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First Published Tuesday, 16 December 2008

“Life is the sum of all your choices.” –Albert Camus

Happiness is in our hands if only we could make the right decisions in life. Decisions often rely on making accurate predictions of how we will feel in the future. Unfortunately for us psychologists have shown that there are five major biases in the way we predict our future emotional states.

The good news is that psychological research reveals that each of these biases can be countered. Understanding and remembering these five biases will help you make decisions that will increase your happiness.

1. The distinction bias

What is it?
Imagine this: you are offered two jobs. The first is an interesting job that pays $60,000 a year. The second is a boring job that pays $70,000 a year. For the sake of argument, imagine that everything else is equal – which do you choose?

The distinction bias predicts that people will consistently over-estimate the importance of the $10,000 compared to how interesting the job is. Consequently, research shows that many will pick the boring job even though it makes them miserable and the extra money might well make little difference.

How to combat the distinction bias
Ignore conventional wisdom – comparing options directly is often too difficult because we’re forever weighing up apples against oranges. Instead focus on the pros and cons of each scenario individually then make decisions on that basis.

» Read more about the distinction bias.

2. The projection bias

What is it?
Going to the supermarket when I’m really hungry, and without a shopping list, is a recipe for disaster. It will take an act of iron will to avoid returning without some kind of junk food. Later, after eating, I’ll wonder how I could have bought junk food but forgotten healthy staples like rice and pasta.

Part of the reason people make mistakes like this is that research shows the projection bias anchors us in current emotional and cognitive states. The present is often like an emotional cage which we can’t break out of to understand how we will feel in the future.

How to combat the projection bias
To make the most accurate decisions about what will make our future selves happy we need to be in roughly the same emotional state at the moment of choice. The bigger the difference in emotional state between present and future, the worse the decision will be.

» Read more about the projection bias.

3. The impact bias

What is it?
People often overestimate their emotional reaction to future events. Studies have found that two months after a relationship finished people were generally not as unhappy as they expect. It worked the other way around too: sports fans were generally not as happy as they expected when their team won. Finally, academics both overestimated how happy they would be when given tenure, and also overestimated their unhappiness at being denied tenure.

How to combat the impact bias
First, consciously widen your future focus; remember that other events are bound to intervene. Second, remember that rationalisation tends to reduce the emotional impact of both positive and negative events. The future doesn’t normally have such an extreme effect on our emotions (whether good or bad) as we imagine.

» Read more about the impact bias.

4. The memory bias

What is it?
When making decisions about the future, we naturally use events from the past as litmus tests. Unfortunately the type of memories we retrieve to make decisions about our future happiness are often biased to unusual examples that are either very positive or very negative.

A study on subway travellers showed that people freely recalled their previous worst experience of missing the train. As a result they then predicted that if they were to miss the train later that day they would feel worse than did other people who had recalled less disastrous times they had missed the train.

How to combat the memory bias
Recalling more than one past instance of an event you want to make a decision about helps average out the emotion. Also, simply be aware that you are likely to recall the best or worst past example of an event.

» Read more about the memory bias.

5. Belief biases

What are they?
Over time we build up many rules of thumb about the situations that make us happy (or unhappy). Unfortunately we often over-generalise these beliefs to situations where they don’t apply.

Research has uncovered four common belief biases:

• The contrast effect is the often incorrect belief that a good experience will be more enjoyable when it follows a bad experience (and that a bad experience will be worse when it follows good). Research on jelly bean tasting showed this can be a mirage.
• More choice is often not better: Research with gourmet jams has found people can be happier, and even better motivated, when they have fewer options to choose from.
• Adaptation: People often expect that repeated exposure to an experience will lessen the pleasure it gives. Research on ice cream, yoghurt and music showed that most people adapted to the taste, either coming to like it more, or at the very least dislike it less.
• Certainty: People expect to feel happier when they have reduced the uncertainty in a situation. Often, though, mystery can increase pleasure.

How to combat belief biases
Research suggests the amount that we are swayed by each of these biases depends on how much we believe in them. So, just reading, remembering and believing (!) this post should allow you to combat the belief biases.

