Mental Health Research
23 Jan Psychiatric Problems Related to Lead Exposure Detected As Early As Age 11
Posted at 18:33h
in Author Interviews, Duke, JAMA, Mental Health Research, Pediatrics, Toxin Research
MedicalResearch.com Interview with:
Aaron Reuben, MEM
Department of Psychology and Neuroscience
Duke University, Durham, North Carolina
MedicalResearch.com: What is the background for this study? What are the main findings?
(1) Study members with greater lead exposure in childhood tended to endorse more psychiatric symptoms when assessed for psychiatric disorders in adulthood (between 18 and 38 years of age).
- These individuals tended to report more internalizing (e.g., depression, anxiety) and thought disorder (e.g., OCD, schizophrenia, mania) symptoms.
- Compared to other findings from this sample, the associations reported in this article are similar to those reported for lead and IQ, and are stronger than those reported for lead and criminal offending.
- Informants who knew Study members well reported higher levels of difficult adult personality traits among Study members with greater lead exposure in childhood.
- Specifically, Study members with greater blood lead levels at age 11 were rated as more neurotic, less agreeable, and less conscientious by 38 years of age.
- These personality traits have been previously linked to a number of poor life outcomes, including greater psychopathology, worse physical health, less job satisfaction, and troubled interpersonal relationships
- Psychiatric problems related to lead exposure could be detected as early as 11 years of age. In the 1980’s, parents and teachers of children with higher blood-lead levels had described them as displaying more antisocial behavior, hyperactivity, and negative emotions (e.g., sadness, anxiety).
21 Jan Adolescents: Comparison of Recovery from Concussions vs Fractures
MedicalResearch.com Interview with: [caption id="attachment_47062" align="alignleft" width="200"] Dr. Russell[/caption]
Kelly Russell PhD
Department of Pediatrics and Child Health
University of Manitoba
MedicalResearch.com: What is the background for this study?
Response: Health-related quality of life (HRQOL) is an important patient-reported outcome that measures the patient’s perception on how their condition effects various aspects of their life, such as their physical, emotional, social and school quality of life. HRQOL can measure the more subtle or hidden consequences of a condition, such as concussion. Patient reported outcomes are important because they give a more complete picture of the patient’s condition than just reporting symptoms or outcomes that are only measured by their clinician. We wanted to compare the effects of sport-related concussions versus sport-related limb fractures on HRQOL in adolescents after their injury and during their recovery.
We chose to compare adolescents with sport-related concussions to a sport-related limb fracture group because we wanted to be able to attribute the results to having a concussion since not being able to play sports with their friends and teammates may decrease HRQOL regardless of the actual type of injury. We also wanted to identify which clinical variables were associated with worse HRQOL in adolescent patients with sports-related concussion.
21 Jan Depression May Be a Driver of Alopecia Areata
MedicalResearch.com Interview with: [caption id="attachment_47053" align="alignleft" width="200"]
Dr. Vallerand[/caption]
Isabelle Vallerand, PhD
Epidemiologist, MD Student
Department of Community Health Sciences
Cumming School of Medicine
University of Calgary
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It is well known that patients with alopecia areata, a form of autoimmune hair loss, are at a higher risk of suffering from depression than the general population. But in practice, we often hear patients tell us that they believe their hair loss developed as a result of stress or problems with mental health – certainly the phrase “so stressed your hair is falling out” is something most people have heard of. Despite this, there has actually been very little research investigating the role that mental health may have on development of alopecia areata.
Interestingly, depression has recently been associated with increased systemic inflammatory markers, so there is biologic plausibility that depression could increase the risk of alopecia areata. Our group was interested in addressing this question, and used a large population-level health records database with up to 26 years of follow-up to study it. We ultimately found that not only does depression increase one’s risk of alopecia areata, but that it increases their risk by nearly 90% compared to people who have never had depression. We also found that using antidepressants can significantly decrease the risk of developing alopecia areata in patients with depression. So there appears to be an important link between mental health and development of hair loss from alopecia areata.
21 Jan Zika: Simple General Movement Assessment Tool Can Predict Babies at Risk of Developmental Problems
Posted at 02:56h
in Author Interviews, Global Health, JAMA, Mental Health Research, Pediatrics, UCLA, Zika
MedicalResearch.com Interview with:
[caption id="attachment_47036" align="alignleft" width="200"] Dr. Nielsen[/caption]
Karin Nielsen-Saines, MD, MPH
Professor of Clinical Pediatrics
Division of Pediatric Infectious Diseases
David Geffen School of Medicine at UCLA
MedicalResearch.com: What is the background for this study?
