Mental Health Research
06 Apr Psychiatric Research Focuses On Major Hubs of Complex Brain Systems
MedicalResearch.com Interview with: [caption id="attachment_22994" align="alignleft" width="149"]
Dr. Glenn Saxe[/caption]
Glenn Saxe, MD
Arnold Simon Professor of Child and Adolescent Psychiatry and
Chair, Department of Child and Adolescent Psychiatry
NYU Langone’s Child Study Center
Dr. Saxe’s bio page
MedicalResearch.com: What is the background for this approach? What are the main advantages and drawbacks to the CS-CN method in psychiatry research?
Dr. Saxe: Psychiatric disorders are complex and, in all likelihood, emerge and are sustained over time because they form what is called a complex system, involving the interaction between a great many variables of different types (e.g. molecules, neurons, brain circuits, developmental, social variables). There is a strong literature on complex systems in other fields that show remarkably similar properties between vastly different types of systems. Unfortunately, data methods used in research in psychiatry are not designed to ‘see’ the possible complex systems nature of a psychiatric disorder. Our method is designed to identify networks of variables related to psychiatric disorders that, together, have properties of complex systems. If such a system is identified, it may reveal new ways to treat these disorders.
06 Apr Fewer Teeth Linked To Greater Cognitive Decline
MedicalResearch.com Interview with: [caption id="attachment_23195" align="alignleft" width="134"]
Dr. Elham Emami[/caption]
Elham Emami, DDS, MSc, PhD
Director , Oral Health and Rehabilitation Research Unit & Associate Professor
Faculty of Dental Medicine & School of Public Health
Université de Montréal
Adjunct Professor McGill University
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Emami: Over the past 20 years, scientific evidence has shown that oral and general health are closely linked. Recently, studies have shown that there is also a link between the number of teeth an older person has and his/her cognitive status.
We carried out a meta-analysis using the data from these latter studies. Our results indicate that, taking into account socioeconomic differences and other potential confounding variables, a person with less than 20 teeth has a 20% greater risk of having cognitive decline (HR= 1.26, 95% CI = 1.14 to 1.40) and dementia (HR = 1.22, 95% CI = 1.04 to 1.43) than someone who has 20 or more teeth.
01 Apr More Concussions When NFL Games Played in Below Freezing Temperatures
MedicalResearch.com Interview with: Dr. David W. Lawrence, MD Department of Family & Community Medicine St Michael's Hospital, University of Toronto Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Lawrence: The risk of all-cause injury and concussion for NFL athletes is significant. There has been a lot of discussion recently about this risk of injury in the NFL and general player safety, particularly regarding concussions. The first step in improving player safety and lowering that risk is to identify the factors affecting injury rates. Once we can answer those questions, we can begin to modify player exposure.30 Mar Gestational Diabetes Raises Risk of Neuropsychiatric Issues in Children
MedicalResearch.com Interview with: [caption id="attachment_22988" align="alignleft" width="159"]
Prof. Eyal Sheiner[/caption]
Eyal Sheiner, MD,PhD
Department of Obstetrics and Gynecology
Soroka University Medical Center Beer-Sheva
Israel
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Sheiner: The reported rates of gestational diabetes mellitus (GDM) are constantly escalating and little is known about the long term complications in the offspring. Evidence from the field of epigenetics strongly advocated the need for research on the neuropsychiatric impact of being exposed prenatally to GDM. In our study, in utero exposure to gestational diabetes mellitus was found to be an independent risk factor for long term neuropsychiatric morbidity of the offspring.
29 Mar Blood Biomarkers Can Help Evaluate Mild Concussion
MedicalResearch.com Interview with: [caption id="attachment_22921" align="alignleft" width="160"] Dr. Linda Papa[/caption] Linda Papa MD.CM, MSc, CCFP, FRCPC, FACEP Director of Academic Clinical Research Attending Emergency Physician Orlando Regional Medical Center Professor, University of Central Florida College of Medicine Associate Professor, Florida State University College of Medicine Adjunct Professor, University of Florida College of Medicine and Department of Neurology and Neurosurgery McGill University MedicalResearch.com:...
27 Mar PTSD Linked To Worse Vascular Function in Veterans
MedicalResearch.com Interview with: [caption id="attachment_22802" align="alignleft" width="143"]
Dr Marlene Grenon[/caption]
S. Marlene Grenon, MDCM, MMSc, FRCSC
Associate Professor of Surgery
Division of Vascular and Endovascular Surgery
University of California, San Francisco
Veterans Affairs Medical Center- Surgical Services
San Francisco, CA
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Grenon: In this study, we investigated the impact of PTSD on endothelial function using flow-mediated brachial artery vasodilation.
After adjustments for different risk factors and comorbidities, we found that patients with PTSD had worse endothelial function.
