Quoted paragraphs offer a glimpse into the content and viewpoint of each article; they are not summaries - use the links to read more fully. For an introduction and start in the free use of Medscape, see the large blockquote at this diary.
Let's begin with (no pun intended) a reality-check:
Comment #22 qedeileen, re: Psychological Fallacy in Psychiatry Sep 3, 2013:
If you have a traumatic event and have resources to cope, you may not cross any threshold or be overwhelmed, and you may bounce back faster. If you have a traumatic or stressful event, multiple events, continual stressors, a life with no power or control, no choices except bad ones, with no stable housing or income, and so on, you are in a totally different situation. Resilience is not necessarily a biological or genetic trait, but often a result of material and social supports, and connections more available to certain groups or individuals. In general, the Bio-psych-social paradigm I keep reading about seems to neglect actual material resources, as well as overempha- sizing certain bio (NTs, genes) compared to other bio (sleep, relaxation and rest, leisure, good and adequate food, clean water, shelter, reliable transportation, nonviolent home and neighborhood, care and support in childhood, etc.)... editorial emphasis added
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Continue Reading below the orangepeel ▼
▼ Novel Stem Cell Research to Shed Light on Bipolar Disorder
Investigators the University of Michigan (UM) have used skin fibroblasts from patients with bipolar disorder (BD) to create the first-ever stem cell lines specific to the disorder.
They coaxed patient-derived induced pluripotent stem cells (iPSCs) into neurons and are using them to gain a better understanding of BD.
"This gives us a model that we can use to examine how cells behave as they develop into neurons. Already, we see that cells from people with bipolar disorder are different in how often they express certain genes, how they differentiate into neurons, how they communicate, and how they respond to lithium," Sue O'Shea, PhD, the UM stem cell researcher who co-led the work, said in a statement...
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National Trends in the Mental Health Care of Children, Adolescents, and Adults by Office-Based Physicians Abstract of Study
Section:Conclusions and Relevance
Compared with adult mental health care, the mental health care of young people has increased more rapidly and has coincided with increased psychotropic medication use. A great majority of mental health care in office-based medical practice to children, adolescents, and adults is provided by nonpsychiatrist physicians...
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NIMH Tightens Up Funding Criteria for Clinical Trials
In an effort to improve and reinvigorate the development of treatments for psychiatric disorders, the National Institute of Mental Health has made several changes to its funding policies for future clinical trials, [under the Cures Acceleration Network within the Patient Protection and Affordable Care Act to find more efficient pathways to new treatments]. according to the NIMH Web site.
The policy changes include requiring that all new trials meet new efficiency, transparency, and reporting standards and that they must now examine possible mechanisms of action.
"To ensure that these new requirements become the norm and not the exception, we will not support new clinical trials under past funding announcements," said coauthor NIMH director Thomas Insel, MD, in a blog post. "Treatment development has stalled. The pharmaceutical industry pipeline for medications is depleted after several decades of 'me too' drugs. For anxiety, mood disorders, and psychosis, there are few viable new targets because of an inadequate understanding of the biology of the disorders."
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e-Cigs' Promise as Effective Quitting Tool Up in Smoke
Results from a longitudinal analysis of e-cigarette use and smoking cessation in a national sample of 1549 participants showed that baseline e-cigarette use was not associated with change in cigarette consumption at 1 year. ... The study was published online March 24 in JAMA Internal Medicine.
These findings mirror those of another recent study [published in JAMA Pediatrics] ...[finding] that e-cigarettes not only did not deter smoking in teens but that they actually contributed to nicotine addiction.
and
four Democratic senators Slam 'Glamorization' of E-Cigarettes at Golden Globes
▼ Anticancer Compounds Show Potential in Schizophrenia
Researchers from the United States and Japan engineered mice to carry the mutant disrupted-in-schizophrenia 1 (DISC1) gene, which leads to synaptic deterioration akin to that seen in schizophrenia. Experimental p21-activated kinase (PAK) inhibitors reversed schizophrenia-like behaviors and restored some lost brain function... [The] PAK inhibitors not only significantly ameliorated the synaptic deterioration triggered by DISC1 knockdown but also partially reversed the size of deteriorated synapses.