Response: Our study used a very simple evaluation called GMA (General Movement Assessment tool) which checks baby movements at approximately 3 to 5 months of age.
We examined 111 babies exposed to maternal illness during the Zika epidemic in Brazil and 333 control babies without this exposure by GMA at 3 months and then tested them through standard neurodevelopmental tests at the age of 12 months.
We found that this simple evaluation, which consists of filming a baby lying down on their back for one minute and studying their movements worked extremely well in predicting which babies would or would not have future problems in their neurodevelopment. The study advances knowledge in the area because a simple one minute video of a baby can predict neurodevelopment, something that is extremely hard to determine in young babies. This is true even in places where sophisticated brain scans are available. By identifying which babies are at risk of developmental problems early on, professionals can rapidly refer these babies to stimulation programs when they are very young, which increases their chances of having better outcomes. Because the brains of young children respond much better to stimulation, the timing of interventions to improve their development is very important, that is why they need to be identified early.
21 Jan Take Control of Your Life and Treat Your Gambling Addiction
An addiction to gambling can be an isolating ordeal that causes havoc among someone’s personal relationships, destroys personal finances, and exacerbates any mental health issues that a person may have.
Addiction is rarely an isolated incident. Typically there are many factors at play that can manifest themselves in the form of gambling. By tackling these underlying causes one can treat their addiction and eliminate the toxic habits that created it. In addition to confronting this by oneself, it is important for those who suffer from this to confide in those close to them as well as seeking advice from their doctor.
One major issue brought on by any kind of addiction is the sense of alienation that someone can experience. This is where it is important for them to open up to those who are close to them, like a loved one or a close friend. It will help alleviate the burden of struggling alone and will help others to understand what they are going through. Getting in touch with self-help groups can be another means of alleviating the feelings of alienation that addicts can experience while they are treating their compulsive gambling. This provides an outlet for an addict to express what they are going through while simultaneously getting the perspective of others who have struggled in a similar fashion.
One of the most important steps to take is the very first one. That is to be able to admit that there is a problem with gambling. Once this has been done, the problem becomes tangible and the addiction can be confronted directly.
14 Jan Midurethral Sling Complications May Be Associated with Psychological Stress, esp in Young Women
MedicalResearch.com Interview with: [caption id="attachment_46921" align="alignleft" width="114"] Dr. Welk[/caption]
Blayne Welk MD, MSc, FRCSC
Associate Professor of Surgery
St. Joseph's Hospital
Western University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: I found that when I was referred women with midurethral sling complications, they were often quite emotional and described a significant period of time when they struggled with the complications before they were referred to someone to assess them.
The study looked at the rate of depression and self-harm behavior of women who had surgery for midurethral sling complications compared to women who did not have midurethral sling complications.
I found that there was an increased risk of both of these outcomes among women who had surgery for complications, however this risk was primarily present in younger women.
13 Jan Loss of Deep Sleep Associated With Early Alzheimer’s Disease
MedicalResearch.com Interview with: [caption id="attachment_46932" align="alignleft" width="137"]
Dr. Lucey[/caption]
Brendan P. Lucey, MD, MSCI
Assistant Professor of Neurology
Director, Sleep Medicine Section
Washington University School of Medicine
Saint Louis, Missouri 63110
MedicalResearch.com: What is the background for this study?
Response: Alzheimer’s disease and sleep are currently thought to have a two-way or bidirectional relationship.
First, sleep disturbances may increase the risk of developing AD.
Second, changes in sleep-wake activity may be due to Alzheimer’s disease pathology and our paper was primarily focused on this aspect of the relationship. If sleep changes were a marker for AD changes in the brain, then this would be very helpful in future clinical trials and possibly screening in the clinic.
09 Jan Parental Drinking Linked to Anxiety and Depression in Children
MedicalResearch.com Interview with: [caption id="attachment_46863" align="alignleft" width="200"] Dr. Ingunn Olea Lund[/caption]
Dr. Ingunn Olea Lund, PhD
The Norwegian Institute of Public Health
Oslo, Norway
MedicalResearch.com: What is the background for this study?
