Wednesday, February 29, 2012

WAFFLE: Why Most Books Are Too Long

I have a theory about modern books.

There's a certain kind of book, let's call it the "TITLE: How This Subtitle Summarizes My Big Idea" genre.

I don't think I need to name names.

Now, I read a lot of these, and I've come to the conclusion that most of these books shouldn't books at all. That's not to say they're bad - the big idea may be brilliant, but I don't care how big your idea is, you do not need 100-200 pages to explain one idea.

They tend to contain a couple of core chapters with the good stuff and maybe 4 or 5 chapters of what can best be called waffle. Anecdotes, backstory, additional illustrations, etc. Like a waffle this may be perfectly pleasant - but it's not very nutritious.

Here's why I think this is - publishers (we are told) increasingly want books with a single big idea that can be summed up in a sentence. Partly because they sell, and partly because publishers are overstretched and just don't have time themselves to spend hours thinking through a complex argument to find out if it's any good.

But the problem is that, for whatever historical and business reasons, books are meant to be a certain length, say 100 pages bare minimum. No-one prints 50 page books and few people would buy one, except children etc.

So there's a gap in the profile of the length of non-fiction writing. There are all kinds of shortish pieces - from the briefest news reports and op-eds up to long feature articles and New York Review of Books type articles. That covers all the way from 1 to up to, say, 10,000 words.

But then there's nothing until you reach the short book at (say) 35,000 words, after which, it's plain sailing again.

Think about it - have you ever read a 20,000 word piece of non-fiction? I don't think I have. It's too long for a periodical but too short to be a book. (Academic papers are an exception; I'm thinking of general interest pieces).

Yet it seems to me that a great many of today's books could have been that length, without weakening the argument or dumbing down in any way. And, if so, then they should be, because a fundamental rule of good writing is to keep things as concise as possible. The problem is that while that would make them better as pieces of writing, it would make them unmarketable as books, or anything else; there's practically no market for 20,000 good words and true.

Except... now we have ebooks.

So you could see this post as an argument in praise of ebooks, not just as a new technology but as a whole new form of writing falling somewhere between the "article" and the "book". Which is ironic because I don't even have a Kindle yet. Of course I'm not saying that all books are too long. I like books. Many are the right length, some I wish were longer; but just because an idea could be made into a book, doesn't mean it should be.

Edit: I hadn't read this when I wrote this post but it seems the industry are way ahead of me -
Yesterday, Amazon began selling its Kindle Singles online. Singles are e-books between 5,000 and 30,000 words long. According to the press release, these e-books are meant to “allow a single killer idea — well researched, well argued and well illustrated — to be expressed at its natural length.”

Tuesday, February 28, 2012

Bringing the Real World into Brain Scanning

Canadian Neuroscientists Jacqueline Snow et al propose a new method of making brain scanning studies a bit more realistic.
Typically, in an fMRI or other neuroimaging study, any visual stimuli shown to the volunteer are just pictures on a screen. Sometimes videos will be used, but in almost all cases they're just 2D images. Is that adaquate? People have hoped so.

Snow et al's data suggest that it might not be.

They created a contraption for presenting subjects with real objects during a scan. See above. Now, to the uninitiated this might not seem like a big deal, but those with MRI experience will appreciate how impressive this is.

Everything from the angle of the volunteer's head to the LED lighting is an achivement, given the nature of MRI. The stimuli were controlled by one of the researchers, who had to sit next to the scanner, in total darkness, and operate the turntable with the help of some glow-in-the-dark stickers.

