415 posts · 641,625 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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- May 22, 2008
- 05:00 AM
- 849 views
Screening Adolescents for Depression on the Internet
by Dr Shock in Dr Shock MD PhD
Screening for depression through the Internet is feasible and is acceptable to large groups of adolescents. Furthermore, the Major Depression Inventory (MDI) and the Center for Epidemiological Studies-Depression scale for Children (pdf, small) (CES-D) are reliable and valid instruments that can be used for this screening.By the age of 18 about one in every four adolescents has had at least onedepressive episode, and most adults with recurrent depression have their initial depressive episodes as teenagersTeen depression or depression during adolescence can be... Read more »
Pim Cuijpers, Petra Boluijt, & Annemieke Straten. (2008) Screening of depression in adolescents through the Internet. European Child , 17(1), 32-38. DOI: 10.1007/s00787-007-0631-2
- May 21, 2008
- 04:00 AM
- 844 views
Facts about Chocolate and Health
by Dr Shock in Dr Shock MD PhD
Cocoa is rich in polyphenols, similar to those found in green tea, and as polyphenols have been shown to have beneficial effects on cardiovascular disease such as hypertension, stroke, myocardial infarction but also diabetesFor cocoa, the terms that are used to describe the particular compounds of interest are flavanols. Flavanols are a subclass of flavonoids which are, in turn, a subclass of polyphenolsCocoa is the non-fat component of cocoa liquor (finely ground cocoa beans) which is used in chocolate making or as cocoa powder (commonly 12 % fat) for cooking and drink... Read more »
Karen Cooper, Jennifer L Donovan, Andrew L Waterhouse, & Gary Williamson. (2008) Cocoa and health: a decade of research. British Journal of Nutrition, 99(01). DOI: 10.1017/S0007114507795296
- May 16, 2008
- 04:00 AM
- 900 views
How can Genes and Stress cause Depression?
by Dr Shock in Dr Shock MD PhD
The answer is: in the stress system. Stress reactivity might be an important link between a genetic variant of the serotonin transporter gene, stressful life events in early years and depression.There is evidence of interaction between a functional genetic variant of the serotonin transporter gene and life events. Depression is not based on a simple gene or a cluster of genes. But on a gene and environment interaction. So the risk of getting a depression is higher when a certain genetic variant of the serotonin transporter gene is present in the presence of life stress, espec... Read more »
I GOTLIB, J JOORMANN, K MINOR, & J HALLMAYER. (2007) HPA Axis Reactivity: A Mechanism Underlying the Associations Among 5-HTTLPR, Stress, and Depression. Biological Psychiatry. DOI: 10.1016/j.biopsych.2007.10.008
- May 15, 2008
- 06:00 AM
- 907 views
Speciality Choice of Medical Students, Impact of Clerkship
by Dr Shock in Dr Shock MD PhD
I wanted to be a psychiatrist before I went to Med School. Fascinated by the work of Jung and especially Freud, psychiatry seemed the ultimate goal for Med School. Encountered these pioneers while reading literature and a new goal was formulated. Before that my hart was set on social geography, thank god I changed my mind.Other factors such as the encounter with people out of the ordinary during my earlier years most certainly did help my career choice but I found out after finishing Med School during residency in psychiatry.During Med School I only once doubted my choice. It... Read more »
Tanja Maiorova, Fred Stevens, Albert Scherpbier, & Jouke van der Zee. (2008) The impact of clerkships on students’ specialty preferences: what do undergraduates learn for their profession?. Medical Education, 42(6), 554-562. DOI: 10.1111/j.1365-2923.2008.03008.x
- May 12, 2008
- 05:00 AM
- 877 views
Does Vascular Depression Exist?
