Emotional & Mental Health - SUN Cornwall

Rise in the number of suicides in the South West

Sat, 03 Mar 2012 01:25:00 +0000

Rise in the number of suicides in the South West

Hospital admissions for self-harm also rise

Public health leaders in the South West have outlined a new approach to combat a significant increase in the number of suicides and cases of self- harm in the region.

The number of suicides in the South West rose by 24% from 417 in 2007 to 515 in 2009, according to a report published by the South West Public Health Observatory today.

This follows a period of decline in suicide deaths following the publication of the National Suicide Prevention Strategy in 2002.

The report, Suicide and Self-harm in the South West, recommends that the incidence of suicide is now closely monitored, that any areas where there are higher number of suicides are identified and that where necessary health, mental health and social care organisations should work together to reduce risk.

Men account for three-quarters of these deaths and those most at risk are men aged 35-44 and 85 and over.

There is also a clear link with deprivation, with suicide rates in the most deprived fifth of areas more than twice the rate in the least deprived areas.

The report also found that there has been a large increase in the number of hospital admissions due to self-harm, from 6,271 in 2002/03 to 10,846 in 2008/09 – an increase of 73%. This is the second highest percentage increase in England. The fastest rise was in girls aged 15 to 24. Five percent of admissions for self harm were in people aged 65 and over.

Regional Director of Public Health, Dr Gabriel Scally said:

“Together these statistics reveal suffering on a scale that should concern us all. It is vital that we work with a wide range of partners in health, mental health, social care and the third sector to reverse these trends.”

Co-author of the report and Director of the South West Public Health Observatory, Dr Julia Verne, said:

“Although deaths from suicide account for a relatively small number of deaths overall (0.9%), each death is a tragedy for the individual, their family and friends. Also, because of the relatively young age at which people die, deaths from suicide in the South West account for 2.8% of years of life lost in the region through premature death. This report makes recommendations to enable agencies to work together more effectively to prevent suicide and self-harm and to improve monitoring of the data, which will help us target resources more effectively.”

Other key recommendations from the report are:

· Raise awareness of suicide and self-harm and their risk factors in health, social care, criminal justice and local community settings.

· Ensure robust training strategies are in place across sectors and services.

· Introduce social and coping skills for young people in schools.

Hanging is the most common method of suicide in men. In women, hanging and poisoning are the two most common methods. Poisoning is the most common reason for self-harm admissions. Over-the-counter drugs and prescribed drugs account for similar numbers of admissions and together they account for 87% of male and 92% of female poisoning admissions.

Self-harm, like suicide, is strongly linked with deprivation.

Dr Verne said: “As a society we must care for the vulnerable and ensure the provision of appropriate services and support. This report provides the evidence to help us do this.”

ENDS

Notes to Editors:

1. For further information or to interview Dr Julia Verne, please contact Helen Bolton or Jon Templeton on Tel: 0117 970 6474.

2. The report, Suicide and Self-harm in the South West, is published by the South West Public Health Observatory (SWPHO) and available from the SWPHO website at www.swpho.nhs.uk. The research was commissioned by NHS South West.

3. The term ‘suicide’ includes all suicides and ‘undetermined deaths’ (i.e. where it was not clearly established by the coroner whether suicide was intended).

Anorexia nervosa study finds inner conflicts over the 'real' self

Mon, 28 Nov 2011 04:00:00 +0000

Anorexia nervosa study finds inner conflicts over the 'real' self that have treatment implications

November 22nd, 2011 in Psychology & Psychiatry

"It feels like there's two of you inside – like there's another half of you, which is my anorexia, and then there's the real K, the real me, the logic part of me, and it's a constant battle between the two." - 36 year old study participant with anorexia nervosa.

(Garrison, NY) People with anorexia nervosa struggle with questions about their real, or "authentic," self – whether their illness is separate from or integral to them – and this conflict has implications for compulsory treatment, concludes a study in the Hastings Center Report. The researchers also conclude that exploring ideas of authenticity may help clinicians formulate therapeutic approaches and provides insights into whether compulsory treatment can be justified.

For the study, researchers in the U.K. interviewed 29 women who were being treated for anorexia nervosa at clinics throughout the south of England. The interviews asked questions about how the women view their condition, including their understanding of it, how they feel about compulsory treatment, and their thoughts about the impact of anorexia on decision-making. Although the researchers did not ask about authenticity or identity, almost all of the participants spoke in terms of an "authentic self," the researchers write, "and, for almost all, the relationship between anorexia nervosa and this authentic self was a significant issue."

Participants characterized this relationship in different ways. Many saw anorexia nervosa as separate from their real self. Some expressed the idea of a power struggle between their real and inauthentic self. Others said that other people could provide support to enable the authentic self to gain strength within the struggle.

The researchers interpret the patients' notion of their illness as separate from their authentic self as a sign of hope. "Conceptualizing the anorexic behavior as an inauthentic part of the self may well be a valuable strategy for many in helping to overcome it," the authors write.

The authors also say that, in their view, the distinction between an authentic and an inauthentic self is not necessarily the same as a lack of capacity for decision-making and cannot justify overriding a patient's refusal to consent to treatment, although they believe that their findings give grounds for not simply acquiescing to refusals of help. "Some authorities argue that compulsory treatment should never be used for anorexia nervosa," they write. "We believe, however, that we should take seriously the possibility that a person in the throes of anorexia nervosa may be experiencing substantial inner conflict, even though the person may not be expressing that feeling at the time."

The authors conclude that clinicians need to monitor patients' views over time and that if the inner conflict persists, it suggests a lack of capacity for decision-making and, therefore, a risk of significant harm. In this case, they say, "perhaps the evidence from these accounts is sufficient to override treatment refusal in the person's best interest." An unanswered question is whether patients who regard anorexia nervosa as an inauthentic part of the self are most likely to respond to treatment. "A question of empirical study is whether those who separate the anorexic self from a perceived authentic self are more successful at overcoming anorexia nervosa than those who do not," the researchers write.

Provided by The Hastings Center

"Anorexia nervosa study finds inner conflicts over the 'real' self that have treatment implications." November 22nd, 2011. http://medicalxpress.com/news/2011-11-anorexia-nervosa-conflicts-real-treatment.html

People with early Alzheimer's disease may be more likely to have lower BMI

Mon, 28 Nov 2011 03:55:00 +0000

People with early Alzheimer's disease may be more likely to have lower BMI

November 21st, 2011 in Diseases

Studies have shown that people who are overweight in middle age are more likely to develop Alzheimer's disease decades later than people at normal weight, yet researchers have also found that people in the earliest stages of Alzheimer's disease are more likely to have a lower body mass index (BMI). A current study examines this relationship between Alzheimer's disease and BMI.

The study, published in the November 22, 2011, print issue of Neurology, the medical journal of the American Academy of Neurology, examined 506 people with advanced brain imaging techniques and analyses of cerebrospinal fluid to look for biomarkers for Alzheimer's disease, which can be present years before the first symptoms begin. The participants, who were part of the Alzheimer's Disease. Neuroimaging Initiative, included people with no memory problems, people with mild cognitive impairment, or mild memory problems, and people with Alzheimer's disease.

