Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Mental Health Research / 20.07.2017

MedicalResearch.com Interview with: Bastian Ravesteijn PhD Department of Health Care Policy Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We find that higher out-of-pocket costs for mental health care could have the unintended consequence of increasing the use of acute and involuntary mental health care among those suffering from the most debilitating disorders. (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, JAMA, Mental Health Research / 05.06.2017

MedicalResearch.com Interview with: Carl G Streed Jr. M.D. Pronouns: he, him, his, himself Fellow, Division General Internal Medicine & Primary Care  Brigham & Women’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: The National Institutes of Health (NIH) has underscored the need to better understand the health of gender minorities, including transgender and gender non-conforming individuals. Prior investigations of gender minorities are limited by the lack of national gender identity data. In 2013, the Centers for Disease Control and Prevention (CDC) developed a gender identity question for the Behavioral Risk Factors Surveillance System (BRFSS); states had the option to administer this module beginning 2014. Our study aims to examine the health status of gender minorities in the US compared to cisgender peers. Compared to cisgender adults, gender minority adults are younger, less likely to be non-Hispanic white, married or living with a partner, have a minor child in the household, or be English speaking; but are more likely to have lower income, be unemployed, be uninsured, have unmet medical care due to cost, be overweight, and report depression. Gender minority adults, compared to cisgender adults, are more likely to report: poor or fair health; difficulty concentrating, remembering, or making decisions; and being limited in any way. These outcomes remained significant after adjustment. (more…)
Author Interviews, Mental Health Research, Microbiome / 01.06.2017

MedicalResearch.com Interview with: Dr. Gerard Clarke PhD APC Microbiome Institute Department of Psychiatry and Neurobehavioural Science University College Cork, Cork, Ireland MedicalResearch.com: What is the background for this study? Response: Over the last decade or so, we and others have shown that the gut microbiome exerts a broad influence on the central nervous system, reflected in a range of abnormal behaviours and altered brain function in germ-free animals. These germ-free animals grow up in a sterile bubble and allow us to see what aspects of brain and behaviour could be under the influence of the microorganisms in our gastrointestinal tract. One of the most consistent findings to emerge relates to anxiety-like behaviours. (more…)
Author Interviews, JAMA, Mental Health Research / 31.05.2017

MedicalResearch.com Interview with: Michael Large, BSc, MBBS, FRANZCP, DMedSci School of Psychiatry, University of New South Wales,  The Prince of Wales Hospitals, Randwick New South Wales, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been increasingly recognized that recently discharged patients have an increased suicide risk. We synthesized the global research over the last half century finding a dramatically elevated suicide rate in the months post discharge and a surprisingly high and enduring rate over much longer periods. (more…)
Author Interviews, Lancet, Mental Health Research, Pediatrics / 26.05.2017

MedicalResearch.com Interview with: Dr Annie Herbert, PhD Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare University College London London  UK  MedicalResearch.com: What is the background for this study? Response: 1 in 25 adolescents (i.e. one in every classroom) will be admitted to hospital as an emergency with injuries related self-harm, drug or alcohol misuse, or violence. Currently, the guidelines for how these adolescents are managed differ greatly depending on the type of injury they come in with (whether through self-harm, drug or alcohol misuse, or violence). MedicalResearch.com: What are the main findings? Response: In our study, we found that adolescents admitted with any of these injuries were at an increased risk of suicide and of drug or alcohol related death in the ten years after leaving hospital, compared to other admitted adolescents.While the overall risk is relatively low—for example, 2–3 girls out of 1000 and 7 boys out of 1000 who are admitted as an emergency to hospital with drug or alcohol related injuries die from suicide within 10 years—the rates are 5–6 times higher than among adolescents admitted to hospital following an accident. (more…)
Alzheimer's - Dementia, Author Interviews, Genetic Research, Mental Health Research / 23.05.2017

