Latest news with #psychiatry
ABC News
4 days ago
- Health
- ABC News
What is kleptomania? Understanding the compulsive urge to steal
Lynn* can remember the very first time she stole something. A kid's toy from a friend when she was seven years old. It was nothing out of the ordinary — young kids often steal and tend to grow out of it. But as she got older, Lynn found herself stealing more often. She'd take hair ties from her teacher's desk, umbrellas from her university, a small doll from the shops. And at 22, the urge to steal has taken over Lynn's life. "Almost everywhere I go right now I have to steal something, which is really disabling for me," she says. Two years ago, Lynn was officially diagnosed with kleptomania — a mental health condition characterised by a compulsive urge to steal. Kleptomania is considered an "impulse control disorder" under the Diagnostic and Statistical Manual of Mental Disorders (DSM), a clinician's key handbook for mental health conditions. Impulse control disorders are a relatively rare cluster of conditions that also includes pyromania (an intense fascination with fire and the repeated, deliberate setting of fires) and oppositional defiant disorder (a pattern of disobedient or hostile behaviour towards authority figures in childhood). People with kleptomania repeatedly steal items, but they do it impulsively and they find it very difficult to stop," says Sam Chamberlain, a professor of psychiatry at the University of Southampton. "Importantly, when they steal these items, it's not because they need them and it's not for personal or financial gain," he says. According to Dr Chamberlain, the typical pattern of behaviour for someone with kleptomania is a sense of tension that builds up before the theft, followed by a feeling of gratification or release after they've done it. Lynn says the urges feel like she is being pulled towards a particular object — that "it feels like there's no way of not taking it." She says it feels reflexive and difficult to suppress, like a sneeze or a yawn. And once she's taken the object, there's a rush of euphoria, quickly followed by guilt. "After a minute already I feel so very guilty about it. And I feel like a terrible human being," she says. Despite being mentioned in medical manuscripts for hundreds of years, kleptomania is still not well understood. "It's really stigmatised and hidden," Dr Chamberlain says. "And this means, sadly, that the person with a condition will suffer more. "It also makes this condition hard to study because people might be reluctant to come forward for research and admit that they've got this condition," he adds. The evidence we do have suggests about three to six in every 1,000 people have kleptomania. That makes it much rarer than conditions like anxiety and depression, which affect sizeable proportions of the population. It typically emerges during someone's teenage years and is thought to be more common in women than men — though again, that finding is based on the limited number of people diagnosed with the disorder. And while the numbers of people affected are small, kleptomania can be debilitating. Lynn often avoids going to the shops or visiting friends because she's scared of stealing and being caught. "And my parents will know and I will be arrested and convicted and the anxiety starts going up from there," she says. Concealing the condition — and the associated anxiety that comes with it — is typical of people with kleptomania, Dr Chamberlain says. "We often see that people, develop, anxiety and depressive disorders and other addictions such as alcohol use disorder. Sometimes these can be a direct consequence of the kleptomania and other times they can be happening in parallel." Research into kleptomania is limited, and work that examines the drivers of the condition is less common still. While no clear cause has been identified, we do know people with severe symptoms of kleptomania are more likely to also be diagnosed with other conditions such as obsessive-compulsive disorder or an eating disorder. They also tend to have higher levels of impulsivity. "This means that in terms of their personality, they have a tendency towards doing things on the spur of the moment. Maybe in response to reward, perhaps not planning things through to the extent that a less impulsive person would," Dr Chamberlain says. When researchers look at the brains of people diagnosed with kleptomania against those who don't have the condition, there appear to be subtle differences in the white matter tracts (bundles of nerve fibres) that connect key parts of the brain together. "We also see changes in the white matter tracts … in people with other conditions such as attention deficit hyperactivity disorder or obsessive-compulsive disorder," Dr Chamberlain says. "So probably there's some kind of common brain processes contributing to these different conditions." After receiving her diagnosis two years ago, Lynn trialled a number of different strategies to curb her impulses. These included talking therapies, recordings of her friends' words of encouragement she plays through headphones while at the shops, and a card she carries listing the potential consequences of stealing. She's also been prescribed the drug naltrexone, which is most often used to treat alcohol use disorder — and which has the best evidence of any medication for treating kleptomania, Dr Chamberlain says. A small but high-quality study done in 2009 found the drug was better than a placebo pill in reducing both urges and actual stealing among people with kleptomania. "So naltrexone is often a useful choice, but obviously as with any medication there are side effects for some people … it's not the easiest medication to prescribe," he says. For Lynn, none of these treatments have been effective in reducing her stealing. She wants more work done in researching ways to address the urges. In the meantime, she manages as best she can. "I have never been caught, and I hope to let it stay that way. But I'm not sure how long I will be able to," she says. *Lynn's name has been changed to protect her identity. Listen to the full episode of All In The Mind about kleptomania and its impact , and follow the podcast for more.