» Read more about belief biases.

Following through on decisions

Even after conquering these biases, we need to actually follow through with the decision. This is where the happiness-seeking individual gets into trouble again… Read the second part of this article: 4 Reasons We Fail to Choose Happiness.

Source:   http://www.spring.org.uk/2008/05/how-to-choose-happiness-combat-5.php

First Published Tuesday, 16 December 2008

by Elisha Goldstein, Ph.D.

Holidays are traditionally a time to take a pause in our hectic lives, gather together with family and friends, and celebrate. However, for many who have recently, or not too recently, suffered the loss of a close friend, family member, or relationship, it can be an uncomfortable reminder that they are no longer here. The death of a loved one may leave you with feelings of sadness, guilt, or anger, reeling at the injustice of the world. You may be left financially challenged or at odds with other members of your family or friends. Sadness or depression may loom overhead with the thought “I don’t know how I’m ever going to make it through this.” Conscious and unconscious reminders seem like they’re everywhere. It’s pretty tough to hold all this when others are expecting you to be celebrating and cheerful. These expectations alone make you feel more depressed and like isolating more.

Here are some suggestions for surviving the holidays while grieving.

• *Set realistic expectations – Grieving can take quite some time and everyone is on their own clock. If this is your first holiday, be kind to yourself by knowing that this holiday may be more difficult than those passed. You will likely have uncomfortable emotions and may not be very cheerful.
• *Finding the light – See if you can notice any moments that provide a sense of comfort. Whether it’s a child being pleasantly surprised by a gift, the taste of special food, a smile on your face, or simply feeling relieved when the holidays pass. These feelings will come and go, but see if you notice any moments while they are there.
• *Let others know – Often times other friends and family may feel the inclination to try and “cheer you up” if any sadness or uncomfortable emotions arise. Let them know that these emotions may arise and while you appreciate them trying to cheer you up, it’s Ok for you to experience them.
• *Know your limits – Give yourself permission to leave the group of people if it’s getting too overwhelming and take a time-out. Go on a walk, lie down in another room, or just remove yourself and have a good cry. These emotions need to pass through and it is Ok to take time to experience them.
• *Spending time with the person who passed – You may want to create some sort of ritual where you express your feelings toward the person who passed. This could be writing a letter, going to the grave, or spending time in prayer if you are spiritual or religious. You can create your own idea.
• *Giving – Often times being altruistic is a great way to work through grief. Maybe this year you want to volunteer somewhere like a homeless shelter or make/buy special gifts for those who are around that you care about. Try this out.
• *Grief support group & individual therapy – If you haven’t already checked out a grief support group, this may be a good thing to investigate. Look online in your area to see if there are any around. You may also want to look into individual therapy which can also be a powerful support during this time.
• Overall, treat yourself with love and kindness during this time and know that the intensity of this feeling will lessen over time. It is important to spend time reminiscing and feeling the emotions and also important to live in the present moment knowing that “this too shall pass”.

Please feel free to share what has worked for you in your time of grief. Your living wisdom can be enormous support to others.

Source:   http://www.mentalhelp.net/poc/view_doc.php?type=weblog&id=575&wlid=10&cn=58

First Published Tuesday, 16 December 2008

Make sure you tune in to BBC1 on Sunday 21 December at 3.25pm to see 14-year-old Lizzy Clarke – who has Asperger syndrome – performing alongside actresses Juliet Stevenson and Dakota Blue Richards in the BBC’s adaptation of Jacqueline Wilson’s novel ‘Dustbin Baby’.

Dustbin Baby is the story of teenager April (played by Dakota Blue Richards) who sets out to discover where she came from and, along the way, discovers where she belongs, having been abandoned in a dustbin as a baby. April goes back to the world she left behind – one of foster and care homes – and remembers and revisits the people who shaped her life.