Response: There are significant amounts of research on children of parents with alcohol use disorders – where the children are shown to be at risk of several adverse outcomes, including mental disorders, substance use disorders, suicide, impaired school performance, and employment problems. There is very little previous research on how other, more normal levels of parental drinking may influence child outcomes, such as mental health. This is a grave oversight, as there are vastly more parents with normal drinking patterns than there are parents who suffer from an alcohol use disorder. This means that there are potentially a lot more cases of adverse effect for children, and the number of children at risk may be higher than previously assumed.
In addition to parents' alcohol use, several other risk factors in the family that may affect child mental health outcomes, such as parents' mental health and socio-economic status. Researchers have tended to look at these risk factors separately, but as these risks tend to co-occur, it may be more informative to consider them together.
To our knowledge, this is the first study that examines possible harm from normal levels of parental drinking, alone or in combination with other parental risk factors, on children’s anxiety and depression.
The sample consists of more than 8700 triads: children and both their parents. We combined information from three health registries with survey data where both adolescents and their parents provided information about health and social conditions. The health registers include information about the children 's actual contact with the health care system; we used information about whether children received diagnoses and/or treatment for anxiety and/or depression.
08 Jan Depression Rates Climb with Hearing Loss
MedicalResearch.com Interview with: [caption id="attachment_46841" align="alignleft" width="147"] Dr. Golub[/caption]
Justin S. Golub, MD, MS
Assistant Professor
Otology, Neurotology, and Skull Base Surgery
Department of Otolaryngology-Head and Neck Surgery
Columbia University Vagelos College of Physicians and Surgeons
NewYork-Presbyterian/Columbia University Irving Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Age-related hearing loss is extremely common, yet few people do anything about it. We studied a population of over 5,000 individuals and found that hearing loss was related to feelings of depression. The worse the hearing loss, the worse the symptoms of depression. Even people with just mild hearing loss had nearly two times the odds of depressive symptoms compared to normal hearing people. Among people with moderate hearing loss, the odds of depressive symptoms were four times as high. These statistics take into account various factors that can cause both hearing loss and depression, such as age and demographic background.
08 Jan NUEDEXTA® (Dextromethorphan and Quinidine) Studied for ALS and MS but Primarily Use in Dementia
Posted at 20:39h
in ALS, Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, JAMA, Multiple Sclerosis
MedicalResearch.com Interview with:
[caption id="attachment_46832" align="alignleft" width="200"] Dr. Fralick[/caption]
Michael Fralick, MD, FRCPC, SM, PhD (Cand)
Clinical Associate, General Internal Medicine
St Michael’s Hospital
Phillipson Scholar, Clinician Scientist Program, University of Toronto
PhD Candidate, IHPME, University of Toronto
Affiliated Faculty, Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics
Brigham and Women’s Hospital, Harvard University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This medication is a pill that combines two ingredients: dextromethorphan (the active ingredient in cough syrup) and quinidine (used to increase the concentration of dextromethorphan). The medication was primarily studied and evaluated in patients with amyotrophic lateral sclerosis (ALS) or (multiple sclerosis) MS, but anecdotal evidence suggested it was being prescribed to patients with dementia. We used data from two nationwide healthcare databases to understand how the medication was being used in routine care.
04 Jan Autistic Adults Also Display Non-Social Cognitive Deficits
MedicalResearch.com Interview with: [caption id="attachment_46784" align="alignleft" width="158"] Dr. Velikonja[/caption]
Tjasa Velikonja, PhD
Department of Psychiatry
The Seaver Autism Center for Research and Treatment
Icahn School of Medicine at Mount Sinai
New York, New York
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Autism is a lifelong condition, and challenges associated with autism persist from childhood into adulthood. Despite this, research and treatment have been largely dedicated to children. Because of that, we had very little understanding of what areas – what cognitive domains - are most severely impacted in adults with autism. Importantly, the lack of such information also limits treatment development in this area.
What is known already is that adults with autism display deficits in social cognition (which refers to the role that cognitive processes play in our social interactions). Although our meta-analysis supported these theories, it also highlighted several other challenges in cognitive processing, such as deficits in processing speed and verbal learning and memory. And these impairments were observed in adults with autism without an overall intellectual disability.
03 Jan Multiple Concussions Linked to Decrease in Executive Brain Functions
MedicalResearch.com Interview with:Robert Ross, Ph.D.
Assistant Professor
McConnell Hall, Room 424
University of New Hampshire
MedicalResearch.com: What is the background for this study?