Having built this device, they then used it to compare the brain's responses to real objects vs photos of those same objects. The experiment was designed to test fMRI adaptation - the phenemenon whereby if you present the same stimuli repeatedly, the neural responses are reduced.

fMRI adaptation has been found to happen in many studies using 2D pictures, but Snow et al show that the effect was much smaller, maybe entirely absent, when people were repeatedly shown real objects: this graph shows the BOLD neural response in the lateral occipital complex. Seeing the same pictures over and over led to a weaker response, as expected; but seeing the same 3D objects didn't:

This is a good study and an important result, which suggests that the much-studied fMRI adaptation might not be a universal phenemonon. And the potential implications are big, as the authors write:
Finally, our preliminary fMRI results raise the provocative suggestion that the presence of real-world objects (i.e., as indicated initially via stereoscopic cues) invokes qualitatively different computations to those elicited by 2D images. Researchers in the field of behavioral psychophysics have expressed long-standing concern about the extent to which pictures of objects capture the properties of their real-world counterparts (i.e., their ecological validity), with reservations as to their appropriateness as stimuli with which to examine the nature of human object perception...
ResearchBlogging.orgSnow, J., Pettypiece, C., McAdam, T., McLean, A., Stroman, P., Goodale, M., and Culham, J. (2011). Bringing the real world into the fMRI scanner: Repetition effects for pictures versus real objects Scientific Reports, 1 DOI: 10.1038/srep00130

Thursday, February 23, 2012

Prescription Drug Abuse

What do you think of when you hear the words 'drug addict'? Do all kinds of scary images come to mind? In my 13 years of working with people who have addictions, each one of them has been an ordinary human being caught up in extraordinary situations. Not one of them has ever wanted to grow up to be a drug addict. These people come from all walks of life, all demographics and who may be functioning or non-functioning with regards to their lives, jobs, etc.

One group of addictions that have been underestimated is prescription drug abuse. There seems to be a different mindset with regards to this addiction mainly because prescription drugs are seen as helpful, not harmful and that they are given to us by doctors so they are safe. This could not be farther from the truth.

Prescription drug use is on the rise in the arena of drug abuse. This is mostly due to the improper use of these drugs and the type of drugs themselves.

Prescription drugs that most commonly become addictive are 'narcotic' based drugs. These drugs are painkillers mostly, but others are for anxiety, sleep disorders, muscle relaxers as well as stimulant and depressive drugs.

Two factors usually come into play when an addiction is formed by use of prescription drugs. One way being that the drug is taken improperly. This means that some people, especially the elderly or people suffering with cognitive disorders may forget if they've taken the pills and take more, or take them in a way that was not prescribed, leading to doubling and even tripling the amount that was prescribed. This can have devastating effects. They may take other peoples prescription meds that are not suitable for them, even though they have the same symptoms.

Another way is that people become addicted to the 'effects' and sometimes 'side effects' of the medication. They like the fact that they can relax without worries when they take their meds, or that the pain goes away and also gives them a euphoric feeling. They then start taking the medication whenever they want to reproduce those effects, regardless of whether they are in pain, can't sleep, or whatever the original issue was.

If you or someone you know is addicted to prescription drugs, please call for help, or tell your doctor. This is serious and can be life threatening. You can call Telehealth Ontario 1-866-797-0000 for information about the drugs and their effects or you can call any drug treatment centre. The phone number for the Centre for Addiction and Mental Health (CAMH) which can provide information and treatment is 416-535-8501 or 1-800-463-6273. Keep your face to the sunshine.

Wednesday, February 22, 2012

Beware Reverse Publication Bias

In all the fuss over the pressure for scientists to publish positive results, we may have been missing an equally dangerous kind of publication bias operating in the opposite direction.
So say Luijendijk and Koolman in the Journal of Clinical Epidemiology: The incentive to publish negative studies: how beta-blockers and depression got stuck in the publication cycle.

The background here is the possible link between beta blockers and depression. Beta blockers are drugs widely used to treat high blood pressure. Some studies have reported that they raise the risk of depression, though many others found no link. Propranolol is said by some to be the worst offender because it's best at entering the brain.

Luijendijk and Koolman say that beta blocker-depression studies have appeared in the form of "publication cycles" - first a positive study appears, and then negative ones follow. Then another study finds a positive link using a different method - and rebuttals, using those methods, soon appear. They sketch out several such positive-negative cycles based on different methods and particular hypotheses.

Now, there's two ways to look at this. You could explain this in terms of standard positive publication bias. Maybe lots of people looked into a possible link, the ones who found nothing didn't publish. Then someone, by chance, did find an association with depression, and they published it. Once that happens, the question became a hot topic so the unpublished negative studies were dusted off and submitted.

