Mental Health Research

31 Aug

Posted at 12:29h in Author Interviews, Breast Cancer, Genetic Research, Mental Health Research, Ovarian Cancer, Psychological Science
MedicalResearch.com Interview with: Mag. Dr. Anne Oberguggenberger PhD Medizinische Universität Innsbruck Department für Psychiatrie, Psychotherapie und Psychosomatik Innsbruck Austria MedicalResearch.com: What is the background for this study? Response: Genetic counseling and testing is increasingly integrated in routine clinical care for breast- and ovarian cancer (BOC). Knowledge on follow-up psychosocial outcomes in all different groups of counselees is essential in order to improve follow-up care and counselees’ quality of life.

30 Aug

Posted at 18:40h in Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Education
MedicalResearch.com Interview with: [caption id="attachment_27491" align="alignleft" width="180"]Deborah Blacker MD, ScD Director of the Gerontology Research Unit Department of Psychiatry Massachusetts General Hospital Dr. Deborah Blacker[/caption] Deborah Blacker MD, ScD Director of the Gerontology Research Unit Department of Psychiatry Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings Response: Many observational studies have found that those who are cognitively active have a lower risk of developing Alzheimer's disease or any type of dementia. However, we and others have been concerned that these findings might be spurious due to two potential biases:
  • 1) “confounding,” meaning that those who are cognitively active have lower rates of Alzheimer’s disease for another reason, in particular the effect of greater education, which is associated with both lower risk of Alzheimer’s and higher levels of cognitive activity; and
  • 2) “reverse causation,” meaning that theassociation could be due to a reduction in cognitive activity among those already in the long preclinical phase of cognitive decline before Alzheimer’s dementia (rather than the lack of cognitive activity causing the Alzheimer’s). Our study performed a systematic review of the literature on the association, and then a set of bias analyses to assess whether confounding or reverse causation could account for the observed associations.

28 Aug

Posted at 11:32h in Alzheimer's - Dementia, Author Interviews, Nutrition
MedicalResearch.com Interview with: [caption id="attachment_27409" align="alignleft" width="150"]William B. Grant, Ph.D. Director, Sunlight, Nutrition, and Health Research Center San Francisco, CA www.sunarc.org, Dr. William Grant[/caption] William B. Grant, Ph.D. Director, Sunlight, Nutrition, and Health Research Center San Francisco, CA www.sunarc.org MedicalResearch.com: What is the background for this study? What are the main findings? Response: The present study is the culmination of 20 years of investigating dietary links to Alzheimer's disease (AD). I am a physicist by training and spent my salaried career as an atmospheric scientist. In the 1990s while studying the effect of acid rain and ozone on eastern hardwood forests, I became familiar with the geographical ecological study approach. In this approach, populations are defined geographically, such as by state or country, and health outcomes are compared statistically with risk-modifying factors. Ecological studies are an efficient way to analyze the results of unplanned experiments. In 1996, I read that Japanese-American men living in Hawaii had two and a half times the prevalence of  Alzheimer's disease as native Japanese. I knew that AD patients often had higher concentrations of aluminum in their brains than other people, and that acid rain increased the concentration of aluminum in trees. It quickly occurred to me that the American diet must be the cause of the increased AD rate, and that by using the ecological approach, I could prove it. My first study, published in 1997, compared AD prevalence rates for 11 countries with macro-dietary factors of national diets. Total fat was found to have the highest correlation with AD, followed by total energy (calories), with fish reducing risk slightly, while countries such as China, Japan, and India, with large amounts of rice in the diet, had very low  Alzheimer's disease rates. This study was the first major study linking diet to risk of AD and led to observational studies that confirmed the findings five years later.