It’s a TV first as Lizzy is the first actress to play the part of someone with Asperger Syndrome who actually has the condition herself. Lizzy was picked for the role after taking part in auditions. She was nervous about meeting Jacqueline Wilson for the first time:

“I was so nervous before I met Jacqueline but I was also really excited too. It was a completely different experience to be involved in a production like this but everyone was so kind and helpful and I had a wonderful time. I hope everyone enjoys watching it!”

Source:   http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=253&a=18329

First Published Wednesday, 17 December 2008

Meltdown. Collapse. Depression. Panic. The words would seem to apply equally to the global financial crisis and the effect of that crisis on the human psyche.

Of course, it is too soon to gauge the true psychiatric consequences of the economic debacle; it will be some time before epidemiologists can tell us for certain whether depression and suicide are on the rise. But there’s no question that the crisis is leaving its mark on individuals, especially men.

One patient, a hedge fund analyst, came to me recently in a state of great anxiety. “It’s bad, but it might get a lot worse,” I recall him saying. The anxiety was expected and appropriate: he had lost a great deal of his (and others’) assets, and like the rest of us he had no idea where the bottom was. I would have been worried if he hadn’t been anxious.

Over the course of several weeks, with the help of some anti-anxiety medication, his panic subsided as he realized that he would most likely survive economically.

But then something else emerged. He came in one day looking subdued and plopped down in the chair. “I’m over the anxiety, but now I feel like a loser.” This from a supremely self-confident guy who was viewed by his colleagues as an unstoppable optimist.

He was not clinically depressed: his sleep, appetite, sex drive and ability to enjoy himself outside of work were unchanged. This was different.

The problem was that his sense of success and accomplishment was intimately tied to his financial status; he did not know how to feel competent or good about himself without this external measure of his value.

He wasn’t the only one. Over the last few months, I have seen a group of patients, all men, who experienced a near collapse in their self-esteem, though none of them were clinically depressed.

Another patient summed it up: “I used to be a master-of-the-universe kind of guy, but this cut me down to size.”

I have plenty of female patients who work in finance at high levels, but none of them has had this kind of psychological reaction. I can’t pretend this is a scientific survey, but I wonder if men are more likely than women to respond this way. At the risk of trading in gender stereotypes, do men rely disproportionately more on their work for their self-esteem than women do? Or are they just more vulnerable to the inevitable narcissistic injury that comes with performing poorly or losing one’s job?

A different patient was puzzled not by his anxiety about the market, but by his total lack of self-confidence. He had always had an easy intuitive feel for finance. But in the wake of the market collapse, he seriously questioned his knowledge and skill.

Each of these patients experienced a sudden loss of the sense of mastery in the face of the financial meltdown and could not gauge their success or failure without the only benchmark they knew: a financial profit.

The challenge of maintaining one’s self-esteem without recognition or reward is daunting. Chances are that if you are impervious to self-doubt and go on feeling good about yourself in the face of failure, you have either won the temperamental sweepstakes or you have a real problem tolerating bad news.

Of course, the relationship between self-esteem and achievement can be circular. Some argue that that the best way to build self-esteem is to tell people at every turn how nice, smart and talented they are.

That is probably a bad idea if you think that self-esteem and recognition should be the result of accomplishment; you feel good about yourself, in part, because you have done something well. On the other hand, it is hard to imagine people taking the first step without first having some basic notion of self-confidence.

On Wall Street, though, a rising tide lifts many boats and vice versa, which means that there are many people who succeed — or fail — through no merit or fault of their own.

This observation might ease a sense of personal responsibility for the economic crisis, but it was of little comfort to my patients. I think this is because for many of them, the previously expanding market gave them a sense of power along with something as strong as a drug: thrill.

The human brain is acutely attuned to rewards like money, sex and drugs. It turns out that the way a reward is delivered has an enormous impact on its strength. Unpredictable rewards produce much larger signals in the brain’s reward circuit than anticipated ones. Your reaction to situations that are either better or worse than expected is generally stronger to those you can predict.

In a sense, the stock market is like a vast gambling casino where the reward can be spectacular, but always unpredictable. For many, the lure of investing is the thrill of uncertain reward. Now that thrill is gone, replaced by anxiety and fear.

