[News release] Voices in people’s heads more complex than previously thought

From the 11 March 2015 Durham University news release

Voices in people’s heads are far more varied and complex than previously thought, according to new research by Durham and Stanford universities, published in The Lancet Psychiatry today.

One of the largest and most detailed studies to date on the experience of auditory hallucinations, commonly referred to as voice hearing, found that the majority of voice-hearers hear multiple voices with distinct character-like qualities, with many also experiencing physical effects on their bodies.

The study also confirmed that both people with and without psychiatric diagnoses hear voices.

The findings question some of the current assumptions about the nature of hearing voices and suggest there is a greater variation in the way voices are experienced than is typically recognised.

The researchers say this variation means different types of therapies could be needed for voice-hearers, such as tailored Cognitive Behavioural Therapy (CBT) geared towards distinct voice sub-types or patterns of voice hearing.

Current common approaches to help with voices include medication, CBT, voice dialogue techniques and other forms of therapy and self-help.

Auditory hallucinations are a common feature of many psychiatric disorders, such as psychosis, schizophrenia and bipolar disorder, but are also experienced by people without psychiatric conditions. It is estimated that between five and 15 per cent of adults will experience auditory hallucinations during their lifetimes.

This is one of the first studies to shed light on the nature of voice-hearing both inside and outside schizophrenia, across many different mental health diagnoses.

Related articles

• Hearing voices? Don’t assume that means schizophrenia
• What Hearing Voices Is Like, As Told By Those With Auditory Hallucinations
• Voices in people’s heads more complex than previously thought
• Study Highlights Complexity of ‘Hearing Voices’
• Study Highlights Complexity of ‘Hearing Voices’

[Press release] Losing a family member in childhood associated with psychotic illness

From the 21 January 2014 press release

Highest risk seen in children who experience suicide in close family members

Experiencing a family death in childhood is associated with a small but significant increase in risk of psychosis, suggests a paper published today on bmj.com.

The researchers say that the risks are highest for children who have experienced a suicide in the ‘nuclear family’ (brothers, sisters, parents).

Previous studies have concluded that the risk of adult disease can be influenced by genetics, lifestyle and environmental experience. There is also evidence that maternal psychological stress adversely affects the development of the fetus.

Population studies have so far provided weak support for an association between prenatal maternal psychological stress and later psychosis. Researchers from the UK, US and Sweden therefore set out to examine the association between deaths in the family as a form of severe stress to the individual and subsequent psychosis. Data were taken from Statistics Sweden and the Swedish National Board of Health and Welfare and children born between 1973 and 1985 in Sweden.

Definitions of psychosis were: non-affective psychosis (including schizophrenia) and affective psychosis (bipolar disorder with psychosis and unipolar depression with psychosis).

Exposure periods were divided into ‘any exposure’ (all pre and postnatal); ‘any prenatal’ (prior to birth) and ‘any postnatal’ (birth up to 13 years of age) and further subdivided by trimester (first, second, third) and by three year periods in childhood between birth and 13 years of age (0-2.9 years; 3-6.9 years and 7-12.9 years). If more than one exposure occurred during the study period, priority was given to the earliest exposure.

Death was categorised into suicide, fatal injury / accident and others (such as cancers and cardiac arrests).

Models were adjusted for year of birth, child sex, maternal and paternal age, maternal and paternal nationality, parental socioeconomic status and history of any psychiatric illness in the family.

The final number of children included in the study was 946,994. Altogether, 321,249 (33%) children were exposed to a family death before the age of 13. Of individuals exposed to any death during the study period, 1323 (0.4%) developed a non-affective psychosis while 556 (0.17%) developed an effective psychosis. 11,117 children were exposed to death from suicide, 15,189 from accidents and the majority, 280,172 to deaths due to natural causes.

No increased risk of psychosis was seen following exposure in any prenatal period. Postnatally, an increased risk of ‘all psychosis’ was associated with deaths in the nuclear family and risk increased the earlier in childhood the death occurred.

Risks associated with exposure to suicide were higher compared with exposure to deaths from accidents which in turn were higher than risks associated with other deaths from natural causes.

The largest risk was seen in children exposed ages 0-3 years and risks reduced as age of exposure increased.

Professor Kathryn Abel, from the Centre for Women’s Mental Health at The University of Manchester, said: “Our research shows childhood exposure to death of a parent or sibling is associated with excess risk of developing a psychotic illness later in life. This is particularly associated with early childhood exposure. Further investigation is now required and future studies should consider “the broader contexts of parental suicide and parental loss in non-western, ethnically diverse populations.”

 

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Research: Severe bereavement stress during the prenatal and childhood periods and risk of psychosis in later life: population based cohort study

 

 

The psychiatric profile of the U.S. patient population across age groups

From the article at the May 2012 issue of Open Journal of Epidemiology

[Abstract]     Introduction: As the U.S. population undergoes continuous shifts the population’s health profile changes dynamically resulting in more or less expression of certain psychiatric disorders and utilization of health-care resources. In this paper, we analyze national data on the psychiatric morbidity of American patients and their summated cost in different age groups. Methods: The latest data (2009) on the number of hospital discharges and national bill (hospital charges) linked with psychiatric disorders were extracted from the Nationwide Inpatient Sample (NIS). Results: National data shows that mood disorders are the largest diagnostic category in terms of percentage of psychiatri-crelated discharges in the 1 – 17 years age group. The proportion decreases gradually as age progresses while delirium, dementia, amnestic and other cognitive disorders increase exponentially after 65 years of age. Schizophrenia and other psychotic disorders as well as alcohol and substance-related disorders peak in the working age groups (18 – 64 years). From an economic point of view, mood disorders in the 18 – 44 age group has the highest national bill ($5.477 billion) followed by schizophrenic and other psychotic disorders in the same age group ($4.337 billion) and mood disorders in the 45 – 64 age group ($4.310 billion). On the third place come schizophrenic and other psychotic disorders in the 45 – 64 age group ($3.931 billion). Conclusion: This paper illustrates the high cost of psychiatric care in the U.S., especially the large fraction of healthcare money spent on working-age patients suffering from mood disorders. This underlines psychiatric cost-efficiency as a vital topic in the current healthcare debate.

Related article

• Major Depressive Episode among Full-Time College Students and Other Young Adults, Aged 18 to 22 (US Substance Abuse and Mental Health Administration, May 2012)