Stress Can Cause Brain Shrinkage
Features Mark George, MD, Medical University of South Carolina
It’s final exam week and Patti Rumsey is marching on a treadmill at the local Y.
The mother of four is studying to be a social worker, and when she’s not shuttling the kids between activities or taking care of the house, her nose is buried in the books.
At least for the moment, her life is the definition of stress. And a half hour on the treadmill or in the pool helps her handle it.
“I don’t know why,” said the Greenville woman, “but it just works.”
Four in 10 Americans say their stress level increased over the past year. And in an age of home foreclosures, nearly half of all marriages ending in divorce, and a decade of war, it can be tough to avoid.
Stress can keep you awake at night, cause pounding headaches and send you scrambling for a box of chocolates.
Read full article here
Posted to Members in the News & Publications on May 16, 2012
Early Guidance, Preventive Therapy Urged for Young Athletes
Features Ira D. Glick, MD, Stanford University
The recent death of former professional football player Junior Seau from apparent suicide once again highlights the need for elite athletes of all ages to receive early counselling and perhaps even mandatory prophylactic talk therapy to prevent psychiatric illness later in life in this high-risk population.
These were just some of the suggestions that emerged from a roundtable discussion between mental health professionals and several former and current athletes held here at the American Psychiatric Association's (APA's) 2012 Annual Meeting and hosted by the International Society for Sports Psychiatry (ISSP).
Junior Seau's death closely follows 2 other recent suicides by former National Football League (NFL) players Ray Easterling and Dave Duerson. All 3 players suffered multiple concussions during their careers, and Easterling, who was the eldest of the 3, had been diagnosed with dementia.
Retired NFL player Duerson, who reportedly believed he was suffering from the effects of chronic traumatic encephalopathy (CTE), shot himself in the chest and requested that his brain be donated to science. A degenerative condition, CTE can lead to depression, uncontrolled impulses, and dementia.
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Posted to Members in the News & Publications on May 16, 2012
Psychiatrist Leads National Trial for Depression Markers
Features Madhukar Trivedi, MD, University of Texas Southwestern
UT Southwestern Medical Center psychiatrists are leading a national clinical trial to find biomarkers that can better predict how people suffering from depression will respond to medications so physicians eventually can personalize treatments.
The new trial, launched at UT Southwestern and three other U.S. institutions, is an effort to bring clinical solutions to issues raised by the world’s largest depression study, which was conducted by UT Southwestern. That study showed that most depressed patients must make multiple attempts before finding an antidepressant that works best for them.
“Depression is very complex and difficult to treat, and individual differences can impact the way medication works with a particular patient,” said Dr. Madhukar Trivedi, professor of psychiatry at UT Southwestern and principal investigator for the study. “Early indicators of whether a treatment is going to work are imperative.”
Read full article here
Posted to Members in the News & Publications on May 15, 2012
Those with Depression at Higher Risk of Sleepwalking
Features Maurice Ohayon, MD, PhD, DSc, Stanford University
About 8.5 million adults in the USA have experienced nighttime wanderings and those with sleep apneas and psychiatric disorders, depression or obsessive compulsive disorders are at higher risk, says the study of 19,136 Americans ages 18 and older. Antidepressants, over-the-counter sleeping pills and certain other medications can increase the risk, but they bring on events in people with a history of sleepwalking.
"I would like to correct the impression that this phenomenon is rare," says study author Maurice Ohayon, professor of psychiatry and behavioral sciences at the Stanford Sleep Epidemiology Research Center. "This is a huge number of people."
Participants were asked in telephone surveys about their sleeping habits, general health, medications and mental disorders. People who wandered at night at least once during the year were more likely to have a family history of sleepwalking — and they often tread on quality sleep for household members. Ohayon says that's how most of them reported knowing of their somnambulism.
Read full article here
Posted to Members in the News & Publications on May 14, 2012
Latest Bipolar Treatments: Video from APA 2012
Features Mark Frye, MD, Mayo Clinic
Dr. Mark Frye, department chair of Mayo Clinic Psychiatry and Psychology department, talks about the latest bipolar disorder treatments with a distinguished panel of researchers at the 165th annual American Psychiatric Association meeting Sunday, May 6, 2012 in Philadelphia.
Watch the video here
Posted to Members in the News & Publications on May 14, 2012
Update on Trichotillomania
Features Martin Franklin, PhD, University of Pennsylvania
Despite its occurrence in up to 3.4% of adults, hair–pulling disorder or trichotillomania (TTM) is often under-diagnosed and inappropriately treated, according to a panel of experts presenting at the recent APA meeting in Philadelphia.
The experts described the phenomenology, epidemiology, symptoms and diagnosis of trichotillomania; discussed psychopharmacologic and behavioral treatment modalities for the disorder, along with recent trials in children and adults; highlighted research advances; and summarized proposed changes for the disorder in the DSM-5.
Presenters were Douglas Woods, PhD, Professor of Psychology at the University of Wisconsin-Milwaukee, who has an NIH grant to study Acceptance-Enhanced Behavior Therapy for Trichotillomania; Jon E Grant, MD, MPH, JD, Professor of Psychiatry and Co-Director of the Impulse Control Disorders Clinic at the University of Minnesota-Milwaukee; and Martin Franklin, PhD, Associate Professor of Clinical Psychology in Psychiatry at the University of Pennsylvania and Director of the Child and Adolescent OCD, Tic, Trich and Anxiety Group (COTTAGe). Others were Michael Bloch, MD, Assistant Professor in the Yale Child Study Center and Assistant Director of the Yale OCD Clinic, and Eric Hollander, MD, Clinical Professor in the Department of Psychiatry and Behavioral Sciences and Director of the Autism and Obsessive Compulsive Spectrum Program at the Albert Einstein College of Medicine, Montefiore Medical Center, in New York. Melissa Rooney, MD, served as Chair.
Read full article here
Posted to Members in the News & Publications on May 14, 2012
Alternative Treatments for Depression: Do They Work?
Features Descartes Li, MD, University of California San Francisco
The majority of people with depression and bipolar disorder can and do have fulfilling, meaningful lives. Dr. Descartes Li, Professor Psychiatry and Director of UCSF Bipolar Disorder Program, discusses alternative treatments for depression - what works and what doesn't.
Watch the video here
Posted to Members in the News & Publications on May 14, 2012
Statement from HHS Secretary Kathleen Sebelius on Mental Health Month
Last year, 45.9 million adult Americans had a mental illness, according to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health. These conditions affect individuals, their families and loved ones, and communities. Unfortunately, many individuals do not receive needed services and treatment. In fact, estimates show that one-fifth to one-third of the uninsured are people with mental and substance use disorders. People with mental illnesses also experience disparities in income, employment, education, homelessness, full community participation, and most tragically – life expectancy. Outdated misperceptions, myths, and prejudice lead to many of these outcomes.
Read full statement here
Posted to Policy & Advocacy on May 14, 2012
Preventing Depression Requires Proactive Interventions by Health Care System
Features Ricardo Muñoz, PhD & Yan Leykin, PhD, UCSF; William Beardslee, MD, Brigham & Women's Hospital
Major depressive episodes can be prevented, and to help ensure that they are, the health care system should provide routine access to depression-prevention interventions, just as patients receive standard vaccines, according to a new article co-authored by UCSF researcher Ricardo F. Muñoz, PhD.
The article builds on a 2009 Institute of Medicine report on prevention of mental, emotional and behavioral disorders, which provided presented evidence that mental disorders can be prevented.
The article, “Major Depression Can Be Prevented,” will appear in a special section of the May-June 2012 issue of the American Psychologist. In it, the authors provide a road map for what needs to be accomplished in the next 10 years to make headway against depression. Previous studies suggest that 22 percent to 38 percent of major depressive episodes could be prevented with currently available interventions, according to Muñoz.
Muñoz and co-authors William Beardslee, MD, professor of child psychiatry at Harvard Medical School, and Yan Leykin, PhD, assistant adjunct professor in the Department of Psychiatry at UCSF, are calling their article a “call to action for the health care system.”
Read full article here
Posted to Members in the News & Publications on May 14, 2012
A Father’s Battle to Change the Future of Brain Research
Features Jeffrey Lieberman, MD, Columbia University
At a recent lunch organized by Jeffrey Lieberman, Columbia University’s chairman of psychiatry, New York’s top neurological researchers gathered to meet the nonprofit team they had been told would transform the very nature of their jobs.
Patrick Kennedy (Ted’s son and a former Congressman from Rhode Island), the cochairman and public face of the charity One Mind for Research, kicked off the meeting by deeming the assembled luminaries “today’s astronauts.” General Pete Chiarelli, One Mind’s new CEO—recruited from his just-completed stint as the U.S. Army’s vice chief of staff—discussed the astonishing increase in post-traumatic stress disorder and traumatic brain injury seen in soldiers returning from Afghanistan and Iraq.
The key figure at the gathering, though, was Garen Staglin, the quiet force behind One Mind and two other mental health charities, all of which have helped promote psychiatric-drug research even as big pharmaceutical firms have scaled back their efforts. Despite pressure on the National Institutes of Health’s budget, Staglin averred, it was still possible to get the government to open its coffers—if politicians could only be made to recognize the toll taken by mental illness, from the Alzheimer’s striking aging baby boomers to the autism afflicting their grandchildren.
Read full article here
Posted to Members in the News & Publications on May 11, 2012
Moral Injury in Veterans of War
Features Shira Maguen, PhD, University of California San Francisco
Military personnel serving in war are confronted with ethical and moral challenges, most of which are navigated successfully because of effective rules of engagement, training, leadership, and the purposefulness and coherence that arise in cohesive units during and after various challenges. However, even in optimal operational contexts, some combat and operational experiences can inevitably transgress deeply held beliefs that undergird a service member’s humanity. Transgressions can arise from individual acts of commission or omission, the behavior of others, or by bearing witness to intense human suffering or the grotesque aftermath of battle. An act of serious transgression that leads to serious inner conflict because the experience is at odds with core ethical and moral beliefs is called moral injury.
Read full article here
Posted to Members in the News & Publications on May 11, 2012
Court Reverses Itself on Veterans Healthcare Overhaul
A federal appeals court has reversed a ruling that the U.S. Department of Veterans Affairs must overhaul how it cares for veterans with combat-related mental health care illnesses.
By a 10-1 decision, a panel of the 9th U.S. Circuit Court of Appeals in San Francisco said it could not conclude that the VA's treatment of veterans, which sometimes causes claims to remain unaddressed for several years, was unconstitutional.
The panel said only Congress or the President had authority to direct changes to speed up how veterans are treated. Nonprofit groups contended the VA contributed to the despair that led to roughly 6,500 suicides a year by U.S. veterans.
"As much as we may wish for expeditious improvement in the way the VA handles mental healthcare and service-related disability compensation, we cannot exceed our jurisdiction to accomplish it," Judge Jay Bybee wrote for the majority.
Citing President Abraham Lincoln's second inaugural address, he added: "There can be no doubt that securing exemplary care for our nation's veterans is a moral imperative. But Congress and the President are in far better position 'to care for him who shall have borne the battle.'"
Monday's decision overturned a 2-1 ruling last May by a panel of the same court.