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Community Care for Schizophrenia Promising
For patients with schizophrenia in low-income countries, community-based treatment can work, a new study from India shows. In the first randomized, controlled trial to rigorously test this approach, community care proved modestly more effective than standard facility-based care for reducing disability and psychotic symptoms and helping patients stick to their antipsychotic drug therapy.
▼ (from Canada, 2004)
Culturally Sensitive Community Care Reduces Hospital Admissions for Severe Mental Illness
Providing easily accessible community-based care to ethnic minorities with severe and persistent mental illnesses can help reduce hospital admissions and improve quality of life, particularly if care is provided in an appropriate linguistic and cultural context, according to a presentation at the 54th annual meeting of the Canadian Psychiatric Association.
Assertive Community Treatment (ACT) teams provide community-based care and support to individuals with severe and persistent mental illnesses, and they have been implemented all over Canada and the U.S. A typical ACT team involves a multidisciplinary group with expertise in areas that include psychiatry, nursing, social work, occupational therapy, addiction, peer support, and mental health. Services they offer range from prescribing and dispensing medication to teaching life skills, helping find housing, and providing a place to drop in.
"In working with severe and persistently mentally ill populations, the [ACT] model has been very useful in allowing patients to remain in the community since the deinstitutionalization of the '60s put a lot of chronically mentally ill patients out on the street or without proper outpatient facilities," investigator Lisa Andermann, MD, FRCP(C), told Medscape. She is an assistant professor in the department of psychiatry at the University of Toronto and a staff psychiatrist at Mount Sinai Hospital in Toronto, Ontario, Canada.
Dr. Andermann is affiliated with a unique ACT team that works in an area of downtown Toronto with a large populace of eastern and southeastern Asian origin. Many of these individuals are functionally illiterate in both English and French, the two national languages of Canada, as well as being unfamiliar with mainstream culture. The severely mentally ill in this population, therefore, have particular difficulty finding appropriate care.
▼ A terrifically written article on the role of a societally encouraged mental illness (wish fulfillment fantasizing) in commercial pressures on public health nutrition:
Brawn, Brains, and Grains of Truth
One would like to think that our refined brains are resistant to the brawn and brute force of fashion or fad, the percussion of repetition. But any such conviction would be the triumph of hope over experience. The most indelible warning of this vulnerability is perhaps the allegorical tale of the emperor's new clothes,1 but the tendency reverberates routinely through our culture with implications of far greater moment to public health than imperial nudity.
One example that springs to mind is the notion that more nutritious foods cost more. Certainly, diets made up of highly nutritious foods cost more than diets made up of highly processed junk.2 But..how many times you have heard that more nutritious foods cost more, then ask yourself how many times any data were attached to the assertion. My colleagues and I studied this issue and found no meaningful price differential when more and less nutritious foods within given categories were compared... The assertion is in larger part urban legend than truth, testimony to the power of repetition -- a power to which the professionally trained mind is apparently about as vulnerable as all the rest.
We might refer to this as memetic brawn: the compelling cultural force of a repetitive cycle of hear and repeat. The follies of history have shown abundantly that such irresistible force need have little to do with truth...
There is, then, predictably, a grain of truth in the assertion that dementia and other forms of cognitive decline and neurodegeneration may at times owe something to grain consumption.5 There is a similar grain of truth in the assertion that epidemic obesity owes something to the ingestion of wheat.6 That truth derives from what we generally do with wheat and other grains: We turn them into bagels and biscuits, muffins and macaroni, Danish and donuts. America, as we know, runs on Dunkin'.
