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Author Interviews, Eating Disorders, JAMA, Karolinski Institute, Mental Health Research / 17.01.2016

More on Eating Disorders from MedicalResearch.com MedicalResearch.com Interview with: Shuyang Yao, MSc Department of Medical Epidemiology and Biostatistics Karolinska Institutet, Stockholm, Sweden Medical Research: What is the background for this study? Response: Suicide risk is much higher in individuals with eating disorders than individuals without the disorders. The mechanism underlying the high suicide risk in eating disorders (i.e., why?) is not clear. Large studies and genetically informative designs can help us understand the nature of the association between suicide attempts and eating disorders. Medical Research: What are the main findings? 1) Eating disorders are associated with increased risk of suicide attempts and death by suicide. 2) Increased risk of suicide attempts is also found in relatives of individuals with eating disorders. 3) Some, but not all of the increased risk for suicide in individuals with eating disorders is accounted for by the presence of comorbid major depressive, anxiety, and substance use disorders. (more…)
ALS, Alzheimer's - Dementia, Author Interviews, JAMA, Multiple Sclerosis, Neurological Disorders, Stem Cells / 12.01.2016

MedicalResearch.com Interview with: Prof. Dimitrios Karussis M.D., Ph.D. Professor of Neurology Head, Multiple Sclerosis Center Hadassah BrainLabs Medical Research: What is the background for this study? What are the main findings? Prof. Karussis: BrainStorm Cell Therapeutics is developing innovative, autologous stem cell therapies for highly debilitating neurodegenerative diseases such as Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis (MS), and Parkinson’s Disease (PD).  Our technology, NurOwn™ is a first-of-its-kind approach that induces autologous bone marrow-derived Mesenchymal Stem Cells (MSCs) to secrete Neurotrophic Growth Factors (NTFs).  These MSC-NTF cells have been shown to be protective in several animal models of neurodegenerative diseases. Data from the clinical trials described in the recent issue of the Journal of American Medicine – Neurology (JAMA Neurology), suggest that NurOwn can help patients with ALS.  The two trials featured in the article, a phase 1/2 and a phase 2a, studied the transplantation NurOwn cells in ALS patients.  These trials confirmed the excellent safety profile of NurOwn and suggest a clinically meaningful effect. The investigators used two well established clinical endpoints that measure disease activity in ALS, the Revised ALS Functional Rating Scale and Forced Vital Capacity, and were able demonstrate a slowing of disease activity in the period following treatment. (more…)
Author Interviews, Depression, JAMA, Surgical Research, UCLA, Weight Research / 12.01.2016

MedicalResearch.com Interview with: Aaron J. Dawes, MD Fellow, VA/RWJF Clinical Scholars Program Division of Health Services Research University of California Los Angeles Los Angeles, CA 90024 Medical Research: What is the background for this study? What are the main findings? Dr. Dawes: We reviewed the published literature to answer three basic questions about bariatric surgery and mental health conditions. First, how common are mental health conditions among patients being referred for or undergoing bariatric surgery?
  • Second, do patients who carry a diagnosis of one of these conditions lose less weight after surgery than patients without these conditions?
  • And, third, what happens to the clinical course of mental health conditions after patients undergo surgery? Do they get better, worse, or stay the same?
We found that mental health conditions are surprisingly common among bariatric patients, especially depression and binge eating disorder, which occur at almost twice the rate among bariatric patients than in the general U.S. population. We also found no strong evidence to suggest that patients with depression lose less weight after surgery and some evidence that the condition may actually improve after surgery. Eleven of the twelve studies on the topic found either lower rates or fewer symptoms of depression, at least during the first 3 years post-operatively. (more…)
Accidents & Violence, Author Interviews, Autism, JAMA / 12.01.2016

MedicalResearch.com Interview with: Diana Schendel, Professor MSO Department of Public Health Institute of Epidemiology and Social Medicine and Department of Economics and Business                             National Centre for Register-based Research Aarhus University Denmark Medical Research: What is the background for this study? What are the main findings? Dr. Schende: Elevated mortality has been reported in persons with autism spectrum disorder (ASD), especially with comorbid epilepsy and intellectual disability. The effect of comorbidity on the risk for mortality in ASD, however, has not been rigorously examined in large, population-based studies. Our study aim was to investigate ASD mortality patterns overall and to assess the specific effects of comorbid mental, behavioral, and neurologic disorders on ASD mortality into young adulthood. Our study comprised a nation-wide Danish cohort of 1.9 million children of whom 20,492 were diagnosed with ASD. We observed 68 deaths in persons with ASD; 83% of the persons with ASD who died had comorbid mental/behavioral or neurologic disorders. The risk for mortality was two-fold higher in persons with autism spectrum disorder overall. An elevated risk for mortality was also seen in persons who had ASD only, or had both ASD and other neurologic or mental/behavioral disorders, compared to persons without these other morbidities and no ASD. However, the co-occurrence of ASD in persons with neurologic, or with mental/behavioral disorders, added no additional mortality risk compared to persons with these disorders and no autism spectrum disorder. These results suggest that the mechanisms underlying mortality risk in ASD in part may be shared with these other disorders, although what might be the specific shared mechanisms cannot be determined with these data. (more…)
Author Interviews, Depression, Hormone Therapy, JAMA, Menopause / 08.01.2016

