Dr Shock

415 posts · 641,337 views

This is the personal blog of a Dutch psychiatrist working in a University hospital. His specialty in psychiatry is the treatment of depression. This explains his interest in electroconvulsive therapy and the development of new forms of neurostimulation for the treatment of depression. He is also involved in medical education. He does research in the treatment and neuroscience of depression. He mostly writes about these topics on this blog for fun and to keep up with recent developments. Besides writing about his work he also writes about other subjects that (neuro)stimulates him such as chocolate, computer gaming, gadgets, and Internet. The postings are based on what I want to write about and what I feel will be interesting to read.

Dr Shock MD PhD
415 posts

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  • August 13, 2009
  • 02:52 AM
  • 2,465 views

Motives For Online Gaming

by Dr Shock in Dr Shock MD PhD


Why do young adults play online games such as First Person Shooters? What are their motives?

Communication before, during, and after online gaming is of the utmost importance for these gamers. They like the “togetherness” in these centers. Paying for going to an online game center was far better than the solitude of gaming from their [...]... Read more »

  • August 11, 2009
  • 03:06 AM
  • 2,811 views

The Neuroanatomy of Psychopathy

by Dr Shock in Dr Shock MD PhD


Lombroso believed that 40% of criminals were ‘born criminals’ who could be distinguished by physical features including relatively long arms, prehensile feet with mobile big toes, low and narrow forehead, large ears, thick skull, large jaw, etc. The main objection to his hypotheses were his campaign on the basis of his theory for a preventive [...]... Read more »

Benning, T. (2003) Neuroimaging psychopathy: lessons from Lombroso. The British Journal of Psychiatry, 183(6), 563-564. DOI: 10.1192/bjp.183.6.563  

Blair, R. (2003) Neurobiological basis of psychopathy. The British Journal of Psychiatry, 182(1), 5-7. DOI: 10.1192/bjp.182.1.5  

Craig, M., Catani, M., Deeley, Q., Latham, R., Daly, E., Kanaan, R., Picchioni, M., McGuire, P., Fahy, T., & Murphy, D. (2009) Altered connections on the road to psychopathy. Molecular Psychiatry. DOI: 10.1038/mp.2009.40  

Yang, Y., Raine, A., Colletti, P., Toga, A., & Narr, K. (2009) Abnormal temporal and prefrontal cortical gray matter thinning in psychopaths. Molecular Psychiatry, 14(6), 561-562. DOI: 10.1038/mp.2009.12  

  • August 4, 2009
  • 03:14 AM
  • 2,453 views

Teaching Psychotherapy: The Y Model

by Dr Shock in Dr Shock MD PhD


Psychotherapy training in residency has lost much of it’s importance due to the increasing interest for biological psychiatry and biological treatments. Especially those using long term psychotherapy haven’t supplied the answers for the growing demand for evidence based treatment. In the US the residency review committee has reduced the number of psychotherapy schools back to [...]... Read more »

  • July 28, 2009
  • 02:54 AM
  • 1,298 views

Computer Games at Work are Good For You

by Dr Shock in Dr Shock MD PhD

I’ve told you that so now and than I am playing computer games. Not only at home but since I’ve installed some games on my IPhone I also play while waiting for patients, meetings etc. It relaxes me. Getting my mind of. That’s why a recent study got my attention. The study investigated the [...]... Read more »

  • July 27, 2009
  • 02:59 AM
  • 2,115 views

Medical Interviewing or Listening

by Dr Shock in Dr Shock MD PhD

As a psychiatrist you get the opportunity to listen to your patients. Especially in psychotherapy you have the privilege of listening and understanding the patient. As a general practitioner this time is not always given. In The Netherlands most appointments with a GP lasts for 5 to 10 minuets at the most. Here is a [...]... Read more »

Lucassen, P. (2009) The man, the poem, the secret☆. Patient Education and Counseling, 75(2), 147-148. DOI: 10.1016/j.pec.2008.10.011  

  • July 22, 2009
  • 03:27 AM
  • 2,967 views

Cyberbullying in the Workplace

by Dr Shock in Dr Shock MD PhD

What is cyberbullying?

