Addiction Withdrawal Treatment Using Transcranial Magnetic Stimulation

MedicalResearch.com Interview with:

Crystal meth – illicit methamphetamine hydrochloride

Crystal meth – illicit methamphetamine hydrochloride

TiFei YuanPhD
School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China
Guangdong-Hongkong-Macau Institute of CNS Regeneration, Ministry of Education CNS Regeneration Collaborative Joint Laboratory, Jinan University, Guangzhou, China
School of Psychology, Nanjing Normal University, Nanjing, China

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Addiction is causing serious challenge to public health. Few drugs can treat or even alleviate addiction.

In recent years, non-invasive brain stimulation has been used to modulate craving responses in different types of drug addicts (heroin, methamphetamine, cocaine), and to prevent smoking or alcohol abuse.

However it is unknown if brain stimulation can also help addicts get rid of the aversive symptoms in the early withdrawal period.

The present study is to our knowledge, the first trial to alleviate drug withdrawal symptoms and associated insomnia with non-invasive transcranial magentic stimulation.  Continue reading

Does Methylphenidate (Ritalin) Cause Psychotic Symptoms in ADHD ?

MedicalResearch.com Interview with:
Erica Ramstad Pre-graduate research student hos Psychiatric Research Unit, Department of Children and Youth Psychiatry Copenhagen Area DenmarkErica Ramstad MD
Physician, Psychiatric Research Unit
Child and Adolescent Psychiatric Department
Region Zealand, Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Methylphenidate is the first-choice drug treatment of attention-deficit/hyperactivity disorder (ADHD), which affects around 5.3% children and adolescents worldwide. For 50 years, psychotic symptoms have occasionally been reported in relation to methylphenidate treatment – however, it has not been established whether the symptoms occur as an adverse event to the treatment.

We performed a systematic review on the topic. The data we included in our study are a subset and an update of data from the most comprehensive systematic reviews of methylphenidate to date. Despite this, we could not confirm or refute whether psychotic symptoms occur as an adverse event. The data are too sparse, and the quality of evidence is too low.

MedicalResearch.com: What should readers take away from your report?

Response: Methylphenidate treatment may cause psychotic symptoms in 1.1% to 2.5% of children and adolescents with ADHD. Physicians, patients and their caregivers should be aware of this possible adverse event. However, concerns about this rare possible adverse event should of course be balanced against the potential beneficial effects of methylphenidate on ADHD symptoms, general behaviour and quality of life.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: In future studies, psychotic symptoms should be assessed concurrently with other possible adverse events and beneficial effects of methylphenidate treatment of ADHD in children and adolescents. Psychotic symptoms, the severity and implication for the child/adolescent ought to be assessed by clinical interviews. Of course, high-quality, long-term randomized placebo-controlled trials are on the top of the wish list, but long-term placebo administration is ethically questionable, and therefore also non-randomized studies may be of great importance.

MedicalResearch.com: Is there anything else you would like to add?

Response: This study was funded by the Region Zealand Research Foundation, Denmark; Psychiatric Research Unit, Region Zealand, Slagelse, Denmark; the Copenhagen Trial Unit, the Centre for Clinical Intervention Research, Copenhagen University Hospital, Denmark. For conflicts of interest please see the original article (p. 16).

Citation: Scandinavian Journal of Child and Adolescent Psychiatry and Psychology. VOLUME 6 , ISSUE 1 , ISSN (Online) 2245-8875, DOI: 10.21307/sjcapp-2018-003, July 2018 © 2018.

Aug 25, 2018 @ 6:13 pm

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Accelerated Aging Seen on Brain Imaging with Schizophrenia and Cannabis Use

MedicalResearch.com Interview with:

Dr. Daniel G. Amen MD Amen Clinics, Inc., Founder Costa Mesa, CA

Dr. Daniel Amen

Dr. Daniel G. Amen MD
Amen Clinics, Inc., Founder
Costa Mesa, CA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In the largest known brain imaging study, scientists evaluated 62,454 brain SPECT (single photon emission computed tomography) scans of more than 30,000 individuals from 9 months old to 105 years of age to investigate factors that accelerate brain aging.