by Dr Shock in Dr Shock MD PhD
Are the recent claims to fame from a SSRI and rTMS right for treatment of vascular depression or just treatments seeking new markets? I think the latter. rTMS is of dubious efficacy in the treatment of depression and new "me too" SSRI's are struggling for a share.Vascular depression is in the news, especially due to the latest annual meeting of the American Psychiatric Association in Washington DC. Claim has been made that Several Therapies Show Promise for Vascular Depression meaning a SSRI and rTMS. See also Anxiety Insights. But does the diagnostic entity of Va... Read more »
Emma Teper, & John O'Brien. (2008) Vascular factors and depression. International Journal of Geriatric Psychiatry. DOI: 10.1002/gps.2020
H Luijendijk, B H Stricker, A Hofman, J C Witteman, & H Tiemeier. (2008) Cerebrovascular risk factors and incident depression in community-dwelling elderly. Acta Psychiatrica Scandinavica, 2147483647. DOI: 10.1111/j.1600-0447.2008.01189.x
- May 9, 2008
- 05:00 AM
- 915 views
Chronicity in Depression
by Dr Shock in Dr Shock MD PhD
Major depressive disorder is unremitting in 15% of casesMajor depressive disorder is recurrent in 35%.About half of those with a first-onset episode recover and have no further episodes.53% of those with a lifetime episode of depressive disorder either do not recover at all or have at least 1 recurrence.What is new in this research?The focus of this analysis is the group of 92 participants who experienced an episode of depression (meeting criteria for DSM-IV) for the first time in their life during the follow-up. Seventy-one first lif... Read more »
William Eaton. (2008) Population-Based Study of First Onset and Chronicity in Major Depressive Disorder. Archives of GeneralPsychiatry, 65(5), 513-520. info:PMID/18458203
- May 8, 2008
- 04:00 AM
- 589 views
rTMS not Effective for Depression
by Dr Shock in Dr Shock MD PhD
Rapid Transcranial Magnetic Stimulation (rTMS) to the left prefrontal cortex is not more effective than sham rTMS for depression. This was the result of a recent published randomized controlled trial with 4 month follow-up.rTMS is a non-invasive method to stimulate the brain. Weak electric currents are induced in the cortex of the brain by rapidly changing magnetic fields (electromagnetic induction). This way, brain activity can be triggered with minimal discomfort, no need for anesthesia, and no cognitive side-effects. Side effects of rTMS are: discomfort or pain from the st... Read more »
A Mogg, G Pluck, S V Eranti, S Landau, R Purvis, R G Brown, V Curtis, R Howard, M Philpot, & D M McLoughlin. (2008) A randomized controlled trial with 4-month follow-up of adjunctive repetitive transcranial magnetic stimulation of the left prefrontal cortex for depression. Psychological Medicine, 38(03). DOI: 10.1017/S0033291707001663
K P Ebmeier, & L L Herrmann. (2008) TMS – the beginning of the end or the end of the beginning?. Psychological Medicine, 38(03). DOI: 10.1017/S0033291707001651
- May 7, 2008
- 03:00 AM
- 585 views
Elderly Refuse Clinical Trials
by Dr Shock in Dr Shock MD PhD
A failed randomized controlled trial of Fluoxetine versus placebo in elderly stroke survivors due to reluctance and subsequent informal discussions by their treating physicians. Also due in part to high community prescribing rates of antidepressants by general practitioners. In a recent research showed that 15% of adults aged over 75 years are in receipt of an antidepressant prescription from their general practitioner, half of them for more than 2 years and many without formal review. So adolescents your not alone. Elderly are not alone as well, in The Netherlands it was ha... Read more »
M Ruddell, A Spencer, K Hill, & A House. (2007) Fluoxetinevs placebo for depressive symptoms after stroke: failed randomised controlled trial. International Journal of Geriatric Psychiatry, 22(10), 963-965. DOI: 10.1002/gps.1771
- May 5, 2008
- 04:00 AM
- 557 views
More Agressive People Play The Game More Violently
by Dr Shock in Dr Shock MD PhD
Computer game players with more physical-aggressive personality manifest more violent behaviors in game playing with more violent interactions, more frequent punching and kicking actions, and more frequent shootings. This research is one of the first to show that personality is an important factor in how a game is played.The most important contribution of this study is that it investigated the individual experience of game playing. Most of the existent studies, especially experimental studies, simply compare a group of people playing a violent game and another group playing a... Read more »
Wei Peng, Ming Liu, & Yi Mou. (2008) Do Aggressive People Play Violent Computer Games in a More Aggressive Way? Individual Difference and Idiosyncratic Game-Playing Experience. CyberPsychology , 11(2), 157-161. DOI: 10.1089/cpb.2007.0026
- May 3, 2008
- 02:00 PM
- 702 views
Genes Predict Reponse to Lithium Addition for Treatment Resistant Depression
