Sarcasm finds medical use in dementia detection
by Julie Shingleton Julie Shingleton

SYDNEY (AFP) – Sarcasm may be the lowest form of wit, but Australian scientists are using it to diagnose dementia, according to research published on Friday.
Researchers at the University of New South Wales found that patients under the age of 65 suffering from frontotemporal dementia (FTD), the second most common form of dementia, cannot detect when someone is being sarcastic.
The study, described by its authors as groundbreaking, helps explain why patients with the condition behave the way they do and why, for example, they are unable to pick up their caregivers' moods, the research showed.
"This is significant because if care-givers are angry, sad or depressed, the patient won't pick this up. It is often very upsetting for family members," said John Hodges, the senior author of the paper published in "Brain".
"(FTD) patients present changes in personality and behaviour. They find it difficult to interact with people, they don't pick up on social cues, they lack empathy, they make bad judgements," he told AFP.
"People with FTD become very gullible and they often part with large amounts of money," he said, adding that one in 4,000 people around the world are afflicted with the condition.
Researchers began studying the role of sarcasm in detecting FTD because it requires a patient to spot discrepancies between a person's words and the tone of their voice, Hodges said.
"One of the things about FTD patients is that they don't detect humour -- they are very bad at double meaning and a lot of humour (other than sarcasm) is based on double meaning," he said.
The research, conducted in 2006-07, put 26 sufferers of FTD and 19 Alzheimer's patients through a test in which actors acted out different scenarios using exactly the same words.
While in one scenario, the actors would deliver the lines sincerely, in others they would introduce a thick layer of sarcasm. Patients were then asked if they got the joke, Hodges said.
For example, said Hodges, if a couple were discussing a weekend away and the wife suggested bringing her mother, the husband might say: "Well, that's great, you know how much I like your mother, that will really make it a great weekend."
When the same words were delivered sarcastically and then in a neutral tone, the joke was lost on FTD patients, while the Alzheimer's patients got it.
"The patients with FTD are very literal and they take what is being said as genuine and sincere," said Hodges.
FTD, often referred to as Pick's disease, is similar to Alzheimer's in that it involves a progressive decline in mental powers over a number of years, but FTD affects different regions of the brain.
"It can be very difficult to diagnose in early stages and to separate from depression or, later on, schizophrenia or personality disorders," Hodges said.
The sarcasm test could replace some more expensive and less widely available tests for dementia, he said.
When questioned about the applicability of the test to people from countries not renowned for their appreciation of sarcasm or irony, Hodges said the test could be modified.

Source: http://news.yahoo.com/s/afp/20081212/ts_afp/healthaustraliadementia

When the Emperor Was Dying

by Deepak Chopra

When Barack Obama's remarkable eloquence was dismissed as "just words" during the primary campaign, he survived the criticism. Telling the truth and offering inspiration aren't just words. They are incredibly important in keeping a society together. Now Obama faces another challenge where words can make a difference over whether the economy recovers. Injections of billions of dollars have done little good to the financial system so far. What we need is an injection of confidence.
I was reminded of Japan's aging Emperor Hirohito, who went in for surgery on his pancreas in the fall of 1987. He recovered well until a year later when he suddenly collapsed, and from that time onward, his health steadily deteriorated until he died the following spring. What he didn't know is that his surgeons had discovered cancer of the duodenum during the original operation. No one told the emperor he was dying, because in Japan the news of a fatal diagnosis is traditionally kept from the patient.
The connection with the economy is this: When is too much news worse than none? Full disclosure can harm the patient, whether you are talking about a sick emperor or a sick economy. The words "You are dying" have a devastating effect, and I'd say the same is true of the words "worst crisis since the Great Depression." It's a firm belief among doctors that some patients die from their diagnosis; they go into sudden, rapid decline despite assurances that their condition is treatable. There's even a term for this, the nocebo effect, which is the opposite of the placebo effect (where patients get better because they are told they will).
The American public took the news of economic crisis harder than anyone expected. Consumer confidence and spending nose-dived, and much of it was due to "just words." It wasn't just ordinary citizens who reacted this way; sophisticated financial institutions panicked as well.
Which brings up an ethical dilemma. For decades in this country it was standard practice not to frighten patients by telling them that they had a fatal illness. Sometimes even the family wasn't told (the emperor's family wasn't, as I understand it). Then ethics changed, and now we have the opposite practice: full disclosure. Is that an improvement? Nobody knows, really. Most patients demand full disclosure as their right, just as market analysts demand full disclosure from companies. A lot of the current crisis, we are told, was brought on by lying. Banks were doing their best to keep secret their astoundingly foolish risks.
Fortunately, the U.S. economy isn't dying. But it has collapsed, just like Hirohito, when the official press report was that things were just fine. Now we are going through a weird phase in which happy talk is foisted on us, alternating with dire warnings. It's like telling the emperor, "You're dying, but the outlook is rosy." The great economist John Maynard Keynes realized almost a century ago that all markets are psychological. The current crisis is proving how right he was, and how tricky a role "just words" play in the ongoing drama. As a master of words, Obama needs to give us some we can believe.

Source: http://www.huffingtonpost.com/deepak-chopra/when-the-emperor-was-dyin_b_147589.html