The study found that in people with no memory or thinking problems and in people with mild cognitive impairment, those who had the Alzheimer's biomarkers were also more likely to have a lower BMI than those who did not have the biomarkers.

For example, 85 percent of the people with mild cognitive impairment who had a BMI below 25 had signs of the beta-amyloid plaques in their brains that are a hallmark of the disease, compared to 48 percent of those with mild cognitive impairment who were overweight. The relationship was also found in people with no memory or thinking problems.

"These results suggest Alzheimer's disease brain changes are associated with systemic metabolic changes in the very earliest phases of the disease," said study author Jeffrey M. Burns, MD, MS, of the University of Kansas School of Medicine in Kansas City and a member of the American Academy of Neurology. "This might be due to damage in the area of the brain called the hypothalamus that plays a role in regulating energy metabolism and food intake. Further studies should investigate whether this relationship reflects a systemic response to an unrecognized disease or a long-standing trait that predisposes a person to developing the disease."

Provided by American Academy of Neurology

"People with early Alzheimer's disease may be more likely to have lower BMI." November 21st, 2011. http://medicalxpress.com/news/2011-11-people-early-alzheimer-disease-bmi.html

Helping others helps teens stay on the road to addiction recovery

Mon, 28 Nov 2011 03:55:00 +0000

Helping others helps teens stay on the road to addiction recovery

November 9th, 2011 in Health

A new study of teens undergoing substance abuse treatment finds helping others helps the adolescent helper by reducing cravings for alcohol and drugs, a major precipitator of relapse. These novel findings stem from the "Helping Others" study (http://helpingotherslivesober.org) led by Maria Pagano, PhD, associate professor of psychiatry at Case Western Reserve University School of Medicine.

Results of this large investigation involving 195 substance dependent juvenile offenders reveal that helping others in 12-step programs significantly improves adolescent treatment response. Featured in the November issue of the Journal of Studies on Alcohol and Drugs, this study also shows that youth service participation mediates the influence of lifetime religious practices on treatment outcomes.

"Our findings indicate that service participation in 12-step programs can reduce the craving symptoms experienced by adolescents in treatment for alcohol and or drug addiction," Dr. Pagano says. "Similarly, we found that substance-dependent adolescents with greater religious backgrounds participate more during treatment in 12-step programs of recovery, which leads to better health outcomes."

This observational, longitudinal study is the first to examine the relationship between adolescent 12-step participation during treatment, lifetime religiosity, and clinical outcomes, replicating findings shown among adults in Dr. Pagano's prior collaborative research.

Funded by the John Templeton Foundation, the investigation comprised 93 boys and 102 girls, ages 14-18, court-referred for residential treatment at New Directions, the largest adolescent residential treatment facility in Northeast Ohio. The majority were marijuana dependent (92%) with comorbid alcohol dependence (60%). Participants were interviewed within the first 10 days of treatment and two months later at treatment discharge. Outcomes assessed included urine toxicology screens, alcohol/drug craving symptoms, clinical characteristics, and global psychosocial functioning.

Controlling for background characteristics and clinical severity, Dr. Pagano and colleagues found that Alcoholics Anonymous and Narcotics Anonymous-related helping, as part of treatment, improved four of seven outcomes. These included reductions in two types of craving symptoms, reduced narcissistic entitlement, and improved psychosocial functioning. Higher lifetime religious practices, such as prayer, worship, and meditation, were associated with higher service participation during treatment, which in turn, led to better outcomes.

"Because most religions encourage altruistic behaviors, youths entering treatment with greater religious backgrounds may have an easier time engaging in service in 12-step programs of recovery," Dr. Pagano explains. "In turn, youth entering treatment with low or no religious background may require greater 12-step facilitation or a different approach to derive equal benefit from treatment."

Adolescent addiction has increased dramatically in the past decade at a time when treatment resources are dwindling. Craving for alcohol and drugs is a major precipitator of relapse and can linger long after the detoxification period. While newly developed medications can block cravings, they are not approved for use with adolescents. Service participation is a natural, no-cost behavioral approach that can reduce adolescents' craving symptoms as they adjust to a sober lifestyle.

Provided by Case Western Reserve University

"Helping others helps teens stay on the road to addiction recovery." November 9th, 2011. http://medicalxpress.com/news/2011-11-teens-road-addiction-recovery.html

Cognitive reframing can help dementia caregivers with depression, stress

Mon, 28 Nov 2011 03:50:00 +0000

Cognitive reframing can help dementia caregivers with depression, stress

November 9th, 2011 in Health

Family caregivers of people with dementia experience more burden and are at greater risk of developing depression than caregivers of people with a chronic illness. A new evidence review from the Netherlands finds that a psychotherapy technique called cognitive reframing can help reduce caregivers’ stress when they are caring for loved ones with dementia.

Cognitive reframing focuses on thinking differently by “reframing” negative or untrue assumptions and thoughts into ones that promote adaptive behavior and lessen anxiety and depression. Cognitive reframing can be offered by a trained primary health care provider or by a mental health care professional.

Several studies have focused on psychosocial intervention in dementia care, but this is the first review that focused on the effectiveness of cognitive reframing in particular. The review appears in the latest issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research.

Led by Myrra Vernooij-Dassen Ph.D., of the Radboud University Nijmegen Medical Centre in the Netherlands, the review looked at whether caregivers benefited from various interventions to provide education about dementia and whether their beliefs about caregiving responsibilities and their own needs could be changed.

“We found that changing their thinking and understanding helps a lot to allow more positive feelings to emerge and to reduce distress,” Vernooij-Dassen said.

Caregivers who received a cognitive reframing intervention had fewer symptoms of anxiety and depression and felt less stress or distress related to their caregiving. While reframing helped caregivers manage their stress, it didn’t change the burden of being a dementia caregiver or their coping skills. However, reframing may also lead to a more positive relationship with the person who has dementia. “When a caregiver is able to reframe self-defeating cognitions into more constructive reasoning, it is a major change,” said Vernooij-Dassen.

The evidence review comprised eleven randomized controlled trials involving family caregivers of people with dementia. None of the trials focused solely on cognitive reframing, but they all used cognitive reframing as the main component in their intervention. Caregivers ranged in age from 19 to 84. The majority of participants—40.2 percent—were caring for a spouse.

Dementia symptoms include diminished reasoning, memory, social and language skills that can alter a person’s ability to function in daily life. Alzheimer’s disease is the most common form of advanced dementia.

“Alzheimer’s is a chronic, progressive, fatal disease and caregiving at home for someone with the disease is fraught with many challenges but also rewards,” said, Beth Kallmyer, M.S.W., senior director of constituent services for the Alzheimer’s Association, a non-profit advocacy organization.

Kallmyer said the Alzheimer’s Association encourages caregivers to reach out for assistance and take care of themselves. “Because of the progressive, debilitating nature of the disease and the extended length of the caregiving process, multiple services are needed to provide comprehensive support and education to dementia caregivers.”

