This blog post is also downloadable as a Word format handout. 

The June edition of the journal "Clinical psychology: science and practice"  focused on bipolar disorder.  This is very valuable and the fact that all the articles are freely viewable in full text makes the publication even more helpful.  As Youngstrom & Kendall write in their introductory article (see below) "Knowledge about bipolar disorder is rapidly advancing. One consequence is that current evidence about the diagnostic definitions, prevalence, phenomenology, associated features and underlying processes, risk factors and predictors, and assessment or treatment strategies for bipolar disorder is often markedly different than the conventional wisdom reflected even in recent textbooks and clinical training."  Karam & Fayyad (see below for all articles mentioned, with abstracts and links) discuss diagnosis and the boundaries of the bipolar spectrum.  Merikangas & Pato review recent research on bipolar epidemiology and write "During the past decade, there has been increasing recognition of the dramatic personal and societal impact of bipolar disorder I and II (DSM-IV).

Here are five papers on difficulties experienced by adolescents.  A couple of the papers are follow-up studies.  Colman et al looked at the multiple negative personal & relationship outcomes in a UK national cohort of adolescents with conduct problems followed over 40 years.  Wentz et al studied the somewhat more encouraging 18 year outcomes of a group of adolescents suffering from anorexia. 

A couple of the papers are about depression.  Kennard and colleagues report again on the well-known Treatment for Adolescents with Depression Study (TADS) comparing antidepressants, cognitive-behavioural therapy and combined treatment.  By about six months there was little difference between the three forms of treatment.  At nine months the remission rate for intent-to-treat cases was 60% overall.  Primack et al investigated the association between electronic media use in adolescence and subsequent depression in young adulthood.  They reported "Controlling for all covariates including baseline Center for Epidemiologic Studies-Depression Scale score, those reporting more television use had significantly greater odds of developing depression."

Here are a couple of studies on the prevalence of depression and anxiety, and four on risk factors for depression, bipolar disorder and suicide.  Strine et al report on a major survey of depression and anxiety in the United States.  They found "The overall prevalence of current depressive symptoms was 8.7% (range by state and territory, 5.3%-13.7%); of a lifetime diagnosis of depression, 15.7% (range, 6.8%-21.3%); and of a lifetime diagnosis of anxiety, 11.3% (range, 5.4%-17.2%)."  Smoking, lack of exercise, and excessive drinking were all associated with increased likelihood of mental disorders, as too was physical ill health.  Young et al, in a separate study, looked at the likelihood of depression and anxiety becoming persistent.  They estimated - at nearly 3 year follow-up - that the US prevalence of persistent depressive or anxiety disorder was 4.7%.  Only about a quarter of these sufferers were using appropriate medication and only about a fifth appropriate counselling.

Last month's BMJ published another in the long line of research articles that highlight the huge importance of lifestyle choices for our health:

Dam, R. M. v., T. Li, et al. (2008). "Combined impact of lifestyle factors on mortality: prospective cohort study in US women." BMJ 337(sep16_2): a1440-  [Free Full Text]

Back in January I wrote a blog post entitle "Does a healthy lifestyle really make a difference? "   I highlighted that it makes a hell of a lot of a difference.  At around that time another major study was published that hammered this point home even more thoroughly and I've been meaning to mention it in a post ever since.  The recent publicity on poor fruit and veg intake in the UK population triggered me into looking the earlier study out. 

Bryant, R. A., J. Mastrodomenico, et al. (2008).

The young man sitting in front of me thought he was going mad.

In an earlier post (January 3, 08), I looked at how common sense isn’t common, at least for healthy behaviours. Only about 3% of the population are ticking all the right boxes for non-smoking, alcohol use, exercise, weight and diet. This is interesting and maybe surprising, but does it really matter much?

Common sense isn’t common, at least with healthy behaviours. The vast majority of us know that we should eat sensibly, be a reasonable weight, exercise regularly, not abuse alcohol, and avoid smoking. Do you know what percentage of people actually follow all this obvious advice? A survey (Reeves and Rafferty 2005) of over 153,000 US adults in 2000 found that only 3% ticked all four boxes when asked if they didn’t smoke, were a healthy weight (body mass index, calculated as weight in kilograms divided by square of height in meters, 18.5 to 25.0), consumed 5 or more portions of fruit and vegetables daily, and exercised in leisure time for at least 30 minutes, 5 or more times per week (this includes brisk walking).