26 Mar Women With High Genetic Predisposition to Schizophrenia Tend To Have First Child at Earlier or Later Age
MedicalResearch.com Interview with: [caption id="attachment_22881" align="alignleft" width="171"]
Dr. Hong Lee[/caption]
S. Hong Lee, PhD
Queensland Brain Institute, The University of Queensland, Brisbane
School of Environmental and Rural Science, University of New England, Armidale
Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous studies reported increased risk of schizophrenia (SCZ) in offspring associated with both early and delayed parental age. However, it remains unclear if the risk to the child is due to psychosocial factors associated with parental age or if those at higher risk for schizophrenia tend to have children at an earlier or later age.
We found evidence for a significant overlap between genetic factors associated with risk of schizophrenia and genetic factors associated with Age at First Birth (AFB). We observed a U-shaped relationship between schizophrenia risk and maternal AFB, consistent with the previously reported relationship between schizophrenia risk in offspring and maternal age when not adjusted for age of the father.
21 Mar Slow Sparse Ketamine Infusions Show Promise For Resistant Depression
MedicalResearch.com Interview with: Theodore Henderson, MD, PhD Neuroluminance Ketamine Infusion Centers MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Henderson: Depression is a widespread problem. Psychotropic medications or therapy are the standard treatments, but they are often disappointing. Some studies have shown that the response rate to antidepressant medications is only 12-17% better than placebo response rate. Newer non-pharmacetical treatments, like transcranial magnetic stimulation, appear to have only a 50% response rate at best. The seminal study by Berman and colleagues in 2000 showed that sub-anesthetic dose infusions of the anesthetic, ketamine, produced a rapid antidepressant response. Many clinics across the United States focus on these rapid effects. Our clinic has been treating patients with treatment-resistant depression (defined as failing five or more antidepressants) for over three years. Our response rate is 80% based on multiple depression rating scales. We report here on 100 of the over 300 patients in our clinic who agreed to share their data in a research study. We treated patients with ketamine infusions no more frequently than once per week, unlike the clinical studies and many other ketamine clinics. We found our patients did equally well or better and received fewer treatments. The neurobiology of ketamine and its mechanism of action hold the key. Ketamine is a potent activator of the growth factor, brain derived neurotrophic factor (BDNF). This growth factor reverses the damage that depression causes to the brain – loss of synapses, dearborization of dendrites, and neuronal death. Ketamine’s ability to activate BDNF over time is responsible for a persistent antidepressant effect upon the brain.19 Mar Meta-analysis Reassesses Omega 3 Fatty Acids in Major Depressive Disorders
MedicalResearch.com Interview with: [caption id="attachment_22787" align="alignleft" width="106"]
Dr. RJT Mocking[/caption]
Dr. Roel JT Mocking
Program for Mood Disorders
Department of Psychiatry
Academic Medical Center
University of Amsterdam, The Netherlands
MedicalResearch.com: What is the background for this study?
Response: Omega-3 polyunsaturated fatty acid supplementation (popularly referred to as fish oil) is being promoted as (add-on) treatment for depression. Thus far, many studies have been performed that tested the effects of omega-3 fatty acids in depression. In order to overcome differences between these results of individual studies, a meta-analysis can be performed. A meta-analysis pools the results of all individual studies, and thereby provides a more definitive conclusion regarding the effect of omega-3 fatty acids in depression. Moreover, using the differences between the individual studies, a meta-analysis can point to factors that are associated with a better effect of the supplementation, for example supplementation dose or duration.
There have been meta-analyses performed previously, but they seemed to contain several inconsistencies. For example, they accidentally included the same study two or three times, which results in errors. In addition, these meta-analyses did not only include studies performed in patients with the psychiatric disorder "major depressive episode", but also subjects from the general population with less severe depressive complaints. This makes it more difficult to interpret the results. Therefore, we performed a meta-analysis that included only studies performed in patients with major depressive disorder, and corrected errors from earlier meta-analyses.
