WKPIC is thrilled to announce that former intern Danielle McNeill has completed licensure in the State of Kentucky! She’s all official now!
WAY TO GO, DR. MAC!!
<You are now free to recruit minions of your very own.>
May 05 2016
May 05 2016
Friday Factoids Catch-Up: Controversial Illnesses–Morgellons Disease
Morgellons Disease is a controversial and poorly understood condition in which unusual thread-like fibers appear under the skin. The patient may feel like something is crawling, biting, or stinging all over. Some medical experts say Morgellons is a physical illness, while others suggest it is a type of psychosis called “delusional parasitosis,” in which a person thinks parasites have infected their skin. Patients with delusional parasitosis often present pieces of clothing lint, skin, or other debris and place them in plastic wrap, on adhesive tape, or in matchboxes. They typically state that these contain the parasites; however, these collections have no insects or parasites.
Symptoms that are typically associated with Morgellons are unpleasant skin sensations, feeling like bugs are crawling all over the skin, burning or stinging sensations under the skin, intense itching, skin sores that appear suddenly and heal slowly, sores that leave very red scars, and reports thread-like fibers stuck in the skin. People with Morgellons sometimes complain of other symptoms which may include extreme fatigue, hair loss, joint and muscle pain, nervous system problems, tooth loss, sleep problems, and short-term memory loss. Doctors often tell patients that this is an “unexplained dermopathy,” which means a skin condition that occurs without a known reason. Other medical professionals have called the condition a “fiber disease.”
In the past, few doctors had heard of Morgellons. But in response to scattered reports, the Centers for Disease Control and Prevention (CDC) worked together with several other health care agencies to investigate this condition. Most reports come from California, Texas, and Florida, although patients have been seen in all 50 states. A CDC study found that Morgellons is most likely to affect middle-aged white women. Oddly enough, delusions of parasitosis also occur primarily in white middle-aged or older women.
The question of whether Morgellons is a disease or a delusion has prompted debate and new research in recent years. The CDC states that the condition is not caused by an infection or anything in the environment. The CDC study also included a lab analysis of skin fibers in Morgellons patients. The analysis showed that these fibers were mostly cotton, such as typically found in clothing or bandages. From a 2012 study, neuropsychological testing revealed a substantial number of study participants who scored highly in screening tests for one or more co-existing psychiatric or addictive conditions, including depression, somatic concerns, and drug use.
Others researchers say that Morgellons results from an infectious process in the skin cells. Research also revealed that the skin sores seemed to be the result of long-term picking and scratching the skin. Previous case studies have suggested that Morgellons may be linked to Lyme disease. Some patients with signs and symptoms of Morgellons had tested positive for the bacteria that causes Lyme disease. But according to Morgellons researchers at Oklahoma State University, there is no evidence to prove this theory. Likewise, there was no evidence of Lyme infection in any of the people in the CDC study. A 2010 study found a potential link between Morgellons symptoms and hypothyroidism. More research needs to be done to further investigate the findings.
There is no known cure for Morgellons. Treating any medical or psychiatric problems that occur at the same time as Morgellons may help ease symptoms in some patients. Medical researchers usually recommend that patients with these symptoms should undergo psychiatric evaluation. Some people who suspect they have Morgellons disease claim they have been ignored or dismissed as fakers. It is not uncommon for people who report signs and symptoms of Morgellons disease to resist other explanations for their condition,
References:
Ballatyne, C. (2009). “What is Morgellons Disease? Is it a physical or psychological condition?” Scientific American. Retrieved from http://www.scientificamerican.com/article/morgellons-disease-parasites-skin-psychiatric/
Pearson, M.L., Selby, J.V., Kenneth, K.A., Cantrell, V., Braden, C.R., Parise, M.E.,…Lewis, B. (2012). Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy. Plos One. Retrieved at http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0029908
The Morgellon Research Foundation. (n.d.)What is Morgellons Disease? Retrieved from http://www.morgellons-research.com
Jonathan Torres
WKPIC Pre-doctoral Intern
May 05 2016
Friday Factoids Catch-Up: Euthanasia for Psychiatric Patients?