MedicalResearch.com Interview with: Auriel Willette, M.S., Ph.D. Assistant Professor Departments of Food Science and Human Nutrition and Psychology Iowa State University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Translocase of Outer Mitochondrial Membrane 40 (TOMM40) is a gene that regulates the width of the outer mitochondrial pore, facilitating the transport of ribosomal pre-proteins into the inner mitochondrial matrix for translational modification into functional proteins. In 2010, Dr. Allen Roses, who discovered the Apolipoprotein E (APOE) gene, Dr. Michael Lutz, and other colleagues found that a variation in poly-T length at locus rs10524523 ('523) within intron 6 predicted Alzheimer's disease onset. Specifically, a "long" versus "short" poly-T length was related to earlier age of onset by 8 years. However, several multi-cohort studies either failed to replicate the findings or found the opposite relationship, where a "long" or "very long" poly-T length was related to later age of onset. The literature has remained mixed to this day. We were interested in testing factors that might change the relationship between TOMM40 and both cognitive decline and risk for having Alzheimer's disease. It is known that a family history (FH) of Alzheimer's disease has been associated with mitochondrial dysfunction. We reasoned, then, that FH may interact with TOMM40 to modulate how it was related to our outcomes of interest. We investigated this hypothesis in two separate cohorts: the Wisconsin Registry for Alzheimer's Prevention (WRAP), a late middle-aged cohort, and the Alzheimer's Disease Neuroimaging Initiative (ADNI), a well-characterized sample of aged participants from across the Alzheimer's spectrum. (more…)
Author Interviews, Mental Health Research, Psychological Science / 19.05.2017

MedicalResearch.com Interview with: Justin M. Kim, Ph.D Dartmouth College Advisor: Paul J. Whalen MedicalResearch.com: What is the background for this study? What are the main findings? Response: Anxiety (and its co-conspirator ‘worry’) is an active, energy consuming process. You haven’t given up - you are still fighting back, trying to anticipate what might happen tomorrow. The problem of course is that there are an infinite number of ‘what if…’ scenarios you can come up with. For some individuals, the uncertainty of what ‘might happen’ tomorrow, is actually worse than the negative event itself actually happening. These individuals are intolerant of uncertainty. We were interested in how uncertainty and ambiguity of potential future threat contribute to the generation of anxiety and how they might be represented in our brain. In the psychology literature, how we deal with an uncertain future can be quantified as intolerance of uncertainty (IU). As is the case with any other personality characteristic, we all have varying degrees of IU. For example, individuals high in IU display difficulty accepting the possibility of potential negative events in the future. Importantly, psychiatric disorders such as generalized anxiety disorder (GAD) or obsessive-compulsive disorder (OCD), whose symptoms are marked with worrying/obsessing, are commonly associated elevated IU. We noticed that while much of the neuroimaging research on IU has been primarily focused on brain function, brain structural correlates of IU have received little attention so far. As such, we believed that it was an important endeavor to assess the relationship between IU and the structural properties of the brain, which can be done through the use of magnetic resonance imaging (MRI) techniques. (more…)
Author Interviews, Emory, Mental Health Research, Technology / 10.05.2017

MedicalResearch.com Interview with: Jessica Maples-Keller Emory University School of Medicine. MedicalResearch.com: What is the background for this study? What are the main findings? Response:  This manuscript is a review of the use of Virtual Reality (VR) technology within psychiatric treatment. VR refers to an advanced technological communication interface in which the user is actively participated in a computer generated 3-d virtual world that includes sensory input devices used to simulate real-world interactive experiences. VR is a powerful tool for the psychiatric community, as it allows providers to create computer-generated environments in a controlled setting, which can be used to create a sense of presence and immersion in the feared environment for individuals suffering from anxiety disorders. (more…)
Author Interviews, Mental Health Research, Occupational Health, Social Issues / 07.05.2017

MedicalResearch.com Interview with: Tarani Chandola Professor of Medical Sociology Social Statistics Disciplinary Area of the School of Social Sciences University of Manchester MedicalResearch.com: What is the background for this study? Response: We (the authors) were particularly interested in examining evidence for the common perception that people at the top of the occupational hierarchy are the most stressed. And also what happens to people’s stress levels when they retire. We had assumed that people with poorer quality work to have decreased levels of stress when they retired. There have been other studies on this topic before, but none that have used salivary cortisol to measure physiological stress responses. We analysed changes in people’s stress levels before and after retirement, in a follow up study of over 1,000 older workers in the British civil service. Stress levels were measured by taking salivary cortisol samples across the day, from awakening until bedtime. (more…)
Author Interviews, Depression, Mental Health Research, Neurological Disorders, NIH / 03.05.2017