MedicalResearch.com Interview with: Eleni Petridou, MD, MPH, PhD Marios K. Georgakis, MD Department of Hygiene, Epidemiology and Medical Statistics School of Medicine National and Kapodistrian University of Athens Athens, Greece Medical Research: What is the background for this study? Response: Previous epidemiologic studies have shown that women during their reproductive life are more vulnerable (by a factor of two) to depression than men; this has been particularly evident during peaks of intense fluctuations of ovarian hormones, like the premenstrual, perimenopausal and postpartum periods. Endogenous (natural) female sex hormones, however, have been shown in various experimental studies to possess neuroprotective and anti-depressive properties. Production of these hormones is diminished after menopause; therefore, age at menopause can be used as a proxy of the lifetime exposure to endogenous hormones. Our research hypothesis was whether longer exposure to endogenous sex hormones has a cumulative anti-depressive action, i.e., whether later age at menopause decreases the risk for postmenopausal depression. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, PTSD, Vanderbilt / 07.01.2016

MedicalResearch.com Interview with: Mayur Patel, MD, MPH, FACS Assistant Professor of Surgery & Neurosurgery Vanderbilt University Medical Center Staff Surgeon and Surgical Intensivist Nashville VA Medical Center Medical Research: What is the background for this study? Dr. Patel: Post-traumatic stress disorder (PTSD) can occur in patients after the traumatizing events of critical illness. Survivors of critical illness have reported PTSD symptoms months to even years after critical illness, possibly related to nightmare-like experiences, safety restraints creating communication barriers, and protective mechanical ventilation causing feelings of breathlessness and fear of imminent death. But, the epidemiology of PTSD after critical illness is unclear with wide ranging estimates (0-64%) and largely fails to distinguish past PTSD from new PTSD specifically resulting from the critical care experience. Our study provides estimates on new cases of PTSD stemming specifically from the ICU experience. Pre-existing PTSD has rarely been systematically assessed in prior cohorts, and our work took extra effort to distinguish pre-existing PTSD from new PTSD cases. Civilian populations have dominated the literature of PTSD after critical illness, and this research is the first to also include the expanding and aging Veteran population.  (more…)
Author Interviews, Gender Differences, Mental Health Research, Race/Ethnic Diversity / 07.01.2016

MedicalResearch.com Interview with: Silvia Sara Canetto, Ph.D., Professor Faculty in the Department of Psychology, and Affiliate Faculty in the Center for Women's Studies and Gender Research, Department of Ethnic Studies, and in the Human Development and Family Studies Department Colorado State University  Medical Research: What is the background for this study? Dr. Canetto: In the United States, older men of European descent (so called white men) have significantly higher suicide rates than any other demographic group. For example, their suicide rates are significantly higher than those of older men of African, Latino or Indigenous descent, as well as relative to older women across ethnicities. Behind these facts there is a cultural story, not just individual journeys of psychological pain and despair. Colorado State University’s Silvia Sara Canetto has spent a large portion of her research career seeking to uncover cultural stories of suicide. A professor in the College of Natural Sciences’ Department of Psychology, Canetto adds a new chapter to that story in an article recently published in the journal Men and Masculinities. The article features a critical review of theories and research on suicide among older men. (more…)
Author Interviews, Depression, OBGYNE, Pharmacology / 06.01.2016

MedicalResearch.com Interview with: Anick Bérard PhD FISPE Research chair FRQ-S on Medications and Pregnancy and Director, Réseau Québécois de recherche sur le médicament (RQRM) and Professor, Research Chair on Medications, Pregnancy and Lactation Faculty of Pharmacy University of Montreal and Director, Research Unit on Medications and Pregnancy Research Center CHU Ste-Justine  Medical Research: What is the background for this study? What are the main findings? Dr. Bérard: Paroxetine (one of the most used antidepressant during pregnancy) has been studied extensively over the past 10-12 years. In 2005, a black box warning was put on the Paxil label to caution against use during pregnancy due to the increased risk of cardiac defects. The ACOG 2010 guidelines also suggested switching to other antidepressants during pregnancy. Over the past decade, many studies, including meta-analyses, were performed on on paroxetine use during pregnancy and the risk of cardiac malformations - but results were sometimes statistically significant or not, although a consistent increased risk was observed. It was thought that these variations could be explained by different study designs, patient populations, and because maternal depression was not always taken into account correctly. Hence, we undertook another meta-analysis (the most recent and updated) to quantify the risk of cardiac defects overall as well as specific cardiac defects associated with paoxetine use during pregnancy and to assess the impact of study designs, maternal depression and patient population on the effect of the risk. We found that women using paroxetine during the first trimester of pregnancy (critical time-window for malformations) were 23% more at risk of having a child with malformations (15 studies combined) - baseline risk of malformation is 3-5% and thus a 23% increased risk is 3.69-6.15% absolute risk; women using paroxetine during the first trimester of pregnancy were 28% more at risk of having a child with cardiac malformations (18 studies combined) - baseline risk of cardiac malformation is 1% and thus a 28% increased risk is 1.28% absolute risk. We found that paroxetine was increasing the risk of many specific cardiac defects as well. Although the estimates varied depending on the comparator group, study design, and malformation detection period, a trend towards increased risk was observed. (more…)
Author Interviews, JAMA, Mental Health Research / 04.01.2016

