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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.
In the recent numbers of British Journal of General Practice articles were published about depression in General Practice. In The Netherlands about 80% of patients with a depression visit the GP. In The Netherlands it’s estimated that in 2003 about 856.000 people in a year suffer from depression. That’s 6.3% on a population of 16 [...]... Read more »
Boardman, J., & Walters, P. (2009) Managing depression in primary care: it's not only what you do it's the way that you do it. British Journal of General Practice, 59(559), 76-78. DOI: 10.3399/bjgp09X395049
van Geffen, E., Gardarsdottir, H., van Hulten, R., van Dijk, L., Egberts, A., & Heerdink, E. (2009) Initiation of antidepressant therapy: do patients follow the GP's prescription?. British Journal of General Practice, 59(559), 81-87. DOI: 10.3399/bjgp09X395067
Cuijpers, P., van Straten, A., van Schaik, A., & Andersson, G. (2009) Psychological treatment of depression in primary care: a meta-analysis. British Journal of General Practice, 59(559), 51-60. DOI: 10.3399/bjgp09X395139
Kendrick, T., Dowrick, C., McBride, A., Howe, A., Clarke, P., Maisey, S., Moore, M., & Smith, P. (2009) Management of depression in UK general practice in relation to scores on depression severity questionnaires: analysis of medical record data. BMJ, 338(mar19 1). DOI: 10.1136/bmj.b750
The benefits of exercise
In children, college students and young adults, exercise or physical activity improves learning and intelligence scores
Moreover, exercise in childhood increases the resilience of the brain in later life resulting in a cognitive reserve
The decline of memory, cortex and hippocampus atrophy in aging humans can be attenuated by exercise
Physical activity improves memory and [...]... Read more »
Depression as a serious debilitating illness and not a weakness. Many patients don’t get adequate treatment for depression. What to do about this?
“the Internet affords the opportunity to make psychosocial interventions available to large segments of the public. Interventions can be delivered programmatically and reliably, greatly extending the numbers and types of people who can [...]... Read more »
Björn Meyer PhD, Thomas Berger DPhil, Franz Caspar, DPhil, Christopher G Beevers, PhD, Gerhard Andersson, PhD, & Mario Weiss, MD, MBA. (2009) Effectiveness of a Novel Integrative Online Treatment for Depression (Deprexis): Randomized Controlled Trial. J Med Internet Res , 11(2).
Alleviating Parkinsons through deep brain stimulation from Science News on Vimeo.
Deep Brain Stimulation (DBS) is mostly used for Parkinson’s Disease. DBS for Obsessive Compulsive Disorder and Depression is just starting to be used. It is unclear how DBS works for Parkinson’s Disease. With DBS an electrical probe is inserted into the brain and it stimulates [...]... Read more »
Gradinaru, V., Mogri, M., Thompson, K., Henderson, J., & Deisseroth, K. (2009) Optical Deconstruction of Parkinsonian Neural Circuitry. Science. DOI: 10.1126/science.1167093
Fuentes, R., Petersson, P., Siesser, W., Caron, M., & Nicolelis, M. (2009) Spinal Cord Stimulation Restores Locomotion in Animal Models of Parkinson's Disease. Science, 323(5921), 1578-1582. DOI: 10.1126/science.1164901
The art of Pimping: pimping occurs when an attending physician (the Pimper) poses a series of difficult questions to a resident or medical student (the Pimpee).
Pimping usually occurs in settings such as “morning report” or “attending rounds,” in which trainees at various levels convene with a faculty member to review patients currently under their care.
So [...]... Read more »
Maybe I have told you in the a previous post that I tried to do some programming in Python. It was nice but extremely difficult. This old brain wasn’t quick enough to pick up the routine. Enjoyed it while it lasted but took a lot of time and effort without much progress.