SPECT was used to determine aging trajectories in the brain and which common brain disorders predict abnormally accelerated aging. It examined these functional neuroimaging scans from a large multi-site psychiatric clinic from patients who had many different psychiatric disorders, including bipolar disorder, schizophrenia and attention deficit hyperactivity disorder (ADHD).  Researchers studied 128 brain regions to predict the chronological age of the patient.

Older age predicted from the scan compared to the actual chronological age was interpreted as accelerated aging.  The study found that a number of brain disorders and behaviors predicted accelerated aging, especially schizophrenia, which showed an average of 4 years of premature aging, cannabis abuse (2.8 years of accelerated aging), bipolar disorder (1.6 years accelerated aging), ADHD (1.4 years accelerated aging) and alcohol abuse (0.6 years accelerated aging).  Interestingly, the researchers did not observe accelerated aging in depression and aging, which they hypothesize may be due to different types of brain patterns for these disorders.

Continue reading

Bridge Symptoms in Adolescence Linked To Adult Anxiety Disorders

MedicalResearch.com Interview with:

Dr Alexandra Rouquette MD PhD Center for Research in Epidemiology and Population... French Institute of Health and Medical Research Paris

Dr. Rouquette

Dr Alexandra Rouquette MD PhD
Center for Research in Epidemiology and Population…
French Institute of Health and Medical Research
Paris

MedicalResearch.com: What is the background for this study? What are the main findings?

 Response: There is a growing number of clues in the literature that suggest that the onset of adult psychopathologic disorders can be traced back to behavioral or emotional symptoms observed in childhood or adolescence. Targeting early childhood symptoms might thus be effective in preventing future mental disorders. However, these interventions are challenging to implement because we lack knowledge on which specific childhood symptoms have predictive associations with adult psychopathologic disorders. In our study, we used a novel methodologic approach, the network perspective, in which symptoms are conceptualized as distinct entities that can causally influence each other, be self-reinforcing and are thus part of causal chains which can culminate in disorders.

We investigated longitudinally the network structure among a broad range of emotional and behavioral symptoms (symptoms of attention deficit, symptoms of hyperactivity, disruptive symptoms, internalizing symptoms, prosocial symptoms) collected in elementary school girls (6-10 years) included in the Quebec Longitudinal Study of Kindergarten Children. We showed that symptoms “irritable”, “blames others”, “not liked by other children”, “often cries”, and “solitary” retained a distinctive position in the network because most of the direct relationships between the disruptive and internalizing symptom clusters transited through them. These symptoms have been termed bridge symptoms in the network perspective, as they constitute pathways that can connect different disorders.

We then investigated the relationships between this emotional and behavioral symptoms network in childhood and the occurrence of anxiety disorders at age 15 and 22 years. Importantly, the bridge symptoms (particularly “not liked by other children” and “irritable”) exhibited the strongest relationships with future anxiety disorders. Continue reading

Study Identifies Gene Mechanism Linked to Fear and Aggression

MedicalResearch.com Interview with:

Prof. Carmen Sandi Director, Brain Mind Institute Laboratory of Behavioral Genetics Brain Mind Institute Ecole Polytechnique Federale de Lausanne Lausanne, Switzerland 

Prof. Sandi

Prof. Carmen Sandi
Director, Brain Mind Institute
Laboratory of Behavioral Genetics
Brain Mind Institute
Ecole Polytechnique Federale de Lausanne
Lausanne, Switzerland 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We are interested in understanding how the brain regulates social behaviors and aggression, both in healthy individuals and individuals with psychiatric disorders. In our recent publication in Molecular Psychiatry, we investigated the impact of an alteration in a gene, St8sia2, that plays important roles during early brain development. Alterations in this gene have been linked with schizophrenia, autism and bipolar disorder, and individuals with these disorders frequently present high aggressiveness. In addition, expression of this gene in the brain can be altered by stressful insults during very early life and development.