Read full article here
Posted to Policy & Advocacy on May 09, 2012
Treating Sleep Disorder Improves Psychiatric Outcomes
Features Umesh Vyas, MD, Mayo Clinic
A new study suggests that treating sleep disorders, and sleep apnea in particular, is associated with improvement over baseline in symptoms of comorbid psychiatric disorders.
"There is a strong need for prospective studies" to further define this relationship, Umesh Vyas, MD, chair of the Department of Psychiatry and medical director of the Sleep Disorders Center in the Mayo Clinic Health System in Mankato, Minnesota, told a press conference here.
The results were presented at the American Psychiatric Association's (APA's) 2012 Annual Meeting.
In a separate report, Abid Malik, MD, medical director of the Adult Unit A and of the Sleep Disorder Center at South Seminole Hospital of Orlando Health and assistant professor of psychiatry at the University of Central Florida College of Medicine, in Orlando, reviewed the literature on sleep parameters, in this case, rapid eye movement (REM) sleep latency, in patients with anxiety disorders to see whether this may provide a biological biomarker, as has been shown previously with major depression.
Read full article here
Posted to Members in the News & Publications on May 09, 2012
Two Proposed Changes Dropped from Psychiatric Guide
Two proposed psychiatric diagnoses failed to make the last round of cuts in the laborious process of revising the Diagnostic and Statistical Manual of Mental Disorders -- an exhaustive catalog of symptoms used by doctors to diagnose psychiatric illness.
Gone from the latest revision are "attenuated psychosis syndrome," intended to help identify individuals at risk of full-blown psychosis, and "mixed anxiety depressive disorder", a blend of anxiety and depression symptoms. Both performed badly on field tests and in public comments gathered by the group in its march toward the May 2013 publication deadline.
Both have been tucked into Section III of the manual -- the place reserved for ideas that do not yet have enough evidence to make the cut as a full-blown diagnosis.
What has survived, despite fierce public outcry, is a change in the diagnosis of autism, which eliminates the milder diagnosis of Asperger syndrome in favor of the umbrella diagnosis of autism spectrum disorder.
Read full article here
Posted to Policy & Advocacy on May 09, 2012
Program Aims to Boost Access to Mental Health Care
Features Mark Williams, MD, Mayo Clinic
Patients across the nation are faced with a dilemma when it comes to mental health care: There aren’t enough psychiatrists to treat their needs. Exacerbating the problem is that when a patient is having mental health problems, they will most likely see their primary care physician who may not have the time or training to effectively treat and diagnosis their ailment. Even if a patient manages to schedule an appointment with a psychiatrist, the waiting period to see someone can take weeks, even months.
The Depression Improvement Across Minnesota, Offering a New Direction (DIAMOND) program is aiming to fix this mental health care gap. Mark Williams, M.D., of the psychiatry and psychology department, has taken part in the program at the Mayo Clinic and within Mayo Clinic Health System sites. In a nutshell, DIAMOND gets a patient in front of an advocate who will spend the appropriate amount talking about their potential condition, begin to suggest treatment and get them in front of a psychiatrist within a week of their original visit to the doctor if need be.
Read the full article and watch the video here
Posted to Members in the News & Publications on May 09, 2012
New Name for PTSD Could Mean Less Stigma
It has been called shell shock, battle fatigue, soldier’s heart and, most recently, post-traumatic stress disorder, or PTSD.
Now, military officers and psychiatrists are embroiled in a heated debate over whether to change the name of a condition as old as combat.
Military officers and some psychiatrists say dropping the word “disorder” in favor of “injury” will reduce the stigma that stops troops from seeking treatment. “No 19-year-old kid wants to be told he’s got a disorder,” said Gen. Peter Chiarelli, who until his retirement in February led the Army’s effort to reduce its record suicide rate.
On Monday, a working group of a dozen psychiatrists will hold a public hearing in Philadelphia to debate the name change. The issue is coming to a head because the American Psychiatric Association is updating its bible of mental illnesses, the Diagnostic and Statistical Manual of Mental Disorders, for the first time since 2000.
The relatively straightforward request, which originated with the U.S. Army, has raised new questions over the causes of PTSD, the best way to treat the condition and the barriers that prevent troops from getting help. The change also could have major financial implications for health insurers and federal disability claims.
Chiarelli took on the problems of PTSD and suicide after two tours in Iraq and pressed harder than any other officer to change the way service members view mental-health problems. His efforts, however, have not resulted in a reduction in suicides.
Read full article here
Posted to Policy & Advocacy on May 08, 2012
Metabolic Screening in Antipsychotic Users: Whose Job Is It?
Features Christina Mangurian, MD, University of California San Francisco
Psychiatrists and primary care physicians (PCPs) have somewhat different opinions over whose role it is to monitor and screen for metabolic abnormalities in patients with mental illness who are taking antipsychotic medications, new research shows
"There appears to be a disconnect between where providers believe metabolic screening should be done (psychiatrists and many PCPs think this should be done in community mental health clinics) and where treatment should be received (neither psychiatrists nor PCPs think psychiatrists should be treating metabolic problems)," Christina Mangurian, MD, who was involved in collecting and analyzing the data, told Medscape Medical News.
"I believe this disconnect likely contributes to the poor rates of screening and treatment of metabolic abnormalities in this vulnerable population," said Dr. Mangurian, assistant professor, Department of Psychiatry, University of California, San Francisco (UCSF), and director of the UCSF/San Francisco General Hospital Public Psychiatry Fellowship Program.
The study was presented here at the American Psychiatric Association's (APA's) 2012 Annual Meeting.
It is well known that many of the medications used to treat patients with psychiatric illnesses, most notably atypical antipsychotics, are associated with rapid metabolic changes, including weight gain and interference with glucose metabolism. These changes may lead to increased rates of cardiovascular disease.
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Posted to Members in the News & Publications on May 08, 2012
The Role of Fatigue in Depressive Disorders & Using Biomarkers for Personalized Treatment
Depression Professional Development
Fatigue frequently occurs in depression, but its importance as a leading cause of morbidity is largely underappreciated. While fatigue is easy to observe, it is difficult to characterize. It can be a prodromal symptom of depression as well as a core component of acute illness; it can be a side effect of antidepressants, a result of sleep disturbance or a residual symptom of depression. The consequences are many: increased severity of depression, decreased productivity, cognitive dysfunction and an increased risk of recurrence.
This interactive program will define and examine the many manifestations and ramifications of fatigue in depression. Participants will learn to define the multifactorial symptom domains of fatigue, identify the role of fatigue in the prodromal, acute and maintenance phases of depression, and employ cutting-edge psychopharmacologic strategies to minimize the occurrence and adverse consequences of fatigue. The program also aims to educate clinicians about the current role of biomarkers in psychiatry and the increased interest in the clinical application of psychiatric biomarkers.
Click here for more information
Posted to Events on May 08, 2012
Amy Kilbourne, PhD, MPH Honored for Contributions to Mood Disorder Research
The Depression and Bipolar Support Alliance (DBSA), the nation’s largest, patient-run organization focusing on depression and bipolar disorder, has honored Amy M. Kilbourne, Ph.D., M.P.H., with its prestigious Klerman Young Investigator Award.
Named after Gerald L. Klerman, M.D., a pivotal figure in psychiatry, this award is one of the highest honors that DBSA extends to members of the scientific community. Presented annually, they recognize researchers whose work contributes to understanding the causes, diagnosis and treatment of depression and bipolar disorder.
Read full article here
Posted to Members in the News & Publications on May 08, 2012
Mental Health Issues Not a Priority in Emergency Department
Features Anthony P. Weiss, MD, Massachusetts General Hospital
Seeking psychiatric care in an emergency department led to a wait of more than 11 hours, and the wait was even longer for older, intoxicated, and uninsured patients, a study of five urban hospitals showed.
The median wait lasted 8.2 hours. Patients discharged to home had a wait on par with the median, but a transfer outside a system of care almost doubled the wait time for patients with psychiatric emergencies.
"The results of this study are important because they highlight the interrelatedness of the various components of the mental health system and provide objectively identified targets for quality improvement," Anthony P. Weiss, MD, of Harvard and Massachusetts General Hospital in Boston, and co-authors wrote in an article published online in Annals of Emergency Medicine.
"Emergency departments (EDs) that are embedded within a larger system of care and have ready access to various levels of after care options ... are likely to be better positioned to more rapidly transition patients through the ED," they added.
Read full article here
Posted to Members in the News & Publications on May 08, 2012
Positive Charge: New Technology to Treat Depression
Features Mark George, MD - Medical University of South Carolina; John Barry, MD, Charles DeBattista, MD, Amit Etkin, MD, PhD, Jaimie Henderson, MD, Alan Schatzberg, MD, Brent Solvason, MD, PhD - Stanford University; Helen Mayberg, MD - Emory University
Neurologist and psychiatrist Mark George, MD, was studying brain imaging and depression in 1990 at London’s Queen Square Hospital, a center for neurological diseases renowned for a century as a hotbed of discovery, when he bumped into a man in an elevator with an astonishing report.
“He said, ‘You’ll never believe it, but this person put a magnet to my head, and it made my thumb move,’” recalls George, who was fresh from South Carolina, where he’d just finished residencies in neurology and psychology. In fact, the man was part of a study in which researchers were experimenting with magnets to treat malfunctions of the brain’s motor cortex — the part of the brain that controls voluntary movements.
The encounter left George, then in his early 30s, with the “crazy idea” that it might be possible to use magnets to influence the brain in other ways and perhaps alter an individual’s mood. After all, he thought, if a magnet could stimulate the brain enough to cause movement, might it be possible to position it over a spot where it might affect feelings and emotions?
Read full article here
Posted to Members in the News & Publications on May 08, 2012
Middle Aged And Elderly With Depression Have Higher Risk Of Dementia
Features Deborah E. Barnes, PhD, MPH, University of California San Francisco
A report in the May issue of Archives of General Psychiatry draws a link between people in mid-life and late-life, suffering from depression and the possibility of them developing dementia.
More than five million people in the US alone suffer from Alzheimer's disease, and the health care costs run at a staggering $172 Billion.
Deborah E. Barnes, Ph.D., M.P.H., of the University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, and colleagues explain how :
Read full article here
Posted to Members in the News & Publications on May 08, 2012
Parents’ Depression Linked to Problems in Children
Features William Beardslee, MD, Brigham & Women's Hospital & Harvard Medical School
Like many other primary care doctors, I sometimes sense the shadow of depression hovering at the edges of the exam room. I am haunted by one mother with severe postnatal depression. Years ago, I took proper care of the baby, but I missed the mother’s distress, as did everyone else.
Nowadays it’s increasingly clear that pediatricians, obstetrician-gynecologists and internists must be more alert. Research into postnatal depression in particular has underscored the importance of checking up on parents’ mental health in the first months of a baby’s life.
But a parent’s depression, it turns out, can be linked to all kinds of problems, even in the lives of older children.
“Depression is an illness that feeds upon itself,” said Dr. William Beardslee, professor of child psychiatry at Harvard Medical School, who has spent his career studying depression in children and developing family interventions. “Very often people who are depressed don’t seek the care they need.”
Read full article here
Posted to Members in the News & Publications on May 08, 2012
Dr. John Greden on Line One: Your Health Connection
Listen to an archived recording of Dr. Greden talking about depression and bipolar illnesses on Line One: Your Health Connection
Posted to Members in the News & Publications on May 07, 2012
Seeking the Line Between Grieving & Depression
Features Kay Redfield Jamison, PhD, Johns Hopkins University
Should grieving people be considered clinically depressed?
