Science & Medicine Links for August

Case report from the BMJ that would also make a good Twilight Zone episode: Woman hallucinates ghost children. Husband takes pictures of scene to try to prove that there’s nobody there. Woman sees exact same hallucinations in the photographs. Woman takes some psychiatric drugs, mostly stops having hallucinations, but still sees the hallucinatory ghost children in the (empty to everyone else) old photos. Psychiatry is weird, and/or possibly haunted.

A very strange but creative methodology with by which to study the notoriously complicated field of diet: scientists find that a gene that makes vegetables taste better also makes you live longer. Weak evidence suggesting that eating more vegetables makes you live longer? Maybe!

A Critical Review of the First Ten Years of Candidate Gene by Environment Interaction Research in Psychiatry. Key phrase: “Ninety-six percent of novel cG×E studies were significant compared with 27% of replication attempts.” Note that gene x environment interaction studies are a very particular kind of study that is especially easy to do bad work on and this might not generalize to other types of genetics research – but that at least to some degree it probably does.

A while ago there was great excitement at the discovery that the drug rapamycin extended lifespan in mice. Although this finding has since been replicated and seems broadly correct, the bad news seems to be that is now clear that the drug just treats some very specific deadly pathologies (like cancer) and does not fight or slow aging. Although if the bad news is that a drug cures cancer, we’re still doing pretty well.

But if you absolutely must have some miracle substance that might cure aging in lab animals to be excited about, you’ll be happy to know that rhodiola extends the lifespans of fruit flies 24% and delays age-related loss in physical performance. Also it might be a nootropic or antidepressant or something.

Speaking of miracles, Skin Abnormality May Prove Biological Basis For Fibromyalgia. I predict this will probably turn out to be nothing, the same way everyone was super excited a few years ago that we’d discovered that the real cause of multiple sclerosis was venous outflow obstruction and then it didn’t replicate, but until then at least fibromyalgia sufferers will get a few good years in of “SEE! I TOLD YOU IT WAS BIOLOGICAL AND YOU DIDN’T BELIEVE ME!”

Not technically a study but a good thing to include here: Eight Toxic Foods and a Little Chemical Education. Describes some of the scare claims the media sometimes makes about chemicals and health risks and dissects them carefully and rigorously.

And if that was too basic for you, here’s the Epic-level version of the same thing: the Last Psychiatrist dissects claims made in a presentation on the drug Geodon. This is old, but I just found it and it terrifies me, in that I thought I knew what to look for and yet this study would have completely passed all the filters I usually have to protect myself from this sort of thing. A good example of how a drug company can run a seemingly rigorous study that stays far away from anything even resembling data falsification or cover-ups – and yet still get exactly the results they want.

Here’s Scientific American giving a good exposition of one of the best current theories about why we sleep. Also, it apparently has evidence behind it now, which it didn’t the last time I heard about it. Still doesn’t really explain why some people can go without sleep completely, but maybe that’s why they brought in the “local sleep” points.

Back when people realized it was easy to get positive results from a drug for spurious reasons, they started adding a control group to the experiment. Now that people have realized it’s easy to get positive results from a controlled trial for spurious reasons, is it time to go one meta-level up and add a control experiment on to the study? One group takes an experiment used to “prove” that SSRIs cause gastric bleeding, compares it to dozens of “control experiments” run with drugs that don’t cause gastric bleeding, and finds that, although the real experiment reported positive results, it in fact does no different than placebo experiments. This is really clever although probably impractical in most cases.

Psychotherapy over the Internet works at least as well and probably better than face-to-face psychotherapy, says a study this month, adding to the small mountain of evidence saying the same. A friend of mine uses online psychotherapy and says it’s easier and more productive because the therapist is less of a Terrifying Authority Figure. Also good for people who want a psychologist who will have severe difficulty calling the cops on them and having them committed. Also good for social phobics who are currently required to leave the house and hang out at a busy medical office if they want to get treatment for their social phobia who the heck came up with this system?

“Adoption study of human obesity” sounds like something you would get from a Things Scott Is Interested In Mad Libs, along with “utilitarian behavioral genetics” or “double-blind placebo-controlled cuddling of cute girls”. But it turns out this is a real field that various people have looked into, and the conclusion of most of the studies, including a very rigorous one in Denmark published in NEJM and a huge UK one by Robert Plomin agree that whether the parents who raise you are obese has zero impact on whether you will become obese, but whether your biological parents whom you may never meet are obese has massive impact on whether you will become obese. This doesn’t completely disprove the idea that the childhood environment affects obesity – it could still be that whether or not parents are good at teaching their children not to be obese just has zero correlation with whether the parents themselves are obese – but it sure casts a lot of doubt on environmental hypotheses and confirms that genetics plays a very big role.

On the other hand, here’s a study from 2011 which shows that people with lower Conscientiousness and higher Impulsivity are much more likely to be obese – “Participants who scored in the top 10% of impulsivity weighed, on average, 11 kg more than those in the bottom 10%”. LWers pointed out that this is not itself incompatible with genetics, since most personality traits are themselves somewhat heritable.

On the mutant third hand, if it’s all just impulsive people who have been poorly trained by their parents, why are wild animals getting fatter?

JAMA Psychiatry: Rapid Improvement of Acute Schizophrenia Symptoms After Intravenous Sodium Nitroprusside. Anything that improves schizophrenia symptoms is good news, but this is especially interesting for two reasons. First, the rapid and dramatic effect is easier to replicate and less corruptible than the usual “take this pill for a month and maybe you will feel better”, and is reminiscent of the very similar effect of ketamine on depression. Second, sodium nitroprusside is a drug used for high blood pressure without any previously known relevance to psychiatry, opening up a whole new direction in research. The small but interesting field of nitric oxide in schizophrenia is about to get a lot more scrutiny.