Author Interviews, Depression, Lancet / 23.07.2016 Interview with: Professor David A. Richards, PhD Professor of Mental Health Services Research and NIHR Senior Investigator University of Exeter Medical School University of Exeter St Luke's Campus Exeter United Kingdom What is the background for this study? Response: Depression is a common mental health disorder affecting around 350 million people worldwide. Untreated depression is expected to cost the global economy US$5.36 trillion between 2011 and 2030. Many patients request psychological therapy, but the best-evidenced therapy—cognitive behavioural therapy (CBT)—is complex and costly. A simpler therapy—behavioural activation (BA)—might be as effective and cheaper than is CBT. We aimed to establish the clinical efficacy and cost-effectiveness of BA compared with CBT for adults with depression. (more…)
Author Interviews, Mental Health Research, Pharmacology, Schizophrenia / 21.07.2016 Interview with: Glorimar Ortiz, MS Senior Researcher/Statistician NRI-National Association of State Mental Health Program Directors Research Institute Falls Church, VA 22042 What is the background for this study? What are the main findings?  Response: Despite the lack of empirical evidence that antipsychotic polypharmacy produces greater outcomes to antipsychotic monotherapy, and that several clinical guidelines recommend against it, patients with a diagnosis of schizophrenia continue to being discharged on polypharmacy. Over the past few years, attempts have been made to lower the rate of antipsychotic polypharmacy throughout the country. Most of the existing literature on this topic are based on Medicaid claims data which exclude data for patients discharged from state psychiatric inpatient hospitals. Our study is very important because it is the first time that data on the use of antipsychotic medications are analyzed using a large sample of discharges from state psychiatric inpatient hospitals. These hospitals now have the opportunity to benchmark their antipsychotic medication use rate with national rates more accurately, and therefore, develop and implement performance improvement activities that are more precise. The study found that 12% of all discharges were prescribed two or more antipsychotic medications. Of those patients discharged on at least one antipsychotic medication, 18% were prescribed two or more antipsychotics. The study also found that patients with a schizophrenia diagnosis and an inpatient hospital stay of 3 months or longer are more likely of being discharged on polypharmacy, and that the main reason for this was to reduce patient’s symptoms. Antipsychotic polypharmacy affects nearly 10,000 patients with schizophrenia annually in state psychiatric inpatient hospitals. (more…)
Author Interviews, Karolinski Institute, Mental Health Research / 20.07.2016 Interview with: Lorena Fernández de la Cruz | Assistant Professor Department of Clinical Neuroscience | Karolinska Institutet Child and Adolescent Psychiatry Research Center Stockholm What is OCD? Response: Obsessive-compulsive disorder (OCD) is one of the most common psychiatric disorders. OCD has a lifetime prevalence of about two per cent in the general population, generally runs a chronic course, and is often associated with a significantly reduced quality of life. Despite this, the risk of suicide in OCD has traditionally been considered low, probably due the particular personality profile of this patient group, typically described as “harm avoidant”. However, we have seen that the risk of suicide is higher than previously thought. (more…)
Alcohol, Author Interviews, Memory / 19.07.2016 Interview with: Jeff Boissoneault, PhD Research Assistant Professor Center for Pain Research and Behavioral Health Department of Clinical and Health Psychology University of FloridaJeff Boissoneault, PhD Research Assistant Professor Center for Pain Research and Behavioral Health Department of Clinical and Health Psychology University of Florida What is the background for this study? What are the main findings? Response: Many older adults are regular moderate drinkers. Although moderate drinking is considered to be a low risk behavior, growing evidence suggests older adults may be more susceptible to the cognitive and behavioral effects of moderate alcohol intake than younger people. We have previously shown that blood alcohol concentrations (BACs) below the legal limit for driving in the United States, 0.08 g/dL, affect working, or short-term, memory performance in older but not younger adults. For this study, we examined frontal theta power (FTP) and posterior alpha power (PAP), which are electrophysiological measures of brain activity associated with cognitive effort and maintenance of visual information, during a working memory task in both older and younger social drinkers. We found that during a nine-second delay period during which participants held briefly-displayed images in memory, moderate alcohol intake increased PAP in younger adults but decreased PAP in older adults. Examining the relationship between PAP and behavioral performance (accuracy and reaction time) suggested older adults may attempt to compensate for moderate alcohol-induced working memory impairment by prioritizing quick responding over the protection of their mental representation of the task images from environmental distractions. Younger adults did not show this effect. (more…)
