Tag Archives: Mental Health

Atypical Movements in Autism Spectrum Disorders


Impaired motor function occurs in autism spectrum disorders, as well as the core symptoms of repetitive behaviours, and difficulty with social interaction. Individuals with autism often present with faulty perception of movement and problems with motor control. Presence of gross and fine motor skill impairments suggest a basic flaw in movement kinematics.

This study investigated 14 adults with ASD and 15 controls to see if abnormal movements contribute to the perception aberration and motor control symptoms. Trajectory, velocity, jerk and sinusoidal arm movements were measured and compared between ASD adults and controls. Also the perceptions of what was natural and unnatural movements were recorded by participants.

An IR Vicon motion tracking system was used to assess velocity, acceleration and jerk during a movement execution task including sinusoidal arm movements. In the perception task, ASD adults classified whether specific virtual movements were abnormal or normal.

In this study, ASD adults showed greater kinematic acceleration and velocity and more jerky movements compared with controls. The level of atypical movements correlated with their perception of the degree of their kinematic abnormality, and severity of autism symptoms measured by ADOS.

The authors suggested that atypical kinematics in ASD adults may contribute to loss of motor control and distort their perception of the actions of others.

Cook JL, Blakemore S-J, Press C. Atypical basic movement kinematics in autism

spectrum conditions. Brain 2013: 136; 2816-24.

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Male Teachers in Health Peril


Pain In The Neck

Pain In The Neck (Photo credit: Cayusa)

The statistics are enlightening and perhaps a little frightening. It is not healthy being a male teacher.

Teaching is high stress especially English language teaching with an estimated 30% drop out after first year from burnout. It may be as high as up to 50-70% in Asia.

It was Freudenberger who defined burnout as a “state of mental and physical exhaustion caused by one’s professional life”.

The consequences of teacher burnout are depletion and loss of motivation, increased absenteeism, decreased performance, less commitment, less tolerance of students in the classroom and decreased preparation and planning for classes.

The risk factors for ELT teachers are related to culture shock, organisation in which they work, time pressure, culture shock, tend to be younger and unmarried, dealing with the unknown in their work, for example complicated visa issues and lack of job stability.

To combat burnout, the things to do are make sure you eat and exercise well, relax and in some instances biofeedback and cognitive behaviour therapy can help.

What is Ergonomics?

Ergonomics is the study of how we as humans interact with our surroundings or environment. There are three aspects to these interactions – physical, cognitive and organizational. Cognitive ergonomics is how we mentally interact with our environment.

Generally we as individual teachers can exert control over the first two aspects, but tend to have less control over the latter.

Ergonomic studies show that male teachers are prone to a number of health conditions much more than their non-teacher counterparts.

Males at Risk

If you are a teacher and a male, then you are more likely to get a range of conditions including

  • Mental health disorders or anxiety, which can progress to a  nervous breakdown.
  • Back pain.
  • Articular pain.
  • Stress – both physical and emotional.
  • Headaches due to stress or dehydration, particularly in hotter countries.
  • Cardiac disease and other metabolic disorders may be exacerbated due to stress.
  • Laryngitis – from talking too much
  • Somatoform disorders.
  • Eye infections and conjunctivitis
  • Varicose veins, cystitis or bladder infections do occur. But are more common in female teachers

Working on Posture

It is hazardous and physically stressful standing for long periods of time in a classroom and this is compounded if the teacher already has developed a bad physical posture.

The first step to prevent bad posture or improve it is to be aware of your posture. This will help  correct anything that you may be harmful to your health and perhaps cause future pain or disability. If you are aware of your posture, then you are more likely not to slouch and to adopt a straighter and more erect stance.

The posture that you adopt is directly related to your total weight. If you are obese with too much weight on the front of your body, then you are more likely to slouch. Slouching will increase the likelihood that you will have pain in your back. It has been estimated that having 1kg extra weight in front of your body translates into 10kg of strain on the back.

Teaching is a Pain

Musculoskeletal disorders are a common experience in the teaching profession. In the teaching profession, they result in decreased productivity, increased absenteeism, more sick leave, and can trigger early retirement.