MedicalResearch.com Interview with: Josephine Mollon MSc Department of Psychosis Studies Institute of Psychiatry, Psychology, and Neuroscience King’s College London London, England  Medical Research: What is the background for this study? What are the main findings? Dr. Mollon: Psychotic symptoms, such as hallucinations and delusions, are core features of psychotic disorders. A significant minority of the general population also reports subclinical psychotic experiences. Evidence suggests that these experiences may lie on a continuum with clinically significant psychotic symptoms. For example, cognitive deficits, which are a hallmark of psychotic disorders, are also seen in people with subclinical psychotic experiences. We used population-based survey data to characterize cognitive functioning in adults with psychotic experiences while adjusting for important sociodemographic characteristics and investigating the effect of age. The 171 (9.7%) adults with psychotic experiences showed significant memory and verbal deficits, but not IQ or processing speed deficits. Only participants 50 years and older with psychotic experiences showed medium to large impairments in general IQ, verbal knowledge, working memory and memory after adjusting for socioeconomic status, cannabis use, and common mental disorders. (more…)
Author Interviews, Autism, Pediatrics, Pharmacology / 02.01.2016

MedicalResearch.com Interview with: Diane C. Chugani, PhD Director, Nemours Neuroscience Research Nemours—AI DuPont Hospital for Children Wilmington, DE 19803  Medical Research: What is the background for this study? What are the main findings? Dr. Chugani: This clinical trial was performed at 5 sites throughout the country and was lead by our team at Wayne State University and Children’s Hospital of Michigan in Detroit.  The study was sponsored by the National Institutes of Health through an Autism Centers of Excellence Network grant.  Based upon our previous PET scanning studies showing low  serotonin synthesis  in the brains of young children with autism, we tested whether the serotonin-like drug buspirone would be beneficial in treating young children with Autism Spectrum Disorder.  We found that low doses of buspirone were effective in reducing repetitive behaviors with no significant side effects in this group of children. (more…)
Author Interviews, Nutrition, Schizophrenia / 19.12.2015

MedicalResearch.com Interview with: Zoltan Sarnyai, M.D., Ph.D. Associate Professor of Pharmacology Head, Laboratory of Psychiatric Neuroscience Australian Institute of Tropical Health and Medicine (AITHM) Comparative Genome Centre Centre for Biodiscovery and Molecular Development of Therapeutics James Cook University Townsville, Australia Medical Research: What is the background for this study? Dr. Sarnyai: Schizophrenia has long been conceptualized as a disease contributed by the increased activity of the neurotransmitter system that provides dopamine for the brain. All clinically used antipsychotic drugs inhibit dopamine transmission in the brain by blocking dopamine receptors. These drugs have only a limited efficacy on a certain set of symptoms associated with schizophrenia. More recent research has uncovered that abnormal glucose and energy metabolism in the brain may contribute in the development of schizophrenia. This is not altogether surprising considering that our brain is using a disproportionately high amount of glucose to fuel neurotransmission (cell-to-cell communication in the brain), to maintain normal electrical activity of nerve cells and to deal with damaging free oxygen radicals. Therefore, even relatively small changes in the machinery that is required to provide energy for the brain cells can have very significant impact on brain function. In fact, recent studies have identified altered expression of genes and proteins that are responsible for enzymatic breakdown of glucose and proper handling of the metabolites to create the energy-rich molecule ATP. In addition, recent research shows decreased number and impaired function of the mitochondria, the powerhouses of the cell, in the brain of individuals with schizophrenia.  These recent results that show abnormal energy metabolism in schizophrenia raise the possibility of targeting metabolic pathways for therapeutic benefit in this condition. Ketogenic diet provides and alternative source of energy to the brain through fatty acids. Furthermore, since this diet is very low in carbohydrates, almost all the energy needs of the cells comes from breaking down fat (fatty acids) as opposed to glucose. This can circumvent the classic glucose metabolic pathways that maybe impaired in the disease. Also, breaking down fatty acids produces 40% more of the energy-rich molecule ATP than breaking down the carbohydrate glucose. Altogether, ketogenic diet may provide extra energy and can help neurotransmission in the brain, leading to the improvement of neurobiological processes underlying schizophrenia. (more…)
Author Interviews, Breast Cancer, Cancer Research, Depression / 17.12.2015

