Tuesday, June 29, 2010

Clapping Therapy

I absolutely love clapping in music (though other supposed music lovers I know detest it). As it turns out, there is a ‘clapping therapy’ also know as interactive metronome training.

Interactive Metronome® was developed in 1994 by Jim Cassily, a recording engineer … who taught piano lessons on the side, discovered that I.M. helped his autistic students. Not only did they get the timing down, it also helped them with attention, concentration, coordination, language processing, reading skills and control of aggression.

One study on children with attention and coordination disorders found, “...Interactive Metronome training may address deficits in visuomotor control and speed, but appears to have little effect on sustained attention or motor inhibition.”

A case study: “This child's participation in a new intervention for improving timing and coordination was associated with changes in timing accuracy, gross and fine motor abilities, and parent reported behaviors.”

A study on children with ADHD: “The Interactive Metronome training appears to facilitate a number of capacities, including attention, motor control, and selected academic skills, in boys with ADHD.”

A Parkinson’s study: “These results suggest that computer-based motor training
regimens might be useful for improving or retaining motor function in Parkinson’s disease.”

Another Parkinson’s study: “This study provides evidence for the potential of cueing to improve gait in PD-CI. Only individuals with mild CI were included, and the effect with increased CI and different types of dementia requires further evaluation.”

A Parkinson’s study which examines an alternative to the audio metronome: “Rhythmic somatosensory cueing may be a viable alternative for auditory cueing and is robust to changes in walking speed and visual distractors.”

A study in schizophrenic patients found that, “…patients with marked negative symptoms performed best when their actions were more stimulus-driven [marked by metronome] than willed [consciously attempting to perform well] strengthens the case that negative schizophrenic symptoms reflect a disorder of willed action.”

A paper published by the Institute for Applied Psychometrics looks at four different timing therapies and has a long list of references for further reading.

According to a site which sells the IM, “The device can strengthen motor skills, including mobility and gross motor function, and improve many fundamental cognitive capacities such as planning, organizing and language.”

Clapping itself is used in conjunction with music therapy in the treatment of autism, dementia, and Alzheimer’s.



As far as I can tell, there has been no clinical research investigating the specific effects of clapping on mood. But it is exercise, so I imagine a heavy regime of clapping could boost mood.

A song about clapping that refuses to let you dwell in a bad mood:

Thursday, June 17, 2010

Lithium and Suicide

An article in the British Journal of Psychiatry examined the relationship between lithium levels in drinking water and risk of suicide. The analysis was done by a team in Japan.

“We found that lithium levels were significantly and negatively associated with SMR [standardised mortality ratio] averages for 2002–2006. These findings suggest that even very low levels of lithium in drinking water may play a role in reducing suicide risk within the general population.”
And UBC’s very own Dr. Allan Young had some words to say on the matter, particularly on the possible future debate of whether or not lithium should be added to drinking water:
“It would be most unfortunate if these findings became little more than a factual curiosity, of the sort that bright students sometimes use to highlight the limitations of a professor’s wisdom… It would be surprising if lithium in drinking water were not to raise a…panoply of questions… Following up on these findings will not be straightforward or inexpensive, but the eventual benefits for community mental health may be considerable.”

The following studies provide support for decreased suicidality with lithium treatment. However, all of these studies are done by the same group of authors, more or less. As well, there are some conflicts of interest between the authors and companies producing pharmaceuticals, including lithium.

The findings indicate major reductions of suicidal risks (attempts > suicides) with lithium maintenance therapy in unipolar >/= bipolar II >/= bipolar I disorder, to overall levels close to general population rates. These major benefits in syndromes mainly involving depression encourage evaluation of other treatments aimed at reducing mortality in the depressive and mixed phases of bipolar disorder and in unipolar major depression.

Results from 33 studies (1970-2000) yielded 13-fold lower rates of suicide and reported attempts during long-term lithium treatment than without it or after it was discontinued. Although greatly reduced, these rates remain above those estimated for the general population. Evidence for substantial, if incomplete, protection against suicide with lithium is supported by more compelling evidence than that for any other treatment provided for patients with mood disorders. Studies of commonly used, but incompletely evaluated, alternative treatments are required, and further protection against premature mortality can be anticipated with better protection against bipolar depression.

There is no definitive evidence from this review as to whether or not lithium has an anti-suicidal effect.

Protection against suicide with lithium is incomplete, but rates of suicides plus attempts during lithium treatment may approach general population base rates.

The findings indicate major reductions of suicidal risks (attempts > suicides) with lithium maintenance therapy in unipolar >/= bipolar II >/= bipolar I disorder, to overall levels close to general population rates.

Risks of completed and attempted suicide were consistently lower, by approximately 80%, during treatment of bipolar and other major affective disorder patients with lithium for an average of 18 months. These benefits were sustained in randomized as well as open clinical trials.

The findings support growing evidence of lower risk of suicidal acts during closely monitored and highly adherent, long-term treatment with lithium and indicate that treatment adherence is a potentially modifiable factor contributing to antisuicidal benefits.

Studies done by some different people:

In view of the fact that a placebo-controlled mortality study under long-term conditions is neither ethically nor practically feasable, our findings cannot prove definitively that long-term lithium treatment counteracts factors responsible for the excess suicide and cardiovascular mortality of affective disorders. However, our observations are compatible with such a notion.

The findings suggest that ongoing lithium treatment is associated with a lower suicide risk. Whether this is due to lithium's mood-stabilizing properties, to lower suicide risk per se in the patients who remain in treatment, or to a specific antisuicidal effect of the lithium ion cannot be determined since patients were not randomized to discontinue treatment. This methodological shortcoming is shared with every study in the field. All results regarding the influence of lithium on suicide rates must therefore be interpreted with extreme caution.

The reduction in suicide attempts, in both responders and non-responders, indicates that lithium possesses a specific anti-suicidal effect besides its mood-stabilising property.