There’s no doubt that meeting partners on the Internet is a growing trend. But can we trust the information that people provide about themselves via online dating services? And why is depression so dissatisfying in relationships? These two questions are explored in articles appearing in the latest issue of the Journal of Social and Personal Relationships, published by SAGE. The authors also discuss their findings in a new podcast series: Relationship Matters.

Jeffrey Hall of the University of Kansas is lead author of the paper on internet dating, which shows that people looking for romance online actually behave very much as they do in face to face dating and relationships. “Our findings dispel the myth that people using online dating are that different than any one else who might find a relationship through friends, school or work,” Hall explains.

His team investigated over 5000 individuals dating online in search of long-term partners, from all walks of life and over a wide age range (18 to over 60). The survey included questions on personality traits such as openness, extroversion, education and income. “We also asked a series of questions on an important trait that we call self monitoring,” Hall says. “Self monitoring is about how we try to present ourselves in a favourable light to others, to make people like us.” Someone who scores as ‘low’ on self monitoring is extremely authentic when describing themselves in all circumstances, and those who score ‘high’ are more prone to so-called white lies.

Self-monitoring scores turned out to be a major factor in the likelihood of people changing their presentation to others across all dating indicators (topics such as previous relationships, likes, dislikes, appearance, etc).

Whether a person is likely to lie about themselves online also depends on what kind of person they are: Someone who is very open to new experiences (e.g. foreign travel) is highly unlikely to misrepresent themselves about their experiences – because they are naturally interesting people. On the other hand extroverts are more likely to misrepresent themselves when describing past relationships. Extroverts tend to have many past relationships because they meet new people easily, but may play this down when looking for a new relationship.

The good news, according to Hall, is that the likelihood of people misrepresenting themselves overall is actually very low. The research also showed that not all men are from Mars and Women from Venus – the differences between individuals was far greater than any difference between the sexes. However women were somewhat more likely to fib about their weight, whereas men were more prone to tell white lies on other subjects, such as how many previous partners they had had, or how serious they were about finding a long-term relationship. “Men and women aren’t as different from one another as we might believe,” Hall says. Next up – Hall and his team are developing an inventory of flirting styles, which they aim to publish later this year.

Meanwhile twin sisters Leanne Knobloch of the University of Illinois, US and Lynne Knobloch-Fedders from The Family Institute at Northwestern University, US put their heads together to look at a longstanding question about what explains the association between depressive symptoms and relationship quality.

Over three decades of research have shown that people with depression are less satisfied in their romantic relationships. But questions remain about exactly why these go together. Now the sisters’ research shows that relational uncertainty could be one explanation.

Relational uncertainty is how sure individuals are about their perceptions of involvement in a relationship. It has three sources. Self uncertainty is the questions people have about their own relationship involvement, such as, “how certain am I about my view of this relationship?” Partner uncertainty involves questions about a partner’s relationship involvement, such as, “how certain am I about where my partner wants this to go?” Finally relationship uncertainty involves questions about the relationship status, such as “How certain am I about the future of this relationship?”

There were three main findings from the study of couples experiencing depressive symptoms or relationship problems: Those with more severe depressive symptoms reported more relationship distress; people experiencing more relational uncertainty were less satisfied with their relationship; and finally, women’s depressive symptoms predicted all three sources of their relational uncertainty, which in turn predicted both men’s and women’s relationship quality. For men, only the self source of relational uncertainty acted as a mediator.

This finding could suggest treatment options. For example, working through relational uncertainty issues in psychotherapy may help alleviate depressive symptoms. Alternatively treating depression might help individuals achieve more relational certainty, leading to more satisfying relationships.

“People suffering from depressive symptoms may wrestle with more questions about their romantic relationship, which may be dissatisfying,” says Knobloch. “If we find ways to help people address their uncertainty about their relationship, then their depressive symptoms might not be so debilitating for their romantic relationships.”