26 Aug

Posted at 17:37h in Author Interviews, Mental Health Research, Schizophrenia, Telemedicine
MedicalResearch.com Interview with: [caption id="attachment_27385" align="alignleft" width="200"]Dror Ben Zeev, PhD Associate Professor of Psychiatry Director, mHealth for Mental Health Program Dartmouth College Hanover, NH Dr. Dror Ben Zeev[/caption] Dror Ben Zeev, PhD Associate Professor of Psychiatry Director, mHealth for Mental Health Program Dartmouth College Hanover, NH MedicalResearch.com: What is the background for this study? Response: We deployed a mobile phone intervention called FOCUS as part of a larger multi-component effort called Improving Care Reducing Costs (ICRC). ICRC was the first technology-aided relapse prevention program of its kind for people with schizophrenia; a very exciting multi-state project funded by the Center for Medicare and Medicaid Innovation (CMMI) led by Dr. John Kane at the Zucker Hillside Hospital and a team of researchers from multiple institutions. Several other technological interventions were used in concert with mHealth, including a web intervention called Coping with Voices Developed by Dr. Jen Gottlieb and a Daily Support Website developed by Dr. Armando Rotondi. A truly multi-disciplinary effort designed to help prevent re-hospitalization in people with psychosis who were recently discharged from the hospital; this is a group that is at very high risk for relapse.

26 Aug

Posted at 17:27h in Author Interviews, BMJ, Mental Health Research, Sleep Disorders
MedicalResearch.com Interview with: Donna Littlewood PhD School of Health Sciences Faculty of Biology, Medicine and Health The University of Manchester MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was the first qualitative study to examine the role of sleep problems in relation to suicidal thoughts and behaviours. In-depth semi-structured interviews were conducted with 18 participants, who all had experienced major depressive episode(s) and suicidal thoughts and behaviours. Data were analysed with thematic analysis which identified three interrelated pathways whereby sleep contributed to suicidal thoughts and behaviours. The first was that being awake at night heightened the risks of suicidal thoughts and attempts, which in part was seen as a consequence of the lack of help or resources available at night. Secondly, the research found that a prolonged failure to achieve a good night's sleep made life harder for respondents, adding to depression, as well as increasing negative thinking, attention difficulties and inactivity. Finally, participants said sleep acted as an alternative to suicide, providing an escape from their problems. However, the desire to use sleep as an avoidance tactic led to increased day time sleeping which in turn caused disturbed sleeping patterns - reinforcing the first two pathways.

25 Aug

Posted at 17:56h in Author Interviews, Depression, Heart Disease, HIV, Vanderbilt
MedicalResearch.com Interview with: Matthew S Freiberg, MD, MSc Cardiovascular Medicine Division, Vanderbilt University School of Medicine Tennessee Valley Geriatric Research Education and Clinical Center, Nashville  TN Tasneem Khambaty, PhD Department of Psychology, University of Miami, Coral Gables, Florida Jesse C. Stewart, PhD Department of Psychology, Indiana University–Purdue University , Indianapolis, Indianapolis MedicalResearch.com: What is the background for this study? Response: Due to highly effective antiretroviral therapy, people with HIV are living longer. Unfortunately, these HIV-infected individuals remain at a higher risk for other chronic diseases, with cardiovascular disease (CVD) being one of the leading cause of death in this population. In the general population, depressive disorders, such as major depressive disorder (MDD) and dysthymic disorder, are associated with increased risk of new-onset CVD. Given that roughly 24-40% of HIV-infected individuals have a depressive disorder, we examined whether MDD and dysthymic disorder are also associated with an increased risk of new-onset CVD in people with HIV.

25 Aug

Posted at 17:47h in Author Interviews, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_27291" align="alignleft" width="200"]Ian Rockett, PhD, MPH, FACE Professor, Department of Epidemiology School of Public Health West Virginia University Morgantown, WV Dr. Ian Rockett[/caption] Ian Rockett, PhD, MPH, FACE Professor, Department of Epidemiology School of Public Health West Virginia University Morgantown, WV MedicalResearch.com: What is the background for this study? Response: Self-injury deaths in the United States are seriously underestimated because they are officially limited to registered suicides, and exclude non-suicide deaths from drug self-intoxication. Suicides themselves are undercounted due primarily to under-resourcing of medical examiner and coroner offices and associated challenges in detecting drug suicides. Although most drug-intoxication deaths involve deliberate behaviors that markedly elevate risk of premature death, they are formally classified, but mischaracterized, as “accidents” on death certificates. Representing self-injury mortality (SIM) as a combination of registered suicides and estimated deaths from drug self-intoxication (DDSI), this study compared its national trends and patterns with those of 3 proximally ranked top 10 causes of death.

