Author Interviews, JAMA, Mental Health Research / 12.02.2015

Elizabeth Walker, PhD, MPH, MAT FIRST Postdoctoral Fellow Center for Behavioral Health Policy Studies Rollins School of Public Health, Emory UniversityMedicalResearch.com Interview with: Elizabeth Walker, PhD, MPH, MAT FIRST Postdoctoral Fellow Center for Behavioral Health Policy Studies Rollins School of Public Health, Emory University   Medical Research: What is the background for this study? Response: Mental disorders are a major cause of disability globally and are associated with premature mortality.  Quantifying and understanding excess mortality among people with mental disorders can inform approaches for reducing this burden.  The purpose of this study was to systematically review the literature in order to estimate individual- and population-level mortality rates associated with mental disorders.  We conducted a comprehensive systematic review and meta-analysis, which included 203 studies from 29 countries. Medical Research: What are the main findings? Response: We estimated that 8 million deaths worldwide per year are attributable to mental disorders.  People with mental disorders have over 2 times the risk of mortality compared to the general population or people without mental disorders.  This translates to a median of 10 years of life lost.  In total, 67.3% of people with mental disorders died from natural causes, 17.5% from unnatural causes, and the remainder from unknown causes. (more…)
Author Interviews, Mental Health Research, Occupational Health / 10.02.2015

Prof.dr. Judith K. Sluiter Principal Investigator Manager KMKA: Kenniscentrum Medische Keuringen in Arbeid Nationaal secretaris voor ICOH (International Commission on Occupational Health) Coronel Instituut voor Arbeid en Gezondheid, Academisch Medisch Centrum / UvA Meibergdreef AmsterdamMedicalResearch.com Interview with: Prof.dr. Judith K. Sluiter Principal Investigator Manager KMKA: Kenniscentrum Medische Keuringen in Arbeid Nationaal secretaris voor ICOH (International Commission on Occupational Health) Coronel Instituut voor Arbeid en Gezondheid, Academisch Medisch Centrum / UvA Meibergdreef Amsterdam Medical Research: What is the background for this study? Prof. Sluiter: Professional footballers contain a group of employees working in a job with specific job demands. The occupational guidance and prevention of decreased work functioning of workers in these kinds of jobs should receive more attention. The mental health of professional footballers receive less attention compared to their physical health. We studied the prevalence of self-reported mental health problems and psychosocial difficulties in a group of current and former professional footballers, and we explored the association between having had psychosocial stressors and the health conditions under study. Medical Research: What are the main findings? Response: The response rate was 29% with available data from 253 footballers. In current players, the prevalence of mental health complaints ranged from 5% (burnout) to 26% (anxiety/depression). In former players, the prevalence ranged from 16% (burnout) to 39% (anxiety/depression). A small percentage of players had low self-esteem (3-5%). One quarter to two-fifth of the players showed adverse nutrition behaviour. Small but significant association between experiencing lower social support (OR=1.1) and having had recent life events (OR=1.4-1.6) and mental health complaints were found in current players. Having had severe injuries was associated with better nutrition behavior. In former players, having had life events showed a preventive effect on smoking (OR=0.4) and having had previous surgery was significantly associated with current smoking behavior (OR=1.9). (more…)
Author Interviews, Mental Health Research, Nursing / 09.02.2015

Erin L. Kelly PhD Post Doctoral Scholar Health Services Research Center University of California, Los Angeles, CaliforniaMedicalResearch.com Interview with: Erin L. Kelly PhD Post Doctoral Scholar Health Services Research Center University of California, Los Angeles, California MedicalResearch: What is the background for this study? What are the main findings? Dr. Kelly: Mental health facilities can be hazardous workplaces. Nationally, compared to their counterparts in other healthcare settings, mental health workers are at the highest risk for patient assaults. Many studies have focused on predictors for assault such as gender, years of experience, or the position that staff hold in the hospital, which can account for a small amount of violence. However, psychiatric care is largely about relationships. Our study examined how conflicts with patients and coworkers, and how people react to conflict, influences their risk of assault. In our study, 70% of staff at a large public mental hospital were assaulted in a single year, which is closer to the lifetime assault rate for mental health workers. We also found that the likelihood of assault is predicted by conflicts when we also include stress reactions to conflict as a moderator. We found that workers who reported being less reactive to conflict but experienced a great deal of conflict, with staff or patients, were at the highest risk of assault. This could mean that people who aren't afraid of conflict with patients are more likely to jump in with agitated patients or that people who are insensitive to conflict are missing important social cues and being assaulted more often. However, despite the similarity in the relationships of staff conflict and patient conflict with assault risk, it’s possible that the direction of the relationship between staff conflict and assault may be different. For example, mental health staff who have a lot of conflict with their co-workers may be isolated and therefore a target for assault by patients. (more…)
Author Interviews, Genetic Research, JAMA, Personalized Medicine / 09.02.2015

