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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MedicalResearch.com Interview with:Alessandra d’Azzo PhD
Department of Genetics, St Jude Children’s Research Hospital
262 Danny Thomas Place, Memphis, Tennessee 38105
MedicalResearch.com: What are the main findings of the study?Dr. d’Azzo: We have discovered a connection between a rare childhood disorder and Alzheimer’s disease that usually affects older people.
The culprit is a metabolic enzyme called NEU1 that normally controls the recycling or disposal of proteins in a specific cell compartment, the lysosome.
When NEU1 is defective, children develop the severe metabolic disease, sialidosis.
Our study suggests that NEU1 also plays an important role in the development of Alzheimer’s disease. Based on this discovery, we decided to increase NEU1 enzyme activity in the brain of an Alzheimer’s disease mouse model that shows features characteristic of the human disease, namely the accumulation of toxic protein aggregates or plaques. Remarkably, we could significantly diminish the number of plaques in the brain of these mice by increasing NEU1 enzyme activity.
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MedicalResearch.com Interview with:Ian Kronish, MD, MPH
Assistant Professor of Medicine
Center for Behavioral Cardiovascular Health
Division of General Medicine
Columbia University Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Kronish:Among primary care patients with persistently uncontrolled blood pressure despite medication treatment, we found that medication non-adherence was more than twice as common in patients with PTSD (68%) as compared to patients without PTSD (26%). The association between PTSD and medication non-adherence remained present after adjustment for key covariates including regimen complexity and depression. Recent research shows that PTSD not only contributes to psychological distress, but is also associated with increased risk for incident and recurrent cardiovascular disease. The data from our study suggest that medication non-adherence may be an important mechanism by which PTSD increases risk for cardiovascular disease.
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MedicalResearch.com Interview with:Jakob Christensen
Department of Neurology, Aarhus University Hospital, Aarhus, Denmark;
Merete Juul Sørensen
Regional Centre of Child and Adolescent Psychiatry, Aarhus University Hospital
Risskov, Denmark
MedicalResearch.com: What are the main findings of the study?Answer: We found that the risk of autism spectrum disorder was increased by 50% in children of mothers who took antidepressants during pregnancy. However, when we controlled for other factors related to the medication, by comparing with children of mothers with a diagnosis of depression or with un-exposed siblings, the risk was smaller and not significantly increased.
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MedicalResearch.com InterviewDr. Michael Shevell
Chair of the Pediatrics Department at the McGill Faculty of Medicine and Pediatrician-in-Chief at the Montreal Children’s Hospital and the McGill University Health Centre
MedicalResearch.com: What are the main findings of the study?Dr. Shevell: At risk term infants who have spent some time in a Level III NICU after birth are at substantially increased later risk for an autistic spectrum disorder. Frequently this disorder occurs in conjunction with substantial co-morbidity.
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MedicalResearch.com Interview with:Prof Ype Elgersma PhD
Professor, Neuroscience
Neuroscience Institute, Erasmus University Rotterdam
Rotterdam, Netherlands
MedicalResearch.com: What are the main findings of the study?Answer: Research in genetic mouse models suggested that inhibition of HMG-CoA-reductase by statins might ameliorate the cognitive and behavioral phenotype of children with Neurofibromatosis type 1 (NF1), an autosomal dominant disorder. In a 12-month randomized placebo-controlled study including 84 children with NF1, we found that simvastatin, an inhibitor of the HMG-CoA-reductase pathway had no effect on full-scale intelligence, attention problems or internalizing behavioral problems, or on any of the secondary outcome measures.
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MedicalResearch.com Interview with:Alize J. Ferrari
University of Queensland
School of Population Health
Herston, Queensland, Australia
MedicalResearch.com: What are the main findings of the study?Answer: In our paper recently published in PloS Medicine, we report findings from the Global Burden of Disease Study 2010 for depression. We found that depression (defined as major depressive disorder and dysthymia) accounted fr 8% of the non fatal burden in 2010, making it the second leading cause of disability worldwide. Burden due to depression increased by 35% between 1990 and 2010, although this increase was entirely driven by population growth and ageing. Burden occurred across the entire lifespan, was higher in females compared to males, and there were differences between world regions.When depression was considered a risk factor for other health outcomes it explained 46% of the burden allocated to suicide and 3% of the burden allocated ischemic heart disease.
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MedicalResearch.com Interview with:Dr. Soo Borson, M.D.
Professor Department of Psychiatry and Behavioral Sciences,
University of Washington School of Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Borson: We developed a new short screen to help clinicians and health care systems identify dementia patients and their caregivers who have unmet needs for dementia care services - extra help from primary care providers or clinical specialists skilled in understanding and managing problems related to dementia, working with caregivers to alleviate stress and burden, and locating community-based support services.