25 Aug

Posted at 17:43h in Author Interviews, Autism, Diabetes, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_27380" align="alignleft" width="200"]Evdokia Anagnostou MD Canada Research Chair (Tier II) in Translational Therapeutics in Autism Senior Clinician Scientist and co-lead of the Autism Research Centre Holland Bloorview Kids Rehabilitation Hospital Dr. Evdokia Anagnostou[/caption] Evdokia Anagnostou MD Canada Research Chair (Tier II) in Translational Therapeutics in Autism Senior Clinician Scientist and co-lead of the Autism Research Centre Holland Bloorview Kids Rehabilitation Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Researchers from Holland Bloorview Kids Rehabilitation Hospital / University of Toronto (Canada), Ohio State University, University of Pittsburgh, Columbia University, and Vanderbilt University, led a double-blind, placebo-controlled randomized clinical trial to examine whether metformin, a common type-2 diabetes drug, may be effective in counteracting weight gain commonly seen with the use of atypical antipsychotic medications, indicated by the FDA for the treatment of irritability in children and youth with autism spectrum disorder (ASD). Results showed that metformin was effective in helping overweight children and adolescents with autism spectrum disorder (ASD) who take antipsychotic medications lower their body mass index (BMI). Both FDA-approved antipsychotic medications for treating irritability and agitation symptoms in children and adolescents with ASD can cause a significant increase in weight gain, which in addition to increasing BMI, enhances long-term risk of diabetes. This complicates an already challenging issue as adolescents with autism spectrum disorder are ~ two times more likely to be obese than adolescents without developmental disabilities. Findings of this research are important, especially for families of children with ASD, as managing long-term physical health while also treating irritability/agitation symptoms, can help ensure that their child can participate fully in life (school, etc.).

19 Aug

Posted at 20:34h in Alzheimer's - Dementia, Author Interviews, Calcium, Neurology
MedicalResearch.com Interview with: [caption id="attachment_27225" align="alignleft" width="150"]Silke Kern, MD, PhD Neuropsychiatric Epidemiology Unit and Clinical Neurochemistry Laboratory Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg, Sweden Dr. Silke Kern[/caption] Silke Kern, MD, PhD Neuropsychiatric Epidemiology Unit and Clinical Neurochemistry Laboratory Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: Calcium has an important role in ischemic neuronal cell death and atherosclerosis. Several studies suggest that increased serum calcium increases the risk for vascular events and worsens the outcome after stroke. Widespread ischemic neuronal cell death and atherosclerosis might lead to dementia. We therefore examined if Calcium supplementation is associated with development of dementia. Our study is the first to show a relationship between Calcium supplementation and increased risk for dementia in older women. This risk is mainly confined to women with cerebrovascular disease (history of stroke or presence of white matter lesions).

19 Aug

Posted at 00:05h in Author Interviews, Brigham & Women's - Harvard, JAMA, Mental Health Research, OBGYNE
MedicalResearch.com Interview with: [caption id="attachment_27170" align="alignleft" width="179"]Krista F. Huybrechts, M.S., Ph.D. Assistant Professor of Medicine at Harvard Medical School Epidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital. Boston, MA 02120 Dr. Krista Huybrechts[/caption] Krista F. Huybrechts, M.S., Ph.D. Assistant Professor of Medicine Harvard Medical School Epidemiologist Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital Boston, MA 02120 MedicalResearch.com: What is the background for this study? Response: The use of antipsychotic medications during pregnancy has doubled in the last decade. Yet, information on the safety of antipsychotic medication use during pregnancy for the developing fetus is very limited: existing studies tend to be small (the largest study available to date includes 570 exposed women) and findings have been inconsistent. Concerns have been raised about a potential association with congenital malformations. The objective of our study was to examine the risk of congenital malformations overall, as well as cardiac malformations given findings from earlier studies, in a large cohort of pregnant women. We used a nationwide sample of 1.3 mln pregnant women insured through Medicaid between 2000-2010, of which 9,258 used an atypical antipsychotic and 733 used a typical antipsychotic during the first trimester, the etiologically relevant period for organogenesis. We also examined the risks associated with the most commonly used individual medications.