Andres Moreno De Luca, MD Investigator and Resident Physician Autism & Developmental Medicine Institute Department of Radiology Geisinger Health System Danville, PA 17822MedicalResearch.com Interview with: Andres Moreno De Luca, MD Investigator and Resident Physician Autism & Developmental Medicine Institute Department of Radiology Geisinger Health System Danville, PA 17822   Medical Research: What is the background for this study? What are the main findings? Response: The main finding of our study is that family background contributes to the variability in cognitive, behavioral, and motor performance seen in children with 16p11.2 deletions, and perhaps other genetic syndromes, and this may be attributed in part to genetic background effects. In the general population the best predictor of a child’s outcomes in traits such as cognitive ability, height, BMI, etc. is the biparental mean performance in such domains and this is due in part to genetic background. For example, if a child’s parents have IQ scores of 130 and 110, it is expected that the child will have an IQ within 2 standard deviations of 120 (bi-parental mean). However, when studying individuals with genetic conditions, most researchers tend to overlook the influence of familial/genetic background on the affected child’s outcomes and commonly attribute the manifestations (or lack thereof) to the genetic mutation alone. This creates confusion when studying children with neurodevelopmental disorders, such as autism, which show significant clinical variability, as some children with a specific genetic mutation (e.g. deletion 16p11.2) may have intellectual disability without autism, while other children with the same mutation may have autism without intellectual disability. Based on these observations, some researchers have argued that deletion 16p11.2 is incompletely penetrant. However, our study showed that the 16p11.2 deletion has a detrimental effect on cognitive and behavioral performance for all children, but the clinical status (affected vs. unaffected) and ultimate performance level is influenced by the parental performance. (more…)
Author Interviews, Mental Health Research, UCSF / 09.02.2015

Ezequiel Morsella, Ph.D. Associate Professor of Neuroscience Department of Psychology San Francisco State University Assistant Adjunct Professor Department of Neurology University of California, San Francisco Boardmember, Scientific Advisory Board Institute of Cognitive Neurology (INECO), Buenos AiresMedicalResearch.com Interview with: Ezequiel Morsella, Ph.D. Associate Professor of Neuroscience Department of Psychology San Francisco State University Assistant Adjunct Professor Department of Neurology University of California, San Francisco Boardmember, Scientific Advisory Board Institute of Cognitive Neurology (INECO), Buenos Aires Medical Research: What is the background for this study? What are the main findings? Dr. Morsella: Previous studies have demonstrated that, under certain experimental conditions, conscious processes in the brain can function in a way that resembles reflexes.  In past research, a single ‘high-level’ thought (e.g., the name of a visually-presented object) was triggered involuntarily by external stimuli. The current research is the first to trigger, not one, but two high-level unintentional conscious thoughts. In this experiment, participants were presented with an object (e.g., the picture of a star) and instructed to not subvocalize (i.e., name in one’s head but not aloud) the name of the object nor count the number of letters comprising the name of the object.  On many trials, participants experienced both cognitions (e.g., “STAR” and “4”), even though these thoughts were against the intentions of the participant. Thus, this is the first demonstration of external control of two thoughts in the stream of consciousness. This research is based in part on the pioneering investigations of Wegner, of Gollwitzer, and of Ach. (more…)
Author Interviews, Emergency Care, Mental Health Research, UCSD / 05.02.2015

Michael Wilson, MD, PhD, FAAEM Attending Physician, UCSD Department of Emergency Medicine Director, Department of Emergency Medicine Behavioral Emergencies Research (DEMBER) lab UC San Diego Health SystemMedicalResearch.com Interview with: Michael Wilson, MD, PhD, FAAEM Attending Physician, UCSD Department of Emergency Medicine Director, Department of Emergency Medicine Behavioral Emergencies Research (DEMBER) lab UC San Diego Health System MedicalResearch: What is the background for this study? What are the main findings? Dr. Wilson: Emergency departments (EDs) nationwide are crowded. Although psychiatric patients do not make up the largest proportion of repeat visitors to the emergency department, psychiatric patients stay longer in the ED than almost any other type of patient. So, it’s really important to find out things about these patients that may predict longer stays. In this study, we looked at patients on involuntary mental health holds. The reasoning is simple: patients on involuntary mental health holds aren’t free to leave the ED. So, the only thing that should really matter is how quickly an Emergency department can release them from the involuntary hold. Surprisingly, though, this wasn’t the only thing that correlated with longer stays. (more…)
Author Interviews, Columbia, Schizophrenia / 04.02.2015