Tools to decrease stress for family dementia caregivers will be even more important in years to come as people continue to live longer. Kallmyer said cognitive reframing is one among many appropriate interventions as part of a package of individual support for caregivers. “More research is needed overall for improving our knowledge of how to best support and educate caregivers.”

Vernooij-Dassen emphasized dementia caregivers don’t need to go it alone. “When they need support, reframing their thinking and understanding about dementia can yield positive results.”

More information: Vernooij-Dassen, M. et al. Cognitive reframing for carers of people with dementia. Cochrane Database of Systematic Reviews 2011. Issue 11.

Provided by Health Behavior News Service

"Cognitive reframing can help dementia caregivers with depression, stress." November 9th, 2011. http://medicalxpress.com/news/2011-11-cognitive-reframing-dementia-caregivers-depression.html

Cognitive reframing can help dementia caregivers with depression, stress

Mon, 28 Nov 2011 03:50:00 +0000

Cognitive reframing can help dementia caregivers with depression, stress

November 9th, 2011 in Health

“We found that changing their thinking and understanding helps a lot to allow more positive feelings to emerge and to reduce distress,” Vernooij-Dassen said.

Vernooij-Dassen emphasized dementia caregivers don’t need to go it alone. “When they need support, reframing their thinking and understanding about dementia can yield positive results.”

More information: Vernooij-Dassen, M. et al. Cognitive reframing for carers of people with dementia. Cochrane Database of Systematic Reviews 2011. Issue 11.

Provided by Health Behavior News Service

"Cognitive reframing can help dementia caregivers with depression, stress." November 9th, 2011. http://medicalxpress.com/news/2011-11-cognitive-reframing-dementia-caregivers-depression.html

Research reveals autistic individuals are in fact superior in multiple areas

Mon, 28 Nov 2011 03:50:00 +0000

Research reveals autistic individuals are in fact superior in multiple areas

November 2nd, 2011 in Psychology & Psychiatry

We must stop considering the different brain structure of autistic individuals to be a deficiency, as research reveals that many autistics – not just "savants" – have qualities and abilities that may exceed those of people who do not have the condition, according to a provocative article published today in Nature by Dr. Laurent Mottron at the University of Montreal's Centre for Excellence in Pervasive Development Disorders. "Recent data and my own personal experience suggest it's time to start thinking of autism as an advantage in some spheres, not a cross to bear," Mottron said.

Mottron's research team has strongly established and replicated the abilities and sometimes superiorities of autistics in multiple cognitive operations such as perception and reasoning, as have others. His group includes several autistics, and one of them, Michelle Dawson, is a particular success. Dawson makes major contributions to our understanding of the condition through her work and her judgment. "Michelle challenged my scientific perception of autism," Mottron explained. Dawson's insight is the interpretation of autistic strengths as the manifestation of authentic intelligence rather than a kind of trick of the brain that allows them to mindlessly perform intelligent tasks. "It's amazing to me that for decades scientists have estimated the magnitude of mental retardation based on the administration of inappropriate tests, and on the misinterpretation of autistic strengths," Mottron added.

"We coined a word for that: normocentrism, meaning the preconception you have that if you do or are something, it is normal, and if autistic do or have it, it is abnormal," Mottron said. He points out that there's a strong motivation for this perception, as it is the standard rhetoric of fund raising and grant applications, but that it comes at a cost in terms of how autistics are designated in social discourse. "While state and nonprofit funding is important for advancing our understanding of the condition, it's exceptional that these tools are used to work towards goals identified by the autistic community itself," Mottron said, lamenting the fact that many autistics end up working repetitive, menial jobs, despite their intelligence and aptitude to make much more significant contributions to society. "Dawson and other autistic individuals have convinced me that, in many instances, people with autism need more than anything opportunities, frequently support, but rarely treatment," Mottron said. "As a result, my lab and others believe autism should be described and investigated as an accepted variant within human species, not as a defect to be suppressed."

Laurent Mottron's article claims that science should do its part to bring back autistics as members of the human community. His paper goes into more detail about the specific abilities of some autistic individuals, provides a range of real world examples, and offers some personal insights into his collaborations with Michelle Dawson.

Provided by University of Montreal

"Research reveals autistic individuals are in fact superior in multiple areas." November 2nd, 2011. http://medicalxpress.com/news/2011-11-reveals-autistic-individuals-fact-superior.html

New findings contradict dominant theory in Alzheimer's disease

Mon, 28 Nov 2011 03:45:00 +0000

New findings contradict dominant theory in Alzheimer's disease

October 28th, 2011 in Neuroscience

For decades the amyloid hypothesis has dominated the research field in Alzheimer's disease. The theory describes how an increase in secreted beta-amyloid peptides leads to the formation of plaques, toxic clusters of damaged proteins between cells, which eventually result in neurodegeneration. Scientists at Lund University, Sweden, have now presented a study that turns this premise on its head.

The research group's data offers an opposite hypothesis, suggesting that it is in fact the neurons' inability to secrete beta-amyloid that is at the heart of pathogenesis in Alzheimer's disease.

The study, published in the October issue of the Journal of Neuroscience, shows an increase in unwanted intracellular beta-amyloid occurring early on in Alzheimer's disease. The accumulation of beta-amyloid inside the neuron is here shown to be caused by the loss of normal function to secrete beta-amyloid.

Contrary to the dominant theory, where aggregated extracellular beta-amyloid is considered the main culprit, the study instead demonstrates that reduced secretion of beta-amyloid signals the beginning of the disease.

The damage to the neuron, created by the aggregated toxic beta-amyloid inside the cell, is believed to be a prior step to the formation of plaques, the long-time hallmark biomarker of the disease.

Professor Gunnar Gouras, the senior researcher of the study, hopes that the surprising new findings can help push the research field in a new direction.

"The many investigators and pharmaceutical companies screening for compounds that reduce secreted beta-amyloid have it the wrong way around. The problem is rather the opposite, that it is not getting secreted. To find the root of the disease, we now need to focus on this critical intracellular pool of beta-amyloid.

"We are showing here that the increase of intracellular beta-amyloid is one of the earliest events occurring in Alzheimer's disease, before the formation of plaques. Our experiments clearly show a decreased secretion of beta-amyloid in our primary neuron disease model. This is probably because the cell's metabolism and secretion pathways are disrupted in some way, leading beta-amyloid to be accumulated inside the cell instead of being secreted naturally", says Davide Tampellini, first author of the study.

The theory of early accumulation of beta-amyloid inside the cell offers an alternate explanation for the formation of plaques. When excess amounts of beta-amyloid start to build up inside the cell, it is also stored in synapses.

When the synapses can no longer hold the increasing amounts of the toxic peptide the membrane breaks, releasing the waste into the extracellular space. The toxins released now create the seed for other amyloids to gather and start forming the plaques.

