See-through brain?

The brain is, understandably, a popular topic for research. Traditionally researchers wishing to study the brain have had to use invasive and time-consuming methods of cutting it up. However, recently a team lead by Dr Karl Deisseroth at Stanford University has developed a method to make brains transparent, allowing them to be studied without having to be sliced up. The process can also be used with other organs, "revolutionising the three-dimensional study of important organs within the body".

The brain is surrounded by lipids that help form the membranes around the cells and bind the tissues together. This membrane blocks the view into the brain. The revolutionary new process referred to as CLARITY replaces the lipids with a clear gel, which preserves the tissues while revealing the internal structure of the brain. The gel is injected into the organ and is absorbed into the tissue. The lipids are then removed, while the rest of the brain remains intact, leaving the neurons, axons, dendrites, proteins and synapses in place and able to be viewed.

Previously these structures could only be seen following the brain being sliced up, and only across tiny slivers of tissue. Researchers then needed to reconstruct three-dimensional data from images of these thin slices to form a three dimensional view of the brain.

Using CLARITY scientists can then use fluorescent proteins and neuro-imaging to see neuronal connections, subcellular structures, proteins, nucleic acids and how cells interact and relate to each other. This opens up the possibility of viewing large networks of neurons with unprecedented ease and accuracy.

The procedure has already been used to investigate the nerves in the post-mortem brain of an autistic boy. They noticed unusual patterns in the neurons, which is likely to help advance the understanding of autism.

We at ANTS look forward to hearing more about how this procedure can be used for advancing our understanding of various neurological and neuropsychological conditions.

Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V)

The DSM is the 'bible' for mental health practitioners around the world. It is used to diagnose disorders affecting mood, personality, identity, development and cognition. It has recently undergone a major revision from the previous edition, the DSM-IV (released in 1994), and is set to be released in May 2013.

There have been many significant changes from the previous edition. Keep reading to find out about some of the most important changes.

New or amended diagnoses
Autism Spectrum Disorder (ASD)
This is one of the most important changes, given the prevalence and severity of ASD in the community. ASD is characterised by communication deficits, difficulties interpreting nonverbal communication, social difficulties, issues coping with change to routines, and intense focus or obsessions with inappropriate items. Some symptoms must be shown from early childhood. The symptoms fall on a continuum, with some individuals showing mild symptoms and others having much more severe symptoms. ASD is a single umbrella disorder which incorporates four separate disorders from the DSM-IV: autistic disorder, Asperger’s disorder, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified.Researchers from the DSM-V workgroup found that these separate diagnoses were not consistently applied across different clinics and treatment centres, and that a single disorder improves diagnosis of ASD.

Disruptive Mood Dysregulation Disorder
This is characterised by severe outbursts or tantrums and prolonged irritable mood in children. It was included to capture children who display these characteristics and are misdiagnosed with Bipolar Disorder and/or Attention Deficit Hyperactivity Disorder.

Hoarding Disorder
Public interest in hoarding, the compulsive collection of possessions that may or may not have monetary value, is demonstrated by the popularity of reality television shows and docu-dramas dealing with this issue. Hoarding will now be listed as a separate condition from obssessive compulsive disorder in recognition of its unique symptoms and effects.

Structure
The complex multiaxial system with five 'levels' or axes of disorders will be removed. The DSM-V will instead present a simplified list of 20 chapters by grouping related disorders.

Rejected diagnoses
A number of proposed diagnoses were subsequently rejected and will not be included as separate disorders in the DSM-V. These include: Anxiety Depressive-Syndrome, Attenuated Psychosis, Hypersexual Disorder, Parental Alienation Syndrome and Sensory Processing Disorder.

Certain specifics of the DSM-V will not be made public until its release. However, more details about what has been publicly released can be found at the DSM-V development website.

While various websites publish diagnostic criteria from the DSM-IV (and likely the DSM-V once its released), a trained, experienced psychologist, neuropsychologist or psychiatrist is the best person to help you clarify or confirm a diagnosis of a psychological disorder. If you would like more information about our neuropsychological services, please contact us.

Right brain/left brain

If further proof was needed that the human brain is a fascinating organ, because of the way our brains are organised, there is a slight but discernible difference between the left and right sides of our faces.

Our brains are composed of approximately 100 billion neurons (nerve cells), with 50 billion neurons in each half. However, only approximately 250 million neurons join the two halves, meaning that our left and right brains are mostly unconnected and work separately. One result of this is our faces are unsymmetrical.

Many actors and other famous people (such as David Caruso, pictured) are known for having a 'good side' - preferring to be photographed on one side of their face than the other. Research shows support for the assertion that the different sides of our faces are different and one side is actually considered to be more attractive than the other.

Professors Kelsey Blackburn and James Schirillo from the University of Wake Forest asked undergraduate university psychology students to rate the attractiveness of 20 volunteers who had been photographed on both their left and right sides, about 37 degrees from the centre on each side. Some photographs were untouched, while other photos has been Photoshopped so that they were mirror-reversed so the left side looked like the right and vice versa.