But there's a more worrying possibility. What if the original positive studies were correct, and the subsequent negative studies were the product of an inverse publication bias in favor of contrarian negative results?
The publication cycles in the literature about beta-blockers and depression seem to suggest that
the very publication of positive studies, whether true or false, increases the incentive to publish negative results, whether true or false... [in the case in question] the first as well as a significant number of subsequent negative studies were published in high-impact journals (8 of 19 journals with 2009 impact factor greater than 4.0). Third, power analysis showed thatd in two cycles, the first negative studies were underpowered...

If a true-positive study stimulated the publication of one or more false-negative studies, again an invalid picture of the true association would emerge. Publication of false-negative studies may thus give rise to publication bias, just like publication of false-positive studies. Research groups usually compete to get the first positive study published in a high-impact journal. It has been suggested that it could also be worthwhile to aim at getting the first study that challenges the former published.
This is not an entirely new idea. It was described in the classic Why Most Published Research Findings Are False, but only in passing.

To be honest it's impossible to know, in any particular case, whether inverse publication bias is at work. Depending upon whether you think beta blockers cause depression (and that's still controversial), your interpretation of the biases in the literature will probably differ.

However, I think the basic idea is important. Publication bias isn't a bias in favor of positive results per se. It's a bias towards "interesting" results - which in most cases means positive ones, but could equally well include negative ones, in certain contexts. In some ways, this could be a good thing, if the negative and positive biases eventually cancelled out, leaving a neutral playing field; but there's no guarantee that would ever happen.

As for how to fix publication bias - my opinions on that question are well known...

ResearchBlogging.orgLuijendijk, H., and Koolman, X. (2012). The incentive to publish negative studies: how beta-blockers and depression got stuck in the publication cycle Journal of Clinical Epidemiology DOI: 10.1016/j.jclinepi.2011.06.022

Monday, February 20, 2012

The Stigma(s) of Mental Illness

Fighting "the stigma of mental illness" is big business at the moment. But does "the stigma" really exist?

As I said back in 2010 :
There is a stigma of schizophrenia, and there's a stigma of depression, etc. but they're not the same stigma. We're told it's a myth that "the mentally ill are violent" - [but] no-one thinks depressed or anorexic people are violent. They think (roughly) that people with psychosis are. They have other equally silly opinions about each diagnosis, but there's no monolithic "stigma of mental illness".
Now a paper has come out which explores this idea in some detail: Stereotypes of mental disorders differ in competence and warmth. The title says it all : people have stereotypical views of people suffering from different mental disorders, but these stereotypes vary substantially.

The authors use the "Stereotype Content Model" framework, which despite the fancy name is very simple. On this view stereotypes are characterised by two dimensions, "competence" and "warmth". These are pretty self-explanatory. Warmth is whether you're seen as nice and friendly, or hostile and dangerous. Competence is whether you're thought to be good at it.

We all know that warmth and competence are distinct and indeed orthogonal concepts, and they crop up in other languages and in popular culture.

Anyway, in two Mechanical Turk online surveys of American adults, they first showed that respondants felt that "people with mental illness" were low on competence and (slightly) low on warmth, compared to other social and ethnic groups. That's similar to the ratings of the homeless, poor, and welfare recipients.

However in the second study, they asked about specific diagnoses, and this revealed a more complex pattern. I've shown the results above (colors are mine). There seemed to be four clusters. Mental retardation and Alzheimer's were perceived as warm, but incompetent; sociopaths and violent criminals were the opposite.

Schizophrenia clustered with homelessness and addiction in a worst-of-both-worlds category of low warmth and competence, while what could broadly be called "emotional" disorders, like bipolar, depression and anxiety, were rated more favorably. For what its worth, OCD was the least bad diagnosis.

These are interesting results. The only oddity about the method was that people weren't actually asked what they thought about these people; they were asked “In general, how much do Americans believe that..." This is, apparantly, standard procedure in this kind of stereotype research, but it seems a little strange to me.