Cyberbullying techniques use modern communication technology to send derogatory or threatening messages directly to the victim or indirectly to others, to forward personal and confidential communication or images of the victim for others to see, and to publicly post denigrating messages

Cyberbullying has been in the news mostly for children and young adults. There [...]... Read more »

Privitera, C., & Campbell, M. (2009) Cyberbullying: The New Face of Workplace Bullying?. CyberPsychology , 2147483647. DOI: 10.1089/cpb.2009.0025  

  • July 21, 2009
  • 02:47 AM
  • 1,973 views

Treatment Resistant Depression and Algorithm Guided Treatment

by Dr Shock in Dr Shock MD PhD

50 to 60 % of patients with a depressive disorder fail to respond to their first antidepressant. These rates increase in clinical practice setting to 65 to 85%. Estimates of treatment resistant depression (TRD) prevalence varies greatly depending on treatment setting. The lowest TRD prevalence is in primary care and progressively higher rates occur in [...]... Read more »

Bauer, M., Pfennig, A., Linden, M., Smolka, M., Neu, P., & Adli, M. (2009) Efficacy of an Algorithm-Guided Treatment Compared With Treatment as Usual. Journal of Clinical Psychopharmacology, 29(4), 327-333. DOI: 10.1097/JCP.0b013e3181ac4839  

  • July 15, 2009
  • 02:30 AM
  • 1,922 views

The Effect of Gender on Clerkship during Medical Education

by Dr Shock in Dr Shock MD PhD

In the last 10 years 60% of medical students are women nevertheless medical specialists are mainly men in The Netherlands. In the US close to 50% of all medical schools are women. Women in academic medicine are underrepresented and are less well payed.

Only 1 in 10 medical clinical professors are women in the [...]... Read more »

  • July 13, 2009
  • 02:29 AM
  • 2,299 views

Architecture and Neuroscience

by Dr Shock in Dr Shock MD PhD

Architecture is not only about aesthetics. Like the Bilbao Guggenheim Museum buildings also need to respond to the functional needs of the occupants, and users need to be provided with adequate lighting, well-modulated heating and cooling systems, structural soundness, and public safety provisions. These requirements can vary according to the type of building, a hospital [...]... Read more »

  • July 9, 2009
  • 02:21 AM
  • 1,873 views

Changes over Time in Digital Literacy

by Dr Shock in Dr Shock MD PhD

Digital literacy is the ability to employ a wide range of cognitive and emotional skills in using digital technologies. 6 digital skills:

(a) Photovisual literacy is the ability to work effectively with digital environments, such as user interfaces, that employ graphical communication. (b) Reproduction literacy is the ability to create authentic,meaningful written and artwork by reproducing [...]... Read more »

Eshet-Alkalai, Y., & Chajut, E. (2009) Changes Over Time in Digital Literacy. CyberPsychology , 2147483647. DOI: 10.1089/cpb.2008.0264  

  • July 6, 2009
  • 02:43 AM
  • 1,825 views

How and Why Junior Physicians use Web 2.0

by Dr Shock in Dr Shock MD PhD

The answers:

89% (32/35) of physicians used at least one Web 2.0 tool in their medical practice, with 80% (28/35) reporting the use of wikis, only one respondent contributed to web 2.0 making regular contribution to a medical wiki site

physicians checked for medical information on an average of 2.6 different sites a day, with 1.4 visits [...]... Read more »

  • July 1, 2009
  • 02:22 AM
  • 1,574 views

FDA Antidepressant Warning has Unintended Consequences

by Dr Shock in Dr Shock MD PhD

We discussed a prior publication in the Archives of General Psychiatry about the decline of antidepressants use after the FDA black box warning. In a more recent study published in the same journal this prior study was criticized because it had some serious limitations. The study used prevalent use instead of incidence use. This [...]... Read more »

Libby, A., Orton, H., & Valuck, R. (2009) Persisting Decline in Depression Treatment After FDA Warnings. Archives of General Psychiatry, 66(6), 633-639. DOI: 10.1001/archgenpsychiatry.2009.46  