Our study shows that genetic and environmental conditions linked to a reduction in the expression of this neuroplasticity gene during early life can lead to impaired fear learning and associated pathological aggression. We could further reveal that deficits in St8sia2 expression lead to a dysfunction in a receptor in the amygdala (a brain region critically involved in emotionality and fear learning), the GluN2B subunit of NMDA Receptors.

This allowed us to target this receptor with D-cycloserine, a drug that facilitates NMDA receptor function. This treatment, when given acutely, ameliorated the capacity to learn from adversity and reduced individuals’ aggressiveness.  Continue reading

Parents’ Religiosity May Influence Suicidal Risk in Children

MedicalResearch.com Interview with:

Priya Wickramaratne PhD Associate Professor of Clinical Biostatistics (in Psychiatry) Department of Psychiatry, College of Physicians and Surgeons Columbia University New York State Psychiatric Institute New York

Dr. Wickramaratne

Priya Wickramaratne PhD
Associate Professor of Clinical
Biostatistics (in Psychiatry)
Department of Psychiatry, College of Physicians and Surgeons
Columbia University
New York State Psychiatric Institute
New York

MedicalResearch.com: What is the background for this study?

Response: Approximately 12% of adolescents in the United States report having thoughts about attempting suicide. Moreover, suicide is a primary cause of death among females 15 to 19 years of age. Religious and spiritual beliefs have received little attention in previous research examining risk and protective factors of child and adolescent suicide. This study used data from a three-generation study of 214 children and adolescents from 112 nuclear families whose parents were at high or low risk for major depressive disorder to study the association of children and parent’s religious beliefs with risk of suicidal behavior in the children.

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Cognitive Changes Mapped Over Time in Young Persons at Risk for Psychosis

MedicalResearch.com Interview with:

Richard Keefe PhD Professor in Psychiatry and Behavioral Sciences Duke Institute for Brains Sciences

Dr. Keefe

Richard Keefe PhD
Professor in Psychiatry and Behavioral Sciences
Duke Institute for Brains Sciences

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: A lot of studies have shown that cognitive deficits are present in young people at risk for psychosis. There have been calls for investigations of the idea that cognition declines over time in the young people who are at highest risk, but longitudinal studies are hard to conduct so not much work has been done to address this question.

The main finding from our study is that the cognitive architecture – the way the various aspects of cognitive functioning appear to be organized in each individual’s brain based upon their pattern of performance – changes over time in those young people who are in the midst of developing psychosis. Interestingly, cognitive architecture also becomes more disorganized in those whose high-risk symptoms do not remit over a two year period, and is related to the functional difficulties they may be having. The young people whose high risk symptoms were present at the beginning of the study but remitted later actually improved cognitively over the two year period of the study. Continue reading

Young Pregnant Women More Likely To Be Depressed Than Their Mothers

MedicalResearch.com Interview with:

Rebecca Pearson, PhD Lecturer in Psychiatric Epidemiology Centre for Academic Mental Health School of Social & Community Medicine University of Bristol

Dr. Pearson

Rebecca Pearson, PhD
Lecturer in Psychiatric Epidemiology
Centre for Academic Mental Health
School of Social & Community Medicine
University of Bristol

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: We know depression and anxiety are common in young women and during pregnancy when there are also implications for the developing child.

It is therefore important to investigate whether symptoms are rising given the pressures of modern life.

We found that compared to their mothers generation in the 1990s young pregnancy women today are more likely to be depressed. This was driven largely by symptoms of anxiety and feeling overwhelmed rather than feeling down.  Continue reading

Machine Learning Can Help Identify First Episodes of Schizophrenia, As Well As Treatment Response

MedicalResearch.com Interview with:

Bo Cao, Ph.D. Assistant Professor Department of Psychiatry Faculty of Medicine & Dentistry University of Alberta Edmonton

Dr. Bo Cao

Bo Cao, Ph.D.
Assistant Professor
Department of Psychiatry
Faculty of Medicine & Dentistry
University of Alberta
Edmonton

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Schizophrenia is a severe psychiatric disorder that comes with delusions, hallucinations, poor motivation, cognitive impairments.