ResearchBlogging.orgSadler, M., Meagor, E., and Kaye, K. (2012). Stereotypes of mental disorders differ in competence and warmth Social Science and Medicine DOI: 10.1016/j.socscimed.2011.12.019

Sunday, February 19, 2012

A Correction

In my previous post, on the paper A Facial Attractiveness Account of Gender Asymmetries in Interracial Marriage by Michael B. Lewis, I wrongly stated that it was unclear from the paper whether the research assistant who selected the Facebook images was blind to the hypothesis of the study.

In fact, the paper did state that they were "a naive research assistant", something I missed. Apologies for this avoidable mistake. I've corrected the post.

I'd also like to take this opportunity to remind everyone that sometimes comments will get caught in the Blogger spam filter, especially if they're long or contain links, but it can happen to any comment. If your comment doesn't appear immediately, don't worry, I will manually approve such comments as soon as possible.
ResearchBlogging.orgLewis, M. (2012). A Facial Attractiveness Account of Gender Asymmetries in Interracial Marriage PLoS ONE, 7 (2) DOI: 10.1371/journal.pone.0031703

Saturday, February 18, 2012

The Evolutionary Psychology of Race, Beauty and Marriage

There are some papers that you can tell are going to be hot potatoes just from the titles. This is one of them: A Facial Attractiveness Account of Gender Asymmetries in Interracial Marriage.

Coming so soon after The Unconquered World, you'd be forgiven for thinking I am taking this blog in a more linkbaiting direction because I'm planning to introduce ads. I'm really not, it's just a coincidence.

The paper claims that white women are on average more attractive than black, while East Asians are prettier still.  For men, however, the positions were reversed (and the effects were even stronger.)

Saying that black women are on average less attractive than others was what got evolutionary psychologist and blogger Satoshi Kanazawa into spot of bother last year. The current paper agrees with Kanazawa on that point (though doesn't cite him)... although it also declares Kanazawa to be part of the least attractive race for males, so I don't know how happy he'll be about it.

Author Michael B. Lewis of Cardiff University took 600 Facebook photos "from people who were members of groups associated with further and higher education bodies either in the UK (for White faces), sub-Saharan Africa (for Black faces) and East Asia (for Asian faces)."

Photos with a "weird expression" and people who "looked" under 18 or over 30 were excluded. The actual ages were not checked. Hmm.

A panel of 40 British students (half male) were asked to rate all of the opposite-sex faces for attractiveness from 1 to 10. The ethnicity of the rater made no difference to the results but there were only 5 black and 6 Asian students out of 40 though:

After this we get some models proposing how these data might relate to British and American inter-racial marriage patterns, and some evolutionary speculation regarding why this might have evolved - Asia was cold so men were in short supply, that kind of thing - but that's all assuming the basic data are solid.

There are many possible objections to the methodology here, some of which are addressed in the paper, but there's one massive that isn't -

It's not stated how the Facebook images were gathered. All we're told is that "a research assistant" got the images from higher education institutions. Were they, consciously or subconsciously, picking photos that fitted the expected some pattern?

We're not told whether or not this individual was aware of the hypothesis of the study when they chose the pics. If they were aware, it's a fatal confound; (Edit - 19th Feb 2012 - The paper in fact says that the research assistant was "naive" i.e. that they were not aware of the hypothesis of the study, which is of course sound methodology. I missed this statement in the first version of this post.)

However, the broader point remains that they might have been selecting in line with their own preferences, or some other bias. Clearly, there's much room for cherry picking the examples, based on whether they "looked" too young or old, or had a "weird" expression...

Link: Also blogged about here.

ResearchBlogging.orgLewis, M. (2012). A Facial Attractiveness Account of Gender Asymmetries in Interracial Marriage PLoS ONE, 7 (2) DOI: 10.1371/journal.pone.0031703

Wednesday, February 15, 2012

Reckoned Drug rehab centers

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About the Author:

This article is written by Dr.Naina

The Unconquered World

A thought struck me the other day: China is the only place in the world that has never been controlled by a European power, whether as a colony, protectorate, territory, mandate, etc.