MedicalResearch.com Interview with: Ronald Cannon, Ph.D. Staff scientist at NIH’s National Institute of Environmental Health Sciences MedicalResearch.com: What is the background for this study? Response: The protein pump, P-glycoprotein, is a major obstacle to the delivery of therapeutic drugs across the blood-brain barrier and into the central nervous system (CNS). During the last 10 years, our laboratory has studied the regulation of P-glycoprotein with the hope of treating CNS diseases. MedicalResearch.com: What are the main findings? Response: Our most recent finding shows that the antidepressant, amitriptyline, suppresses P-glycoprotein pump activity. The discovery is significant because P-glycoprotein restricts most CNS targeted drugs from entering the brain. If fully translatable to human patients, suppression of P-glycoprotein could allow higher levels of CNS therapeutic drugs to reach their intended target. (more…)
Accidents & Violence, Author Interviews, JAMA, Mental Health Research, Surgical Research / 30.04.2017

MedicalResearch.com Interview with: Elinore J. Kaufman, MD, MSHP Department of Surgery, New York Presbyterian Hospital Weill Cornell Medicine New York, New York MedicalResearch.com: What is the background for this study? What are the main findings? Response: Deaths of civilians in contact with police have recently gained national public and policy attention. However, we know very little about nonfatal injuries, which far outnumber deaths. MedicalResearch.com: What should readers take away from your report? Response: Nonfatal injuries are much more pervasive than law enforcement-associated deaths, and rates have remained stable over several years, at approximately 51,000 emergency department visits and hospitalizations each year. These injuries primarily affect young men, and mental illness is a common theme. As a physician, my goal is always to get to zero preventable injuries. (more…)
Author Interviews, JAMA, Mental Health Research, Pediatrics / 25.04.2017

MedicalResearch.com Interview with: Dr. Yongfu Yu, PhD Department of Clinical Epidemiology Aarhus University Hospital Aarhus, Denmark MedicalResearch.com: What is the background for this study? Response: Bereavement by the death of a close relative is ranked as one of the most severe life events and it is likely to cause psychological stress regardless of coping mechanisms. An increased risk of mortality and adverse health outcomes has been observed among the bereaved spouses, parents, and children. It is estimated that nearly 8% of individuals in the US experienced a sibling death in childhood but much less is known about its health consequences. Sibling relationship tends to be the longest and the most intimate in family thus the death of a sibling can be a devastating life event, especially when this event happens at early ages. However, to our knowledge, no study has investigated the effects of sibling death in childhood on subsequent mortality in bereaved siblings with a long follow-up time. (more…)
Author Interviews, BMJ, Karolinski Institute, Mental Health Research, Pediatrics / 22.04.2017

MedicalResearch.com Interview with: Charlotte Björkenstam PhD Dept of Clinical Neuroscience Karolinska Institutet Division of Insurance Medicine Stockholm MedicalResearch.com: What is the background for this study? What are the main findings? Response: In a prior study we revealed that exposure to childhood adversities were associated with a substantial risk increase for self-harm. The risk was even higher for those exposed to accumulated childhood adversities. This finding together with the fact that the suicide rate among young adults is increasing (as opposed to decreasing in the general population) lead us to want to examine the relationship between childhood adversities and death by suicide. We investigated 7 different childhood adversities, including familial death (suicide analyzed separately), parental substance abuse, parental psychiatric disorder, substantial parental criminality, parental separation/single-parent household, public assistance recipiency, and residential instability occurring between birth and age 14. We then followed the individuals up until age 24 at most. All adversities were entailed with an increased suicide risk from IRR: 1.6 (95% CI: 1.1 to 2.4) for residential instability to IRR: 2.9 (95% CI; 1.4 to 5.9) for familial suicide. We also found a dose-response relationship between accumulating CA and suicide risk where IRR ranged between 1.1 (95% CI: 0.9 to 1.4) for those exposed to 1 CA, to 2.6 (95% CI: 1.9 to 3.4) for those exposed to 3 or more adversities. (more…)
Author Interviews, Cognitive Issues, Exercise - Fitness, Mental Health Research / 18.04.2017