Mark Slifstein, PhD Associate Professor of Neurobiology (In Psychiatry) Dept. of Psychiatry Columbia University NYSP Dr New York NY 10032 MedicalResearch.com Interview with: Mark Slifstein, PhD Associate Professor of Neurobiology (In Psychiatry) Dept. of Psychiatry Columbia University NYSP Dr New York NY 10032 MedicalResearch: What is the background for this study? Dr. Slifstein: There has been considerable basic and clinical neuroscience research showing that the neurotransmitter dopamine plays a role in tuning cognitive processes taking place in the cortex. It has long been thought that dopamine is involved in the cognitive difficulties experienced by patients with schizophrenia, but it has been challenging to study dopamine in the cortex and other parts of the brain except in a deep structure rich in this neurotransmitter and its receptors, the striatum. In our study, we used an experimental design with Positron Emission Tomography (PET) imaging that allowed us to infer the amount of dopamine in the cortex. (more…)
Author Interviews, Genetic Research, Mental Health Research, Scripps / 25.01.2015

Dr. Gavin Rumbaug Professor (Associate) The Scripps Research InstituteMedicalResearch.com Interview with: Gavin Rumbaug Professor (Associate) The Scripps Research Institute Medical Research: What is the background for this study? What are the main findings? Response: We have developed a genetic approach that protects animal models against a type of genetic disruption that causes intellectual disability, including serious memory impairments and altered anxiety levels. The findings focus on treating the effects of mutations to a gene known as Syngap1. In our new study, we examined the effect of damaging Syngap1 mutations during development and found that the mutations disrupt a critical period of neuronal growth—a period between the first and third postnatal weeks in mouse models. We found that a certain type of cortical neuron grows too quickly in early development, which then leads to the premature formation of certain types of neural circuits. These findings help explain why genetic treatments in adult mice are not very effective. (more…)
Author Interviews, CDC, OBGYNE, Opiods / 25.01.2015

Dr. Jennifer Lind PharmD, MPH Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, CDCMedicalResearch.com Interview with: Dr. Jennifer Lind PharmD, MPH Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, CDC Medical Research: What is the background for this study? Dr. Lind:  CDC researchers published a new study estimating the proportion of women aged 15-44 years who filled a prescription for opioid pain medications.  Opioids are prescribed by healthcare providers to treat moderate to severe pain. They are also found in some prescription cough medications. Opioids include medications like codeine, oxycodone, hydrocodone, or morphine. For this study, researchers used data from two large insurance claims datasets—one on Medicaid and one on private insurance—and looked at data from 2008-2012. Medical Research: What are the main findings? Dr. Lind: Opioid medications are widely used among women of reproductive age in the United States, regardless of insurance type. On average, more than a third (39 percent) of women aged 15-44 years enrolled in Medicaid, and more than one fourth (28 percent) of those with private insurance filled a prescription for an opioid pain medication each year during 2008-2012. Taking these medications early in pregnancy, often before women know they are pregnant, can increase the risk for some birth defects (such as spina bifida) and other poor pregnancy outcomes (such as preterm birth or low birth weight). (more…)
Author Interviews, Baylor College of Medicine Houston, JAMA, Mental Health Research / 21.01.2015

M. Justin Coffey MD Associate Professor Menninger Department of Psychiatry & Behavioral Sciences Baylor College of MedicineMedicalResearch.com Interview with: M. Justin Coffey MD Associate Professor Menninger Department of Psychiatry & Behavioral Sciences Baylor College of Medicine MedicalResearch: What is the background for this study? What are the main findings? Dr. Coffey: Although both the US Surgeon General and the Institute of Medicine have called on health care systems to reduce suicide, the few assessments of suicide in such systems have examined only specific patient groups and not the entire population of health plan members. Our study reports the first information on suicide for the entire membership of a large health maintenance organization (HMO). The findings provide a previously unavailable baseline data for health care systems who are engaged in important efforts to measure and prevent suicide. We identified all suicides among the entire membership of our HMO network between 1999 and 2010, determining the date and cause of death using official state mortality records. In our sample, the annual suicide rate among all HMO members (including non-patient members) did not change over time, whereas the annual suicide rate in the general population of the state of Michigan increased significantly. Importantly, suicides actually decreased among HMO members who received specialty mental health services, whereas suicides increased among HMO members who accessed general medical services but not specialty mental health services.   (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Medicare, Mental Health Research, Pharmacology / 16.01.2015