About 39-95% of teachers will have back pain at any one time. Geographically there is variation in the prevalence of back pain, but is cited as being as high as high as 95% in Hong Kong, whereas it is much lower in countries such as Brazil at  55% and Turkey at  51.4%.

The body locations where must teachers get pain is in the back, upper limbs, and neck.

Back pain is a very common disorder. About 60% of entire world population will get back pain at some time in their lives.

Excessive weight is a common cause of back pain. Back pain in a male teacher could be due to a problem with the prostate gland. Male teachers from the age of 30-35 onwards should undergo an annual prostate check. This check should be performed every year and the younger it is started the better as it will detect any problems that could lead to a cancer early.

Lower limb pain is likely to be a further symptom of back pain. This should be investigated unless there is a history of a sports injury to the lower limbs. When the back pain is treated and alleviated then frequently the lower limb pain will go away.

Teachers get a lot of shoulder pain because of the propensity to tense up the neck when writing. It can be avoided by relaxing the arm when writing.

Men have a sudden onset of shoulder pain it might be a preliminary sign of heart-attack. Similarly, a pain of sudden onset in the arm – usually on the left side, but it can be on the right side – can be an early warning of a heart-attack. It is important to take these pains of sudden onset with no obvious trigger seriously and to get them checked out by a medical professional.

If you work as a teacher, then there is a 59.7% increased risk of neck pain when compared with other professions. Teachers get a lot of neck pain from looking downwards, particularly in the classroom when they are standing and the students are sitting down. Or when they use laptops, which should ideally have their screens raised to eye level to avoid neck strains.

Neck pain can have strange presentations and may present as eye pain or even high blood pressure.

Risk Factors for Musculoskeletal Problems

The one thing in favour of being a male teacher is that female teachers are at greater risk of musculoskeletal disorders. That said there are a number of risk factors that increase the risk in male teachers:

  • Age more than 40 years. if you are over 35 years of age, then neck pain becomes more common. If you are over 50 limb pain becomes more common.
  • Length of employment with one company. The longer you are employed with a company the more you are at risk.
  • Longer work hours and the risk increases if you work more than 35 hours per week.
  • If the furniture where you are working is poor ergonomically.
  • If you have a history of somatoform disorders
  • Little professional or managerial support

Look After Your Mental Health

Mental health problems are directly related to your work environment and if there are high work demands, perceived stress, low job control, monotony, boredom then the risk of a mental health problem are much more likely.

Prevention is Key

Some of the preventative strategies to adopt if you want to remain a healthy teacher are self-evident and obvious. But there are some things that you can do to reduce your risk of developing health problems.

The best way to combat the development of musculoskeletal disorders is to exercise for at least three to four times a week for a period of 40 minutes or more.

Adopting the Brugger’s relief position and stretching daily will help prevent and alleviate back pain. Doing wall angels four times a day will help relieve any pre-existing back pain.

A good way to prevent neck pain is to do neck stretches and the best place to do them is in a hot shower.

To avoid the development of carpal tunnel syndrome, forearm stretches and wrist stretches should be performed regularly.

Practice Good Posture

By concentrating on your posture you will be more aware of any difficulties and this will help focus on any negative aspects of the posture you adopt. The best ways to improve already bad posture is to lose weight and to exercise regularly.

Another preventative approach is to ensure that you change your shoes regularly. The shoes that you wear should not be more than two years old and should be changed more frequently if your posture is already bad.

Doing good abdominal exercises will also help you attain a better posture.

Good ergonomics at your workstation will help prevent problems related to posture occurring. The workstation should be designed according to the 90 degree rule with the screen in line with your eyes while you work.

Eat Well for Health

Food is a poison but we also need to eat for nutrition and energy and it is a prerequisite to life. The active male needs about 2677 calories a day, those over who are active but over 65 need 2318 calories per day and those who are sedentary need 2030 calories per day.

Overeating will result in the gain of weight and may result in obesity. To keep your weight in balance the energy in from food should equal the energy out from exercise and activity.