MedicalResearch.com Interview with: Ruhi Kanani  Cancer Epidemiology and Population Health Research Oncology King's College London London, UK  MedicalResearch.com: What is the background of this study? What are the main findings? Response: There is a long history of research investigating the possible association between psychological and physical health. This study is the first to analyse cancer registration information and hospital records of depression for a large group of women with breast cancer in South East England. 77, 173 women diagnosed with breast cancer between 2000 and 2009 were included and followed until the end of 2010. 955 women had a record of depression, 422 before, and 533 in the year after their cancer diagnosis. The results showed that women with a record of depression had a worse overall survival. This was particularly so for those with a  new record of depression after the cancer diagnosis, who had a 45% higher risk of death from all causes compared to those who didn’t develop depression after their cancer diagnosis. (more…)
Author Interviews, BMJ, Mental Health Research / 16.12.2015

MedicalResearch.com Interview with: Dr. Rashmi Patel MA (Cantab) MA BM BCh PGDip (Oxon) MRCPsych Psychiatry King's College London, London  Medical Research: What is the background for this study? What are the main findings? Dr. Patel: Antidepressants are a safe and effective treatment for depression. However, in a minority of cases, people who take antidepressants can also develop symptoms of elevated mood and mania as part of a bipolar disorder. This is important because although bipolar disorder is uncommon, people who are affected often first present with symptoms of depression and, if left untreated, bipolar disorder can be very distressing and significantly affect social and occupational functioning. In our study we investigated the association of antidepressants with mania in people with depression receiving care from the South London and Maudsley NHS Foundation Trust, a large provider of specialist mental healthcare in South London (UK). We found that antidepressants were widely prescribed and associated with a small increased risk in developing mania. However, we did not demonstrate a causal association between antidepressants and mania. Instead, it is likely that people who developed symptoms of mania with antidepressants already had a propensity towards developing mania prior to antidepressant treatment. (more…)
Author Interviews, Cognitive Issues, Weight Research / 16.12.2015

MedicalResearch.com Interview with: Dr Anne Martin PhD Research Associate/Research Fellow Physical Activity for Health Research Centre (PAHRC) Institute for Sport, PE & Health Sciences University of Edinburgh TeleScot Research Group Usher Institute for Population Health Sciences and Informatics Edinburgh Medical Research: What is the background for this study? What are the main findings? Dr. Martin: Impairments in cognitive development during childhood can have detrimental effects on health behaviour, educational attainment, and socio-economic status later in life. Epidemiological evidence indicates an association between childhood obesity and cognition and educational attainment. Knowledge of when obesity related deficits in cognition and attainment emerge, and how large the deficits are at various ages, may be useful to support arguments for school-based obesity prevention initiatives and in translating evidence on this topic into policy aimed at preventing obesity. In this study we explored whether the adverse association between obesity and cognition emerges in early childhood. Measures of cognitive abilities included visuo-spatial skills, expressive language skills and reasoning skills. Our findings indicated that obesity in the pre-school years may be weakly associated with some poorer cognitive outcomes at age 5 years in boys, independently of socioeconomic status. Stronger relationships between obesity and cognition or educational attainment may emerge later in childhood. Evidence from an English cohort study suggested an adverse association between obesity in teenage girls and lower academic attainment in Mathmatics, Science and English. (more…)
Author Interviews, JAMA, Mental Health Research, MRI, Neurological Disorders / 12.12.2015

MedicalResearch.com Interview with: Stephane De Brito, PhD Birmingham Fellow School of Psychology Robert Aitken Building, Room 337a University of Birmingham  UK Medical Research: What is the background for this study? What are the main findings? Dr. De Brito: In the last decade, an increasing number of neuroimaging studies have used structural magnetic resonance imaging (sMRI) to examine the brains of youths who show behavioural problems that include antisocial and aggressive behaviour. Those studies have mostly relied on a method called voxel-based morphometry (or VBM), which is a whole-brain and automated technique that allows researchers to objectively assess the local composition of brain tissue, such as grey matter volume. The main problem is that the findings from those sMRI studies have been quite disparate and few have been replicated, partly due to differences in sample sizes and characteristics across studies. Therefore, we set out to carry out a meta-analysis of the available data to provide a clearer account of the literature on this topic. A particular strength of our meta-analysis is that we used the original brain imaging maps (also referred to as statistical parametric maps) from 11 of the 13 studies, which makes our analysis more accurate and reliable. The final sample comprised of 394 youths with behavioural problems and 350 typically developing youths, making it the largest study on this topic to date. Our results showed that, compared to typically developing youths, those with behavioural problems show reduced grey matter volume in the amygdala, the insula, and the prefrontal cortex. These brain areas have been shown to be important for decision-making, empathic responses, processing facial expressions and emotion regulation; key cognitive and affective processes that are shown to be deficient in youths with behavioural problems. (more…)
Author Interviews, Cancer Research, Depression, MD Anderson, Tobacco / 11.12.2015