More information: "Impaired β-Amyloid Secretion in Alzheimer's Disease Pathogenesis" http://www.jneuros … 3/15384.full

Provided by Lund University

"New findings contradict dominant theory in Alzheimer's disease." October 28th, 2011. http://medicalxpress.com/news/2011-10-contradict-dominant-theory-alzheimer-disease.html

Reversing aging

Mon, 28 Nov 2011 03:40:00 +0000

Reversing aging

October 17th, 2011 in Research

Technology developed by researchers at The University of Texas at Austin could significantly reduce the time and cost to finding a cure for Alzheimer's disease and help answer one of the greatest biological questions: why do we age?

The research, led by Cockrell School of Engineering Associate Professor Adela Ben-Yakar and College of Natural Sciences Assistant Professor Jon Pierce-Shimomura, aims to prevent degeneration of the nervous system, which occurs through natural aging and diseases like Alzheimer's.

Degeneration has become a pervasive and growing problem in the last century due to new treatments that extend lifespan but cannot prevent neurological decline. This year alone, 5.4 million Americans are living with Alzheimer's, and every 69 seconds another American develops the disease, according to the Alzheimer's Association. The toll of the disease extends beyond those living with it. It impacts their families, caretakers and society, which will pay $183 billion this year to care for people with Alzheimer's.

"We can treat cancer when we diagnose it on time and maybe find solutions for heart problems, but when it comes to the brain we don't have many effective solutions," said Ben-Yakar, from the Department of Mechanical Engineering. "[Neurodegeneration] is a big problem for all of humanity. As an engineer, it excites me to find new ways of doing things, but the end result is what really motivates me and my colleague."

Ben-Yakar and Pierce-Shimomura were selected late last month to receive a competitive $3 million Transformative Research Projects Award from the National Institutes of Health (NIH) for their research.

The grants are part of a $143.8 million funding initiative provided by NIH this year to 79 researchers around the nation, including Biomedical Engineering Professor Aaron Baker, who received the New Innovator award.

"The awards are intended to catalyze giant leaps forward for any area of biomedical research, allowing investigators to go in entirely new directions," said James M. Anderson, director of the NIH Division of Program Coordination, Planning and Strategic Initiatives.

The answers could be in a worm

Many neurological diseases, like Alzheimer's, can be caused by the mysterious faulty function of neuronal proteins, which are still not understood in the scientific community.

Because of this, scientists don't know how neurological diseases develop, what causes their progression or how to stop it. Even the very reason for aging remains elusive.

"We do not know the real reason why we should age. Basically, the body's certain parts are shutting down slowly or abruptly," Ben-Yakar said. "So what things can interfere with this pathway, the natural or biological, to give us insight on how it works? Answering that will give us insight and, secondly, it will help us develop techniques to protect our neurons so that we can live longer and healthier lives."

A challenge to understanding aging and development of degenerative diseases is that new technology is needed to directly characterize how neuronal proteins are distributed across the entire nervous system over time, and how specific neurons degenerate and are malformed with age. A second huge barrier to preventing or treating diseases like Alzheimer's disease is the amount of time it takes to identify drugs that work effectively. Typically, drugs are tested on mice — a process that is expensive and requires one to two years for mice to age while testing just a few dozen drugs at a time.

With the NIH grant, Ben-Yakar, Pierce-Shimomura and a team of students aim to eliminate both hurdles by developing an automated system that rapidly reduces the time and cost of drug testing. Instead of mice, the researchers will use a short-lived, 1 mm-long worm, known as C. elegans, to test the effectiveness of millions of drugs.

Despite having only 302 neurons compared to the billions of neurons in the human brain, the worms have a genetic makeup similar to humans – making them prime for testing drugs.

Researchers in Pierce-Shimomura's lab engineered a new strain of worm that develops Alzheimer's disease. Just as in humans, a subset of the worm's brain degenerates in "middle age" – which conveniently is only 5-days-old in the tiny worms. The dying neurons can be visualized easily through the transparent body. The researchers have recently discovered that candidate drugs for treating human Alzheimer's disease also prevent the death of neurons in their worm model. This result provides the basis to use their worm model to search for new drugs that may delay or prevent neurodegeneration in humans.

It will be up to Ben-Yakar to develop the novel optical techniques and microfluidic devices capable of determining — within a matter of seconds — which drugs are effective at repairing or regenerating neurons within the worms.

Ben-Yakar, whose engineering feats already include developing a precise laser nanosurgery for nerve regeneration studies in C. elegans and the first laser microscalpels capable of removing cancerous cells without damaging neighboring cells, said the worms will be genetically engineered to have color-coded neurons with florescent probes. Neurons in the worm that emit a strong florescent signal will indicate that the specific neurons in the worm are healthy and that the drug being tested is working.

"Using Adela's microfluidic system, we will automate the monitoring of the nervous system, enabling us to test how millions of candidate medicines might prevent or delay neurodegeneration," said Pierce-Shimomura, an assistant professor in the Section of Neurobiology. "A drug screen of this size has never been attempted."

Research is personal

For Ben-Yakar and Pierce-Shimomura, the research is as much about scientific discovery as it is a personal cause. Ben-Yakar's mother has Alzheimer's disease and one of Pierce-Shimomura's sons has Down syndrome, a condition that predisposes him to Alzheimer's.

"I know the disease and I live with it daily, so for me this research is very important," Ben-Yakar said.

"Most people with Down syndrome develop Alzheimer's between 40 and 60 years. When I look at my 10-year-old son, I feel the clock ticking," added Pierce-Shimomura.

Together, the two researchers are combining their backgrounds and disciplines to tackle a complex challenge with new approaches.

"We're constantly sharpening our research approach by collaborating, sharing ideas and bringing our different areas of expertise to the table," Ben-Yakar said. "That's our advantage. If we can find new ways to accelerate finding of new treatments and help people, we'll have done our jobs."

Provided by University of Texas at Austin

"Reversing aging." October 17th, 2011. http://medicalxpress.com/news/2011-10-reversing-aging.html

CAMH study confirms genetic link to suicidal behavior

Mon, 28 Nov 2011 03:40:00 +0000

CAMH study confirms genetic link to suicidal behavior

October 7th, 2011 in Psychology & Psychiatry

A new study from the Centre for Addiction and Mental Health has found evidence that a specific gene is linked to suicidal behaviour, adding to our knowledge of the many complex causes of suicide. This research may help doctors one day target the gene in prevention efforts.

In the past, studies have implicated the gene for brain-derived neurotrophic factor (BDNF) in suicidal behaviour. BDNF is involved in the development of the nervous system.

After pooling results from 11 previous studies and adding their own study data involving people with schizophrenia, CAMH scientists confirmed that among people with a psychiatric diagnosis, those with the methionine ("met") variation of the gene had a higher risk of suicidal behaviour compared to those with the valine variation.

The review, published in the International Journal of Neuropsychopharmacology, included data from 3,352 people, of whom 1,202 had a history of suicidal behaviour.

The news coincides with Mental Illness Awareness Week, October 2-8, and World Mental Health Day, October 10.

"Our findings may lead to the testing and development of treatments that target this gene in order to help prevent suicide," says Dr. James Kennedy, director of CAMH's Neuroscience Research Department. "In the future, if other researchers can replicate and extend our findings, then genetic testing may be possible to help identify people at increased risk for suicide."