18 Mar Nightmares Linked to Increased Suicide Risk in PTSD
MedicalResearch.com Interview with: Donna L. Littlewood PhD Student School of Psychological Sciences University of Manchester, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Every year over 800,000 people die by suicide, and for every individual’s death, it is estimated that another 20 people will make a suicide attempt. Therefore, to be able to prevent suicide, we need to understand the different factors that can combine to make an individual think about ending their own life. Recent research indicates that nightmares are associated with suicidal thoughts and behaviours, and that this association is independent of other related suicide risk factors, such as, depression and PTSD. However, it is now important for research to examine the mechanisms that underpin this association, as this information will support the development of clinical interventions to prevent subsequent suicide attempts and deaths18 Mar Older Adults with Chronically High Depressive Symptoms May Be At Higher Risk of Dementia
MedicalResearch.com Interview with: Allison R. Kaup, PhD Assistant Adjunct Professor, UCSF Department of Psychiatry Clinical Research Psychologist / Clinical Neuropsychologist and Kristine Yaffe MD Professor of Psychiatry, Neurology and Epidemiology Chief of Geriatric Psychiatry and Director of the Memory Evaluation Clinic San Francisco VA Medical Center MedicalResearch.com: What is the background for this study? Response: Previous research has shown that older adults with depression are more likely to develop dementia. But, most studies have only examined an older adult’s depressive symptoms at one point in time. This is an important limitation because we know that depressive symptoms change over time and that older adults show different patterns of depressive symptoms over time. For the present study, older adults were followed for several years. We assessed what patterns of depressive symptoms they tended to have during the early years of the study, and then investigated whether these different patterns were associated with who developed dementia during the later years of the study. MedicalResearch.com: What are the main findings? Response: Older adults in this study tended to show one of 3 different patterns of depressive symptoms. Most tended to have few, if any, symptoms over time. Some tended to have a moderate level of depressive symptoms at the beginning of the study, which increased over time. And others tended to have a high level of depressive symptoms at the beginning of the study, which increased over time. We found that older adults with the high-and-increasing depressive symptoms pattern were almost twice as likely to develop dementia than those with minimal symptoms, even when accounting for other important factors. While older adults with the moderate-and-increasing depressive symptom pattern were also somewhat more likely to develop dementia, this association was not as strong and did not hold up in our statistical models when we accounted for what individuals’ cognitive functioning was like during the early years of the study.18 Mar Better Cardiovascular Health Associated With Better Cognitive Functioning
MedicalResearch.com Interview with: Hannah Gardener, ScD Department of Neurology, Miller School of Medicine University of Miami Miami, FL MedicalResearch.com: What is the background for this study? Response: At the beginning of the study, 1,033 participants in the Northern Manhattan Study (average age 72; 65 percent Hispanic, 19 percent black and 16 percent white), were categorized using the American Heart Association’s “Life’s Simple Seven®” definition of cardiovascular health, which includes tobacco avoidance, ideal levels of weight, physical activity, healthy diet, blood pressure, cholesterol and glucose. The participants were tested for memory, thinking and brain processing speed. Brain processing speed measures how quickly a person is able to perform tasks that require focused attention. Approximately six years later, 722 participants repeated the cognitive testing, which allowed us to measure performance over time. The cardiovascular health factors, which have been shown to predict risk of stroke and myocardial infarction, were then examined in relation to cognitive performance and impairment over time.16 Mar Refugees Granted Asylum More Likely to Have Schizophrenia and Psychotic Disorders
Posted at 14:00h
in Author Interviews, BMJ, Karolinski Institute, Mental Health Research, Schizophrenia
MedicalResearch.com Interview with:
[caption id="attachment_22721" align="alignleft" width="159"]
Dr. Anna Clara Hollander[/caption]
Anna-Clara Hollander PhD
Division of Social Medicine, Department of Public Health Sciences
Karolinska Institutet, Stockholm, Sweden.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The humanitarian crises in Europe, the Middle East, north Africa, and central Asia have led to more displaced people, asylum seekers, and refugees worldwide than at any time since the second world war. Refugees are known to be at an increased risk of mental health problems, such as post-traumatic stress disorder and other common mental disorders, compared to non-refugee migrants, but little is known about their risk of psychosis.
The aim of the study was to determine the risk of schizophrenia and other non-affective psychotic disorders among refugees, compared to non-refugee migrants, and the general Swedish population. We used a linked national register data to examine more than 1.3 million people in Sweden, and tracked diagnoses of non-affective psychotic disorders among the population. The cohort included people born to two Swedish-born parents, refugees, and non-refugee migrants from the four major refugee generating regions: the Middle East and north Africa, sub-Saharan Africa, Asia, Eastern Europe and Russia.
Results showed 3,704 cases of non-affective psychotic disorders during the 8.9 million person years of follow up. Refugees granted asylum were on average 66% more likely to develop schizophrenia or another non-affective psychotic disorder than non-refugee migrants. In addition, they were up to 3.6 times more likely to do so than the Swedish-born population. Incidence rates for non-affective psychosis were 385 per million in those born in Sweden, 804 per million in non-refugee migrants, and 1264 per million in refugees.
The increased rate in refugees was significant for all areas of origin except sub-Saharan Africa, for whom rates in both groups were similarly high relative to the Swedish-born population. One possible explanation is that a larger proportion of sub-Saharan Africa immigrants will have been exposed to deleterious psychosocial adversities before emigration, irrespective of refugee status. Alternatively post-migratory factors, such as discrimination, racism, and social exclusion may explain these high rates.
Overall, our findings are consistent with the hypothesis that increased risk of non-affective psychotic disorders among immigrants is due to a higher frequency of exposure to social adversity before migration, including the effects of war, violence, or persecution.