Response: In the United States, 1.5-2 million people suffer from mild traumatic brain injuries, more commonly referred to as concussions, per year.
There is a large body of work illustrating the cognitive impairments associated with concussions in the immediate aftermath of the concussive event. However, it is not clear whether concussions can change cognition more long-term and how concussions might change how the brain functions during specific types of cognition.
In our study, we examined executive function, which is a cognitive process that helps control or manage other cognitive functions, in a group of healthy young adults aged 18-24 that had suffered at least two concussions and compared their performance and their brain oscillations to a group that had not suffered any concussions. Brain oscillations help the brain coordinate the activity of the thousands of neurons necessary for any sort of cognitive process to occur. The participants in the study self-reported their concussions with all concussions occurring at least one month prior to participating in the experiment.
02 Jan What Causes ‘Chemo Brain’ in Women?
Posted at 17:44h
in Author Interviews, Cancer Research, Chemotherapy, Menopause, Mental Health Research
MedicalResearch.com Interview with:
[caption id="attachment_46764" align="alignleft" width="128"] Dr. Gervais[/caption]
Nicole J. Gervais, Ph.D.
Postdoctoral fellow | Einstein lab
University of Toronto, Department of Psychology
Toronto, ON
MedicalResearch.com: What is the background for this study?
Response: Aromatase inhibitors (AIs) including letrozole are given as an adjuvant therapy for postmenopausal women with hormone receptor positive breast cancer. Women taking this drug have reported a number of symptoms including hot flashes, memory complaints and mood changes. However, not all studies report memory issues. This might be due to the fact that studies in this population are hampered by confounds, such as chemotherapy/radiotherapy, stress and disease stage, all of which can also adversely impact memory. These confounds make it challenging to observe the independent effects of AIs on memory. By using a non-human primate model, we were able to examine the effects of aromatase inhibition on these symptoms as well as brain function without these confounding effects.
27 Dec Coordinated Care Program For Dementia Patients Reduced Need For Nursing Home Placement
MedicalResearch.com Interview with: [caption id="attachment_46720" align="alignleft" width="200"] Dr. Jennings[/caption]
Lee A. Jennings, MD, MSHS
Assistant Professor of Medicine
Director, Oklahoma Healthy Aging Initiative
Reynolds Department of Geriatric Medicine
University of Oklahoma Health Sciences Center
Oklahoma City, OK 73117
MedicalResearch.com: What is the background for this study?
Response: The research study focused on a novel model of care for persons living with Alzheimer’s disease and other types of dementia, the UCLA Alzheimer’s and Dementia Care Program. In the program, people with dementia and their caregivers meet with a nurse practitioner specializing in dementia care for a 90-minute in-person assessment and then receive a personalized dementia care plan that addresses the medical, mental health and social needs of both people. The nurse practitioners work collaboratively with the patient’s primary care provider and specialist physicians to implement the care plan, including adjustments as needs change over time.
The research was designed to evaluate the costs of administering the program, as well as the health care services used by program participants, including hospitalizations, emergency room visits, hospital readmissions and long-term nursing home placement. A total of 1,083 Medicare beneficiaries with dementia were enrolled in the program and were followed for three years. The study compared them to a similar group of patients living in the same ZIP codes who did not participate in the program.
19 Dec When Asked, Teens Frequently Report Hallucinations, Paranoia or Anxiety with Marijuana Use
Posted at 12:53h
in Author Interviews, Brigham & Women's - Harvard, Cannabis, JAMA, Mental Health Research, Pediatrics
MedicalResearch.com Interview with:
[caption id="attachment_46574" align="alignleft" width="132"] Dr. Levy[/caption]
Sharon Levy, MD, MPH
Director, Adolescent Substance Use and Addiction Program
Boston Children's Hospital
Associate Professor of Pediatrics
Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: For this study we analyzed data that were collected as part of a larger survey study that recruited a sample of adolescents who were coming to the doctor's office for routine medical care. We asked them a lot of questions about their health, school, extracurricular activities, plans for the future, substance use patterns and problems associated with use among other things.
The main finding was that among the participants who reported marijuana use in the past year, many of them, more than 40%, said that they had experienced either an hallucination, or paranoia/anxiety related to their use.
Kids who used more frequently and those who met criteria for a substance use disorder were more likely to experience these symptoms, as were those who had symptoms of depression
18 Dec Not All Electronic Health Record Warnings Are Accurate
MedicalResearch.com Interview with: [caption id="attachment_46627" align="alignleft" width="150"] Dr. Phillips[/caption]
Katharine Phillips, M.D.