Johns Hopkins professor and author Kay Jamison, who has written about her struggles with bipolar disorder, weighed in today on that knotty question that’s popped up as doctors consider changing how depression is diagnosed.
The main psychiatric diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders, or DSM, currently excludes people who are mourning from getting diagnosed with major depression. A proposed revision would change that. As the New York Times has reported, this has raised worries that this would pathologize a normal response to painful loss.
Jamison, speaking to a packed room of hundreds at the American Psychiatric Association conference, described her own her experience when her husband, Richard, died about 10 years ago.
She said she felt distraught and restless. She ruminated and had dark thoughts, doubting that she’d love again, but she didn’t think about suicide.
“My thoughts were on the pain of missing life, not the pointlessness of life” as in depression, she said.
Read full article here
Posted to Members in the News & Publications on May 07, 2012
We Search Together Announcement
How would your research program change if you did not have to worry about the challenge of recruiting participants for your studies? What would happen if you knew you could fill a study within days or months rather than years?
We hope to find out.
The University of Michigan Depression Center (UMDC) and the Depression and Bipolar Support Alliance (DBSA) are pleased to announce the launch of WeSearchTogether.org.
Read the full announcement here
Posted to Policy & Advocacy on May 07, 2012
Mayo Clinic Biobank Begins to Elucidate Bipolar Disorder
Features Manuel E. Fuentes, MD & Mohit Chauhan, MD, Mayo Clinic
Researchers at the Mayo Clinic aim to provide an important tool for the characterization and investigation of bipolar disorder through development of the Mayo Clinic Bipolar Disorder Biobank.
The project, part of a large general biobank at the institution, aims to provide a resource for clinical, genetic, and epidemiologic study of bipolar disorder, with the goal of individualized medicine in the future.
Manuel E. Fuentes, MD, from the Mayo Clinic, Rochester, Minnesota, discussed some of the baseline clinical and demographic findings from the biobank registry here at the American Psychiatric Association's 2012 Annual Meeting.
To date, 708 patients with bipolar disorder, starting with patients with bipolar disorder I and expanding more recently to include those with bipolar disorder II, have been fully analyzed, Dr. Fuentes said. In addition, "Mayo has the possibility to have a really nice control group," he said, noting that the general biobank, including participants without any current illness, now tops 20,000 individuals.
In a separate presentation here, Mohit Chauhan, MD, an Instructor in psychiatry at Mayo Health Systems–Austin, Mayo Clinic College of Medicine in Austin, Minnesota, presented early data on the same patient population but focusing on life stressors associated with bipolar disorder.
By examining the role of these life stressors, Dr. Chauhan said, "perhaps we'll be able to identify better how particular genes interact with a patient's social milieu and impacts the illness."
Read full article here
Posted to Members in the News & Publications on May 07, 2012
Shock Therapy: New Twist on an Old Treatment
Features Richard Weiner, MD, PhD, Duke University
One in 10 adults suffers from some type of depression. Medications and psychotherapy are common treatments, but for many, they just do not work. Now, a treatment considered barbaric decades ago is making a big comeback.
The past six years have been anything but easy for Jim and Amy Adkins. Jim suffers from severe depression that started when his dad committed suicide.
"I attempted suicide twice. I was just at the end of my rope,” says Jim.
Drugs and therapy did not work, so Jim’s doctor told him about shock therapy, now known as ECT. Duke psychiatrist Richard Weiner says ECT has been used since the 1930s but Hollywood gave it a bad rap.
He says, "For a lot of the public, what they know about ECT is what they saw on One Flew over the Cuckoo's Nest.”
Now, Jim is on his thirteenth treatment. Doctors first give him general anesthesia and a muscle relaxer. Once Jim is asleep, doctors deliver a quick electrical current that causes a seizure in the brain. The seizure produces chemical changes in the brain that reduce the depressive symptoms.
Dr. Weiner explains, "The same kind of neurotransmitter changes that occur with antidepressants also occur with ECT. It's just that ECT does it more powerfully."
There is no pain and studies show for those who are good candidates, ECT works between 80 and 90 percent of the time. But there are risks including headache, muscle pain, nausea and temporary memory problems. Still, Jim is happy he gave it a try. Since starting ECT, he has not had any thoughts of suicide.
Jim says, "Now, there's hope. I see a future."
The number of patients using ECT has tripled since the 1980's. Most patients will need follow-up treatments or other drug therapies after ECT. The shock therapy is mainly used for patients with severe, debilitating depression.
Read full article here
Posted to Members in the News & Publications on May 07, 2012
Virtual World Helps Returning Soldiers Battle Addiction
Features M. Zachary Rosenthal, PhD, Duke University
Many veterans of war return home to their families haunted by memories of violence and death, and, in some cases, soldiers turn to substance abuse to help mask or cope with the feelings and emotions associated with war.
Soldiers dealing with the symptoms of Post-Traumatic Stress Disorder can have an especially difficult time, but thanks to a Duke University Hospital research program that uses virtual gaming technology, some are getting exactly the type of help they need.
Using a computer-generated world full of temptation, researchers are able to test former soldiers with anything from a glass of beer to a cigarette. The world, designed to look like parts of Durham, even includes a local bar.
Charles McCrimmon, a former Marine who returned home in 1977, joined the Duke study in August after dealing with PTSD symptoms for years. McCrimmon said he would drink heavily in an attempt to eliminate memories of his time overseas and a head-on collision he was involved in just before being deployed.
Read full article here
Posted to Members in the News & Publications on May 04, 2012
DSM-5 Field Trial Results a Hot Topic at APA 2012 Meeting
Features Kenneth Silk, MD, University of Michigan
Telepsychiatry, neuromodulation, the role of genetics, and updates for the upcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are just some of the hot items on the agenda of this year's American Psychiatric Association's 2012 Annual Meeting in Philadelphia.
"Telepsychiatry is one of many tools we currently have. But in many situations, it may be the only tool where people can get psychiatric services," APA Scientific Program Committee chair Kenneth R. Silk, MD, told Medscape Medical News.
"So how do we make our resources available to a wide range of patients? How do you connect to individuals who do not have access to needed services? More than just an interesting idea, I think this is our responsibility to figure out," said Dr. Silk, who is also professor in the Department of Psychiatry and director of the Personality Disorders Program at the University of Michigan Medical School in Ann Arbor.
He reported that other important topics include integrated care, which is the theme of this year's meeting; maternal mental health issues; disaster psychiatry; and ways that clinicians can protect themselves against burnout and workplace violence.
He noted that the last-mentioned issue "is terribly important" in light of the recent shootings at the Western Psychiatric Institute and Clinic at the University of Pittsburgh, where 1 person was killed and several others wounded.
"It makes you pause and really think: Do we work in safe environments? Is a mental health facility less safe than another facility? I like to think that it's safer because we're more cognizant of what might go on in these situations. But it's important to be careful and to take precautions," said Dr. Silk.
So far, more than 9000 attendees are registered for the meeting, which will feature 1139 abstracts. In addition to 4 days of new research posters, there will be 475 sessions, including oral scientific presentations, symposia, and educational courses. The full program is posted on the APA's Web site.
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Posted to Members in the News & Publications on May 03, 2012
Mental Health Screening of African American Adolescents and Facilitated Access to Care
Features Mathilde Husky, PhD, Columbia University
Abstract: This study retrospectively reviews de-identified records from school-based mental health screening in a predominantly African American community. We compare participation rates, screening results, referrals to services and access to care of white and African American adolescents. Among those offered screening, 20.1% of white students (n = 297), and 28.8% of African American students (n = 499) were screened (χ2 = 32.47, df = 1, P < .001). African American students (45.1%) were significantly more likely than white students (33.0%), (AOR = 1.59; P = .003) to be identified as being at risk. In both racial groups, most youth accessed the school-based services (89.02%, 95% CI 82.25–95.79) and community services (86.57%, 95% CI 78.41–94.73) to which they were referred. The groups did not differ in the odds of accessing community-based services (AOR = .58; P = .49). African American students were, however, more likely than white students to access school-based services (AOR = 10.08; P = .022). The findings support the effectiveness of screening in school settings in predominantly African American communities.
Read full article here
Posted to Members in the News & Publications on May 03, 2012
Yoga May Help Prevent Adolescent Mental Problems
High school students who do yoga may derive psychological benefits, researchers from Brigham and Women's Hospital and Harvard Medical School reported in the April issue of Journal of Developmental & Behavioral Pediatrics. Leading author, Jessica Noggle, PhD of Brigham and Women's Hospital and Harvard Medical School in Boston said that since mental health disorders usually develops in teenage years:
"Yoga may serve a preventive role in adolescent mental health."
The study involved 51 students from the 11th- and 12th-grade who were registered for physical education (PE) at a Massachusetts high school. Two thirds of the students were randomly assigned to Kripalu yoga classes that consisted of physical yoga postures as well as breathing exercises, relaxation, and meditation, whilst the remaining third was assigned to regular PE classes.
Read full article here
Posted to Members in the News & Publications on May 02, 2012
Blood Pressure Drugs Linked with Lower PTSD Symptoms
Features Kerry Ressler, MD, PhD, Emory University
The finding suggests that ACE (angiotensin converting enzyme) inhibitors or ARBs (angiotensin receptor blockers) could be valuable tools for treating or preventing post-traumatic stress disorder.
The results were published online May 1 in the Journal of Clinical Psychiatry.
"These results are particularly exciting because it's the first time ACE inhibitors and ARBs have been connected to PTSD, and it gives us a new direction to build on," says senior author Kerry Ressler, MD, PhD, associate professor of psychiatry and behavioral sciences at Emory University School of Medicine and a researcher at Yerkes National Primate Research Center.
"These data come from an observational study, not a randomized clinical trial, so it is important to limit our interpretation until larger, placebo-control, double-blinded trials can be performed. Still, they provide evidence from a human population that could be followed up in a rigorous controlled trial. This class of medications has been widely prescribed for hypertension for years and their safety profiles are well known, so our results could be translated into action relatively quickly."
Read full article here
Posted to Members in the News & Publications on May 02, 2012
Improving Mental Health
Features Kerry Ressler, MD, PhD, Emory University
"More than 1 in 5 Americans experience depression or bipolar disorder during their lifetime.", states Dr. Jesse Wright, director of the University of Louisville Depression Center. These alarming numbers are a sign that Americans need to take time to consciously improve their mental health.
Mental health is a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community as defined by World Health Orginization. Therefore, an absence of these symptoms is a sign that an individual should work on improving their mental health so that they do not fall into the 1 in that already suffer from depression or bipolar disorder.
Everyone has a bad day, a slump, or period of "blah". How we react to these periods in our life has a great deal to do with our over all mental health. Here are a few tips to maintain and/or improve your mental health.
Read full article here
Posted to Members in the News & Publications on May 02, 2012
AHRQ Report: Treatment for Depression After Unsatisfactory Response to SSRIs
View the final research report here
Posted to Members in the News & Publications on April 30, 2012
Emergency Therapy May Prevent PTSD in Trauma Victims
Features Barbara Olasov Rothbaum, PhD, Emory University
Immediate psychiatric therapy for trauma patients in the emergency department (ED) may decrease the emergence of posttraumatic stress disorder (PTSD) and appears to be most effective in sexual assault victims, new research shows.
