Author Interviews, JAMA, Schizophrenia, Yale / 01.02.2018

MedicalResearch.com Interview with: Josephine Mollon PhD Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience King’s College London, London, England Currently with the Department of Psychiatry Yale University School of Medicine New Haven, Connecticut MedicalResearch.com: What is the background for this study? Response: Psychotic disorders, such as schizophrenia, are severe mental disorders that cause a range of abnormalities in perception and thinking. Individuals with psychotic disorders also experience severe impairments in IQ and there is evidence that these impairments begin many years before hallucinations and delusions first appear. Understanding how and when individuals with psychotic disorder experience a drop in IQ scores will help us better predict and treat poor cognition in these individuals, and perhaps even the disorder itself. (more…)
Author Interviews, Cognitive Issues, Genetic Research, JAMA, Medical Imaging, Mental Health Research / 25.01.2018

MedicalResearch.com Interview with: “The Fourth Sex: Adolescent Extremes” by Victor Soto is licensed under CC BY 2.0Dag Alnaes, PhD Norwegian Centre for Mental Disorders Research KG Jebsen Centre for Psychosis Research Division of Mental Health and Addiction, Oslo University Hospital Oslo, Norway  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The transition from childhood to adulthood is characterized by swift and dramatic changes, both in our environment and in our brains. This period of life also coincides with the onset of many mental disorders. To gain a better understanding of why, the clinical neurosciences must attempt to disentangle the complex and dynamic interactions between genes and the environment and how they shape our brains. The ultimate goal is to be able to predict which individuals are at risk before clinical symptoms appear. Advanced brain imaging has been proposed to represent one promising approach for such early detection, but there is currently no robust imaging marker that allows us to identify individuals at risk with any clinically relevant degree of certainty. Our study shows that self-reported early signs of mental illness are associated with specific patterns of brain fiber pathways in young people, even if they may not fulfill criteria for a formal diagnosis or are currently in need of treatment.  (more…)
Author Interviews, JAMA, PTSD / 23.01.2018

MedicalResearch.com Interview with: “Man’s best friend helps NC Guardsman with PTSD [Image 1 of 8]” by DVIDSHUB is licensed under CC BY 2.0, PhD Professor of Psychiatry Director, Center for the Treatment and Study of Anxiety University of Pennsylvania Philadelphia, Pa 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Response: As much as 10 to 20 percent of military members deployed to Iraq and Afghanistan following the September 11th attacks suffer from PTSD, which is often chronic and incapacitating. A constant increase in the number of individuals suffering from PTSD as a result of massive natural disasters, terror attacks, and the wars in Iraq and Afghanistan, has prompted an urgent need for effective and efficient evidence-based treatments for PTSD. Prolong exposure (PE) is a form of cognitive-behavioral therapy that involves exposure to trauma memories and daily life trauma reminders. Previous studies have proven PE is quite effective for treating civilians and veterans with PTSD. In this five-year study, the researchers sought to determine whether PE could have similar success with active-duty military personnel. The researchers examined the benefit of various methods for delivering PE including Massed-PE, (10 therapy sessions administered over two weeks) and Spaced-PE (10 sessions administered over 8 weeks), as well as Present Centered Therapy (PCT), a non-trauma-focused therapy that involves identifying and discussing daily stressors in 10 sessions over eight weeks, and Minimal Contact Control (MCC), which included supportive phone calls from therapists once weekly for four weeks. Patients who received Massed-PE therapy, delivered over two weeks, saw a greater reduction in PTSD symptoms than those who received MCC. Importantly, Massed-PE therapy was found to be equally effective to Spaced-PE in reducing PTSD symptom severity. The researchers also found that PCT might be an effective treatment option for PTSD in active military personnel although it was less effective than PE in veteran and civilian PTSD sufferers.  (more…)
Allergan, Author Interviews, Bipolar Disorder, Brigham & Women's - Harvard / 20.12.2017

MedicalResearch.com Interview with: allerganGary Sachs, MD Associate Clinical Professor of Psychiatry Harvard Medical School  MedicalResearch.com: What is the background for this data milestone? Response: Bipolar disorder affects about 5.7 million adults in the United States.  It is a common, often disabling condition in which abnormal mood states impair a person’s ability to carry out everyday tasks. Bipolar disorder touches nearly every family and community in America, because periods of illness, a patient’s symptoms often impact their family, their friends, and their community. There are a limited number of products approved to treat bipolar depression and even fewer products that have been studied and approved to treat the full spectrum of bipolar disorder, from mania through depression. Having another product proven to treat the full range of bipolar disorder would be a welcome addition to the treatment options currently available to the psychiatry community and patients. (more…)
Accidents & Violence, Author Interviews, JAMA, Karolinski Institute, Mental Health Research, Pediatrics / 14.12.2017