My patients lost more than money in the market. Beyond the rush and excitement, they lost their sense of competence and success. At least temporarily: I have no doubt that, like the economy, they will recover. But it’s a reminder of just how fragile our self-confidence can be.

First Published Wednesday, 17 December 2008

A new study has revealed the most commonly prescribed medication for Australian women is antidepressants.

The study, by researchers from Australian Longitudinal Study on Women’s Health (ALSWH). The ALSWH is a 20 year project involving three cohorts spanning three generations. More than 40,000 women participate in the study.

Pharmaceutical Benefits Scheme and Medicare data were linked to survey data to examine claims and costs of medications and other health care resources.

University of Newcastle study co-director and lead author of the Use and costs of medications and other health care resources report, Professor Julie Byles, said the research indicated the prevalence of antidepressant use increased with age.

“Eight percent of younger women and 14 percent of mid-age women used antidepressants during the surveyed period,” Professor Byles said. “This figure jumps to 18 percent in older women.“

“However, the use of antidepressants is not a clear indicator of the extent of depression among women. For example, among young women who reported a diagnosis of depression, 40 percent had not used prescribed antidepressant medication.“

Other significant findings from the research include:

• *Older women, in particular, mentioned the impact of of costs of medication on their ability to manage their incomes
• *There were few differences in patterns of claims between women living in urban, rural and remote areas
• *There was evidence that women who made claims for common medications had a lower socio-economic status.

The Australian Longitudinal Study on Women’s Health is funded by the Australian Department of Health and Ageing.

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Byles J, Loxton D, Berecki J, et al. Use and costs of medications and other health care resources: Findings from the Australian Longitudinal Study on Women’s Health. Australian Government Department of Health and Ageing   [Full text ()]

First Published Wednesday, 17 December 2008

Fwd:

Hello,

Early next week, the Autistic Self-Advocacy Network (ASAN) has been invited
to give input to the Office of the President-elect at two meetings relating
to disability policy in the upcoming administration. The first meeting will
focus on autism policy issues specifically while the second will focus on
health care policy from the disability perspective. The meetings will be
small, intimate and include representatives from several other autism and/or
disability organizations as well.

I’d like to take this opportunity to invite people to give their thoughts as
to what issues matter to them in relation to Autism Policy and Health Care
Policy in the upcoming administration. We’ve been asked to take 2-3 policy
priorities into the first meeting and will want to represent some of the
specific needs of autistic self-advocates in the second. As an organization
that seeks to represent the needs of the community of autistic people and to
fight for the rights of ourselves, our families and our supporters, we want
to hear from you. Please feel free to either reply directly here or by
e-mail to me at aneeman@autisticadv ocacy.org. I’m looking forward to hearing
from you and please distribute.

Regards,
Ari Ne’eman
President
The Autistic Self Advocacy Network
1660 L Street, NW, Suite 700
Washington, DC 20036
http://www.autistic advocacy. org
732.763.5530

First Published Friday, 19 December 2008

The very things that many ‘neurotypical’ people enjoy about the festive season and similar celebrations are the things that some people with autism find difficult – the change to the normal routine, the surprises, the unexpected guests and so on. This year, Communication, our members’ magazine, asked readers for their ideas about what makes the holiday season easier. Here is what they suggested.

Our readers have written about their sons, but the information could apply to all children with autism.

1. Look at the world of Christmas through your son’s eyes.

What aspects of Christmas would he enjoy? Incorporate one of these into his daily schedule, billed perhaps as ‘his daily Christmas activity’, something perhaps that your other children could either observe or do alongside him.

2. Which aspects of Christmas would overload him and which might be avoided?

Could some take place in a bedroom, eg could the Christmas tree be put in a bedroom? If your other children have separate bedrooms from your son, they could perhaps decorate their bedrooms and make them the Christmas zones in your house, rather than communal areas, such as the living room. This will greatly reduce any sensory overload and anxiety about the changes in your house for your son.

3. Give him some Christmas-free time on his schedule each day.

This can be helpful for you to observe his level of anxiety and make any adaptations you need to preparations for the rest of the day.

