"Better together: Scotland's patient experience programme" works to use the public's experience of NHS Scotland to improve health services.  At the end of April they published provisional results for GP Practices throughout Scotland, and pilot results for a few initial hospitals are beginning to come through as well.  I find this fascinating, sobering, helpful stuff. 

Five of these six studies are from last month's American Journal of Psychiatry.  Kendler et al discuss the many similarities and only occasional differences between bereavement-related and other life event-related depression - an issue explored further in Maj's editorial.  Li et al show that depression in pregnancy (exacerbated further by stressful life events and obesity) increases the risk of preterm delivery.  Miklowitz reviews research on the value of adjunctive psychotherapy for bipolar disorder sufferers (already taking medication) and discusses the various ways it can be helpful.  Oquendo et al (in a freely viewable editorial) argue that suicidal behaviour should be placed on a "separate axis" in the next version of the DSM diagnostic system.  Finally Vertanen et al, in an interesting study, demonstrate that increased hospital overcrowding - measured by bed occupancy rates - is associated with increased use of antidepressants by hospital staff.

Kendler, K. S., J. Myers, et al. (2008). "Does Bereavement-Related Major Depression Differ From Major Depression Associated With Other Stressful Life Events?" Am J Psychiatry 165(11): 1449-1455.  [Abstract/Full Text]  

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]

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).