Some anti-depressant drugs are associated with an increased chance of developing cataracts, according to a new statistical study by researchers at the University of British Columbia, Vancouver Coastal Health Research Institute and McGill University.

The study, based on a database of more than 200,000 Quebec residents aged 65 and older, showed statistical relationships between a diagnosis of cataracts or cataract surgery and the class of drugs called selective serotonin reuptake inhibitors (SSRIs), as well as between cataracts and specific drugs within that class.

Published online in the journal Ophthalmology, the study does not prove causation but only reveals an association between the use of SSRIs and the development of cataracts. The study could not account for the possibility of smoking – which is a risk factor for cataracts – and additional population-based studies are needed to confirm these findings, the researchers say.

This study of statistical relationships is the first to establish a link between this class of drugs and cataracts in humans. Previous studies in animal models had demonstrated that SSRIs could increase the likelihood of developing the condition.

“When you look at the trade-offs of these drugs, the benefits of treating depression – which can be life-threatening – still outweigh the risk of developing cataracts, which are treatable and relatively benign,” says Dr. Mahyar Etminan, lead author of the article, a scientist and clinical pharmacist at the Centre for Clinical Epidemiology at Vancouver Coastal Health Research Institute and an assistant professor in the Dept. of Medicine at UBC.

Researchers found patients taking SSRIs were overall 15 per cent more likely to be diagnosed with cataracts or to have cataract surgery.

The degree of risk among specific and different types of SSRIs varied considerably. Taking fluvoxamine (Luvox) led to a 51 per cent higher chance of having cataract surgery, and venlafaxine (Effexor) carried a 34 per cent higher risk. No connection could be made between fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft) and having cataract surgery.

Co-author Dr. Frederick S. Mikelberg, professor and head of the Dept. of Ophthalmology and Visual Sciences at UBC and head of the Dept. of Ophthalmology at Vancouver General Hospital, notes that the average time to develop cataracts while taking SSRIs was almost two years.

“While these results are surprising, and might inform the choices of psychiatrists when prescribing SSRIs for their patients, they should not be cause for alarm among people taking these medications,” Mikelberg says.

Psychosurgery is making a comeback. Recently published case series have shown encouraging results of so-called deep brain stimulation (DBS) in treatment-resistant obsessive-compulsive disorder, depressive disorders, and Tourette syndrome. In the current issue of Deutsches Ärzteblatt International, authors Jens Kuhn (University of Cologne) and Theo P J Gründer (Max Planck Institute, Cologne) and their co-authors provide an introduction to the method (Dtsch Arztebl Int 2010; 107(7)105-13).

In order to determine the clinical utility of DBS in psychiatric disorders, the authors evaluated therapeutic studies from 1980 to 2009. They found improvement rates of between 35% and 70% in treatment-resistant obsessive-compulsive disorder, depression, and Tourette syndrome. The rate of side effects associated with DBS was usually low and mostly reversible by modulating the stimulation parameters.

This favourable side effect profile is not all that surprising because DBS is a procedure that is well known; it has been in use for 20 years. In Parkinson’s disease and essential tremor, the method has proved to be so effective that it has been licensed as a therapeutic option for many years. To administer DBS, two electrodes are implanted into the patient that deliver continuous, high frequency, short electrical impulses, enabling modulation of the functional neuronal circuits. The electrodes are connected via a cable to an impulse generator, which is usually implanted below the collarbone.

Although DBS seems to offer new perspectives for the treatment of psychiatric disorders, further studies into its efficacy, mechanisms of action, and side effect profile and especially its long term course are needed.

A daily dose of vitamin D may just be what Chicagoans need to get through the long winter, according to researchers at Loyola University Chicago Marcella Niehoff School of Nursing (MNSON). This nutrient lifts mood during cold weather months when days are short and more time is spent indoors.

“Vitamin D deficiency continues to be a problem despite the nutrient’s widely reported health benefits,” said Sue Penckofer, PhD, RN, professor, MNSON. “Chicago winters compound this issue when more people spend time away from sunlight, which is a natural source of vitamin D.”