by Dr Shock in Dr Shock MD PhD
Genotyping the serotonin transporter gene polymorphism could be a tool for predicting response to a certain treatment pathway. Patients with the s/s genotype who according to the literature seem to be at risk for a less favorable response to antidepressant monotherapy might particularly benefit from augmentation strategies.Thus, early lithium augmentation in these patients (with the s/s genotype) could be a promising strategy and might help to reduce the occurrence of treatment resistance in depressive disorders.There is evidence of interaction between a functiona... Read more »
Thomas Stamm. (2008) Serotonin transporter gene and response to lithium augmentation in depression. Psychiatric Genetics, 18(2), 92-97. info:PMID/18349701
- May 3, 2008
- 06:00 AM
- 728 views
Genes Predict Reponse to Lithium Addition
by Dr Shock in Dr Shock MD PhD
Genotyping the serotonin transporter gene polymorphism could be a tool for predicting response to a certain treatment pathway. Patients with the s/s genotype who according to the literature seem to be at risk for a less favorable response to antidepressant monotherapy might particularly benefit from augmentation strategies.Thus, early lithium augmentation in these patients (with the s/s genotype) could be a promising strategy and might help to reduce the occurrence of treatment resistance in depressive disorders.There is evidence of interaction between a functiona... Read more »
Thomas Stamm. (2008) Serotonin transporter gene and response to lithium augmentation in depression. Psychiatric Genetics, 18(2), 92-97. info:PMID/18349701
- May 1, 2008
- 05:00 AM
- 903 views
Short-term Chocolate Effects on Health
by Dr Shock in Dr Shock MD PhD
In a placebo controlled trial of 6 weeks duration the consumption of dark chocolate had no beneficial effects on neuropsychological (e.g. memory, concentration) or cardiovascular (e.g. blood pressure, lipid levels) health related variables. At least not when your healthy, well educated and above 60 (see the limitations).Chocolate and cocoa products may promote cardiovascular and neurocognitive health and provide cardioprotective effects: chocolate and cocoa-related products have been shown to decrease or inhibit both LDL oxidation and platelet activat... Read more »
David Crews. (2008) A double-blind, placebo-controlled, randomized trial of the effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health: clinical findings from a sample of healthy, cognitively intact older adu. American Journal of Clinical Nutrition, 87(4), 872-880. info:PMID/18400709
- April 30, 2008
- 05:00 AM
- 527 views
Alzheimer Severity and Prevalence of Depression Not Associated
by Dr Shock in Dr Shock MD PhD
Comorbid depressive symptomatology or diagnosed depression is not more prevalent in early, mild or severe Alzheimer's disease. This is an important conclusion from a recent systematic review. Before theories existed about the relationship between Alzheimer's and depression. These theories said that the prevalence of depression either decreases or increases with the increasing severity of Alzheimer's disease.This is comparable to the relationship between depression and personality, does personality predispose to depression or is personality affected by going through depression... Read more »
Renate Verkaik, Jasper Nuyen, François Schellevis, & Anneke Francke. (2007) The relationship between severity of Alzheimer's disease and prevalence of comorbid depressive symptoms and depression: a systematic review. International Journal of Geriatric Psychiatry, 22(11), 1063-1086. DOI: 10.1002/gps.1809
- April 29, 2008
- 04:00 AM
- 916 views
Personality of Online Game Players
by Dr Shock in Dr Shock MD PhD
Online game players score higher in openness, conscientiousness and extraversion compared to non players. They are eager to learn and master new challenges, they are motivated by competition and they enjoy social activities which can all be provided by online game playing. The online game playing provides them with initial experiences of success and then provide them with more complex challenges creating a flow of immersed experience further satisfying their needs. This creates a positive spiral enhancing their online game experience.Chin-I Teng the author o... Read more »
Ching-I Teng. (2008) Personality Differences between Online Game Players and Nonplayers in a Student Sample. CyberPsychology , 11(2), 232-234. DOI: 10.1089/cpb.2007.0064
- April 28, 2008
- 06:00 AM
- 961 views
Computer Based Psychotherapy
by Dr Shock in Dr Shock MD PhD
Patients often improve more with computer based cognitive-behavioral psychotherapy than with conditions such as waiting list control or care as usual, says a recent review. This is coupled with an over 50% cut in usual therapist time. This review is published in a book: Hands-on Help Computer-aided Psychotherapy. A book review in the Am. J. PsychiatryHands-on Help is a narrative review of the mushrooming field of computer-aided psychotherapy for mental health problems as a whole, from the time it began in the 1960's through to the present day. The many types of computer-aided psychother... Read more »
