Science and Research News

All the very latest OCD science and research news. 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.

 

Countryside Boost to Mental Health

As little as five minutes spent exercising in the countryside or parkland can boost mental health, researchers claim.

Scientists suggested a short walk, cycle, run or even gardening in green spaces can boost well-being.

The research by Dr Jo Barton and Professor Jules Pretty at Essex University showed that exercising in wilderness areas or near water tended to have the biggest impact on mental state. Other rural areas and city parks were also beneficial. Dr Barton said: “A walk a day should help to keep the doctor away – and help to save the country money. There is a large potential benefit to individuals, society and to the costs of the health service if all groups of people were to ‘self-medicate’ more with green exercise.”

The researchers are now calling for the development of specially designed green areas that can be used for therapy purposes. Their findings add to the growing body of evidence that green spaces can have a positive impact on people’s health.

Experts claim the combination of exercise and the sense of escape that being surrounded by nature and fresh air can bring, provides a psychological boost.

The greatest health changes were seen in the young and the mentally-ill, although all age and social groups benefited.

 

Mental Health Services Online

NHS Choices and the website Patient Opinion have come together in order to enable patients to give their feedback on mental health services.

The partnership between the Department of Health’s flagship website and Patient Opinion is due to be launched today by care services minister Phil Hope.

The DH said the partnership means service users, carers and their families will be able to share stories and leave feedback on care they receive via either NHS Choices or Patient Opinion.

Once a comment has been posted, staff at the trust will be notified and have the opportunity to respond to the feedback.

The DH said trusts would also be able to take any necessary action and that the partnership would help to drive up standards in mental health services.

Care services minister Phil Hope said: “Personalising services and making them more responsive to patients’ needs is at the very heart of our New Horizons strategy.

"So this partnership means every single trust in the country can see what they are doing well and what needs to be improved helping to drive up quality.”

Paul Hodgkin, chief executive of Patient Opinion, said the partnership meant more people would be able to help trusts provide the services users want and that making all the comments public would ensure greater accountability and give users an even stronger voice.

He added: “We are delighted NHS Choices asked up to team up with them. The simple fact is that the more mental health services listen and act on these stories, the better care will be.”

New Horizons is the government’s strategy to promote good mental health and well-being. The DH said NHS Choices is now the most popular health website in the UK, recording nearly 10m visits a month.

 

Landmark Review of Mental Health

The Medical Research Council (MRC) is calling for a rethink in strategic funding of mental health research following a major six-month review, published online and reported in The Lancet.

The review undertaken by the MRC to advise the Government’s Office for Strategic Coordination of Health Research (OSCHR), aims to address the huge mismatch between the social and economic burden of mental health diseases on our society and the lower levels of investment and progress in research.

The findings pick out priority areas, strengths and gaps in current research practice and focus on four key themes in mental health; severe mental illness (primarily psychosis); anxiety and depression (bipolar disorder is included in this theme); neurodevelopmental, learning and intellectual disabilities; and pathways to mental wellbeing.

Key recommendations to be addressed by the UK research community in the next 5-10 years set out the ambition to focus on the prevention of mental disorders based on better understanding of causes, risk levels and new approaches to early preventive measures; accelerate research and development to provide new, more effective treatments for mental illness and to expand the capacity for research in this area in the UK.

Professor Chris Kennard, Chair of the Medical Research Council’s Neurosciences and Mental Health Board said:

“We know it’s not easy to unravel the complex interplay of genetic, social and environmental influences that affect our mental wellbeing and lead to mental health disorders. More work must be done to translate current scientific advances in brain research to make progress in finding effective preventive, therapeutic and rehabilitative strategies. The UK is in a strong position to play a major role internationally in this area of research. With expertise already embedded in the UK and the increased research capacity we are proposing, we are well placed to achieve this. Mental health disorders are extremely common and have a devastating impact on individuals, their families and our society. We hope that additional funding for research resulting from our review will enable UK researchers to address these problems more effectively and reduce the burden of mental health disorders.”