Author Interviews, PTSD, Sleep Disorders / 19.07.2016 Interview with: Jim Burch, MS, PhD Associate Professor Dept. of Epidemiology & Biostatistics Cancer Prevention & Control Program Arnold School of Public Health University of South Carolina, Columbia, SC and Health Science Specialist WJB Dorn Department of Veterans Affairs Medical Center Columbia, SC What is the background for this study? Response: Over 21 million Veterans live in the U.S., and nearly 9 million of them receive healthcare through the Veterans Health Administration, which is the largest integrated healthcare system in the U.S. The military population is particularly vulnerable to sleep disturbances due to their work schedules, living conditions, and other physical and psychological factors that accompany their jobs. However, previous studies have not comprehensively described the scope and characteristics of sleep disorders among Veterans. Sleep is considered a physiological necessity. Inadequate sleep has been associated with a wide range of adverse health outcomes, including an increased risk of chronic diseases such as heart disease and cancer, psychiatric disorders, reduced quality of life, and increased mortality. (more…)
Author Interviews, Depression, JAMA, Mental Health Research, Pediatrics / 18.07.2016 Interview with: Dr Carmen Pace MPsych (Clin Child) PhD AMACPA Clinical Psychologist and Research Fellow Murdoch Childrens Research Institute The Royal Children’s Hospital Flemington Rd Parkville, Victoria AUS What is the background for this study? Response: We know that mothers of very preterm infants (born prior to 32 weeks gestation) are at higher risk for psychological distress compared to mothers who have healthy full term infants. However, detailed longitudinal research looking at how symptoms evolve over the first weeks and months is limited, and fathers are largely neglected in the literature. We addressed these gaps by assessing symptoms of depression and anxiety in both mothers and fathers every two weeks for the first twelve weeks after birth, and again at six months. (more…)
Author Interviews, Education, Memory, Neurological Disorders / 15.07.2016 Interview with: Kalipada Pahan, Ph.D Floyd A. Davis, M.D., Endowed Chair of Neurology Professor, Departments of Neurological Sciences, Biochemistry and Pharmacology Rush University Medical Center VA Scientist, Jesse Brown VA Medical Center Chicago, IL 60612 What is the background for this study? What are the main findings? Response: Individual difference in learning and educational performance is a global issue. In many cases between two students of the same background studying in the same class, one turns out to be a poor learner and does worse than the other academically. Little is known on what changes occur in the brain of poor learners and how to improve performance in poor learners. Here, we have demonstrated that cinnamon, a common food spice and flavoring material, converts poor learning mice to good learners. Results of the study were recently published in the Journal of Neuroimmune Pharmacology. (more…)
Alzheimer's - Dementia, Author Interviews, Endocrinology, Hormone Therapy, Mayo Clinic, Menopause / 13.07.2016 Interview with: Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology What is the background for this study? What are the main findings? Response: A rapid decline in estrogen with menopause may be associated with an increased risk of Alzheimer’s disease risk in women. This study was conducted in newly postmenopausal women who received 17β-Estradiol via a skin patch or conjugated equine estrogen orally or placebo. Those who received 17β-Estradiol patch had reduced β-amyloid deposits, the plaques found in the brains of people with Alzheimer’s disease, three years after the end of the hormone therapies. In the study, women with APOE e4 — one form of the most common gene associated with late-onset Alzheimer's disease — who received the 17β-Estradiol patch had lower levels of β-amyloid deposits than those who received placebo. (more…)