Diet alone may not be sufficient to manage vitamin D levels. A combination of adequate dietary intake of vitamin D, exposure to sunlight, and treatment with vitamin D2 or D3 supplements can decrease the risk of certain health concerns. The preferred range in the body is 30 – 60 ng/mL of 25(OH) vitamin D.

Loyola faculty members plan to take vitamin D research a step further by evaluating whether weekly vitamin D supplements improve blood sugar control and mood in women with diabetes. Depression is associated with increased insulin resistance, so people with diabetes have a greater risk for the disease than those without depression. Women also tend to have greater rates of depression and poorer blood sugar control than men with diabetes.

“There is evidence to suggest that vitamin D supplementation may decrease insulin resistance,” said Dr. Penckofer. “If we can stabilize insulin levels, we may be able to simply and cost effectively improve blood sugar control and reduce symptoms of depression for these women.”

Loyola is currently enrolling women in this clinical trial. In order to enter the study, they must be 18 to 70 years of age, have stable type 2 diabetes, signs of depression and no other major medical illness. Eighty women with type 2 diabetes and signs of depression will be given a weekly dose of vitamin D (50,000 IU) for a period of six months. Study participants will be evaluated at three points during this time.

“Vitamin D has widespread benefits for our health and certain chronic diseases in particular,” Dr. Penckofer said. “Our research may shed greater light on the role this nutrient plays in managing two conditions that impact millions of Americans. If proven to be successful, vitamin D may an important addition to care for diabetes and depression.”

The next advance in treating major depression may relate to a group of brain chemicals that are involved in virtually all our brain activity, according to a study published in Biological Psychiatry. The study is co-authored by Drs. Andrea J. Levinson and Zafiris J. Daskalakis of the Centre for Addiction and Mental Health (CAMH).

This study shows that compared to healthy individuals, people who have major depressive disorder have altered functions of the neurotransmitter GABA (gamma-aminobutyric acid). In the study, individuals with the most treatment-resistant forms of illness demonstrated the greatest reductions of GABA levels in the brain.

This points to the possibility that medications which correct a GABA imbalance could advance the treatment of major depressive disorder. Approximately 4% of Canadians experience major depressive disorder each year.

Several current medications for mood disorders correct imbalances in neurotransmitters such as serotonin and dopamine. However, many patients do not benefit from these medications. “Our findings build on the idea that some current medications do not help many patients because those drugs don’t affect the GABA-related brain chemistry,” says study author Dr. Andrea Levinson.

Applying the brakes

The GABA neurotransmitter and its receptors are involved in many different brain functions. Imbalances in GABA also are relevant to bipolar disorder, schizophrenia, and anxiety disorder.

The GABA neurotransmitter and its receptors are critical to how humans think and act, Dr. Levinson adds. “We apply so many conscious and unconscious perceptions and judgments to our actions at every second, without even realizing that we are doing so,” she says. “GABA is part of the brain system that allows us to fine-tune our moods, thoughts, and actions with an incredible level of detail.”

“It’s a little like driving a car. You need the accelerator, but at every stage you need the brakes to work. Some of our neurotransmitters apply the spark and the gas to the engine, and GABA supplies the brakes,” she says. “GABA provides the necessary inhibitory effect that we need in order to block out excessive brain activity that in depression may lead to excessive negative thinking.”

In addition, this study points to the reason why electroconvulsive therapy is still the most efficacious therapy for major depressive disorder, Dr. Levinson adds. “Electroconvulsive therapy may act on GABA brain chemicals in a way that can reset the balance,” she says.

Largest study to date

This study of 85 people is the largest such research effort on GABA and major depressive disorder to date. It compared four groups: 25 individuals with treatment-resistant depression, 16 with major depression who were unmedicated, 19 individuals with major depression who were successfully treated with medication and had normal mood, and a control group of 25 healthy individuals.