14 Mar Autism Spectrum Disorders Linked To Depression in Adults
MedicalResearch.com Interview with: [caption id="attachment_22637" align="alignleft" width="112"]
Dr. Rebecca Charlton[/caption]
Dr. Rebecca A. Charlton PhD
Senior Lecturer in Psychology; Undergraduate Admissions Tutor
Department of Psychology
Goldsmiths, University of London
New Cross London, UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Charlton: Although Autism Spectrum Disorders are classified as developmental disorders, they last throughout life. Autism Spectrum Disorders were first identified in the 1940s, but it was only from the 1960s onwards that awareness of the condition began to increase. Initial research into Autism focused on the area of greatest need, i.e. childhood and education. Only now that those individuals first diagnosed with Autism are reaching old age are studies able to examine what happens in late-life. Although there are an increasing number of older adults with a diagnosis of Autism Spectrum Disorders, it is often difficult to identify individuals willing to participate in research. One alternative is to explore Autism traits in the general population, this is known as the Broad Autism Phenotype (BAP). These BAP traits occur in relatives of those with Autism and in the general population. By examining the BAP in community-dwelling older adults, we can begin to understand whether these traits confer additional risk to in ageing.
MedicalResearch.com: What did you do in the study? What are the main findings?
Dr. Charlton: Adults aged over 60 years old were recruited to take part in the study. They completed questionnaires reporting on presences of Broad Autism Phenotype traits, executive functions (the ability to plan and organise behaviour), mood (depression and anxiety), and social support.
Of the 66 individuals who participated, 20 individuals reported significant BAP traits – classified as the Broad Autism Phenotype group. Individuals in the BAP group reported more problems with executive functions, higher rates of depression and anxiety, and less social support than those in the non-BAP group. Further analyses demonstrated that having Broad Autism Phenotype traits was the factor that most explained presence of depression and anxiety symptoms among these older adults.
14 Mar Leisure Physical Activities Linked To Increase in Brain Gray Matter
Posted at 11:52h
in Alzheimer's - Dementia, Author Interviews, Exercise - Fitness, Lifestyle & Health
MedicalResearch.com Interview with:
[caption id="attachment_22605" align="alignleft" width="160"]
Dr. Cyrus Raji[/caption]
Cyrus A. Raji, MD, PhD
Resident in Diagnostic Radiology
UCLA Health System
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Raji: The purpose of this study was to investigate the relationship between caloric expenditure from leisure physical activities (15 different ones were assessed from walking to gardening to dancing to swimming etc.).
Increased caloric expenditure from these physical activities were related to larger gray matter volumes in key brain areas for memory and learning (hippocampus, precuneus) that are also affected by Alzheimer's. These findings were demonstrated in 876 persons who had MRI scans and caloric expenditure assessed. Five years after the scan a subset of 326 persons from the larger group of 876 were followed cognitively and it was found that those with larger gray matter volumes associated with physical activity in the orbital frontal cortex and precuneus had a 2 fold reduction in the risk for cognitive decline to mild cognitive impairment and Alzheimer's dementia.
10 Mar Clinical Score Improves Prediction of Concussion Outcomes in Children
MedicalResearch.com Interview with: [caption id="attachment_22413" align="alignleft" width="137"]
Dr. Roger Zemek[/caption]
Roger Zemek, MD, FRCPC
Associate Professor, Dept of Pediatrics and Emergency Medicine, Clinical Research Chair in Pediatric Concussion, University of Ottawa
Director, Clinical Research Unit, Children’s Hospital of Eastern Ontario
Ottawa, ON
MedicalResearch.com: What is the background for this study?
Dr. Zemek: The number of concussions have dramatically increased over the past decade. Not only are children and adolescents are at highest risk for getting concussions, they also take longer to recover. As part of our background work, our team performed a systematic review (published in JAMA Pediatrics) confirming that validated, easy-to-use prognosticators did not exist for clinicians to identify children with concussion who are at the highest risk for persistent post-concussive symptoms (PPCS) and sequelae.
MedicalResearch.com: What are the main findings?
Dr. Zemek: In this, the largest concussion study in the world to-date, we derived and validated in a large, diverse cohort of children a clinical risk score that is significantly superior to clinicians’ ability to predict future PPCS at the time of ED presentation. Multivariate analysis revealed that age group, female sex, past history of migraine, prior concussion with symptom duration of >1 week, ED presentation with “answering questions slowly”, 4 or more errors on BESS Tandem stance, and the initial symptoms of headache, noise sensitivity and fatigue were all clinically significant and strongly associated with PCS at 1-month.
We assigned points based on the adjusted multivariate odds ratio, and the rule incorporating patient demographic factors, past history, early cognitive deficits, balance (an physical exam finding), and early symptoms. The rule has a maximum of 12 points. We selected two cut-off points in order to yield three clinically relevant (low, intermediate and high risk) categories for the development of PPCS at one month.