The economic burden of schizophrenia was estimated at $155.7 billion in 2013 alone in the United States. Schizophrenia usually emerges early in life and can potentially become a lifetime burden for some patients. Repeated untreated psychotic episodes may be associated with irreversible alterations of the brain. Thus, it is crucial to identify schizophrenia early and provide effective treatment. However, identifying biomarkers in schizophrenia during the first episode without the confounding effects of treatment has been challenging. Limited progress has been made in leveraging these biomarkers to establish diagnosis and make individualized predictions of future treatment responses to antipsychotics.

In a recent study by Dr. Cao and his colleagues, they successfully identified the first-episode drug-naïve schizophrenia patients (accuracy 78.6%) and predict their responses to antipsychotic treatment (accuracy 82.5%) at an individual level by using a machine learning algorithm and the functional connections of a brain region called the superior temporal cortex.  Continue reading

Structural Brain Changes in Sleep Apnea Linked to Cognitive Decline

MedicalResearch.com Interview with:
“Woman sleeping” by Timothy Krause is licensed under CC BY 2.0Nathan E. Cross PhD, first author
School of Psychology.
Sharon L. Naismith, PhD, senior author
Leonard P Ullman Chair in Psychology
Brain and Mind Centre
Neurosleep, NHMRC Centre of Research Excellence
The University of Sydney, Australia 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Between 30 to 50% of the risk for dementia is due to modifiable risk factors such depression, hypertension, physical inactivity, obesity, diabetes and smoking.

In recent years, multiple longitudinal cohort studies have observed a link between sleep apnoea and a greater risk (1.85 to 2.6 times more likely) of developing cognitive decline and dementia.  Furthermore, one study in over 8000 people also indicated that the presence of obstructive sleep apnoea (OSA) in older adults was associated with an earlier age of cognitive decline, and that treatment of OSA may delay the onset of cognitive impairment.

This study reveals important insights into how sleep disorders such as OSA may impact the brain in older adults, as it is associated with widespread structural alterations in diverse brain regions. We found that reduced blood oxygen levels during sleep are related to reduced thickness of the brain’s cortex in both the left and right temporal areas – regions that are important in memory and are early sites of injury in Alzheimer’s disease. Indeed, reduced thickness in these regions was associated with poorer ability to learn new information, thereby being the first to link this structural change to memory decline. Continue reading

Perinatal Folic Acid May Protect Against Serious Mental Illness in Young People

MedicalResearch.com Interview with:

Joshua L. Roffman, MD Department of Psychiatry Mass General Hospital

Dr. Roffman

Joshua L. Roffman, MD
Department of Psychiatry
Mass General Hospital

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Autism, schizophrenia, and other serious mental illness affecting young people are chronic, debilitating, and incurable at present.  Recent public health studies have associated prenatal exposure to folic acid, a B-vitamin, with reduced subsequent risk of these illnesses.  However, until this point, biological evidence supporting a causal relationship between prenatal folic acid exposure and reduced psychiatric risk has remained elusive.

We leveraged the rollout of government-mandated folic acid fortification of grain products in the U.S. from 1996-98 as a “natural experiment” to determine whether increased prenatal folic acid exposure influenced subsequent brain development.  This intervention, implemented to reduce risk of spina bifida and other disabling neural tube defects in infants, rapidly doubled blood folate levels among women of childbearing age in surveillance studies.

Across two large, independent cohorts of youths age 8 to 18 who received MRI scans, we observed increased cortical thickness, and a delay in age-related cortical thinning, in brain regions associated with schizophrenia risk among individuals who were born during or after the fortification rollout, compared to those born just before it.  Further, delayed cortical thinning also predicted reduced risk of psychosis spectrum symptoms, a finding that suggests biological plausibility in light of previous work demonstrating early and accelerated cortical thinning among school-aged individuals with autism or psychosis.