MedicalResearch.com Interview with: Emma Björkenstam PhD Department of Public Health Sciences Karolinska Institutet MedicalResearch.com: What is the background for this study? What are the main findings? Response: My research team and I have previously shown that childhood adversity is associated with an elevated suicide risk in young adults, and this increased risk may be explained by maladaptive trajectories during adolescence. We also know that adolescent violent offending is linked with suicide, but up until now, less was known about the role of violent offending in the association between childhood adversity and later suicide. Our main finding in the current study, based on almost half a million Swedes, is that individuals with a history of childhood adversity who also engage in violent offending in late adolescence, have a substantial increased risk of suicide. (more…)
Accidents & Violence, Author Interviews, CDC, Emergency Care, JAMA, Mental Health Research / 21.11.2017

MedicalResearch.com Interview with:

Dr. Melissa C. Mercado PhD, MSc, MA Behavioral scientist Division of Violence Prevention National Center for Injury Prevention and Control CDC

MedicalResearch.com: What is the background for this study? What are the main findings? Response: Suicide ranks as the 10th leading cause of death for all age groups combined and has been among the top 12 leading causes of death since 1975 in the U.S. In 2015, across all age groups, suicide was responsible for 44,193 deaths in the U.S., which is approximately one suicide every 12 minutes. Suicide was the second leading cause of death among U.S. youth aged 10-24 years in 2015. Self-inflicted injury is one of the strongest risk factors for suicide. This study examined trends in non-fatal self-inflicted injuries treated in hospital emergency departments (EDs) among youth aged 10 to 24 years in the United States from 2001-2015.  The overall weighted age-adjusted rate for this group increased by 5.7% annually during the 2008 to 2015 period.  Age-adjusted trends for males overall and across age groups remained stable throughout 2001-2015.  However, rates among females increased significantly, by 8.4% annually. The largest increase among females was observed among those aged 10-14 years, with an increase of 18.8% annually from 2009 to 2015. (more…)
Author Interviews, Education, JAMA, Karolinski Institute, Mental Health Research / 16.11.2017

MedicalResearch.com Interview with: Ana Pérez-Vigil MD Department of Clinical Neuroscience Child and Adolescent Psychiatry Research Center Karolinska Institutet MedicalResearch.com: What is the background for this study? Response: Everyone who regularly works with persons who have obsessive-compulsive disorder (OCD) has seen that their patients often struggle with school work. It is not uncommon for these individuals to have poor school attendance and severe patients can be out of the education system altogether. This applies to persons of all ages, from school children to young adults who may be at university. On the other hand there is a group of patients who, against all odds, working 10 times as hard as everybody else, manage to stay in education and eventually get a degree. So we have long suspected that OCD has a detrimental impact on the person’s education, with all the consequences that this entails (worse chances to enter the labour market and have a high paid job). But we did not really know to what extent OCD impacts education. So we wanted to know what is the actual impact of OCD on educational attainment using objectively collected information from the unique Swedish national registers. Previous work had been primarily based on small clinical samples from specialist clinics, using either self or parent report and cross-sectional designs. Previous work also tended not to control for important confounders such as psychiatric comorbidity or familial factors (genetic and environmental factors that could explain both OCD and the outcomes of interest). (more…)
Author Interviews, Education, Pediatrics, Sleep Disorders / 12.10.2017

MedicalResearch.com Interview with: Jack Peltz, Ph.D. Clinical assistant professor in Psychiatry Rochester Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Approximately 90% of high-school aged adolescents get either insufficient sleep during school nights or barely meet the required amount of sleep (ie, 8–10 hours) expected for healthy functioning.(1) In fact, sleep problems and insufficient sleep are so pervasive for adolescents that they could be considered an epidemic due to their adverse impact on adolescent mental and physical health.(2–5) As a result,addressing insufficient adolescent sleep represents a critical point of study and intervention. The growing body of evidence suggests that later school start times (SST), 8:30 AM or later as recommended by the American Academy of Pediatricians,6 convey multiple benefits on adolescents, including improved sleep, better mental and physical health, and improved academic outcomes.(7–10) This research, however, has focused on the direct effects of delaying school start times, or specifically how moving SST back directly predicts changes in an outcome (eg, mental health, academic achievement). This type of analysis precludes examining the important role that SST might play as a condition or context under which other sleeprelated processes take place. For instance, earlier school start times might exacerbate the impact of sleep-related processes on adolescent behavioral health outcomes. Thus, incorporating school start times as a larger contextual variable that might moderate models of sleep and adolescent functioning represents a gap in the literature and a unique opportunity to advance conceptual models. Accordingly, the current study examines the moderating role of school start times on the associations between sleep hygiene, sleep quality, and mental health. (more…)
Author Interviews, Education, Gender Differences, Mental Health Research, Sexual Health, Social Issues / 03.10.2017