Alzheimer's - Dementia, Author Interviews, Chemotherapy, Parkinson's / 13.07.2016 Interview with: Charbel Moussa MD. PhD Assistant Professor of Neurology Director- Laboratory for Dementia and Parkinsonism Clinical Research Director- National Parkinson's Foundation Center for Excellence Translational Neurotherapeutics Program Department of Neurology Georgetown University Medical Center Washington DC. What is the background for this study? What are the main findings? Response: We conducted a pilot open label proof-of-concept study to evaluate the safety and tolerability of Nilotinib in participants with advanced Parkinson’s disease (PD) with dementia (PDD) or dementia with Lewy bodies (DLB). Our primary objective is to demonstrate that low oral daily doses of 150mg or 300mg Nilotinib (compared to 600-800mg in cancer) are safe and tolerated. Our secondary objectives are that Nilotinib will cross the blood brain barier and may inhibit cerebral spinal fluid Abl. Based on preclinical data we also hypothesized that Nilotinib will increase DA levels. Motor and cognitive functions were also measured as exploratory clinical outcomes. Other exploratory outcomes are that Nilotinib may alter PD-related CSF biomarkers DJ-1 and α-synuclein. As most participants in this study had dementia we also explored the effects of Nilotinib on Alzheimer's Disease-related CSF biomarkers, including Aβ40 and Aβ42, total tau and phosphorylated tau (p-tau). (more…)
Alzheimer's - Dementia, Author Interviews, Brain Injury, JAMA, Parkinson's / 11.07.2016 Interview with: Paul K. Crane, MD MPH Professor Department of Medicine Adjunct Professor Department of Health Services University of Washington What is the background for this study? Response: The background is that the most common experience of head injury with loss of consciousness is an apparent recovery. Sometimes this is very fast, sometimes it takes somewhat longer, but typically people return to their prior baseline. Nevertheless there is concern that the head injury may have set in motion processes that would lead to late life neurodegenerative conditions. This is bad enough for someone to deal with but it's made even worse if the head injury isn't even the victim's fault. Previous research has focused especially on Alzheimer's disease. A more limited research has focused on Parkinson's disease. We used data from three prospective cohort studies that included more than 7,000 people to study the relationship between head injury with loss of consciousness and subsequent risk of Alzheimer's and Parkinson's disease. We collected head injury exposure data at study enrollment, at a time when we administered cognitive tests and knew they did not have dementia, so our exposure data are not biased. Each of these studies also performed brain autopsies on people who died, and we evaluated data from more than 1500 autopsies. (more…)
Author Interviews, Cannabis, JAMA, Mental Health Research / 06.07.2016 Interview with: Mary P. Heitzeg, PhD Assistant Professor Department of Psychiatry University of Michigan What is the background for this study? What are the main findings? Response: We wanted to find out if marijuana use changed the way the brain’s reward system responded to natural rewards. To probe response to natural reward, we used the chance to win some money and we observed brain response using functional magnetic resonance imaging (fMRI). We looked at brain activity when participants were 20 years old on average, and then again 2 years later and 4 years later. We found that over time marijuana use was associated with a decrease in the brain’s reward response to the chance to win money. This finding is consistent with current theories of addiction that suggest that repeated use of a substance may dampen the brain’s reward response to things normally perceived as pleasurable and this alteration may drive the individual to continue substance use. (more…)
Author Interviews, Bipolar Disorder, JAMA, Schizophrenia / 06.07.2016 Interview with: Thomas M. Lancaster, PhD Neuroscience and Mental Health Research Institute Cardiff University Brain Imaging Research Centre Cardiff University, Cardiff, United Kingdom What is the background for this study? What are the main findings? Response: Psychotic disorders such as schizophrenia and bipolar disorders are heritable. Part of this genetic risk may be conferred by the combined effects of common risk alleles identified via genome wide association studies. Individuals with psychosis are also more likely to experience alterations in the ventral striatum (VS); a key node in the brain’s reward processing network. We hypothesized that common genetic risk for psychosis may confer risk via alterations in the VS. Using functional magnetic resonance imaging (fMRI) data from an adolescent sample (the IMAGEN cohort), we showed that increased psychosis risk was associated with increased BOLD (blood oxygen level dependency) in the VS, during reward processing. (more…)