Thinking about it a bit more I realized this is not quite true, but it's not far off. As far as I can tell (thanks Wikipedia) the following countries were never officially under European control. I'm including the USA, Australia, New Zealand and the USSR as "European". Note that I use the modern names of countries to refer to the territory that falls within their borders, even though it wasn't always called that.

Most of China
Saudi Arabia (assuming the Ottoman Empire was not a "European power")

Iran and Turkey make the list, unless you count Alexander the Great.

Japan and North and South Korea make the list unless you count the post-WW2 occupations.

All of these areas were under various forms of influence at different times, but they never formally lost their sovereignty to Europe. (Edit: Iran and Turkey removed because they were conquered by Alexander.) (Edit 2: Added Bhutan and Nepal which I missed before. Changed map to show special status of Japan, Korea, Turkey & Iran).

Disclaimer: I'm not a geographer; this is something I put together purely out of interest. It's quite likely that I've missed some. In particular I don't know anything about the small island nations. Please comment if you can correct this, it's a work in progress.

Monday, February 13, 2012

Tired Brains Are More Excitable

An important new study shows how being awake causes progressive changes to the brain. This could shed light on the function of sleep - but it also raises warnings for neuroscientists.

Italian researchers Huber et al report that Human Cortical Excitability Increases with Time Awake. The experiment was conceptually simple - they measured cortical excitability when people were well rested and then looked to see how it changed as they were kept awake for over 24 hours.

The participants woke up at 7 am on Day 1 and were kept awake all of that day, all of the subsequent night, and all of Day 2. The excitability measurements spanned a period of 30 hours, from 9 am to 3 pm the next day. They were finally allowed to go to sleep on the next night and one final session took place on Day 3. I hope they got well paid for taking part.

The results showed a nice linear increase in excitability with increasing time spent awake. Sleep put this back to normal - mostly:
"Excitability" was measured using electroencephalography (EEG) combined with transcranial magnetic stimulation (TMS). Essentially, they zapped the brain (left frontal cortex) with a strong magnetic pulse, and measured the electrical activity that this provoked in the brain.

It was a small study but the findings look solid, with all six participants showing clearly higher stimulation-evoked potentials after sleep deprivation. EEG cortical theta band activity was also correlated with time spent awake, replicating previous findings.

The authors say that these data fit with the idea that the function of sleep is to prevent the brain from becoming too excitable. I previously described this as the "defragmentation" hypothesis of sleep.

The theory goes that while we're awake, our brains are constantly forming new and stronger synaptic connections, as we learn and remember. Most of the new connections are excitatory. However this creates a problem because the brain must maintain a delicate balance between excitation and inhibition. Too much neural excitation and you'll have a seizure, amongst other things. So some researchers believe that during sleep, the brain "prunes" the new excitatory connections in such a way that the information they store is preserved, but the overall excitability is reset.

These data are the first clear-cut human evidence in favor of the theory. Most of the previous work was in animals.

So sleep researchers will be very interested by this paper, but all neuroscientists should take note. If being awake changes cortical excitability, it means that the time of day that you conduct your experiments could have an impact on your results. EEG researchers should pay particular notice, but it could well be that these changes also affect the fMRI signal.

This could be a serious confounding factor in your data. Suppose, for example, that your healthy controls are more likely to have jobs than your patients with, say, autism or depression - which is sadly all too common. Now people with jobs would naturally prefer to attend your study later in the day, after work, leaving those with more flexible schedules to come in bright and early... you see the problem.

ResearchBlogging.orgHuber, R., Maki, H., Rosanova, M., Casarotto, S., Canali, P., Casali, A., Tononi, G., and Massimini, M. (2012). Human Cortical Excitability Increases with Time Awake Cerebral Cortex DOI: 10.1093/cercor/bhs014

Friday, February 10, 2012

Good Science, Bad History, in the British Journal of Psychiatry

The latest February 2012 issue of the British Journal of Psychiatry features a paper about the association between child abuse and later mental health problems. I haven't read it yet, but it looks pretty good.