Professor of Psychiatry
DeWitt Wallace Senior Scholar
Residency Research Director
Department of Psychiatry
Weill Cornell Medical College, Cornell University
Attending Psychiatrist, New York-Presbyterian Hospital
Adjunct Professor of Psychiatry and Human Behavior
Alpert Medical School of Brown University
Weill Cornell Psychiatry Specialty Center
Weill Cornell Medicine I NewYork-Presbyterian
MedicalResearch.com: What is the background for this study? What are the main findings?
- Electronic prescribing of medication by clinicians is widespread; it is required in many institutions and in some states. Electronic prescribing systems commonly use computerized decision support algorithms that give prescribers automated warnings or alerts at the time of prescribing if the system identifies a potential prescribing error.
- Some prior studies suggest that electronic prescribing warnings/alerts may reduce prescribing errors and thus can be clinically useful. However, other prior studies caution that these alerts may have substantial limitations.
- Despite the importance of this topic, relatively few studies have examined the accuracy of automated prescribing warnings in electronic prescribing systems; to our knowledge, no prior study has focused primarily on prescribing of medications for psychiatric conditions.
- This report presents results from a survey of members of the American Society of Clinical Psychopharmacology (ASCP), a specialty society that advances the science and practice of clinical psychopharmacology, regarding automated warnings generated by electronic prescribing systems.
10 Dec Younger Siblings of Children with Autism or ADHD More Likely To Be Similarly Diagnosed
MedicalResearch.com Interview with: [caption id="attachment_46451" align="alignleft" width="150"] Dr. Miller[/caption]
Meghan Miller, Ph.D.
Assistant Professor
Department of Psychiatry & Behavioral Sciences
UC Davis MIND Institute
Sacramento, CA 95817
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study evaluated within-diagnosis sibling recurrence and sibling cross-aggregation of ADHD and autism spectrum disorder among later-born siblings of diagnosed children. We specifically chose to include only families who had at least one subsequent child after the diagnosis of an older child because failing to do so could bias recurrence risk estimates.
We found that, compared to later-born siblings of non-diagnosed children, later-born siblings of children with autism were more likely to be diagnosed with autism or with ADHD. Likewise, compared to later-born siblings of non-diagnosed children, later-born siblings of children with ADHD were more likely to be diagnosed with ADHD or with autism.
06 Dec Hysterectomy Can Impair Short Term Memory (at least in rats)
MedicalResearch.com Interview with: [caption id="attachment_46437" align="alignleft" width="200"] Dr. Bimonte-Nelson[/caption]
Heather A. Bimonte-Nelson, Ph.D.
Professor, Barrett Honors Faculty
Department of Psychology
Arizona State University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The dogma in the field is that the nonpregnant uterus is dormant, and therefore it has not necessarily been of interest to study. Textbooks have described the nonpregnant uterus as “quiescent,” “dormant,” and “useless.” When I was in graduate school studying endocrinology, I read statements in books saying that the sole purpose of the uterus is for gestation.
However, all women aging into midlife will experience some type of menopause, and some of these women will undergo surgical menopause via removal of all, or a part of, their reproductive tracts. Research evaluating reproductive tract-brain connections has grown quite a bit in the last few decades. For example, the ovary-brain connection has been focused on quite a bit, and we now know that hormones coming from the ovaries (such as estrogens and progesterone) can affect more than reproduction, and can impact brain functioning. While the uterus-brain connection is not well understood, there is research indicating that the uterus and autonomic nervous system communicate directly.
We also know that hormones released from the ovaries impact the uterus. Therefore, there is a uterus-ovary-brain triad system. This uterus-ovary-brain triad has undergone little scientific investigation for functions outside of reproduction. Given that by age 60 one in three women experience hysterectomy, thereby interrupting this uterus-ovary-brain triad system, we believe it is important to understand the effects of variants of surgical menopause including hysterectomy.
This led to our current evaluation testing multiple variations in surgical menopause using a rat model, where we tested the effects of uterus removal alone (hysterectomy), ovarian removal alone, or uterus plus ovarian removal.