Author Interviews, Depression, Fertility / 04.07.2016 Interview with: Jessica Datta Department of Social & Environmental Health Research London School of Hygiene & Tropical Medicine London What is the background for this study? Response: The paper presents an analysis of data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Natsal-3 is a survey of more than 15,000 women and men aged 16-74 resident in Britain, conducted in 2010-2012, which includes a wide range of questions about sexual relationships and behaviour and reproductive history. In this paper we analysed responses to the questions: ‘Have you ever had a time, lasting 12 months or longer, when you and a partner were trying for a pregnancy but it didn’t happen?’ and ‘Have you (or a partner) ever sought medical or professional help about infertility?’. As well as calculating the prevalence of experience of infertility and help seeking, we looked at associated factors e.g. education, employment, relationship status. (more…)
Author Interviews, Autism, OBGYNE / 04.07.2016 Interview with: Dr-Claudia-Avella-GarcíaClaudia Avella-García MD, MPH, PhD ISGlobal - Institut de Salut Global Barcelona Unitat Docent de Medicina Preventiva i Salut Publica H.Mar-UPF-ASPB What is the background for this study? Response: Acetaminophen (paracetamol) is used by around half of all pregnant women in developed countries and is currently the recommended treatment for fever and pain during gestation. However, evidence linking exposure to this medication with negative changes in neurodevelopment has been coming to light, warranting further study. Therefore, our objective was to evaluate whether prenatal exposure to acetaminophen was adversely associated with child neurodevelopment at 1 and 5 years of age. For this reason, we evaluated 2644 mother-child pairs recruited during pregnancy as part of the INfancia y Medio Ambiente – Childhood and Environment (INMA) project, a Spanish general population-based cohort. We collected information on acetaminophen use prospectively up until week 32 of gestation. We evaluated neurodevelopment at 1 year of age using the Bayley Scales of Infant Development. At 5 years of age we applied a battery of tests evaluating different aspects of neurodevelopment including both cognitive and behavioural aspects. (more…)
Author Interviews, Depression, JAMA, PTSD / 01.07.2016 Interview with: Bradley E. Belsher, Ph.D. Chief of Research Translation and Integration, Deployment Health Clinical Center, Defense Center of Excellence for PH and TBI Research Assistant Professor, Department of Psychiatry Uniformed Services University of the Health Sciences What is the background for this study? What are the main findings? Response: One out of five U.S. military service members returning from overseas military conflicts meets screening criteria for at least one mental health condition, yet fewer than half of service members will receive help from a mental health professional. The consequences of inadequate mental health treatment are considerable and can lead to significant social and functional problems for service members and their families. In response to these mounting concerns, the Military Health System (MHS) has increased efforts to expand and improve the identification and treatment of mental health disorders. Given that the average service member visits primary care three times each year, the MHS has invested considerable resources into the integration of mental health services into the primary care setting. Collaborative care is an effective model for integrating mental health services into primary care and has demonstrated effectiveness in treating different mental health conditions to include depression and anxiety disorders. However, no previous studies have examined whether the concept can work in the MHS. Recently, the first large-scale, randomized effectiveness trial evaluating an integrated health care model in primary care for PTSD and depression in the DoD was conducted. This trial randomized 666 military members treated across six large Army bases to a centrally-assisted collaborative telecare (CACT) approach for PTSD and depression or to the existing standard of care (usual collaborative care). This effectiveness trial targeted a large population of service members as they came into primary care and minimized exclusion criteria to improve the generalizability of the findings and broaden the applicable reach of the intervention. (more…)