4. Receiving presents can be overwhelming and confusing for people on the spectrum.

One idea would be to introduce toy time on your sons daily schedule and put out a new toy next to a favourite toy. This way your son isn’t overloaded with new toys all in one go. Consider leaving them unwrapped, unless your son specifically likes the sensation of unwrapping presents. Try giving your son one new toy a day, instead of giving him all his presents at once. You could introduce a time/activity symbol on his schedule each day, when he can play with a new toy.

5. Use advent calendars to help you get through the Christmas period.

The advent calendar could help your child be aware of upcoming events and prepare him for daily changes. You could have a photo of a trip you are going to make and show him how many days (or, as some people say, sleeps) until you will be visiting this place. It can be used to show home days and school days to prepare for the end-of-term.

6. Give your son quiet time with a favourite activity at key Christmas moments for your other children, such as when the others are opening their presents.

Could your son play on the computer or watch a favourite DVD in a Christmas-free zone at these times?

7. Utilise friends and family at key Christmas moments.

When your other children want to write Christmas letters, practise for their Christmas plays or decorate the tree (and if your son doesn’t wish to be involved in these activities), ask a friend to watch your child undertaking a favourite activity eg, playing on the computer. Or you might want to watch your son while grandparents or friends undertake Christmas activities with your other children.

8. Liaise with school. Ask your child’s teacher what he/she does with about preparing your child for Christmas changes.

Try to incorporate the same strategies and symbols at home. By trying to keep them the same, your son may be less anxious. If you use different symbols and strategies, he may think school Christmas and home Christmas are two different things and become doubly-overloaded!

9. Christmas Day.

Whatever Christmas period changes you have introduced, don’t change them on Christmas Day. Keep his schedule the same as far as possible. It is important to think about Christmas changes as early as possible and then try to prepare your child for these. You could have six pictures of his bed and then a photo of the relative who is coming to stay: six sleeps and then Nana comes, for example. Each day you could remove or cross through one of the pictures of the bed.

10. Father Christmas!

Sometimes the sight of a man dressed as Father Christmas can make
children on the autism spectrum scream and run in the opposite direction. If you are taking your child to a Christmas event, it may be wise to prepare him for the fact he might see a man dressed in a red suit by showing him a photo of a man dressed in a Santa suit.

The NAS says:

These readers have pretty much covered everything, we’d say. We might add that, when putting up decorations, it is important to involve the person, even if they don’t want to put them up themselves. Doing it within eye-shot, or making them aware in another way that it is happening, is important. Returning home to find a tree in the middle of the room can be a bit of a shock!

Also, if your child is becoming obsessive about Christmas, you might try to set boundaries around the obsession. Our information sheet, Obsession, repetitive behaviours and routines, may help. Download this from www.autism.org.uk/a-z

For more information about autism and related issues, call our Autism Helpline on 0845 070 4004 (Monday-Friday, 10am-4pm) or email autismhelpline@nas.org.uk Just £10 helps two more people to get the support they desperatley need from our Autism Helpline: make a donation today.

To find out more about becoming a member of The National Autistic Society (NAS), visit www.autism.org.uk/joinus Among other benefits, members receive Communication magazine quarterly.

Source:   http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=2059&a=18392

First Published Friday, 19 December 2008

Group reviews conventional and alternative therapies to treat irritable bowel symptoms

 

By Amanda Gardner
HealthDay Reporter

 

THURSDAY, Dec. 18 (HealthDay News) — A leading organization of gastroenterologists has released new guidelines on the management of irritable bowel syndrome (IBS).

 

The guidelines, issued by the American College of Gastroenterology and published in the January issue of The American Journal of Gastroenterology, essentially replace a 2002 document.

 

“The world of IBS is changing quickly because of more therapies and an increased awareness. It is considered a ‘real disease,’ ” said Dr. Lawrence Brandt, chairman of the group’s IBS task force and chief of gastroenterology at Montefiore Medical Center in New York City. “A lot of new drugs are being developed, and a lot of work still needs to be done, but there’s enough new information since the last time.”

