha.87; 95% CI.86-89) and a convergent validity toward the available variables.

The MedSupport mean score was 3.8 (standard deviation.9, median 3.8).

Increasing age and the experience of stronger needs for psychotropic medication were associated with perception of more support to cope with medication, whereas higher concern toward use of psychotropic medication was associated with perception of less support.

Patients diagnosed with behavioural and emotional disorders, onset in childhood and adolescence perceived more support than patients with Mood disorders.

Conclusions

The MedSupport inventory was suitable for assessing the patients’ perceived support from health care service regarding their medication.

Awareness of differences in patients’ perceptions might enable the service to provide special measures for patients who perceive insufficient medication support.

Reference

Drivenes, K., Vederhus, J.K., Haaland, V.Ø., Ruud, T., Hauge, Y.L., Regevik, H., Falk, R.S. & Tanum, L. (2020) Enabling patients to cope with psychotropic medication in mental health care: Evaluation and reports of the new inventory MedSupport. Medicine (Baltimore). 99(1):e18635. doi: 10.1097/MD.0000000000018635.

Do We Need to be Aware of Differences in Patients’ Perceptions of Medication Support?

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Research Paper Title

Enabling patients to cope with psychotropic medication in mental health care: Evaluation and reports of the new inventory MedSupport.

Background

This cross sectional study examined patients’ perceptions of professional support regarding use of psychotropic medication in a specialist mental health care setting.

The aims were to evaluate reliability and validity of the MedSupport inventory, and investigate possible associations between MedSupport scores and patient characteristics.

Methods

A cross-sectional study was performed.

The patients completed the MedSupport, a newly developed self-reported 6 item questionnaire on a Likert scale ranged 1 to 5 (1 = strongly disagree to 5 = strongly agree), and the Beliefs about Medicines Questionnaire.

Diagnosis and treatment information were obtained at the clinical visits and from patient records.

Among the 992 patients recruited, 567 patients (57%) used psychotropic medications, and 514 (91%) of these completed the MedSupport and were included in the study.

Results

The MedSupport showed an adequate internal consistency (Cronbach alpha.87; 95% CI.86-89) and a convergent validity toward the available variables.

The MedSupport mean score was 3.8 (standard deviation.9, median 3.8).

Increasing age and the experience of stronger needs for psychotropic medication were associated with perception of more support to cope with medication, whereas higher concern toward use of psychotropic medication was associated with perception of less support.

Patients diagnosed with behavioural and emotional disorders, onset in childhood and adolescence perceived more support than patients with Mood disorders.

Conclusions

The MedSupport inventory was suitable for assessing the patients’ perceived support from health care service regarding their medication.

Awareness of differences in patients’ perceptions might enable the service to provide special measures for patients who perceive insufficient medication support.

Reference

Drivenes, K., Vederhus, J.K., Haaland, V.Ø., Ruud, T., Hauge, Y.L., Regevik, H., Falk, R.S. & Tanum, L. (2020) Enabling patients to cope with psychotropic medication in mental health care: Evaluation and reports of the new inventory MedSupport. Medicine (Baltimore). 99(1):e18635. doi: 10.1097/MD.0000000000018635.

Linking Spatial Working Memory, Affective Disorders, & Mild Current Depression

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Research Paper Title

[Disorders of spatial working memory in affective disorders with mild current depression and their neurophysiological correlates].

Background

To assess spatial working memory disorders in patients with mild depressive disorders and determine their neurophysiological correlates.

Methods

Thirty patients (right-handed) with ICD-10 diagnosis Mood Disorders (F31.3, F32.0, F33.0, F34.1), aged 37±8 years, were examined before treatment. A control group included 30 mentally and somatically healthy individuals (32±7 years old). The study of spatial working memory was carried out using the Corsi Block-Tapping test. EEG was recorded and the values of the spectral power of theta, alpha and beta rhythms were analysed.

Results and Conclusions

A decrease in the level of working memory that was correlated with higher values of theta rhythm power in the frontal and occipital regions and alpha rhythm in the frontal cortex was observed in affective disorders with mild depressive symptoms.

Reference

Galkin, S.A., Peshkovskaya, A.G., Simutkin, G.G., Vasil’eva, S.N., Roshchina, O.V., Ivanova, S.A. & Bokhan, N.A. (2019) [Disorders of spatial working memory in affective disorders with mild current depression and their neurophysiological correlates]. (in Russian). Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova. 119(10):56-61. doi: 10.17116/jnevro201911910156.