Brain changes noted in holocaust survivors and their children

Brain changes noted in holocaust survivors and their children


(HealthDay)—Holocaust survivors may have suffered permanent harmful changes to their brain structure, and the brains of their children and grandchildren may also be affected, a small study reveals.

“After more than 70 years, the impact of surviving the Holocaust on brain function is significant,” said researcher Ivan Rektor, a neurologist from Brno, Czech Republic.

MRI scans of 28 Holocaust survivors showed they had a significantly decreased volume of gray matter in the brain compared to 28 people in the same age group without a personal or family history of the Holocaust. Their average age was about 80.

The affected parts of the brain are responsible for stress response, memory, motivation, emotion, learning and behavior, the study authors said.

Reductions in gray matter were significantly higher among Holocaust survivors who were younger than 12 in 1945, compared to those who were older. This may be because a child’s developing brain is more vulnerable to stress, the researchers suggested.

Gray matter reductions in the Holocaust survivors were found in areas of the brain associated with post-traumatic stress disorder (PTSD) in combat veterans and people who suffered high levels of stress early in life.

But gray matter reductions found elsewhere in the brains of Holocaust survivors were far greater than previously found in people with PTSD, the findings showed.

The study can’t prove that the horrors of the Nazi regime actually caused the changes in brain structure seen among survivors and their descendants.

However, the researchers are now assessing Holocaust survivors’ children and grandchildren. And early findings in the children show reduced connectivity between brain structures involved in processing emotion and memory.

“We revealed substantial differences in the brain structures … between Holocaust survivors and controls. Early results show this is also the case in children of survivors, too,” Rektor said in a European Academy of Neurology news release.

“Our hope is that these findings and our ongoing research will allow us to understand more about the effect of these experiences in order to focus therapy to support survivors’ and their descendants’ resilience and growth,” Rektor said. “We may also reveal strategies that Holocaust survivors used to cope with trauma during their later lives and to pass on their experience to further generations.”

The study results were recently presented at a European Academy of Neurology meeting in Oslo, Norway. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.


New study reveals biological toll on brain function of Holocaust survivors


More information:
The U.S. National Institute of Mental Health has more on stress.

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Study asked people with mental health disorders to recommend changes to international diagnostic guidelines

Study asked people with mental health disorders to recommend changes to international diagnostic guidelines


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A Rutgers University researcher contributed to the first study to seek input from people with common mental health issues on how their disorders are described in diagnostic guidelines.

The study, which was conducted by researchers in the United Kingdom and the United States in collaboration with the World Health Organization Department of Mental Health, appears in The Lancet.

“Including people’s personal experiences with disorders in diagnostic manuals will improve their access to treatment and reduce stigma,” said Margaret Swarbrick, an adjunct associate professor and Director of Practice Innovation and Wellness at Rutgers University Behavioral Health Care, who collaborated with Kathleen M. Pike, executive director and scientific co-director of the Global Mental Health Program on the U.S. portion of the study.

The researchers talked to people with five common disorders—schizophrenia, bipolar disorder type 1, depressive episode, personality disorder and generalized anxiety disorder—about how their conditions should be described in the upcoming 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11). The ICD is the most widely used classification system for mental disorders. This is the first time people with diagnosed mental health disorders who are not health practitioners have been invited to give input on any published mental health diagnostic guidelines.

The project surveyed 157 people diagnosed with these conditions in the United Kingdom, India and the United States. The participants reviewed an initial draft of the ICD-11 chapter on mental, behavioral and neurodevelopmental disorders and recommended changes to more accurately reflect their experiences and/or remove objectionable language.

Many participants said the draft omitted emotional and psychological experiences they regularly have. People with schizophrenia added references to anger, fear, memory difficulties, isolation and difficulty communicating internal experiences. People with bipolar disorder added anxiety, anger, nausea and increased creativity. People with generalized anxiety disorder added nausea and anger. People with depression added pain and anxiety. People with personality disorder added distress and vulnerability to exploitation.

The participants also suggested removing confusing or stigmatizing terms such as “retardation,” “neuro-vegetative,” “bizarre,” “disorganized” and “maladaptive.”

“We discovered that the current draft reflected an external perspective of these conditions rather than the perspective of the person’s lived experience,” Swarbrick said. “This is a needed perspective for clinicians and researchers. Participants appreciated the non-technical summaries, which suggest that using such common language would go a long way in bridging the communication gap between the people being diagnosed and clinicians.”


WHO mental health guidelines could better capture ‘lived experience’


More information:
Corinna Hackmann et al, Perspectives on ICD-11 to understand and improve mental health diagnosis using expertise by experience (INCLUDE Study): an international qualitative study, The Lancet Psychiatry (2019). DOI: 10.1016/S2215-0366(19)30093-8

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Do you need a bone density test?

Do you need a bone density test?


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Dear Mayo Clinic: I’ve never had a fracture or bone health issues. Should I still get a bone density test?

A: It depends. A bone density test uses a low dose of X-rays in a quick, noninvasive way to measure the amount of calcium and other minerals in a segment of bone, usually the hips and spine. By identifying decreases in bone mineral density, your health care provider can determine your risk of fractures, and diagnose and monitor osteoporosis progression.

Most young, healthy people do not need a bone density test. But as you age, your risk for osteoporosis increases because bone density tends to decrease as people grow older. That is especially true in women. If you’re a woman 65 or older, a bone density test is recommended. Even if testing reveals your bone health is good, this test can be a baseline measurement for future testing.

For men without fractures, the answer isn’t quite as clear. The U.S. Preventive Services Task Force doesn’t recommend routine bone density testing for men. Because men have a higher bone mass and lose bone more slowly than women, they’re at a lower risk of fracture. There’s also no conclusive evidence that osteoporosis medications can prevent fractures in men. However, up to 1 in 4 men over 50 will break a bone due to osteoporosis. Groups such as the National Osteoporosis Foundation still recommend testing for men 70 and older.

Men 50-69 and women under 65 also may want to have bone density testing if they have risk factors for osteoporosis, including a family history of the disease or a history of fractures. Another risk factor is taking certain kinds of drugs that can interfere with the body’s process of rebuilding bone. Examples of these drugs include steroid medications, such as prednisone, and immunosuppressant medications, such as those taken after an organ transplant or bone marrow transplant.

People over 50 who have broken a bone and people who have lost 1.5 inches of height or more also may need a bone density test to screen for osteoporosis.

Bone density test results are reported in a measurement known as a “T-score.” A T-score of minus 1 or higher is normal. A score of minus 2.5 or lower is osteoporosis. The range between normal and osteoporosis is considered osteopenia, a condition where bone density is below the normal range and puts a person at higher risk for developing osteoporosis. Osteopenia also raises the risk for breaking a bone.

There are things you can do to help keep your bones stay healthy as you get older:

– Exercise is important. Be sure to include a combination of weight-bearing exercises, such as walking, jogging, running or stairclimbing.

– Eat a healthy diet, making sure to get the right amounts of calcium and vitamin D.

– If you smoke, stop. Research suggests that tobacco use contributes to weak bones.

– Limit the amount of alcohol you drink. Regularly having more than two alcoholic drinks a day raises your risk of osteoporosis, possibly because alcohol can interfere with the body’s ability to absorb calcium.

Talk to your health care provider about getting a bone density test, and discuss with him or her any concerns you have about your bone health. Taking steps now can help ensure good bone health in the future.


What’s the right age to test for osteoporosis?


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