The interface between chronic fatigue syndrome and depression:A psychobiological and neurophysiological conundrum

The chronic fatigue syndrome (CFS) remains a contentious and controversial presentation despite decades of systematic research from a variety of medical specialties and associated disciplines. Variously championed as a condition of immunological, neurological, neurophysiological, psychiatric or psychological origin, consensus on a cogent and evidenced-based pathway has yet to be achieved. Irrespective of the ambiguity regarding aetiology, what is incontrovertible is the experience of significant depression, which often accompanies this most distressing clinical presentation. The current paper examines the potential underlying mechanisms, which may determine and explain this relationship between CFS and depression. In doing so, it offers some insights, which may be of value in the development of evidence-based and scientifically-anchored interventions in individuals experiencing this diagnosis, to improve outcomes in relation to depression specifically and quality of life more generally

Commentary on Phillipou et al., Anorexia Nervosa: Eating Disorder or Body Image Disorder?

Phillipou et al. (2018) assert that anorexia nervosa (AN) should be thought of as a body image disorder (BID), and not as it is currently categorized as an eating disorder (ED, American Psychiatric Association, 2013). They propose that the change in description may serve as a more valuable and accurate portrayal of the illness, and suggest that conceptualizing AN as an ED is too simplistic and thus misleading. Phillipou et al. (2018) examine the view that AN is somehow different from other eating disorders such as pica, rumination disorder, avoidance/restricted food intake disorder, binge eating disorder and bulimia nervosa, because at its core AN is fundamentally an illness of ‘body image’. A parallel objective of Phillipou et al. (2018) is to alter the general public’s perception of AN, from one in which the public believe the AN patient is principally driven by disordered eating behaviour in order to reduce body fat, to one in which the patients’ overriding stimulus is actually body image

THE RISE AND REACH OF 'THE DOCTRINE OF CATEGORICAL EXCLUSION': How the Supreme Court Should More Clearly Define Speech Placed in the 'First Amendment Free Zone' from Chaplinsky to Elonis

Chapter 1 introduces the “Doctrine of Categorical Exclusion” which to date has been loosely but persistently articulated by the Supreme Court (without use of the phrase itself). At its core, the Doctrine is a set of rules to identify and analyze certain categories of expression that fall outside the “Freedom of Speech” protected by the First Amendment. Chapters 2 and 3 trace various disjointed roots of the unarticulated doctrine from the mists of history up until the Supreme Court’s first attempt to coalesce and synthesize disparate rulings into what had the appearance of a single doctrine, the landmark 1942 case Chaplinsky v. New Hampshire. Chapters 4 through 7 trace the development of the doctrine, while still unnamed, from Chaplinsky in 1942 to the verge of the Supreme Court’s next attempt, in 2010, at synthesizing the doctrine into a coherent and comprehensive articulation. That 68-year period witnessed the evolution of the excluded categories articulated in Chaplinsky, the rise and fall of an additional category, the enduring recognition of more categories, the rejection of others, and methods developed by the Supreme Court to control the categorical boundaries. Thus, Chapters 4 through 7 travel the jurisprudential path from Chaplinsky to the verge of United States v. Stevens. Chapters 8 and 9 consider the two modern, somewhat comprehensive attempts by the Supreme Court to synthesize the various rules and holdings into a single, coherent doctrine: United States v. Stevens (2010) and United States v. Alvarez (2012). Chapter 10 features a proposal for a simplified, coherent approach to the modern Doctrine of Categorical Exclusion——determining what speech falls in the “First Amendment Free Zone” that is outside the freedom of speech protected by the Constitution. The chapter explains how a simplified approach would promote Speech Clause values and bring greater order and predictability to this aspect of the First Amendment

Topological susceptibility from twisted mass fermions using spectral projectors and the gradient flow

We compare lattice QCD determinations of topological susceptibility using a gluonic definition from the gradient flow and a fermionic definition from the spectral projector method. We use ensembles with dynamical light, strange and charm flavors of maximally twisted mass fermions. For both definitions of the susceptibility we employ ensembles at three values of the lattice spacing and several quark masses at each spacing. The data are fitted to chiral perturbation theory predictions with a discretization term to determine the continuum chiral condensate in the massless limit and estimate the overall discretization errors. We find that both approaches lead to compatible results in the continuum limit, but the gluonic ones are much more affected by cut-off effects. This finally yields a much smaller total error in the spectral projector results. We show that there exists, in principle, a value of the spectral cutoff which would completely eliminate discretization effects in the topological susceptibility.Comment: 18 pages, 19 figure

When winners need help: Mental health in elite sport

What connects these individuals Frank Bruno, Dame Kelly Holmes, Marcus Trescothick and Clarke Carlisle? If you said are all are winners you would be correct, if you said all are elite sports individuals you would also be correct, but there is something else that connects these elitelevel athletes. They have all reported having mental health concerns either whilst performing or shortly after retiring. Boxer Frank Bruno has bipolar disorder and depression and has been admitted to psychiatric wards 3 times in the last 12 years. Dame Kelly Holmes was battling depression in the lead up to the 2004 Olympics. Marcus Trescothick was playing cricket for England when depression forced his retirement. In 2014, Clarke Carlisle attempted to take his own life by jumping in front of an oncoming lorry and was later admitted to a psychiatric unit for depression. These elite sportspeople are not alone, the list could have included Gary Speed, footballer and Manager who took his own life in November 2012 after battling with depression or Terry Newton, Rugby league player, who also sadly took his own life in 2010, after being sacked and being found to have used performance-enhancing drugs

Quality of Life in a Mixed Ethnic Population after Myocardial Infarction

Background: Although South Asian people are a significant ethnic group at increased risk of coronary heart disease and high mortality rates and experience greater delays with respect to diagnosis, referral and treatment, comparatively little is known about their quality of life during recovery from a myocardial infarction.Objectives: We sought to determine and compare the impact of ethnicity on quality of life after myocardial infarction (MI) in a mixed ethnic population (South Asian and white people) in the UK.Methods: A 2x2 mixed-group design with repeated measures on the second factor. The independent variables were ethnic group (white/South Asian) and time since MI (2 weeks/3 months). The dependent variables were the subscale scores on the Short-Form 36-item health survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS).Results: At 2 weeks, significant differences were observed between groups on 5 of the 8 SF-36 subscale domain scores, with the white group reporting higher quality of life. Significant improvement in reported quality of life occurred in both groups over time on all domains of the SF-36, except bodily pain. There was a significantly greater improvement in favour of the white group for the role-physical domain. There was no significant difference between groups in terms of anxiety or depression at 2 weeks. Both groups showed a significant reduction in anxiety and depression by 3 months, but the degree of reduction was not significantly different between them. At 3 months, there was no significant difference between groups in terms of anxiety scores, but the South Asian group scored significantly higher on the depression scale.Conclusions: South Asian people have significantly poorer quality of life than white people after MI. While both groups showed improvement over time, South Asian people reported significantly less improvement in physical role function and were more depressed at 3 months. Identifying the factors accounting for such differences is important to develop models of care for delivering the most effective and culturally-sensitive interventions to this group