
Harvard Mental Health Letter: January 2011
Articles in this issue:
Mental illness and violence
Multiple interacting factors contribute to violent behavior.
Public opinion surveys suggest that many people think mental illness and violence go hand in hand. A 2006 national survey found, for example, that 60% of Americans thought that people with schizophrenia were likely to act violently toward someone else, while 32% thought that people with major depression were likely to do so.
In fact, research suggests that this public perception does not reflect reality. Most individuals with psychiatric disorders are not violent. Although a subset of people with psychiatric disorders commit assaults and violent crimes, findings have been inconsistent about how much ...
Painkillers fuel growth in drug addiction
Opioid overdoses now kill more people than cocaine or heroin.
Opioid drugs such as oxycodone (OxyContin), hydrocodone (Vicodin), and meperidine (Demerol) are among the most powerful painkillers available. Opioids are used both to treat severe acute pain (limited in duration, such as following surgery) as well as various types of chronic pain (lasting longer than three months).
Consensus exists that prescribing opioids for chronic pain caused by cancer or experienced at the end of life is appropriate and humane. Much more controversial is the practice of prescribing these medications for other types of chronic conditions, such as arthritis, migraine, or ...
Anxiety and heart disease
New research suggests there may be a link, but it's not clear why.
While there is a well-known relationship between major depression and cardiovascular disease, much less is known about how anxiety disorders affect the heart. Various studies have found that 24% to 31% of patients with cardiovascular disease have symptoms of anxiety. Moreover, severe anxiety — which may manifest as a panic attack — can mimic a heart attack (see "A panic attack or a heart attack?" below). One analysis of studies involving people admitted to emergency rooms for chest pain found that 22% of those who underwent cardiovascular ...
In Brief: Fish, omega-3 fatty acids, and pregnancy
A large randomized controlled study has concluded that daily omega-3 fatty acid supplements do not lower the risk of postpartum depression in women or improve cognitive development in their toddlers. An editorial accompanying the study, however, points out that these supplements offer other benefits and advises that pregnant women continue to take the recommended amount.
Omega-3 fatty acids, which include docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), contribute to heart and neurological health. For example, omega-3 fatty acids help prevent blood clots. In the fetus, DHA contributes to brain development. Observational studies suggested that omega-3 fatty acids might also reduce ...
Ask the doctor: What is metacognitive therapy?
Q. My husband has attention deficit hyperactivity disorder. Someone suggested that metacognitive therapy might help him become better organized. What is that?
A. Metacognitive therapy is sometimes described as a type of therapy that involves changing how people think rather than what they are thinking about. In this way, metacognitive therapy is distinct from cognitive behavioral therapy, which focuses more on the content of people's thoughts.
Two psychologists, Dr. Adrian Wells of the University of Manchester and Dr. Gerald Matthews of the University of Cincinnati, developed the theory underlying metacognitive therapy in the early 1990s. Initially intended only for patients ...
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