The Guardian
5 days ago
- Health
- The Guardian
Fundamental flaws in the NHS psychiatric system
I am disappointed to read such a scathing review of Bella Jackson's book Fragile Minds (A furious assault on NHS psychiatry, 30 June). It is a difficult read, and yet I thought that Jackson wrote about her experiences with compassion for both patients and staff unwittingly caught up in erratic and overstretched services. I am a doctor, with experience as a psychiatric patient and as a senior 'staff grade' doctor on an acute psychiatric ward. My memoir, Unshackled Mind: A Doctor's Story of Trauma, Liberation and Healing, confirms Jackson's claims that abuses do happen in these places. More subtly, there is a continued reliance on the disease-centred model of biomedical psychiatry without sufficient attention paid to the circumstances and adversities suffered by patients before they ever came in contact with psychiatry. As a result, my own early trauma was unaddressed for more than 20 years, while I was subjected to increasingly damaging interventions, including electroconvulsive therapy and even a cingulotomy. It is only since leaving psychiatry that I have been able to recover. Jackson's book is a reminder that despite the best intentions, many patients are failing to get the help they need in a fundamentally flawed psychiatric Cathy WieldAbingdon, Oxfordshire I am writing to congratulate Dr Rachel Clarke for her excellent rebuttal of Bella Jackson's assault on the failings of modern psychiatry. I have worked as the head of mental health law for a large NHS trust for 35 years, and as a frequent visitor to mental health wards, entirely agree that Jackson's views are at odds with my experience. I was last on a secure, forensic mental health ward just a few days ago – with incredibly challenging patients. All the staff I encountered were not only humane, but kind, compassionate and caring. I've also worked in roles where I visited many hospitals and have almost without exception experienced the same. Our mental health nurses and psychiatrists, as well as so many others, go out of their way to display the same values. I am far from naive, and recognise that there is a tiny minority of individuals who fail to live up to the same core values. Over decades I have witnessed interactions where psychiatrists, nurses and others are challenged to a degree that might seem almost impossible to cope with, but they rise to the challenge with great skill, kindness and compassion, in line with their respective professional codes of conduct. Kevin TowersHead of mental health law and data protection officer, West London NHS Trust I'm writing in response to the review by Rachel Clarke, especially the suggestion that the memoir is 'scaremongering'. I am a consultant clinical psychologist with more than 20 years' experience in the NHS across several London-based trusts. I train people, including ward staff and crisis services, in working effectively with people with personality disorder. Similar stories to those that Bella Jackson relates are reported to me and colleagues regularly. I don't doubt the veracity of Jackson's complaint, nor that NHS mental health is in a dire state; it is interesting that Clarke does, given her admission of relatively scant mental health and address supplied Have an opinion on anything you've read in the Guardian today? Please email us your letter and it will be considered for publication in our letters section.
Globe and Mail
09-07-2025
- Health
- Globe and Mail
Ottawa Hospital receives US$2.3-million in funding for bipolar disorder research
In 2013, Ruby Rubaiyat left a series of desperate voicemails with psychiatrists in Ottawa he had Googled, seeking help for his suicidal thoughts. This began an eight-year journey of misdiagnoses and unsuccessful treatments before a manic episode finally catalyzed a correct diagnosis of bipolar disorder. But since then, Mr. Rubaiyat has continued struggling for relief, cycling through 11 failed treatment regimens while his career, relationships and self-esteem have frayed. 'I could never understand why my personal life was such chaos and disaster,' said Mr. Rubaiyat, 45, who also has complex post-traumatic stress disorder. 'And even though this diagnosis [was made], it really doesn't mean anything, because there is no incoming treatment that is going to help me.' Mr. Rubaiyat's struggles are not rare among people with bipolar disorder, an illness that remains difficult to treat and takes an average of nine years to correctly diagnose. Psychiatric research in general has long been underfunded and bipolar disorder is particularly neglected, despite affecting an estimated 40 million people worldwide. But a nascent research initiative, called Breakthrough Discoveries for thriving with Bipolar Disorder (BD²), is aiming to change that by building a sprawling scientific network of 15 institutions, which will share data and collaborate on cutting-edge research. The initiative includes a longitudinal cohort study that will follow 4,000 patients over five years, collecting data using everything from blood analysis and MRI scans to wearable devices that track patients' sleep patterns. First person: Being open about being bipolar isn't easy And on Tuesday, BD² – in partnership with the non-profit organization Brain Canada – announced that US$2.3-million will be given to the Ottawa Hospital Research Institute, the first Canadian site to join the potentially transformative research effort. 