But the grain of truth is no larger than that. The rest of the Grain Brain5 story is one of brawn, not brain -- the raw power of pop culture repetition, not the staying power of truth. Whole wheat does not make us fat; whole grains do not make us stupid.7 In fact, no one food, food group, or nutrient is responsible for the prevailing ills of modern epidemiology, any more than just one thing can fix it all...
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Reducing Symptoms of Major Depressive Disorder Through a Systematic Training of General Emotion Regulation Skills Protocol of a Randomized Controlled Trial This study is registered with
ClinicalTrials.gov, number NCT01330485.
Abstract: Section: Methods/Design In the evaluation of the Affect Regulation Training, we will conduct a prospective randomized-controlled trial. Effects of the Affect Regulation Training on depressive symptom severity and outcomes of subsequent individual therapy for depression will be compared with an active, common factor based treatment and a waitlist control condition. The study sample will include 120 outpatients meeting criteria for Major Depressive Disorder. Depressive symptom severity as assessed by the Hamilton Rating Scale will serve as our primary study outcome. Secondary outcomes will include further indicators of mental health and changes in adaptive emotion regulation skills application. All outcomes will be assessed at intake and at 10 points in time over the course of the 15-month study period. Measures will include self-reports, observer ratings, momentary ecological assessments, and will be complemented in subsamples by experimental investigations and the analysis of hair steroids...
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Suicide and Communal Values: Ethical Implications for Psychiatrists Sections: Our Collective Grief, Self-chosen Dying, The "Reality Test".
...In my view as a psychiatrist and bioethicist, the momentous issue of self-chosen dying must be carefully examined in the context of the patient's circumstances, motivations, clinical status, and "provisions" for friends and loved ones...
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A New 'Champion of Mental Health Care'
Representative Tim Murphy, a Republican Congressman from Pennsylvania [and] trained psychologist, has seen fit to take on as a primary interest the plight of the mentally ill and our badly needed improvement in mental health care services. In all candor, this interest is in part prompted by the recent spate of mass violence incidents and particularly the incident in Newtown, Connecticut...
Congressman Murphy has proposed the Helping Families in Mental Health Crisis Act(H.R.3717) and in doing so he has followed in the footsteps of a number of other previous Congressional leaders who have advocated for mental health care legislation to improve the treatment of the mentally ill. In recent years, many if not most of these leaders have retired or are not active in this area for other reasons. I am speaking of people such as Senators Pete Domenici and [the late] Arlen Specter, the late Senator Paul Wellstone, and Congressmen John Porter, Gordon Smith, and Patrick Kennedy. They were major figures in the efforts to advance the cause of mental health care...
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Anxiety and Depression Association of America (ADAA) Conference 2014
Conference news links in the article: ~ Anxiety, Depression May Influence Quality of Acute MI Care, Medscape Medical News, April 4, 2014 ~ Anxious Kids With Comorbidity May Need Specialized Approach, Medscape Medical News, April 2, 2014 ~ Attitudes Toward 'Talk Therapies' Increasingly Negative, Medscape Medical News, April 1, 2014.
▼ Evidence of Brain Changes in MS-Related Depression
Using a novel automated imaging technique, researchers have identified shrinkage in the hippocampus in a large group of women with multiple sclerosis (MS) and depressed mood.
The results suggest that "regionally clustered reductions in hippocampal thickness can be detected by automated surface mesh modeling and may be a biological substrate of MS depression in female patients," the researchers write.
"We were able to see local differences in the hippocampus related to symptoms specific to depression in patient with MS," Nancy Sicotte, MD, neurologist at Cedars-Sinai Medical Center in Los Angeles, California, told Medscape Medical News. "This helps to reproduce work we have done previously using a manual segmenting technique."
The advantage of automated surface mesh modeling, Dr. Sicotte explained, is that it is fully automated and can be derived from relatively standard MRI examinations done routinely for clinical purposes. "This allows us to more easily monitor changes over time in these hippocampal regions and more readily determine the effects of therapies aimed at treating depression and/or MS," she said.
The study was published in the January 2014 issue of Human Brain Mapping...