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Harvard Mental Health Letter: April 2009

Articles in this issue:

Mentalization-based treatment for borderline personality disorder

A small, long-term study concludes that this therapy is effective.

Borderline personality disorder is one of the most challenging psychiatric disorders to treat. It affects about 2% of people in the general population, but roughly 20% of hospitalized psychiatric patients. The disorder consists of three major components: an unstable sense of self, impulsive thoughts and behaviors, and sudden shifts in mood.

As a result, patients with borderline personality disorder may become suddenly depressed, irritable, anxious, or enraged for no apparent reason. They provoke conflict, even while fearing abandonment. They engage in self-destructive habits such as self-mutilation or substance abuse, and ...

Rare diseases offer insights into autism spectrum disorders

Preliminary laboratory studies suggest new biological targets for intervention.

At the November 2008 annual symposium of the Autism Consortium — a research collaboration of 14 institutions in Boston — several speakers discussed progress in a promising avenue of basic research: using rare single-gene disorders to better understand the brain basis of autism spectrum disorders.

Although the research is still preliminary, the studies suggest that — at least in mice or fruit flies — it is possible to reverse the molecular abnormalities caused by certain genetic mutations, thereby alleviating or even eliminating particular symptoms.

Of course, it's a long leap from ...

Yoga for anxiety and depression

Studies suggest that this practice modulates the stress response.

Since the 1970s, meditation and other stress-reduction techniques have been studied as possible treatments for depression and anxiety. One such practice, yoga, has received less attention in the medical literature, though it has become increasingly popular in recent decades. One national survey estimated, for example, that about 7.5% of U.S. adults had tried yoga at least once, and that nearly 4% practiced yoga in the previous year.

Yoga classes can vary from gentle and accommodating to strenuous and challenging; the choice of style tends to be based on physical ability and ...

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More evidence on risks of antipsychotics in adults

Commentaries provide advice about putting the results in perspective.

Two studies provide evidence that second-generation antipsychotics increase risk of death, especially when the drugs are prescribed at high doses. Another report, on the third phase of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia study, found unexpected increases in blood sugar levels among patients taking aripiprazole (Abilify).

It seems lately that the news about antipsychotics is unrelentingly disappointing. However, editorials accompanying two of the studies help put results in perspective and offer practical advice for clinicians.

Sudden cardiac death In a study published in the New England Journal of ...

In Brief: Type 2 diabetes may slow thinking ability early on

A Canadian study suggests that certain types of mental functioning are affected by type 2 diabetes at an earlier stage in the disease than was previously believed.

In Brief: Reducing teens' risk on the Internet

Many teenagers post information about risky behavior in their online social networking profiles, but a study found that nearly half responded to an intervention aimed at getting them to make their profiles safer by altering or removing such information.

Questions & answers

Questions & answers Q. What is reminiscence therapy?

A. Reminiscence therapy is a treatment that is offered to people in their later years because they have mood or memory problems, or simply because they are dealing with the ignominy of aging. With the aid of prompts, such as photos, music, or familiar items from the past, the therapist encourages the patient to talk about memories from earlier in life. Since the late 1990s, partially controlled studies have shown that this treatment has a small but significant positive effect on mood, self-care, ability to communicate, and well-being. In some cases, this ...

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