17 Aug

Posted at 23:34h in Accidents & Violence, Author Interviews, Gender Differences, JAMA, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_27045" align="alignleft" width="178"]Edith Chen, Ph.D. Professor Faculty Fellow, Institute for Policy Research Northwestern University Department of Psychology Evanston, IL 60208-2710 Dr. Edith Chen[/caption] Edith Chen, Ph.D. Professor Faculty Fellow, Institute for Policy Research Northwestern University Department of Psychology Evanston, IL 60208-2710 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has documented psychiatric consequences of childhood abuse, but less is known about possible physical health consequences. The main finding is that women who self-reported childhood abuse (in adulthood) were at greater risk for all-cause mortality compared to those who did not report abuse.

16 Aug

Posted at 02:36h in Author Interviews, Autism, Genetic Research, NIH
MedicalResearch.com Interview with: [caption id="attachment_27025" align="alignleft" width="146"]Karen Usdin, Ph. D. Senior Investigator Chief, Gene Structure and Disease Section Laboratory of Cell and Molecular Biology National Institute of Diabetes, Digestive and Kidney Diseases National Institutes of Health Bethesda MD 20892 Dr. Karen Usdin[/caption] Karen Usdin, Ph. D. Senior Investigator Chief, Gene Structure and Disease Section Laboratory of Cell and Molecular Biology National Institute of Diabetes, Digestive and Kidney Diseases National Institutes of Health Bethesda MD 20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our laboratory is interested in the causes and consequences of the unusual repeat expansion mutation that causes the Fragile X-related disorders. However these disorders are challenging to study, in part because the repeat tract is difficult to amplify by PCR. This makes monitoring of repeat length, as well as other factors we are interested in such as methylation status and the presence of AGG interruptions, quite difficult. In our experience, both repeat number and methylation status are very variable in patient stem cells and in disease-relevant cell types derived from them. This variability arises because the repeat is prone to both expansion and contraction and because at different times there can be selection for smaller alleles or against unmethylated ones. Thus the frequent monitoring of repeat length and methylation status is critical for work with patient cells, particularly when those cells are to be used for drug screening or to examine the consequences of expansion. While other assays are available to determine one or more of these parameters, some are cumbersome to use or lack the necessary robustness and sensitivity, whilst others are prohibitively expensive for routine laboratory work. We thus saw a need for assays that are robust, sensitive and cost-effective for preclinical studies.

11 Aug

Posted at 22:01h in Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA, Mental Health Research
MedicalResearch.com Interview with: Helene Lund-Sørensen BM Department of Biomedical Sciences Section of Cellular and Metabolic Research University of Copenhagen MedicalResearch.com: What is the background for this study? What are the main findings? Response: Accumulating research has shown that inflammation and infections are associated with psychiatric diagnoses and interactions between infectious agents, known to affect the brain, and suicidal behavior have been reported. We find an increased risk of death by suicide among individuals hospitalized with infections. The risk of suicide increased in a dose-response relationship with the number of hospitalizations with infections and with the number of days hospitalized with infections. We also examined the risk of suicide association with the time since the last hospitalization with infection and found that infection was linked to an elevated risk with the strongest effect after 1 and 2 years compared with those without infections.

10 Aug

Posted at 10:25h in Aging, Author Interviews, BMJ, Geriatrics, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_26773" align="alignleft" width="180"]Dr. Faiza Tabassum, PhD University of Southampton, Southampton Dr. Faiza Tabassum[/caption] Dr. Faiza Tabassum, PhD Southampton Statistical Sciences Research Institute  University of Southampton Southampton, UK MedicalResearch.com: What is the background for this study? Response: Previous research has shown that volunteering in older age is associated with better mental and physical health, but it’s unclear whether this extends to other age groups. We aimed to examine the association of volunteering with mental health or well-being among the British population across all ages. The British Household Panel Survey (BHPS) was used which has collected information from 1991 to 2008 from over 5000 households. The published study has analysed over 66,000 responses representing the whole of the UK. The BHPS included a wide range of questions on leisure time activities, which covered the frequency of formal volunteering—from at least once a week through to once a year or less, or never. The BHPS also included a validated proxy for mental health/emotional wellbeing known as the GHQ-12.