MedicalResearch.com Interview with: Brian Levine, Ph.D., C.Psych, ABPP-cn Senior Scientist, Rotman Research Institute, Baycrest Professor, Departments of Psychology and Medicine (Neurology) University of Toronto MedicalResearch.com: What is the background for this study? Response: There is growing concern about the effects of concussion on brain function with aging. Retired professional athletes provide a unique perspective on this question, as many of them have a high concussion exposure before retirement in their 20’s or 30’s. Yet much of the research on professional athletes has been in post-mortem samples. There is a need for more research in retired athletes during life. (more…)
Accidents & Violence, Author Interviews, JAMA, Karolinski Institute, Mental Health Research / 06.04.2017

MedicalResearch.com Interview with: Hanna Sahlin MSc, Lic psychologist, Lic psychotherapist Specialist in clinical psychology PhD-student Departement of Clinical Neuroscience Karolinska Institutet National Self-harm project Centre for Psychiatry Research, CPF Stockholm, Sweden What is the background for this study? What are the main findings? Response: This study is the result of wanting to find a more conclusive answer to whether individuals who engage in non-fatal deliberate self-harm are more prone to aggression towards others. There has long been a debate on whether aggression to oneself and aggression towards others co-occur, but the studies that have been conducted thus far have been on smaller samples or with clinical or forensic cohorts. Also, the studies have had great variability regarding the definition of both “deliberate self-harm” and “violence”. Thus, it has been difficult to establish an ”overall” effect size for this association, or to draw firmer conclusions on how and if this association plays out in the general population. We had the opportunity to study this association in several large nationwide population-based registries including all Swedish citizens, and with high specificity regarding the ingoing variables of interest – i.e., non-fatal deliberate self-harm (as registered in the National Patient Register) and violent crime convictions (as registered in the National Crime Register). We found a five times increased crude risk (hazard) of being convicted of a violent crime if one had received self-harm associated clinical care, and vice-versa, that there was an equally increased risk of self-harm if one had been convicted of a violent crime. After controlling for relevant psychiatric comorbidities and socio-economic status, an almost doubled risk of violent crime conviction remained among self-harming men and women compared to individuals not exposed to self-harm. It is important to notice that our study did not find any evidence suggesting that self-harm behaviours cause violent criminality. Therefore, we conclude that the engagement in violence towards oneself and towards others share an underlying vulnerability to impulsive and aggressive behaviours. (more…)
AHA Journals, Author Interviews, Heart Disease, Mental Health Research / 04.04.2017

MedicalResearch.com Interview with: Alessandro Paoletti Perini, MD, PhD and Valentina Kutyifa MD, PhD University of Rochester Medical Center Heart Research Follow-Up Program Rochester, New York, 14642 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The present study is a pre-specified sub-study of the Multicenter Automatic Defibrillator Implantation Trial – Reduce Inappropriate Therapy (MADIT-RIT), which was published on the New England Journal of Medicine in 2012. The main trial showed that innovative ICD programming was associated with reduction in inappropriate ICD therapy and mortality. In the present investigation we focused on the detrimental effects that ICD firings, either appropriate or inappropriate, may have on patients’ psychological well-being. We observed that multiple appropriate and inappropriate shocks are associated with increased levels of ICD-related anxiety, a specific kind of psychological disorder which affects patients implanted with an ICD. Multiple appropriate ATP were also proved associated with higher anxiety, although not as much as shocks. On the other hand, we did not find a significant association with anxiety for multiple inappropriate ATP. (more…)
Author Interviews, Cannabis, Mental Health Research, Pediatrics / 04.04.2017

