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It is sometimes described as a pacemaker for the brain. Yet deep
brain stimulation (DBS) is not yet ready for widespread use. Unlike
cardiac pacemakers, DBS does not have an established track record
of success or clear guidelines for its use.
The research on DBS is at a much earlier stage — known in the
research literature as “proof of principle.” Although small
preliminary studies suggest that DBS appears safe and may be
effective for some patients, questions remain about its
applicability and long-term effects.
In DBS, a surgeon implants electrodes in the brain and connects
them to a small electrical generator in the chest. DBS uses
electricity to modulate the transmission of brain signals in
particular areas of the brain, although exactly how it does so
Most psychiatric research on DBS has focused on its use in patients
with treatment-resistant major depression or obsessive-compulsive
disorder (OCD). And although the early results are promising, they
are based on findings from only a small number of patients.
Published results are available for 46 patients with depression.
About 100 patients with OCD have undergone DBS, but only some of
the results have been published.
But the early state of the science hasn’t stopped patients from
wondering whether DBS is a reasonable treatment option, especially
when other approaches haven’t provided sufficient symptom relief.
Recognizing this, the National Institutes of Health and the Dana
Foundation convened an international group of experts, who
published a detailed set of recommendations for when DBS should be
considered and what challenges remain. In addition, some of the
leading researchers in the field have published their own advice in
Cognitive behavioral therapy may be an effective treatment option
for people with seasonal affective disorder who do not respond to
A smoking-cessation study found that the combination of a
nicotine patch and a nicotine lozenge achieved the best results.
Mental health problems affect many employees — a fact that is
usually overlooked because these disorders tend to be hidden at
work. Researchers analyzing results from the U.S. National
Comorbidity Survey, a nationally representative study of Americans
ages 15 to 54, reported that 18% of those who were employed said
they experienced symptoms of a mental health disorder in the
But the stigma attached to having a psychiatric disorder is such
that employees may be reluctant to seek treatment — especially in
the current economic climate — out of fear that they might
jeopardize their jobs. At the same time, managers may want to help
but aren’t sure how to do so. And clinicians may find themselves in
unfamiliar territory, simultaneously trying to treat a patient
while providing advice about dealing with the illness at work.
As a result, mental health disorders often go unrecognized and
untreated — not only damaging an individual’s health and career,
but also reducing productivity at work. Adequate treatment, on the
other hand, can alleviate symptoms for the employee and improve job
performance. But accomplishing these aims requires a shift in
attitudes about the nature of mental disorders and the recognition
that such a worthwhile achievement takes effort and time.
What is the difference between the "unconscious" and the
Bewernick BH, et al. "Nucleus Accumbens Deep Brain Stimulation
Decreases Ratings of Depression and Anxiety in
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Disorder: Worldwide Experience," Molecular Psychiatry
(May 20, 2008): Electronic publication ahead of print.
Greenberg BD, et al. "Invasive Circuitry-Based Neurotherapeutics:
Stereotactic Ablation and Deep Brain Stimulation for OCD,"
Neuropsychopharmacology (Sept. 16, 2009): Electronic
publication ahead of print.
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For more information:
Anxiety Disorders Association of
Children and Adults with Attention Deficit/Hyperactivity
As people age, they tend to suffer from vitamin deficiencies. The
elderly are commonly deficient in vitamin B12, for example, because they produce
less stomach acid than younger people, and therefore are not as
able to metabolize this vitamin from food sources. Age-related
changes also make older adults less efficient at producing vitamin
D following sun exposure.
Certain vitamin deficiencies can impair brain functioning. Probably
the best known example is vitamin B12 deficiency, which can mimic
symptoms of Alzheimer’s disease and other types of dementia by
causing disorientation and confusion. People can prevent or treat a
vitamin B12 deficiency
by taking supplements or eating fortified foods — which do not
require stomach acid for absorption.
Evidence is growing that other sorts of vitamin deficiencies are
also associated with cognitive decline or dementia. This has
prompted researchers to investigate whether, as in the case of a
vitamin B12 deficiency, providing
supplements might either prevent deterioration or treat symptoms
once they appear. Here’s a quick review of three vitamin therapies
most often investigated.