Author Interviews, Depression, Heart Disease, JAMA / 01.07.2016 Interview with: Prof. Dr. med. Christiane E. Angermann, FESC, HFA Deutsches Zentrum für Herzinsuffizienz Würzburg Comprehensive Heart Failure Center (CHFC) Universitätsklinikum Würzburg Würzburg What is the background for this study? What are the main findings? Response: Previous meta-analysis indicates that depression prevalence in patients with heart failure is much higher than in the general population, 10 percent to 40 percent, depending on disease severity. Depression has been shown to be an independent predictor of mortality and rehospitalization in patients with heart failure, with incidence rates increasing in parallel with depression severity. Furthermore, it is associated with poor quality of life and increased healthcare costs. It would, against this background, seem desirable to treat the depression, and when planning the study we hypothesized that by doing so we might be able to improve depression and thus reduce mortality and morbidity of this population. Long-term efficacy and safety of selective serotonin reuptake inhibitors (SSRIs), which are widely used to treat depression and have proven efficacious in individuals with primary depression, is unknown for patients with heart failure and (comorbid) depression. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Memory, University Texas / 28.06.2016 Interview with: Timothy Q. Duong, Ph.D Stanley I. Glickman MD Professor of Ophthalmology, Radiology, and Physiology South Texas Veterans Health Care System, VA Southwest National Primate Research Center University of Texas Health Science Center San Antonio, Texas What is the background for this study? What are the main findings? Response: A single oral dose of methylene blue increased fMRI response in the bilateral insular cortex during a task that measured reaction time to a visual stimulus. The fMRI results also showed an increased response during short-term memory tasks involving the brain’s prefrontal cortex, which controls processing of memories. Methylene blue was also associated with a 7 percent increase in correct responses during memory retrieval. The findings suggest that methylene blue can regulate certain brain networks related to sustained attention and short-term memory after a single oral low dose. (more…)
Author Interviews, Mental Health Research, Pediatrics, Telemedicine / 23.06.2016 Interview with: Mirna Becevic, PhD, MHA Assistant Research Professor University of Missouri - Department of Dermatology Missouri Telehealth Network What is the background for this study? Response: Psychiatry is, by far, the biggest utilizer of telemedicine services on the Missouri Telehealth Network (MTN). MTN supports an average of 4000 tele-psychiatry appointments every month, and 10% of those are provided by the University of Missouri Department of Psychiatry. Since we are all aware of the ever-increasing demand for child and adolescent psychiatry, but also the stigma that goes along with it, we wanted to examine more closely the actual usage of those services at the University of Missouri. (more…)
Anesthesiology, Author Interviews, Cognitive Issues, NYU, Pediatrics, Science / 23.06.2016 Interview with: Guang Yang, Ph.D. Assistant Professor NYU Langone School of Medicine Alexandria Center for Life Sciences New York, NY 10016 What is the background for this study? How common is the problem of long-lasting behavioral deficits after repeated anesthesia exposure in neonates? Response: Each year, in the United States alone, more than 1 million children under 4 years of age undergo surgical procedures that require anesthesia. Many lines of evidence from animal studies have shown that prolonged or repeated exposure to general anesthesia during critical stages of brain development leads to long-lasting behavioral deficits later in life. The results from human studies are less clear, although some studies suggest a higher incidence of learning disabilities and attention-deficit and hyperactivity disorders in children repeatedly exposed to procedures requiring general anesthesia. To date, there has been no effective treatment to mitigate the potential neurotoxic effects of general anesthesia. (more…)
