MedicalResearch.com Interview with:
Dr. Anna-Maija Tolppanen PhD
Department of Neurology
University of Eastern Finland, Kuopio
MedicalResearch: What are the main findings of the study?
Dr. Tolppanen: Persons who had higher levels of cynical distrust were about three times more likely to develop dementia over eight-year follow-up.
MedicalResearch.com Interview with:
William Kronenberger, Ph.D., HSPP
Professor and Director, Section of Psychology
Acting Vice Chair of Administration
Department of Psychiatry
Indiana University School of Medicine
Riley Child and Adolescent Psychiatry Clinic
MedicalResearch: What are the main findings of the study?
Dr. Kronenberger: The main findings of the study are that children with cochlear implants had two to five times the risk of delays in executive functioning compared to children with normal hearing. Executive functioning is the ability to regulate and control thinking and behavior in order to focus and achieve goals; it is important for everything from learning to social skills. The areas of executive functioning that were most affected in children with cochlear implants were working memory, controlled attention, planning, and concept formation. Approximately one-third to one-half of the sample of children with cochlear implants had at least mild delays in these areas, compared to one-sixth or fewer of the normal-hearing sample. We think that reduced hearing experience and language delays cause delays in executive functioning to occur at higher rates in children with cochlear implants.
MedicalResearch.com Interview with: MedicalResearch.com Interview with: Albert L. Siu, MD, MSPH Co-Vice Chair Mount Sinai School of Medicine, New York MedicalResearch: What are the main findings of the study? Dr. Siu: The Task Force looked to see if primary care clinicians could identify people who are at risk of suicide among those without a diagnosed mental...
MedicalResearch.com Interview with:
Scott Stroup, MD, MPH
Professor of Psychiatry
Director, Program for Intervention Effectiveness Research,
Associate Director for Adult Services, Division of Mental Health Services and Policy Research, New York State Psychiatric Institute
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
MedicalResearch: What are the main findings of the study?
Dr. Stroup: We conducted a study sponsored by the National Institute of Mental Health that compared long-acting injectable antipsychotics for people with schizophrenia. Long-acting injectable antipsychotics, also known as depot antipsychotics, are used to promote treatment adherence. We compared a newer injectable antipsychotic, paliperidone palmitate, to an older one, haloperidol decanoate. We did not find an advantage for the newer drug in overall effectiveness. The drugs performed very similarly, and were tolerated about the same.
MedicalResearch.com Interview with:
Susan Farr, Ph.D.
Research Professor of Geriatrics
Saint Louis University
MedicalResearch: What are the main findings of the study?
Dr. Farr: We found that reducing the conversion of amyloid precursor protein (APP) to beta amyloid with an antisense targeting the beta amyloid portion of amyloid precursor protein in the Tg2576 mouse which overexpresses human beta amyloid, improves learning and memory and reduces neuroinflammatory cytokine (inflammation in the brain).
MedicalResearch.com Interview with
T. Jared Bunch, MD
Medical director for Heart Rhythm Services
Director of Heart Rhythm research
Intermountain Medical Center, Utah
MedicalResearch: What are the main findings of the study?
Dr. Bunch: The main findings of the study are:
1) Atrial fibrillation patients treated with warfarin anticoagulation that have lower percentages of time in therapeutic range have significantly higher risks of all forms of dementia.
2) The dementia relative risk related to lower percentages of time in therapeutic range was higher than all other variables associated with stroke or risk of bleeding.
3) The risk of dementia related to lower percentages of time in therapeutic range was highest in younger patients in the study (<80 years).
MedicalResearch.com Interview with:
Yvette I. Sheline, M.D.
Professor of Psychiatry, Radiology, Neurology
Director, Center for Neuromodulation in Depression and Stress (CNDS)
University of Pennsylvania Perelman School of Medicine
Philadelphia, PA 19104
MedicalResearch: What are the main findings of this study?
Prof. Sheline: The main findings were that in transgenic mice who are genetically altered to develop Alzheimer's amyloid plaques, citalopram dramatically slowed the growth of plaques but did not cause existing plaques to shrink. In normal young people, it decreased the production of amyloid.
MedicalResearch Interview with:
Patrick S. F. Bellgowan, PhD
Laureate Institute for Brain Research
Faculty of Community Medicine, The University of Tulsa,
Tulsa, Oklahoma
MedicalResearch: What are the main findings of the study?