09 Aug

Posted at 00:57h in Author Interviews, Brigham & Women's - Harvard, Mental Health Research, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_26837" align="alignleft" width="120"]David S. Kroll, MD Harvard Medical School Department of Psychiatry Brigham and Women's Hospital Dr. David Kroll[/caption] David S. Kroll, MD Harvard Medical School Department of Psychiatry Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our primary care clinic has the capacity to provide 9 psychiatry evaluations per week, but before we started this project nearly half of the evaluation appointments went unused due to no-shows, and meanwhile the waiting time was two months. We had tried appointment reminders but this had very little impact on the problem—it turns out that forgetting is only a small part of why patients miss their appointments and that instead they have competing obligations—family, housing, legal, etc. Since the traditional model of scheduling and keeping appointments wasn’t working for so many patients, we implemented a referral-based walk-in clinic instead and found that this significantly increased the number of patients who were seen while virtually eliminating our wait list.

05 Aug

Posted at 23:16h in Author Interviews, Cognitive Issues, Dental Research, Geriatrics, Kidney Disease
MedicalResearch.com Interview with: [caption id="attachment_26794" align="alignleft" width="164"]Danielle Mairead Maire Ni Chroinin, MB BCh BAO BMedSc MD MRCPI FRACP Staff Specialist in Geriatric Medicine Liverpool Hospital and Senior Conjoint Lecturer UNSW Dr. Danielle Ni-Chroinin[/caption] Danielle Mairead Maire Ni Chroinin, MB BCh BAO BMedSc MD MRCPI FRACP Staff Specialist in Geriatric Medicine Liverpool Hospital and Senior Conjoint Lecturer UNSW MedicalResearch.com: What is the background for this study? What are the main findings? Response: Oral disease may have a large impact on older persons’ health and wellbeing, causing pain, impairing speech, adversely affecting nutrition, contributing to systemic infection and harming self-esteem. However, this important issue may be neglected in the acute hospital setting. Our aim was to investigate oral health status and abnormalities in older patients admitted acutely to hospital, exploring the association with medical co-morbidities. We included all individuals aged 70 and older admitted to a geriatric service over 3 months (N=202), and evaluated oral health using a simple bedside tool the Oral Health Assessment Tool (OHAT). Overall, we found that poor oral health was not uncommon, and was associated with dementia and renal impairment. This association persisted even after adjustment for anticholinergic medication and oral pH, highlighting that patients with these conditions may be particularly vulnerable.

05 Aug

Posted at 13:25h in Alzheimer's - Dementia, Author Interviews, Neurological Disorders
MedicalResearch.com Interview with: [caption id="attachment_26735" align="alignleft" width="160"]Auriel Willette, PhD Assistant Professor Departments of Food Science and Human Nutrition, and Psychology Iowa State Universit Dr. Auriel Willette[/caption] Auriel Willette, PhD Assistant Professor Departments of Food Science and Human Nutrition, and Psychology Iowa State University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Alzheimer's disease (AD) field continues to look for biological markers that can detect onset and progression of the disease, mainly memory decline and atrophy of medial temporal lobe where conscious memories are formed. The immune system has long been known to affect the onset and progression of Alzheimer's disease (AD), usually through a process called inflammation in the brain that causes damage to brain cells called neurons. We wished to examine all available immune system data in a large, well-established cohort across the AD spectrum and discover which immune markers best explained memory decline and medial temporal atrophy over 2 years. In essence, among dozens of candidate immune markers, we consistently found two to be most relevant: neuronal pentraxin 2 (NPTX2) and chitinase-3-like-protein-1 (C3LP1). NPTX2 is important for facilitating communication between neurons, whereas C3LP1 is related to activation of a part of the immune system that causes inflammation in the brain. To our surprise, higher NPTX2 levels at baseline were potently related to less memory loss and less medial temporal atrophy over 2 years. C3LP1, by contrast, was a relatively poor predictor. NPTX2 also better predicted levels of amyloid and tau in the brain, which are generally thought to help cause AD. Finally, we found that more years of education led to higher NPTX2 levels, suggesting that more formal learning leads to more stable, stronger connections between neurons that give rise to memory.