Alzheimer's - Dementia, Author Interviews, Cost of Health Care, Geriatrics / 22.06.2016 Interview with: Pei-Jung Lin, Ph.D. Assistant Professor Center for the Evaluation of Value and Risk in Health Institute for Clinical Research and Health Policy Studies Tufts Medical Center Boston, MA 02111 What is the background for this study? What are the main findings? Response: Alzheimer’s disease (AD) is a slow, progressive disease. Many people with AD may live for years with the disease left unrecognized or untreated, in part because the early symptoms are mild and often mistaken as part of normal aging. In this study, we found that Alzheimer’s patients may use more health care services and incur higher costs than those without dementia even before they receive a formal diagnosis. For example, total Medicare expenditures were 42% higher among Alzheimer’s patients than matched controls during the year prior to diagnosis ($15,091 vs. $10,622), and 192% higher in the first year immediately following diagnosis ($27,126 vs. $9,274). We also found similar trends among Medicare patients with mild cognitive impairment (MCI)— a prodromal stage of AD and associated with higher dementia risk. Our study suggests that an Alzheimer’s disease or MCI diagnosis appears to be prompted by other health problems such as cardiovascular and cerebrovascular diseases, pneumonia, renal failure, urinary tract infections, and blood and respiratory infections. This finding likely reflects a failure of ambulatory care related to the impact of cognitive impairment on other chronic conditions. (more…)
Author Interviews, Depression, Race/Ethnic Diversity / 22.06.2016 Interview with: Sirry Alang PhD Assistant professor of sociology and anthropology Lehigh University What is the background for this study? What are the main findings? Response: Discrepancies exist between how some Black populations perceive depression and how depression is conceptualized within research and clinical settings. African Americans are exposed to a lot of stress from structural racism, yet, they perceive themselves to be resilient. The context of stress from discrimination and beliefs about depression inform how they express psychological distress. Depression is thought of as a weakness that is inconsistent with notions of strength in the community. Although depression was expressed through classic depressive symptoms such as feeling hopeless, loss of sleep, and losing interests in activities, symptom like anger, agitation, and the frantic need for human interaction were considered to be indicative of depression. Anger, agitation, and the frantic need for human interaction are not consistent with how depression is defined in the latest manual for psychiatric diagnosis- the DSM-V. (more…)
Author Interviews, Genetic Research, Mental Health Research, PNAS / 22.06.2016 Interview with: Brian W. Haas PhD Department of Psychology Interdisciplinary Neuroscience Graduate Program University of Georgia, Athens, GA What is the background for this study? Response: A burgeoning body of evidence highlights the role of several key genes within the oxytocin signaling pathway linked to sociability. Although many studies strongly supports the role of OXTR in the phenotypic expression of sociability in humans, the roles of other oxytocin pathway genes, such asOXT, has received relatively little attention. (more…)
Author Interviews, Mental Health Research, Pediatrics, Psychological Science, Radiology / 19.06.2016 Interview with: Dr. Luca Passamonti MD Department of Clinical Neurosciences University of Cambridge What is the background for this study? Dr. Passamonti: We wanted to study if the brain of young people with two different forms of conduct disorder (CD) (, a neuropsychiatric disease associated with severe and persistent antisocial behaviors (weapon use, aggression, fire-setting, stealing, fraudulent behavior), was different from that of young peers with no such abnormal behaviors. There is already evidence that conduct disorder may have a biological basis (i.e., reduced levels of cortisol under stress) and brain alterations but a whole “map” of the brain in conduct disorder studying cortical thickness was never been done before. (more…)
Author Interviews, Depression, JAMA, OBGYNE, Pediatrics / 17.06.2016 Interview with: Mari Videman Senior Consultant in Child Neurology BABA Center Children’s Hospital, Helsinki University Hospital What is the background for this study? What are the main findings? Response: Depression and anxiety are common during pregnancy, and up to 5% of all pregnant women are treated with serotonin uptake inhibitors (SRI). It is now known that SRIs do not cause major malformations in humans, however recent animal studies have suggested that fetal early SRI exposure may cause changes in brain microstructure and neuronal signaling. Prior human studies have shown that fetal SRI exposure leads to transient postnatal adaptation syndrome, as well as to an increased risk of developing childhood depression. We used electroencephalography (EEG) and advanced computational methods to assess both the local and global cortical function of the newborn brain. We found that several aspects of newborn brain activity are affected by exposuse to SRI during pregnancy. Most importantly, the communication between brain hemispheres, and the synchronization between cortical rhythms were weaker in the SRI-exposed newborns. These changes were most likely related to SRI exposure, because they did not correlate with the psychiatric symptoms of the mothers. (more…)