Dr. Jeanne Madden PhD Instructor, Department of Population Medicine Harvard Medical SchoolMedicalResearch.com Interview with: Dr. Jeanne Madden PhD Instructor, Department of Population Medicine Harvard Medical School   Medical Research: What is the background for this study? What are the main findings? Dr. Madden: When Medicare Prescription Drug Coverage started in 2006, many experts voiced concerns about disabled patients with serious mental illness making the transition from state Medicaid coverage to Medicare.  Our study is one of the first to examine the impact of the transition in mentally ill populations.  People living with schizophrenia and bipolar disorder are at high risk of relapse and hospitalization and are especially vulnerable to disruptions in access to their treatments. We found that the effects of transitioning from Medicaid to Medicare Part D depended on where patients lived.  Transition to Part D in states that put limits on Medicaid drug coverage resulted in fewer patients going without treatment. By contrast, in states with more generous drug coverage, we saw reductions in use, of antipsychotics in particular, after patients shifted to Medicare Part D.  This may have been due to new cost controls used within many private Medicare drug plans.  Given that most states in the US are in this latter category, with the relatively generous Medicaid drug coverage, we also found reductions in antipsychotic use nation-wide. Although a very large group of people made that transition from Medicaid to Medicare in 2006, thousands more still transition every year because when disabled people qualify for Medicare, they must wait 2 years for their benefits kick in.  Also, many other disabled patients are on Medicaid only and don’t qualify for Medicare.  They are of course affected by restrictions on Medicaid coverage, which vary from state to state. (more…)
Author Interviews, JAMA, Mental Health Research, University of Pittsburgh / 06.01.2015

Dr. Brent David MD Academic Chief, Child and Adolescent Psychiatry at Western Psychiatric Institute and Clinic Professor of Psychiatry, Pediatrics & Epidemiology University of Pittsburgh School of Medicine MedicalResearch.com Interview with: Dr. Brent David MD Academic Chief, Child and Adolescent Psychiatry at Western Psychiatric Institute and Clinic Professor of Psychiatry, Pediatrics & Epidemiology University of Pittsburgh School of Medicine Medical Research: What is the background for this study? Dr. David: There are now many studies that show that suicide and suicidal behavior run in families. A family history of suicide increases the risk for suicide attempt and vice versa, so that we believe that the trait that is being passed from parent to child is a tendency to act on suicidal thoughts, resulting in either an attempt or an actual suicide. However, what was not not known was the mechanism by which parents transmitted the risk of suicidal behavior to their children, and what the precursors of suicidal behavior looked like in individuals who were at risk for suicidal behavior, but had not yet engaged in a suicide attempt. Therefore, we conducted a high-risk family study, in which studied the children of parents with mood disorders, about half of whom also had a history of a suicide attempt. Medical Research: What are the main findings? Dr. David: We followed 701 offspring for an average of 5.6 years, and found that those offspring whose parents had made a suicide attempt were almost 5 times more likely to make a suicide attempt themselves, even after accounting for mood disorder in parent and child and past suicidal behavior in the offspring. We found three main pathways by which suicidal behavior was passed from parent to child:
  • Parental mood disorder was transmitted to children, and that was a precursor of a suicide attempt.
  • Parent attempt was related to offspring impulsive aggression, which in turn increased the risk for mood disorder, which then increased the likelihood of a suicide attempt. (We define impulsive aggression as a tendency to response with hostility or aggression to provocation or frustration.
  • Finally, there is a direct path from parent attempt to child attempt, with no precursors or intervening variables.
Implications for clinicians and patients:
  • First, these findings highlight that a parental history of a suicide attempt increases the risk of an attempt in the parent's children. Clinicians who take care of adults who have attempted suicide should make sure that children are assessed as they are at increased risk and that parents know what to look for in the future in order to get their children into needed treatment.
  • Second, the transmission of suicidal behavior from parent to child can be attenuated by preventing the transmission of mood disorder, and of impulsive aggression. There are now evidence based interventions that reduce the likelihood of a child of a depressed parent from developing depression; these treatment involve cognitive behavioral principles and may also involve family interventions. There are now good family-based interventions for impulsive aggression that can attenuate the risk that the child or adolescent will go on to develop a mood disorder, which in turn greatly increases the risk for suicidal behavior.
(more…)
Author Interviews, Brigham & Women's - Harvard, Psychological Science, Surgical Research / 20.12.2014