As the low-functioning BDNF met variation is a risk factor for suicidal behaviour, it may also be possible to develop a compound to increase BDNF functioning, Dr. Kennedy says.

About 90 per cent of people who have died by suicide have at least one mental health disorder, the researchers note. Within the studies they reviewed, participants had schizophrenia, depression, bipolar disorder or general mood disorders. In each case, the researchers compared the genotypes of people who had attempted or completed suicide with those who were non-suicidal.

"Our findings provide a small piece of the puzzle on what causes suicidal behaviour," says Dr. Kennedy.

"When assessing a person's suicide risk, it's also important to consider environmental risk factors, such as early childhood or recent trauma, the use of addictive drugs or medications and other factors."

Provided by Centre for Addiction and Mental Health

"CAMH study confirms genetic link to suicidal behavior." October 7th, 2011. http://medicalxpress.com/news/2011-10-camh-genetic-link-suicidal-behavior.html

Trillion-dollar brain drain

Mon, 28 Nov 2011 03:40:00 +0000

Published online 4 October 2011 | Nature 478, 15 (2011) | doi:10.1038/478015a

Trillion-dollar brain drain

Enormous costs of mental health problems in Europe not matched by research investment.

Kerri Smith

Brain disorders cost Europe almost €800 billion (US$1 trillion) a year — more than cancer, cardiovascular disease and diabetes put together. That's the conclusion of a report1 commissioned by the European Brain Council that provides the most comprehensive assessment of the financial consequences of mental ailments so far.

The report's authors argue that these enormous costs — which exceed the entire gross domestic product of the Netherlands — mean that research into brain disorders receives disproportionately little funding compared with other diseases. They call on politicians and funders to step up support for basic research on these conditions, which are so costly because they often require long-term care and erode the productivity of those affected for years or decades.

The report is an update of a similar survey in 2005, which found that brain disorders were costing Europe €386 billion2. Since then, Bulgaria and Romania have joined the European Union and seven more categories of disorder have been added to the assessment, including eating disorders, sleep disorders, mental retardation, and childhood and developmental disorders such as autism. The authors say that their new estimate, although double the 2005 figure, is likely to be "very conservative".

Mood disorders top the cost estimates, consuming €113.4 billion a year, following closely by dementia, at €105.2 billion (see 'Heavy burden'). On average, the annual cost per citizen is €1,550, with Luxembourg and the United Kingdom spending the most per head of population.

Drugs, visits to doctors and hospitalizations — the direct health-care costs — make up 37% of the bill. A further 23% is spent on direct non-medical costs, including informal care, social services and nursing homes. The remainder (40%) is sucked away by indirect costs, such as lost productivity as a result of time off work or early retirement. One reason for the high indirect costs is that "people don't tend to die quickly from brain disorders", says Jes Olesen, the neurologist at the University of Copenhagen who headed the survey team. "People live for years in a disabled condition."

More than 100 scientists and health economists in Europe were involved in collecting data for the report. For each country, the team found out how many people had a particular condition, estimated the financial costs, and then calculated Europe-wide figures. Where data weren't available, the prevalence and costs of disorders were estimated from figures from other countries. "They are of course imputations, but they are the best available," says Olesen.

No directly comparable reports exist elsewhere in the world, but several studies have looked at the costs of individual conditions, such as bipolar disorder, attention deficit hyperactivity disorder and schizophrenia, in both Europe and the United States. Overall, health-care costs per person are similar in both regions, but the direct costs — doctors and drugs — are higher in America.

The drug industry, however, is increasingly shying away from these disorders. "The basic science is such that it's quite difficult to identify a new target, so you start with your hands tied behind your back," says Patrick Vallance, head of medicines discovery and development for London-based drug giant GlaxoSmithKline, which last year stopped funding drug-development programmes in psychiatry, pain and cognitive neuroscience. Vallance also cites problems with unrealistic animal models, unpredictable results from early trials and difficulties in diagnosing and allocating patients to trials. "At every stage of the process your risk is very much higher" for brain disorders than for other conditions, he says.

A report produced by the European Brain Council in 20063 estimated that Europe spent about the same amount on brain research as on cancer research (about €4 billion each), despite the much higher cost of brain disorders.

Olesen says that the report presents clear evidence that greater scientific effort is required to tackle brain disorders. "The only way is to increase research and understand these disorders better," says Olesen. Focusing on preventing these disorders in the first place would have the greatest cost benefit, he adds.

References

Gustavsson, A. et al. Eur. Neuropsychopharmacol. 21, 718-779 (2011). | Article |

Andlin-Sobocki, P. et al. (eds) Eur. J. Neurol. 12, Suppl. 1, 1-90 (2005). | Article | PubMed | ISI |

Source: Nature

http://www.nature.com/news/2011/111005/full/478015a.html?WT.ec_id=NATURE-20111006

Alzheimer's might be transmissible in similar way as infectious prion diseases

Mon, 28 Nov 2011 03:35:00 +0000

Alzheimer's might be transmissible in similar way as infectious prion diseases: study

October 4th, 2011 in Diseases

The brain damage that characterizes Alzheimer's disease may originate in a form similar to that of infectious prion diseases such as bovine spongiform encephalopathy (mad cow) and Creutzfeldt-Jakob, according to newly published research by The University of Texas Health Science Center at Houston (UTHealth).

"Our findings open the possibility that some of the sporadic Alzheimer's cases may arise from an infectious process, which occurs with other neurological diseases such as mad cow and its human form, Creutzfeldt-Jakob disease," said Claudio Soto, Ph.D., professor of neurology at The University of Texas Medical School at Houston, part of UTHealth. "The underlying mechanism of Alzheimer's disease is very similar to the prion diseases. It involves a normal protein that becomes misshapen and is able to spread by transforming good proteins to bad ones. The bad proteins accumulate in the brain, forming plaque deposits that are believed to kill neuron cells in Alzheimer's."

The results showing a potentially infectious spreading of Alzheimer's disease in animal models were published in the Oct. 4, 2011 online issue of Molecular Psychiatry, part of the Nature Publishing Group. The research was funded by The George P. and Cynthia W. Mitchell Center for Research in Alzheimer's Disease and Related Brain Disorders at UTHealth.

Alzheimer's disease is a form of progressive dementia that affects memory, thinking and behavior. Of the estimated 5.4 million cases of Alzheimer's in the United States, 90 percent are sporadic. The plaques caused by misshapen aggregates of beta amyloid protein, along with twisted fibers of the protein tau, are the two major hallmarks associated with the disease. Alzheimer's is the sixth leading cause of death in the United States, according to the Alzheimer's Association.

Researchers injected the brain tissue of a confirmed Alzheimer's patient into mice and compared the results to those from injected tissue of a control without the disease. None of the mice injected with the control showed signs of Alzheimer's, whereas all of those injected with Alzheimer's brain extracts developed plaques and other brain alterations typical of the disease.