06 Dec Fluoxetine (Prozac) Did Not Reduce Risk of Depression After Stroke, But Did Raise Risk of Fractures
MedicalResearch.com Interview with: [caption id="attachment_46429" align="alignleft" width="100"] Prof. Mead[/caption]
Prof. Gillian Mead
Chair of Stroke and Elderly Care Medicine
[caption id="attachment_46430" align="alignleft" width="100"]
Prof. Dennis[/caption]
Prof. Martin Dennis
Chair of Stroke Medicine
Centre for Clinical Brain Sciences
The University of Edinburgh
MedicalResearch.com: What is the background for this study?
Response: We are both practicing stroke physicians as well as clinical trialists. Therefore our interest in this area was triggered by the exciting results of the FLAME trial in 2011. This appeared to indicate that fluoxetine might boost the recovery of stroke patients. Potentially this was very important given the increasing numbers of people having disability due to stroke, and the fact that fluoxetine is inexpensive and could be introduced very easily into clinical practice. We were further encouraged by the large numbers of small RCTs we identified when we carried out a Cochrane systematic review on the topic. These trials provided more evidence of potential benefit but there was evidence that trials of greater quality showed less benefit, and benefits were greater in patients who were depressed. We felt there was a need for more evidence derived from much larger numbers of patients.
05 Dec Black Mothers More Likely To Think Their Sons Have ADHD
MedicalResearch.com Interview with: [caption id="attachment_46390" align="alignleft" width="136"] Dr. DuPaul[/caption]
George J. DuPaul, PhD
Department of Education and Human Services
Lehigh University
[caption id="attachment_46407" align="alignleft" width="144"]
Dr. Barrett[/caption]
Charles Barrett. Ph.D.
School Psychologist
Loudon County Virginia
Public Schools
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Numerous studies have shown that Black children are more likely to receive ratings that are more indicative of displaying externalizing behavior difficulties, including Attention Deficit Hyperactivity Disorder (ADHD). However, many of these studies included teachers as the informants. Consistent with most teachers in the United States, raters have typically been White females. For this reason, it is unclear if these outcomes would exist if the rater and child shared the same racial/ethnic background. Additionally, most research in the United States that involved cross-cultural comparisons has used White and Hispanic boys. Few empirical studies have examined differences between Black and White boys.
The present study sought to address several limitations in the field. Most notably, cross-cultural comparisons between Black and White boys were included instead of Hispanic and White children. Next, maternal figures, rather than teachers, were included as the informants.
The present study was developed using a similar methodology that examined Hispanic and White boys’ behavior from the perspective of Hispanic and White teachers (Dominguez de Ramirez & Shapiro, 2005). In sum, we sought to determine if there were differences in how Black and White maternal figures rated Black and White boys who were demonstrating the same level/type of behavior (i.e., sub-clinical levels of ADHD). Notably, although the boys’ behaviors were the same, maternal ratings were not identical.
Specifically, using the ADHD Rating Scale, Fourth Edition (ARS-4), Black mothers assigned higher ratings to both Black and White boys.
05 Dec 1 in 40 Children Reported By Parents To Have ASD
MedicalResearch.com Interview with: Michael Kogan, Ph.D. Director of the office of Epidemiology and Research Health Resources and Services Administration’s Maternal and Child Health Bureau MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a study led by the Health Resources and Services Administration’s Maternal and Child Health Bureau, along with researchers from the Centers from Disease Control and Prevention, Harvard, Drexel, and George Washington Universities. We used the 2016 National Survey of Children’s Health, a nationally representative survey of over 50,000 children that examines the health and well-being of US children, to examine the prevalence, treatment, and health care experiences of children with Autism Spectrum Disorder (ASD). We found that 1 out of 40 children in the US were reported by their parents to have been diagnosed with Autism Spectrum Disorder. We also found that children with ASD were significantly less likely to receive services like needed care coordination, referrals to other services, and mental health counseling – even compared to children with other emotional, behavioral or developmental disorders (EBDs). Parents of children with ASD were also significantly more likely to report being usually or always frustrated in their attempts to get services, again compared to families of children with other EBDs. Finally, we looked at treatment patterns for children with ASD and found that 64% had received behavioral therapy in the year before the interview, and 27% had received medications to treat symptoms of irritability.
29 Nov Newer MRIs May Predict Alzheimer’s Disease Before Any Symptoms
MedicalResearch.com Interview with: [caption id="attachment_46187" align="alignleft" width="145"] Dr. Raji[/caption]
Cyrus A. Raji, MD PhD
Asst Prof of Radiology, Mallinckrodt Institute of Radiology
Neuroradiology Faculty and the Neuoimaging Laboratories
Washington University School of Medicine
St. Louis
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Alzheimer's disease is the most common cause of dementia and every patient suspected of having this disorder receives an MRI scan of the brain.