Brian I. Labow, MD Director, Adolescent Breast Clinic Assistant in Surgery Assistant Professor of Surgery Harvard Medical School PrimaryMedicalResearch.com Interview with: Brian I. Labow, MD Director, Adolescent Breast Clinic Assistant in Surgery Assistant Professor of Surgery Harvard Medical School Primary   Medical Research: What is the background for this study? What are the main findings? Dr. Labow:  This study is part of our larger Adolescent Breast Disorder Study, in which we examine the impact of several breast disorders on adolescent girls and boys and measure the effect of treatment. In this present study we have found breast asymmetry, defined as having at least 1 cup size difference between breasts, can have a significant impact on the psychological wellbeing of adolescent girls.  Validated surveys were given to adolescent girls with breast asymmetry, macromastia (enlarged breasts), and healthy unaffected girls between the ages of 12-21 to assess a wide array of health domains. Girls with breast asymmetry had noted deficits in psychological wellbeing and self-esteem when compared to healthy girls of the same age.  These impairments were similar to those of girls with macromastia, a condition known to have significant negative mental health effects. Interestingly, these negative psychological outcomes did not vary by patient’s age or severity of breast asymmetry. Older and younger adolescents were negatively impacted similarly, as were those with lesser and greater degrees of breast asymmetry. (more…)
Author Interviews, JAMA, Johns Hopkins, Mental Health Research / 28.11.2014

Daniel Safer MD Department of Psychiatry Johns Hopkins University School of Medicine Baltimore, Maryland Medicalresearch.com with: Daniel Safer MD Department of Psychiatry Johns Hopkins University School of Medicine Baltimore, Maryland Medical Research: What is the nature of this study? Dr. Safer: A large national sample of annual physician office-based visits by youth (aged 2-19) covering 12 years (1999-2010), focusing on trends in psychiatric DSM-IV diagnoses, with psychiatric diagnostic data analyzed proportionally comparing diagnoses that were subthreshold (not otherwise specified) with those that met full diagnostic criteria. (more…)
Author Interviews, JAMA, McGill, Mental Health Research / 03.11.2014

Frank J. Elgar, PhD Associate Professor of Psychiatry Canada Research Chair in Social Inequalities in Child Health Institute for Health and Social Policy, McGill University Montreal, Quebec, CanadaMedicalResearch.com Interview with: Frank J. Elgar, PhD Associate Professor of Psychiatry Canada Research Chair in Social Inequalities in Child Health Institute for Health and Social Policy, McGill University Montreal, Quebec, Canada Medical Research: What are the main findings of the study? Dr. Elgar: Our study addressed two questions. The first was whether cyberbullying has unique links to adolescent mental health, or is an extension of traditional (face-to-face) bullying. We measured various forms of bullying and found that cyberbullying does indeed have a unique impact on mental health. Our second question about protective factors in the home environment.  We examined the frequency of family dinners as potential a moderating factor - understanding, of course, that dinners are a proxy of various family characteristics that benefit adolescents, such as communication, support, and parental monitoring. We found that teens who were targeted by cyberbullying but had ate dinner with their families more often had significantly better mental health outcomes as a result. (more…)
Author Interviews, JAMA, Mental Health Research / 23.10.2014

Karl Ole Köhler, Research assistant Department of Clinical Medicine The Department of General Psychiatry Aarhus UniversityMedicalResearch.com Interview with: Karl Ole Köhler, Research assistant Department of Clinical Medicine The Department of General Psychiatry Aarhus University   Medical Research: What are the main findings of the study? Response:  We found that anti-inflammatory drugs and ordinary analgesics, which mainly are used against physical disorders, may have treatment effects against depression when used in combination with antidepressants. Thereby, our results furthermore support the hypothesis regarding a comorbidity between inflammatory diseases and depression, i.e. a connection between somatic and mental disorders. (more…)
Author Interviews, Bipolar Disorder, Genetic Research, Nature / 21.10.2014

Edward I. Ginns, MD, PhD, Director Program in Medical Genetics and Lysosomal Disorders Treatment and Research Program University of Massachusetts Medical School Reed Rose Gordon Building, Room 137 Shrewsbury, MA 01545MedicalResearch.com: Interview with: Edward I. Ginns, MD, PhD, Director Program in Medical Genetics and Lysosomal Disorders Treatment and Research Program University of Massachusetts Medical School Reed Rose Gordon Building, Room 137 Shrewsbury, MA 01545 Medical Research: What are the main findings of the study? Dr. Ginns: Our study identified that sonic hedgehog signaling, an important brain pathway, is involved in bipolar affective disorder. This finding shows a mechanism and provides new targets for drug development. It suggests that sonic hedgehog signaling can be modulated to help manage bipolar symptoms in adults by using drugs already being studied in clinical trials for other medical conditions. The new findings were uncovered by decades of translational research in the Old Order Amish families of Pennsylvania, where in a few special families in the Amish Study there is a high incidence of both bipolar disorder and a rare genetic dwarfism, Ellis van‐Creveld (EvC) syndrome. No person with EvC had bipolar disorder despite forty years of documented research across multiple generations, suggesting that the genetic cause of this rare dwarfism was protective of bipolar affective disorder. (more…)
Author Interviews, JAMA, Schizophrenia / 09.10.2014

Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine Hofstra North Shore LIJ School of Medicine Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital Investigator Feinstein Institute for Medical Research North Shore Long Island Jewish Health SystemMedicalResearch.com Interview with: Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine Hofstra North Shore LIJ School of Medicine Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital Investigator Feinstein Institute for Medical Research North Shore Long Island Jewish Health System Medical Research: What are the main findings of the study? Dr. Correll: The main findings of the study of 398 patients with first-episode schizophrenia-spectrum disorders who were on average in their mid twenties are that:
  • 1) despite their young age, an average of only 47 days lifetime antipsychotic exposure and overweight/obesity figures that were comparable to similarly aged US population members, there was a clear pattern of increased smoking and several metabolic risk parameters compared to similarly aged persons in the general US population;
  • 2) dyslipidemia, a constellation of at least one relevant abnormal blood fat value, was as frequent as in a 15-20 years older general US population;
  • 3) body composition related risk markers were significantly associated with longer total psychiatric illness duration, whereas metabolic risk markers were significantly associated with the overall very short mean lifetime antipsychotic treatment duration; and
  • 4) relevant for treatment choice and recommendations for patients, significantly higher continuous metabolic risk factor values were associated with olanzapine treatment and, less so, with quetiapine treatment. (more…)
Author Interviews, Mental Health Research / 11.09.2014

MedicalResearch.com Interview with: Patrick Corrigan Psy.D. Distinguished Professor of Psychology Illinois Institute of Technology PI: National Consortium on Stigma and Empowerment www.NCSE1.orgPatrick Corrigan Psy.D. Distinguished Professor of Psychology Illinois Institute of Technology PI: National Consortium on Stigma and Empowerment www.NCSE1.org Medical Research:  What are the main findings of this review? Dr. Corrigan: People with serious mental illness often do not seek out services, or drop out early, when in need. Stigma is a major reason for why this happens. Stigma refers to the stereotypes about a group that undermine status and lead to discrimination. Discrimination refers to the behaviors that block the opportunities of group members. Some employers do not hire people with mental illness, some landlords do not rent to them, and some primary care practitioners offer a substandard of care. Stereotypes and discrimination undermine engagement in mental health services in three ways (Corrigan, 2005): Label Avoidance: In order to escape the pernicious effects of stigma, people avoid settings where they are labeled mentally ill; for example, people coming out of a psychiatrist’s office may be perceived as “nuts.” Self-Stigma: Some people who internalize stereotypes suffer diminished self-esteem and self-efficacy leading to the “why try” effect. “Why should I try to get a job? Someone like me is not worthy.” “Why should I try to get mental health treatment? I am not able to benefit from it.” Structural Stigma: Stereotypes and discrimination become institutionalized in the laws and practices of government and business. For example, insurance coverage for mental health services was significantly below that for most other conditions.   (more…)
Author Interviews, Mental Health Research / 07.09.2014

Sean Clouston Ph.D. Assistant Professor Core Faculty, Program in Public Health Department of Preventive Medicine Stony Brook University Health Sciences Center Stony Brook, NY 11794MedicalResearch.com Interview with: Sean Clouston Ph.D. Assistant Professor Core Faculty, Program in Public Health Department of Preventive Medicine Stony Brook University  Health Sciences Center Stony Brook, NY 11794 Medical Research: What is the background for this study: Dr. Clouston: A number of epidemiological studies have found that suicide rates have decreased rapidly with the widespread distribution of SSRI antidepressants. Our group has found that proliferation of preventive medicine has, with regard to other causes of death, tended to occur unequally. We hypothesized that if SSRI antidepressants prevent suicide by treating depression, then suicide might also be susceptible to such inequality. Our study used mortality data to show that decreases in suicide were concentrated in regions with higher socioeconomic status. Medical Research: What are the main findings of the study? Dr. Clouston We used the best available data from the US and found that socioeconomic inequalities have increased dramatically in conjunction with the proliferation of SSRI antidepressants. (more…)
Author Interviews, JAMA, Mental Health Research, Schizophrenia / 06.09.2014

MedicalResearch.com Interview with: Sandra M. Meier, PhD The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, National Centre for Register-Based Research Aarhus University, Aarhus, Denmark Medical Research: What are the main findings of the study? Dr. Meier: People with an obsessive-compulsive disorder are at a 6 to 7 times higher risk of developing schizophrenia than people without an obsessive-compulsive disorder. If the parents are diagnosed with an obsessive-compulsive disorder, their offspring experience a 3 to 4 times higher chance to develop schizophrenia. (more…)
Author Interviews, Bipolar Disorder, JAMA, Stanford / 27.08.2014

