MedicalResearch.com Interview with: Ellen R. Meara
Associate Professor of The Dartmouth Institute
Adjunct Associate Professor in Economics & Nelson A. Rockefeller Center for Public Policy, Dartmouth College
MedicalResearch.com: What are the main findings of this study?Answer: When insurance coverage for young adults rose by over 15 percentage points following Massachusetts' 2006 health reform, use of inpatient care for mental illness and substance use disorders fell and emergency department visits for these conditions grew more slowly for 19 to 25 year olds in Massachusetts relative to other states. Also, their care was much more likely to be paid for by private or public insurance insurers.
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MedicalResearch.com Interview with:Gemma Taylor MSc MBPsS Doctoral Researcher
and
Paul Aveyard and PhD MRCP MRCGP FFPG Professor of Behavioral Medicine
Fellow of Wolson College
Primary Care Clinical Sciences
The University of Birmingham
Birmingham United Kingdom
MedicalResearch.com: What are the main findings of the study?Answer: Smoking cessation is associated with improvements in mental health compared with continuing to smoke. The effect sizes seem as large for those with psychiatric disorders as those without and are equal or larger to effect estimates of antidepressant treatment for mood and anxiety disorders.
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MedicalResearch.com Interview with:Dr Peter de Jonge
Interdisciplinary Center for Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Netherlands
MedicalResearch.com: What are the main findings of the study?Dr. de Jonge:The main findings were that depression and impulse control disorders, in particular binge eating and bulimia were associated with diabetes.
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MedicalResearch.com Interview with: Rachelle S. Doody, M.D.,Ph.D.
Effie Marie Cain Chair in Alzheimer's Disease Research
Director, Alzheimer's Disease and Memory Disorders Center
Baylor College of Medicine-Department of Neurology
Houston, Texas 77030: MedicalResearch.com
MedicalResearch.com: What are the main findings of the study? Dr. Doody: The study set out to see whether the antibody infusion treatment, Solanezumab, would improve the course of mild to moderate Alzheimer's disease in the ways necessary to gain drug approval. Unfortunately, the results did not support an approvable treatment for this purpose.
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MedicalResearch.com Interview with: Roberto Fernández Galán, PhD
Department of Neurosciences, School of Medicine
Case Western Reserve University
Cleveland, OH, USA
MedicalResearch.com: What are the main findings of the study?Dr. Galán: The main finding is that autistic brains create more information at rest than non-autistic brains. This is consistent with the classical view on autism as withdrawal into self. It is also consistent with a recent theory on autism, the “Intense World Theory”, which claims that autism results from hyper-functioning neural circuitry, leading to a state of excessive arousal. From both perspectives, the classical and the IWT, communication and social deficits associated with autism result from having a more intense inner life and a higher level of introspection.
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MedicalResearch.com Interview with:Golda Ginsburg, Ph.D
Professor Director, Research,
Division of Child and Adolescent Psychiatry
Department of Psychiatry and Behavioral Sciences
The Johns Hopkins University School of Medicine
Baltimore, Maryland
MedicalResearch.com: What are the main findings of the study?Dr Ginsburg: This study examined the long-term outcomes of youth treated for an anxiety disorders. Findings revealed that almost half of anxious youth treated for an anxiety disorder were in remission (i.e., did not meet diagnostic criteria for any of the three study entry anxiety disorders) at an average of six years since starting treatment. Youth showing clinically meaningful improvement after 12 weeks of treatment, were more likely to be in remission, had lower anxiety severity, and had better functioning compared to youth who showed minimal or no initial clinical improvement.
Treatment type did not affect long-term outcomes.
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MedicalResearch.com Interview with:Steven Rowson, Ph.D.
Research Assistant Professor
Virginia Tech
Wake Forest University
MedicalResearch.com: What are the main findings of the study?Dr. Rowson: We found that there were large differences in concussion risk between football helmet types. This is the first study to address this question while controlling for the number of times each helmet type was impacted.
This allowed us to compare apples to apples. For example, we're not comparing starters who frequently get hit in one helmet type to second string players who don't get hit as much.