MRI scans of the brain in dementia are currently limited to evaluating for structural lesions that could be leading to memory loss such as stroke or tumor. What this study sought to accomplish was to determine if a newer type of MRI scan called diffusion tensor imaging (DTI) can predict who will experience cognitive decline and dementia. We found that DTI can predict persons who will demented 2.6 years before the earliest onset of symptoms.
This study was done in 61 individuals, 30 converters and 31 non-converters, from the Alzheimer's Disease Neuroimaging Initiative and we found that DTI metrics could predict dementia 2.6 years later with 89-95% accuracy.
27 Nov Gene Expression Differences Detected in Toddlers with Autism
MedicalResearch.com Interview with: [caption id="attachment_46215" align="alignleft" width="149"] Dr. Lombardo[/caption]
Michael Lombardo, PhD
Assistant professor of Psychology
the University of Cyprus
MedicalResearch.com: What is the background for this study?
Response: Autism is a diagnostic label we give to children with difficulties in the areas of social-communication and restricted, repetitive stereotyped behaviors and interests. The diagnosis is made based on observations about behavior and is a consensus label, meaning that clinicians can show high degrees of agreement that a given set of behaviors is ‘autism’. But aside from the diagnostic label, there is a fair degree of heterogeneity within patients that have the diagnosis. One way in which patients are heterogeneous is with regard to early language development. Some toddlers with autism are minimally verbal, while at the other end, many toddlers with autism develop language typically. An important question to answer is whether that kind of difference in language development indicates a subtype with different underlying biology.
To examine this question, we first split toddlers with autism into two subtypes defined by their language outcome at 4 years of age. Some toddlers were classified as poor language outcome, because their language performance was 1 standard deviation below typical norms. Other toddlers with autism had relatively good language outcome, as their language performance by 4 years of age was within 1 standard deviation of typical norms.
We also measured the biology behind these two autism subtypes. First we used functional magnetic resonance imaging (fMRI), which is a non-invasive method to look at blood oxygenation response that changes according to a task. Blood oxygenation changes are an indirect measure of neural activity. We used fMRI during natural sleep at around 29 months of age while the toddlers were played language stimuli through headphones to elicit neural responses to speech. Second, we measured molecular aspects of biology, by taking blood samples, isolating leukocyte cells, and then quantifying gene expression for all protein coding genes in the genome, at around the same time as the fMRI scan.
26 Nov Aggression in Dementia: Alternatives to Antipsychotics Also Have Side Effects
MedicalResearch.com Interview with: [caption id="attachment_46190" align="alignleft" width="150"] Dr. Watt[/caption]
Jennifer Watt, PhD
Clinical Epidemiology and Health Care Research
Institute of Health Policy, Management, and Evaluation
University of Toronto
MedicalResearch.com: What is the background for this study?
Response: Behavioral and psychological symptoms of dementia (e.g. aggression, agitation) are common among persons living with dementia.
Pharmacological (e.g. antipsychotics) and non-pharmacological (e.g. reminiscence therapy) interventions are often used to alleviate these symptoms. However, antipsychotics are associated with significant harm among older adults with dementia (e.g. death, stroke). Regulatory agencies such as the Food and Drug Administration (FDA) and Health Canada issued black box warnings to advise patients and clinicians of this potential for harm. And initiatives were championed to decrease the use of antipsychotics in persons living with dementia.
In response, we have seen a rise in the use of other pharmacological interventions, such as trazodone (an antidepressant). Its potential to cause harm in older adults with dementia is largely unknown.
26 Nov Exposure to Police Violence May Be Associated With Mental Health Disparities
Posted at 02:13h
in Accidents & Violence, Author Interviews, Mental Health Research, Race/Ethnic Diversity, Social Issues
MedicalResearch.com Interview with:
Dr. Jordan E. DeVylder, PhD
Graduate School of Social Service
Fordham University, New York, New York
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study is intended to address the lack of empirical research on police violence from a public health perspective.
The main findings are that police violence is relatively widespread in Baltimore and New York City, is disproportionately directed toward people of color and sexual or gender minorities, and is associated with psychological distress, suicidal behavior, and psychosis-like symptoms.