MedicalResearch.com Interview with: Manpreet K. Singh, MD MS Assistant Professor of Psychiatry and Behavioral Sciences Akiko Yamazaki and Jerry Yang Faculty Scholar in Pediatric Translational Medicine Stanford University School of Medicine Medical Research: What are the main findings of the study? Dr. Singh: Our research team used a monetary incentive delay paradigm to measure fronto-limbic activity and connectivity associated with anticipation and receipt of reward and loss in healthy offspring of parents with bipolar I disorder. We found that compared to youth offspring without any family history of psychopathology, high-risk offspring had aberrant prefrontal and cingulate activations and connectivity during reward processing. Further, greater striatal, amygdalar, and insula activations while anticipating and receiving rewards and losses were associated with greater novelty-seeking and impulsivity traits in high-risk youth. (more…)
Author Interviews, JAMA, Mental Health Research / 12.07.2014

MedicalResearch.com interview with: Lee M. Hampton, MD, MSc: Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta, Georgia Medical Research: What are the main findings of the study? Dr. Hampton: The study, which used CDC's national outpatient adverse drug event surveillance system (NEISS-CADES), found that there are almost 90,000 estimated annual emergency department visits by adults for adverse drug events from therapeutic use of antipsychotics, antidepressants, sedatives and anxiolytics, lithium salts or stimulants between 2009 and 2011. Almost one in five of those emergency department visits (19.3%) resulted in hospitalization. Sedatives and anxiolytics, antidepressants, and antipsychotics each caused 20,000 to 30,000 emergency department visits annually. However, relative to how often each of these types of medications was prescribed at outpatient visits, antipsychotics and lithium salts were more likely to cause emergency department visits for adverse drug events than were sedatives, stimulants, and antidepressants. Antipsychotics caused 3.3 times more emergency department visits for adverse drug events than sedatives, 4.0 times more emergency department visits than stimulants, and 4.9 times more emergency department visits than antidepressants relative to their outpatient use. Out of the 83 specific drugs the study looked at, ten drugs were implicated in nearly 60% of the emergency department visits for ADEs from therapeutic use of antipsychotics, antidepressants, sedatives and anxiolytics, lithium salts or stimulants. Zolpidem was implicated in nearly 12% of all such emergency department visits and 21% of such emergency department visits involving adults aged 65 years or older, more than any other antipsychotic, antidepressant, sedative or anxiolytic, lithium salt or stimulant. (more…)
Author Interviews, BMJ, Gender Differences, Mental Health Research / 01.07.2014

Dr. Flora I Matheson PhD Centre for Research on Inner City Health St. Michael's Hospital Toronto, ON, CanadaMedicalResearch.com Interview with: Dr. Flora I Matheson PhD Centre for Research on Inner City Health St. Michael's Hospital Toronto, ON, Canada MedicalResearch: What are the main findings of the study? Dr. Matheson:
  • We found that women were 10 per cent more likely to use mental health services than men.
  • And that within any 3-year period, women with physical illness used medical services for mental health treatment 6 months earlier than men.
(more…)
Author Interviews, JAMA, Mental Health Research / 17.06.2014

Monika Waszczuk 1+3 PhD Student MRC SGDP Research Centre Institute of Psychiatry, King's College London DeCrespigny Park London UKMedicalResearch.com Interview with: Monika Waszczuk 1+3 PhD Student MRC SGDP Research Centre Institute of Psychiatry, King's College London DeCrespigny Park London UK MedicalResearch: What are the main findings of the study? Answer: Little is known about the genetic influences on the relationship between depression and anxiety disorders across development. We used two population-based prospective longitudinal twin and sibling studies to investigate phenotypic associations between the symptoms of these disorders, and tested genetic structures underlying these symptoms across three developmental stages: childhood, adolescence and early adulthood. We found that depression and anxiety disorder symptoms are largely distinct in childhood and are influenced by largely independent genetic factors. Depression and anxiety symptoms become more associated and shared most of their genetic etiology from adolescence. An overarching internalizing genetic factor influencing depression and all anxiety subscales emerged in early adulthood. These results provide preliminary evidence for different phenotypic and genetic structures of internalizing disorder symptoms in childhood, adolescence and young adulthood, with depression and anxiety becoming more associated from adolescence. (more…)
Author Interviews, Compliance, JAMA, Pharmacology, Schizophrenia / 23.05.2014