Presented here at the Anxiety Disorders Association of America (ADAA) 32nd Annual Conference, a study by investigators from Emory University in Atlanta, Georgia, showed that trauma patients who received emergency psychiatric treatment had fewer PTSD symptoms at 3 months than their counterparts who received a basic assessment.
"This is something we want to be able to transport and use wherever traumas occur and before people sleep on it — in theater, at emergencies and disasters," said Barbara Olasov Rothbaum, PhD, director of the Trauma and Anxiety Recovery Program and professor of psychiatry at Emory University School of Medicine.
"The clinical war is until you sleep on it," she explained. "We know that memories are consolidated when you sleep, so we wanted to try and catch people before."
Read full article here
Posted to Members in the News & Publications on April 30, 2012
Stressed Physicians Reluctant to Seek Support
Features Jo Shapiro, MD, Brigham & Women's Hospital
Nearly 80% of physicians at an academic medical center said they experienced a personal crisis within the past year, yet most said they would not seek support from physician-health services or employee-assistance programs.
The 108 surgeons, anesthesiologists and emergency physicians surveyed said they experienced a wide range of stressful events, such as serious illnesses or deaths in their families and severe adverse events in their patients. But most they said they were unlikely to turn to institutional sources of support, with 40% saying they would be willing to consult physician-health services and 29% open to using employee-assistance programs. About a third of the doctors had never even heard of these services, said an Archives of Surgery study published in March.
The reason offered most frequently for not getting help was lack of time, with 90% of the physicians surveyed at Brigham and Women’s Hospital in Boston citing it. About 70% feared a lack of confidentiality, negative impact on their careers or the stigma of mental illness. Nearly half feared legal consequences or thought “using services means I am weak.”
Between 15% and 75% of physicians are under severe stress or burned out. As many as 30% are depressed, according to 12 previous studies cited in the Archives article. Male physicians are 1.4 times more likely than other men their age to die of suicide, according to the American Foundation for Suicide Prevention. The problem is even worse among female physicians, who are about 2.3 times likelier to commit suicide compared with similarly aged women. Burned-out physicians also are likelier to make medical errors, change jobs or specialties, or retire from patient care, the Archives study said.
“Physicians underestimate the long-term effect of chronic emotional stress, and they certainly underestimate the effect of acute or chronic stress on their ability to give good care,” said Jo Shapiro, MD, senior author of the study. “There is great data that correlates burnout with errors, and I don’t think physicians have internalized that idea. We’re not trained to think that our emotional state is worth examining, no less tending to.”
Read full article here
Posted to Members in the News & Publications on April 30, 2012
Dr. John Greden on KSKA Radio Show
Dr. John Greden, Founding Chair of the NNDC, will be on KSKA Alaska Public Radio on Monday May 7 at 6:00 pm ET to talk about depression and the National Network of Depression Centers. Live stream available at kska.org.
Posted to Events on April 30, 2012
Being Left Out Puts Youths With Special Needs at Risk for Depression
Features Margaret Ellis McKenna, MD, Medical University of South Carolina
The challenges that come with battling a chronic medical condition or developmental disability are enough to get a young person down. But being left out, ignored or bullied by their peers is the main reason youths with special health care needs report symptoms of anxiety or depression, according to a study to be presented`123 April 29, at the Pediatric Academic Societies (PAS) annual meeting in Boston.
Being bullied has been shown to increase students' risk for academic and emotional problems. Little research has been done specifically on how being a victim of bullying affects youths with special needs.
In this study, researchers led by Margaret Ellis McKenna, MD, senior fellow in developmental-behavioral pediatrics at Medical University of South Carolina, investigated the impact of bullying, ostracism and diagnosis of a chronic medical condition on the emotional well-being of youths with special health care needs.
Participants ages 8-17 years were recruited from a children's hospital during routine visits with their physicians. A total of 109 youths and their parents/guardians completed questionnaires that screen for symptoms of anxiety and depression. Youths also completed a screening tool that assessed whether they had been bullied or excluded by their peers.
Read full article here
Posted to Members in the News & Publications on April 30, 2012
Study Finds Antipsychotics Do Not Improve Cognition
Features Jean Frazier, MD, UMass Medical School / UMass Memorial Health Care
Early-onset young patients show the same disappointing results found in adults, refuting industry claims that second-generation antipsychotics produce enduring effects on neurocognition.
Young people with early-onset schizophrenia demonstrated minimal neurocognitive improvements associated with antipsychotic treatment, and the small improvements that were demonstrated were consistent with practice effects as described in adults with chronic schizophrenia treated with first-generation antipsychotics and second-generation antipsychotics.
That was the finding from the Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS), funded by the National Institute of Mental Health. The study was published in the Journal of the American Academy of Child and Adolescent Psychiatry and posted on March 15.
The TEOSS study itself did not include a control group and as a result could not provide an estimation of “practice” effects—the effects of subjects gaining proficiency on neuropsychological test performance because of practice— between time points. For that reason, even such small improvements as were seen in early-onset patients treated with atypicals cannot be reliably related to the drug treatment itself.
Early intervention in psychosis is widely recognized as crucial to long-term outcome, and many researchers have come to regard cognitive deficits as a critical—even defining—feature of psychosis. So while the CATIE study and others have shown little benefit for cognition from atypical antipsychotics, the TEOSS study was designed to test whether such benefits might accrue if treatment was begun early, before patients have experienced years of psychosis.
But the results extend to early-onset patients the same disappointing results found for adults in the CATIE trials and elsewhere, refuting industry claims that atypical antipsychotics produce enduring improvements in cognition for patients with schizophrenia.
“The magnitude of change in neuropsychological test performance observed in TEOSS is quite modest and very much within the range of effect sizes attributable to practice effects, which are often larger,” lead author Jean Frazier, M.D., told Psychiatric News. “This is why it remains important for child and adolescent psychiatrists to monitor cognitive problems associated with the illness carefully, and support or facilitate alternative or augmentative strategies for cognitive compensations, such as environmental supports, development of compensatory strategies, and cognitive remediation.”
Read full article here
Posted to on April 27, 2012
Iowa House Approves Changes to Mental Health Reform Bill
DES MOINES — Iowans should have access to mental health services regardless of where they live as a result of legislation lawmakers say will be approved before they adjourn.
The legislation, which was approved 66-32 by the Iowa House on Tuesday, puts into place a state funding mechanism for locally-delivered services. The current county-based mental health system would be replaced under the bill, which likely will be tweaked by the Senate, where it was approved earlier 32-18.
The House action “continues the direction of the Senate bill … it improves the bill,” said Sen. Jack Hatch, D-Des Moines. There are “small changes” he said he would like to make, but Hatch said he hopes to avoid sending the bill to conference committee.
“There’s nothing that should prevent us from getting this done,” he said.
“The alternative is not good,” said floor manager Rep. Renee Schulte, R-Cedar Rapids. Although “this bill’s not perfect,” she warned colleagues the current county-based mental health system is an “unsustainable system with an unsustainable future.”
Read full article here
Posted to Policy & Advocacy on April 26, 2012
Former NFL QB Eric Hipple Talks about Men & Depression
Features Eric Hipple, University of Michigan
GOLDEN VALLEY, Minn. - Monday Night Football and Monday night is jail is something that former NFL quarterback Eric Hipple knows about. What he didn't know about were his symptoms of depression that hit him harder than a linebacker when his teenage son took his own life. Sharing signs of depression from both his own life and his son's life is something that now takes him all over the country as a mental health advocate. Hipple will speak on this topic Thursday, April 19, at Mt. Olivet Lutheran Church in Minneapolis at 6:30. Tickets are $10.
View video here
Posted to Members in the News & Publications on April 26, 2012
Senate VA Committee Conducts Hearing on VA Access to Care
(Washington, D.C.) – The Senate Committee on Veterans’ Affairs conducted a hearing yesterday to evaluate the Department of Veterans Affairs’ efforts to address the growing problem of veterans’ receiving mental health care in a timely and sufficient manner. Chairman Senator Patty Murray (D-WA) and Ranking Member (present) Senator Scott Brown (R-MA) led the inquiry by allowing nine witnesses, with various backgrounds, to testify to the efficiency of the Veterans Affairs. The inquiry included representatives from Veterans Affairs, and the VA’s Office of Inspector General to investigate the true availability of mental health care services at VA facilities.
The Department’s recent announcement to hire 1,600 mental health care professionals drew some concerns from the Committee’s members about the Veteran Affairs’ hiring plan details. “While I commend VA for the decision to hire another 1,600 mental health providers,” said Sen. Murray, “there is still no reliable staffing model to determine where these individuals are needed. Without that model, VA needs to explain how they will know where to place these additional providers.”
Sen. Brown was skeptical of the VA’s foresight into the actual hiring process. Brown questioned the VA representative on how the Department concluded the need for 1,900 positions, why only 2 percent of veterans get outsourced to private providers when there is presently an overload of cases, and the importance of evaluating “immediate risk patients.”
Read full article here
Posted to Policy & Advocacy on April 26, 2012
SAMHSA Releases 2010 Mental Health Report
The Substance Abuse and Mental Health Services Administration (SAMHSA) today released Mental Health, United States, 2010, the latest in a series of publications issued biannually by SAMHSA since 1980. Modeled after CDC's annual report, Health, US, this new report includes mental health statistics at the national and State levels from 35 different data sources. The report is organized into three sections:
* People: the mental health status of the U.S. population and prevalence of mental illness;
* Providers: providers and settings for mental health services, types of mental health services, and rates of utilization;
* Payers: expenditures and sources of funding for mental health services
Download or order the report here
Posted to Policy & Advocacy on April 26, 2012
VA to Increase Mental Health Staff by Nearly 10 Percent
WASHINGTON –Secretary of Veterans Affairs Eric K. Shinseki today announced that the department would add approximately 1,600 mental health clinicians – to include nurses, psychiatrists, psychologists, and social workers as well as nearly 300 support staff to its existing workforce of 20,590 mental health staff as part of an ongoing review of mental health operations.
“As the tide of war recedes, we have the opportunity, and the responsibility, to anticipate the needs of returning Veterans,” said Secretary of Veterans Affairs Eric K. Shinseki. “History shows that the costs of war will continue to grow for a decade or more after the operational missions in Iraq and Afghanistan have ended. As more Veterans return home, we must ensure that all Veterans have access to quality mental health care.”
VA’s ongoing comprehensive review of mental health operations has indicated that some VA facilities require more mental health staff to serve the growing needs of Veterans. VA is moving quickly to address this top priority. Based on this model for team delivery of outpatient mental health services, plus growth needs for the Veterans Crisis Line and anticipated increase in Compensation and Pension/Integrated Disability Evaluation System exams, VA projected the additional need for 1,900 clinical and clerical mental health staff at this time. As these increases are implemented, VA will continue to assess staffing levels.
“Mental health services must be closely aligned with Veterans’ needs and fully integrated with health care facility operations,” said VA Under Secretary for Health Dr. Robert Petzel. “Improving access to mental health services will help support the current and future Veterans who depend on VA for these vital services.”