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MedicalResearch.com Interview with:Bennett L. Leventhal, MD
Nathan S. Kline Institue for Psychiatric Research
140 Old Orangeburg Road, Building 35
Orangeburg, NY 10962
MedicalResearch.com: What are the main findings of the study?Dr. Leventhal:In the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders, 5th Edition (DSM5) released in May 2013, changes include major alterations in criteria for developmental disorders, in particular, the DSMIV diagnostic criteria for Pervasive Developmental Disorder (PDD), including elimination of subtypes found in DSMIV such as Asperger Disorder and PDD NOS. Additionally, DSM 5 adds a new diagnostic category, Social Communication Disorder (SCD): individuals with SCD have difficulties similar to ASD but these problems are solely restricted to the realm of social communication and do not include the restrictive and repetitive behaviors found in ASD.
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MedicalResearch.com Interview with:
Jason R. Richardson MS, PhD, Associate Professor
Department of Environmental and Occupational Medicine
Robert Wood Johnson Medical School and
Resident...
MedicalResearch.com Interview with:
Stephen Salloway, MD, MS
Director of Neurology and the Memory and Aging Program, Butler Hospital
Professor of Neurology and...
MedicalResearch.com Interview with: Prof. Kathryn M Abel
Professor of Psychiatry & Honorary Consultant Psychiatrist
University of Manchester and Honorary Senior Lecturer at the Institute of Psychiatry, London.
MedicalResearch.com: What are the main findings of the study?Answer: The main study findings were that exposure of a mother to a severe psychological stress of losing a close family member up to either 6 months before conception or at any time during pregnancy did not increase risk of subsequent psychotic illness in the offspring. Secondly, we found during childhood, if a close family member died then, especially a sibling of the child or one of their parents, these children were at slightly increased risk of developing a psychotic illness later in life. This was most likely to happen following a sudden death especially suicide and in particular following suicide a psychotic mood disorder was more likely than other kinds of psychosis such as schizophrenia (although the risk of schizophrenia was also increased following suicide). This effect was not accounted for by having a family history of a psychotic illness or suicide.
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MedicalResearch.com Interview with:John W. O'Kane M.D.
Associate Professor Family Medicine and Orthopaedics and Sports Medicine
Medical Coordinator, U.W. Intercollegiate Athletics
University of Washington Sports Medicine Clinic, Seattle
MedicalResearch.com: What are the main findings of the study?Dr. O’Kane: In 11 to 14 year old female elite soccer players the concussion incidence was 13% with a rate of 1.2 per 1000 athletic exposures. Symptoms lasted a median of 4 days and players with light or noise sensitivity, emotional lability, memory loss, nausea, and concentration problems took significantly longer to recover. Heading the ball accounted for 30.5% of concussions and the vast majority of concussions (86%) occurred in games. The majority of players (58.6%) reported playing with symptoms and less than half (44.1%) sought medical attention for their symptoms. Those seeking medical attention were symptomatic longer and were less likely to play with symptoms.
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MedicalResearch.com Interview InvitationMaurice Dysken, MD
Professor, School of Medicine
Department of Psychiatry
Minneapolis VA Health Care System,
Minneapolis, Minnesota
MedicalResearch.com: What are the main findings of the study?Dr. Dysken: In patients with mild-to-moderate Alzheimer’s disease who were taking an acetylcholinesterase inhibitor, a dosage of 2000 IU/d of vitamin E significantly slowed functional decline compared to placebo by 6.2 months over the mean follow-up period of 2.27 years. Over this period of time caregiver time increased least in the vitamin E group compared to the other three groups (memantine alone, vitamin E plus memantine, and placebo) although the only statistically significant difference was between vitamin E alone and memantine alone. There were no significant safety concerns for vitamin E compared to placebo and mortality was lowest in the vitamin E alone group. It should be noted that patients who were on warfarin were excluded from the study because of a possible interaction with vitamin E that could have possibly increased bleeding events.
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MedicalResearch.com Interview with:Sarah M. Hartz, MD, PhD
Assistant Professor of Psychiatry
Washington University in St. Louis, MissouriMedicalResearch.com: What are the main findings of this study?Dr. Hartz: This is the first large-scale study to comprehensively evaluate substance use in people with schizophrenia, bipolar disorder, and other severe mental illness.We found that people with severe mental illness have rates of smoking, alcohol use, and other substance use that are 3 to 5 times higher than people in the general population.