Dr. Bellgowan: These results demonstrate 14% and 24% smaller hippocampal volumes in collegiate football players with and without a history of concussion relative to education-, sex- and age-matched controls participants. Further, the number of years of tackle football experience was correlated with smaller hippocampi and slower baseline reaction times. The hippocampus plays a key role in memory and emotional regulation. Volumetrics of other medial temporal lobe structures (I.e. The amygdala) did NOT show differences among groups suggesting that this effect is localized to the hippocampus.
MedicalResearch.com Interview with:
Professor Jayashri Kulkarni MBBS, MPM, FRANZCP, PhD
Monash University
MedicalResearch.com: What are the main findings of the study?
Professor Kulkarni: Persistent schizophrenia is difficult and unfortunately common, despite advances over the past years in antipsychotic drug development. New treatment approaches are urgently needed. Also, a specific focus for women with schizophrenia is still somewhat lacking and there is a need to consider the special issues facing women with schizophrenia.
Over many years, we have been conducting clinical trials to develop the role of adjunctive estradiol use to treat symptoms of schizophrenia. This study is the largest clinical trial in the world of this type and we found that in an 8 week, three arm, double blind, placebo-controlled, adjunctive trial of transdermal estradiol (200mcg v 100mcg v placebo) in 183 women with schizophrenia, that the women who received either 200mcg or 100mcg transdermal estradiol made a better recovery. The women who received 200mcg transdermal estradiol made a slightly better recovery than women receiving 100mcg transdermal estradiol. Both estradiol groups were significantly better than the group who received adjunctive transdermal placebo.
MedicalResearch.com interview with:
Dr Alexandra Pitman MBBS MRC Psych
MRC Clinical Research Fellow,
UCL Division of Psychiatry, UCL (University College London
MedicalResearch: What are the main findings of the study?
Answer: We conducted a systematic review of all published research comparing the experience of suicide bereavement with bereavement due to other causes, in which we considered the evidence from 57 studies evaluating the effect of bereavement on death, mental health, and social functioning of family members, friends, and other close contacts of the deceased. These studies showed that parents and children bereaved by suicide were at higher risk of mental health problems after the loss than parents and children bereaved by other causes, and that spouses and mothers bereaved by suicide were at higher risk of suicide than spouses and mothers bereaved by other causes. We also found some evidence that people from a range of kinship groups bereaved by suicide report more rejection and shame than people bereaved by other violent deaths, and that feeling stigmatised by the death is commonly experienced after any violent bereavement. It seemed that people bereaved by violent deaths, for example due to accidental death, homicide, drug-related death, motor vehicle crash, undetermined death or suicide, shared a sense of feeling blamed for the death or tainted by their association with the deceased.
MedicalResearch.com Interview with:
Meesha Ahuja, MD
Department of Psychiatry and Human Behavior of the
Warren Alpert Medical School of Brown University
Young Adult Behavioral Health Program at Rhode Island Hospital
Mentors: Laura Whiteley, MD and Larry Brown, MD
MedicalResearch: Why did you decided to study this topic?
Dr. Ahuja: Severe mental illness is more common among college students than it was a decade ago, and the number of college students presenting for psychiatric care both on and off campus has dramatically increased. The rates of cannabis use have also been increasing among college students in the United States since the mid-1990s. The concomitant use of cannabis and other substances among general samples in psychiatric treatment has been linked to poorer clinical outcomes including increased hospitalizations, increased symptomatology, poorer treatment adherence, higher treatment resistance. However, before doing this study, there was no research that examined the effect of cannabis and other substance use disorders on the scholastic and general functioning of college students in psychiatric care.
MedicalResearch.com Interview with: Niklas Mattsson MD, PhD University of California San Francisco Center for Imaging of Neurodegenerative Diseases VA Medical Center San Francisco, CA 94121, USA Clinical Neurochemistry Laboratory Institute of Neuroscience and Physiology Sahlgren’s University Hospital/Mölndal MedicalResearch.com: What are the main findings of the study? Dr. Mattsson: The main finding of this study was that cognitively healthy people with signs of...
MedicalResearch.com Interview with:
Marianna Virtanen PhD
Finnish Institute of Occupational Health
Helsinki, Finland
MedicalResearch: What are the main findings of the study?
Dr. Virtanen: We examined whether psychological distress predicts incident type 2 diabetes and if the association differs between populations at higher or lower risk of type 2 diabetes. We used a clinical type 2 diabetes risk score to assess future diabetes risk and in addition, participants’ prediabetes status. We found that psychological distress did not predict future type 2 diabetes among participants who were normoglycemic and among those with prediabetes combined with a low diabetes risk score. However, psychological distress doubled the risk of type 2 diabetes among participants with prediabetes and a high diabetes risk score.