Read full announcement here
Posted to Policy & Advocacy on April 26, 2012
Army Encourages New Way of Looking at PTSD
In a move to improve treatments for post-traumatic stress disorder, the Army is discouraging the use of traditional definitions such as feelings of fear, helplessness and horror — symptoms that may not be in a trained warrior's vocabulary. It also is recommending against the use of anti-anxiety and antipsychotic medications for such combat stress in favor of more proven drugs.
The changes are reflected in a new policy document released this month, one that reflects a growing understanding of the "occupational" nature of the condition for many troops. For them, the symptoms often associated with combat stress — hyperarousal, anger, numbness and sleeplessness — may be signs of illness at home but also responses crucial to survival in a war zone.
Doctors who adhere strictly to traditional PTSD definitions could withhold lifesaving treatment for those who need it most, Army doctors now warn, passing over soldiers or accusing them of faking problems.
"There is considerable new evidence that certain aspects of the definition are not adequate for individuals working in the military and other first-responder occupations," such as firefighting and police work, according to the policy, developed by the U.S. Army Medical Command.
"They often do not endorse 'fear, helplessness or horror,' the typical response of civilian victims to traumatic events. Although they may experience fear internally, they are trained to fall back on their training skills [and] may have other responses such as anger."
Charles Hoge of the Walter Reed Army Institute of Research, who for seven years oversaw the institute's research on the psychological consequences of the wars in Iraq and Afghanistan, said the document reflected work already underway by a committee of the American Psychiatric Assn. to refine the standards for treating PTSD based on an abundance of new research.
Read full article here
Posted to Policy & Advocacy on April 26, 2012
A blood test may eventually help diagnose depression
Features George Papakostas, MD, Massachusetts General Hospital
An estimated 19 million Americans are battling depression. Those affected complain of feeling sad or unhappy. They could be irritable, not sleeping, or sleeping far too much. They could complain that they’re unable to concentrate, they could have unexplained physical symptoms, or have a change in appetite. Right now, doctors diagnose depression based on patients' reported symptoms. However, the accuracy of that process varies. All that could change, though, if there were a concrete way to identify depression. New research out of Massachusetts General Hospital (MGH) is giving hope that there could eventually be a clinical tool to do just that.
A small, pilot study shows a new blood test accurately distinguishes patients diagnosed with depression from control participants. In a paper published in the journal Molecular Psychiatry, a team including MGH researchers reports a test of nine biological measures, or "biomarkers," in a patient’s blood could determine whether they are depressed. The biomarkers are associated with factors such as inflammation, neuron development and stress response in the brain structure.
Posted to Members in the News & Publications on April 23, 2012
Post-Prozac Nation: The Science & History of Treating Depression
Features Helen Mayberg, MD, FRCPC, Emory University
Few medicines, in the history of pharmaceuticals, have been greeted with as much exultation as a green-and-white pill containing 20 milligrams of fluoxetine hydrochloride — the chemical we know as Prozac. In her 1994 book “Prozac Nation,” Elizabeth Wurtzel wrote of a nearly transcendental experience on the drug. Before she began treatment with antidepressants, she was living in “a computer program of total negativity . . . an absence of affect, absence of feeling, absence of response, absence of interest.” She floated from one “suicidal reverie” to the next. Yet, just a few weeks after starting Prozac, her life was transformed. “One morning I woke up and really did want to live. . . . It was as if the miasma of depression had lifted off me, in the same way that the fog in San Francisco rises as the day wears on. Was it the Prozac? No doubt.”
Like Wurtzel, millions of Americans embraced antidepressants. In 1988, a year after the Food and Drug Administration approved Prozac, 2,469,000 prescriptions for it were dispensed in America. By 2002, that number had risen to 33,320,000. By 2008, antidepressants were the third-most-common prescription drug taken in America.
Fast forward to 2012 and the same antidepressants that inspired such enthusiasm have become the new villains of modern psychopharmacology — overhyped, overprescribed chemicals, symptomatic of a pill-happy culture searching for quick fixes for complex mental problems. In “The Emperor’s New Drugs,” the psychologist Irving Kirsch asserted that antidepressants work no better than sugar pills and that the clinical effectiveness of the drugs is, largely, a myth. If the lodestone book of the 1990s was Peter Kramer’s near-ecstatic testimonial, “Listening to Prozac,” then the book of the 2000s is David Healy’s “Let Them Eat Prozac: The Unhealthy Relationship Between the Pharmaceutical Industry and Depression.”
Posted to Members in the News & Publications on April 20, 2012
Treating Depression with Electrodes Inside the Brain
Features Helen Mayberg, PhD, FRCPC, Emory University
Atlanta (CNN) -- The first time Edi Guyton tried to commit suicide, she was 19 years old, wracked with depression and unable to deal with the social and academic pressure of college.
Even as a little girl, Guyton never seemed happy. Her mother had encouraged her to smile, but she didn't see any reason to. In her mind, everyone who smiled was "faking it."
She often thought about taking her own life, and one night in her college dorm, Guyton's dark thoughts gave way to action. With a razor blade, Guyton cut one wrist, then the other.
"I think I wanted it to get better or I wanted to die," she said. "The point was that everything was so bad, I wanted people to know that it was controlling me."
Edi Guyton lived with debilitating depression for 40 years before experimental brain surgery.
Her depression controlled her life for the next 40 years -- until she decided to volunteer for an experimental treatment. A neurosurgeon would drill two holes in Guyton's skull and implant a pair of battery-powered electrodes deep inside her brain.
The procedure -- called deep brain stimulation, or DBS -- targets a small brain structure known as Area 25, the "ringleader" for the brain circuits that control our moods, according to neurologist Dr. Helen Mayberg.
Read full article here
Posted to Members in the News & Publications on April 19, 2012
Killing in War Linked with Suicidal Thoughts Among Vietnam Veterans, Study Finds
Features Shira Maguen, PhD, University of California San Francisco
The experience of killing in war was strongly associated with thoughts of suicide, in a study of Vietnam-era veterans led by researchers at the San Francisco VA Medical Center (SFVAMC) and the University of California, San Francisco (UCSF).
The scientists found that veterans with more experiences involving killing were twice as likely to have reported suicidal thoughts as veterans who had fewer or no experiences.
To evaluate the experience of killing, the authors created four variables – killing enemy combatants, killing prisoners, killing civilians in general and killing or injuring women, children or the elderly. For each veteran, they combined those variables into a single composite measure. The higher the composite score, the greater the likelihood that a veteran had thought about suicide.
The relationship between killing and suicidal thoughts held even after the scientists adjusted for variables including post-traumatic stress disorder (PTSD), depression, substance use disorders and exposure to combat.
The study, which was published electronically on April 13 in the journal Depression and Anxiety, was based on an analysis of data from the National Vietnam Veterans Readjustment Survey, a comprehensive study of a nationally representative sample of Vietnam-era veterans.
The authors cited other research indicating that veterans are at elevated risk of suicide compared to people with no military service. They noted that by 2009, the suicide rate in the U.S. Army had risen to 21.8 per 100,000 soldiers, a rate exceeding that of the general population.
“The VA has a lot of very good mental health programs, including programs targeting suicide prevention. Our goal is to make those programs even stronger,” said lead author Shira Maguen, a clinical psychologist at SFVAMC and an assistant clinical professor of psychiatry at UCSF. “We want clinicians and suicide prevention coordinators to be aware that in analyzing a veteran’s risk of suicide, killing in combat is an additional factor that they may or may not be aware of.”
Read full article here
Posted to Members in the News & Publications on April 19, 2012
Antidepressants: Somber Questions
Features Andrew Nierenberg, MD & Jerrold Rosenbaum, MD, MGH; Michael Thase, MD, UPenn; Madhukar Trivedi, MD, UTSW
More than one in 10 Americans takes one or more antidepressant medications, and for that large chunk of the population, recent events surely have been unsettling. Three books published in 2010 were uniformly damning of the No. 1 type of medication taken by people ages 18 to 44, though each author takes aim at antidepressants from a different angle. Clinical psychologist Irving Kirsch lays out evidence that antidepressants simply don’t work in The Emperor’s New Drugs: Exploding the Antidepressant Myth—he argues that they’re no more effective than the dummy pills used in clinical trials. Journalist Robert Whitaker, in Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, makes a more harrowing claim—that chronic use of antidepressants and other psychotropic drugs has created legions of mentally disabled people who are far worse off as a result of treatment. And psychiatrist Daniel Carlat, in Unhinged: The Trouble With Psychiatry—A Doctor’s Revelations About a Profession in Crisis, charges that psychiatrists have engaged in “a binge of drug prescribing” because they can earn half again as much by adjusting medications as they would be paid for talk therapy. “The income differential is a powerful incentive to drop therapy from our repertoire of skills, and psychiatrists have generally followed the money,” Carlat writes.
One hallmark of depression is extreme self-doubt, and the furor the books have caused seems to have led many patients to question their treatment. In the wake of their publication, a number of people under the care of depression researcher Madhukar H. Trivedi abruptly stopped taking antidepressants. Some of those patients then relapsed, again suffering major depression, says Trivedi, professor of psychiatry and director of the Mood Disorders Research Program and Clinic at the University of Texas Southwestern Medical Center at Dallas. But others who quit the drugs have done just fine, Trivedi says.
Read full article here
Posted to Members in the News & Publications on April 19, 2012
Greden Honored for Advancement of Depression and Bipolar Research
Features John F. Greden, MD, University of Michigan
John F. Greden, M.D., executive director of the University of Michigan Comprehensive Depression Center, has been named the 2012 recipient of the Gerald R. Klerman Senior Investigator award from the Depression and Bipolar Support Alliance (DBSA).
The award recognizes Greden’s significant contributions to research that improves the lives of people living with mood disorders.
Greden is currently the Rachel Upjohn Professor of Psychiatry and Clinical Neurosciences, research professor in the Molecular and Behavioral Neuroscience Institute, and served as chair of the Department of Psychiatry for more than 22 years before stepping down in 2007 to devote his full efforts toward his role as executive director of the Depression Center. He is also founder and chair of the National Network of Depression Centers, whose membership includes 21 leading depression centers and academic medical centers.
Read full article here
Posted to Members in the News & Publications on April 17, 2012
Remembering Mike Wallace: 1918-2012
On April 7, 2012, the millions who struggle with clinical depressions, bipolar illnesses, and their associated stigma lost a tremendous voice with the death of Mike Wallace, revered journalist and passionate advocate for people living with mental illness. Mr. Wallace championed openness, honesty, and forthrightness when discussing depression and related conditions. His messages and unique “voice” appeared early in the fight, and he was uniquely powerful in puncturing the national conspiracy of silence about mental illnesses. Mike Wallace served on the National Advisory Board of the University of Michigan inaugural depression center and prepared an exceptional video for the opening of the Depression Center. Almost a decade later, the passion behind Mike’s message remains just as timely and powerful as the day he recorded it.
Posted to Policy & Advocacy on April 10, 2012
New View of Depression: An Ailment of the Entire Body
Features Owen Wolkowitz, MD, University of California San Francisco
Scientists are increasingly finding that depression and other psychological disorders can be as much diseases of the body as of the mind.
People with long-term psychological stress, depression and post-traumatic stress disorder tend to develop earlier and more serious forms of physical illnesses that usually hit people in older age, such as stroke, dementia, heart disease and diabetes. Recent research points to what might be happening on the cellular level that could account for this.
Scientists are finding that the same changes to chromosomes that happen as people age can also be found in people experiencing major stress and depression.