MedicalResearch.com Interview with: Dr. Eileen H. Shinn PhD Assistant Professor, Department of Behavioral Science Cancer Prevention and Population Sciences MD Anderson Cancer Center The University of Texas Houston, TX  Medical Research: What is the background for this study? What are the main findings? Dr. Shinn: Recent studies with leukemia, breast, lung, renal and liver cancer patients have shown that patients with depression have worsened survival.  These effect sizes are small, but independent of any of the traditional factors that are known to impact survival, such as extent of cancer, types of treatment administered and baseline health and age of the patient.  The current thinking is that cancer patients who are depressed have chronically heightened responses to stress; the constant release of stress hormones trigger changes in the tumor itself (such as noradrenergically-driven tumor angiogenesis) or may weakens the body’s immune function and ability to resist tumor growth. When we measured depression in newly diagnosed patients with oropharyngeal cancer (cancer of the base of tongue and tonsil), we found that those patients who scored as depressed were 3.5 times more likely to have died within the five year period after their diagnosis, compared to nondepressed patients.  We also found that patients who were depressed were also 3.8 times more likely to have their cancer recur within the first five years after diagnosis.  We also found that patients who continued to smoke after diagnosis were more likely to recur within the first five years. These effect sizes were larger than those typically found in recent studies.  We believe that the larger effect size may be due to the tight eligibility criteria ( e.g., we did not include patients who already had recurrent disease, we only included patients with one specific type of head and neck cancer, oropharyngeal) and also due to controlling other known factors (all patients completed individualized treatment regimens of radiation/ chemoradiation at a comprehensive cancer center and patients with more advanced disease stage were more likely to have received treatment intensification compared to patients with early stage disease).  In all, we had 130 patients, one of the largest prospective studies with oropharyngeal cancer to examine the effect of depression on cancer outcome. (more…)
Alcohol, Alzheimer's - Dementia, Author Interviews, BMJ / 11.12.2015

MedicalResearch.com Interview with:

Professor, Frans Boch Waldorff General Practitioner Research Unit of General Practice Denmark

MedicalResearch: What is the background for this study? What are the main findings? Prof. Waldorff: While there are numerous studies focusing on alcohol as a risk factor for dementia and mortality in healthy subjects, virtually no attention has been paid to the effect of alcohol consumption in patients with Alzheimer’s disease (AD). Considering that AD is a neurodegenerative disorder and that alcohol has known neurotoxic effects, one could easily jump to the conclusion that alcohol is damaging for patients with AD. The aim of this study was to investigate whether the positive association between moderate alcohol intake and mortality shown in population-based studies on healthy subjects can be transferred to patients with mild AD. In our study we found that patients with mild  Alzheimer’s disease , moderate alcohol consumption (two to three units per day) was associated with a significantly lower risk of death compared with those who only had alcohol occasionally (one or less than one unit per day), and with those who had high alcohol intake (more than 3 units per day). Abstinence or high alcohol intake did not significantly raise mortality compared with those drinking only occasionally. (more…)
Alzheimer's - Dementia, Author Interviews, Journal Clinical Oncology, Prostate Cancer, Testosterone, University of Pennsylvania / 10.12.2015

MedicalResearch.com Interview with: Kevin T. Nead, MD, MPhil Dept. of Radiation Oncology Perelman School of Medicine University of Pennsylvania MedicalResearch: What is the background for this study? What are the main findings? Dr. Nead: There are a growing number of studies suggesting that the use of  Androgen Deprivation Therapy (ADT)  may be associated with cognitive changes and some of these changes overlap with characteristic features of Alzheimer’s disease. In addition, low testosterone levels have been associated with Alzheimer’s disease risk and ADT lowers testosterone levels. Despite these findings, we could not identify any studies examining the association between ADT and Alzheimer’s disease risk. We therefore felt this study could make an important contribution in guiding future research to fully understand the relative risks and benefits of ADT. We examined electronic medical record data from Stanford University and Mt. Sinai hospitals to identify a cohort of 16,888 patients with prostate cancer. We found that men with prostate cancer who received Androgen Deprivation Therapy were more likely to develop Alzheimer’s disease than men who did not receive  Androgen Deprivation Therapy. We also found that this risk increased with a longer duration of ADT. These results were consistent using multiple statistical approaches and separately at both Stanford and Mr. Sinai. (more…)
Author Interviews, Depression, Education, JAMA / 09.12.2015

MedicalResearch.com Interview with: Douglas A. Mata, M.D., M.P.H. Anatomic and Clinical Pathology Resident Physician, Brigham & Women’s Hospital Clinical Fellow, Harvard Medical School Boston, MA 02115 Marco A. Ramos, M.Phil., M.S.Ed. History of Science and Medicine M.D./Ph.D. Candidate, Yale School of Medicine New Haven, CT 06511 Medical Research: What is the background for your study? Dr. Mata: Training to be a doctor is clearly stressful, but the prevalence of depression among trainees is not well known. They may get especially depressed during their grueling years of residency, when young physicians are learning their craft by working long hours and taking care of critically ill patients. Coming up with a reliable estimate of the prevalence of depression among graduate medical trainees would help us identify causes of resident depression and begin to treat or prevent it. We thus aimed to find answers to two questions:
  • First, what percentage of new doctors might be depressed?
  • Second, how much has that changed over time?
Medical Research: What are the main findings? Dr. Mata: We set out to find every study ever published on this subject. We analyzed 50 years of research on depression in resident physicians. We collected and combined data from 54 studies conducted around the world, and found that a startling 29% of physicians in training have signs of depression. We also detected a small but significant increase in the prevalence of depression over the five decades the study covered. Mr. Ramos: Twenty-nine percent is a concrete number you can hang your hat on, so to speak. But this number alone doesn’t capture the extent of the problem. We conducted additional studies that revealed that up to 43% of residents have depressive symptoms. (more…)
Author Interviews, BMJ, Depression / 08.12.2015