However, it also includes an editorial from John Read and Richard Bentall which argues that:
Just 20 years ago, however, it would have been difficult to get the paper published. Mental health professions have been slow, even resistant, to recognise the role of childhood adversities in psychiatric disorder... Until very recently the hypothesis that abuse in childhood has a causal role in psychosis was regarded by many biologically oriented psychiatrists as heresy...
Really? I checked the BJP from exactly 20 years ago. The February 1992 issue contained:
  • A paper about child sexual abuse in female psychiatric patients.
  • A letter praising a different article, on the same topic.
  • A review of 11 studies on psychosocial family interventions as treatments for schizophrenia.
  • A paper looking at the effect of the social environment on symptoms of schizophrenia.
Four strikes and they're out. It's not true that this kind of thing wasn't being discussed 20 years ago.

Such grandstanding is bad for science. Few would deny that psychiatry in recent years has undervalued psychosocial factors and overvalued genetics and neuroscience, but it's actually quite a complicated story, not a Punch and Judy show with bad guys on one side and good guys on the other.

Rhetorical flourishes like this editorial certainly get attention but in the long run, down that road lies madness.
    ResearchBlogging.orgRead, J., and Bentall, R. (2012). Negative childhood experiences and mental health: theoretical, clinical and primary prevention implications The British Journal of Psychiatry, 200 (2), 89-91 DOI: 10.1192/bjp.bp.111.096727

    Thursday, February 9, 2012

    Selected Drug Treatment Programs

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    About the Author:

    This article is written by Dr.Naina

    Wednesday, February 8, 2012

    Visualizing The Connected Brain

    So it seems as though the "connectome" is the latest big thing in neuroscience. This is the brain's wiring diagram, in terms of the connections between neurons and on a larger scale, between brain regions.

    We certainly won't understand the brain without getting to grips with the connections but equally, it's not the whole story. I previously emphasised that the brain is not made of soup; it's not made of spaghetti, either.

    Connectomics does however unquestionably provide some of the prettiest images in neuroscience. And they just got prettier, with a new technique for visualizing connections, just revealed in Neuroimage: Circular representation of human cortical networks for subject and population-level connectomic visualization.

    See above. It's a rather lovely vista (for which the authors Irimia et al share credit with the folks behind the Circos visualization tool they used).

    All you need are some MRI scans, and a lot of image processing, and you can produce one of these "Connectograms". But what does it mean? Here's the authors' description:
    The outermost ring shows the various brain regions arranged by lobe (fr — frontal; ins — insula; lim — limbic; tem — temporal; par — parietal; occ — occipital; nc — non-cortical; bs — brain stem; CeB — cerebellum) and further ordered anterior-to-posterior. The color map of each region is lobe-specific and maps to the color of each regional parcellation.
    In other words, the outer ring is just a list of brain regions, each with an assigned colour. The inner rings tell us about those regions:
    Proceeding inward towards the center of the circle, these measures are: total GM volume, total area of the surface associated with the GM–WM interface (at the base of the cortical ribbon), mean cortical thickness, mean curvature and connectivity per unit volume. For non-cortical regions, only average regional volume is shown.
    So each of the five inner rings displays data about one aspect of brain anatomy, for each of the regions. The colors are a heat map of the numbers.

    Finally, the lines between regions represent the degrees of connectivity between regions via white matter tracts, as measured with diffusion tensor imaging:
    The links represent the computed degrees of connectivity between segmented brain regions. Links shaded in blue represent DTI tractography pathways in the lower third of the distribution of FA, green lines the middle third, and red lines the top third (see text for details).
    You can also make a pooled connectogram of the average neuroanatomy across a group of people. Still, it remains to be seen whether these are as useful as they are beautiful.

    ResearchBlogging.orgIrimia A, Chambers MC, Torgerson CM, and Van Horn JD (2012). Circular representation of human cortical networks for subject and population-level connectomic visualization. NeuroImage PMID: 22305988

    Sunday, February 5, 2012

    Mystery Joker Parodies Neuroscience

    Someone has created a hilarious spoof paper poking fun at neuropsychoanalysis (but all of fMRI takes some hits too): A Triple Dissociation of Neural Systems Supporting ID, EGO, and SUPEREGO.