 

An estimated 7 percent to 10 percent of people have IBS, which can involve abdominal pain, bloating and other discomfort, including constipation and diarrhea. IBS affects both quality of life and productivity for millions of people.

 

Most IBS treatments relieve symptoms rather than resolve the condition itself.

 

The new guidelines encompass existing evidence on conventional treatments for IBS as well as new therapies (probiotics, for example) and alternative therapies (acupuncture and more). In summary, the updated guidelines say:

 

• *Fiber products — including psyllium, anti-spasmodic medications and peppermint oil — may be effective, at least in some people. “The evidence is poor, but some patients say they feel better,” Brandt said. He cautioned that fiber should be used carefully in people with narrowed colons.

• *More data is needed on probiotics, live microorganisms (usually bacteria) similar to the “good” organisms found normally in the gut. “This is a very hot topic but an exceedingly complicated subject,” Brandt said. Researchers and practitioners need to consider the species of bacteria used, how many species, and dosages.
• *Non-absorbable antibiotics — those targeted to the gut only, such as rifaximin (Xifaxan) — also seem to help some people, especially those who have “diarrhea-predominant IBS.” Brandt said that “the data is not great, but some patients swear they’re helping them dramatically.”
• *Tricyclic antidepressants as well as the antidepressants known as selective serotonin reuptake inhibitors (SSRIs) benefit a broad range of people with IBS. This is backed up by quality studies, although with small numbers of participants, and could change as research on larger numbers of people is evaluated. Psychological counseling may also provide some relief.
• *Selective C-2 chloride channel activators, notably lubiprostone (Amitiza), are effective for “constipation-predominant IBS.”
• *5HT 3 antagonists such as alosetron (Lotronex) relieve symptoms of diarrhea but can cause constipation and colon ischemia, a restriction of blood flow.
• *5HT 4 agonists, though effective against constipation, are not available in North America because of a heightened risk of cardiovascular problems.
• *There is yet to be conclusive evidence on Chinese herbal mixtures, and the mixtures run the risk of causing liver failure and other problems. Differences in the content of compounds and the purity of ingredients complicate evaluation of benefits.
• *Similarly, the evidence on acupuncture remains inconclusive.
• *There is no evidence at this point that testing for food allergies or following diets that exclude certain foods alleviates IBS symptoms.
• *Routine diagnostic testing for IBS is not recommended, although some testing should be performed in certain subgroups of patients.

Though comprehensive, the guidelines were criticized for not explaining what outside funding was used for in the development process. The document does disclose that support was received from Takeda Pharmaceutical Company and Salix Pharmaceuticals, which make products targeted to IBS.

 

Dr. Mark Ebell, deputy editor of American Family Physician, said he would feel more comfortable if the guidelines had been “very clear about what support was provided and what they needed the support for: paying for literature searches, for staff. … It’s common to have support for guidelines. … I think it’s generally unintentional, but when we have a relationship, it creates the potential for problems.”

 

Ebell said that Brandt had relationships with pharmaceutical companies.

 

Brandt had a different view. “I don’t have any ties to industry that would have any relevance to this publication,” he said. “I don’t receive money directly from any company. I own no stock and, nor does my family, so this is a totally unbiased thing. I have no conflict of interest whatsoever, and I think that does it.”

 

The American College of Gastroenterology said: “No company was involved in any way in either structuring or completing the meta-analysis that forms the basis for the College’s evidence-based recommendations on IBS. Furthermore, no company was in any way involved in deciding who served on the Task Force or in any of its work.”

 

More information

 

To learn more about IBS, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases online.

 

Source:   http://health.usnews.com/articles/health/healthday/2008/12/18/new-guidelines-issued-for-management-of-ibs.html

 

Irritable Bowel Syndrome Linked To Genetic Causes

 

Irritations of the bowel can have genetic causes. Researchers at the Institute of Human Genetics at Heidelberg University Hospital have discovered this correlation. The causes of what is known as irritable bowel syndrome (IBS), one of the most common disorders of the gastrointestinal tract, are considered unclear – making diagnosis and treatment extremely difficult. The results from Heidelberg, which were published in the journal Human Molecular Genetics, improve the outlook for an effective medication against a disease that is frequently played down as a functional disorder.