Scott Stroup, MD, MPH Professor of Psychiatry Director, Program for Intervention Effectiveness Research, Associate Director for Adult Services, Division of Mental Health Services and Policy Research, New York State Psychiatric Institute Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New YorkMedicalResearch.com Interview with: Scott Stroup, MD, MPH Professor of Psychiatry Director, Program for Intervention Effectiveness Research, Associate Director for Adult Services, Division of Mental Health Services and Policy Research,  New York State Psychiatric Institute Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York MedicalResearch: What are the main findings of the study? Dr. Stroup: We conducted a study sponsored by the National Institute of Mental Health that compared long-acting injectable antipsychotics for people with schizophrenia. Long-acting injectable antipsychotics, also known as depot antipsychotics, are used to promote treatment adherence.  We compared a newer injectable antipsychotic, paliperidone palmitate, to an older one, haloperidol decanoate.  We did not find an advantage for the newer drug in overall effectiveness.  The drugs performed very similarly, and were tolerated about the same. (more…)
Author Interviews, Mental Health Research, Schizophrenia / 13.05.2014

prof_jayashri_kulharniMedicalResearch.com Interview with: Professor Jayashri Kulkarni MBBS, MPM, FRANZCP, PhD Monash University MedicalResearch.com: What are the main findings of the study? Professor Kulkarni: Persistent schizophrenia is difficult and unfortunately common, despite advances over the past years in antipsychotic drug development. New treatment approaches are urgently needed. Also, a specific focus for women with schizophrenia is still somewhat lacking and there is a need to consider the special issues facing women with schizophrenia. Over many years, we have been conducting clinical trials to develop the role of adjunctive estradiol use to treat symptoms of schizophrenia. This study is the largest clinical trial in the world of this type and we found that in an 8 week, three arm, double blind, placebo-controlled, adjunctive trial of transdermal estradiol (200mcg v 100mcg v placebo) in 183 women with schizophrenia, that the women who received either 200mcg or 100mcg transdermal estradiol made a better recovery. The women who received 200mcg transdermal estradiol made a slightly better recovery than women receiving 100mcg transdermal estradiol. Both estradiol groups were significantly better than the group who received adjunctive transdermal placebo. (more…)
Author Interviews, Lancet, Mental Health Research / 13.05.2014

Dr Alexandra Pitman MBBS MRC Psych MRC Clinical Research Fellow, UCL Division of Psychiatry, UCL (University College LondonMedicalResearch.com interview with: Dr Alexandra Pitman MBBS MRC Psych MRC Clinical Research Fellow, UCL Division of Psychiatry, UCL (University College London MedicalResearch: What are the main findings of the study? Answer: We conducted a systematic review of all published research comparing the experience of suicide bereavement with bereavement due to other causes, in which we considered the evidence from 57 studies evaluating the effect of bereavement on death, mental health, and social functioning of family members, friends, and other close contacts of the deceased. These studies showed that parents and children bereaved by suicide were at higher risk of mental health problems after the loss than parents and children bereaved by other causes, and that spouses and mothers bereaved by suicide were at higher risk of suicide than spouses and mothers bereaved by other causes. We also found some evidence that people from a range of kinship groups bereaved by suicide report more rejection and shame than people bereaved by other violent deaths, and that feeling stigmatised by the death is commonly experienced after any violent bereavement. It seemed that people bereaved by violent deaths, for example due to accidental death, homicide, drug-related death, motor vehicle crash, undetermined death or suicide, shared a sense of feeling blamed for the death or tainted by their association with the deceased. (more…)
Cannabis, Mental Health Research / 08.05.2014

Meesha Ahuja, MD Department of Psychiatry and Human Behavior of the Warren Alpert Medical School of Brown University Young Adult Behavioral Health Program at Rhode Island Hospital Mentors: Laura Whiteley, MD and Larry Brown, MDMedicalResearch.com Interview with: Meesha Ahuja, MD Department of Psychiatry and Human Behavior of the Warren Alpert Medical School of Brown University Young Adult Behavioral Health Program at Rhode Island Hospital Mentors: Laura Whiteley, MD and Larry Brown, MD MedicalResearch: Why did you decided to study this topic? Dr. Ahuja: Severe mental illness is more common among college students than it was a decade ago, and the number of college students presenting for psychiatric care both on and off campus has dramatically increased. The rates of cannabis use have also been increasing among college students in the United States since the mid-1990s. The concomitant use of cannabis and other substances among general samples in psychiatric treatment has been linked to poorer clinical outcomes including increased hospitalizations, increased symptomatology, poorer treatment adherence, higher treatment resistance. However, before doing this study, there was no research that examined the effect of cannabis and other substance use disorders on the scholastic and general functioning of college students in psychiatric care. (more…)