'We've long felt stifled by the inability to move things forward,' says Jess Fiedorowicz, the head of mental health at The Ottawa Hospital, who will be leading the BD² site in Ottawa. 'What's required to advance knowledge is … to really follow people over a long period of time, collect data, and to understand this illness. 'The potential is tremendous. And that's what makes me so excited about this.' Bipolar disorders are chronic psychiatric conditions that cause recurrent episodes of mania and depression. BD², pronounced 'BD squared,' was launched in 2022 with US$150-million in funding from three philanthropic families in the United States, including that of David Baszucki (founder and chief executive of Roblox), Kent Dauten (chairman of Keystone Capital) and Sergey Brin (co-founder of Google) – all of whom have children or family members affected by the disorder. The initiative began with just six sites, including leading institutions like Johns Hopkins University and the Mayo Clinic. The Ottawa Hospital Research Institute becomes the network's 11th site – the remaining four are not yet selected – and the first to be chosen outside of the United States. BD² is investing in discovery research aimed at unravelling the underlying genetics and mechanisms of bipolar disorder, with an end goal of finding better diagnostics and treatment. Its longitudinal cohort study will be among the largest of its kind, with at least 100 of its 4,000 patients enrolled in the Ottawa area. Institutions participating in the study are also forming a 'learning health network,' where the reams of data being collected across sites will be simultaneously analyzed and leveraged to improve clinical care – in real time. Historically, there has been an estimated 15- to 17-year delay between discovery and the implementation of new practice models. BD² aims to close that gap, Dr. Fiedorowicz says. 'We could be developing new treatments, new approaches to treatment, and I think that's super exciting. But there's another piece too, and that is in the here and now,' he says. 'Through participation in this study, we're going to be working to improve and refine our clinical services.' Dr. Fiedorowicz hopes BD² can replicate the successes of major cancer centres, which have long been advancing research through the creation of vast and co-ordinated research networks. He emphasizes the network's overarching goal of enabling all people with bipolar disorder to thrive – not just by reducing their hospitalizations and symptom burdens, but by empowering them to live well, function in society, and maintain healthy lifestyles. 'You can keep people out of hospitals,' Mr. Rubaiyat says. 'But we're not addressing what happens to them when they leave.'
Times
08-07-2025
- Health
- Times
Behind closed doors: what I saw as a nurse on a psychiatric ward
'My God, I hope I never get mentally ill,' says a doctor in Fragile Minds, an account of life on psychiatric wards in Britain. You can only agree with her. The book — by Bella Jackson, a trainee mental health nurse so shocked by what she witnessed that she left the profession — reads like a cross between One Flew Over the Cuckoo's Nest and Nineteen Eighty-Four. But as she says when we meet, 'This is now.' A rape victim is slapped with a diagnosis of personality disorder (PD) and called 'attention-seeking'. Her request to be assessed by a female is refused as she's 'manipulative'. A man dares to tell the consultant his medication is causing chest pain. He's threatened with 'seclusion''. He pleads, in tears, but is made to feel like nothing, bullied into meekly submitting. As he was as a child, you imagine. 'It's re-traumatising,' Jackson says. Jackson — now 41, a therapist in private practice and mental health mentor, in London — had worked in social care and in prisons for five years when she began training as a psychiatric nurse on NHS acute mental health wards and centres in the south of England 'within the last ten years', she says, vague to preserve confidentiality. She was stunned by the 'dissociation' of staff. She wanted to believe the doctors knew best, but instinctively felt something was 'very wrong'. Her university tutor agreed there was 'bad practice', but not enough for anyone to do anything. 'There are pockets of good care,' he told her, 'but there is a lot of this.' She thought: 'Can't we complain?' She's taken aside, told not to ask so many questions. 'I want people to see what's happening behind these closed doors,' she says now, so they can 'protect themselves and their loved ones, if they are involved in mental health services'. So they know what questions to ask. Too often, 'We assume the answers we are being given are the correct ones.' She says: 'You need to be curious. When it comes to mental health, the expert on us is us.' This affects us all. It's alarmingly easy for anyone to be locked away. 'There wasn't consistency — of diagnosis, of sectioning,' Jackson says. 