02 Aug

Posted at 11:23h in Author Interviews, Brain Injury, JAMA, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_26633" align="alignleft" width="142"]Danny G. Thomas, MD, MPH Department of Pediatrics, Emergency Medicine Children’s Hospital of Wisconsin Corporate Center Milwaukee, WI Dr. Danny Thomas[/caption] Danny G. Thomas, MD, MPH Department of Pediatrics, Emergency Medicine Children’s Hospital of Wisconsin Corporate Center Milwaukee, WI MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a secondary analysis of a randomized controlled trial of strict rest after concussion published last year. We wanted to find out how mental and physical activity levels related to symptom spikes or sudden increases in concussion symptoms. We found that one in three patients had symptoms spikes in recovery. Patients who had symptom spikes tended to have higher symptoms in the emergency department and throughout recovery. Most symptom spikes were not associated with an increase in physical and mental activity level the day prior. We did find that a sudden increase in activity like returning to school did increase the risk of having a symptom spike, but the good news is these symptom spikes seemed to resolve the following day and did not impact recovery by 10 days.

29 Jul

Posted at 23:40h in Accidents & Violence, Addiction, ADHD, Author Interviews
MedicalResearch.com Interview with: [caption id="attachment_26625" align="alignleft" width="150"]Anna Chorniy PhD Postdoctoral Research Associate Center for Health and Wellbeing 321 Wallace Hall, Princeton University Princeton NJ 08544 Dr. Chorniy[/caption] Anna Chorniy PhD Postdoctoral Research Associate Center for Health and Wellbeing Princeton University Princeton NJ 08544 MedicalResearch.com: What is the background for this study? Response: Attention-deficit/hyperactivity disorder (ADHD) is one of the common chronic mental conditions affecting children. In the U.S., 11% of children ages 4–17 (6.4 million) are estimated to have an ADHD diagnosis and almost 70% of them report taking medication for the condition (e.g. Visser et al., 2014). However, little evidence exists on the effects of ADHD treatment on children’s outcomes. We use a panel data set of South Carolina Medicaid claims paid out in 2003–2013 to investigate the effects of ADHD medication treatment on a seldom studied set of outcomes associated with this condition: adolescent risky behaviors and the incidence of injuries. The occurrence of injuries allows us to evaluate short-term effects of ADHD treatment, while substance abuse and risky sexual behavior outcomes speak for the long-term effects of medication. Second, we use Medicaid spending on treatment of these negative events to evaluate the impact of ADHD drugs on the severity of ADHD, and compare the cost of ADHD treatment with the costs of negative health events.

29 Jul

Posted at 23:19h in Author Interviews, Memory
MedicalResearch.com Interview with: [caption id="attachment_26619" align="alignleft" width="148"]Flavio Frohlich PhD Assistant Professor Departments of Psychiatry, Cell Biology and Physiology, Biomedical Engineering, and Neurology Neuroscience Centerm School of Medicine University of North Carolina at Chapel Hill Dr. Flavio Frohlich[/caption] Flavio Frohlich PhD Assistant Professor Departments of Psychiatry, Cell Biology and Physiology, Biomedical Engineering, and Neurology Neuroscience Center School of Medicine University of North Carolina at Chapel Hill MedicalResearch.com: What is the background for this study? Response: Although we do not understand why we sleep, it is clear that sleep is very important for overall well being and health. One of many likely functions of sleep is memory consolidation, the process of stabilizing previously acquired memories. In particular, a brief electric brain activity pattern called the sleep spindle has been shown to correlate with memory consolidation and learning in general. We asked if this brain rhythm causes memory consolidation by using non-invasive feedback brain stimulation to selectively enhance sleep spindles. We applied a weak electric current in the shape of a sleep spindle to the scalp each time our algorithm detected a sleep spindle in the EEG.

29 Jul

Posted at 22:45h in Accidents & Violence, Author Interviews, Columbia, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_26611" align="alignleft" width="133"]J. John Mann MD Paul Janssen Professor of Translational Neuroscience Director, Molecular Imaging and Neuropathology Division Department of Psychiatry Columbia University/New York State Psychiatric Institut Dr. Mann[/caption] J. John Mann MD Paul Janssen Professor of Translational Neuroscience Director, Molecular Imaging and Neuropathology Division Department of Psychiatry Columbia University/New York State Psychiatric Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2014 there were 21,000 firearm suicides in the USA. Overseas, programs that have resulted in major reductions in firearm availability have reduced firearm suicide rates which have also been shown in the USA to be closely correlated with risk of firearm suicide. Reducing access to firearms to those at risk for suicide would help reduce firearm suicide rates in the USA. Most such suicides involve a firearm purchased many years earlier. We recommend methods for reducing such access including improved gun safety and smart gun technology.