The phenomenon, known as "accelerated aging," is beginning to reshape the field's understanding of stress and depression not merely as psychological conditions but as body-wide illnesses in which mood may be just the most obvious symptom.
"As we learn more…we will begin to think less of depression as a 'mental illness' or even a 'brain disease,' but as a systemic illness," says Owen Wolkowitz, a psychiatry professor at the University of California, San Francisco, who along with colleagues has conducted research in the field.
Read full article here
Posted to Members in the News & Publications on April 10, 2012
Americans Less Willing to Pay to Prevent Mental Illness
Features Peter Ubel, MD, Duke University
A new survey discovers Americans are less willing to pay to avoid mental illness as compared to medical conditions.
Researchers analyzed responses from a nationally representative sample of 710 adults and found that while respondents viewed mental health as burdensome, in fact often more burdensome than general medical illness, they were less willing to pay for prevention of the condition.
Specifically, survey respondents were willing to pay 40 percent less than what they would pay to avoid medical illnesses, said study leader Dylan M. Smith, Ph.D.
Survey participants were presented with five health conditions. These included three medical illnesses or conditions (diabetes, below-the-knee amputation, and partial blindness), and two mental illnesses (depression and schizophrenia).
Participants rated each health condition for severity and level of burden in relation to quality of life. Then they indicated how much they would pay, out of pocket, to avoid the condition.
Read full article here
Posted to Members in the News & Publications on April 10, 2012
Minorities, Medicare Recipients Less Likely to Get Antidepressants
Features Rajesh Balkrishnan, PhD, University of Michigan
MONDAY, April 9 (HealthDay News) -- Hispanics and blacks are less likely to be prescribed antidepressants than whites, and Medicare and Medicaid patients are less likely to receive the drugs than those with private insurance, a new study says.
University of Michigan School of Public Health researchers examined data from 1993 to 2007 and found that whites were 1.5 times more likely to receive antidepressants than blacks or Hispanics with major depression.
The study also found that Medicare and Medicaid patients were 31 percent and 38 percent less likely to be prescribed antidepressants than privately insured patients.
Race didn't play a role in the type of antidepressants prescribed to patients, but insurance did. Medicare and Medicaid patients were 58 percent and 61 percent less likely to receive newer antidepressants than privately insured patients.
Newer types of antidepressants such as serotonin reuptake inhibitors (SSRIs) are considered the first-line drug treatments for major depression. Older types of antidepressants tend to cause more side effects.
"This study confirmed previous findings that sociological factors, such as race and ethnicity, and patient health insurance status, influence physician prescribing behaviors," principal investigator Rajesh Balkrishnan, an associate professor in the school of public health, said in a university news release.
Read full article here
Posted to Members in the News & Publications on April 10, 2012
Prenatal Antipsychotic Drugs Linked to Motor Delays: Study
Features Katrina Johnson, PhD, Emory University
TUESDAY, April 3 (HealthDay News) -- Infants born to mothers who take antipsychotic medications during pregnancy have significantly lower than normal scores on a standard test of movement, posture and reflexes, a new study has found.
Antipsychotic drugs often are used in the treatment of schizophrenia and bipolar disorder.
Researchers from Emory University in Atlanta compared the neuromotor skills of more than 300 infants at age 6 months. Some of the babies' mothers took either antipsychotic drugs or antidepressants during pregnancy, and some took no psychiatric medications.
Infants born to mothers who took antipsychotics had much lower scores on the neuromotor test than those born to mothers who took antidepressants or no psychiatric medications. Only 19 percent of infants exposed to antipsychotic medications had normal test results.
Read full article here
Posted to Members in the News & Publications on April 10, 2012
Emory Health Blog: Stigma and Shame Block Mental Health Treatment in Black Community
Features Sarah Vinson, MD, Emory University
As Dr. Sarah Vinson rotated through her first year of clinical work as a Child Psychiatry Fellow in the Department of Psychiatry and Behavioral Sciences at Emory, she quickly became aware that there are some significant roadblocks in getting people in the African-American community engaged in treatment for mental health problems.
“Misinformation, an absence of trust in the system, racism and financial circumstances are some of the forces that can create barriers in making appropriate decisions about seeking treatment,” says Vinson.
Read the full article here
Posted to Members in the News & Publications on April 03, 2012
Hopelessness and Lack of Connectedness to Others as Risk Factors for Suicidal Behavior Across the Lifespan: Implications
Features David Goldston, PhD, Duke University
Abstract
The rates of suicide attempts and death by suicide vary considerably over the lifespan, highlighting the influence of different contextual, risk, and protective factors at different points in development (Daniel & Goldston, 2009). Hopelessness and lack of connectedness to others are two factors that have been associated with increased risk for suicidal thoughts and behaviors across the lifespan. The primary purposes of this paper are to describe how hopelessness and lack of connectedness to others may contribute to risk for suicidal behaviors, and to outline empirically supported cognitive-behavioral interventions for these difficulties at three developmental periods during which suicidal behavior is prevalent: (a) adolescence and young adulthood, (b) middle adulthood, and (c) older adulthood. This paper is not intended as an exhaustive review, but rather an overview of selected developmental issues related to hopelessness and lack of connectedness to others as risk factors for suicidal behavior. Special emphasis is given to clinical implications for cognitive-behavioral interventions, which are illustrated through case conceptualizations and examples at each developmental period.
Read the full article here
Posted to Members in the News & Publications on April 03, 2012
Safety Planning Intervention: A Brief Intervention to Mitigate Suicide Risk
Features Gregory Brown, PhD, University of Pennsylvania
Abstract
The usual care for suicidal patients who are seen in the emergency department (ED) and other emergency settings is to assess level of risk and refer to the appropriate level of care. Brief psychosocial interventions such as those administered to promote lower alcohol intake or to reduce domestic violence in the ED are not typically employed for suicidal individuals to reduce their risk. Given that suicidal patients who are seen in the ED do not consistently follow up with recommended outpatient mental health treatment, brief ED interventions to reduce suicide risk may be especially useful. We describe an innovative and brief intervention, the Safety Planning Intervention (SPI), identified as a best practice by the Suicide Prevention Resource Center/American Foundation for Suicide Prevention Best Practices Registry for Suicide Prevention (www.sprc.org), which can be administered as a stand-alone intervention. The SPI consists of a written, prioritized list of coping strategies and sources of support that patients can use to alleviate a suicidal crisis. The basic components of the SPI include (a) recognizing warning signs of an impending suicidal crisis; (b) employing internal coping strategies; (c) utilizing social contacts and social settings as a means of distraction from suicidal thoughts; (d) utilizing family members or friends to help resolve the crisis; (e) contacting mental health professionals or agencies; and (f) restricting access to lethal means. A detailed description of SPI is described and a case example is provided to illustrate how the SPI may be implemented.
Read the full article here
Posted to Members in the News & Publications on April 03, 2012
Working With the Suicidal Client Who Also Abuses Substances
Features David Goldston, PhD, Duke University
Abstract
Substance use disorders and suicidal thoughts and behaviors commonly co-occur in adolescent and adult psychiatric populations and are often functionally interrelated. Although the evidence base for treatment of this population is sparse, integrated cognitive behavioral treatment (CBT) protocols, or those that rely heavily on CBT techniques, hold promise. In this paper, we provide an overview of the evidence-based literature for interventions that target suicidal behavior and substance use disorders with adults and adolescents. We then discuss the manner in which these behaviors may be functionally interrelated and offer a conceptual framework (S-O-R-C) to guide case conceptualization and treatment planning for clients with co-occurring suicidality and substance use disorders. Next, we provide a case example of a client with suicidal behavior and an alcohol use disorder and demonstrate how to apply an integrated CBT treatment protocol to this case. This case example is followed by a more general discussion about the potential advantages of integrated CBT protocols for suicidality and substance use disorders, guidelines for prioritizing treatment targets and skill selection for each individual client, and other important treatment considerations. We conclude with recommendations for future research in this area.
Read the full article here
Posted to Members in the News & Publications on April 03, 2012
Health Behavior Theories and Research: Implications for Suicidal Individuals’ Treatment Linkage and Adherence
Features Cheryl King, PhD, University of Michigan
Abstract
Treatment linkage and adherence to psychotherapeutic interventions can be challenging with suicidal individuals. Health behavior theories, specifically the Health Belief Model, Stages of Change, and Theory of Planned Behavior, focus on individuals' beliefs, their readiness to change, their perceptions of illness severity and "threat," their perceptions of significant others' attitudes toward illness and treatment, and their behavioral intentions to change. These constructs have relevance both for understanding suicidal individuals' behaviors related to treatment utilization and for understanding cultural variations in these behaviors. Furthermore, these theories have implications for clinical practices aimed at facilitating improved treatment follow-through and adherence. After describing the theories and their constructs, clinical examples are provided to illustrate applications to practice with suicidal individuals.
Read the full article here
Posted to Members in the News & Publications on April 03, 2012
Working With Suicidal Clients: Not Business As Usual
Features David Goldston, PhD, Duke University
Abstract
In this introduction to a special series of articles on working with suicidal clients, we note that much of the recent growth in theory and research pertaining to suicidal individuals has been contributed by cognitive-behavioral theorists and researchers. This work has established that suicidal people manifest important cognitive vulnerabilities that can be addressed in therapeutic interventions specifically designed for them. Studies to date have produced outcomes that support this framework. We provide brief previews of the collection of articles that follow, which cover safety planning, protocols for evaluating risk, the utility of health behavior theory for informing treatment, mindfulness-based approaches for suicidality, developmental and family considerations, intensive inpatient CBT for individuals in the military, integrated interventions for substance abuse and suicidal behaviors, and coping with the impact of client suicide. We conclude that clinicians are now in a position to begin moving beyond a “therapy as usual” mindset in working with suicidal clients.
Read the full article here
Posted to Members in the News & Publications on April 03, 2012
Louisville: Raising a generation in the technology age: What are parents to do?
Thursday, April 19 at 7PM
Goals:
1. Review the positive and negative impacts of growing up in a
Techno generation
2. Review where tweens and teens spend their time on line
3. Review online risks for kids and teens
Download the program flier here
Posted to Archived News on April 03, 2012
First Annual Greden Scholar Psychiatry Lecture to Address Mood Disorders
Special Department of Psychiatry Grand Rounds presents the first annual John F. Greden, M.D., Scholar in Residence Lecture, presented by Husseini Manji, M.D., FRCPC, Global Therapeutic Area Head, Neuroscience Janssen Research & Development, LLC.
The talk “Developing Novel Plasticity-Based Therapeutics for Severe Mood Disorders” will be held Wednesday, March 28, from 10:15 a.m. to noon at the Rachel Upjohn Building — Garden Level Auditorium, 4250 Plymouth Road.
Refreshments will be served.
Background on the event:
In 2007, after more than 22 years, John F. Greden, M.D., stepped down as chair of the University of Michigan Department of Psychiatry to devote his attention to his role as executive director of the U-M Depression Center. A widely respected leader, Greden led the department with consummate vision and commitment, expanding U-M’s position in the forefront of academic psychiatry.
To honor Greden for his exceptional contributions, the Department of Psychiatry established the John F. Greden, M.D., Scholar in Residence Program, providing an ongoing opportunity to pay tribute to Dr. Greden for his leadership, mentorship, and academic achievements.