  • June 4, 2009
  • 03:09 AM
  • 1,886 views

The placebo response of transcranial magnetic stimulation

by Dr Shock in Dr Shock MD PhD

The field of placebo response with the use of devices as treatment for major depression is hardly researched. Herb one of my very much appreciated readers and commenter asked me about the evidence on the placebo response to devices for major depression, didn’t have an answer. Tried searching but to no effect until recent. A [...]... Read more »

  • June 3, 2009
  • 03:49 AM
  • 2,214 views

Ethical Guidelines for Deep Brain Stimulation

by Dr Shock in Dr Shock MD PhD

Deep Brain Stimulation (DBS) should only be used when there is a high change that the lives of patients will be improved by its use and when all other possible interventions have been tried

Patients must be fully informed and informed consent must be obtained

The whole procedure should be done by teams of appropriate specialists like [...]... Read more »

Kringelbach, M., & Aziz, T. (2009) Deep Brain Stimulation: Avoiding the Errors of Psychosurgery. JAMA: The Journal of the American Medical Association, 301(16), 1705-1707. DOI: 10.1001/jama.2009.551  

  • June 2, 2009
  • 03:49 AM
  • 2,112 views

Hippocampus and Depression

by Dr Shock in Dr Shock MD PhD

We used to believe that brain tissue couldn’t regenerate, couldn’t grow only prenatal and during early postnatal development. Since than neurogenesis or the process creation of new neurons (nerve cells) has been demonstrated in vitro and vivo experiments and animal research.

It has also been shown that this neurogenesis has an age-related decline from preadolescence (8–10 [...]... Read more »

  • May 29, 2009
  • 03:25 AM
  • 2,514 views

Major enhancements to Electroconvulsive therapy

by Dr Shock in Dr Shock MD PhD

//

The major recent enhancements to ECT technique are:

Right Unilateral electrode placement. The cognitive side-effects of ECT such as retrograde and anterograde amnesia are significantly less compared to Bilateral electrode placement.

Brief pulse stimulus currents. The characteristics of the electrical stimulus affect the effectiveness and cognitive outcomes of the seizure. Sine wave stimuli have been [...]... Read more »

SACKEIM, H., PRUDIC, J., NOBLER, M., FITZSIMONS, L., LISANBY, S., PAYNE, N., BERMAN, R., BRAKEMEIER, E., PERERA, T., & DEVANAND, D. (2008) Effects of pulse width and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy. Brain Stimulation, 1(2), 71-83. DOI: 10.1016/j.brs.2008.03.001  

  • May 27, 2009
  • 02:50 AM
  • 2,400 views

Emotional Intelligence and Medical Specialty Choice

by Dr Shock in Dr Shock MD PhD

The relationships between doctor personalities and medical specialties continues to interest me since we regularly have to select excellent young physicians to become psychiatrists. The usual caricatures of different specialties just won’t suffice as in the differences between surgeons and internists. It’s fun to read so if anyone knows some about psychiatrists and others please [...]... Read more »

  • May 21, 2009
  • 02:34 AM
  • 1,997 views

Dark Chocolate Improves Coronary Blood Flow

by Dr Shock in Dr Shock MD PhD

Flavonoid rich dark chocolate (45 g per day) significantly improved coronary flow velocity reserve (CFVR), this means that the researchers used Doppler echocardiography to assess the ability of the coronary arteries to dilate and allow more blood flow in response to dark chocolate. Dark chocolate improves coronary circulation in healthy adults. The other group in [...]... Read more »

  • May 20, 2009
  • 02:59 AM
  • 1,680 views

Electronic Patient Records

by Dr Shock in Dr Shock MD PhD

In The Netherlands the National Electronic Patient Record has led to a lot of concern and refusal of participation. 31% of the Dutch physicians have objected against subscribing to the National Patient Record (Dutch), 25% are still considering this step. Most of the Dutch Physicians don’t want their medical data in a National Patient Record. [...]... Read more »

  • May 19, 2009
  • 02:58 AM
  • 2,221 views

Size does matter with video games and movies

by Dr Shock in Dr Shock MD PhD

Recent gadgets such as the handheld portable Nintendo DS video game console, portable Sony Playstation Portable (PSP), iPhone and iPod touch go with video games. The advantage being obvious that any moment waiting can be used to play a video game.

Screens of these portable media consoles are comparable with television and video monitors in terms [...]... Read more »

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