In all groups, a thumb twitch response to transcranial magnetic (brain) stimulation (TMS) was used to measure how GABA acts physiologically in the brain. GABA receptors were found to be dysfunctional in the three groups with major depressive disorder when compared to healthy subjects. In people who were the least responsive (treatment-resistant) to medications, the physiological effect of GABA in the brain was at its lowest.

Personalized medicine

“We are advancing the goal of a truly personalized medicine,” says study co-author Dr. Daskalakis. “It is intriguing to think that we may soon be able to apply simple brain stimulation to identify which treatments are most likely to help the individual person, eliminating the guesswork. That is, through these findings we may be able to one day determine who is and who is not going to respond to traditional pharmacological approaches to depression.”

New research shows that migraine and depression may share a strong genetic component. The research is published in the January 13, 2010, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“Understanding the genetic factors that contribute to these disabling disorders could one day lead to better strategies to manage the course of these diseases when they occur together,” said Andrew Ahn, MD, PhD, of the University of Florida in Gainesville, who wrote an editorial accompanying the study and is a member of the American Academy of Neurology. “In the meantime, people with migraine or depression should tell their doctors about any family history of either disease to help us better understand the link between the two.”

The study involved 2,652 people who took part in the larger Erasmus Rucphen Family study. All of the participants are descendants of 22 couples who lived in Rucphen in the 1850s to 1900s.

“Genealogical information has shown them all to be part of a large extended family, which makes this type of genetic study possible,” said study author Gisela M. Terwindt, MD, PhD, of Leiden University Medical Center in the Netherlands.

Of the participants, 360 had migraine. Of those, 151 had migraine with aura, which is when headaches are preceded by sensations that affect vision, such as seeing flashing lights, and 209 had migraine with no aura. A total of 977 people had depression, with 25 percent of those with migraine also having depression, compared to 13 percent of those without migraine.

The researchers then estimated the relative contribution of genetic factors for both of the disorders. They found that for both types of migraine, the heritability was estimated at 56 percent, i.e., 56 percent of the trait is explained by genetic effects. For migraine with aura, the estimate was 96 percent. “This finding shows that migraine with aura may be a promising avenue to search for migraine genes,” Terwindt said.

Comparing the heritability scores for depression between those with migraine and those without showed a shared genetic component in the two disorders, particularly with migraine with aura. “This suggests that common genetic pathways may, at least partly, underlie both of these disorders, rather than that one is the consequence of the other,” Terwindt said.

Wives of soldiers deployed to Iraq and Afghanistan are more likely to be diagnosed with depression, anxiety, sleep disorders and other mental health conditions than women whose husbands are not deployed, according to a new study by researchers at the University of North Carolina at Chapel Hill and the Uniformed Services University of the Health Sciences.

The study, published Jan. 14, 2010, in The New England Journal of Medicine, examined medical records of the wives of active duty U.S. Army personnel, comparing those whose husbands were serving abroad with those whose husbands were not deployed.

“This study confirms what many people have long suspected,” said Alyssa Mansfield, Ph.D., the study’s lead author, who conducted the research as a doctoral student at the UNC Gillings School of Global Public Health and is now a research epidemiologist at RTI International. “It provides compelling evidence that Army spouses are feeling the impact of recent deployments to Iraq and Afghanistan. The result is more depression, more stress, more sleepless nights.”

Understanding the scope of the problem can help the U.S. military better plan mental health prevention and treatment programs for the families of active duty personnel, she said. The study also may provide insight into families’ long-term medical needs.

The researchers examined medical records of more than 250,000 female spouses of active duty Army personnel for outpatient care received between 2003 and 2006. About 31 percent of the wives’ husbands were not deployed during that period, while about 34 percent were overseas for between one and 11 months and 35 percent were deployed for longer.

Although the three groups were similar in size, the study found almost 3,500 more diagnoses of mental health conditions among wives of soldiers deployed for less than a year, compared to the group of wives of non-deployed soldiers. Also, there were more than 5,300 additional diagnoses among wives of soldiers deployed for a year or longer.