'It was so bizarre to see this incredibly important decision-making be so haphazard.' She witnesses a middle-class student brought into A&E. A spiteful-sounding nurse judges her 'bipolar' and calls a psychiatrist who declares, 'She's totally psychotic.' Jackson says: 'Hasn't she just smoked a load of spice?' A clinician can argue that drug-taking has 'activated' an underlying illness. People aren't believed. The shrink says: 'She thinks she's a famous singer.' Jackson looks up the girl on her phone — she's a folk singer. Only her family turning up, refusing antipsychotics — and the lack of an available bed — avoid her being admitted to an acute psychiatric ward. • Read more expert advice on healthy living, fitness and wellbeing Once someone's in the system, labelled with, for example, schizophrenia, PD (often 'weaponised') or delusional disorder, anything they say can be paranoia. Racism features, a lot. An African woman insists she's been sectioned because her kids want her house. Crazy. But it turns out she's sane enough to get a diplomat from her country of origin to order her release. Another inpatient, in his fifties, characterised as sharp, witty — 'I understand you, I just don't agree with you,' he tells a patronising nurse — appears to have autism. His family's request for an assessment is refused as it's 'too late'. Jackson is told 'they don't want the stigma of mental illness''. She saw little understanding of neurodiversity, and cites research that finds misdiagnosis is common. Yet, if a doctor says, ''Oh no, it's not that,' how often do we push back?' Why couldn't his family get him out? 'The legalities around sectioning would mean that it was very difficult.' On a section, you're deemed unsafe to be outside. 'You'd have to go through a tribunal. Some people did really fight to get their family members out, but a lot of people didn't.' ('How do I argue with a doctor who says my relative is unwell?') Characters are composites to protect identities, but it all happened, 'all these things were said to me,' Jackson says. She carried around a tatty notebook, 'just writing everything down, because I could not believe what was happening'. Patients' treatment by staff is frequently callous. 'Some people have good experiences,' Jackson stresses — but Fragile Minds focuses on the worst. The mentally unwell are often traumatised, yet there's no attempt to understand the context for their behaviour. When people go into services, 'they really are hopeful for compassion. It's devastating when they don't get it,' she says. 'It makes me so angry. It can really destroy us.' Most are 'boxed into a diagnosis' and medicated, often oversedated. Jackson and another decent nurse question a young man being given four daily doses of lorazepam — a benzodiazepine — as he can barely stand. They're ignored until he nearly drowns shaving — collapsing unconscious face-down in his sink. 'These medications do help a lot of people,' Jackson says. But many have severe side-effects, and also they're used 'punitively'. She saw medication used 'as a restraint on wards, to calm people down, to shut them up, put them to sleep. It's used by force, it's used through coercion — very different to someone choosing, and saying, 'This helps me.'' • Our new health crisis — we're diagnosing too much, too early One nurse says: 'I'm all about a good injection.' To Jackson's horror that a woman prescribed the antipsychotic clozapine has undergone a drastic mental and physical deterioration on the drug, her doctor responds Orwellian-style: 'I think she's got better.' Soon after, the patient dies. Jackson hopes it doesn't come across 'that the staff are demonised'. She says they're exhausted, overworked, and don't receive adequate psychological training or support to withstand working with distressed, unwell people and remain empathic. 'You needed a shield, almost, an absence of feeling. And what that created then was very much an 'us and them'.' But it wasn't just no empathy — your book describes cruelty, I point out. 'I think there was some cruelty,' she says slowly. 'You saw prejudice and bias, and cruelty.' She suspects much of it comes from emotional burnout, 'and being asked to do things that feel morally dubious — if they're asked to restrain someone and inject them against their will, what does that do to a person?' You can't then be all chatty and empathic with that patient. It's upsetting to dig deeper. Numbing yourself is 'survival mode'. So, 'You almost become this jailor.' Plus, psychiatry is hierarchical. 'There's a cruelty that comes from unchecked power. It was easy to forget that it was a person in front of you.' Ideally — 'and these things are being fought for, in the wings' — there'd be more access to psychological therapy, family therapy, arts therapy and peer-to-peer support. We need to help people to find meaning in their lives, acquire skills, agency and self-esteem, she says. 'These are all parts of us that we need to rebuild once we break down, and we can't do that stuck in a ward where there's a TV screwed to the floor and some non-throwable furniture and there's nothing else to do other than take your drugs and sit still.' And yet, she stresses, it's complex. 