Til Wykes, Director of the Mental Health Research Network and Professor of Clinical Psychology and Rehabilitation, Institute of Psychiatry, King’s College London said:

“I welcome this thoughtful analysis which shows where research can make a real contribution to the understanding, prevention and treatment of mental health problems across all ages. The report highlights the strengths of UK research and how we can answer the important questions raised by patients and their families.”

Poor mental health is common and disabling, affecting 16.7 million people in the UK at any one time and accounting for 15 per cent of all the disability due to disease. A mental health problem is now the most common reason for someone claiming Incapacity Benefit. It is estimated to cost at least £77 billion annually in England alone, and severe forms of mental illness are associated with social exclusion and deprivation.

MRC will be working with key funding agencies such as the Economic and Social Research Council (ESRC), the National Institute of Health Research (NIHR) and the Health Departments of the devolved administrations on approaches to take forward these recommendations.

 

Anti-Depressant Pregnancy Risk

Children born to women taking anti-depressants in early pregnancy have a small but important increased risk of heart defects, researchers say.

Exposure to anti-depressants in the womb caused problems in less than 1% of children. The authors say the overall risk is very low and women should speak to doctors before stopping their drugs.

Selective serotonin re-uptake inhibitors (SSRIs) are medicines commonly used for the treatment of depression and OCD. In 2005, the US Food and Drug Administration issued a warning about the SSRI paroxetine because of an increase in birth defects if it was taken during pregnancy.

Septal heart defects

This study looked at whether there was an association between SSRIs taken in the first trimester of pregnancy and malformations in over 400,000 children born in Denmark between 1996 and 2003. Maternal age and smoking were taken into account.

The defects found are known as septal heart defects where there is a problem with the wall that divides the left side of the heart from the right side. The researchers from Aarhus University in Denmark said these defects were 0.4% more prevalent in children of women who redeemed a prescription for an SSRI in the first trimester of pregnancy.

Two SSRIs, sertraline and citalopram, were associated with the problem. Two others, paroxetine and fluoxetine, were not.

A four-fold increase in septal heart defects was found if women were taking more than one SSRI. There were no other malformations associated with taking SSRIs.

The researchers say the absolute differences in heart defects were low. Septal heart defects occurred in 2,315 (0.5%) of unexposed children, 12 (0.9%) of SSRI exposed children and 4 (2.1%) of children exposed to more than one type of SSRI. They estimate that one child for every 246 children exposed was likely to suffer a heart defect. Lars Henning Pedersen, who led the research, said: "Treatment of depression during pregnancy balances the risk of the medicine with that of the depression, and we investigated only a part of the information needed to make evidence based decisions.
Even if SSRI use is causally related to septal heart defects, these heart defects might not necessarily require treatment and some might resolve spontaneously."

Professor Basky Thilaganathan, of the Royal College of Obstetrics and Gynaecology, said it was important to remember that many women who suffered depression could be treated without resorting to drugs.

He said: "All hospitals now have a dedicated doctor or liaison officer for women suffering psychiatric symptoms in pregnancy.

"This study shows a less than one in a 100 chance of getting a baby with a defect in the heart."

Cathy Ross, cardiac nurse at the British Heart Foundation (BHF), said: "Depression can be a debilitating condition.

"The benefits to the mother of taking SSRIs during pregnancy needs to be weighed up against the small increase in risk to the foetus."

Editor Note: OCD-UK will be publishing an advice booklet for pregnant women with OCD later in the year.

 

Bone Marrow Transplants Cure Mental Illness – in Mice

Scientists in the US claim to have used a bone marrow transplant to cure mental illness in a study that could have profound implications for patients with mental health problems.

Bone marrow transplants are routinely used to treat leukaemia and other life-threatening diseases, but have never been used to treat mental health problems.