MedicalResearch.com Interview with: Oliver Ferlatte PhD Men's Health Research Program University of British Columbia Vancouver , British Columbia , Canada MedicalResearch.com: What is the background for this study? Response: Suicide, like many other health inequities, is unevenly distributed among the population, with marginalized groups being most affected. In Canada, suicide has been found to particularly affect gay and bisexual men, aboriginal people and people living in rural and remote communities. While the populations affected by suicide are not mutually exclusive – for example someone can be a bisexual Aboriginal man living in a remote community – much of the suicide prevention literature tends to treat these groups as such. Moreso, very little attention is given in suicide prevention research to diversity within groups: for example, we know very little about which gay and bisexual men are most at risk of attempting suicide. This situation creates a vacuum of knowledge about suicide among gay and bisexual and deprives us of critical information for the development of effective suicide prevention activities. We therefore investigated in a survey of Canadian gay and bisexual men (Sex Now Survey), which gay and bisexual men are at increased risk of reporting a recent suicide attempt. The large sample of gay and bisexual men with 8493 participants allows for this unique analysis focused on the multiple, intersecting identities of the survey participants. (more…)
Author Interviews, Exercise - Fitness, JAMA, Mental Health Research, Pediatrics / 19.09.2017

MedicalResearch.com Interview with: Michael Alosco, PhD NRSA Postdoctoral Fellow Boston University Alzheimer’s Disease & CTE Center Boston University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: TThe goal of this study was to investigate whether playing youth tackle football, particularly before the age of 12, is associated with worse emotional, behavioral, and cognitive difficulties later in life. Participants in this study included 214 former amateur and professional American football players who were part of the LEGEND study at Boston University. Participants had an average age of 51. 43 played high school football, 103 played college football, and there were 68 professional American football players. The former players were divided into two groups: those who began playing tackle football before age 12 and those who began at age 12 or older. Participants received telephone-administered cognitive tests and completed online measures of depression, behavioral regulation, apathy, and executive functioning, such as initiating activity, problem-solving, planning, and organization. Results from former players who started playing tackle football before the age of 12 were compared to those of participants who started playing at age 12 or later. The study showed that participation in tackle football before age 12 increased the odds for having problems with behavioral regulation, apathy and executive functioning by two-fold and increased the odds for clinically elevated depression scores by three-fold. These findings were independent of the total number of years the participants played football or at what level they played, such as high school, college, or professional. Even when a specific age cutoff was not used, younger age of exposure to tackle football corresponded with worse clinical status. (more…)
Author Interviews, JAMA, Mental Health Research / 07.09.2017

MedicalResearch.com Interview with: Dr. Patricia Moreno-Peral, PhD Research Unit, Primary Care District of Málaga-Guadalhorce Prevention and Health Promotion Research Network Institute of Biomedical Research in Málaga Málaga, Spain  MedicalResearch.com: What is the background for this study? Response:  No systematic reviews or meta-analyses have been performed on the effectiveness of preventive psychological and/or educational interventions for anxiety in varied populations. Previously, other systematic reviews have been focused on prevention efficacy in specific interventions (e.g. cognitive behavior interventions) or age groups (e.g. adolescents). (more…)
Author Interviews, JNCI, Mental Health Research, Pharmacology, UT Southwestern, Weight Research / 23.08.2017