I Marks, K Cavanagh, & L Gega. (2007) Computer-aided psychotherapy: revolution or bubble?. The British Journal of Psychiatry, 191(6), 471-473. DOI: 10.1192/bjp.bp.107.041152
- April 24, 2008
- 05:00 AM
- 887 views
Cocaine addiction, web based information useless
by Dr Shock in Dr Shock MD PhD
The quality of information on cocaine addiction on the web is generally poor, confirming previous studies on other health issues. Furthermore, universities seem to be poorly active in proposing websites (8.2%), while commercial organizations hold 55.7% of the studied websites.This seems a little of topic but for depression the quality of websites for information about depression and it's treatment is also poor. Wouldn't it be nice to have a quality scale for health websites? The authors used quality indicators. They looked at: quality of content, design and aesthe... Read more »
Y KHAZAAL, A CHATTON, S COCHAND, & D ZULLINO. (2008) Quality of web-based information on cocaine addiction. Patient Education and Counseling. DOI: 10.1016/j.pec.2008.03.002
- April 21, 2008
- 06:00 AM
- 838 views
Light Affects Mood and Performance during Computer Gaming
by Dr Shock in Dr Shock MD PhD
Game players perform best and fastest in a computer game world lit with a warm (reddish) as compared to a cool (bluish) lighting. Red lightning in a Computer Game also induced the highest level of pleasantness in game users.It was probably the level of pleasantness induced by the warm lighting that enhanced the players' better performance in that digital game world.These were the results of a recent article in CyberPsychology & Behavior: Lighting in Digital Game Worlds: Effects on Affect and Play PerformanceThese results are important for game designers and ... Read more »
Igor Knez, & Simon Niedenthal. (2008) Lighting in Digital Game Worlds: Effects on Affect and Play Performance. CyberPsychology , 11(2), 129-137. DOI: 10.1089/cpb.2007.0006
- April 18, 2008
- 05:00 AM
- 946 views
Again Open Label Research with rTMS
by Dr Shock in Dr Shock MD PhD
Another open labeled trial with rTMS. It is a continuation trial after a recent double-blind placebo controlled trial with rTMS.This study is discussed in a recent post on this blog: Finally some good news about rTMS?Considering the outcome on the time point at week 4, Dr Shock is not very impressed by the results. For significant difference with the primary outcome 6 patients had to be excluded from the analysis. The mean difference between active and sham on the severity scales is in the range of 2-3 points, significant but hardly clinical relevant. The NICE guidelines use a diff... Read more »
David Avery. (2008) Transcranial magnetic stimulation in the acute treatment of major depressive disorder: clinical response in an open-label extension trial. Journal of Clinical Psychiatry, 69(3), 441-451. info:PMID/18294022
- April 17, 2008
- 02:00 AM
- 711 views
6 Reasons Not To Trust Medical Publications
by Dr Shock in Dr Shock MD PhD
Medicine in every aspect is influenced by the pharmaceutical companies and medical device industries. This influence also jeopardizes medical publications in, until recent respected journals. These are the tricks used to influence the medical publications even in high ranking medical journals:They use Guest authorship. This has been defined as the designation of an individual who does not meet authorship criteria as an author.First authorship is wrongly attributed to academically affiliated investigators who had little or nothing to do with the reported research.... Read more »
Joseph Ross. (2008) Guest Authorship and Ghostwriting in Publications Related to Rofecoxib. JAMA, 299(15), 1800-1812. http://jama.ama-assn.org/cgi/content/full/299/15/1800
- April 15, 2008
- 06:00 AM
- 554 views
25% of Medical women students experience sexual harassment
by Dr Shock in Dr Shock MD PhD
Most of the incidents referred to flirtations or sexual remarks.The majority experienced 1 incident of sexual harassment, 6.7% reported 3 or more incidents.The offenders were all male except in one case, 66% were patients the others were medical doctors or residents.Three of 10 students reported that the incident had a negative influence on their functioning afterwards.The majority (77.8%) discussed the incident with their peers, usually other medical studentsThree quarters of the students were satisfied with the way the incident was dealt with... Read more »
Jany Rademakers, Maria E van den Muijsenbergh, Geerte Slappendel, Antoine L Lagro-Janssen, & Jan C Borleffs. (2008) Sexual harassment during clinical clerkships in Dutch medical schools. Medical Education, 42(5), 452-458. DOI: 10.1111/j.1365-2923.2007.02935.x
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