As you will probably [...]... Read more »
Zamarian, L., Ischebeck, A., & Delazer, M. (2009) Neuroscience of learning arithmetic—Evidence from brain imaging studies. Neuroscience , 33(6), 909-925. DOI: 10.1016/j.neubiorev.2009.03.005
The American Journal of Psychiatry has three articles on borderline personality disorder by some of the leading experts. Mostly about the development of the concept which is sumarized by Otto F. Kernberg and Robert Michels as:
…we have made tremendous strides in only a few decades, beginning with a theoretical concept in psychoanalysis that was ridiculed [...]... Read more »
According to a recent review of reviews it is concluded that while awaiting further high quality trial evidence it would seem appropriate for exercise to be recommended in combination with other treatments. This cautious conclusion should be that exercise is more effective than no treatment and that for mild to moderate depression it is efficacious [...]... Read more »
A recent review in Circulation is published: Cocoa and Cardiovascular Health. It reviews the clinically relevant cardiovascular effects of cocoa, focusing on potential mechanisms involved in the response to cocoa and the potential clinical implications associated with its consumption.
Recently we discussed the possible ways chocolate protects the cardiovascular system in a post. In short you [...]... Read more »
Haven’t written about adolescence for some time now. The hype of antidepressants and suicidal behavior in adolescents has slow down a bit. Did some about adolescents being brain damaged people.
To reach to some conclusions about maturation of personality during adolescence we need a scale and a lot of follow up data in a large [...]... Read more »
Adolescents need to be a part of their social group. The need to be part of a group and the need for popularity are key elements in their lives. Facebook is a way for a lot of young adults to connect to a social network. Being visible within a social network is perceived to be [...]... Read more »
Christofides, E., Muise, A., & Desmarais, S. (2009) Information Disclosure and Control on Facebook: Are They Two Sides of the Same Coin or Two Different Processes?. CyberPsychology , 2147483647-5. DOI: 10.1089/cpb.2008.0226
Chocolate milk after intensive prolonged exercise helps recovery much better than a carbohydrate replacement drink or a fluid replacement drink. After my 10 kilometer run on Sunday I’ll have some chocolate milk.
This was tested in a study in which during recovery from prolonged exercise (cycling) the participants ingested chocolate milk, carbohydrate replacement drink or a [...]... Read more »
Thomas, K., Morris, P., & Stevenson, E. (2009) Improved endurance capacity following chocolate milk consumption compared with 2 commercially available sport drinks. Applied Physiology, Nutrition, and Metabolism, 34(1), 78-82. DOI: 10.1139/H08-137
Teaching communication skills is an important component in undergraduate and postgraduate medical education. It is one of the core competencies of physicians. But how to teach these communication skills?
Why do physicians have to learn these communication skills? Because they have to discuss important topics with their patients such as:
Discussing end-of life issues
Delivering bad news
They have [...]... Read more »
Wong, R., Saber, S., Ma, I., & Roberts, J. (2009) Using television shows to teach communication skills in internal medicine residency. BMC Medical Education, 9(1), 9. DOI: 10.1186/1472-6920-9-9
In a recent study published in the Journal of the American College of Cardiology, depressive symptoms were associated with an increased risk of fatal coronary Heart Disease (CHD) in relatively healthy women with no prior coronary disease. Depressive symptoms especially antidepressant use were also associated with sudden cardiac death (SCD).