MedicalResearch.com Interview with: Chen Liu, Ph.D. Assistant Professor Departments of Internal Medicine and Neuroscience Division of Hypothalamic Research The University of Texas Southwestern Medical Center Dallas, Texas 75390-9077  MedicalResearch.com: What is the background for this study? Response: Atypical antipsychotics are second-generation antipsychotics (SGAs) that have been increasingly used to treat a variety of neuropsychiatric conditions such as schizophrenia, depression, and autism. Many patients taking these medications, however, are left in an agonizing dilemma. On one hand, they rely on these drugs’ psychotropic effect for normal functioning in daily life. On the other, many SGAs, including the most widely prescribed olanzapine and clozapine, can cause a metabolic syndrome that is known for excessive weight gain, dyslipidemia, and type-2 diabetes_ENREF_2. Notably, while full-blown type 2 diabetes and morbid obesity typically take years to unfold in the general population, these conditions progress at a much faster pace (within months) following second-generation antipsychotics treatment. Other factors such as ethnicity, age, and sex can also aggravate SGA-induced metabolic syndrome. Together, these peculiar features strongly suggest a distinct etiology underlying SGA-induced metabolic syndrome that has yet been fully elucidated. Currently, there is no medication specifically targeting SGA-induced metabolic syndrome. For many youths and adults taking second-generation antipsychotics, metabolic complications are difficult to manage as lifestyle changes, nutritional consulting, and commonly used anti-diabetic medications only provide limited relief. (more…)
Author Interviews, Gender Differences, Mental Health Research / 26.07.2017

MedicalResearch.com Interview with: Areti Smaragdi, PhD University of Southampton Southampton, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Conduct Disorder is a psychiatric disorder that involves severe antisocial behavior – symptoms of the condition include behaviors like physical fighting, pathological lying, and serious theft. The disorder affects around 5% of school-aged children and adolescents, and is up to three times more common in boys than girls. Because of this, very little research has focused on the possible brain basis of the disorder in girls. We used MRI scanning methods to measure the brain structure of 48 boys and 48 girls with Conduct Disorder (14-18 years old) and 52 boys and 52 girls without severe antisocial behavior. We found that boys and girls with Conduct Disorder had reduced thickness and more folding in the prefrontal cortex, an area at the front of the brain which is responsible for reward and punishment processing and helping us to control our emotions and impulses. In contrast, in some other areas such as the superior frontal gyrus, which is involved in short-term memory, boys and girls with Conduct Disorder showed structural changes in opposite directions (e.g., more versus less folding) compared with controls. This suggests that there are common abnormalities in brain structure in boys and girls with Conduct Disorder, but also some sex differences that might indicate that the causes of the disorder are partly different in boys and girls. (more…)
ADHD, Author Interviews, JAMA, Pharmacology / 26.07.2017

MedicalResearch.com Interview with: Professor Ian Chi Kei Wong and Kenneth KC Man, Senior Research Assistant Department of Social Work and Social Administration, Faculty of Social Science Department of Pharmacology and Pharmacy, LKS Faculty of Medicine The University of Hong Kong MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with attention-deficit/hyperactivity disorder (ADHD) are at higher risk of various mental health problems. Previous studies suggested that individuals with ADHD are having a higher chance of both attempted and completed suicide. Methylphenidate is a psychostimulant that is recommended for the treatment of ADHD. With the increasing usage of methylphenidate over the past decade, there are concerns about the safety of the medication, in particular, psychiatric adverse effects such as suicide attempt. The current study looked into over 25,000 patients aged 6 to 25 years in Hong Kong who were receiving methylphenidate in 2001 to 2015. Using the self-controlled case series design, in which the patients act as their own control, we found that the risk of suicide attempt was 6.5 fold higher during a 90-day period before methylphenidate was initiated, remained elevated 4-fold during the first 90 days of treatment, and returned to the normal level during ongoing treatment. (more…)
Author Interviews, JAMA, Mental Health Research / 26.07.2017

MedicalResearch.com Interview with: Robert J. Ursano, M.D. Professor of Psychiatry and Neuroscience Director, Center for the Study of Traumatic Stress Dept of Psychiatry Uniformed Services University of the Health Sciences Bethesda, MD  MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is part of the STARRS study- a study to identify risk and protective factors for suicide in US Army. Originally funded by NIMH it is not funded by DoD. It has been called the "Framingham study" for suicide and has been highly productive. In this study we report that units with one suicide attempt are at increased risk of a second- indicating clustering of suicide attempts. (more…)
AHRQ, Author Interviews, Cost of Health Care / 22.07.2017