To put what we eat into perspective it is worth realizing that a KFC meal will provide half our daily energy intake of 1413 calories, a Big Mac will provide more than half at 1620 calories per day , one slice of pizza about 440 calories, and a whole 14 inch pizza provides a staggering 3520 calories which is 135% of the total daily energy requirements of a normal male.

This also needs to be considered in the context of the fact that in our modern world we need much more than out hunter gatherer ancestors because they did not live sedentary lifestyles.

Cardiovascular disease is the number one health problem in the world and obesity is a major contributing risk factor to its development. Obesity and cardiovascular disease are entirely preventable.

Be Aware of What you Eat

The best approach is to eat sensibly and to enjoy your food, but to eat in variety. Also it is vital to be active and to drink water at least two litres a day.

According to the WHO guidelines it is important to include starchy foods in your diet and part of most of your meals, and they should not be eliminated. For example, a handful of rice, which is enough, is recommended. Eating vegetables and fruit will help keep you healthy and especially green leafy vegetables.

Eggs should not be avoided because of concerns about cholesterol. It is good to have egg, fish, chicken, and lean meat as part of a varied diet. It is also important to obtain calcium from dairy produce.

Sugars and hard fats should be avoided. It is best to avoid fruit juices as they are full of sugar. It is better to eat an apple than to drink apple juice that is very high in sugar. Also sodas should be avoided as they are unhealthy. For example, one cola will provide you with half of your daily salt intake.

Conclusion

Teachers who are more aware of the potential health hazards of their job and who adopt preventative practices are more likely to avoid problems or at least alleviate any pre-existing problems that they may have.

After a CPD presentation by Dr Quinton Hohls at King Saud University, Riyadh.

Conor Caffrey writes on Science and Medicine.

Little Bee by Chris Cleave


Post-traumatic stress blocks out horrible events that we witness.

Little Bee is caught up in a violent uprising in Nigeria.

A British couple encounter during a moment so horrific they want to forget forever.

But they can never do it. And as soon as she escapes to England you feel that it is inevitable that the consequences will be too great.

Cover of "Little Bee: A Novel"

Cover of Little Bee: A Novel

A great and impelling read from Chris Cleave.

Genetics of Psychiatric Disorders


The stigma of mental disorders still puts proactive policy in terms of mental wellness promotion on the long finger in many countries. The conditioned approach of burying heads in sand is the norm. Surely the time is nigh for change with recent research beginning to elucidate the complex heritable components of disease?

Disorders of the mind are complex. The traditional view that the brain is a mysterious black box is being dispelled more and more each day as the wiring mechanisms of the brain are delineated.

  • Discrimination is Clinical

The clinical expression of psychiatric disorders is distinctive, and yet there is often a great difficulty to diagnose disorders. There is much commonality between the major psychiatric disorders despite there being typical symptoms in specific disease classifications.

There is overlap in the clinical features of many of these conditions. Schizophrenia and bipolar disorder share many clinical features. There is some overlap between schizophrenia and autism. In early definitions of schizophrenia, autism features were included in the diagnosis.

Despite this clinical overlap, there are differences that make them clearly definitive diagnoses. There may be clear age of onset differences between some disorders; they may have different prevalence. They have different treatments and can have distinct outcomes.

  • Gene versus Environment

The involvement of brain chemical defects is undeniable in many cases of mental disorder, but it is not clear how much such defects play a role. In many cases, there is an unclear distinction between core neuropsychiatric disorders genes and psychological conditions and reactions due to environmental exacerbators, such as stress.

  • Genetic Tools

With new genetic tools, including genome wide analysis and relatively much cheaper methods of sequencing whole genomes and exons (bits of coding DNA), coming onstream novel candidate genes are being identified as potential causative agents in mental disease all the time. The result is not surprisingly that there is more complexity than expected.

Mutations in specific genes that may cause damage have been found to be common to a number of psychiatric disorders. Clinical similarity is in part due to these shared causative genes or associated genes or risk haplotypes. This bears up with the genetic studies as certain risk haplotypes or groups of genes that link together have been shown to be inherited in families with mental disorders. DISC1 is a gene that has been shown to be linked to a variety of psychiatric disorders.