Continue reading

Highly Empathetic People Perceive Music Differently

MedicalResearch.com Interview with:
“Divine Piano” by François Philipp is licensed under CC BY 2.0Zachary Wallmark, Ph.D
Assistant Professor of Musicology Directo
MuSci Lab SMU Meadows School of the Art
Music Division Dallas, TX 75275

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Music making and listening is an intensely social behavior. Individual differences in trait empathy are associated with preferential engagement of social cognitive neural circuitry, including regions of the medial prefrontal cortex, cingulate, and insula, during the perception of socially relevant information.

In our study, we used fMRI to explore the degree to which differences in trait empathy modulate music processing in the brain.

We found that higher empathy people experience greater activation of social circuitry as well as the reward system while listening to familiar music, compared to lower empathy people.  Continue reading

Eating Disorders Occur Across All Age, Ethnic and Gender Groups

MedicalResearch.com Interview with:

Tomoko Udo, PhD Assistant Professor Department of Health Policy, Management, and Behavior School of Public Health University at Albany, State University of New York

Dr. Tomoko Udo

Tomoko Udo, PhD
Assistant Professor
Department of Health Policy, Management, and Behavior
School of Public Health
University at Albany, State University of New York

MedicalResearch.com: What is the background for this study?  

Response: The National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC III) was the largest epidemiological study on psychiatric disorders in US non-institutionalized adults that was conducted by the National Institution on Alcohol Abuse and Alcoholism, and the first one sinceDSM-5 came out. The last population-based study with US adults that examined eating disorders was the National Comorbidity Survey-Replication Study conducted by Hudson and his colleagues and published in 2007.

We felt that it was important to obtain new prevalence estimates in a larger and representative sample especially because the DSM-5 included several changes to the criteria for eating disorders from the earlier DSM-IV. Thus, we thought it was important to provide updated and new prevalence estimates for eating disorders as well as how they are distributed across sex, ethnicity/race, and age.  Many  researchers and clinicians expected higher estimates than earlier studies as a result of “loosening” of diagnostic criteria for eating disorders.

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Higher Connectivity of Brain Networks Linked to Increased Risk of Psychopathology

MedicalResearch.com Interview with:

Maxwell Elliott Clinical psychology PhD student Working with Ahmad Hariri and the Moffitt & Caspi lab Duke University

Maxwell Elliott

Maxwell Elliott
Clinical psychology PhD student
Working with Ahmad Hariri and the Moffitt & Caspi lab
Duke University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The traditional clinical science model identifies individuals who meet specific criteria for mental illness diagnoses (e.g. Depression, Anxiety) and compares them to “healthy” controls to find brain correlates of mental illness.  However, this approach often overlooks the high rates of comorbidity and shared symptamatology across mental illnesses. Emerging research has identified a general factor of psychopathology that accounts for shared risk among internalizing, externalizing, and thought disorders across diverse samples.

This general factor of psychopathology has been called the p-factor. In our study we investigate the brain correlates of the p-factor using a data-driven analysis of resting state functional connectivity. We find that higher p-factor scores and associated risk for common mental illness maps onto hyper-connectivity between visual association cortex and both frontoparietal and default mode networks.

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Functional Brain ‘Fingerprint’ Identified in Schizophrenia

MedicalResearch.com Interview with:

Tobias Kaufmann UiO Institute of Clinical Medicine

Dr. Kaufmann

Tobias Kaufmann PhD
Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine
University of Oslo, Oslo, Norway

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Over the past years, a lot of work has pointed toward impaired brain networks in schizophrenia. With this work we assessed brain network stability across different loads of a cognitive task using functional magnetic resonance imaging of the brain.

Based on our earlier work on adolescents with pre-clinical signs of mental illness who showed decreased stability of networks across different tasks and conditions, we hypothesized that brain networks in adults with schizophrenia show similar properties of decreased stability. Our results confirmed this hypothesis. Stability was reduced in several large-scale brain networks across the sampled age range from early adulthood to the sixties. Further, network stability was associated with polygenic risk for schizophrenia as well as cognitive task performance.