 

In Germany, approximately five million people are affected by IBS, women about twice as often as men. But only around 20 percent of these people even consult a physician. Many patients suffer from constipation, others from severe diarrhea, or a combination of both. The illness affects the general condition and quality of life of these patients and often lasts for months or even years.

 

Serotonin plays an important role in the complex processes in the digestive tract – just as it affects sleep, mood, and blood pressure. Various types of a receptors are located in the intestine, to which serotonin attaches according to the lock and key principle and thus transmits cellular signals.

 

“We have determined that patients who suffer from irritable bowel syndrome with diarrhea show a higher frequency of certain mutations,” explains Dr Beate Niesler, who investigates the genetic causes of complex diseases with her team in the Department of Human Molecular Genetics at the Heidelberg Institute of Human Genetics. These mutations appear to cause changes in the composition or number of receptors on the cell surface. “The signal transduction in the digestive tract may be disturbed and this may lead to over stimulation of the intestine. Resulting disturbances in fluid balance could explain the occurrence of diarrhea,” says Johannes Kapeller, a PhD student in the team.

 

The serotonin receptor blocker Alosetron is only approved in the US where it is effectively used in the treatment of diarrhea-predominant IBS, but can only be prescribed with strict limitations due to its side effects. Alosetron inhibits the serotonin receptors in the intestinal tract and thus slows the movement of the bowels.

 

“Currently, patients with irritable bowel syndrome are treated on a trial and error basis,” explains Dr Beate Niesler. The Heidelberg data could contribute to development and prescription of specific medications for certain genetic mutations in patients.

 

Research of the serotonin system shows interesting correlations – serotonin receptors are located on neural transduction pathways involved in pain perception and influence them – which could explain why patients with irritable bowel syndrome often complain of severe pain although no pathological changes such as infections or tumors are present. It has also been noted that persons with modified receptors suffer more frequently from anxiety and depression.

 

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Kapeller J, Houghton LA, Mönnikes H, et al. First evidence for an association of a functional variant in the microRNA-510 target site of the serotonin receptor-type 3E gene with diarrhea predominant irritable bowel syndrome. Hum Mol Genet. 2008;17:2967-2977   [Abstract]

First Published Monday, 22 December 2008

Self-medication of anxiety disorders with alcohol and drugs: Results from a nationally representative sample

Bolton JM, Robinson J, Sareen J.

Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

Self-medication – the use of alcohol or drugs in an attempt to reduce anxiety – has often been invoked as an explanatory mechanism for the high co-occurrence of anxiety and substance use disorders (for reviews, see Allan, C. A. (1995). Alcohol problems and anxiety disorders-A critical review. Alcohol & Alcoholism, 30(2), 145-151; Kushner, M. G., Abrams, K., & Borchardt. (2000). The relationship between anxiety disorders and alcohol use disorders: A review of major perspectives and findings. Clinical Psychology Review, 20(2), 149-171).

The current study expands upon previous self-medication research by: (1) examining prevalence and comorbidity of self-medication for anxiety disorders (panic disorder, social phobia, specific phobia, and generalized anxiety disorder); (2) using a nationally representative sample (National Epidemiologic Survey on Alcohol and Related Conditions; N = 43,093) to do so; and (3) by differentiating self-medication with alcohol from self-medication with drugs.

Prevalence rates ranged from 18.3% (self-medication with alcohol for generalized anxiety disorder) to 3.3% (self-medication with both alcohol and drugs for specific phobia and panic disorder without agoraphobia). Multiple logistic regression analyses determined that self-medication with alcohol was associated with increased likelihood of any mood or personality disorder diagnosis, while self-medication with both alcohol and drugs further increased these associations over and above self-medication with alcohol alone.

Findings remained significant after adjusting for sociodemographic and substance use disorder variables, which suggests that independently of substance use disorders, self-medication can be viewed as a marker of severity.

Source…