"We took a normal mouse model that spontaneously does not develop any brain damage and injected a small amount of Alzheimer's human brain tissue into the animal's brain," said Soto, who is director of the Mitchell Center. "The mouse developed Alzheimer's over time and it spread to other portions of the brain. We are currently working on whether disease transmission can happen in real life under more natural routes of exposure."

More information: "De novo Induction of amyloid-B Deposition in vivo," Molecular Psychiatry.

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The level and nature of autistic intelligence II: What about Asperger Syndrome?

Mon, 28 Nov 2011 03:35:00 +0000

September 28th, 2011 in Psychology & Psychiatry

The level and nature of autistic intelligence II: What about Asperger Syndrome?

Autism spectrum disorders, including Asperger syndrome, have generally been associated with uneven intellectual profiles and impairment, but according to a new study of Asperger individuals published in the online journal PLoS ONE, this may not be the case – as long as intelligence is evaluated by the right test. Both autistic and Asperger individuals display uneven profiles of performance in commonly used intelligence test batteries such as Wechsler scales, and their strongest performances are often considered evidence for deficits.

However, this study reports that Asperger individuals' scores are much higher when they are evaluated by a test called Raven's Progressive Matrices, which encompasses reasoning, novel problem-solving abilities, and high-level abstraction. By comparison, scores for non-Asperger individuals are much more consistent across different tests. Interestingly, Asperger participants' performance on Raven's Matrices was associated with their strongest peaks of performance on Wechsler.

A previous study by the same group found very similar results for autistic individuals as well, whose peaks of ability are perceptual, rather than verbal as in Asperger individuals. This suggests a common information processing mechanism applied to different aspects of information (verbal vs. perceptual).

According to co-author Michelle Dawson, "while we know autistics process information atypically, very little thought has gone into how to fairly assess their abilities. In fact there is so little understanding of what autistics do well that their strong abilities are often regarded as dysfunctional. Here we have again found that measurable strengths in autistic spectrum individuals are not "isolated islets of abilities" as previously thought, but are in fact representative of autistics' intellectual abilities. This in turn raises questions about how we can provide autistics with the kinds of information they can process well, as we do with non-autistic individuals. We consider the effort to understand and encourage autistic strengths to be of paramount importance. "

Based on these results, the authors emphasize that autistic spectrum intelligence is atypical, but also genuine, general, and underestimated.

More information: Soulieres I, Dawson M, Gernsbacher MA, Mottron L (2011) The Level and Nature of Autistic Intelligence II: What about Asperger Syndrome? PLoS ONE 6(9): e25372. doi:10.1371/journal.pone.0025372

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Alzheimer's protein kills nerve cells in nose

Mon, 28 Nov 2011 03:30:00 +0000

Alzheimer's protein kills nerve cells in nose

September 27th, 2011 in Neuroscience

A protein linked to Alzheimer's disease kills nerve cells that detect odors, according to an animal study in the September 28 issue of The Journal of Neuroscience. The findings shed light on why people with Alzheimer's disease often lose their sense of smell early on in the course of the disease.

"Deficits in odor detection and discrimination are among the earliest symptoms of Alzheimer's disease, suggesting that the sense of smell can potentially serve as a 'canary in the coal mine' for early diagnosis of the disease," said Leonardo Belluscio, PhD, of the National Institute of Neurological Disorders and Stroke, who led the study. "The changes taking place in the olfactory system as a result of Alzheimer's disease may be similar to those in other regions of the brain but appear more rapidly" he added.

Researchers once thought that protein plaques commonly seen in the brains of people with Alzheimer's disease were responsible for killing off nerve cells, causing disruptions in memory — a hallmark of the

disease. The plaques are primarily derived from a protein called amyloid precursor protein (APP). The new study suggests that APP alone — in the absence of the plaques — may be to blame

for the death of nerve cells.

In the new study, Belluscio and his colleagues genetically manipulated mice to produce high levels of a mutated version of human APP in olfactory nerve cells. The mutated form of the protein is seen in some people with early-onset Alzheimer's disease, a rare form that runs in families and strikes before age 65.

The researchers found that mice making mutant APP had four times as much olfactory nerve cell death by three weeks of age compared with normal mice. Although the cells that produced mutant APP died, the neighboring cells — that did not have mutant APP — survived. The cell death also occurred in the absence of amyloid plaques. Together, this showed that the cell death was initiated from within the cells making the mutant APP, not from plaques outside the cells. When the researchers blocked the olfactory nerve cells from producing high levels of the mutant precursor protein, more cells lived.

"Reducing APP production suppressed the widespread loss of nerve cells, suggesting that such disease-related death of nerve cells could potentially be stopped," Belluscio said.

"Together, these results support the hypothesis that amyloid proteins are involved in the degeneration of the brain that occurs with Alzheimer's disease," said Donald Wilson, PhD, of New York University School of Medicine and the Nathan Kline Institute for Psychiatric Research, an olfactory system expert who was unaffiliated with the study. "Further, they provide an exciting opportunity to explore how to prevent or reverse the events that lead to cell death and, ultimately, dementia."

More information: http://www.jneurosci.org/

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Study finds dairy products in adult diets improve cognitive function

Mon, 28 Nov 2011 03:30:00 +0000

Study finds dairy products in adult diets improve cognitive function

September 27th, 2011 in Health

Adults who consume dairy products at least once daily have higher cognitive function than those who rarely or never drink milk or eat dairy foods, according to a new study by researchers from the University of South Australia and University of Maine.

Those who consumed the most dairy products had the highest scores in an extensive cognitive test battery that included multiple measures of visual-spatial ability, verbal memory, working memory, reasoning ability and executive functioning (the ability to plan, organize and integrate cognitive functions).

Those who seldom or never consumed dairy performed lower than average for this study population.

The research was led by doctoral student in nutrition and psychology Georgina Crichton of the University of South Australia, in collaboration with UMaine psychologist/epidemiologist Merrill “Pete” Elias, and psychologists Michael Robbins and Gregory Dore. It involved 972 adults free from stroke, dementia and kidney disease who participated in the community-based Maine-Syracuse Longitudinal Study at the University of Maine.

The 35-year Maine-Syracuse Longitudinal Study, initiated by Elias in 1975, is one of the longest-running NIH-funded scientific investigations relating aging, arterial blood pressure and cardiovascular disease risk factors to comprehensive measures of neuropsychological test performance. The longitudinal study focuses on relations among risk factors for cardiovascular disease and cognitive performance across the adult life span.

Beginning in 2001, data collected on participants in the Maine-Syracuse Longitudinal Study also included responses to the 41-question Nutrition and Health Questionnaire, which focuses on dietary intake and lifestyle.

More than a third of the 972 participants in the study of the relationship between dairy food intake and cognitive function reported eating milk products daily, and more than half reported consuming dairy between two and six times weekly.

Cheese was the most popular dairy product, most often eaten two to four times a week. Nearly a third of the participants said they drank at least two and a half cups (600 ml) of milk daily, mostly skim or reduced-fat.