29 Jul

Posted at 22:04h in Author Interviews, Depression, Medical Imaging, Mental Health Research, Radiology
[caption id="attachment_26646" align="alignleft" width="200"]Maria A. Oquendo, M.D. Professor of Psychiatry Vice Chair for Education Columbia University Medical Center American Psychiatric Association, President International Academy of Suicide Research, President Dr. Maria Oquendo[/caption] MedicalResearch.com Interview with: Maria A. Oquendo, M.D. Professor of Psychiatry Vice Chair for Education Columbia University Medical Center American Psychiatric Association, President International Academy of Suicide Research, President MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our team has worked for years on identifying the biological underpinnings of both risk for suicidal behavior (SB) and for predicting the lethality or medical consequences of suicidal behavior. We have shown that if you compare those who are depressed and have had SB to those who are depressed but do not have suicidal behavior, you can see clear differences in the serotonin system using Positron Emission Tomography and a molecule tagged with radioactivity. We predicted that if you could see these differences cross-sectionally, then their presence might also predict suicidal behavior and its lethality in the future. Our study showed that those with higher serotonin 1a binding in the raphe nuclei, which likely indicates low serotonin functioning, made more medically damaging suicide attempts in the two years that followed. They also suffered from more pronounced suicidal ideation in the subsequent year.

26 Jul

Posted at 20:36h in Author Interviews, JAMA, Schizophrenia
MedicalResearch.com Interview with: [caption id="attachment_26441" align="alignleft" width="133"]Prof. Jayashri Kulkarni Prof. Jayashri Kulkarni[/caption] Professor Jayashri Kulkarni MBBS, MPM, FRANZCP, PhD Director, Monash Alfred Psychiatry research centre Vic Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Schizophrenia is a complex psychiatric disorder and many patients are not able to achieve remission on the available treatments. There are clear sex differences in many aspects of the illness, which not only implicates a role for the sex hormone estrogen in schizophrenia, but also highlights the need for sex-specific treatments. Our group has conducted many clinical trials using adjunctive estradiol treatment, with excellent improvement in psychotic symptoms- however, there can be physical side effects with longer term estradiol use. Raloxifene and other selective estrogen receptor modulators ( SERMs) - the so-called "brain estrogens", with their more specific brain impacts and less body side effects - provide an option to use longer term estrogen in people with refractory schizophrenia. We conducted the first ever pilot study of raloxifene in 2010, and now present findings from a bigger study of adjunctive raloxifene treatment in schizophrenia.

24 Jul

Posted at 11:45h in Author Interviews, Gastrointestinal Disease, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_26433" align="alignleft" width="150"]Laureate Professor Nicholas J. Talley, MBBS (Hons.)(NSW), MD (NSW), PhD (Syd), MMedSci (Clin Epi)(Newc.), FRACP, FAFPHM, FAHMS, FRCP (Lond. & Edin.), FACP, FACG, AGAF, FAMS, FRCPI (Hon), GAICD Pro Vice-Chancellor, Global Research, University of Newcastle, Australia Professor of Medicine, Faculty of Health and Medicine, University of Newcastle, Australia Prof. Nicholas Talley[/caption] Laureate Professor Nicholas J. Talley, MBBS (Hons.)(NSW), MD (NSW), PhD (Syd), MMedSci (Clin Epi)(Newc.), FRACP, FAFPHM, FAHMS, FRCP (Lond. & Edin.), FACP, FACG, AGAF, FAMS, FRCPI (Hon), GAICD Pro Vice-Chancellor, Global Research, University of Newcastle, Australia Professor of Medicine, Faculty of Health and Medicine, University of Newcastle, Australia President, Royal Australasian College of Physicians Chair, Committee of Presidents of Medical Colleges Hon. Treasurer, Australian Academy of Health and Medical Sciences Editor-in-Chief, Medical Journal of Australia Senior Staff Specialist, John Hunter Hospital, Newcastle, Australia Professor of Medicine and Professor of Epidemiology, Joint Supplemental Consultant Gastroenterology and Health Sciences Research, Mayo Clinic, Rochester, MN, USA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Functional gastrointestinal diseases (FGIDs) like the irritable bowl syndrome (IBS) are very common, cause major distress including pain and psychological dysfunction, impact on quality of life and drive high health care costs. We speculated that there are two distinct types of functional gastrointestinal disease that others have not recognized. For example, IBS in a subgroup may first begin with gut symptoms (pain, diarrhea, constipation, bloating etc) in those free of psychological distress and only later does new onset anxiety or depression develop, implicating gut disease as the primary driver of the entire symptom complex (a gut-to-brain disease). On the other hand, we speculated there is another quite different subgroup where disease begins with anxiety or depression and only later do new onset gut symptoms develop, and this is likely primarily a central nervous system cause (probably through the stress system), or a brain-to-gut disease. This is exactly what we found, with gut disease occurring first followed by new onset psychological distress in about two thirds of people from the community over a one year follow-up.

