What many people misunderstand is that typically incompetence to stand trial is a temporary condition. If an individual is unable to assist their counsel due to a mental condition, such as depression or anxiety (and posttraumatic stress is an anxiety disorder), then the individual is committed to a forensic jail-based hospital for treatment. They continue their confinement with treatment. They are then re-evaluated and tried for their crimes once they become competent. They do not free. This process prolongs their incarceration. However, an individual cannot receive a fair trial if they are unable to assist their attorney.

Expert: Padilla incompetent to stand trial | February 22, 2007 | MSNBC.com

Expert: Padilla incompetent to stand trial

Years of isolation have put al-Qaida suspect under stress, doctor says MIAMI - Alleged al-Qaida operative Jose Padilla suffers from intense stress and anxiety after being imprisoned in isolation for years and cannot adequately help his lawyers prepare for a criminal trial, a mental expert testified Thursday... More...

This is an excellent article on men and depression. While many see depression as intense feelings of suicide, clinical depression can have more subtle symptoms (like loss of interest in previously enjoyed activities, loss of interest in sex, increased or decreased appetite, difficulty with concentration and sustaining attention, etc.) Many psychologists note people with "smiling depression" because these people are so afraid of their intense feelings of despair that they hide them even from themselves. As described in the article, I've had men come in very reluctantly on referral from their physicians intent on finding a medical cause for their symptoms. "I'd rather have a neurological problem or a tumor than be depressed," they will say. But this is foolish because depression is very treatable. In fact, treatment success in mental health is statistically better than success rates in treating many major medical problems. Men are just as prone to depression as are women. Women, however, are more likely to seek treatment and stick with it over the long haul.

Men & Depression: Facing Darkness | February 22, 2007 | Newsweek

Men & Depression: Facing Darkness

By Julie Scelfo Newsweek Feb. 26, 2007 issue - For nearly a decade, while serving as an elected official and working as an attorney, Massachusetts state Sen. Bob Antonioni struggled with depression, although he didn't know it. Most days, he attended Senate meetings and appeared on behalf of clients at the courthouse. But privately, he was irritable and short-tempered, ruminating endlessly over his cases and becoming easily frustrated by small things, like deciding which TV show to watch with his girlfriend. After a morning at the state house, he'd be so exhausted by noon that he'd drive home and collapse on the couch, unable to move for the rest of the day. More...

The following announcement on the FDA approval of Cymbalta for treatment of Generalized Anxiety Disorder (GAD) is important on a number of fronts.

U.S. Regulators Approve Cymbalta(R) for Treatment of Generalised Anxiety Disorder | March 2, 2007 | PRNewswire

U.S. Regulators Approve Cymbalta(R) for Treatment of Generalised Anxiety Disorder

March 2, 2007 - 8:22 AM INDIANAPOLIS, February 26/PRNewswire/ --

The U.S. Food and Drug Administration (FDA) has approved the antidepressant Cymbalta(R) (duloxetine HCl) for the treatment of generalised anxiety disorder (GAD), Eli Lilly and Company (NYSE: LLY) and Boehringer Ingelheim announced today.

The approval is based on the results of three randomized, double-blind, placebo-controlled studies in which the safety and efficacy of duloxetine in the treatment of GAD was studied in more than 800 non-depressed adults. In all studies, duloxetine significantly improved core anxiety symptoms as measured by the Hamilton Anxiety Scale (HAMA), compared with placebo.(i,ii ,iii) In addition, duloxetine patients reported greater improvement in functional impairment associated with the illness, including improved ability to perform everyday activities at work, home, and in social situations.(iv,v)

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First, the studies continue the practice within the FDA of insisting on homogeneous symptoms. Participants in the studies had to have GAD and not depression. While this makes intuitive scientific sense (you exclude other disorders to see if the medication works on the target symptoms of your study, in this case GAD), it does not represent reality. In the real world, we know from epidemiological studies that fully 80% of the population who have any anxiety disorder (including, probably especially GAD) also have concurrent depression or other mental health disorders. This is called comorbidity. Insisting on a homogeneous study population thus excludes most patients who will actually begin taking the drug based upon physician prescription.

Second, it highlights the notion that most mental disorders are defined by high emotional arousal. I call this in my professional book (DBT in Private Practice) the "single factor" theory. Most major mental disorders (mood disorders, anxiety disorders, impulse control disorders, personality disorders, etc.) respond to the SSRI and SNRI class of medications. Their responsiveness to a variety of disorders suggests that our current diagnostic system (that pretends that disorders are separate and discrete phenomena (like the difference between an infection versus a broken bone) simply does not apply in mental health.

Third, it highlights the prevalence and disability that occurs with GAD. It is a disorder that severely impacts individuals ability to lead lives worth living.

The study written about in the Scientific American article below appears to be a "no brainer." Who wouldn't get depressed when their body changes in ways they can't control and they don't want? Of course I'll become depressed that I lose shape and function to my body. Of course having a disease that inflicts pain and disability will not only affect my mood, but cause me significant emotional disability as well.

Appearance related to illness tied to depression | March 2, 2007 | ScientificAmerican.com

Appearance related to illness tied to depression

NEW YORK (Reuters Health) - Appearance and physical disability are risk factors for depression in people afflicted with rheumatoid arthritis, researchers report. With systemic lupus erythematosus, commonly known as just lupus, only appearance seems to predict depression.

Physical deformities, particularly of the hands and feet, can develop with rheumatoid arthritis, whereas skin rashes and other lesions can occur with lupus, Dr. Louise Sharpe, from the University of Sydney in Australia, and colleagues note in the medical journal Arthritis & Rheumatism.

Although few studies have looked at body image concerns, there is evidence that women with these disorders have a poorer body image than unaffected women, the team notes.

The focus of their study was to evaluate the link between physical appearance concerns and psychological distress in patients with lupus and rheumatoid arthritis.

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It is with sadness that we see one of the great teachers and researchers in psychology retire. I have had the great fortune to hear many lectures by Dr. Zimbardo over the years. He is sincere, devoted to psychology as a profession and science, and has great emphasis on social action issues (combined with scientific inquiry, which is rare).

His dub of his final lecture (imagine, a professor at Stanford who actually still teaches!) as the Lucifer Effect is important: you and I could easily transform from good-hearted members of society to evil creatures of destruction. What does it take? Only what Zimbardo calls the “bad barrel” (the right environment). Consider the implications: innocent young military personnel sent in to war, police sent in to crime scenes, emergency medical personnel who respond to horror.

The line between good and evil is not as defined as we would like to think. And that is
exactly what Dr. Zimbardo wishes us to ponder.

Zimbardo delivers farewell lecture on evil | March 8, 2007 | The Stanford Daily

Zimbardo delivers farewell lecture on evil

Lauded psych prof. explains “The Lucifer Effect”

March 8, 2007

By Heather Heistand

There was not a single empty seat in the psychology lecture hall yesterday morning as Philip Zimbardo, professor emeritus of psychology, delivered his final Psychology 1 lecture, “The Lucifer Effect” — an event that marked the end of his 50-year teaching career.

Yesterday’s lecture by the “Godfather” of Psychology 1 — an allusion to Zimbardo’s Bronx upbringing — focused on the psychology of evil.

Internationally recognized for his 1971 Stanford Prison Experiment, Zimbardo recently served as the president of the American Psychological Association and is the author of the best-selling introductory psychology textbook, “Psychology and Life,” now in its 18th edition. He is also the director of the new Center for Interdisciplinary Policy Education and Research on Terrorism.

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