This cross-sectional study is one of the few to investigate whether dairy food intake is associated with levels of cognitive function while controlling for multiple confounding variables, including cardiovascular disease risk factors such as blood pressure, obesity, cholesterol and other lipids. Previous investigations have focused on the benefits of milk products in relation to body weight and cardiovascular health and dementia.

The researchers point out that milk consumption has decreased worldwide in recent years. In the United States, the trend has coincided with a dramatic increase in soft drink consumption.

Diet modification to include more dairy products is one lifestyle change that could slow or prevent age-related cognitive impairment and decline, according to the researchers, who reported their findings in the International Dairy Journal.

“The reality is that dairy has many benefits in those who are not restricted from consumption for health reasons,” Elias says. “We have learned in recent years that components of dairy — calcium, whey protein, vitamin D and magnesium — may play a role in reducing levels of obesity, diabetes and hypertension. Now we know that eating dairy also is positively associated with cognitive functioning.”

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"Study finds dairy products in adult diets improve cognitive function." September 27th, 2011. http://medicalxpress.com/news/2011-09-dairy-products-adult-diets-cognitive.html

genetic 'overlap' between schizophrenia, bipolar disorder

Mon, 28 Nov 2011 03:25:00 +0000

Large study finds genetic 'overlap' between schizophrenia, bipolar disorder

September 21st, 2011 in Genetics

Knowledge about the biological origin of diseases like schizophrenia, bipolar disorder and other psychiatric conditions is critical to improving diagnosis and treatment.

In an effort to push the field forward, three UCLA researchers, along with scientists from more than 20 countries, have been taking part in one of the largest collaborative efforts in psychiatry — a genome-wide study involving more than 50,000 study participants aimed at identifying which genetic variants make people susceptible to psychiatric disease.

This collaborative, the Psychiatric Genome-Wide Association Study Consortium (PGC), now reports in the current online edition of the journal Nature Genetics that it has discovered that common genetic variants contribute to a person's risk of schizophrenia and bipolar disorder.

The PGC's studies provide new molecular evidence that 11 regions on the genome are strongly associated with these diseases, including six regions not previously observed. The researchers also found that several of these DNA variations contribute to both diseases.

The findings, the researchers say, represent a significant advance in understanding the causes of these chronic, severe and debilitating disorders.

The UCLA researchers who contributed to the schizophrenia study are Roel A. Ophoff, a professor of psychiatry and human genetics and one of the founding principal investigators of the schizophrenia portion of the study; Dr. Nelson Freimer, a professor of psychiatry and director of the Center for Neurobehavioral Genetics at the Semel Institute for Neuroscience and Human Behavior at UCLA; and Rita Cantor, a professor of psychiatry and human genetics.

Schizophrenia and bipolar disorder are common and often devastating brain disorders. Some of the most prominent symptoms of schizophrenia are persistent delusions, hallucinations and cognitive problems. Bipolar disorder is characterized by severe, episodic mood swings. Both affect about 1 percent of the world's population and usually strike in late adolescence or early adulthood.

Despite the availability of treatments, these illnesses are usually chronic, and patients' response to treatment is often incomplete, leading to prolonged disability and personal suffering. Family history, which reflects genetic inheritance, is a strong risk factor for both schizophrenia and bipolar disorder, and it has generally been assumed that dozens of genes, along with environmental factors, contribute to disease risk.

In the schizophrenia study, a total of seven locations on the genome were implicated in the disease, five of which had not been identified before. When similar data from the bipolar disorder study, which ran concurrently, were combined with results from the schizophrenia study, three gene locations were identified that proved to be involved in both disorders, suggesting a "genetic overlap" between schizophrenia and bipolar disorder.

"Genetic factors play an important role in the susceptibility to develop schizophrenia," Ophoff said, "but identifying these genetic factors has been very difficult. We know that schizophrenia is not caused by a single gene that explains everything but an interplay of many genetic and non-genetic factors."

At the same time, he said, the disease itself is not uniform but manifests itself in different ways; currently, there is no objective biological marker or "sign" that can be used for diagnosis.

"This so-called heterogeneity at the genetic and clinical level is the biggest challenge for genetic studies of neuropsychiatric disorders," Ophoff said. "One way to deal with these difficulties is to increase the size of the study so there is sufficient 'power' to detect genetic effects, even amidst this clinical and genetic diversity."

The fact that even this large study resulted in a limited number of schizophrenia and bipolar genes demonstrates once again, he said, the complex nature of the disease.

Provided by University of California - Los Angeles

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Diabetes may significantly increase your risk of dementia

Mon, 28 Nov 2011 03:25:00 +0000

Diabetes may significantly increase your risk of dementia

September 19th, 2011 in Neuroscience

People with diabetes appear to be at a significantly increased risk of developing dementia, according to a study published in the September 20, 2011, print issue of Neurology, the medical journal of the American Academy of Neurology.

"Our findings emphasize the need to consider diabetes as a potential risk factor for dementia," said study author Yutaka Kiyohara, MD, PhD, of Kyushu University in Fukuoka, Japan. "Diabetes is a common disorder, and the number of people with it has been growing in recent years all over the world. Controlling diabetes is now more important than ever."

People with diabetes were more likely to develop Alzheimer's disease and other types of dementia, such as vascular dementia, which occurs when there is damage to blood vessels that eventually deprive the brain of oxygen.

For the study, a total of 1,017 people who were age 60 and older were given a glucose (sugar) tolerance test after an overnight fast to determine if they had diabetes. Study participants were monitored for an average of 11 years and then tested for dementia. During the study, 232 people developed dementia.

The study found that people with diabetes were twice as likely to develop dementia as people with normal blood sugar levels. Of the 150 people with diabetes, 41 developed dementia, compared to 115 of the 559 people without diabetes who developed dementia.

The results remained the same after the researchers accounted for factors such as high blood pressure, high cholesterol and smoking. The risk of dementia was also higher in people who did not have diabetes, but had impaired glucose tolerance, or were "pre-diabetes."

In addition, the study found the risk of developing dementia significantly increased when blood sugar was still high two hours after a meal.

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bidirectional relationship between schizophrenia and epilepsy

Mon, 28 Nov 2011 03:20:00 +0000

Study finds bidirectional relationship between schizophrenia and epilepsy

September 19th, 2011 in Research

Researchers from Taiwan have confirmed a bidirectional relation between schizophrenia and epilepsy. The study published today in Epilepsia, a journal of the International League Against Epilepsy (ILAE), reports that patients with epilepsy were nearly 8 times more likely to develop schizophrenia and those with schizophrenia were close to 6 times more likely to develop epilepsy.

Prior clinical studies have shown a prevalence of psychosis among epilepsy patients and studies of psychiatric illness have found a strong relationship between schizophrenia and epilepsy, suggesting a shared susceptibility between the diseases that may be a result of genetic, environmental or neurobiological causes. While a number of studies have established a bidirectional relationship between depression, mood disorder and epilepsy, the current study is the first to investigate this type of relation between schizophrenia and epilepsy.