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MedicalResearch.com Interview with:Madhav Goyal MD, MPH
Assistant Professor
General Internal Medicine
Johns Hopkins School of Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Goyal:
The evidence is moderately strong that there is a small but consistent benefit for mindfulness meditation programs to improve 3 symptoms: anxiety, depression, and pain. We found low level evidence that mindfulness meditation helps with symptoms of stress and distress, as well as with the mental health dimension of quality of life.
For the symptoms of anxiety and depression for which we find moderate evidence of benefit, we need to keep in mind that most of the trials didn't study people with a clinical diagnosis of anxiety or depression (although a few did). Most were studying diverse patient populations who may have had a low level of these symptoms, such as those with breast cancer, fibromyalgia, organ transplant recipients, and caregivers of people with dementia.
We found about a 5-10% improvement in anxiety symptoms compared to placebo groups. For depression, we found a roughly 10-20% improvement in depressive symptoms compared to the placebo groups. This is similar to the effects that other studies have found for the use of antidepressants in similar populations.
While we found that the evidence was moderately strong that mindfulness meditation programs may improve pain, there weren't as many trials evaluating chronic pain, and so we don't understand what kinds of pain this type of meditation may be most useful for.
MedicalResearch.com Interview withDr. Lisa Croen, PhD
Senior Research Scientist
Director, Autism Research Program
Division of Research
Kaiser Permanente Northern California
MedicalResearch.com: What are the main findings of the study?Dr. Croen: Researchers found that hospital-diagnosed maternal bacterial infections during pregnancy were associated with an increased risk of autism spectrum disorders (ASD) in children. While infections are fairly common in pregnant women, this study only found increased risks in cases of bacterial infections. Women with bacterial infections diagnosed during a hospitalization (including of the genitals, urinary tract and amniotic fluid) had a 58 percent greater risk of having a child with ASD.
Also of note, bacterial infections diagnosed during a hospitalization in the second trimester, while not very common in any of the mothers studied, were associated with children having more than a three-fold increased risk of developing ASD.
These findings resulted from a study of 407 children with autism and 2,075 matched children who did not have autism. The study included infants born between January 1995 and June 1999 who remained members of the Kaiser Permanente health plan for at least two years following birth.
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MedicalResearch.com Interview with: William P. Meehan III, MD
Director, Micheli Center for Sports Injury Prevention
Director, Sports Concussion Clinic, Boston Children?s Hospital
Waltham, MA 02453
MedicalResearch.com: What are the main findings of this study?Dr. Meehan: The study has 2 findings that I believe are the most worthy of attention. First, although cognitive rest has been recommended as a therapy for concussion for several years now, there has been little data showing its effect. This lack of data has led to variability in the recommendations for cognitive rest, with some experts not recommending it all, and others recommending athletes avoid all cognitive activity, lying alone in a dark room even, until they are completely recovered. As you can imaging, this has generated controversy. We believe this is the first study showing the independent, beneficial effect of limiting cognitive activity on recovery from concussion.
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MedicalResearch.com Interview with:
Dr. Bruce Reed PhD
Professor of Neurology,
Associate Director UC Davis Alzheimer's Disease Center
Davis, CA 95616
MedicalResearch.com: What are the main findings of the study?Dr. Reed: We found that high LDL cholesterol and low HDL cholesterol in blood were both associated with higher amyloid deposition in the brain. This is potentially very important because the deposition of amyloid seems to be a critical step that kicks off a whole chain of events that eventually lead to Alzheimer's disease. It is widely believed (although not proven) that if this deposition of amyloid could be blocked that we could greatly decrease the incidence of Alzheimer's. The connection to cholesterol is exciting because we know a fair amount about how to change cholesterol levels. A great deal more research needs to be done, but this does suggest a potential new path toward trying to prevent AD.
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MedicalResearch.com Interview with:Ajay K Parsaik, MD, MS
Department of Psychiatry and Behavior Sciences
The University of Texas Medical School, Houston
Department of Neurology and Mayo Alzheimer’s Disease Research Center, Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What are the main findings of the study?Dr. Parsaik:Main findings of our study are that clinical and subclinical hypothyroidism is not associated with mild cognitive impairment in an elderly population after accounting for possible confounding factors and interactions.