Depression, anxiety, sleep disorders and acute stress reaction and adjustment disorders were the most commonly diagnosed conditions among both groups.

Spouses of deployed military personal naturally fear for their loved ones’ safety, Mansfield said. But they also often face challenges maintaining a household, coping as a single parent and dealing with the marital strain that comes with being apart for an uncertain amount of time.

“The majority of active duty soldiers are married, so we need to pay attention to the needs of their families, both short and long term,” Mansfield said. “These findings should help the military medical system better plan mental health programs not only for treatment, but also for support and prevention.”

Adolescents and parents need help recognizing that suicide is a problem in their own communities, as well as help identifying teens who are suicidal, according to the study, “Attitudes and Beliefs of Adolescents and Parents Regarding Adolescent Suicide,” published in the February issue of Pediatrics (appearing online Jan. 11). In the United States in 2006, 1,771 children and adolescents ages 10 to 19 committed suicide, making suicide the third leading cause of death in this age group.

To design a better suicide prevention program, researchers set out to understand what interventions would be most effective. In focus groups in Chicago and Kansas City, both teenagers and their parents correctly identified many of the known risk factors for suicide, including mental illness, alcohol and substance abuse, relational or social loss, and hopelessness. However, study authors said it was concerning that some of the parents reported regular drug and alcohol use as being a normal part of adolescent development, rather than problem behavior.

Parents and teens suggested guns should be removed if an adolescent is known to be suicidal, but parents acknowledged they may not be able to identify a suicidal teen. Parents and teens didn’t think suicide was a problem in their communities. All groups were interested in learning how to identify and intervene with a suicidal adolescent. Study authors conclude pediatricians should regularly screen all adolescents in their offices and encourage families to be open to discussing depression and suicide.

Scientists have long eyed mutations in a gene known as DISC1 as a possible contributor to schizophrenia and mood disorders, including depression and bipolar disorder. Now, new research led by Johns Hopkins researchers suggests that perturbing this gene during prenatal periods, postnatal periods or both may have different effects in mice, leading to separate types of brain alterations and behaviors with resemblance to schizophrenia or mood disorders.

The findings, reported online Jan. 5 in Molecular Psychiatry, could eventually help researchers treat mental illness in people or even prevent it.

To manipulate DISC1 expression during different periods, the researchers, led by Associate Professor Mikhail Pletnikov, M.D., Ph.D., crafted a novel mouse model in which a mutant form of the gene could be turned off by feeding the animals small amounts of the antibiotic doxycycline in their chow.

The animals could get the drug directly by eating it or through their mothers during gestation. Withdrawing doxycycline turned this gene on. (All the animals also carried the normal DISC1 gene, which wasn’t affected by the drug.)

Using this model, Pletnikov’s team generated four groups of mice: those that expressed mutant DISC1 prenatally (Pre), those that expressed mutant DISC1 postnatally (Post), those that expressed it during both periods (Pre+Post), and those that never expressed it (NO).

When the mice were about 2 months old, the researchers put the animals through a battery of behavioral tests designed to measure characteristics similar to schizophrenia and depression in humans, such as abnormal social interactions and heightened aggression under stress, comparing these animals with “control” animals that didn’t express the mutant gene.

Because previous studies have shown that male mice with mutant DISC1 have such altered traits, the researchers tested male mice in each of the groups by placing them in a cage with a normal male mouse and allowing them to mingle for 10 minutes. They counted various social behaviors, including sniffing, following and attacks. Pletnikov and his colleagues found that the Pre+Post and Post groups spent significantly less time in non-aggressive social interaction with their partners than the mice of the NO group. Those in the Pre+Post group also demonstrated significantly more aggressive attacks on their partners than control mice that did not express mutant DISC1.