MedicalResearch.com Interview with:
Elizabeth Devore, ScD
Associate Epidemiologist
Brigham and Women’s Hospital
Instructor in Medicine, Harvard Medical School
MedicalResearch.com: What are the main findings of the study?
Dr. Devore: In this study, we examined sleep duration and memory performance in a group of ~15,000 women participating in the Nurses’ Health Study. We found that women with sleep durations of 5 or fewer hours/day or 9 or more hours/day, either in midlife or later life, had worse memory at older ages than those sleeping 7 hours/day. In addition, women with sleep durations that changed by two or more hours/day from midlife to later life performed worse on memory tests compared to those whose sleep duration did not change during that time period.The magnitude of these memory differences was approximately equivalent to being 1-2 years older in age.
MedicalResearch.com Interview with:
Tara Lagu MD PhD
Assistant Professor of Medicine
Tufts University School of Medicine
MedicalResearch.com: What are the main findings of the study?
Dr. Lagu: We found that use of mechanical ventilation in patients 65 and older is increasing rapidly. If current rates of increase continue, we expect that by 2020 there will be more than 600,000 hospitalizations per year that involve mechanical ventilation. This is a doubling in 20 years (2001-2020), and represents demand that could easily exceed the capacity of the US critical care system. We also found that increase in use among patients with dementia is 4 times faster than those without dementia. This is important because dementia is a terminal illness, and use of mechanical ventilation in patients with end-stage dementia is associated with poor 30-day and 1-year outcomes.
MedicalResearch.com Interview with:
Jane Topolovec-Vranic, PhD
Clinical Researcher, Trauma and Neurosurgery Program
Assistant Professor, Department of Occupational Science and Occupational Therapy, University of Toronto
Associate Member, Graduate Department of Rehabilitation Sciences, University of Toronto
MedicalResearch.com What are the main findings of the study?
Answer: In our study we found that almost half of the men interviewed in a homeless shelter in Toronto had experienced a traumatic brain injury in their past, and that most of them had experienced their first brain injury prior to becoming homeless, usually in the early teenage years.
MedicalResearch.com Interview with:
Ziad Nasreddine MD FRCP(C)
Professeur adjoint
Université de Sherbrooke et McGill University
Neuro Rive-Sud/CEDRA: Centre Diagnostique et Recherche sur la Maladie d'Alzheimer Québec, Canada
MedicalResearch.com: What are the main findings of this study?
Dr. Nasreddine: The Montreal Cognitive Assessment (MoCA) total score (MoCA-TS) and Memory Index Score (MoCA-MIS) are useful in predicting conversion to Alzheimer’s disease (AD) in individuals with mild cognitive impairment (MCI). Identifying individuals with MCI at high of conversion to Alzheimer’s disease is important clinically and for selecting appropriate subjects for therapeutic trials.
MedicalResearch.com Interview with
Helen C. Kales MD
Professor of Psychiatry
Director, Section of Geriatric Psychiatry and The Program for Positive Aging, University of Michigan
Research Scientist, VA Center for Clinical Management Research
and Geriatric Research Education and Clinical Center
VA Ann Arbor Healthcare System
Please note that this paper is the result of the deliberations of a multi-disciplinary national expert panel, not a specific study.
MedicalResearch.com: What were the main findings of the expert panel?
Dr. Kales: Often more than memory loss, behavioral symptoms of dementia are among the most difficult aspects of caring for people with dementia. These symptoms are experienced almost universally, across dementia stages and causes, and are often associated with poor outcomes including early nursing home placement, hospital stays, caregiver stress and depression, and reduced caregiver employment. Doctors often prescribe these patients psychiatric medications like antipsychotics, despite little hard evidence that they work well in this population and despite the risks they pose including hastening death. Meanwhile, studies show promise for non-medication behavioral and environmental approaches (such as providing caregiver education/support, creating meaningful activities and simplifying/enhancing the environment), but too few health providers are trained in their use. The method created by the national multidisciplinary group of experts (DICE which stands for Describe, Investigate, Create and Evaluate) represents a comprehensive approach to assessment and management of behavioral symptoms in dementia. For example, a new report of “agitation” from a caregiver, should be fully understood and described (e.g. who/what/when/where/risk/safety); underlying causes should be investigated (e.g. pain, changes in medications, medical conditions, poor sleep, fear); a treatment plan should be created (e.g. responding to physical problems, working collaboratively with the caregiver and other team members to institute non-pharmacologic interventions); and evaluating whether the interventions tried were effective.