Author Interviews, JAMA, Schizophrenia / 16.06.2016 Interview with: Kate Merritt PhD Post-Doctoral Research Worker NOC Study (Nitric Oxide in Cognition) Institute of Psychiatry De Crespigny Park London What is the background for this study? What are the main findings? Dr. Merritt: Research has indicated that levels of one of the main chemicals in the brain, glutamate, may be abnormal in schizophrenia. Almost sixty studies have measured glutamate levels in schizophrenia, however the findings are inconsistent, and it is thought that changes in glutamate levels may vary with the length or the severity of illness. This study therefore analysed all the published reports of glutamate in schizophrenia. The main findings are that, overall, schizophrenia is associated with elevated glutamate in several brain regions; namely the medial temporal cortex, the basal ganglia and the thalamus. These changes also differed with the stage of illness; in the medial frontal cortex, glutamate was increased in people at risk for developing schizophrenia, but not in people who had been diagnosed with schizophrenia for several years, whereas in the medial temporal lobe the opposite pattern was detected. (more…)
Author Interviews, Cognitive Issues, Sleep Disorders / 14.06.2016 Interview with: Anna Alkozei, Ph.D. Postdoctoral Research Fellow SCAN Lab, Psychiatry Department University of Arizona Tucson, AZ 85724-5002 What is the background for this study? What are the main findings? Dr. Alkozei: We know that exposure to blue wavelength light, which is similar to the kind of light that we get on a bright sunny day, can improve attention and alertness during the day as well as at night. We wanted to extend previous findings by investigating whether blue light exposure can affect cognitive functioning after the blue light exposure period had already ended. We found that thirty minutes of exposure to blue wavelength light during the day, in comparison to an amber light exposure led to subsequently faster reaction times on a cognitive task forty minutes after the light exposure had already ended. Participants who were exposed to blue light also showed more efficient responding, which means they answered more items correctly per second, than individuals who were exposed to amber placebo light. Finally, we also found that individuals who were exposed to blue light showed greater activation within the prefrontal cortex when performing the task, an area necessary for optimal cognitive performance, than individuals who were exposed to amber light. (more…)
Author Interviews, Mental Health Research / 14.06.2016 Interview with: Dr. Alexandra Pitman BA MSc(Econ) MBBS MRCPsych FHEA PhD Honorary Research Associate & Consultant Psychiatrist, Division of Psychiatry University College London London What is the background for this study? What are the main findings? Dr. Pitman: We conducted this study to settle a long-standing debate over whether bereavement by suicide is more stigmatising than bereavement due to other causes of sudden death. This is important because the more we understand about the stigma of suicide bereavement, the better equipped we are to design services to support this group. Providing support for people bereaved by suicide is one of five key messages in WHO suicide prevention strategy, and features prominently in the suicide prevention strategies of high income countries such as England, Wales, Northern Ireland, the US, and Australia. The evidence to date suggests that we lack effective interventions to address their known risk of suicide and mental health problems, constituting a failure to tackle an important public health problem. Although suicide is commonly believed to be highly stigmatising for bereaved relatives and friends, qualitative work suggests that people bereaved by other causes of death also feel stigmatised by their loss. For example, a British study of people bereaved by suicide and other unnatural causes of death found that interviewees in both groups described societal pressure to contain their grief and even to hide it. Our earlier systematic review in the Lancet Psychiatry had identified studies comparing health and mortality outcomes in people bereaved by suicide and other causes of death, among which 7 studies had compared perceived stigma scores using a validated measure. In all cases the measure was the stigmatization subscale of the Grief Experience Questionnaire. Taken together these studies were inconclusive as to whether people bereaved by suicide and other unnatural mortality causes differed in relation to stigma scores. Partly the problem seemed to be one of sample size in having insufficient statistical power to demonstrate score differences, should they exist. We decided to conduct a large-scale British study to compare grief outcomes such as stigma, shame, responsibility and guilt, as well as clinical outcomes such as suicide attempt. Previously published findings from this study, reported in BMJ Open, show an increased risk of suicide attempt in people bereaved by suicide, whether related to the deceased or not. (more…)
Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, JAMA, Stroke / 14.06.2016 Interview with: Alessandro Biffi, MD Behavioral Neurology and Neuropsychiatry Departments of Neurology and Psychiatry Massachusetts General Hospital / Harvard Medical School What is the background for this study? Dr. Biffi: Intracerebral Hemorrhage (ICH) is the most severe form of stroke. It is a form of hemorrhagic (i.e. bleeding) stroke that accounts for ~ 15% of all acute cerebrovascular conditions, affecting ~ 70,000 Americans every year. However, because of its severity it is responsible for almost half of all stroke-related disability worldwide. Survivors of ICH are at very high risk for cognitive impairment (up to and including dementia) following the acute cerebral bleeding event. However, we possess very limited understanding of the time dynamics and risk factors for post-ICH dementia. In particular, prior to our study it was unclear whether the acute cerebral injury due to ICH would be the only mechanism potentially responsible for subsequent development of dementia. This question is motivated by prior observations suggesting that Intracerebral Hemorrhage represents the acute manifestation of cerebral small vessel disease, a progressive degenerative disorder of small caliber arteries of the central nervous system. There exist two major subtypes of small vessel disease: 1) cerebral amyloid angiopathy, caused by the deposition of a toxic protein product, beta-amyloid, in the blood vessels (in a process similar to the formation of beta-amyloid plaques that cause Alzheimer's disease); 2) arteriolosclerosis, caused by long-standing elevated blood pressure. ICH survivors have been previously shown to harbor very severe small vessel disease, which has been linked to dementia in patients without cerebral bleeding. Our hypothesis was that early-onset dementia (occurring in the first 6 months after ICH) is a manifestation of the acute neurological damage associated with cerebral bleeding, whereas delayed onset dementia (developing beyond 6 months from the acute ICH event) is associated with known markers of small vessel disease, including imaging findings on CT/MRI and genetic markers (such as the APOE gene). (more…)
ADHD, Author Interviews, JAMA, Mental Health Research, Neurological Disorders / 11.06.2016 Interview with: Katya Rubia, PhD Department of Child and Adolescent Psychiatry Institute of Psychiatry, Psychology, and Neuroscience King’s College London London, England  What are the main findings? Dr. Rubia: ADHD and OCD patients both suffer from poor inhibitory control and in both disorders this has been associated with structural and functional deficits in fronto-striatal networks. However, it is not clear to what extent the two disorders differ in their underlying neural substrates. This study therefore conducted a meta-analysis of all published whole brain structural and functional MRI studies of inhibitory control in both disorders. What are the main findings? Dr. Rubia: The main findings are that ADHD and OCD patients differ quite fundamentally in their structural and functional brain abnormalities. OCD patients have enlarged volume in basal ganglia and insula, while ADHD patients have reduced volumes in these regions. In fMRI, in the left hemisphere this was also observed for the left insula and putamen, which were increased in OCD and reduced in ADHD. In addition both disorders have different frontal deficits. OCD patients have deficits in rostro-dorsal medial frontal regions that are important for top-down control of affect while ADHD patients had reduced activation in lateral inferior frontal cortex, a key area of attention and cognitive control. The findings fit into the notion of fronto-striatal dysregulation in OCD where basal ganglia are overactive and poorly controlled by medial frontal regions and a delayed fronto-striatal maturation in ADHD where both lateral frontal regions and the basal ganglia/insula are smaller, and presumably less developed in structure and in function in ADHD. (more…)