As well as asking them about their preferences, the researchers examined the students' pupils. The size of one's pupil is related to the intensity of our emotional response to stimuli. In general, the students preferred the left face of the both men and women — regardless of whether they were shown the untouched left face, or a left face which had been mirror-reversed to look like a right face. This was regardless of the gender of the person in the photo, and the gender of the person doing the judging. And the pupils of the volunteers opened larger when they rated the faces more attractive.

The echoism app, developed by artist Julian Wolkenstein shows a combined image of two photos of either the left or right side of people's faces, with most of these photos posted on line being very different from the people's actual image. This indicates that 'symmetrical' faces don't look quite right. Judge for yourself whether you think the right or left images are more attractive.

Mental health care for Newton

Successful treatment for Matthew Newton

After a string of assaults and alleged assaults, including domestic violence incidents involving two ex- partners, punching a taxi driver in Sydney and attacking a hotel receptionist in the US, Matthew Newton has recently been released from a high care mental health facility for treatment for bipolar disorder and obsessive compulsive disorder. He previously spent time in a mental health facility in Sydney in late 2010.
His latest treatment has reportedly been a resounding success, with Newton currently free of medication and 'unrecognisable' according to his lawyer, since spending 84 days at the clinic, when he appeared in the Downing Centre Local Court to face charges over the taxi driver assault. His lawyer, Chris Murphy is making a second application to have the matter dealt with under the Mental Health Act, given his diagnoses. An application made earlier this year was rejected.

Section 32 of the Mental Health Act diverts people suffering from mental illness who have been charged with a crime from the criminal justice system and imposes a treatment plan. Charges can be dismissed with the condition that the individual undergo treatment.

Serious psychiatric conditions such as bipolar disorder are known to be associated with higher rates of violence, particularly when an individual is in a manic state.

ABC News Photo Illustration

While this is certainly no excuse for violent behaviour, having a diagnosed mental health condition can help to explain Matthew Newton's actions and can be taken into account as an extenuating circumstance in legal matters. Section 32 of the Mental Health Act exists in part, to help ensure that people who have a mental health condition and engage in criminal behaviour undergo appropriate treatment, which benefits both the individual and the wider community.

As his lawyer made the point via Twitter, you "can't cure mental illness with 'You stop that!'".

With appropriate diagnosis and treatment, most people with mental health conditions can lead happy, safe and fulfilling lives.

Early detection of mental health issues

Healthy Australian Kids

The Australian government, supported by the Australian Medical Association (AMA) has proposed an initiative, which will be part of the The Healthy Kids Check, to screen Australian 3 year olds for signs of psychiatric and developmental conditions such as autism

Under this voluntary program parents can bring their children to be assessed by General Practitioners (GPs), who will then refer children who display troubling behaviour to psychologists and paediatricians for further assessment and, if necessary, treatment.

Mental health and the federal budget

The 2012-13 federal budget has been released, and according to some expert commentators, there is good and bad news for mental health arising from the budget.

The good news is:

• Overall funding for mental health has not been cut.
• Funding for the Mental Health Nurse Incentive Program, providing incentives for community based general practices to engage mental health nurses, has been maintained.
• The government will provide $21 million to fund additional allied mental health services for patients under the Better Access initiative, whereby treatment for those with diagnosed mental health problems is partially covered by Medicare.
• New spending of $115m over five years is directed towards better mental health care for veterans.
• From 2014-2015 $9.1m will be provided to the Australian Bureau of Statistics to conduct its Survey of Disability every three years, rather than every six years.

Mental health and the community

ABC TV's Australian Story program on Monday 5 March reported the heart-breaking story of Adam Salter, a man with a history of psychosis, who was shot and killed by police in November 2009 following a call made by his father that he was trying to stab himself.

Full details of the story can be found here.

The police involved on the day and in follow-up investigations of the matter were criticsed by the deputy state coroner of NSW at an inquest into Mr Salter's death in 2011.

Mental health advocates have described Mr Salter's medical and psychological treatment as a "failure of care".

While this is an extreme example of how mental health issues are not always dealt with well within the community, it is not an isolated incident. It has been well documented that mental health continues to carry a stigma within the community and does not always receive the same level of care and attention as physical illnesses. In Mr Salter's case, he was admitted to a mental health facility during a psychotic episode in 2008 as an involuntary patient and discharged without follow-up by the community mental health team and without his family being advised of his high risk of relapse. He is not alone. A Mental Health Council of Australia report, Consumer and Carer Experiences of Stigma from Mental Health and Other Professionals, which reports the results of a study of 400 mental health patients and 200 carers, found that 29% of patients reported feeling shunned or avoided by health professionals. Fourty-four percent of the carers believed that doctors behave differently towards patients when they find out that they have a history of mental health issues. Close to three quarters (73%) of the respondents said they had experienced stigma or discrimination in the last 12 months because of their mental illness.

Mental illness is not uncommon. One in five Australians suffer from a mental illness. The impact of mental illness is felt by the sufferer, their family, friends, workplaces and the broader community. It is important that mental health is treated seriously and that appropriate care is provided, including follow-up, appropriate referrals, case management and consultation with the family. An important component is community education.

We here at ANTS certainly recognise the importance of mental health and of educating the community. We run Mental Health First Aid Training programs to help increase knowledge about common mental health problems and to teach people and organisations to deal with mental health crises.

To learn more about our programs and our services more generally, contact us. We look forward to hearing from you.