MedicalResearch.com Interview with: Halle Amick, research associate Sheps Center for Health Services Research University of North Carolina at Chapel Hill Chapel Hill, NC Medical Research: What is the background for this study? What are the main findings? Response: Major depressive disorder (MDD) affects more than 32 million Americans and millions more worldwide. Many patients first seek care from a primary care provider, and the most common treatment initiated in that setting is medication. Although there is an evidence base that shows certain psychotherapies to be effective treatments, primary care providers may not be familiar enough with psychotherapy to present it as a treatment option. We conducted a full review of clinical trials that compared antidepressant medication—specifically second-generation antidepressants (SGAs)—with cognitive behavioral therapy (CBT). We found that symptom improvement and rate of remission were similar between SGAs and CBT, whether they were used alone or in combination with each other. We also found no difference in the rates of withdrawal from the clinical trials either overall or due to adverse events. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Mental Health Research / 05.12.2015

MedicalResearch.com Interview with: Dr. Jamie Stagl, PhD Was a Ph.D. student in Psychology at University of Miami during the research period Currently, a post-doctoral fellow in Psychiatric Oncology Massachusetts General Hospital Cancer Center in Boston Medical Research: What is the background for this study? What are the main findings? Dr. Stagl: This is a newly published finding from a randomized trial funded by the National Cancer Institute that showed that women with breast cancer who received stress management skills early on in their treatment had longer survival and longer time without breast cancer recurrence at eight to 15 years after their initial diagnosis. This secondary analysis is published online and in the November 2015 issue of Breast Cancer Research and Treatment. The study was conducted by senior investigator, Michael Antoni, Ph.D., Survivorship Theme Leader of the Cancer Control research program at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine and Professor of Psychology and Psychiatry and Behavioral Sciences, and his research team, including lead author Jamie Stagl, Ph.D., currently a postdoctoral fellow at Massachusetts General Hospital Cancer Center in Psychiatric Oncology and Behavioral Sciences. In this trial, women received an intervention called Cognitive-Behavioral Stress Management, which was created by Dr. Michael Antoni at the University of Miami. After surgery for breast cancer, women received 10 weekly, group-based sessions of skills to manage stress based in cognitive-behavioral strategies and relaxation training. Women learned muscle relaxation, mindfulness meditation, and breathing exercises to promote relaxation. Women also learned strategies for altering negative thoughts, worries, and improve coping. Previous studies by Dr. Antoni and his research team have shown that women who received these stress management skills had better psychological adjustment, less distress, and less anxiety through treatment. Dr. Stagl recently published findings showing that these women had less depressive symptoms and better quality of life during survivorship. The current study shows that these women may also benefit from stress management in terms of risk of disease progression and mortality. (more…)
Alzheimer's - Dementia, Author Interviews, Nature, UCSF / 03.12.2015

MedicalResearch.com Interview with: Elsa Suberbielle, DVM, PhD Research Scientist Gladstone Institute of Neurological Diseases San Francisco, CA 94158 Medical Research: What is the background for this study? Dr. Suberbielle: BRCA1 is a key protein involved in DNA repair, and mutations that impair its function increase the risk for breast and ovarian cancer. Research into DNA repair mechanisms in dividing cells recently was recently rewarded by the Nobel Prize in Chemistry. In such cells, BRCA1 helps repair a type of DNA damage known as double-strand breaks that can occur when cells are injured. In neurons, though, such breaks can occur even under normal circumstances, for example, after increased brain activity, as shown by the team of Gladstone scientists in an earlier study. The researchers speculated that in brain cells, cycles of DNA damage and repair facilitate learning and memory, whereas an imbalance between damage and repair disrupts these functions. Medical Research: What are the main findings? Dr. Suberbielle In a new study published in Nature Communications, Researchers from the Gladstone Institutes demonstrates that Alzheimer’s disease is associated with a depletion of BRCA1 in neurons and that BRCA1 depletion can cause cognitive deficits. The researchers experimentally reduced BRCA1 levels in the neurons of mice. Reduction of the DNA repair factor led to an accumulation of DNA damage and to neuronal shrinkage. It also caused learning and memory deficits. Because Alzheimer’s disease is associated with similar neuronal and cognitive problems, the scientists wondered whether they might be mediated by depletion of BRCA1. They therefore analyzed neuronal BRCA1 levels in post-mortem brains of Alzheimer’s patients. Compared with non-demented controls, neuronal BRCA1 levels in the patients were reduced by 65-75%. To determine the causes of this depletion, the investigators treated neurons grown in cell culture with amyloid-beta proteins, which accumulate in Alzheimer brains. These proteins depleted BRCA1 in the cultured neurons, suggesting that they may be an important cause of the faulty DNA repair seen in Alzheimer brains. Further supporting this conclusion, the researchers demonstrated that accumulation of amyloid-beta in the brains of mice also reduced neuronal BRCA1 levels. They are now testing whether increasing BRCA1 levels in these mouse models can prevent or reverse neurodegeneration and memory problems. (more…)
Author Interviews, Breast Cancer, Depression, JNCI, Kaiser Permanente / 03.12.2015