09 Mar Study of Cognitive Functioning after Surgery Has Reassuring Findings
MedicalResearch.com Interview with: [caption id="attachment_22515" align="alignleft" width="109"]
Unni Dokkedal[/caption]
Unni Dokkedal, M.P.H.
Unit of Epidemiology, Biostatistics, and Biodemography
University of Southern Denmark
MedicalResearch: What is the background for this study?
Response: Early (seven days) postoperative cognitive impairment is common in adult surgical patients of all ages, but elderly patients are at higher risk for this complication. Previous studies have shown that these impairments are detectable up to three months after surgery in patients older than 60 years. Furthermore, the condition may persist for longer than six months in some patients with potential long-term implications of the surgery leading to impaired quality of life and increased mortality risk. We wanted to investigate the contribution of surgery, anesthesia, preexisting conditions and other factors on the postoperative cognitive functioning of elderly patients.
MedicalResearch: What are the main findings?
Response: For a sample of 4,299 middle-aged twins younger than 70 years and 4,204 elderly twins over 70 years, all of whom were residents of Denmark, medical records were reviewed from 1977 and until the accomplishment of cognitive tests in the period from 1995 to 2001. Results from five cognitive tests were compared in twins exposed to surgery, classified as major, minor, hip and knee replacement, or other, with those of a reference group without surgery. A statistically significant lower composite cognitive score was found in twins with at least one major surgery compared with the reference group (mean difference, −0.27; 95% CI, −0.48 to −0.06), which is a negligible effect size. None of the other groups differed from the reference group except the knee and hip replacement group that tended to have higher cognitive scores (mean difference, 0.35; 95% CI, −0.18 to 0.87).To consider genetic and shared environmental confounding and to take preoperative cognition into account, intrapair analyses were performed in same-sexed pairs in whom one had a history of major surgery and the other no surgery. No difference was found in the intra-pair analysis. The results suggest that preoperative cognitive functioning and underlying diseases were more important for cognitive functioning in mid- and late life than surgery and anesthesia.
09 Mar Genetic Variation Affects Recovery From Concussion
MedicalResearch.com Interview with: [caption id="attachment_22498" align="alignleft" width="200"]
Dr. Jane McDevitt[/caption]
Dr. Jane McDevitt
Temple University in Philadelphia
MedicalResearch.com: What is the background for this study?
Dr. McDevitt: During a head impact there is a mechanical load that causes acceleration and deceleration forces on the brain within the cranium. The acceleration and deceleration causes stress to the neurons and initiates a neurometabolic cascade, where excitatory neurotransmitters such as glutamate are released and depolarize the cell. This triggers protein channels to open and allow ions into and out of the cell. Increases in calcium persist longer and have greater magnitude of imbalance than any other ionic disturbance. One channel responsible for allowing calcium into the cell is r-type voltage-gated calcium channel. One of the main proteins within this voltage-gated calcium channel is the CACNA1E protein produced by the CACNA1E gene. This protein forms the external pore and contains a pair of glutamate residues that are required for calcium selectivity. It is also responsible for modulating neuronal firing patterns. A variation within this gene (i.e,CACNA1E ) that regulates expression levels of CACNA1E could be associated with how an athlete recovers following a concussion injury.
Upwards of 20% of the concussed population fall into the prolonged recovery category, which puts these athletes at risk for returning to play quicker than they should. Variation in recovery depends on extrinsic factors like magnitude of impact, and sport, or intrinsic factors like age or sex. One intrinsic factor that has not been definitively parsed out is genetic variation. Recovery is likely to be influenced by genetics because genes determine the structure and function of proteins involved in the cell’s resistance and response to mechanical stress. Due to CACNA1E’s relationship to calcium influx regulation, a single nucleotide polymorphism (SNP) could modify the expression level of the protein responsible for regulating calcium. Altered protein levels could lead to athlete’s responding to concussive injuries differently. The main objective of this study was to examine the association between CACNA1E SNPs with concussion recovery in athletes.
