Thursday, January 21, 2010

Harden the f#@& up!

Lately I have been thinking about shifting tides in global psychiatry. For instance the Americanisation of mental illness is becoming increasingly evident, as is the overwhelming propensity for people to pathologise everything that is not neurotypical. Indeed, there is also a growing temptation to diagnose away bad behaviour, or attempt to find some reason why people might just be A-holes. Look at Tiger Woods, after being busted repeatedly burying his iron in the rough, does he man-up and acknowledge that hes a guy-whore with more money than sense? Does he hell...he books himself into rehab for his "sex addiction".

Now other poor sods are finding that after the demise of the Hope and Change Hoe-Down in Copenhagen, their impending demise is making them, well, a bit teary:

Brought to the brink by climate change
Mardi Tindal, the newly elected moderator of the United Church of Canada, returned from last month's climate change summit in Copenhagen with a deep malaise. Not a true clinical depression, but an anxious despair that reduced her to weeping.
"The difference between depression and what I was experiencing is that I wasn't suppressing or finding myself in a place of isolation," she said in an interview about her "lament," and how it helped her to see "the truth about the condition of my own soul."
She was so disappointed by the meeting's failure to reach a binding deal that she broke down in the car one day as her husband drove toward their home church in Brantford, Ont.

The article then trots out a U.K. psychiatrist, Lisa Page:
Dr. Page cites "preliminary evidence" of more extreme possibilities: that suicide increases above a certain temperature threshold; that schizophrenia increases as populations become more urban; and that "impulsivity and aggression could be triggered during periods of hot weather."

One minute we're talking about someone having a bit of a cry, and the next its suicide and schizophrenia?! I certainly hope Dr. Page has to defend those findings, because we already know that linking suicide with temperature is a rather tenuous association, and that in fact suicides rates tend to be highest in northern Europe. The top five countries for suicide according to the WHO are:
1. Lithuania.
2. Belarus.
3. Russia.
4. Kazakhstan.
5. Hungary.

Which would indicate to me that this might have just as much to do with a socio-politico-economic climate than a meteorological one.

Presumably, Dr. Page is referring to a recent article that examined suicide data from Italy over the last few decades and came to a rather zig-zaggy conclusion that Italian men were more likely to suicide when it was warmer. (But not Italian women. Go figure.) The authors themselves even note that:

It is worth mentioning the somehow speculative character of our interpretation of results, to be weighted against other possible contributing mechanisms
Really? You think?

Swiss researchers also set out to look at the relationship of seasonality to suicide, thinking that they would find evidence supporting the classical hypothesis that suicides peak when its warmer. Probably because they didn't think to hook this study up to climate change, they discoverered something completely different instead:
To summarize, the results show unexpected associations between monthly suicide and temperature data. Contrary to overall seasonality, the associations based on monthly residuals emerge mainly during the winter months. In analogy to the overall seasonality, suicides that are performed outdoors appear to play again a major role. The results suggest that temperature and similar meteorologic variables contribute little to our understanding of the overall seasonality in suicide, even though the meteorologic variables are involved indirectly in various ways.

Translation: Instead of finding that suicides are higher when its warmer, they discovered that most suicides correspond with winter, with a secondary peak during summer when people are more likely to suicide in the great outdoors.

We also know already that rates of schizophrenia are higher in people who are born in winter in climates with low levels of winter sunlight exposure. The most striking epidemiology came from the high level of schizophrenia in second generation Afro-Carribean migrants to the United Kingdom. Schizophrenia has thus been linked with a low level of maternal vitamin D during the third trimester. (To joint the long list of other diseases that seem to be linked with inadequate vitamin D levels: Heart disease, diabetes, cognitive impairment, cancer...theres more, but I have a short attention span and got bored listing them.)

If I met an individual in person who was feeling really down about the fact we are all going to die of climate by tuesday because Copenhagen went bosoms up, I would be very sympathetic to them. I'm not a bitch or anything. You can't go around making judgements about other peoples feelings. Feelings are personal and trying to negate someone else's is futility on the level of pushing manure up a hill with a pointy stick. However, on a population level, I would like to request that everyone feeling climate angst of this nature watch this delightfully educational clip (warning: Very foul language included. Don't watch if you are F-word phobic):

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