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The Rosalynn Carter Fellowships for Mental Health Journalism 2004-2005

Greg Miller
Senior writer, WIRED magazine
San Francisco, Calif., USA

TOPIC: Explore the looming mental health crisis in developing countries.

The Tsunami's Psychological Aftermath
The massive psychosocial relief effort has had its problems, but most survivors of the Indian Ocean disaster have shown remarkable resilience.

Poor Countries, Added Perils for Women
When the Indian government disbursed the first round of financial aid to families in Tamil Nadu state, hard hit by the 26 December 2004 tsunami, they doled it out to the men, the traditional household heads.

The Unseen: Mental Illness's Global Toll
Proper care of the mentally ill is often viewed as an expendable luxury in the developing world. Recent research, including studies of depression in China and schizophrenia treatment in India, suggests it doesn't have to be that way.

China: Healing the Metaphorical Heart
Eastern and Western concepts of mental health clash as psychiatrists seek to reconcile China's apparent scarcity of mental illness with its high suicide rate.

A Spoonful of Medicine - and a Steady Diet of Normality
Private hospitals in India are showing that the best treatment for mentally ill patients is to lend purpose to their lives.

Mapping Mental Illness: An Unseen Topography
Mental disorders were once considered diseases of the affluent, but there are reasons to suspect that the opposite might be correct because known risk factors for poor mental health--poverty, HIV, and violence--afflict many parts of the developing world.

In a steady stream of recent papers, social psychologists have identified several potentially unhealthy changes in the cardiovascular, immune, and nervous systems of chronically lonely people. The findings could help explain why epidemiological studies have often found that socially isolated people have shorter life spans and increased risk of a host of health problems, including infections, heart disease, and depression.

People who are good at solving one type of brainteaser tend to excel at a variety of mental calisthenics - support, many psychologists say, for the concept of general intelligence. A study published online this week in Science extends this concept to groups of people, arguing that groups have a "collective intelligence" that predicts their performance on a range of collaborative tasks.


On 4 February, GlaxoSmithKline (GSK) announced that it planned to pull the plug on drug discovery in some areas of neuroscience, including pain and depression. A few weeks later, news came that AstraZeneca was closing research facilities in the United States and Europe and ceasing drug-discovery work in schizophrenia, bipolar disorder, depression, and anxiety.


Recent work suggests that so-called epigenetic mechanisms of gene regulation, which alter the activity of genes without changing their DNA sequence, could explain how early life experiences can leave an indelible mark on the brain and influence both behavior and physical health later in life. These effects may even carry over to subsequent generations.

Modern research in neuroscience and genetics has provided a more sophisticated understanding of mental illness, and harnessing this knowledge to improve the diagnosis of psychiatric disorders was a major impetus for undertaking a revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM). But even some of those leading the revision say there's still too little known about the biological basis of mental illness, and as a result, DSM continues to be based on symptoms rather than causes.

The clinicians and researchers working on revisions to psychiatrists' bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM), have been wrestling with how to improve the diagnosis of mental disorders in children and adolescents. It's not clear how their suggestions, released last month, would affect the prevalence of mental disorders if adopted, but they are already altering the discussion.


After more than a decade of labor, the American Psychiatric Association (APA) has released draft proposals for the upcoming fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the most influential book in psychiatry. Among a number of new proposals that seem likely to cause a stir are a diagnosis of "pre-psychotic risk syndrome" applicable to young people and a redefinition of autism spectrum disorders that would eliminate Asperger's syndrome, which many consider a mild form of autism.


The Alzheimer's Disease Neuroimaging Initiative (ADNI), an effort to develop biomarkers for Alzheimer's disease, is churning out new data and making plans to expand. ADNI researchers are now poring over brain scans and other biomarker data to document changes as people who started out with a clean slate of cognitive health have developed mild cognitive impairment, a condition that often presages Alzheimer's, and as those with MCI have progressed to Alzheimer's.

Guided by a passionate leader, a new research institute hopes to draw lessons from Buddhism to study altruism and make the world a better place. The Center for Compassion and Altruism Research and Education will study the biological roots of benevolent behavior and investigate whether mental exercises derived from the centuries-old tradition of Buddhist compassion meditation--but stripped of religious trappings - can foster compassion in nonbelievers.


A wide range of neuropsychiatric disorders seems to respond to deep brain stimulation - but how does it work, and where will it lead?

With a mobile brain scanner and permission to work with inmates in New Mexico state prisons, Kent Kiehl hopes to understand what goes awry in the brains of psychopathic criminals

 
Two studies appearing in this week's issue of Science - one with rats (p. 1322) and one with people undergoing surgery for intractable epilepsy - suggest that patterns of neuron firing in the hippocampus are also involved in recalling past experiences.


A collaboration between sports psychologists and cognitive neuroscientists is trying to figure out what gives successful athletes their mental edge.


Neurobiologists, philosophers, psychologists, and legal scholars are probing the nature of human morality using a variety of experimental techniques, including one reported online this week in Science, and moral challenges.


New treatments, some now in clinical trials, reflect a growing awareness that people with different genetic profiles and drinking histories may need different therapies.


On page 980 of this week's issue of Science, a multidisciplinary team describes a technique that uses magnetic resonance spectroscopy to detect a biomarker for the progenitor cells that give rise to new neurons.

Biomedical facilities are expanding after a growth spurt in the budget of the National Institutes of Health. Yet individual scientists say that it's harder than before to get their work funded.


The lessons of Vietnam have prompted U.S. military leaders to do more to protect the mental health of troops in Iraq and Afghanistan. But will these efforts be effective?


By scanning activity within the skull, researchers are trying to understand how our brains manage interactions with other people.

Many studies have found modest correlations between the size of a person's brain and various measures of mental ability. Now, a study in the 30 March issue of Nature suggests that how the brain develops may be even more important to one's intellect than its final dimensions.


Can pre-deployment tests identify - and possibly help - the soldiers most susceptible to posttraumatic stress disorder and depression?


Could brain injuries suffered in battle put troops at risk for dementia? Recent findings of pathology in athletes, among other evidence, are raising concerns.


At a new clinic for troops, doctors tackle a complex interplay between head injuries and posttraumatic stress.


Mental health care is desperately needed throughout the developing world. An Indonesian province is testing an unconventional approach.


Less than a year before a new edition of the diagnostic reference for psychiatric illnesses is to be released, the controversy it has generated continues. The Diagnostic and Statistical Manual of Mental Disorders, now in its fifth edition (DSM-5), is the most influential catalog of mental and behavioral disorders, and the 13-year revision process has sparked much-heated discussion as psychiatrists decide what new diagnoses to add and which existing ones to change or eliminate.

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