08 Mar Outcome of Psychosis Better If Patients Stop Cannabis
MedicalResearch.com Interview with: Dr Sagnik Bhattacharyya Reader in Translational Neuroscience and Psychiatry Institute of Psychiatry, Psychology & Neuroscience, KCL Consultant Psychiatrist, Early Intervention Pathway Director, Maudsley Early Intervention in Dual Diagnosis clinic Psychosis Clinical Academic Group, South London & Maudsley NHS Foundation Trust King’s Health Partners MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Bhattacharyya: Cannabis is the most commonly used illicit drug in the world and its use has been linked to the onset of psychotic disorders such as schizophrenia. Whilst a lot of research has investigated the association between cannabis use and the development of psychosis, there is less clarity regarding the consequences of continued cannabis use in those with an established psychotic disorder. We therefore pooled together all available evidence from studies that specifically looked at the effects of cannabis use on outcome following the onset of psychosis. Based on data from more than 16000 patients with a first episode or more established psychosis, our results show that continued cannabis use is consistently associated with poor outcome in the form of more relapses (as indexed by psychiatric hospitalisation), longer hospitalisations and increased positive symptoms. However, outcomes were not as bad if cannabis use was discontinued following the onset of psychosis.06 Mar Marijuana Use Increases Hospitalizations and Poor Outcomes in Patients With Psychotic Disorders
MedicalResearch.com Interview with: [caption id="attachment_22289" align="alignleft" width="180"]
Dr. Rashmi Patel[/caption]
Dr. Rashmi Patel MA (Cantab) MA BM BCh PGDip (Oxon) MRCPsych
Clinical Lecturer in General Psychiatry
Kings College London
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Patel: Previous studies suggest that cannabis use is associated with an increased risk of developing a psychotic disorder but, until now, little was known about the effects of cannabis on people with an established psychotic disorder. Using novel text mining techniques, we investigated the association of cannabis use with the clinical outcomes of over 2,000 people following their first episode of psychosis.
We found that cannabis use was associated with significantly poorer clinical outcomes including a 50% increased frequency of hospital admission and 35 additional days spent in hospital in the 5 years after first receiving treatment. We also found that the poor outcomes associated with cannabis use may be linked to antipsychotic treatment failure.
04 Mar Study Examines Trajectory of Moderate or Severe Depression
MedicalResearch.com Interview with: [caption id="attachment_22323" align="alignleft" width="180"]
Dr. Katherine Musliner[/caption]
Katherine L. Musliner, PhD
National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
The Lundbeck Foundation Initiative for Integrative Psychiatric Research
Department of Mental Health
The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is great variation among patients with depression in terms of long-term illness course. This variation may be indicative of underlying differences in the cause of the illness, and from a practical perspective, it also has implications for treatment and allocation of public health resources. Our goal was to identify different trajectories of depression course by examining inpatient and outpatient contacts for depression at psychiatric treatment facilities in Denmark (where healthcare is free) during the 10-year period following patients’ initial depression diagnosis.
We found that the majority of patients (77% in our sample) followed a trajectory characterized by a brief period of contact with the psychiatric treatment system and no contact for depression during the remainder of the 10-year follow up period. Patients with more prolonged contact either had a drawn out initial period of contact lasting as long as five years (13%), left depression treatment for several years only to return with a depression diagnosis years later (7%) or exhibited a chronic course (3%).
03 Mar Potential New Blood Test For Chronic Traumatic Encephalopathy Measures Plasma Tau Levels
MedicalResearch.com Interview with: [caption id="attachment_22292" align="alignleft" width="200"]
Mr. Jim Joyce[/caption]
Mr. Jim Joyce
Chairman and CEO of Aethlon
MedicalResearch.com: What is the background for this study? What are the main findings?
Mr. Joyce: Our research into the neurodegenerative disease Chronic Traumatic Encephalopathy (CTE), was inspired by the death of Tom McHale, who was a former teammate and the second person diagnosed with CTE by our colleagues at the Boston University CTE Center. CTE is characterized by exposure to repetitive head trauma and at present, can only be diagnosed post-mortem, thus creating a significant need for a non-invasive method to diagnose and monitor CTE in living individuals.
The aim of our study was to examine exosomal tau levels in plasma as a potential CTE biomarker. Our research team originally discovered the presence of exosomal tau in circulation and then established methods to quantify exosomal tau, which we refer to as a TauSome™, which we believe to be the first potential blood test to detect CTE living individuals. For this study, researchers examined 78 former National Football League players and 17 former athletes of non-contact sports, with preliminary findings suggesting that exosomal tau in plasma may be a noninvasive, accurate biomarker for CTE.
The study results, published in the journal of Alzheimer’s disease, can be accessed here: http://content.iospress.com/articles/journal-of-alzheimers-disease/jad151028?resultNumber=7&totalResults=48&start=0&q=exosome&resultsPageSize=10&rows=10.
29 Feb Fewer Pediatric Abusive Head Trauma In States With Paid Family Leave
MedicalResearch.com Interview with: [caption id="attachment_16316" align="alignleft" width="200"]
Dr. Joanne Klevens[/caption]
Dr. Joanne Klevens, MD, PhD, MPH
Division of Violence Prevention
US Centers for Disease Control and Prevention
Atlanta, Georgia
Medical Research: What is the background for this study? What are the main findings?