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Disturbed Circadian Rhythm Associated With Poor Mental Health

MedicalResearch.com Interview with:

Laura Lyall  MA; MSc; PhD Research Associate Institute of Health and Wellbeing University of Glasgow

Dr. Lyall

Laura Lyall  MA; MSc; PhD
Research Associate
Institute of Health and Wellbeing
University of Glasgow 

MedicalResearch.com: What is the background for this study?  

Response: Previous studies have suggested a link between disturbed circadian rhythms and depression and bipolar disorder. These studies have however usually used small samples, subjective measures of circadian disruption, or have not accounted for potential confounding factors like sociodemographic and lifestyle characteristics. The UK Biobank cohort has accelerometry (activity monitor) data as well as mental health, lifestyle, BMI and sociodemographic data for over 91,000 individuals, and means we can address this question using objective measures of circadian rhythmicity on a large scale.

We derived a measure of relative amplitude from the UK Biobank’s accelerometry data, which was recorded for 7 days between 2013-2014 from around 100,000 participants. Relative amplitude reflects the distinction, in terms of activity levels, between an individual’s most active 10 hours and least active 5 hours, in an average day. If an individual is inactive during the day, or has disturbed sleep at night, the will show low relative amplitude, consistent with disturbed circadian rest-activity patterns.

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Amyloid PET Scan Can Predict Progression to Alzheimer’s in Patients With Mild Cognitive Impairment

MedicalResearch.com Interview with:

David A. Wolk, MD Associate Professor Department of Neurology Co-Director, Penn Memory Center Associate Director, Alzheimer’s Disease Core Center University of Pennsylvania

Dr. Wolk

David A. Wolk, MD
Associate Professor
Department of Neurology
Co-Director, Penn Memory Center
Associate Director, Alzheimer’s Disease Core Center
University of Pennsylvania

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Mild Cognitive Impairment (MCI) is a state when individuals have mild memory problems, but not enough to impact day-to-day function.  Many patients with MCI are on the trajectory to developing Alzheimer’s Disease dementia, but about half will not and remain stable.  As such, patients with MCI are often uncertain about the likelihood they should expect to decline in the future which obviously may be associated with considerable anxiety and this may delay opportunities for them to plan for the future or begin therapeutic interventions.

This study examined the degree to which amyloid PET, which detects the amyloid pathology of Alzheimer’s Disease, a measure of shrinkage of the hippocampus with MRI, and cognitive measures predicted development of dementia over 3 years.  We found that each of these measures enhances prediction of whether an individual will or will not develop dementia in the future.  If all of these measures are positive, one has a very high risk of progression whereas if amyloid PET and the MRI measurement are normal, there is very little risk of progression. Continue reading

Yoga Breathing Really Does Help You Focus – Namaste!

MedicalResearch.com Interview with:
“Open Space Yoga Hawaii” by Open Space Yoga Hawaii is licensed under CC BY 2.0
Michael Christopher Melnychuk PhD candidate
Trinity College Institute of Neuroscience
Trinity, Dublin 

MedicalResearch.com: What is the background for this study?

Response: Practitioners of yoga have claimed for some 2,500 years, that respiration influences the mind. In our study we looked for a neurophysiological link that could help explain these claims by measuring breathing, reaction time, and brain activity in a small area in the brainstem called the locus coeruleus. We chose to focus on the locus coeruleus because this area and the chemical it produces play intimate roles in both attention and respiration.

The locus coeruleus produces noradrenaline and releases it to the entire brain. This neurotransmitter functions as an all-purpose action system. When we are stressed we produce too much noradrenaline and we can’t focus. When we feel sluggish, we produce too little and again, we can’t focus. There is a sweet spot of noradrenaline in which our emotions, thinking and memory are much clearer.  Continue reading

Psychosis: Early Integrated Bests Usual Care

MedicalResearch.com Interview with:

Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Hempstead, NY Investigator, Center for Psychiatric Neuroscience Feinstein Institute for Medical Research Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital, Department of Psychiatry

Dr. Correll

Christoph U. Correll, MD
Professor of Psychiatry and Molecular Medicine
The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Hempstead, NY
Investigator, Center for Psychiatric Neuroscience
Feinstein Institute for Medical Research
Medical Director, Recognition and Prevention (RAP) Program
The Zucker Hillside Hospital, Department of Psychiatry

 

MedicalResearch.com: What is the background for this study?