At least three countries, the Netherlands, Belgium and Switzerland, allow assisted suicides for people who have severe psychiatric illnesses. Other countries, like Canada, are debating such measures, citing the rights of people with untreatable mental illness. Laws in the United States, passed in five states, restrict doctor-assisted suicide to mentally competent adults with terminal illnesses only, not for psychiatric disorders. In 2002, euthanasia was legalized in the Netherlands for those with “unbearable suffering with no prospect of improvement.” The Netherlands has seen a sharp increase in the number of people choosing to end their own lives due to mental health problems.
Last year 56 people were euthanized in the Netherlands, whereas just two people were euthanized in 2010 due to an “insufferable” mental illness. The criteria for euthanasia in the Netherlands essentially require that the person’s disorder be “intractable” and “untreatable.” Experts worry how these criteria can be measured in patients with dementia or psychiatric illnesses. The most recent controversial case, a woman in her twenties was allowed to go ahead with the procedure as she was suffering from “incurable” posttraumatic stress disorder (PTSD), according to the Dutch Euthanasia Commission. Her conditions included childhood sexual abuse, anorexia, depression, and self-harming behaviors. She was given a lethal injection after doctors and psychiatrists decided that her mental health conditions were incurable. The injection went ahead despite improvements in the woman’s psychological condition after ‘intensive therapy’ two years ago.
Records from cases of doctor-assisted death for psychiatric distress from 2011 to mid-2014 show that 37 of the 66 cases, people had refused a recommended treatment that could have helped. Depression was the most common diagnosis and loneliness was a frequent theme. Most of the patients had a chronic and severe mental illness with histories of suicide attempts and psychiatric hospitalizations. Of the patients included in the study, 70 percent (n = 46) were women; 32 percent (n = 21) were aged 70 years or older, and 44 percent (n = 29) were aged 50 to 70 years. The ratio of women to men was notable in that it is the reverse of the ratio of women to men who commit suicide without assistance in the Netherlands (43 percent women versus 57 percent men). More than half had received a personality disorder diagnosis of Avoidant or Dependent Personality Disorder.
The data also revealed that euthanasia is often granted despite disagreement by treating physicians and psychiatrists over whether cases meet criteria for “unbearable suffering.” Although euthanasia review committees typically defer decisions to the judgment of physicians, that judgment often appears inconclusive. In 24 percent (n = 16) of cases, there was disagreement among consultants; 11 percent (n = 7) of cases were found to have had no independent psychiatric input at all; and one case was found by a review committee to have failed to meet legal due-care criteria. Only 41 percent (n = 27) of physicians administering the assisted suicide were psychiatrists, and among 32 percent (n = 21) of patients, previous assisted suicide requests had been refused. Three of the patients had physicians who later changed their mind, and 18 were granted the assisted suicide from physicians who were new to them. Among those, 14 of the physicians were affiliated with a mobile euthanasia clinic called the End-of-Life Clinic. In 12 percent of cases (n = 8), the researchers found evidence that the psychiatrist involved believed that the criteria for granting a request were not met, but the assisted death took place anyway.
Paulan Stärcke, a Dutch psychiatrist, reported that even children as young as 12-years-old who ask to end their lives should be taken seriously. She stated, “Euthanasia is a good death by the wish of the person who dies and no-one else. It is an execution of the wish of a patient.” Opponents of the law argue that the primary purpose of psychiatric care should be the prevention of suicide, but the opposing argument is that the suffering of some psychiatric patients is as “unbearable” as the suffering of patients with other medical conditions prevailed.
I ask the readers, what’s your view point?
References:
Boztas, S. (2016, May 11). Netherlands Sees Sharp Increase In People Choosing Euthanasia Due To ‘Mental Health Problems.’ The Telegraph. Retrieved from
http://www.telegraph.co.uk/news/2016/05/11/netherlands-sees-sharp-increase-in-people-choosing-euthanasia-du/
Melville, N. A. (2016, February 10). Euthanasia for ‘Untreatable’ Mental Illness: New Data. Retrieved from http://www.medscape.com/viewarticle/858786
Jonathan Torres, M.S.