The team, led by a Nobel prizewinning geneticist, found that experimental transplants in mice cured them of a disorder in which they groom themselves so excessively they develop bare patches of skin. The condition is similar to a disorder in which people pull their hair out, called Trichotillomania. “A lot of people are going to find it amazing,” said Mario Capecchi at the University of Utah, who won the Nobel prize for medicine in 2007 for his work on mouse genetics. “That’s the surprise: bone marrow can correct a behavioural defect.”

The team said their work is the first to reveal a direct link between a psychiatric disorder and faulty immune cells, which grow in bone marrow before moving to the brain to protect nerve cells from damage. Capecchi said the condition the animals develop is comparable to OCD, and could shed fresh light on the roots of the disorder.

“The recognition that many neuropsychiatric diseases have a direct connection to the immune system emphasises that we should be taking immune deficiencies associated with neuropsychiatric disease much more seriously,” Capecchi told the Guardian “We know a lot more about the immune system and how to treat immune deficiencies than we know about how our brain works and what the drugs used to treat neuropsychiatric disorders are doing,” he added.

The cost and health risks associated with bone marrow transplants are such that they would never be used to treat mental health problems in people, but the findings will inspire research into immune-based therapies for psychiatric disorders, according to scientists who were not involved with the work.

Naomi Fineberg, a consultant psychiatrist at Queen Elizabeth II Hospital in Welwyn Garden City, said the work was a major development. “This finding is clearly important in directing research in new directions for OCD and OCD-spectrum disorder treatments. Given the intransigence of OCD symptoms, and the fact that roughly one third of treated OCD patients fail to make a good recovery, new treatment directions in this field are sorely needed.”

In the study, Capecchi’s team bred mice that carried a mutation in a gene called Hoxb8 that causes faulty immune cells to grow in the bone marrow. Mice that carry the defective gene groom themselves too often and for too long, leaving them with bare patches and skin wounds.“This is immensely important and incredibly exciting. It’s definitely something people will want to follow up,” said Douglas Blackwood, professor of psychiatric genetics at Edinburgh University. “Current treatments for these kinds of conditions are not incredibly effective and there’s a massive need for alternatives.”

Other researchers were more cautious about the work. Paul Salkovskis, clinical director of the Maudsley Hospital Centre for Anxiety Disorders and Trauma in London, said it was impossible to draw strong conclusions about the role of the immune system in human mental illnesses from the study. “Excessive grooming in mice is not a good model for Obsessive-Compulsive Disorder in humans, a condition that can be treated effectively with cognitive behavioural therapy,” he said.

 

Hoarding Not OCD

New research conducted at the Institute of Psychiatry has shown that, in most cases, compulsive hoarding is not related to an underlying OCD.

Compulsive hoarding, the acquisition of and inability to discard a large number of possessions that appear to be useless and have no apparent value is a frequent (2-4% of the population) and serious problem for the sufferers and their families. In severe cases, it can lead to homelessness and even death from collapsing piles of clutter. Unfortunately, compulsive hoarders respond poorly to conventional treatments including medications and psychotherapy. Clarifying the diagnostic boundaries of compulsive hoarding is an important first step towards developing better treatments for this problem.

Hoarding behaviour has been described in a wide range of neurological and psychiatric disorders such as brain damage, dementia, autism or Prader-Willi syndrome to name a few, but has most often been associated with OCD. However, clinicians and researchers have long suspected that a large proportion of compulsive hoarders do not meet criteria for any organic or psychiatric disorder.

Researchers from the Institute of Psychiatry, led by Dr David Mataix-Cols (Psychobiology of Anxiety and Obsessive-Compulsive Disorders Group), interviewed 52 severe hoarders with no known organic or neurological disorder and found that approximately half did not meet diagnostic criteria for OCD. Crucially, even in those cases where severe hoarding coexisted with OCD, their hoarding behaviour was unrelated to traditional obsessional themes, such as fears of something bad happening. Most hoarders (regardless of whether they have OCD or not) said they find it difficult to discard their possessions because of their intrinsic value (‘I may need it one day’), they feel emotionally attached to the possessions or they feel safe around their possessions.