23 Jul

Posted at 12:46h in Author Interviews, Depression, Lancet
[caption id="attachment_26402" align="alignleft" width="189"]MedicalResearch.com Interview with: 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 MedicalResearch.com: 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. MedicalResearch.com: What are the main findings? Response: We found that behavioural activation, a simpler psychological treatment than CBT, can be delivered by junior mental health workers with less intensive and costly training, with no lesser effect than CBT. Effective psychological therapy for depression can be delivered without the need for costly and highly trained professionals MedicalResearch.com: What should readers take away from your report? Response: Our findings have substantial implications given the increasing global pressure for cost containment across health systems in high-income countries and the need to develop accessible, scalable interventions in low-income and middle-income countries. Such countries might choose to investigate the training and employment of junior workers over expensive groups of psychological professionals. Our results, therefore, offer hope to many societies, cultures, and communities worldwide, rich and poor, struggling with the effect of depression on the health of their people and economies. MedicalResearch.com: What recommendations do you have for future research as a result of this study? Response: Research into these and other potential strengths of behavioural activation in the context of implementation science is necessary for the hope and promise offered by the COBRA trial to be fulfilled. Now that we have support for BA as a treatment that is clinically effective and cost-effective, we can shift our efforts to focus on what is necessary to produce sustainable large-scale behavioural activation implementation across diverse geographical and cultural settings. MedicalResearch.com: Is there anything else you would like to add? Response: Although many obstacles exist to successful dissemination in addition to training of Mental Health Workers, our findings suggest that health services globally could reduce the need for costly professional training and infrastructure, reduce waiting times, and increase access to psychological therapies. MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community. Citation: Lancet Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority trial Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. More Medical Research Interviews on MedicalResearch.com Prof. David Richards[/caption] MedicalResearch.com 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 MedicalResearch.com: 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.

21 Jul

Posted at 14:28h in Author Interviews, Mental Health Research, Pharmacology, Schizophrenia
MedicalResearch.com Interview with: [caption id="attachment_26361" align="alignleft" width="125"]Glorimar Ortiz, MS Senior Researcher/Statistician NRI-National Association of State Mental Health Program Directors Research Institute Falls Church, VA 22042 Glorimar Ortiz[/caption] Glorimar Ortiz, MS Senior Researcher/Statistician NRI-National Association of State Mental Health Program Directors Research Institute Falls Church, VA 22042 MedicalResearch.com: 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.

20 Jul

Posted at 18:47h in Author Interviews, Karolinski Institute, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_26300" align="alignleft" width="150"]Lorena Fernández de la Cruz | Assistant Professor Department of Clinical Neuroscience | Karolinska Institutet Child and Adolescent Psychiatry Research Center Stockholm Lorena Fernández de la Cruz[/caption] Lorena Fernández de la Cruz | Assistant Professor Department of Clinical Neuroscience | Karolinska Institutet Child and Adolescent Psychiatry Research Center Stockholm MedicalResearch.com: 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.

19 Jul

Posted at 23:17h in Alcohol, Author Interviews, Memory
MedicalResearch.com 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 MedicalResearch.com: 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.

19 Jul

Posted at 00:53h in Author Interviews, PTSD, Sleep Disorders
MedicalResearch.com Interview with: [caption id="attachment_26240" align="alignleft" width="170"]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 Dr. Jim Burch[/caption] 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 MedicalResearch.com: 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.

18 Jul

Posted at 18:49h in Author Interviews, Depression, JAMA, Mental Health Research, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_26212" align="alignleft" width="200"]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 AU Dr. Carmen Pace[/caption] 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 MedicalResearch.com: 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.