Dr. Klevens: Pediatric abusive head trauma is a leading cause of fatal child maltreatment among young children and current prevention efforts have not been proven to be consistently effective. In this study, compared to seven states with no paid family leave policies, California’s policy showed significant decreases of hospital admissions for abusive head trauma in young children. This impact was observed despite low uptake of policy benefits by Californians, particularly among populations at highest risk of abusive head trauma.
27 Feb Poor Sleep Linked to Cognitive Issues in Fetal Alcohol Syndrome
MedicalResearch.com Interview with: [caption id="attachment_22137" align="alignleft" width="200"]
Dr. Donald Wilson[/caption]
Donald A. Wilson, Ph.D.
Professor, Departments of Child & Adolescent Psychiatry and Neuroscience & Physiology
NYU Langone Medical Center
Senior Research Scientist
Nathan Kline Institute for Psychiatric Research
Medical Research: What is the background for this study? What are the main findings?
Dr. Wilson: Fetal alcohol spectrum disorder (FASD) is characterized by cognitive, emotional and behavioral problems that are life-long. Generally, it is assumed that the initial trauma of alcohol exposure at a critical time in life is the cause of these problems. In this study using an animal model of FASD, we find that developmental alcohol causes a life-long disturbance in sleep. Given that sleep is important for memory and emotion, among other things, this suggests that developmental alcohol can produce a daily insult to the brain, far outlasting that initial exposure. Each night, the brain is unable to store memories, adjust emotional circuits, remove waste products, in the way that it should, because FASD has disrupted sleep.
26 Feb Symptoms of Anxiety and Heart Disease May Overlap in Women
Posted at 16:39h
in AHA Journals, Author Interviews, Heart Disease, Mental Health Research, Women's Heart Health
MedicalResearch.com Interview with:
[caption id="attachment_21884" align="alignleft" width="133"]
Dr.Kim Lavoie[/caption]
Dr. Kim Lavoie, Ph.D.
CIHR New Investigator, FRQS Chercheur-Boursier Co-Director,
Montreal Behavioural Medicine Centre
Professor, Dept. of Psychology University of Quebec at Montreal Director, Chronic Disease Research Division, Hôpital du Sacré-Coeur de Montreal Adjunct Professor, Faculty of Medicine, University of Montreal
Associate Researcher, Montreal Heart Institute
Chair, Health Psychology and Behavioral Medicine Section
Canadian Psychological Association
Medical Research: What is the background for this study?
Dr. Lavoie: We were interested in looking at whether rates of ischemia in men and women were different as a function of whether or not you had pre-existing heart disease (we would expect those with existing heart disease to have more ischemia because it’s a major marker of disease) or a comorbid anxiety or mood disorder (we expected anx/mood disorders would be associated with higher rates of ischemia because they reflect clinical levels of chronic stress, which has been linked to higher rates of ischemia in previous studies).
Medical Research: What are the main findings?
Dr. Lavoie: Overall, we found that men have higher rates of ischemia than women, and that anxiety or mood disorders overall aren't associated with higher or lower risk of ischemia (in those with or without previously diagnosed heart disease).
HOWEVER, what we did find that was interesting and perhaps new, was that if you looked within women, those without previously diagnosed heart disease AND anxiety disorders (which including things like panic disorder and generalized anxiety - panickers and worriers) had higher rates of ischemia compared to those without anxiety disorders. This suggests higher rates of ischemia among women without heart disease, which seems counter-intuitive because you would expect those WITH disease to have more ischemia. The fact that anxiety disorders were present in those without previously diagnosed heart disease - and they were the ones with more ischemia, suggests that these women likely HAD heart disease that just hadn't been diagnosed up yet, and that the reason might have been because of their anxiety disorder, which can mask many symptoms of heart disease because many of them overlap (e.g., fatigue, decreased energy, heart palpitations, sweating, chest discomfort, hyperventilation, and fear/worry). This could lead physicians to misinterpret symptoms of real heart disease as those of anxiety - but this only appears to be the case in women according to our study, suggesting a possible sex/gender bias here.
25 Feb Intellectual Activity May Delay Onset of Alzheimer’s Dementia
Posted at 23:52h
in Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Education, Mayo Clinic, Neurology
MedicalResearch.com Interview with:
[caption id="attachment_22061" align="alignleft" width="125"]
Dr. Prashanthi Vemuri[/caption]
Prashanthi Vemuri, PhD
Mayo Clinic
Rochester, Minnesota
Medical Research: What is the background for this study? What are the main findings?
Dr. Vemuri: Lifetime Intellectual enrichment has been found to delay the symptoms of dementia but the impact on brain changes due to Alzheimer’s disease has been poorly understood. In this study we studied the impact of lifetime intellectual enrichment (education, occupation, and midlife cognitive activities) on the brain changes related to Alzheimer’s disease. We obtained serial imaging on 393 individuals from a population based sample. We found that in majority of the individuals, there were minimal effects of intellectual enrichment on brain changes due to Alzheimer’s disease. However in those with higher genetic risk of Alzheimer’s, lifetime intellectual enrichment had a protective effect on the brain.