MedicalResearch.com Interview with: James McIntosh PhD Economics Department Concordia University Montreal, Quebec, Canada. MedicalResearch.com: What is the background for this study Response: Marijuana is about to become legal in Canada. Consequently, an analysis of its effects on users is a high priority. This issue has been explored by Canadian researchers to some extent but there are gaps in what is known about the effects of using marijuana. Most of the Canadian studies focus on youth or adolescent use. This is clearly important but adult use is as well. Establishing the link between early usage and the effects of use over an individual’s lifetime was a major objective of the study. (more…)
Author Interviews, Cancer Research, Mental Health Research / 03.04.2017

MedicalResearch.com Interview with: Raffaella Calati, Psy.D., Ph.D. University of Montpellier INSERM U 1061: Neuropsychiatry: Epidemiological and Clinical Research Department of Emergency Psychiatry and Post Acute Care Lapeyronie Hospital, Centre Hospitalier Universitaire Montpellier, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: A number of previous original studies investigated suicidal thoughts and behaviours in cancer patients, finding them to be higher than those in the general population. However, to our knowledge, we performed the first meta-analysis on this link, pooling all the published data to calculate the size of this increased risk. Our main finding is an increased suicide risk in patients with cancer compared to individuals without it. It should be underlined that the analyses presented are the first stage in our work, since at the moment we are analyzing a higher number of studies and we are planning to control for confounders, not considered in our first analyses. This means that the exact strength of this association will be more precisely known. (more…)
Abuse and Neglect, Author Interviews, BMJ, Exercise - Fitness, Mental Health Research / 02.04.2017

MedicalResearch.com Interview with: Tine Vertommen, Criminologist Faculty of Medicine and Health Sciences Universiteitsplein 1 Antwerp, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Response: A recent prevalence study into interpersonal violence against child athletes in the Netherlands and Belgium showed that 6% experienced severe sexual violence, 8% experienced severe physical violence, and 9% of respondents experienced severe psychological violence in sport (Vertommen et al., 2016). While general literature has repeatedly shown that exposure to interpersonal violence during childhood is associated with mental health problems in adulthood, this relationship has not yet been demonstrated in (former) athletes. Thus, the objective of the current study is to assess the long-term consequences of these experiences on adult mental health and quality of life. (more…)
Author Interviews, Mental Health Research / 21.03.2017

MedicalResearch.com Interview with: Dr. Melanie Ullrich PhD Universität Würzburg Physiologisches Institut Würzburg MedicalResearch.com: What is the background for this study? Response: Shortly after the first description of SPRED proteins in 2001, their in vivo functions, especially that of SPRED2, were completely unexplored. Thus we generated a mouse model which lacks functional SPRED2 expression. In our previous study, we identified SPRED2 as a critical regulator of stress hormone release from the hypothalamic-pituitary-adrenal (HPA) axis. In SPRED2 KO mice levels of corticotropin-releasing hormone, adrenocorticotropic hormone, and corticosterone are elevated, a feature often associated with obsessive-compulsive disorders (OCD) in humans. In fact SPRED2 KO mice showed clear signs of OCD-like behavior demonstrated by excessive self-grooming up to the level of self-inflicted lesions. Treatment with the selective serotonin reuptake inhibitor (SSRI) fluoxetine alleviated excessive grooming, confirming the OCD-like nature of the disease. Therefore, the first main finding of our study is that mutations in the SPRED2 gene have to be considered as a possible risk factor for the development of OCD-like diseases. (more…)
Author Interviews, JAMA, Mental Health Research, Urology / 21.03.2017

MedicalResearch.com Interview with: Blayne Welk, MD, FRCSC Assistant Professor of Surgery Western University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Concerns have been raised by regulatory agencies and patients about possible serious psychiatric side effects associated with the use of 5 alpha reductase inhibitors. These medications can be used for both enlarged prostates and alopecia. We used administrative data to assess for potential psychiatric side effects associated with finasteride and dutasteride usage in older men with benign prostatic enlargement. In our study we found that there was no increased risk of suicide associated with the use of these medications. However, there was a small increase in both self-harm and new onset depression associated with the use of 5 alpha reductase inhibitors. (more…)
Author Interviews, JAMA, Mental Health Research / 19.03.2017