To look for behaviors reflecting depression, the researchers gave animals of both sexes in all the groups a forced swim test and a tail suspension test. In both tests, the animals participated in unpleasant activities – being made to swim in a pool, or being lifted by their tails – and were timed for how long they struggled. Mice thought to exhibit depression-like behavior spend more time immobile than non-depressed mice.

Pletnikov’s team found that only female mice of the Post group spent significantly more time immobile in the forced swim test than mice that did not express mutant DISC1. Female mice in the Pre+Post group spent significantly more time immobile in the tail suspension test than control mice . Male mice in each of the groups displayed similar behavior in these tests.

Finally, when the researchers examined the brains of the mice, they found significant differences between animals in different groups. Those in the Pre group had significantly smaller brain volume than the other mice. Mice in the Post and Pre+Post groups had significantly larger lateral ventricles and decreased content of dopamine, a pleasure-producing brain chemical, in the frontal cortex. Both female and male mice in the Pre, Post and Pre+Post groups had fewer neurons that produce GABA, a brain chemical that regulates nerve cell firing, than mice in the NO group.

The researchers say both the behavioral and physiological findings suggest that expressing mutant DISC1 at different time points during fetal or early childhood development can lead to different outcomes. While selective prenatal expression led to smaller brain volumes but mild behavioral effects, pre- and postnatal expression led to behaviors and brain alterations in male mice similar to schizophrenic humans, and postnatal expression produced abnormalities in female mice similar to depression.

The researchers aren’t sure why the animals varied according to sex. However, Pletnikov notes, schizophrenia and depression also vary between the sexes in humans, with schizophrenia more prevalent in males and depression more prevalent in females. He and his team plan to study these sex-related differences in future studies.

The team also plans to try to narrow the time periods in which mutant DISC1 is turned on in their model to study particular stages, such as early postnatal development, sexual maturity, adulthood and aging, since triggers at each of these stages might bring on mental illness.

The goal, says Pletnikov, is to use these findings to develop new therapies to treat psychiatric disorders.

“Right now,” he says, “we cannot treat or reverse all the abnormalities associated with schizophrenia or major mood disorders, but our research gives us hope that we can eventually target some of these abnormalities that are currently considered incurable. If we catch these problems early enough, we may someday be able to prevent schizophrenia or depression from developing.”

A new study shines a light on depression in the workplace, suggesting that psychological stress at the office or wherever people earn their paychecks can make it more difficult for depressed workers to perform their jobs and be productive.

“There is a large economic cost and a human cost,” said study lead author Debra Lerner, Ph.D., director, Program on Health, Work and Productivity, Institute for Clinical Research and Health Policy Studies at Tufts Medical Center.

“We need to develop and test programs that directly try to address the employment of people with depression.”

The researchers screened 14,268 adult employees and ultimately compared 286 depressed workers to 193 who were not depressed. They recruited participants between 2001 and 2003 from doctors’ offices.

The study findings appear in the January/February issue of the American Journal of Health Promotion.

In many cases, the depressed employees had problems at work, Lerner said. “They’re often very fatigued and have motivational issues. They also may have difficulty handling the pacing of work, managing a routine, performing physical job tasks and managing their usual workload.”

The findings suggest that there is a link between productivity and an employee’s ability to control his or her work. “The workplace does play an important part,” Lerner said.

Ronald Kessler, a professor in the Department of Health Care Policy at Harvard Medical School, said the study findings “are consistent with a growing body of evidence that depression has important adverse effects on work performance, both absenteeism and on-the-job performance.”

Depression has a greater effect on attendance and productivity than the “vast majority” of other health conditions with the exception of musculoskeletal problems and insomnia, he said.

“This evidence has led to the development of several workplace depression screening and treatment programs,” he added. “Evaluations are beginning to show that these programs can be cost-effective when implemented carefully in reducing the indirect workplace costs of depression.”

What to do? When it comes to depressed workers, “we are going to need more ways to help those who want to continue working to be able to do so and sustain their productivity,” Lerner said.