Response: Schizophrenia and other psychotic disorders are still all to often chronic and recurring mental health conditions that not uncommonly take a course during which individuals have varying degrees of significantly impaired personal, social and educational/vocational functioning.

Prior individual studies examining early specialty intervention services, which integrate multiple different and complementary treatment components, had shown that this treatment approach can yield superior outcomes for people with early-phase schizophrenia and other psychotic disorders compared to usual care given to all people with psychotic disorders. However, we were lacking a broad overview of the type and results of treatment programs that had been conducted across different countries, continents and mental health service delivery systems. Moreover, we did not yet have a synthesis across all important outcomes that had been examined across these individual studies. This first comprehensive meta-analysis on this topic provides previously missing information on the different early intervention programs and their components as well as on all relevant outcomes for people who did or did not receiving early integrated care, also recently called ‘coordinated specialty care.’

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Over 2.5 Million US Kids Diagnosed With Anxiety and Depression

MedicalResearch.com Interview with:
Rebecca H. Bitsko, PhD

National Center on Birth Defects and Developmental Disabilities
Centers for Disease Control and Prevention 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: CDC’s National Center on Birth Defects and Developmental Disabilities(https://www.cdc.gov/ncbddd/index.html) (NCBDDD) is committed to helping children who have mental, emotional, and behavioral disorders. Anxiety and depression are both internalizing mental disorders that often start during childhood, and that frequently occur together.

In this study, we show that more than 1 in 20, or 2.6 million, US children aged 6-17 had a current diagnosis of anxiety or depression, by parent report, in 2011-12. We also found an increase of diagnosed anxiety in these children from 1 in 28 in 2007 to 1 in 24 in 2011-12.

Further, in 2011-12, approximately 1 in 5 children with current anxiety or depression did not receive mental health treatment in the past year.

Children with current anxiety or depression were more likely than those without to have:

  • Another mental, behavioral, or developmental disorder such as ADHD, learning disability, or speech or language problems
  • School problems
  • Parents who report high levels of stress and frustration with parenting
  • Unmet medical and mental health service needs

Continue reading

Town vs Gown – Why Are City Kids More Stressed?

MedicalResearch.com Interview with:
“dog” by Neil Mullins is licensed under CC BY 2.0Prof. Dr. rer. nat. Stefan O. Reber

Laboratory for Molecular Psychosomatics
Clinic for Psychosomatic Medicine and Psychotherapy
University Clinic Ulm
Ulm, Germany 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our hypothesis was that people who grew up in cities with more than 100.000 inhabitants  and without pets will show a more pronounced immune activation towards psychosocial stressors compared with people raised in rural areas in the presence of farm animals. This hypothesis is based on the fact that stress-associated psychiatric disorders, which are linked to or even promoted by an over(re)active immune system and chronic low grade inflammation,  are more prevalent in urban compared with rural areas. One possible explanation for a hyper(re)active immune system in people raised in urban relative to rural environments might be a reduced contact to immunoregulatory microorganisms (the so called “old friends”), which is significantly increased in rural people with regular contact with farm animals compared with urban people in the absence of pets.

Our results show that a standardized laboratory psychosocial stressor causes a greater inflammatory response in young healthy participants with an urban upbringing in the absence of pets, relative to young healthy participants with a rural upbringing in the presence of farm animals. Continue reading

PCPs Need More Training In Assessing and Treating Irritability in Children

MedicalResearch.com Interview with:
Anna Scandinaro
Medical student
Penn State College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Dr. Usman Hameed, a child and adolescent psychiatrist, and Dr. Dellasega wrote a previous paper called “What is irritability?” which examined the idea and concept of what irritability in school aged children can encompass. After considering possible definitions of irritability, we wanted to see how the concept manifested in clinical practice, especially with the controversy around the new diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) in the DSM 5.

The main findings of this study are that primary care providers (PCP)​identified a need for more training and education in how to assess irritability in pediatric and adolescent populations.