MedicalResearch.com Interview with: Florian Walter MSc Centre for Mental Health and Safety University of Manchester, Manchester, England Dr Roger Webb PhD and Reader in Mental Health Epidemiology Senior Postgraduate Research Tutor Division of Psychology and Mental Health Faculty of Biology, Medicine and Health The University of Manchester MedicalResearch.com: What is the background for this study? Response: Mental disorders are associated with an elevated risk of premature mortality, and risk is especially heightened soon after discharge from inpatient psychiatric services. Previous studies have focused on single causes of death, whereas our study considered a comprehensive array of cause-specific mortality outcomes. We analysed over 1.7 million Danish residents in our national interlinked registry study, which was conducted collaboratively by the Centre of Mental Health and Safety, University of Manchester, UK and the National Centre for Register-based Research, Aarhus University, Denmark. We compared the risk of dying from specific natural and unnatural causes of death among patients following their first discharge from inpatient psychiatric care versus people not admitted. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Gender Differences, Mental Health Research / 16.03.2017

MedicalResearch.com Interview with: Wellington K. Hsu, MD Clifford C. Raisbeck, MD, Professor of Orthopaedic Surgery Associate Professor of Orthopaedic Surgery Northwestern University Chicago, IL MedicalResearch.com: What is the background for this study? What are the main findings? Response: Concussions remains a significant problem in youth sports. The recent enactment of Traumatic brain injury laws have certainly heightened awareness regarding this problem. Our study looked at publicly available data regarding diagnosis of concussion in high school athletes. We found that females are more likely to be diagnosed with a concussion than males. We also concluded that girl soccer players and boys football players are at highest risk for a diagnosis of concussion. Since the neck meant of the Traumatic brain injury state laws, the diagnosis of concussion in this patient group increased significantly past decade. (more…)
Author Interviews, Education, Mental Health Research, Pediatrics, Sleep Disorders / 11.03.2017

MedicalResearch.com Interview with: Dr. Elsie M. Taveras, MD MPH Chief, Division of General Pediatrics Director, Pediatric Population Health Management Director, Raising Healthy Hearts Clinic MassGeneral Hospital for Children MedicalResearch.com: What are the primary findings of this study and why are they important? Response: The primary findings of this study are that children who get an insufficient amount of sleep in their preschool and early school age years have a higher risk of poor neurobehavioral functioning as reported by their mothers and independently by their teachers at age 7. These behaviors included poorer executive function and more hyperactivity/inattention, emotional symptoms, conduct problems, and peer relationship problems. (more…)
Addiction, Author Interviews, Mental Health Research / 10.03.2017

MedicalResearch.com Interview with: Carl Stevenson, PhD Assistant Professor of Neuroscience BSc Animal Science Admissions Tutor Local Group Rep, British Neuroscience Association School of Biosciences University of Nottingham Loughborough, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Anxiety-related and substance abuse disorders can be serious forms of mental illness that are not always treated effectively by psychological therapies or medications. One strategy to enhance their treatment is to boost the effects of psychological therapy by combining it with medication. This study reviewed the literature on the effects of cannabidiol, a chemical found in the cannabis plant, in preclinical models of these disorders. Cannabidiol is safe to use in humans and doesn’t cause the ‘high’ associated with cannabis. This means that cannabidiol might be useful for treating certain symptoms without the unwanted side effects linked to medical cannabis. Our review confirmed that cannabidiol reduces fear and anxiety in various preclinical models, when given on its own or in conjunction with behavioural interventions that model psychological treatment for anxiety-related disorders. This could show that exploring the option of cbd for anxiety could be a step forward in treating the condition. Our review suggested that it can also reduce relapse in some preclinical models of addiction, although research looking at the effects of cannabidiol in substance abuse disorders is still in its infancy. (more…)
Author Interviews, Electronic Records, Mental Health Research / 04.03.2017