22 Nov Serious Mental Illness Raises Risk of 30 Day Readmission
Posted at 01:08h
in Author Interviews, Hospital Readmissions, JAMA, Schizophrenia, University of Pittsburgh
MedicalResearch.com Interview with:
[caption id="attachment_46132" align="alignleft" width="150"] Dr. Germack[/caption]
Hayley D. Germack PHD, MHS, RN
Assistant Professor, School of Nursing
University of Pittsburgh
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As nurse scientists, we repeatedly witness the impact of having a serious mental illness (i.e. schizophrenia, bipolar disorder, and major depression disorder) on patients’ inpatient and discharge experience. As health services researchers, we know how to make use of large secondary data to illuminate our firsthand observations.
In 2016, Dr. Hanrahan and colleagues (https://www.sciencedirect.com/science/article/pii/S0163834316301347) published findings of a secondary data analysis from a large urban hospital system that found 1.5 to 2.4 greater odds of readmission for patients with an serious mental illness diagnosis compared to those without. We decided to make use of the AHRQ’s HCUP National Readmissions Database to illuminate the magnitude of this relationship using nationally representative data. We found that even after controlling for clinical, demographic, and hospital factors, that patients with SMI have nearly 2 times greater odds of 30-day readmission.
19 Nov Adults with Down’s Syndrome at High Risk of Alzheimer’s Disease
MedicalResearch.com Interview with:Rosalyn Hithersay
LonDowns
Kings College, London
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In our research group, we have been following a large group of adults with Down syndrome in the UK to track changes with ageing in their health and cognitive function. It has been known for some time now that people with Down syndrome are at high risk for developing dementia due to Alzheimer’s disease. This new study has shown the huge impact that this risk has on mortality for these adults.
We found that dementia is now the likely underlying cause of death in more than 70% of adults with Down syndrome aged over 35 years. This is a much bigger proportion of deaths due to Alzheimer’s disease compared to the general population: in England and Wales only 17.5% of deaths past the age of 65 would be related to dementia of any kind.
16 Nov Transcendental Meditation May Help Veterans with Resistant PTSD
MedicalResearch.com Interview with: [caption id="attachment_46001" align="alignleft" width="160"]
Dr. Nidich[/caption]
Sanford Nidich, Ed.D.
Director, Center for Social-Emotional Health
Maharishi University of Management Research Institute
Fairfield, Iowa
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Posttraumatic stress disorder (PTSD) is a complex and difficult-to-treat disorder, affecting 10-20% of veterans across eras. Previous research raised the question of whether a non-trauma focused treatment can be as effective as trauma exposure therapy in reducing PTSD symptoms. The overall objective of the study was to compare Transcendental Meditation (TM), a non-trauma focused practice, to prolonged exposure (PE) in a non-inferiority clinical trial, and to compare both to a PTSD health education control group.
Transcendental Meditation was found to be as effective as PE in reducing PTSD symptoms severity from baseline to three-month posttest. In standard superiority comparisons, significant reductions in PTSD symptoms were found for TM vs. HE, and PE vs. HE. Percentages of participants with clinically significant improvement, as measured by the Clinician-Administered PTSD Scale (CAPS) interview (≥10 point reduction), were TM=61%, PE=42%, and HE=32%
16 Nov Testosterone Treatment May Reduce Depression in Men
MedicalResearch.com Interview with: [caption id="attachment_45941" align="alignleft" width="200"] Dr. Walther[/caption]
Dr. Andreas Walther PhD
Department of Biological Psychology, Technische Universität Dresden, Dresden, Germany
Department of Clinical Psychology and Psychotherapy, University of Zurich,
Zurich, Switzerland
Task Force on Men’s Mental Health of the World Federation of the Societies of Biological Psychiatry
MedicalResearch.com: What is the background for this study?
Response: The study situation with regard to endogenous testosterone level and depressive symptoms in men is currently very mixed. There are studies that show no association, but other studies show that low testosterone levels are associated with increased depressive symptoms. That is why several studies have tried to administer testosterone in men to treat depressive symptomatology among other conditions (e.g. erectile dysfunction, cognitive decline).
However, no clear conclusions could be drawn from the studies to date, as some studies reported positive results, while others did not show any effects. Likewise, some studies showed better results in certain subgroups of men such as dysthymic men, treatment resistant, men with low testosterone, which raised the question of relevant moderators.