    Featuring gems such as
    • Authors "Steven Z. Fisher and Stephen T. Student" with contact details "".
    • "Twenty-four healthy participants (all 19-year-old white, male undergraduates who sat near each other in an Introductory Psychology course and were raised in upper middle class suburban New
      England neighborhoods) were scanned but 17 were excluded for not following instructions or falling asleep in the scanner."
    • "If you’re like us, you’ve probably been thinking that Social Neuroscience, Neuroeconomics, and Developmental Social Cognitive Affective Clinical Neuroscience are just not cutting edge enough
      anymore. Do not despair. This study represents the first of what is likely to be a productive and active new field of Psychoanalytic Neuroscience."
    It really is very funny, but it's also deadly accurate in its highlighting serious problems that plague a certain genre of neuroimaging papers. Who made it? The PDF appeared on Dropbox a couple of weeks ago and, while a few people have Tweeted about it, no-one has claimed ownership, yet.

    For the record, it wasn't me.

    Psychiatry's True Blood? Pt 1.

    Imagine that there was a blood test that could detect depression. Wouldn't that be useful?
    It depends.

    Ridge Diagnostics are a US company who offer such a test. They've just published some results of the technology in Molecular Psychiatry. In two samples of patients with major depressive disorder (MDD), they report differences in the "MDDScore", between the patients and healthy controls.

    The MDDScore is an aggregate value, calculated from the levels of 9 metabolites in blood serum. They're all well-known molecules, including hormones, such as cortisol and prolactin. The novelty is in how they're put together to make the MDDScore. We're given equations - but the key variables are not provided, because they're proprietary:

    Long-term Neuroskeptic readers will recall that this "secret ingredients" approach to publishing science was also adopted by another company offering a different depression test.

    Anyway, the performance of the test was impressive. In both the pilot and the replication samples, the MDDScore was significantly higher in the depressed people than in the controls. In both cases, the test had a sensitivity of over 91% and a specificity of over 81%, which is pretty good. Ridge Diagnostics are already offering the MDDScore clinically. For $745 a pop.


    Although there were two depressed patient groups (n=36 and 34), there was only one set of controls (n=43); both patient samples were compared to it. This means the second, "replication", test was not fully independent of the first one. If the first finding was a fluke caused by the control group having weird results by chance, for instance, then the second study would just repeat the fluke.

    The patients were significantly older, and with a higher BMI, than the controls. They did control for these variables, which is good, but this raises the question of whether these folks differed in other ways, that they didn't measure, and hence couldn't control for.

    In both samples, the patients had a very significantly higher MDDScore than the controls (p less than 0.0001, both times). But in both cases, the difference in levels of EGF (epidermal growth factor) was almost as strong: p=0.0003 and p less than 0.0001, respectively. Other metabolites weren't far behind. Testing for EGF would almost certainly be cheaper than getting an MDDScore.

    Finally, all these data demonstrate is that the test can distinguish between people with MDD and entirely healthy people. But how often are doctors going to need to do that? More likely, they'll want to distinguish depression from other things that are often confused with it, such as: bipolar disorder, anxiety disorders, chronic fatigue syndrome, bereavement, "stress", and all manner of physical illnesses e.g. thyroid problems. Daniel Carlat said last year that
    If the test cannot distinguish different psychiatric problems, then the MDDScore is simply a non-specific "biomarker" for emotional difficulties of all stripes, and would be essentially useless.
    How disorder-specific is the MDDScore? This paper doesn't tell us. And to date, this is the only published paper mentioning the MDDScore. The website mentions some conference presentations, but none have yet appeared in a peer reviewed journal.

    Ridge Diagnostics have an interesting history. But that's another story - stay tuned for Part 2.

    ResearchBlogging.orgPapakostas, G., Shelton, R., Kinrys, G., Henry, M., Bakow, B., Lipkin, S., Pi, B., Thurmond, L., and Bilello, J. (2011). Assessment of a multi-assay, serum-based biological diagnostic test for major depressive disorder: a Pilot and Replication Study Molecular Psychiatry DOI: 10.1038/mp.2011.166

    Wednesday, February 1, 2012

    Science Majors are from Mars...