MedicalResearch.com Interview with: Reina Haque, PhD, MPH Research scientist Department of Research & Evaluation Kaiser Permanente Southern California Pasadena Calif Medical Research: What is the background for this study? What are the main findings? Dr. Haque: Tamoxifen is a commonly prescribed generic drug taken by women with breast cancer to reduce their chances of developing a recurrence. Tamoxifen is recommended for five years, but has notable side effects, including hot flashes, night sweats and depression. Since hormone replacement therapy is not recommended to alleviate these symptoms in breast-cancer survivors, antidepressants have been increasingly prescribed for relief. Almost half of the 2.4 million breast-cancer survivors in the U.S. take antidepressants. However, previous studies have suggested that antidepressants reduce tamoxifen's effectiveness in lowering subsequent breast-cancer risk. This study was conducted to determine whether taking tamoxifen and antidepressants (in particular, paroxetine) concomitantly is associated with an increased risk of recurrence or contralateral breast cancer. (more…)
Author Interviews, Cognitive Issues, Exercise - Fitness, JAMA, Lifestyle & Health / 02.12.2015

MedicalResearch.com Interview with: Tina Hoang MSPH Staff Research Associate Northern California Institute for Research and Education, Veterans Affairs Medical Center Dr. Kristine Yaffe MD Professor of Psychiatry, Neurology, and Epidemiology University of California San Francisco, CA  94121 Medical Research: What is the background for this study? What are the main findings? Response: We assessed physical activity and TV watching in young adults over 25 years to see if there was an association with cognitive function in middle age.  Most previous studies have only considered this association in older adults. We found that both low physical activity and high TV watching over time were associated with worse cognitive function. (more…)
Author Interviews, Brain Injury, Mayo Clinic, Neurological Disorders / 02.12.2015

MedicalResearch.com Interview with: Kevin Bieniek B.Sc. Biology and Psychology Neuroscience researcher Mayo Clinic’s campus in Florida.  Medical Research: What is the background for this study? What are the main findings? Response:  Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disorder linked to repetitive traumatic brain injury often sustained through contact sports and military blast exposure.  While CTE was first described in boxers in the 1920s, to date many descriptions of CTE have been made in high-profile professional athletes, but the frequency of Chronic traumatic encephalopathy pathology in athletes with more modest contact sports participation is unknown.  For this study, researchers at the Mayo Clinic in Jacksonville, FL examined the Mayo Clinic Brain Bank, one of the largest brain banks of neurodegenerative diseases.  In searching through medical records of over 1,700 patients, 66 individuals with clinically-documented contact sports participation were identified.  Of these 66 former athletes, 21 or 32% had pathologic changes in their brains consistent with CTE.  By comparison, none of 198 control individuals that did not have contact sports documentation in their medical records (including 66 women) had CTE pathology.  These results have been recently published in the December issue of the journal Acta Neuropathologica <<hyperlink: http://www.springer.com/medicine/pathology/journal/401. (more…)
ADHD, Author Interviews, BMJ, Pharmacology / 26.11.2015

MedicalResearch.com Interview with: Dr. Ole Jakob Storebø Region Zealand, Child and Adolescent Psychiatric Department, Roskilde Region Zealand Psychiatry Psychiatric Research Unit, Slagelse University of Southern Denmark Department of Psychology Faculty of Health Science, Odense Denmark Medical Research: What is the background for this study? What are the main findings? Dr. Storebø: Despite widespread use of methylphenidate for the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD), a comprehensive systematic review of its benefits and harms has not yet been conducted. Over the past 15 years, several reviews investigating the efficacy of methylphenidate for ADHD (with or without meta-analyses) have been published. Each of these reviews, however, has several shortcomings and these are described in detail in the review. The most important concerns are that none of these reviews are based on a pre-published protocol, and most assessed neither the risk of bias (systematic errors) of included trials nor adverse events. Moreover, none of these reviews considered the risk of random errors. Therefore, their interpretation of findings is unlikely to have taken into account the poor reporting of adverse events, the impact of combining data from small trial samples, or the impact of risk of bias on their analyses; information about adverse events is also missing from several RCTs. Because of this it is our opinion that these previous reviews might have overestimated the true treatment effect. We found that Methylphenidate may improve ADHD symptoms, general behaviour and quality of life in children and adolescents aged 18 years and younger with ADHD. We rated the evidence to be of very low quality and, as a result, we cannot be certain about the magnitude of the effects from the meta-analyses. The evidence is limited by serious risk of bias in the included trials, under-reporting of relevant outcome data, and a high level of statistical variation between the results. We found no evidence for serious adverse events, but a lot of non-serious adverse events. Most of these are well known but the number of adverse events might even be higher than the number we found due to underreporting of adverse events. We know very little about the long term effects or harms as most of the trials in our review did not measure outcomes beyond 6 months. The risk of rare, serious adverse events seem low over the short duration of follow-up of the trials that reported on harms, but in general there was inadequate reporting of adverse events in many trials. (more…)
Author Interviews, Cognitive Issues / 24.11.2015

