Depression Study Finds Hope in Different Treatments, at Least for Some People
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This is SCIENCE IN THE NEWS in VOA Special English. I'm Bob Doughty. And I'm Pat Bodnar. This week: A big study of depression and treatments...
Smarter children, bigger brains? No, but scientists say there is a physical difference...
And the effects of social rejection in school.
Results have been published from what researchers say is the first depression study of its kind. It examined the effectiveness of different attempts to treat so-called treatment-resistant patients.
The six-year study involved almost three thousand people around the United States. The National Institute of Mental Health paid for it.
In the first level of the study, the patients took the antidepressant drug citalopram, sold under the name Celexa. They took it for up to fourteen weeks. The treatment helped some of the patients.
The researchers say white, well-educated women with a job and a husband had some of the best results. By comparison, many of those with poorer results had a lower quality of life. These included people with problems with alcohol or illegal drugs or physical disorders.
The results say one-third of the patients became symptom-free after they took the Celexa. But two-thirds of the people still had signs of depression.
These patients were then offered several treatment choices. These included changing medicines or continuing with Celexa, but combined with a second drug.
About one thousand four hundred people continued with the study. Those who decided to change medicines were divided into three groups. Each group received a different antidepressant drug.
In the end, each of the three different drugs produced similar findings. The researchers says one-fourth of the people who changed to a new medicine lost their signs of depression within fourteen weeks.
So what about the patients who continued on Celexa but added a second medicine? The results say about one-third of them became symptom-free.
The researchers say the findings offer good news for people with depression. They say patients should keep trying different treatments. "If the first treatment attempt fails, patients should not give up," says Doctor Thomas Insel. He is the director of the National Institute of Mental Health.
But some experts say the findings are also bad news because they show that a lot of people were not helped by the medicines.
The findings have led to new discussion about the best treatments for depression and also about the causes. Depression is blamed on chemical imbalances in the brain. Experts note that the drugs used in the study work in different ways -- yet none appeared to work better than the others.
The study is known as STAR*D, for Sequenced Treatment Alternatives to Relieve Depression. It did not involve experiments to compare the different drugs under controlled conditions. Instead, the scientists observed what they call "real world patients."
There were four levels to the study. The results from Level One appeared in January in the American Journal of Psychiatry. Level Two findings just appeared in the New England Journal of Medicine.
Researchers are now examining the results from patients who did not complete the study and those who continued on Celexa alone.
They are also observing a group of patients who failed to get any improvement with drug treatments. These patients are now in psychotherapy, talking with mental health professionals about their depression.
Depression interferes with daily life. It causes great feelings of sadness. Common signs include a lack of energy and a loss of interest in activities that a person once enjoyed. Other signs are feelings of hopelessness and difficulty thinking.
Depressed people might have problems sleeping and eating. Depression can also be hidden in physical conditions like headaches, back problems and stomach pains.
The National Institute of Mental Health says major depressive disorder affects about seven percent of adults in the United States. It says depression is the leading cause of disability among Americans age fifteen to forty-four.
Depression is also a leading cause of disability worldwide.
The institute says up to twenty-five percent of women and about ten percent of men will experience depression. People with major depression often experience two or more periods of it in their lifetime. Each episode can last two years or more.
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Scientists have found that brain growth in very intelligent children is different from that in other children. They say their study is the first to show a link between intelligence and brain development.
Researchers from the National Institute of Mental Health and Canada's University of McGill did the study. The findings appeared in the magazine Nature.
The researchers say they found developmental differences in the cerebral cortex. This is the outer part of the brain, often called the gray matter. The cerebral cortex plays some part in almost all brain activity. The researchers call it the “thinking” part of the brain.
The cortex goes through a process of development in which it thickens and thins as children grow up. But the researchers say the cortex reaches its thickest at a later age in highly intelligent children.
The study followed just over three hundred young people, ages five to nineteen years old. They were divided into three levels of intelligence: average, high and superior. They took traditional intelligence tests to measure their I.Q., their intelligence quotient.
Many experts say I.Q. levels change little over time. The value of I.Q. testing itself, however, is widely debated.
The children in the study were tested only once as they grew up. The scientists also took pictures of the children’s brains as they got older. They used magnetic resonance imaging. Most of the children got at least two M.R.I.’s, two years apart, during the study.
Study researcher Judith Rapoport says I.Q. is related to cortex development, not to the amount of gray matter at any one age.
The researchers say the smartest children generally started with a thinner cortex. But it grew faster than the cortex of the average children. It also thickened over a longer period of time.
The researchers say the children in the average group completed the process by eight years of age. But thickening of the cortex continued in the most intelligent children until they were eleven or twelve. One possible explanation is that their brain had more time to develop high-level thinking abilities.
The children in all three groups did have something in common. Their cortex began to thin by their teen years. But during the late teen years, the smartest children had the fastest rate of thinning.
Thinning of the cortex is believed to represent the loss of unused brain cells, neurons and connections as young people become adults.
Philip Shaw led the study team. He says people with a more active mind generally have a more active cerebral cortex. But he also says intelligence is probably a complex mix of the brain a person is born with, and what it experiences in life.
Children will do well in school even if they are rejected by others their age. In fact, they might even work harder to please their teachers. Parents at least have to hope these statements are true.
A new study suggests the opposite. It found that children who face social rejection are more likely to withdraw from school activities. They also are more likely do poorly in their schoolwork.
Researchers studied three hundred eighty students in the central United States over a five-year period. All of them were between five and eleven years of age.
The Journal of Educational Psychology published the results. The study says the problem seems to affect girls and boys equally.
Eric Buhs of the University of Nebraska at Lincoln led the study. The professor says group rejection appears to be one of the strongest measures of a child’s likely success in school.
SCIENCE IN THE NEWS was written by Nancy Steinbach, Caty Weaver and Brianna Blake. I'm Pat Bodnar. And I'm Bob Doughty. Read and listen to our programs at voaspecialenglish.com. And join us next week for more news about science in Special English on the Voice of America.