MedicalResearch.com Interview with: Ruirui Sun, Service Fellow, Economist Center for Delivery, Organization and Markets Agency for Healthcare Research and Quality MedicalResearch.com: What is the background for this study? Response: Hospital inpatient care has experienced changes due to factors such as population growth, rising of prevalence of chronic disease and efforts to reduce unnecessary hospitalizations. We generated information from the National Hospital Utilization and Costs path on Fast Stats (https://www.hcup-us.ahrq.gov/faststats/landing.jsp ), to present the trends on national hospitalization and costs from 2005 to 2014, as well as the most common diagnoses among inpatient stays over the 10-year period. MedicalResearch.com: What are the main findings?
  • Between 2005 and 2014, the inflation-adjusted mean cost per inpatient stay increased by 12.7 percent, from $9,500 to $10,900.
  • Inflation-adjusted cost per stay for patients covered by private insurance or Medicaid increased 16-18 percent. Cost per stay for Medicare-covered patients and the uninsured changed minimally.
  • The rate of inpatient stays decreased the most among patients in the highest income quartiles (15-20 percent decrease).
  • The proportion of Medicaid-covered inpatient stays increased by 15.7 percent, whereas the proportion paid by private insurance and that were uninsured decreased by 12.5 and 13.0 percent, respectively.
  • Mental health/substance use accounted for nearly 6 percent of all inpatient stays in 2014, up 20.1 percent from 2005.
  • Between 2005 and 2014, septicemia and osteoarthritis became two of the five most common reasons for inpatient stays. Septicemia hospital stays almost tripled.
  • Nonspecific chest pain and coronary atherosclerosis decreased by more than 60 percent from 2005 to 2014, falling off the list of top 10 reasons for hospitalization. 
(more…)
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, Depression, Pharmacology / 12.06.2017

MedicalResearch.com Interview with: Greta A Bushnell, MSPH Doctoral Candidate, Department of Epidemiology UNC, Gillings School of Global Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with depression may be co-prescribed a benzodiazepine at antidepressant initiation for a short period for a variety of reasons. Reasons include reducing concurrent anxiety and insomnia, reducing depression severity more quickly, and improved antidepressant continuation. However, there are concerns with benzodiazepines including dependency. As such, benzodiazepines are usually recommended for only short-term treatment. Prior to our study, little was known about a) how often new simultaneous antidepressant and benzodiazepine prescribing occurred among patients initiating antidepressant treatment for depression or b) whether new simultaneous users became long-term benzodiazepine users. In a large commercial insurance database, we identified adults aged 18-64 years with depression who initiated an antidepressant from 2001 to 2014. We found that 11% of adults simultaneously initiated benzodiazepine treatment, which increased from 6% in 2001 to a peak at 12% in 2012. We observed similar antidepressant treatment length at six months in simultaneous new users and among patients initiating antidepressants only. The majority of simultaneous new users had only one benzodiazepine prescription fill before benzodiazepine discontinuation; however, 12% were identified as long-term benzodiazepine users. (more…)
Author Interviews, JAMA, Karolinski Institute, Pharmacology, Schizophrenia / 09.06.2017

MedicalResearch.com Interview with: Jari Tiihonen, MD, PhD Professor, Department of Clinical Neuroscience Karolinska Institutet Stockholm, Sweden  MedicalResearch.com: What are the limitations of existing analyses of the comparative effectiveness of antipsychotics? Response: It has remained unclear if there are clinically meaningful differences between antipsychotic treatments in relapse prevention of schizophrenia, due to the impossibility of including large unselected patient populations in randomized controlled trials, and due to residual confounding from selection biases in observational studies. (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, 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…)
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, Eating Disorders / 13.05.2017

MedicalResearch.com Interview with: Cynthia Bulik, PhD, FAED Founding director of the UNC Center of Excellence for Eating Disorders and Professor at Karolinska Institutet in Stockholm, Sweden. MedicalResearch.com: What is the background for this study? Response: Researchers and clinicians from around the world came together to create the most powerful genome-wide association study of anorexia nervosa to date. Via this global collaboration, we were able to identify the first significant locus that influences risk for anorexia nervosa. We have known that anorexia is heritable for over a decade, but now we are actually identifying which genes are implicated. This is the first one identified! (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, NYU, Schizophrenia / 08.05.2017

MedicalResearch.com Interview with: Donald C. Goff, MD Marvin Stern Professor Vice Chair for Research Department of Psychiatry NYU Langone Medical Center MedicalResearch.com: What is the background for this study? Response: Since their introduction in the 1950’s antipsychotic drugs have been an integral part of the treatment of schizophrenia. However, over the past decade concerns have been raised about whether these drugs might negatively affect the long-term course of the illness—either by causing supersensitivity of dopamine receptors, which might make patients more prone to psychosis and relapse, or by direct toxic effects on the brain. To address these concerns, we convened a panel of international experts to review the evidence supporting these concerns, including findings from clinical studies, brain imaging studies, post-mortem examination of the brains of people treated with these drugs, and studies in which these drugs were administered to animals. (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…)
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…)
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…)