MedicalResearch.com Interview with:
Li-Ching Lee, PhD, ScM
Associate Scientist,
Departments of Epidemiology and Mental Health
Johns Hopkins Bloomberg School of Public Health
Baltimore MD 21205
MedicalResearch.com: What are the main findings of the study?
Dr. Li-Ching Lee: This population-based case-control study in young children provides evidence that prenatal selective serotonin reuptake inhibitor (SSRI) use may be a risk factor for autism and other developmental delays (DD). Among boys, prenatal SSRI exposure was nearly 3 times as likely in children with autism spectrum disorder (ASD) relative to children with typical development; the strongest association occurred with first-trimester exposure. Exposure was also elevated among boys with DD and was strongest in the third trimester.
MedicalResearch.com Interview with:
Dr. George Patton
Department of Paediatrics, University of Melbourne
Centre for Adolescent Health, Murdoch Children's Research Institute,
Royal Children's Hospital, Parkville, VIC, Australia
MedicalResearch.com: What are the main findings of the study?
Dr. Patton: Although there has been wide acceptance that the teens are a time when emotional problems are common, views have been polarized about their significance. Some have viewed these problems are usual for this phase of life with little significance for later life mental health; others have argued that early psychiatric intervention was essential given the risks of ongoing disorders.
In this sample almost two thirds of girls and a third of boys had an episode of emotional troubles (anxiety and depression) at a level that would concern a family physician. For those where the episode were brief lasting weeks to months, recovery without further later life episodes was common. In contrast those with persistent (longer than 6 months) or recurrent emotional problems during the teens had a high likelihood of similar problems with depression and anxiety in their twenties. In general these emotional problems persisted more in females than in males.
MedicalResearch.com Interview with:
John I. Nurnberger, Jr., M.D., Ph.D.
Professor of Psychiatry
Joyce and Iver Small Professor of Psychiatry
Indiana University School of Medicine
MedicalResearch.com: What are the main findings of this study?
Dr. Nurnberger: The main findings of the study are the biological pathways identified to be associated with bipolar disorder, including those involved in hormonal regulation, calcium channels, second messenger systems, and glutamate signaling. Gene expression studies implicated neuronal development pathways as well.
These findings highlight the role of certain neurobiological processes that have been considered in prior hypotheses of bipolar disorder. They underline a role for calcium signaling, which has only been clearly implicated in the genetics of bipolar disorder in recent years. They also feature hormonal processes such as the hypothalamic-pituitary-adrenal axis, which has been known to be involved in stress responses, but has not been prominent in many recent theories of the pathogenesis of bipolar disorder.
MedicalResearch.com Interview with:
Dr. Jeffery C. Huffman, M.D.
Harvard Medical School
Department of Psychiatry
Massachusetts General Hospital, Boston
MedicalResearch.com: What are the main findings of the study?
Dr. Huffman: Depression and anxiety in cardiac patients are associated with adverse cardiac outcomes. We completed a very low-intensity care management intervention to identify depression and anxiety disorders during a cardiac admission and then to assist in the monitoring and management of the condition over the next 24 weeks. There have been other care management trials in cardiac patients, but ours was the first to co-manage depression and anxiety, the first to initiate treatment in the hospital, the first to take a broad population of cardiac patients rather than a single diagnosis, and the first to use such a low-resource strategy with only a single part-time social worker to coordinate care.
We found that the care management intervention was associated with significant improvements in mental health treatment, mental health related quality of life, depression, and function at 24 weeks compared to enhanced treatment as usual. We did not find differences in anxiety, adherence, or cardiac readmissions.
MedicalResearch.com Interview with: Julian Benito-Leon University Hospital “12 de Octubre”, Madrid, Spain MedicalResearch.com: What are the main findings of the study? Dr. Benito-León: It has been suggested that a major problem with epidemiologic studies that have reported an inverse association between Alzheimer’s disease and cancer is the very likely underdiagnosis of cancer once dementia...
MedicalResearch.com Interview with:
Ioannis Tarnanas M.Sc
Senior Researcher
Gerontechnology and Rehabilitation Research Group,
ARTORG Centre for Biomedical Engineering,
University of Bern, 3010 Bern, Switzerland
MedicalResearch.com: What are the main findings of the study?