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MedicalResearch.com Interview with: Maya J. Lambiase, PhD
Department of Psychiatry
University of Pittsburgh School of Medicine
Pittsburgh, PA 15213
MedicalResearch.com: What are the main findings of the study?
Dr. Lambiase: Higher levels of anxiety were associated with a greater risk for stroke.
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MedicalResearch.com Interview with:Dr. Alan B. Zonderman PhD
Cognition Section
Laboratory of Personality and Cognition, NIA
Gerontology Research Center
Baltimore, MD 21224-6825
MedicalResearch.com: What are the main findings of the study?
Dr. Zonderman: In a prospective population-based 5-year follow-up study the authors examined the rate at which participants converted from mild cognitive impairment to dementia or reverted from mild cognitive impairment to normal cognitive performance. As has been common, they found elevated risk for dementia associated with mild cognitive impairment, but also found elevated risk for dementia among those who reverted (temporarily) to normal cognitive performance.
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MedicalResearch.com Interview with: Dr. Ronald C. Petersen M.D., Ph.D.
Division of Epidemiology
Department of Health Sciences Research; Department of Neurology
Mayo Clinic, Rochester, MN
MedicalResearch.com: What are the main findings of the study?
Dr. Petersen: The diagnosis of mild cognitive impairment increases the likelihood of developing dementia.
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MedicalResearch.com Interview with:Rada K. Dagher, Ph.D.
Assistant Professor, University of Maryland School of Public Health
Department of Health Services Administration
College Park, MD 20742
MedicalResearch.com: What are the main findings of the study?Dr. Dagher: The main finding of this study is that taking leave from work up to six months after childbirth is associated with a decrease in maternal postpartum depressive symptoms; thus longer maternity leaves may protect against the risk of postpartum depression. We conclude that the 12 week leave duration provided by the Family and Medical Leave Act (FMLA) of 1993 may not be sufficient for women who are at risk or experiencing postpartum depression. Moreover, the unpaid nature of the FMLA makes it harder for mothers with limited financial means to take longer leaves; thus, many of these mothers may have to take leaves that are much shorter in duration than 12 weeks.
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MedicalResearch.com Interview with:Dewleen G. Baker, MD
Department of Psychiatry
School of Medicine, University of California,
Veterans Affairs San Diego Healthcare System
Veterans Affairs Center of Excellence for Stress and Mental Health
San Diego, California
MedicalResearch.com: What are the main findings of the study?Dr. Baker: Pre-deployment psychiatric symptoms, combat intensity, and traumatic brain injury (TBI) were significant predictors of post-deployment PTSD symptom severity. However, the strongest predictor was deployment-related TBI; mild TBI increased symptom scores by 23%, and moderate to severe injuries increased scores by 71%.
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MedicalResearch.com Interview with:Lieke Smits drs. L.L. Smits
VU University Medical Center
Department of Neurology - Alzheimer Center
1081 HV Amsterdam, The Netherlands
MedicalResearch.com: What are the main findings of the study?Answer: In this study we used two visual ratings scales to estimate atrophy of the medial temporal lobe (MTA) and posterior atrophy (PA) on MRI in patients with Alzheimer’s disease. We assessed associations between MTA and PA with cognitive impairment. We found that MTA was associated with worse performance in memory, language and attention, while PA was associated with worse performance in viuso-spatial functioning and executive functioning.
Further stratification for age at diagnosis revealed that in late onset (>65 years old) MTA was associated with impairment in memory, language, visuo-spatial functioning and attention. In early onset patients (<65 years old), worse performance on visuo-spatial functioning almost reached significance.
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MedicalResearch.com Interview with:Dr. Matthew J. Smith PhD
Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, 13th Floor, Abbott Hall, Chicago, IL 60611
MedicalResearch.com: What are the main findings of the study?Dr. Smith:We observed that the shapes of brain structures involved in a working memory brain circuit seemed to collapse inward in a similar fashion among both of the groups that had a history of daily cannabis use. These cannabis-related changes in shape were directly related to the participants’ poor performance on working memory tasks. Some of the shape abnormalities were more severe in the group with schizophrenia and the history of daily cannabis use. We also found that participants with an earlier age of daily cannabis use had more abnormal brain shapes.