WKPIC Pre-Doctoral Intern
May 05 2016
Friday Factoid Catch-Up: Your Brain on LSD
A Friday Factoid was written by this writer in November 2015 about the research behind psychedelic-assisted therapy. Several studies have shown that positive results can come from short courses or single sessions of psychedelic-assisted psychotherapy.
Until recently, there had been no modern brain images of someone on lysergic acid diethylamide (LSD) to show exactly how this drug affects the brain’s connections.
Researcher David Nutt, a neuropsychopharmacologist at Imperial College London, performed a recent two-day study with twenty healthy volunteers. On one day volunteers got a 75-microgram injection of LSD, and on the second day, they got a placebo. Researchers used three different brain imaging techniques to measure and compare blood flow, brainwaves, and functional connections within and between brain networks in volunteers on the placebo and under the influence of the drug. David Nutt stated about the discovery, “This is to neuroscience what the Higgs boson was to particle physics.” Consider that neuroscientist have waited over 50 years for these images since the drug was banned in the 1960s.
What researchers found sheds lights on how people who have taken psychedelics have reported feeling they are “one with nature” and that the self “dissolved.” The regions of the brain responsible for higher cognition lit up and suddenly become hyper-connected with other networks in the brain that do not normally communicate with one another. The study’s volunteers on LSD reported experiencing their sense of self dissolve, which is what researchers’ call “ego dissolution.” For people, ego dissolution can be a positive experience leading to peace, acceptance, and a new perspective of things.
Volunteers taking LSD appeared to process their visual world in fundamentally different ways from people who were not given the drug. Typically, the activity in our brain flows along specific neural networks. Although the primary visual cortex usually communicates mainly with other parts of the vision system, many other brain areas contributed to the processing of images in volunteers who received LSD. The visual cortex became much more active with the rest of the brain, and blood flow to visual regions also increased, which the researchers believe correlates with the hallucinations reported by volunteers and the emotional experience they can take.
Enzo Tagliazucchi, a neuroscientist who helped lead the study said, “This could mean that LSD results in a stronger sharing of information between regions that deal with how we perceive ourselves and how we perceive the outer world.” For example, LSD appeared to trigger the frontoparietal cortex, which is an area of the brain associated with self-consciousness, and strongly connect it with areas of the brain that process sensory information about the world outside ourselves. That interconnectedness may be creating a stronger link between our sense of self, sense of the environment, and potentially diluting the boundaries of our individuality.
The study found that the increased interconnectedness of brain regions, while on LSD, makes the brain of an adult resemble something like the brain of a baby, which is more free and unconstrained. In the adult brain, networks that control vision, movement, and hearing function separately. LSD lifts the barriers between these networks and stimulates the unconstrained flow of information between them that leads to a hyper-imaginative state of thinking.
Researchers found that communication between the parahippocampus, a brain region important in memory storage and the visual cortex, is reduced when you take LSD. When you hear music the visual cortex receives more information from the parahippocampus, and this is associated with increases in imagery with your eyes closed. Music appears to enhance the LSD experience and might be important in therapeutic settings. This could have great implications in the treatment of depression, addiction, or other mental disorders that emphasize negative thoughts. The improvement of well-being does not appear to subside after the drug has worn off.
References:
Brodwin, E. (2016, April 12). Mind-Blowing New Images Show How LSD Changes The Way Parts of the Brain Communicate. Business Insider. Retrieved from http://www.businessinsider.com/new-images-show-how-lsd-and-psychedelics-affect-the-brain-2016-4
Sample, I. (2016, April 11). LSD’s Impact On The Brain Revealed In Groundbreaking Images. The Guardian. Retreived from https://www.theguardian.com/science/2016/apr/11/lsd-impact-brain-revealed-groundbreaking-images
Schlanger, Z. (2016, April 12). Brain Scans Show Why LSD Makes You Feel One With Nature And Your Self Dissolve. News Week. Retrieved from http://www.newsweek.com/2016/04/22/lsd-brain-scan-nature-self-psychedelics-446513.html
Jonathan Torres, M.S.
WKPIC Pre-Doctoral Intern
May 05 2016
Behind on Blogging!
I admit it. WE’RE BEHIND.
But, we’re starting our catch-up today! With something very, very, very important.
Former intern Brittany Best (2014-2015) is one step closer to being official!