MedicalResearch.com Interview with: Steven K. Dobscha, M.D. Professor, Department of Psychiatry, OHSU Director, VAPORHCS Center to Improve Veteran Involvement in Care Oregon Health & Science University MedicalResearch.com: What is the background for this study?  Response: Several health care systems across the United States now offer patients online access to all of their clinical notes (sometimes referred to as progress notes) through electronic health record portals; this type of access has been referred to as OpenNotes (see www.opennotes.org for more information on the national OpenNotes initiative). Veterans have been able to use OpenNotes in the Veterans Health Care (VHA) system since 2013. However, some individuals have expressed concern that online access to clinical notes related to mental health could cause some patient harms. We are conducting a VA-funded research project with several objectives: 1) to examine benefits and unintended negative consequences of OpenNotes use as perceived by veterans receiving VHA mental health care and by VHA mental health clinicians, and 2) to develop and evaluate brief web-based courses designed to help veterans and clinicians use OpenNotes in ways that optimize Veteran-clinician collaboration and minimize unintended consequences. (more…)
Addiction, Alcohol, Author Interviews, Cannabis, Mental Health Research / 03.03.2017

MedicalResearch.com Interview with: Emil F. Coccaro, M.D. Ellen C. Manning Professor Department of Psychiatry and Behavioral Neuroscience The University of Chicago Chicago, Illinois 60637 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Aggressive behavior and drug use have been related for years but this study shows people with problematic aggression (Intermittent Explosive Disorder: IED) are in fact at risk for developing alcohol, tobacco, and cannabis use disorders and that the onset of problematic aggression (IED) begins before the onset of the drug use. The increased risk for alcohol use disorder was nearly six-fold higher, the increased risk for cannabis use disorder was seven-fold higher, and the increased risk for tobacco use disorder  was four-fold higher. In addition, the presence of IED increased the severity of the substance use disorder. (more…)
Author Interviews, BMJ, Environmental Risks, Mental Health Research, Pediatrics, Toxin Research / 02.03.2017

MedicalResearch.com Interview with: Professor Jean-Francois Viel Department of Epidemiology and Public Health University Hospital Rennes, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of pyrethroid insecticides has increased substantially throughout the world over the past several decades, replacing organophosphate and carbamate insecticides, because of their chemical potency against many pests, their relatively low mammalian toxicity and their favorable environmental profiles. However, despite the neurotoxicity of these insecticides at high doses, the potential impact of environmental exposure to pyrethroid insecticides on child neurodevelopment has only just started to receive attention. Using a longitudinal design (PELAGIE mother-child cohort), we were able to assess pyrethroid exposure (trough urine concentrations) both prenatally and during childhood (at 6 years of age). We showed that increased prenatal concentrations of one pyrethroid metabolite (cis-DCCA, a metabolite of permethrin, cypermethrin and cyfluthrin) were associated with internalising difficulties (children showing behaviours that are inhibited and over-controlled). Moreover, for childhood 3-PBA (a common metabolite of up to 20 synthetic pyrethroid insecticides) concentrations, a positive association was observed with externalising difficulties (children showing behaviours that are under-controlled and having generally a more challenging temperament). (more…)
Author Interviews, Mental Health Research, Pediatrics, Social Issues, Stroke / 28.02.2017

MedicalResearch.com Interview with: Emily C. Maxwell, Ph.D. Pediatric Neuropsychology Bugher Fellow Division of Neurology Instructor | Department of Pediatrics University of Colorado School of Medicine Aurora, CO 80045  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has found increased psychological problems and significantly higher rates of psychiatric disorders after pediatric stroke. However, past studies have mainly used global indices, without comparison to age-based norms. Thus, little is known about the discrete symptomatology exhibited by these children and how discrepant these symptoms may be from normative expectations. At the University of Colorado Denver and Children’s Hospital Colorado, we studied 50 patients who suffered an arterial ischemic stroke during childhood. The parents of these patients completed the Child Behavior Checklist, a questionnaire assessing emotional and behavioral problems. We found that children with stroke had higher symptoms of depression, anxiety, physical complaints, and behavioral difficulties compared to a normative sample of same-aged peers. Additionally, levels of anxiety were higher in children who had a stroke at an early age (before 6 years of age) compared to children who had a stroke at a later age (after 10 years of age). (more…)