'The need to think about what someone's been through, and emotional connection, empathy, is so important in recovery.' But crucially, 'There's all sorts of risk with mental illness and mental distress,' so as a psychiatrist you're assessing risk: 'Is this person going to harm themselves? Harm others?' • Six-day waits and security guards: the mental health crisis crippling A&E A key question. A recent NHS survey found one in five people in Britain have a mental health condition and in 16 to 24-year-olds it's 25.8 per cent. But for all those who think, this could be my child — there are those thinking, 'What about the likes of 'the Nottingham killer'?' This paranoid schizophrenic patient, repeatedly sectioned and with a record of 'extremely serious' violence, was allowed to stop his medication and go free (despite warnings from his family). He murdered three people. We've all seen their faces. Their grieving families. Many patients Jackson encounters exhibit disturbing, frightening behaviour. Some are misunderstood rather than psychotic, she believes — and some are dangerous and violent. Not everyone can recover, surely? 'I agree with that,' she says. So when does giving the benefit of the doubt put others at risk? Jackson stresses she's not denying that some people are very disturbed and need monitoring. 'And we can wonder about what happened to them.' Distinguishing between the dangerous and the harmless, 'figuring out what the dangers are and the risks', she believes, requires 'exploration and curiosity and needing to look at the context and seeing everyone as individuals'. Not, as she saw, 'a blanket approach'. She says: 'The 'how do we get it right' question is something I can't answer.' Having left the profession shortly after qualifying, she still feels some shame that she was 'too crushed' to stay within it. But she remains 'honoured' to help people with their mental health. ('I am not a 'silent therapist',' she promises, on her website, 'and will bring warm, gentle inquisitive exploration to our sessions.') Meanwhile, what Jackson is certain of is this: 'The system we have now is not making it safer for people. It's not reducing the number of suicides or violent crimes. What we're doing now isn't working.'Fragile Minds: Stories from an NHS Mental Health Ward by Bella Jackson (Doubleday £20) is out now
Yahoo
05-07-2025
- Health
- Yahoo
Taiwan's BrainProbe platform uses AI to detect schizophrenia with 91% accuracy
From catching cancer to creating life, artificial intelligence (AI) is rewriting the rules of medicine, and how! It is now being used by scientists in Taiwan to diagnose schizophrenia. As per a report on Taipei Times, researchers at Taipei Veterans General Hospital (TVGH) have developed an artificial intelligence-powered platform capable of helping diagnose schizophrenia. The tools, a first-of-its-kind in the world, mark a major leap forward in the world of psychiatric care, long hampered by subjectivity and guesswork. Named BrainProbe, the tool analyzes magnetic resonance imaging (MRI) scans to detect structural and functional changes in the brain associated with schizophrenia. With an accuracy rate of 91.7 percent, it's the world's first AI tool of its kind and a dramatic departure from traditional methods that rely heavily on clinical interviews and behavioral observation. 'The field of psychiatry has long hoped to identify objective biological markers that can help quantify the symptoms [of mental illness],' TVGH Medical AI Development Center deputy director Albert Yang was quoted as saying by Taipei Times. Schizophrenia is a complex mental disorder characterized by hallucinations, delusions, and cognitive disruptions. Despite decades of research, diagnoses are still mostly based on self-reported symptoms and physician interpretation, leaving room for misdiagnosis and delayed treatment. This subjective approach often overlooks subtle biological markers, making early detection difficult and preventing timely, personalized interventions that could significantly improve patient outcomes. With that challenge in mind, Yang's team turned to artificial intelligence. Using more than a decade of brain scan data from over 1,500 individuals, including both healthy and those diagnosed with schizophrenia, the AI tool was trained to detect subtle, early-stage changes invisible to the human eye. One such case involved a 30-year-old man experiencing auditory hallucinations and paranoid delusions. 'BrainProbe was able to detect signs of degeneration in his brain function and structure, particularly in deeper regions such as the insula and temporal lobe,' Yang said. 'Abnormalities associated with schizophrenia prompted further evaluation, and the man was later confirmed to have the disease.' More than just a diagnostic tool, BrainProbe can also track how the brain changes over time. 'The most important capability of BrainProbe is its ability to track changes in the brain as it ages,' Yang said. 'It has established a brain aging prediction index and a mechanism for monitoring pathological changes.' The technology is currently being offered at TVGH through a self-pay clinical trial program while awaiting approval from Taiwan's Food and Drug Administration. Yang and his team are also working with international partners to include brain scan data from other populations to incorporate information from other populations and validate the tool across ethnic groups for its wider applicability. 'We hope this platform can be applied across different ethnic groups to enable more accurate research,' Yang added. As the platform moves toward broader clinical use, it may eventually become a foundational tool in psychiatric diagnostics that gives physicians a new lens into the human mind.