The program will allow the department to bring a distinguished expert in depression and other mood disorders, to spend time at the U-M each year. The Greden Scholar will give a lecture, meet with faculty and trainees, and expand our focus on the study and treatment of depressive illnesses.
Posted to Archived News on March 26, 2012
Lifestyle Tips for Treatment-Resistant Depression
Features Dean F. MacKinnon, MD, Johns Hopkins University
If you have treatment-resistant depression, getting expert medical and psychological treatment is crucial. But recovery isn't only about dutifully taking your medicine and seeing your therapist. There is actually a lot that you can do on your own to support your treatment.
"Because some treatments have already failed you, you want to do everything you can to improve your chances of success," says Ian A. Cook, MD, director of the Depression Research Program at the University of California, Los Angeles. "That includes paying more attention to your lifestyle -- your stress levels, your sleep, your exercise, and your diet." Making some changes -- when combined with treatment -- can have a big impact on your health, Cook tells WebMD.
Posted to Members in the News & Publications on March 14, 2012
A Hope that Don Cornelius’ Apparent Suicide Opens Door on Taboo Topic
Features Sean Joe, PhD, LMSW, University of Michigan
When the news broke of the death of cultural icon Don Cornelius, shock and condolences permeated the Twittersphere and beyond.
Alongside all the praise and accolades of the history maker, many suicide prevention advocates were hoping that his apparent suicide would give people an avenue for talking about something we don't like to discuss.
"This may be an opportunity, since he was so very well-known and such a cultural icon in the black community, to stir up some discussion about suicide among black people and ways to head it off or prevent it to begin to bring the figures down," said Dr. Alvin Poussaint, author and a psychiatry professor at Harvard Medical School.
Posted to Members in the News & Publications on March 09, 2012
U-M experts: Depression a serious struggle for many college students
Features John F. Greden, MD, University of Michigan
Hailey MacVicar had just moved to a new place. She didn't know anyone, nothing was familiar and her workload was piling up, getting more difficult by the day.
She had just started college. And she was depressed.
"In college there's already a million different stressors and a million different things to worry about. Everything piles up," the University of Michigan freshman said. "In high school you could maybe take a day off and sleep in, but you can't take a day off here because you miss too much.
"It's really never ending."
Posted to Members in the News & Publications on March 09, 2012
Few Depressed College Students Receive Adequate Care
Features Daniel Eisenberg, PhD, University of Michigan
Less than one in four college students with symptoms of serious depression receives adequate treatment. Current health care services on campus might not be sufficient for delivering good quality mental health care, according to a new study in the journal General Hospital Psychiatry.
The study found that only 22 percent of students who reported symptoms of serious depression in the past year received minimally adequate care. Thirteen percent of students who reported signs of depression had no contact with a healthcare professional about the problem. Among students with depressive symptoms and thoughts of suicide, only 34 percent received minimally adequate care.
"It's a little surprising that adequacy of care is just as low among college students as it is in general adult population," said Daniel Eisenberg, Ph.D., associate professor at the School of Public Health at the University of Michigan in Ann Arbor and lead author of the study. College students are a subgroup who should be getting better treatment than the general public, because they usually have access to healthcare facilities on campus, some of which provide free or low-cost care, he noted.
Posted to Members in the News & Publications on March 09, 2012
Greden appointed board president of national suicide prevention organization
Features John F. Greden, MD, University of Michigan
The American Foundation for Suicide Prevention (AFSP) has named John F. Greden, M.D., as its new board president.
Greden is the executive director of the University of Michigan Comprehensive Depression Center, the Rachel Upjohn Professor of Psychiatry and Clinical Neurosciences in the Department of Psychiatry, and research professor at the Molecular and Behavioral Neuroscience Institute.
“We are fortunate to have Dr. Greden in this important volunteer role within AFSP. As president of the board, he will help to guide our organization over the next several years as we expand suicide prevention research, education and advocacy, as well as programs for those bereaved by suicide,” says AFSP Executive Director Robert Gebbia. “Dr. Greden’s clinical and scientific expertise, together with his passion for our cause and leadership abilities, will be invaluable in advancing our suicide prevention mission.”
Posted to Members in the News & Publications on March 09, 2012
Helping cancer patients cope with depression
Features Michelle Riba, MD, University of Michigan
Because the emotional aspects of cancer are just as hard, and often harder, than the physical aspects, even the most optimistic among us are susceptible to depression. Too often, people are reluctant to seek help and a treatable condition goes untreated.
In the video below, which recently aired on the PBS show A Wider World, Dr. Michelle Riba, chair of the University of Michigan Comprehensive Cancer Center PsychOncology Program, and survivor Mel Majoros discuss depression, and Mel talks candidly about her own struggle with it. Together, they offer tips to cope with and combat this all too common condition.
Click here to read the full article
Posted to Members in the News & Publications on March 05, 2012
Mayo Clinic: “Windows into Mood: Stories of Depression and Mania”
“Windows into Mood: Stories of Depression and Mania” will be held on May 12, 2012. This program will give an overview exploring mood disorders with an emphasis on patient stories, diagnosis, treatment intervention and recovery. A special focus will be exploring mood and creativity through biographical review, scientific data, and performance.
Click here to download the brochure for more information
Posted to Events on March 05, 2012
At UMass Medical, brain ‘pacemaker’ targets depression
Features Anthony Rothschild, MD, University of Massachusetts
It sounds like deep space, but actually it’s a deep section of the human brain thought to be responsible for bad moods. If that mood never goes away, even with treatment, it’s called chronic or clinical depression.
Research using modern imaging studies a few years ago found that the area functions differently — it becomes overactive — in people who are chronically depressed and have tried everything from medication to electroshock therapy.
There may be new hope through a pacemaker-like device similar to those used to treat Parkinson’s disease.
Posted to Members in the News & Publications on March 05, 2012
Doctor, (don’t) heal thyself: Self-prescribing declines
Features Constance Guille, MD, Medical University of South Carolina & Srijan Sen, MD, PhD, University of Michigan
NEW YORK (Reuters) - Far fewer doctors-in-training are prescribing themselves medication than in the past, suggests a new study.
Less than one percent of residents surveyed said they wrote themselves a prescription for an allergy medication, antidepressant or another drug over the course of a year.
In a similar study from more than a decade ago, over half of all medical trainees reported self-prescribing, which many consider ethically questionable.
Posted to Members in the News & Publications on March 01, 2012
Susan Lehmann, MD, receives Berkheimer Faculty Education Scholar Fund
Features Susan Lehmann, MD, Johns Hopkins University
Susan Lehmann, M.D., Director of the Geriatric Psychiatry Day Hospital and the Psychiatry Clerkship Director has been awarded the first Berkheimer Faculty Education Scholar Award by School of Medicine's Institute for Excellence in Education to develop a curriculum and materials to teach future physicians about psychiatric illnesses that affect older people. The Institute works to improve medical education, support educational scholarship and recognize educators at Johns Hopkins.
Posted to Members in the News & Publications on February 24, 2012
UCSF: 7th Annual Robert S. Wallerstein, MD Visiting Scholar Lectureship
This year’s Robert S. Wallerstein, MD Visiting Scholar Lectureship will continue to showcase psychoanalytic knowledge and clinical expertise that influence psychiatry, psychotherapy, and psychoanalysis. It is with great pride we host our 7th annual visiting scholar Dr. Robert Michels, from Cornell University; Weill Medical College of Cornell University; and Columbia University Center for Psychoanalytic Training and Research, to highlight the connection between observable clinical phenomena and the meaningful synthesis of contemporary psychoanalytic theory and technical knowledge.
To learn more about the lectureship and how to register, click here to download the flyer (PDF)
Posted to Archived News on February 24, 2012
The Johns Hopkins 26th Annual Mood Disorders Research/Education Symposium
DESCRIPTION
Mood Disorders are among the most common illnesses in the world. An estimated 20 percent of adults suffer from depression or bipolar disorder. Mood disorders are also one of the leading causes of disability worldwide. Despite the availability of effective treatments, the majority of individuals never receive adequate treatment. There is a critical need for improved knowledge about mood disorders including barriers to care, factors that interfere with remaining in care, and the complexity of the diseases. A major factor contributing to poor treatment outcomes is under recognition of comorbid conditions such as alcohol abuse, substance abuse, and anxiety disorders. Each year the Mood Disorders Research/Education Symposium strives to improve knowledge about and treatment of mood disorders. This year the Symposium’s theme is “The Many Faces of Depression." Speakers have been selected to address the diverse and complex patterns of presentation of depression and bipolar disorder that complicate diagnosis as well as emerging treatments to address these illnesses.
One area of emerging knowledge has been in the recognition of the role that diversity plays in illness. Dr. Pamela Collins, Director of the Office for Research on Disparities and Global Mental and the Health Director of the Office of Rural Mental Health Research at the National Institute of Mental Health/NIH will address the commonalities and particulars of depression as it relates to diverse ethnic groups. There has also been a dramatic expansion of our understanding of complicated presentations of mood disorders. Dr. Francis Mondimore, Associate Clinical Director in the Department of Psychiatry and Behavioral Sciences at The Johns Hopkins Hospital, a recognized expert in the treatment of mood disorders, will discuss the wide range of clinical presentations of mood disorders and the implication of this for diagnosis and treatment. Advances are also occurring in the area of child and adolescent psychiatry. Dr. John Walkup, Vice Chair of the Department of Psychiatry and Director of the Division of Child and Adolescent Psychiatry at New York-Presbyterian Hospital/Weill Cornell Medical Center will address the clinical presentation of depression in teens, and the opportunities and challenges that clinicians face in treating adolescents with mood disorders. Comments from previous Symposium attendees underscore the need for more knowledge about psychotherapy treatment options. Dr. Jesse Wright, Medical Director of the University of Louisville Depression Center will address “Using Computer Technology and Self-Help in Psychotherapy for Depression.” Dr. Kay Redfield Jamison, an internationally recognized author and Professor of Psychiatry at Johns Hopkins, will discuss “Writers and the Many Faces of Depression.” Additionally, a family member of someone with a history of a mood disorder will be interviewed by Dr. J. Raymond DePaulo, Jr. the symposium’s founder. Finally, Dr. Karen Swartz, will interview an individual with bipolar disorder to demonstrate methods of examination and to review the signs and symptoms of mood disorders; she will also discuss experiences with treatment and the impact that illness has had on her life. She will also discuss her commitment to the arts and education as a method for addressing stigma.
OBJECTIVES
After attending this activity, the participant will demonstrate the ability to:
Relate comprehensive and current information to patients and family members to help them cope and recover from these mood disorders
Discuss the influences of culture in diagnosing mood disorders in diverse populations and culturally-based challenges in treatment
Explore how patients with mood disorders can be mistakenly diagnosed with ADHD, borderline personality disorder, and other psychiatric problems and lay out principles for accurate diagnosis
Increase knowledge about the clinical presentation and treatment of mood disorders in children and adolescents
Discuss advancements in mood disorders research and treatment utilizing computer assisted technologies
TRANSPORTATION AND PARKING
We recommend that participants carpool and use public transportation (bus, Metro, Light Rail, MARC and taxi) directly to the Johns Hopkins Medical Campus since parking for CME participants is very limited.