MedicalResearch.com Interview with: Catherine Mewborn, B.A. Neuropsychology and Memory Assessment Laboratory Department of Psychology University of Georgia Medical Research: What is the background for this study? Response: Vision and cognitive functioning both tend to decline as individuals age. Processing speed, or the speed at which an individual can process information, is particularly vulnerable to age-related declines. In previous studies, cognition has typically been measured using traditional paper-and-pencil tests; however, these tests can be quite complex and recruit many different abilities. We wanted to use a simpler test to assess processing speed in the hopes of tapping into the more basic abilities that underlie performance on more complex cognitive tasks. For this study, we chose a measure of visual processing speed called critical flicker fusion, or CFF. We tested how well CFF could predict cognition in both younger and older adults. Medical Research: What are the main findings? Response: As expected, younger adults had better visual processing speed than older adults. Interestingly, in both age groups, CFF significantly predicted performance on a test of executive functioning, which assess abilities such as problem-solving and shifting attention between different tasks. (more…)
Author Interviews, Emergency Care, Mental Health Research, Stanford / 22.11.2015

MedicalResearch.com Interview with: Arica Nesper, MD, MAS Resident Physician Stanford/Kaiser Emergency Medicine Residency Stanford University Medical Center Department of Emergency Medicine Stanford Medical Research: What is the background for this study? What are the main findings? Dr. Nesper: Patients with severe mental illness are a distinct demographic in the emergency department. Unfortunately, resources to help these vulnerable patients are frequently the target of funding cuts. We aimed to describe the effect of these cuts on our emergency department and the care provided to our patients. In this study we evaluated data from before our county mental health facility cut its inpatient capacity by half and closed its outpatient unit, and compared this data with data collected after this closure. We found that the mean number of daily psychiatric consultations in our emergency department more than tripled and that the average length of stay for these patients increased by nearly eight hours. These two data combined demonstrate a five-fold increase in daily emergency department bed hours for psychiatric patients, placing a significant strain on the emergency department and demonstrating a delay in definitive care provided to these vulnerable patients. (more…)
Author Interviews, Autism, Pediatrics, PNAS / 21.11.2015

MedicalResearch.com Interview with: Lauren Kenworthy, PhD Associate professor of Neurology, Pediatrics, and Psychiatry George Washington University School of Medicine Director of the Center for Autism Spectrum Disorders Children’s National Health System Medical Research: What is the background for this study? What are the main findings? Dr. Kenworthy: Connectivity among brain regions may account for variability in autism outcomes not explained by age or behavioral measures, according to a study. We have previously shown that behavioral assessments of intelligence, baseline adaptive behavior and executive functions in people with autism can explain some of the variation in outcomes and function, but we have not been able to explain all of the variance in outcome (e.g. Pugliese et al 2015a, 2015b). In this study, we found that 44% of the study group experienced significant change in scores on adaptive behavior between the initial scan and follow-up. Connectivity between three resting-state networks, including the salience network, the default-mode network, and the frontoparietal task control network, was linked not only to future autistic behaviors but also to changes in autistic and adaptive behaviors over the post-scan period. Further, connectivity involving the salience network and associated brain regions was associated with improvement in adaptive behaviors, with 100% sensitivity and around 71% precision. (more…)
Author Interviews, Depression, JAMA / 20.11.2015

MedicalResearch.com Interview with: Raymond W. Lam, MD, FRCPC Professor and Associate Head for Research Department of Psychiatry, University of British Columbia Director, Mood Disorders Centre, Djavad Mowafaghian Centre for Brain Health Executive Chair, Canadian Network for Mood and Anxiety Treatments (CANMAT) Vancouver, BC, Canada Medical Research: What is the background for this study? Dr. Lam: Our multicentre team studied the effects of bright light therapy for nonseasonal depression. Light therapy is a non-pharmacological approach that has been studied as a treatment for seasonal affective disorder (SAD, or "winter depression"), but only a small number of studies has explored the use of light therapy in treating nonseasonal depression. Clinical depression, known formally as Major Depressive Disorder (MDD) is the most common psychiatric disorder and one of the most common medical conditions worldwide. At any given time, at least 1 person in 20 (5% of the general population) is experiencing MDD, which will become the second-leading cause of disability worldwide by 2020, according to the World Health Organization.  (more…)