I wrote yesterday about a pre-conference workshop I attended on "Reimagining CBT for depression" with Keith Dobson.  Today is the first of the three full days of the '9th World Congress of Behavioural & Cognitive Therapies' conference proper.  They aren't taking any prisoners ... each day runs from 8.30am to 6.00pm.  My Airbnb is about a 40 minute walk from the CityCube conference centre, so the day pretty much runs from 7.30am to 7.00pm ... not a holiday!

I have already written a couple of posts on sleep apnea -"Sleep apnea - what is it, how common is it and how does it affect mortality & physical health?" and "Sleep apnea - how does it affect psychological health?".  In this third & last post of the sequence, I'll explore how we can recognise sleep apnea and what we can do about it.

I have already written a first post "Sleep apnea - what is it, how common is it and how does it affect mortality & physical health?" which highlights that sleep apnea is a common, regularly unrecognised disorder, occurring in approaching 1 in 5 adults and that, particularly as it becomes more severe - probably approximately 1 in 10 sufferers (Li et al, 2015) - sleep apnea is linked with a wide range of serious diseases and with significantly increased death rates.  In this second post, I'll look at the relevance of sleep apnea for psychiatric disorders.

I have just given a talk on "Recent research on non-drug treatments for bipolar disorder" to the Lothian branch of "Bipolar Scotland".  There is a description of the first part of the talk at "Non-drug treatments for bipolar disorder (1st post) - the value of psychotherapy" and you can download the full sequence of slides here.  Points touched on in the second part of the talk are illustrated below:

I am due to give a talk for the Lothian branch of "Bipolar Scotland" on "Recent research on non-drug treatments for bipolar disorder".  Here is the downloadable Powerpoint presentation (with pictures removed to reduce the size of the file) and here is a slide illustrating the main points that I touch on:

Here are six recent papers on CBT treatment for a variety of disorders - for fuller details, abstracts and links, see further down this page.  Lamb et al explored the value of "Group cognitive behavioural treatment for low-back pain in primary care".  That their results were reported in the Lancet, highlights the importance of their findings.  The active treatment group received an additional assessment and then six 1.5 hour group therapy sessions (average group size, eight participants).  Therapy focused on "guided discovery, identifying and countering negative automatic thoughts, pacing, graded activity, relaxation, and other skills."   Outcomes demonstrated that "Over 1 year, the cognitive behavioural intervention had a sustained effect on troublesome subacute and chronic low-back pain at a low cost to the health-care provider."

Well, well, well ... what a lot of amazing information there is out there on the internet.  I was trawling to try to find the copyright position of the Panic Disorder Severity Scale (more on this soon in a future post) when I tumbled into Mark Zimmerman's "Outcome Tracker" website.  Mark is "Associate Professor of Psychiatry and Human Behavior at Brown University, the Director of Outpatient Psychiatry at Rhode Island Hospital, and Principal Investigator of the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project."

The June edition of the journal "Clinical psychology: science and practice"  focused on bipolar disorder.  This is very valuable and the fact that all the articles are freely viewable in full text makes the publication even more helpful.  As Youngstrom & Kendall write in their introductory article (see below) "Knowledge about bipolar disorder is rapidly advancing. One consequence is that current evidence about the diagnostic definitions, prevalence, phenomenology, associated features and underlying processes, risk factors and predictors, and assessment or treatment strategies for bipolar disorder is often markedly different than the conventional wisdom reflected even in recent textbooks and clinical training."  Karam & Fayyad (see below for all articles mentioned, with abstracts and links) discuss diagnosis and the boundaries of the bipolar spectrum.  Merikangas & Pato review recent research on bipolar epidemiology and write "During the past decade, there has been increasing recognition of the dramatic personal and societal impact of bipolar disorder I and II (DSM-IV).

Here are a couple of studies on the prevalence of depression and anxiety, and four on risk factors for depression, bipolar disorder and suicide.  Strine et al report on a major survey of depression and anxiety in the United States.  They found "The overall prevalence of current depressive symptoms was 8.7% (range by state and territory, 5.3%-13.7%); of a lifetime diagnosis of depression, 15.7% (range, 6.8%-21.3%); and of a lifetime diagnosis of anxiety, 11.3% (range, 5.4%-17.2%)."  Smoking, lack of exercise, and excessive drinking were all associated with increased likelihood of mental disorders, as too was physical ill health.  Young et al, in a separate study, looked at the likelihood of depression and anxiety becoming persistent.  They estimated - at nearly 3 year follow-up - that the US prevalence of persistent depressive or anxiety disorder was 4.7%.  Only about a quarter of these sufferers were using appropriate medication and only about a fifth appropriate counselling.