One of the main advantages [...]... Read more »
Narayan, S., & Stein, M. (2009) Do Depression or Antidepressants Increase Cardiovascular Mortality?The Absence of Proof Might Be More Important Than the Proof of Absence⁎. Journal of the American College of Cardiology, 53(11), 959-961. DOI: 10.1016/j.jacc.2008.12.009
Whang, W., Kubzansky, L., Kawachi, I., Rexrode, K., Kroenke, C., Glynn, R., Garan, H., & Albert, C. (2009) Depression and Risk of Sudden Cardiac Death and Coronary Heart Disease in WomenResults From the Nurses' Health Study. Journal of the American College of Cardiology, 53(11), 950-958. DOI: 10.1016/j.jacc.2008.10.060
Falling in love is the most overwhelming of all affective states, it typically involves emotional, cognitive, behavioral and erotic components. The functions of romantic love appear not to be limited to generate offsprings, but also to promote in individuals a stable emotional environment as well as to arise pleasant and safe feelings of happiness and [...]... Read more »
Loving, T., Crockett, E., & Paxson, A. (2009) Passionate love and relationship thinkers: Experimental evidence for acute cortisol elevations in women. Psychoneuroendocrinology. DOI: 10.1016/j.psyneuen.2009.01.010
EMANUELE, E., POLITI, P., BIANCHI, M., MINORETTI, P., BERTONA, M., & GEROLDI, D. (2006) Raised plasma nerve growth factor levels associated with early-stage romantic love. Psychoneuroendocrinology, 31(3), 288-294. DOI: 10.1016/j.psyneuen.2005.09.002
Intrinsic motivation occurs when people engage in an activity without obvious external incentives. Research has found that it is usually associated with high educational achievement and enjoyment by students. Intrinsic academic motivation has been shown to be related to better academic achievement in medical students. Extrinsic motivation refers to the desire to do something because [...]... Read more »
Tanaka, M., Mizuno, K., Fukuda, S., Tajima, S., & Watanabe, Y. (2009) Personality traits associated with intrinsic academic motivation in medical students. Medical Education, 43(4), 384-387. DOI: 10.1111/j.1365-2923.2008.03279.x
Metformin reduces the risk of cardiovascular disease after a follow-up period of 4.3 years. The risk of cardiovascular disease is reduced on average with 39% when metformin is concomitantly used with insuline for diabetes mellitus type 2. Cardiovascular disease such as heart attack, cerebrovascular accidents.
Metformin, added to insulin in patients with DM2, improved body weight, [...]... Read more »
Kooy A,, de Jager J,, Lehert P,, Bets D,, Wulffelé MG,, Donker AJ,, & Stehouwer CD. (2009) Long-term Effects of Metformin on Metabolism and Microvascular and Macrovascular Disease in Patients With Type 2 Diabetes Mellitus. Archives of Internal Medicine, 169(6), 616-625. DOI: 19307526
In psychiatry space is an important factor when approaching patients. Psychotic patients can easily misinterpret someone approaching as invading their privacy. Other patients admitted to a hospital value their privacy which is often very limited in crowded units. The space between people creates and defines the social dynamics of our interactions with others. You can [...]... Read more »
Lloyd, D. (2009) The space between us: A neurophilosophical framework for the investigation of human interpersonal space. Neuroscience , 33(3), 297-304. DOI: 10.1016/j.neubiorev.2008.09.007
This is an important question. until now all medication for Parkinson’s disease relieved the symptoms of this disease for a while. The medication couldn’t prevent the progression of the disease resulting in lack of efficacy of the medication. Increasing the dosage until side-effects or adding another therapeutic temporarily resolved the symptoms until the progression again [...]... Read more »
Charles, P., Gill, C., Davis, T., Konrad, P., & Benabid, A. (2008) Is deep brain stimulation neuroprotective if applied early in the course of PD?. Nature Clinical Practice Neurology, 4(8), 424-426. DOI: 10.1038/ncpneuro0848
Psychiatrists in the United Kingdom and The United States of America and probably also in The Netherlands hardly use scales to measure outcome when treating depressed patient. In mental health clinic or outpatient units the evaluation is typically based on unstructured interactions leading to unquantified judgment of progress. Imagine a primary physician or internist [...]... Read more »
Zimmerman, Mark, & McGlincey, Joseph B. (2008) Why Don't Psychiatrists Use Scales to Measure Outcome When Treating Depressed Patients? . Journal of Clinical Psychiatry, 1916-1919. DOI: 19192467
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