People often seem to have their minds made-up in advance about how they need to be treated.  Some want a pill and are very hesitant to seek therapy.  Others don't like to take pills and will resist any suggestion that a medication might be helpful.  In another article I discuss the tendency of providers to use the tools at their disposal, even if that's not what's best for the patient.  This time the subject is the bias that patients bring to treatment.

As a psychologist I generally work with people who don't mind seeing a psychologist.  (Duh.)  Many of these people also take medications - for depression, for bipolar disorder, for a thought disorder such as schizophrenia, or for anxiety.  Others don't need medications, and some could probably benefit, but they resist a referral to a psychiatrist.  Some patients even resist talking with their family doctor about medications.

I was caught off-guard by a conversation with a psychiatrist one day.  She mentioned to me that she had referred a patient to me for therapy, but that the patient was resisting seeing a therapist.  This patient would rather take pills than talk with someone about his problems.  

I'd frequently encountered patients who did not want to take medications.  They were comfortable talking to me, but they did not want to take  drugs.  I was startled to hear that psychiatrists saw patients who were happy taking pills, but resisted psychotherapy.

Australian researchers say that a genotype that heightens the risk for Alzheimer’s disease does not contribute to cognitive change during most of adulthood. The largest study of its kind has found that carriers and non-carriers show the same type and extent of normal age-related cognitive declines, decades before carriers start to more often develop symptoms of dementia. The findings suggest that the higher-risk genotype acts only in later years to layer disease on top of normal aging.

The findings appear in the January 2007 issue of Neuropsychology, which is published by the American Psychological Association (APA). The study may help rule out the possibility of very early Alzheimer's as the cause of the declines among carriers before they reach old age. Write the authors, “[Alzheimer's disease] processes may occur later in the lifespan and add to normal cognitive aging to produce a dementia syndrome.”

The study confirmed that carriers of the APOE4 gene type (allele), which confers higher risk for Alzheimer's, are just like other people their age throughout most of adult life in terms of core mental functions. Previous findings had been unclear. Lead author Anthony Jorm, PhD, DSc, explains, “Although some areas of cognitive decline begin from early adulthood onwards, this is not due – as some have speculated -- to very early Alzheimer's changes in the brain.”