What is surprising from genetic studies is that the same gene can have a different role depending on its segregation with a specific disease or severity of disease. If it is knocked out or its function absent it may for example cause a severe brain disorder; if it is partially functional it may cause a mild autism.

  • Role for Alleles

Allele variation throughout the coding and non-coding parts of the genome seems to be important. It can determine if there is schizophrenia of a milder or more severe type.

This makes treatment more complex as it may not just be mutation of a gene itself but involvement of other parts of the genome involved in regulation of that gene. Factors such as copy number and regulation of translation of a specific gene may come into play.

  • What Fraction is Known?

The upshot is that there will be no one magic drug or fix on a population basis to fix a single defective gene causing a major psychiatric disorder. We may never be able to cure all schizophrenics or people with autism. Life is never that easy. The vast majority of autism and schizophrenia cases are not yet diagnosed by genetics. It has been suggested that we have only identified a fraction of the genes involved anyhow.

This does not mean that individual treatments will have a profound effect on an individual case by case. Some powerful medications have a significant impact on mental disease already, whereas others have little or no impact. Treatment choice remains a conundrum.

  • Probing Early Development

Research into the normal early development of the brain will provide clues as to how diseases develop, but most research focuses on diseased individuals. Mutations of many genes involved in neuronal development can lead to psychiatric disorders but we need to know what is normal. Basic research should focus on how the wiring of the brain mediates functions and then we can determine what happens when those processes go wrong.

Although only a fraction of gene involvement can be explained so far, it seems that many of the candidate genes are involved in the brain plasticity. Plasticity includes mechanism of adaptation and rebuilding.

  • Metabolic Comorbidity

Known metabolic risk markers have also been associated with psychiatric disorders. Certain gene mutations are associated with increased risk of cardiovascular disease and other metabolic conditions and these have been found in patients also with neurodevelopmental disorders including autism and schizophrenia. These metabolic risk factors include obesity, glucose abnormalities and raised lipid levels.

Diabetics do tend to have a more severe course of mood disorders, and more psychiatric hospital stays per lifetime. Perhaps it is burden of disease or it may be commonality of genetic cause, but diabetics with bipolar get more rapid cycling and has a more chronic condition rather than a more episodic course.

Autism spectrum disorders (ASD) have a widely variable presentation. It is highly heritable as defined by twin studies. One twin has autism then a monozygotic twin has somewhere between 60 and 90% chance of having some form of ASD. Despite a particular genetic cause of autism is uncovered in 15% of those diagnosed with autism. So without marker genes and clear diagnosis and the wide spectrum of symptomatology it is most likely that much ASD remains a missed diagnosis.

Removal of funding for schools for support teachers for autism and behavioural disorders and monies for counselling services for the mentally ill will return Ireland to a prehistoric sort of management.

Ireland remains in ignorant bliss of its negligence to the vast majority of these so-called ‘mentally disabled’ children who will become its future.

There is a dearth of affordable community counselling services for people with a range of problems from depression to bipolar disorder.

Psychiatric illness, although considered for so long to be a mental disability in Ireland, has a huge spectrum that affects a large proportion of the population. Some of these conditions are severe and others are mild.

Genetics may eventually provide some of the answers as to the causes of these disorders, but there is a continuum of symptoms that need to be tackled and not ignored to improve patient quality of life.

KEY POINTS

  • There is symptom overlap between different psychiatric disorders and yet there are clear distinctive clinical diagnosis.
  • The genetics of psychiatric disorders is complex and only a small proportion of genes involved have been elucidated.
  • Some genes are involved in seemingly diverse psychiatric disorders and may also be involved in certain metabolic conditions.

Conor Caffrey is a medical and science writer who has recently been diagnosed with bipolar 2.  This article is after several presentations on the genetics of psychiatric disorders at the recent Wiring the Brain Conference held in Powerscourt, County Wicklow.


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