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MedicalResearch.com Interview with: Dan Nation
Assistant Professor, Department of Psychology at University of Southern California
Veterans Affairs San Diego Healthcare System
MedicalResearch.com: What are the main findings of the study?Answer: The main study findings indicate that high blood pressure, specifically pulse pressure (systolic - diastolic pressure), is associated with increased markers of Alzheimer's disease in the cerebral spinal fluid of healthy middle-aged adults. These results suggest a connection between blood pressure and Alzheimer's disease prior to the onset of any symptoms of the disease.
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MedicalResearch.com Interview with:
Dr. Andrew R. Mayer, PhD
The Mind Research Network Lovelace Biomedical and Environmental Research Institute
MedicalResearch.com: What are the main findings of the study?Dr. Mayer:
a) Just because mTBI patients self-report reduced and/or no post-concussive symptoms does not mean that they have completed the healing process.
b) Current gold-standards in the clinical world (CT scans and self-report) may not be accurately capturing brain health after injury.
c) Diffusion imaging shows promise for being a more sensitive biomarker for measuring recovery than currently used techniques.
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MedicalResearch.com: Samantha Gardener PhD Student
Senior Research Assistant for DIAN and AIBL Studies
McCusker Alzheimer's Research Foundation
2/142 Stirling Hwy NEDLANDS
6009 Western Australia
MedicalResearch.com: What are the main findings of your study?Answer: Our research indicates that consuming larger quantities of foods included in a western dietary pattern is associated with greater cognitive decline in visuospatial functioning after 36 months. Foods included in the western dietary pattern are red and processed meats, high fat dairy products, chips, refined grains, potatoes, sweets and condiments. Visuospatial functioning is an area which includes distance and depth perception, reproducing drawings and using components to construct objects or shapes.
In contrast, adherence to the Mediterranean diet, a healthy eating pattern is associated with less decline in executive function. Foods included in the Mediterranean diet are vegetables, fruits and fish. Examples of executive function include planning and organising, problem solving and time management.
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Dr. Abigail Powers PhDClinical Psychology Postdoctoral Fellow
Emory University School of MedicineMedicalResearch.com: What are the main findings of the study?Dr. Powers:Personality disorders (i.e., problematic personality patterns that cause significant distress and dysfunction in individuals’ lives across many areas of functioning) are associated with many negative health outcomes in young adulthood. The goal of this research study was to determine the relationship between personality pathology and medical resource utilization as individuals age and develop new physical health problems. Among community-dwelling later middle-aged adults (ages 55-64), we found that personality pathology was related to higher reported medical resource utilization (including doctor visits, hospitalizations, and number of outpatient procedures) independent of health status. Of the 10 DSM-IV personality disorders assessed, narcissistic and antisocial personality disorder features were associated with greater medical resource utilization independent of the presence of physical health problems. Also, among individuals with a greater number of physical health problems, histrionic and dependent personality disorder features were related to greater medical resource utilization, suggesting that important interactions between personality pathology and health conditions may occur in older age and impact resource use.
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MedicalResearch.com Interview with:Hugh C. Hendrie, MB ChB, DSc
Professor, Department of Psychiatry, Indiana University School of Medicine
Center Scientist, Indiana University Center for Aging Research
Research Scientist, Regenstrief Institute, Inc.
MedicalResearch.com: What are the main findings of the study?
Answer: Our findings of higher rates of emergency care, longer hospitalizations and increased frequency of falls, substance abuse and alcoholism suggest that seriously mentally ill older adults remain a vulnerable population.
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MedicalResearch.com Interview with:Prof David K Menon MD PhD FRCP FRCA FFICM FMedSci
Head, Division of Anaesthesia, University of Cambridge Consultant,
Neurosciences Critical Care Unit BOC Professor,
Royal College of Anaesthetists
Professorial Fellow, Queens' College, Cambridge
Senior Investigator, National Institute for Health Research
Box 93, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK
MedicalResearch.com: What is the background for your study?Dr. Menon:We have known for some time that a history of traumatic brain injury (TBI) results in a significant (between 2 and 10 fold) increase in the likelihood of getting dementia in later life. On possible mechanistic explanation for this comes from the finding that about a third of individuals who died of TBI, regardless of age, are found at autopsy to have deposits of β-amyloid in the brain, often Aβ42, which is the same variant of amyloid seen in the brain of patients who have Alzheimer’s Disease.
However, such detection after death has made it impossible to examine the linkage of such early amyloid deposition to late dementia. More recently, imaging with positron emission tomography (PET) and Pittsburgh compound B (PIB) has been used to image amyloid deposits in Alzheimer’s Disease. However, the technique had not been validated in traumatic brain injury.
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MedicalResearch.com Interview with:
Sarah M. Hartz, MD, PhD
Assistant Professor of Psychiatry
Washington University in St. Louis, Missouri
MedicalResearch.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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