Using data from the Taiwan National Health Insurance database, the team identified 5195 patients with schizophrenia and 11527 patients with epilepsy who were diagnosed between 1999 and 2008. The patient groups were compared to age and sex-matched controls. Analysis included the incidence and risk of developing epilepsy in the schizophrenia patient group and schizophrenia in the epilepsy cohort.

The findings show that the incidence of epilepsy was higher in the schizophrenia patient group at 6.99 per 1,000 person-years compared to 1.19 in the non-schizophrenia control. Incidence of schizophrenia was 3.53 per 1,000 person-years for patient with epilepsy compared to 0.46 in the non-epilepsy group. Researchers also reported that schizophrenia incidence was slightly higher in men with epilepsy than in women with the disease.

"Our research results show a strong bidirectional relation between schizophrenia and epilepsy," said lead author I-Ching Chou, M.D., with China Medical University Hospital and Associate Professor with China Medical University in Taichung, Taiwan. "This relationship may be due to common pathogenesis in these diseases such as genetic susceptibility and environmental factors, but further investigation of the pathological mechanisms are needed."

More information: "Bidirectional Relation Between Schizophrenia and Epilepsy: A Population-Based Retrospective Cohort Study." Yu-Tzu Chang, Pei-Chun Chen, I-Ju Tsai, Fung-Chang Sung, Zheng-Nan Chin, Huang-Tsung Kuo, Chang-Hai Tsai and I-Ching Chou. Epilepsia; Published Online: September 19, 2011 (DOI: 10.1111/j.1528-1167.2011.03268.x).

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Study finds over 70 percent of suicidal teens don't get the mental health services they need

Mon, 28 Nov 2011 03:20:00 +0000

Study finds over 70 percent of suicidal teens don't get the mental health services they need

September 14th, 2011 in Psychology & Psychiatry

Suicidal teens are not likely to get the mental healthcare they need. This is according to a team of researchers at Seattle Children's Research Institute, the University of Washington (UW), and Group Health Research Institute. The study, "Adolescents With Suicidal Ideation: Health Care Use and Functioning," was recently published in Academic Pediatrics.

The researchers found that only 13 percent of teens with suicidal thoughts received mental health visits through their healthcare network and only 16 percent received services in the year after, despite being eligible for and having access to mental healthcare without a referral and with relatively small co-pays. Additionally, when all types of mental health services were combined (including antidepressants and care received through outside sources), still only 26 percent of teens with suicide ideation in the study received services the year prior.

"Teen suicide is a very real issue today in the United States. Until now, we've known very little about how much or how little suicidal teens use healthcare services. We found it particularly striking to observe such low rates of healthcare service use among most teens in our study," said lead author Carolyn A. McCarty, PhD of Seattle Children's Research Institute, and research associate professor of pediatrics at the University of Washington School of Medicine.

According to the Centers for Disease Control and Prevention, suicide is the third leading cause of death for people aged 15 to 24 and the fourth leading cause of death for children between the ages of 10 and 14. Identifying suicidal ideation is critical to preventing suicide. While many experts consider suicidal thoughts normative during adolescence, this study confirms teens with suicidal ideation experience more functional impairment such as interpersonal difficulties, school problems, and mental health problems. Researchers in this study found these impairments persisted into a six-month follow-up period. These difficulties can, in turn, intensify the need for mental healthcare.

In the study, Dr. McCarty and co-investigators examined the use of healthcare services among teens aged 13-18 who were patients at Group Health Cooperative. A total of 198 teens were studied, including 99 teens who endorsed suicidal thoughts, and 99 control teens, matched on age and gender. Administrative data spanning two years were collected from medical records, in addition to interviews conducted with teens and their parents.

Utilization of mental health services was low among both the control group and those with suicidal thoughts. Although 86 percent of the youth with suicidal ideation had seen a healthcare provider, only 13 percent had a mental health specialty visit, and only 7 percent received antidepressant medications. Only 10 percent of those without suicidal ideation had received any mental health visits within the Group Health Cooperative system in the prior year. However, respondents with suicidal ideation had significantly more severe depression, a greater prevalence of lifetime diagnosis of depression or anxiety, and higher scores of pediatric chronic disease. When all mental health service questions were combined, 26 percent of the teens with suicide ideation received services the prior year, and 16 percent received services in the following year. These findings confirmed previous studies examining self-reported mental health services among adolescents.

"We know that asking teens about suicidal ideation does not worsen their problems," said Dr. McCarty. "It's absolutely crucial for a teen who is having thoughts of self-harm or significant depression to be able to tell a helpful, trustworthy adult."

"These findings underscore the need for clinicians to be aware of the potential for suicide in adolescence," added Dr. McCarty. "Primary care physicians and healthcare providers should be specifically assessing suicidal ideation in the context of depression screening for teenagers. Effective screening tools are available, as are effective treatments for depression."

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Mortality gap for people with serious mental illness is increasing

Mon, 28 Nov 2011 03:15:00 +0000

Mortality gap for people with serious mental illness is increasing

September 14th, 2011 in Psychology & Psychiatry

(Medical Xpress) -- People with serious mental illnesses in England are not seeing the improvement in death rates the rest of the population is experiencing, a study led by Oxford University has found.

This is leading to a ‘persistent and increasing’ mortality gap, where people with schizophrenia and bipolar disorder are at a greater risk of premature death compared with the general population – despite many improvements in mental health care.

The findings, published in the BMJ medical journal, highlight the challenge faced by the UK government’s recent mental health strategy, which states that “fewer people with mental health problems will die prematurely.”

Dr. Uy Hoang, an academic clinical fellow in the Department of Public Health at Oxford University, who led the work, says: "More needs to be done to understand the reasons for the increasing mortality gap. And a lot more can be done to identify and treat patients to reduce the number of preventable deaths."

The research team from the University of Oxford and the Institute of Psychiatry analyzed records for all people with schizophrenia or bipolar disorder discharged from inpatient care in England.

They compared the risk of death in the 12 months following discharge with mortality rates in the general population for each year from 1999 to 2006.

They found a significant increase over this period in the mortality gap between patients with schizophrenia or bipolar disorder, and the general population.

By 2006, the risk of death in the year following discharge had reached double the average risk for the population as a whole.

This widening disparity occurred as mortality rates in the general population declined, while those in people with serious mental disorders did not.

About three quarters of the deaths among those with schizophrenia and bipolar disorder were from natural causes. And it was increasing disparities in deaths from heart and respiratory diseases that in large part drove the widening mortality gap.

The researchers say they are encouraged that the UK government has recognized and prioritized the importance of preventing premature mortality in its recently published mental health strategy.

"We do welcome the focus on this mortality gap. It will present a real challenge to the government’s reforms of mental health services," says Dr. Hoang.

Professor Peter Kinderman of the University of Liverpool, who was not involved in the study, says: "We know some of the risks – people with serious mental health problems are at risk from lifestyle factors (smoking, drinking, lack of exercise, poor diet) but also potentially from the medication that is prescribed, often for very long periods ... And, when physical problems are identified, people with mental health problems often receive inadequate care. So it’s vital that mental health services improve – to give people the care they need and to avoid inappropriate forms of care – and work better with physical health services and primary care."

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