23 Feb Does Mom’s Anxiety During Pregnancy Make Her Child A Fussy Eater?
Posted at 23:11h
in Author Interviews, Depression, Eating Disorders, Mental Health Research, Nutrition, OBGYNE, Pediatrics
MedicalResearch.com Interview with:
[caption id="attachment_21832" align="alignleft" width="200"]
Dr. Lisanne De Barse[/caption]
Lisanne de Barse PhD
Department of Epidemiology
Erasmus Medical Center Rotterdam
MedicalResearch: What is the background for this study?
Dr. de Barse: Fussy (or “picky”) eating behaviour, which is characterised by consistent rejection of particular foods, is common in childhood and a source of concern for parents. It is not well understood what affects fussy eating. It is, however, well known that internalizing psychiatric problems of parents (i.e. anxiety and depression) have an impact on children’s health and development. Studies have also shown that mothers’ internalizing problems during the child’s preschool period was linked to child fussy eating. It was not clear whether the child’s eating problems causes stress and psychiatric symptoms in mothers or whether mothers’ symptoms predict child eating behaviour. Nor was it known what potential impact the dads’ state of mind have. The purpose of this study was to examine whether mothers’ and fathers’ internalizing problems during pregnancy and during the child’s life predicts child fussy eating.
MedicalResearch: What are the main findings?
Dr. de Barse: Our main findings indicate that mothers’ anxiety and depressive symptoms during pregnancy could have an influence on children’s fussy eating. This was irrespective of mothers’ internalizing symptoms at the child’s preschool period. We also found indications that fathers’ anxiety and depressive symptoms might influence children’s fussy eating behaviour. This was studied in Generation R, a study that has been tracking the health and wellbeing of children from conception onwards, conducted by the Erasmus Medical Centre, in Rotterdam, the Netherlands.
23 Feb Regulation of microRNAs in the Brain May Be One Key to Autism Spectrum Disorders
MedicalResearch.com Interview with: [caption id="attachment_21940" align="alignleft" width="213"]
Dr. Li Zeng[/caption]
Li ZENG, Ph.D.
Principal Investigator
Neural Stem Cell Research Lab
National Neuroscience Institute
Singapore
Medical Research: What is the background for this study? What are the main findings?
Dr. Zeng: Autism Spectrum Disorders (ASDs) are a group of highly inheritable behavioural disorders that pose major personal and public health concerns. Patients with ASDs have mild to severe communication difficulties, repetitive behaviour and social challenges. Such disorders significantly challenge an individual’s ability to conduct daily activities and function normally in society. Currently there are very few medication options that effectively treat ASDs. Therefore, there is a need to better understand the biology of that produces Autism Spectrum Disorder symptoms.
In the study, we found how one brain-specific microRNA (miR-128) plays a key role in causing abnormal brain development. MicroRNAs are small molecules that regulate gene expression in the human body to ensure proper cellular functions. Although it was known that miR-128 is misregulated in some patients with autism, what that meant and how it functioned was not known. We showed that miR-128 targets a protein called PCM1 that is critical to the cell division of neural precursor cells (NPCs). NPCs during early brain development have two fates - they either stay as NPCs and undergo self-renewal or become neurons through differentiation. The dysfunctional regulation of PCM1 by misregulated miR-128 impairs brain development, which may underlie brain size changes in people with Autism Spectrum Disorders.
19 Feb Depression Can Recur After Opioids Initiated For Non-Cancer Pain
MedicalResearch.com Interview with:
Jeffrey F. Scherrer, PhD
Associate Professor
Research Director
Department of Family and Community Medicine
Saint Louis University School of Medicine
St. Louis, MO 63104
Medical Research: What is the background for this study? What are the main findings?
Dr. Scherrer: We initiated a series of studies on chronic opioid use and risk of depression about 3 years ago and obtained an NIH R21 to study prescription opioid use and risk of new onset depression, depression recurrence and transition to treatment resistant depression. The rationale comes partly from clinical observations of the research team (I am not a clinician, just a epidemiologist). We also observed the large field demonstrating patients with depression are more likely to get opioids for pain, take them longer and develop abuse. We wanted to switch the direction of effect to determine if the reverse exists. After publishing two papers demonstrating longer use of opioid was associated with increasing risk of depression, our next step was to look at recurrence among patients with a recent history of depression.
Medical Research: What should clinicians and patients take away from your report?
Dr. Scherrer: Our main recommendation is clinicians should repeatedly screen patients for depression. While screening at time of starting opioids is common, repeated screening is worth consideration. Patients with depression who may experience temporary euphoria should not expect opioids to cure depression and they may increase risk for worsening mood and or recurrence after long term use.