In contrast, the child and adolescent psychiatrists we interviewed thought more triage from PCPs who care for school aged children with irritability would be helpful.  Continue reading

Prenatal SSRI Exposure Linked to Altered Infant Brain Development

MedicalResearch.com Interview with:

Claudia I. Lugo-Candelas, PhD Postdoctoral Research Fellow Columbia University Medical Center/ New York State Psychiatric Institute

Dr. Lugo-Candelas

Claudia I. Lugo-Candelas, PhD
Postdoctoral Research Fellow
Columbia University Medical Center/ New York State Psychiatric Institute

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We have seen, in the last decade, an increase in the amount of mothers being prescribed SSRIs during pregnancy. While we know that untreated prenatal maternal depression has adverse consequences for both the mother and child, it’s not really clear what, if any, are the consequences of prenatal SSRI exposure on infant’s brain development. There have been some studies finding increased depression and anxiety in children prenatally exposed to SSRIs, but not all studies find these associations.

We thus looked at 2-4 week old infants’ brains, using neuroimaging.  We found increased gray matter volume within the amygdala and insula, and increased white matter connectivity between these two structures in infants prenatally exposed to SSRIs. Of note, the statistical significance and the size of the effects we detected are quite large, even greater than the brain changes that we usually observe in our studies of children and adults with psychiatric disorders. Further, because these structures are involved in emotion processing, and alterations in volume and connectivity are sometimes seen in clinical populations, or in people at risk for anxiety, it important to learn more about what these volume and connectivity differences could mean for these infants.

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When Cousins Marry Mental Health Issues Increase

MedicalResearch.com Interview with:

Dr. Aideen Maguire Centre of Excellence for Public Health Queen's University Belfast Institute of Clinical Sciences B Royal Hospitals Site, Belfast

Dr Aideen Maguire

Dr. Aideen Maguire
Centre of Excellence for Public Health
Queen’s University Belfast
Institute of Clinical Sciences B
Royal Hospitals Site, Belfast

MedicalResearch.com: What is the background for this study?

 

Response: Consanguineous Marriage is the marriage between second or first cousins. Although not common practice in the Western world approximately 1 in 10 children worldwide are born to consanguineous parents. It is legal in all countries worldwide except the United States of America, North Korea and China. Cousin-marriage is associated with an increased risk of autosomal recessive genetic disorders in offspring but the association between cousin-marriage and the mental health of offspring has not been extensively studied.

MedicalResearch.com: What are the main findings?

Response: Children of consanguineous parents are over 3 times more likley to be in receipt of medications for common mood disorders (antidepressant and/or anxioltyic medication) compared to children of non-related parents and over twice as likley to be in receipt of antipsychotic medication compared to children of non-related parents. 

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Phase 3 Trial of Cariprazine (Vraylar) Shows Promise in Bipolar Depression

MedicalResearch.com Interview with:

Dr. C. David Nicholson, PhD Chief R&D Officer  Allergan

Dr. C. David Nicholson

Dr. C. David Nicholson, PhD
Chief R&D Officer
Allergan

MedicalResearch.com: What is the background for this data milestone? 

Response: Bipolar I depression refers to the depressive episodes of bipolar I disorder, the overarching brain and behavioral disorder. People with bipolar I disorder can have manic and depressive episodes, as well as mixed episodes that feature both manic and depressive symptoms at the same time. Bipolar I depression typically lasts at least two weeks, and can be difficult to differentiate from major depression during diagnosis.

Once diagnosed, treating bipolar depression can be difficult given the few therapies available to manage these symptoms of bipolar I disorder. Additionally, patients with bipolar disorder may experience shifts from depression to mania or mania to depression as well as mixed states. More treatment options are needed so that physicians can find a therapy that will treat bipolar depression effectively, while also addressing the myriad of other symptoms that patients can experience.

Cariprazine is already approved for the treatment of mania and mixed episodes. With this new data, we have the potential to also treat bipolar depression, effectively addressing the full spectrum of symptoms associated with bipolar I disorder with just one medication.

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