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MedicalResearch.com Interview with:Miranda M. Lim, MD, PhD
Assistant Professor, Sleep Medicine
Division of Pulmonary and Critical Care
Portland VA Medical Center and Oregon Health & Science University
MedicalResearch.com: What are the main findings of the study?Dr. Lim: People with traumatic brain injury (TBI) often have persistent sleep-wake disturbances including excessive daytime sleepiness and nighttime insomnia, yet the link between a hard blow to the head and drowsiness remains a mystery. We report that a dietary supplement containing branched chain amino acids helps keep mice with TBI awake and alert. The findings suggest that branched chain amino acids, something all humans produce from foods in their normal diets, could potentially alleviate sleep problems associated with TBI. In experiments with brain-injured mice that had trouble staying awake, we found that feeding the animals a dietary supplement enriched with branched chain amino acids improved wakefulness. Treated mice not only stayed continuously awake for longer periods of time, they also showed more orexin neuron activation, neurons known to be involved in maintaining wakefulness. (Previous studies have shown that people with narcolepsy lose significant amounts of orexins.) Branched chain amino acids are the building blocks of neurotransmitters, the chemicals released by neurons in the brain, including glutamate and GABA. We believe that branched chain amino acids act to restore the excitability of orexin neurons after brain injury, which could potentially promote wakefulness. Further studies are needed to pinpoint the exact mechanism of branched chain amino acids effect on sleep pathways in the brain, and to determine any side effects.
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MedicalResearch.com Interview with:Dr. Vitria Adisetiyo, Ph.D.
Postdoctoral Research Fellow
Medical University of South Carolina
Center for Biomedical Imaging Charleston, SC 29425
MedicalResearch.com: What are the main findings of the study?Dr. Adisetiyo: Using a non-invasive MRI method called magnetic field correlation imaging, we detected significantly reduced striatal and thalamic brain iron in medication-naive children and adolescents with ADHD compared to age-, gender- and IQ-matched typically developing controls. ADHD patients who had a history of psychostimulant medication treatment (e.g. Ritalin, Aderrall) had brain iron levels comparable to controls, suggesting brain iron may normalize with psychostimulants. Blood iron measures did not differ between patients and controls.
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MedicalResearch.com Interview with:Professor Desiree Silva MB BS, FRACP, MPH
Consultant Paediatrician
Suite 210 Specialist Centre, Joondalup Health Campus
60 Shenton Avenue, Joondalup WA 6027
MedicalResearch.com: What are the main findings of the study?Prof. Silva: Our study is one of the largest population based studies of 12,991 children with ADHD. We found that smoking in pregnancy, maternal urinary infections, preeclampsia, being induced and threatened pre-term labour increases the risk of ADHD with little gender differences. Prematurity also increased the risk of ADHD including babies born late preterm and early term marginally increased the risk of ADHD.
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MedicalResearch.com Interview with:J. Randall Curtis, MD, MPH
Professor of Medicine
Director, UW Palliative Care Center of Excellence
Section Head, Pulmonary and Critical Care Medicine, Harborview Medical CenterA. Bruce Montgomery, M.D. – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA 98104
MedicalResearch.com: What are the main findings of the study?Dr. Curtis: We examined the effect of a communication-skills intervention for internal medicine and nurse practitioner trainees on patient- and family-reported outcomes. The study was funded by the National Institutes of Nursing Research of the National Institutes of Heatlh. We conducted a randomized trial with 391 internal medicine and 81 nurse practitioner trainees at two universities. Participants were randomized to either an 8-session simulation-based, communication-skills intervention or to usual education. We collected outcome data from a large number of patients with life-limiting illness and their families, including 1866 patient ratings and 936 family ratings. The primary outcome was patient-reported quality of communication and, overall, this outcome did not change with the intervention. However, when we restricted our analyses to only patients who reported their own health status as poor, the intervention was associated with increased communication ratings. Much to our surprise, the intervention was associated with a small but significant increase in depression scores among post-intervention patients. Overall, this study demonstrates that among internal medicine and nurse practitioner trainees, simulation-based communication training compared with usual education improved communication skills acquisition, but did not improve quality of communication about end-of-life care for all patients. However, the intervention was associated with improved patient ratings of communication for the sickest patients. Furthermore, the intervention was associated with a small increase in patients’ depressive symptoms, and this appeared most marked among patients of the first-year residents.
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