Interestingly, the study also identified a small group of hoarders (approx 10% of all studied hoarders) whose hoarding is clearly OCD-related and, characterized by the presence of specific OCD-like obsessions (e.g. ‘If I throw this object away, my father will die’) and the hoarding of unusual items (e.g rubbish, body products).

These results suggest that, in most but not all cases, compulsive hoarding is a separate syndrome from OCD and may explain these patients’ poor response to existing anti-obsessional treatments. The findings also have implications for the classification of OCD and compulsive hoarding in the DSM-V.

The paper ‘Compulsive Hoarding: OCD Symptom, Distinct Clinical Syndrome, or Both?’ (Pertusa A., Fullana M.A., Singh S., Alonso P., Menchón J.M., Mataix-Cols D.) has been published online ahead of print by the American Journal of Psychiatry and is scheduled to appear in the October print edition of the Journal.

The study was supported in part by a grant from the University of London Central Fund awarded to Dr. Mataix-Cols.

 

Scientists Probe Meditation Secrets

Scientists are beginning to uncover evidence that meditation has a tangible effect on the brain.

Sceptics argue that it is not a practical way to try to deal with the stresses of modern life. But the long years when adherents were unable to point to hard science to support their belief in the technique may finally be coming to an end.

When Carol Cattley's husband died it triggered a relapse of the depression which had not plagued her since she was a teenager. "I instantly felt as if I wanted to die," she said. "I couldn't think of what else to do."

Carol sought medical help and managed to control her depression with a combination of medication and a psychological treatment called Cognitive Behavioural Therapy (CBT).

However, she believes that a new, increasingly popular course called Mindfulness Based Cognitive Therapy (MBCT) - which primarily consists of meditation - brought about her full recovery. It is currently available in every county across the UK, and can be prescribed on the NHS.

One of the pioneers of MBCT is Professor Mark Williams, from the Department of Psychiatry at the University of Oxford. He helps to lead group courses which take place over a period of eight weeks. He describes the approach as 80% meditation, 20% cognitive therapy.

New perspective

He said: "It teaches a way of looking at problems, observing them clearly but not necessarily trying to fix them or solve them. It suggests to people that they begin to see all their thoughts as just thoughts, whether they are positive, negative or neutral."

MBCT is recommended for people who are not currently depressed, but who have had three or more bouts of depression in their lives. Trials suggest that the course reduces the likelihood of another attack of depression by over 50%. Professor Williams believes that more research is still needed. He said: "It is becoming enormously popular quite quickly and in many ways we now need to collect the evidence to check that it really is being effective."

However, in the meantime, meditation is being taken seriously as a means of tackling difficult and very modern challenges. Scientists are beginning to investigate how else meditation could be used, particularly for those at risk of suicide and people struggling with the effects of substance abuse.

What is meditation?

Meditation is difficult to define because it has so many different forms. Broadly, it can be described as a mental practice in which you focus your attention on a particular subject or object. It has historically been associated with religion, but it can also be secular, and exactly what you focus your attention on is largely a matter of personal choice. It may be a mantra (repeated word or phrase), breathing patterns, or simply an awareness of being alive.

Some of the more common forms of meditative practices include Buddhist Meditation, Mindfulness Meditation, Transcendental Meditation, and Zen Meditation.

The claims made for meditation range from increasing immunity, improving asthma and increasing fertility through to reducing the effects of aging.

Limited research

Research into the health claims made for meditation has limitations and few conclusions can be reached, partly because meditation is rarely isolated - it is often practiced alongside other lifestyle changes such as diet, or exercise, or as part of group therapy.

So should we dismiss it as quackery? Studies from the field of neuroscience suggest not. It is a new area of research, but indications are intriguing and suggest that meditation may have a measurable impact on the brain.

