Author Interviews, Geriatrics, Mental Health Research / 23.04.2014

Helen C. Kales MD Professor of Psychiatry Director, Section of Geriatric Psychiatry and The Program for Positive Aging, University of Michigan Research Scientist, VA Center for Clinical Management Research and Geriatric Research Education and Clinical Center VA Ann Arbor Healthcare SysteMedicalResearch.com Interview with Helen C. Kales MD Professor of Psychiatry Director, Section of Geriatric Psychiatry and The Program for Positive Aging, University of Michigan Research Scientist, VA Center for Clinical Management Research and Geriatric Research Education and Clinical Center VA Ann Arbor Healthcare System Please note that this paper is the result of the deliberations of a multi-disciplinary national expert panel, not a specific study. MedicalResearch.com: What were the main findings of the expert panel? Dr. Kales: Often more than memory loss, behavioral symptoms of dementia are among the most difficult aspects of caring for people with dementia. These symptoms are experienced almost universally, across dementia stages and causes, and are often associated with poor outcomes including early nursing home placement, hospital stays, caregiver stress and depression, and reduced caregiver employment.  Doctors often prescribe these patients psychiatric medications like antipsychotics, despite little hard evidence that they work well in this population and despite the risks they pose including hastening death.  Meanwhile, studies show promise for non-medication behavioral and environmental approaches (such as providing caregiver education/support, creating meaningful activities and simplifying/enhancing the environment), but too few health providers are trained in their use.  The method created by the national multidisciplinary group of experts (DICE which stands for Describe, Investigate, Create and Evaluate) represents a comprehensive approach to assessment and management of behavioral symptoms in dementia.  For example, a new report of “agitation” from a caregiver, should be fully understood and described (e.g. who/what/when/where/risk/safety); underlying causes should be investigated (e.g. pain, changes in medications, medical conditions, poor sleep, fear); a treatment plan should be created (e.g. responding to physical problems, working collaboratively with the caregiver and other team members to institute non-pharmacologic interventions); and evaluating whether the interventions tried were effective. (more…)
Author Interviews, Lancet, Mental Health Research / 20.04.2014

Dr. George Patton Department of Paediatrics, University of Melbourne Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, AustraliaMedicalResearch.com Interview with: Dr. George Patton Department of Paediatrics, University of Melbourne Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia MedicalResearch.com: What are the main findings of the study? Dr. Patton: Although there has been wide acceptance that the teens are a time when emotional problems are common, views have been polarized about their significance. Some have viewed these problems are usual for this phase of life with little significance for later life mental health; others have argued that early psychiatric intervention was essential given the risks of ongoing disorders. In this sample almost two thirds of girls and a third of boys had an episode of emotional troubles (anxiety and depression) at a level that would concern a family physician. For those where the episode were brief lasting weeks to months, recovery without further later life episodes was common. In contrast those with persistent (longer than 6 months) or recurrent emotional problems during the teens had a high likelihood of similar problems with depression and anxiety in their twenties. In general these emotional problems persisted more in females than in males. (more…)
Author Interviews, JAMA, Mental Health Research / 27.02.2014

Brian D'Onofrio, PhD Associate Professor Department of Psychological and Brain Sciences Indiana University Bloomington, IN MedicalResearch.com Interview with: Brian D'Onofrio, PhD Associate Professor Department of Psychological and Brain Sciences Indiana University Bloomington, IN MedicalResearch.com: What are the main findings of your study? Dr. D'Onofrio: The main finding from our study is that the specific associations between advancing paternal age at childbearing and offspring psychiatric and academic problems were much larger than in previous studies. In fact, we found that advancing paternal age was associated with greater risk for several problems, such as Attention Deficit Hyperactivity Disorder, suicide attempts and substance use problems, whereas traditional research designs suggested advancing paternal age may have diminished the rate at which these problems occur. (more…)
Author Interviews, BMJ, Mental Health Research, Smoking / 14.02.2014

MedicalResearch.com Interview with: Gemma Taylor MSc MBPsS Doctoral ResearcherGemma Taylor MSc MBPsS Doctoral Researcher and Paul Aveyard and PhD MRCP MRCGP FFPG Professor of Behavioral MedicinePaul Aveyard and PhD MRCP MRCGP FFPG Professor of Behavioral Medicine Fellow of Wolson College Primary Care Clinical Sciences The University of Birmingham Birmingham United Kingdom MedicalResearch.com: What are the main findings of the study? Answer: Smoking cessation is associated with improvements in mental health compared with continuing to smoke. The effect sizes seem as large for those with psychiatric disorders as those without and are equal or larger to effect estimates of antidepressant treatment for mood and anxiety disorders. (more…)
Author Interviews, Duke, JAMA, Mental Health Research / 30.08.2013

MedicalResearch.com Interview with: Arif Khan, MD Medical Director, Northwest Clinical Research Center Adjunct Professor of Psychiatry Duke University Medical Center and Christine Khan, Psychiatric Nurse 1951 – 152nd  Place NE Northwest Clinical Research Center Bellevue, WA 98007 MedicalResearch.com: What are the main findings of your study?
  1. The original idea set in early 20th century that psychiatric patients discharged from mental hospitals had a shortened life span or faced early death was supported by this analysis of psychiatric patients participating in research trials for new medications.  There was no increased risk of early death or shortened life span for participating in these research clinical trials. 
  2. Life span shortening or increased risk of early death is highest among patients with schizophrenia, followed by patients with major mood disorders such as Bipolar Mood Disorder and Major Depression. (more…)
Author Interviews, JAMA, Mental Health Research, UT Southwestern / 07.08.2013

Carol S. North, MD, MPE  The Nancy and Ray L. Hunt Chair in Crisis Psychiatry Director, Program in Trauma and Disaster, VA North Texas Health Care System 4500 S. Lancaster Rd., Dallas, TX 75216 Professor of Psychiatry and Surgery/Division of Emergency Medicine UT Southwestern Medical Center 6363 Forest Park Rd. Dallas, TX 75390-8828MedicalResearch.com Interview with: Carol S. North, MD, MPE The Nancy and Ray L. Hunt Chair in Crisis Psychiatry Director, Program in Trauma and Disaster, VA North Texas Health Care System 4500 S. Lancaster Rd., Dallas, TX 75216 Professor of Psychiatry and Surgery/Division of Emergency Medicine UT Southwestern Medical Center 6363 Forest Park Rd. Dallas, TX 75390-8828 MedicalResearch.com: What are the main findings of the study? Answer: In post-disaster settings, a systematic framework of case identification, triage, and mental health interventions can guide overall mental health response and should be integrated into emergency medicine and trauma care responses. (more…)