    According to a new study, students with a family history of autism tend to major in math and science, while substance abuse and depression are more common in the ancestors of humanities fans.

    In an online survey, over 1,000 new Princeton undergrads were asked about their intended major and whether anyone in their family had been diagnosed with one of 16 neurological and psychiatric disorders. More details here.

    Of the 16 maladies, 5 were so rare that there wasn't enough data to analyze. Of the remaining 11, there were significant differences between the three types of students in four. The categories being humanities, social sciences, and "technical" i.e. science, engineering and maths. Social science majors were in the middle, except for autism.

    See the graph I made above.

    It's an interesting study. The autism result seems tenuous though because only 24 of 1077 students reported any autism in their immediate family. That's 3% of "technical" students and 1% of others, so not very many. The authors excluded schizophrenia and epilepsy from the analysis on the grounds of being too rare - and they had 18 each. Substance abuse and depression had over 150 each, so those differences are rather more solid.

    The authors note that this fits with various previous studies and they discuss their findings in Baron-Cohen-esque terms:
    It has been suggested that autism represents an extreme manifestation of a ‘‘systemizing’’ nature. Since ASDs have complex inheritance, shared genetic variation between close relatives might establish a continuous phenotype which in milder forms confers interest or benefits in understanding highly structured fields... Similarly, affective disorders may represent an extreme phenotype of emotional lability that, in milder forms, is commensurate with interest in the humanities.
    Hmm. OK, but does that really make sense? Sure, it fits with the popular image of the Geeky Scientist vs the Tortured Artist - but that's not science, that's stereotypes. Why would emotional lability make you favor the humanities, exactly?

    Imagine if the stereotype was the Geeky Artist vs the Tortured Scientist (and there really have been plenty of both, over the years). Couldn't we rationalize that equally well? Picture the scene... -
    "People with autistic traits are drawn to study the humanities because they wish to learn about humans and their emotions, something they find hard to do in day-to-day life... While emotionally volatile people like science and maths because they offer a calming sense of order and stability..."
    ResearchBlogging.orgCampbell BC, and Wang SS (2012). Familial Linkage between Neuropsychiatric Disorders and Intellectual Interests. PloS one, 7 (1) PMID: 22291951

    Private Drug Treatment Centers

    Private drug treatment centers are a dime a dozen these days because of the high use of drugs in our society. These facilities offer services to people who are desperately in need of help and some who want to keep their privacy intact. Most of the people that are admitted in these establishments are celebrities or those who have enough medical insurance and money to afford the higher cost of ,000 or more per month. Some will be eligible for government subsidy grants to supplement their health insurance. For the most part, it has more to do with keeping their lives private and from the public eye than about money.

    Drug addiction is not going away anytime soon because it is so easy to get these drugs. Drug dealers push their drugs to anyone that will pay for it and law enforcement has their work cut out for them because this problem is becoming worse than better.

    Even teenagers are being affected by the onslaught of drugs in the communities across the United States. It is a travesty, but it is real and it is destroying the family structure as mothers and fathers are taken down by it. They don't have the control to stop and it is the children that suffer in the end.

    Many parents lose their children to the Children and Family Services Department of the government due to drugs. When that happens, it is very difficult to get the children back unless treatment from one of the reputable private drug treatment centers is in place and the parents also has to show that they are serious about becoming clean from drugs. It is sad for the children because they have to be without their parents until that time and most of the time, the drug addicts don't think about their children and end up having to give them up in the end.

    However, some can be saved, if we do something about it and get these mothers and fathers off the streets and back with their children where they belong. The family structure depends on the strength of the addict to get well enough to be a good parent. It will take more than love to do this. It may take tough love from family members and help from professional and trained individuals from private drug treatment centers.

    People use drugs to smother their innate feelings instead of dealing with it. They spend their lives regretting certain things in their lives or going through something traumatic and don't know how to deal with it. Drugs become their comfort and friend. They see it as filling the void in their lives and not judging them.

    There are many people who do not understand why there are so many private drug treatment centers, but if they would look close to home and see how many people are suffering from this disease, it would definitely shed some more light. No one wants to talk about it even though it is an epidemic in our society.