In Boston, Massachusetts, Dr Sara Lazar has used a technique called MRI scanning to analyse the brains of people who have been meditating for several years. She compared the brains of these experienced practitioners with people who had never meditated and found that there were differences in the thickness of certain areas of the brain's cortex, including areas involved in the processing of emotion. She is continuing research, but she believes that meditation had caused the brain to change physical shape.

Buddhist monks

In Madison, Wisconsin, Dr Richard Davidson has been carrying out studies on Buddhist monks for several years. His personal belief is that "by meditating, you can become happier, you can concentrate more effectively and you can change your brain in ways that support that."

In one study he observed the brains of a group of office workers before and after they undertook a course of meditation combined with stress reduction techniques. At the end of the course the participants' brains seemed to have altered in the way they functioned. They showed greater activity in the left-hand side - a characteristic which Davidson has previously linked to happiness and enthusiasm.

This idea that meditation could improve the wellbeing of everyone, even those not struggling with mental illness, is something that is exciting researchers. Professor Williams believes it has huge potential. "It involves dealing with expectations, with constantly judging ourselves - feeling we're not good enough," he said.

"And, that is something which is so widespread in our communities.

"All of these things are just thoughts. And, they will come up in meditation and learning to recognize what they are as thoughts, and let them go, can be enormously empowering for anybody."

There is, of course, a distinct possibility that this research will come to nothing and that interest in meditation will turn out to be a passing fad, but for now this ancient discipline is being taken seriously by scientists as a tool with potential to make each one of us happier and more content.

 

Brain pattern associated with genetic risk of OCD

Cambridge researchers have discovered that individuals with obsessive compulsive disorder (OCD) and their close family members have distinctive patterns in their brain structure. This is the first time that scientists have associated an anatomical trait with familial risk for the disorder.

These new findings, reported today in the journal Brain, could help predict whether individuals are at risk of developing OCD and lead to more accurate diagnosis of the disorder.

Obsessive compulsive disorder is a prevalent illness that affects 2–3 % of the population. OCD patients suffer from obsessions (unwanted, recurrent thoughts, concerns with themes of contamination and ‘germs’, the need to check household items in case of fire or burglary, the symmetrical order of objects or fears of harming oneself or others) as well as compulsions (repetitive behaviours related to the obsessions such as washing and carrying out household safety checks). These symptoms can consume the patient’s life, causing severe distress, alienation and anxiety.

OCD is known to run in families. However, the complex set of genes underlying this heritability and exactly how genes contribute to the illness are unknown. Such genes may pose a risk for OCD by influencing brain structure (e.g. the amount and location of grey matter in the brain) which in turn may impact upon an individual’s ability to perform mental tasks.

In order to explore this idea, the researchers used cognitive and brain measures to determine whether there are biological markers of genetic risk for developing OCD. Using magnetic resonance imaging (MRI), the Cambridge researchers captured pictures of OCD patients’ brains, as well as those of healthy close relatives (a sibling, parent or child) and a group of unrelated healthy people.

Participants also completed a computerised test that involved pressing a left or right button as quickly as possible when arrows appeared. When a beep noise sounded, volunteers had to attempt to stop their responses. This task objectively measured the ability to stop repetitive behaviours.

Both OCD patients and their close relatives fared worse on the computer task than the control group. This was associated with decreases of grey matter in brain regions important in suppressing responses and habits.

Lara Menzies, in the Brain Mapping Unit at the University of Cambridge, explains, “Impaired brain function in the areas of the brain associated with stopping motor responses may contribute to the compulsive and repetitive behaviours that are characteristic of OCD. These brain changes appear to run in families and may represent a genetic risk factor for developing the condition. The current diagnosis of OCD available to psychiatrists is subjective and therefore knowledge of the underlying causes may lead to better diagnosis and ultimately improved clinical treatments.

“However, we have a long way to go to identify the genes contributing to the distinctive brain structure found in OCD patients and their relatives. We also need to identify other contributing factors for OCD, to understand why close relatives that share similar brain structures don’t always develop the disorder.”

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