Answer: We examined 75 healthy older people and 134 patients with mild cognitive impairment. Our aim was to collect neuropsychological, neurophysiological, neuroimaging and behavioural data by means of a virtual reality serious game, in order to model the profile of the patients who will progress to dementia within the next 2-4 years. We found that the prediction based on the performance at the virtual reality based computerized assessment instrument is comparable to that of more established and widely accepted biomarkers, such as ERP and MRI. This can be explained by the cognitive fidelity and richness of behavioural data collected with virtual reality based measures, which directly reflect neurocognitive processes affected at a very early stage.
MedicalResearch.com Interview with:
Michael B. Blank, PhD
Associate Professor of Psychology in Psychiatry
Perelman School of Medicine
University of Pennsylvania
Philadelphia, PA 19104-3309
MedicalResearch.com: What are the main findings of the study?
Dr. Blank: We found that people in treatment for mental illnesses in inpatient and outpatient settings in Philadelphia and Baltimore were about times as likely to be infected with HIV as the general population in those cities and about 16 times as likely to be HIV infected as the general population of the US. We also found that severity of psychiatric symptoms increased the likelihood of infection.
MedicalResearch.com Interview with:
Prof. Dr. med. Piotr Lewczuk
Head,Lab for Clinical Neurochemistry
and Neurochemical Dementia Diagnostics,
Universitätsklinikum Erlangen,
Department of Psychiatry and Psychotherapy,
91054 Erlangen, Germany
MedicalResearch.com: What are the main findings of the study?
Prof. Dr. med. Piotr Lewczuk: In our study, we investigated the concentrations of four isoforms of amyloid beta peptides in the blood of healthy young volunteers without memory complains. The participants were stratified into three groups according to their apolipoprotein E (APOE) genotype, which is the mostly investigated and generally accepted genetic risk factor for sporadic Alzheimer’s Disease (AD). It is known that the alterations of the amyloid beta metabolism are the earliest changes in the course of AD, occurring many years (or even decades) before the onset of the clinical symptoms, but it is actually not known how early these alterations start. Correspondingly, we wanted to investigate if healthy persons with genetic risk factor show changes in their amyloid beta metabolism already 30-40 years before the age when AD is usually diagnosed. We did not find any differences between the groups with and without APOE-driven risk, which might be carefully interpreted as no signs of Alzheimer’s Disease pathology in persons at risk at such an early life stage. Taken together, we think that the Alzheimer’s Disease pathology starts some 10-20 years before the beginning of the clinical symptoms, but not earlier.
MedicalResearch.com Interview with:
Bradley S. Peterson, MD
Director of the Center for Developmental Neuropsychiatry
Director of the Center for Developmental Neuropsychiatry,
New York State Psychiatric Institute
Suzanne Crosby Murphy Professor in Pediatric Neuropsychiatry,
Columbia University, NY
MedicalResearch.com: What are the main findings of the study?
Dr. Peterson: We detected the presence of lactate in the brains of 13% of 75 participants who had ASD (Autism Spectrum Disorder), compared with 1% of the brains of 96 typically developing control participants. The presence of lactate was especially more common in adults who have ASD. Lactate is a product of anaerobic metabolism, which generally should not occur in healthy, living brains under normal circumstances. The presence of lactate in the brains of persons with Autism Spectrum Disorder therefore suggests the presence of deficient production of energy stores by a component of brain cells called “mitochondria”. We detected lactate most commonly in the cingulate gyrus, a region that supports the higher-order control of thought, emotion, and behavior, and that has been implicated previously in Autism Spectrum Disorder.
MedicalResearch.com Interview with
Ulla Räisänen
Senior Researcher
HERG Health Experiences Research Group
Department of Primary Care Health Sciences
University of Oxford Oxford OX1 2ET
MedicalResearch.com : What are the main findings of the study?
Answer: We conducted a qualitative interview study exploring how young men (aged 16-25) recognise eating disorder symptoms and decide to seek help, and to examine their experiences of initial contacts with primary care in the UK.
Our data suggest that the widespread perception of eating disorders as uniquely or predominantly a female problem led to an initial failure by young men to recognise their behaviours as symptoms of an eating disorder. Many presented late in their illness trajectory when eating disorder behaviours and symptoms were entrenched, and some felt that opportunities to recognise their illness had been missed because of others’ lack of awareness of eating disorders in men. In addition, the men discussed the lack of gender-appropriate information and resources for men with eating disorders as an additional impediment to making sense of their experiences, and some felt that health and other professionals had been slow to recognise their symptoms because they were men.