Telephone number for bus, Metro, Light Rail and MARC: (410) 539-5000 or (800) 543-9809
PLEASE NOTE: If you plan to drive, participants should use the satellite parking lot at 3700 East Monument Street (current rate is $5 per day) and take the complimentary shuttle directly to and from the Turner Building. Only those vehicles with handicapped license plates will be able to park in the Rutland garage, which is entered from Madison Street. Visit our website for driving/parking directions: www.HopkinsCME.edu.
OPTIONAL BOX LUNCH
Attendees have the option to purchase a box lunch at $10 each, which includes a choice of a Turkey and American Cheese, Ham and Swiss Cheese, or Tuna Salad Sandwich, or Grilled Vegetable Wrap, chips, whole fruit, cookie and choice of drink. Please indicate your preference on the registration form. Box lunches must be pre-ordered. No on-site orders will be accepted.
Policy On Speaker And Provider Disclosure
It is the policy of the Johns Hopkins University School of Medicine that the speaker and provider disclose real or apparent conflicts of interest relating to the topics of this educational activity, and also disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentation(s). Johns Hopkins University School of Medicine OCME has established policies in place that will identify and resolve all conflicts of interest prior to this educational activity. Detailed disclosure will be made in the activity handout materials.
Posted to Archived News on February 22, 2012
University of Michigan Depression on College Campuses Conference
Many protective factors can help individuals at risk of depressive illnesses to maintain wellness and prevent relapse, including resilience, social connections, mindfulness, and positive thinking. How can we reframe the campus mental health mission to include prevention of depression through a focus on student strengths?
Join us for the 10th Annual Depression on College Campuses Conference to learn about new research findings and innovative strategies to help college campuses integrate prevention, resilience, and positive mental health into their ongoing efforts for students.
March 7-8, 2012
Rackham Graduate School
915 East Washington Street
Ann Arbor, Michigan
The conference will feature a choice of intensive three-hour workshops in addition to keynote presentations, panel discussions, and concurrent sessions.
Online registration is now open! To register, please go to www.depressioncenter.org/docc
Registration is FREE for all students from any campus. Registration fee for non-students is $130 before February 1st, and $145 after February 1st.
For more information, please visit www.depressioncenter.org or contact Trish Meyer at 734-763-7495 or meyerpa@umich.edu. We hope to see you in March!
Depression on College Campuses is presented by the U-M Depression Center, in partnership with schools and colleges of the University of Michigan.
Posted to Archived News on February 22, 2012
ENHANCED Act
Since the founding of the NNDC, widespread concern for the public health challenge of depression has led to unprecedented legislative actions to establish and fund Centers of Excellence dedicated to depression and bipolar disorder.
The ENHANCED Act of 2009 (to Establish a National Health-Advancing Network of Centers of Excellence for Depression) was drafted in response to a whitepaper authored by NNDC members. The concept was strongly endorsed by an impressive collection of national health experts and by over 50 professional and advocacy groups, including the National Alliance on Mental Illness, the American Psychiatric Association and the American Psychological Association.
The ENHANCED Act, introduced with bipartisan support and subsequently passed in 2009 as an amendment to the 2010 Patient Protection and Affordable Care Act, is a tangible example of the power of a network to focus national attention on the advancement of care, treatment and maintenance of wellness.
Highlights of the advancements promoted by the ENHANCED ACT include the:
- creation of a national network for the development and expansion of depression Centers of Excellence to increase access to effective, evidence-based treatments, and to facilitate education and training, advance knowledge and eradicate the stigma associated with mood disorders
- development and dissemination of evidence-based treatment standards, clinical guidelines and protocols to improve accurate and timely diagnosis of depression and bipolar disorders
- fostering of multidisciplinary, translational, patient-oriented research collaborations between academic and community-based centers
- formation of a national information database to facilitate multidisciplinary, large-sample research studies
Download a PDF Fact Sheet about the ENHANCED ACT here [LINK].
Download a full text PDF of the ENHANCED ACT as enacted by Congress here [LINK]
Unfortunately, given the current economic and political climate, funding to support the ENHANCED Act has yet to be approved. The NNDC is committed to keeping policy-makers focused on funding this vital national priority. When compared with the cost of not acting, the impact on the federal budget of investing in the ENHANCED Act over five years is small –just one-tenth of one percent of what it costs the U.S. each year in lost productivity due to depressive illnesses.
Posted to Policy & Advocacy on February 21, 2012
2012 Conference: Save The Date
Posted to Annual Conference on February 15, 2012
Knowledgeable Society Can Bring Hope
Paul E. Keck, Jr., MD, University of Cincinnati & Lindner Center of HOPE
Abraham Lincoln, Virginia Woolf, Eugene O'Neill, Leo Tolstoy, Tennessee Williams, Winston Churchill, Charles Dickens, Carrie Fisher, Mike Wallace, Patty Duke, Demi Lovato, Catherine Zeta-Jones - all talented and gifted individuals, each has made unique contributions to society, are heroes to many and all have touched our lives in one way or another.
Is it surprising that these individuals have experienced a mental illness such as schizophrenia, bipolar disorder, obsessive compulsive disorder, and/or personality disorder? It shouldn't be. Mental illness affects one in four individuals, and five of the top 10 causes of disability worldwide are due to psychiatric illness. They strike men and women in almost equal proportions and affect people of all ages, ethnic groups and socioeconomic levels.
Posted to Members in the News & Publications on January 23, 2012
Great wits and madness: More near allied?
Kay Redfield Jamison, PhD, Johns Hopkins University
A purported association between creativity and psychopathology is ancient, persistent and controversial. Biographical research, studies of living artists and writers, and investigations into the cognitive and temperamental factors linked to both creativity and mood disorders suggest a more specific link to bipolar illness. A new, large and well-designed population-based study adds further support to this connection.
Posted to on January 23, 2012
Transmission & Prevention of Mood Disorders…
William Beardslee, MD, et al
Objective: To provide a conceptual review of the literature on children of depressed parents
over the past 12 years. Method: This selective review focused on published studies that
delineate the diagnosis of depression in parents, have large samples, describe children 6 to 17
years old, and are methodologically rigorous. The review emphasized conceptual advances
and major progress since 1998. Recent efforts in prevention research were discussed, gaps in
the existing literature were noted, and directions for targeted research on children of depressed
parents were highlighted. Results: Over the past 12 years there has been considerable progress
in delineating the gene-by-environment interplay in determining the range of outcomes in
children. In addition, progress has been made in identifying risk mechanisms and moderators
that underlie the transmission of disorder and in developing effective prevention programs.
Conclusions: This review highlights directions for further research, including different areas
affected by parental depression in parents and children, and in understanding the underlying
mechanisms involved in the intergenerational transmission of depression, so that preventive
and treatment efforts can be tailored effectively. J. Am. Acad. Child Adolesc. Psychiatry, 2011;
50(11):1098 –1109.
Posted to Members in the News & Publications on January 23, 2012
A measure of glucocorticoid load provided by DNA methylation…
Richard S. Lee, PhD, Johns Hopkins University, et al
Given the contribution of cortisol dysregulation to neuropsychiatric and metabolic disorders, it is important to be able to accurately compute glucocorticoid burden, a measure of allostatic load. One major problem in calculating cortisol burden is that existing measures reflect cortisol exposure over a short duration and have not been proven to reliably quantify cortisol burden over weeks or months. We treated two cohorts of mice with corticosterone in the drinking water and determined the relationship between serial plasma corticosterone levels drawn over 4 weeks and the whole-blood DNA methylation (DNAm) changes in a specific glucocorticoid-sensitive gene, Fkbp5, determined at the end of the treatment period.
Posted to Members in the News & Publications on January 23, 2012
Do Antidepressants Cause Suicide?
Anthony Rothschild, MD, University of Massachusetts
In this article, I provide a brief outline of the discussion of two timely topics: whether antidepressants “really work” and whether antidepressants “can cause suicide.”
Clinicians have successfully used antidepressants to treat patients suffering from depression for 50 years. Kirsch et al. published in 2008 in PLoS Medicine a meta-analysis of the data held by the Food and Drug Administration from 35 randomized, placebo-controlled trials of four newer antidepressants in the acute treatment of major depression. The authors claimed that although antidepressants are statistically superior to placebo, the magnitude of the drug-placebo difference is small, and that these differences were only clinically relevant in patients with severe depression.
Posted to Members in the News & Publications on January 23, 2012
VA Wants to Collect Clinical Laboratory Blood Specimens from One Million Veterans…
Features Jennifer Hoblyn, MD, MPH, Stanford University
Veterans Administration calls it a “genomics game changer” and is now building a treasure trove of data for health researchers, including pathologists
Imagine a massive data repository that contains the blood specimens and genetic information of thousands of individuals, along with a detailed medical history for each patient that may reach back as far as 20 years! Such a data repository, long the dream of many pathologists and clinical laboratory scientists, will soon become a reality.
That’s because the Department of Veterans Affairs (VA) has announced what it calls the “Million Veteran Program” (MVP). It is actively recruiting one million veterans who are willing to provide a blood specimen. These specimens will become part of a database that contains the full electronic health records (EHR) of millions of veterans.
Posted to Members in the News & Publications on January 20, 2012
With Depression, Helping Others May in Turn Help You
Features Michelle Riba, MD, University of Michigan
MONDAY, Jan. 2 (HealthDay News) — Doing something nice for someone else often leaves people feeling good about themselves and positive about their place in the world.
But does that mean practicing random acts of kindness has scientifically proven therapeutic value in treating mood disorders like depression?
Yes, according to a growing body of research that has found that “positive activity interventions” — like helping someone with groceries, writing a thank you note or even counting your blessings — can serve as an effective, low-cost treatment for depression.
Posted to Members in the News & Publications on January 20, 2012
Antidepressants Linked to Hypertension in Babies
Features Jennifer Payne, MD, Johns Hopkins University
Pregnant women who take certain anti-depressants can significantly increase their chance of having babies that develop a condition known as pulmonary hypertension, according to a study published Thursday in the British Medical Journal.
An estimated 1 in every 1000 babies born develop pulmonary hypertension, characterized by high blood pressure in the lung arteries, according to the American Academy of Pediatrics.
Posted to Members in the News & Publications on January 20, 2012
Low Vitamin D Associated with Depression
Features E. Sherwood Brown, MD, PhD, University of Texas Southwestern Medical Center
A new study finds that levels of Vitamin D are low among people with depression. The discovery adds to a recent appreciation of the health potential of the vitamin, a nutrient that the body makes from sunlight and that is also found in fish and fortified milk.
Low levels of vitamin D already are associated with a range of health condition including osteoporosis, cardiovascular diseases, neurological ailments and many other disorders. However, experts do not agree on the ideal level of the vitamin and even if supplements can improve health.
Posted to Members in the News & Publications on January 20, 2012
Tackling Prescription Drug Abuse With Formulary Restriction?
Features Stephen M. Strakowski, MD, University of Cincinnati
Editor's Note:
In April 2011, clinicians in 7 Kentucky counties stopped writing alprazolam prescriptions for their patients due to a concerning number of overdoses involving the drug.[1] Fast forward to November 1, when the Centers for Disease Control and Prevention (CDC) issued a press release reporting that the mortality rate from prescription painkiller overdoses has more than tripled in the past decade.[1] Prescription drug abuse, misuse, and overdose are a major concern facing this country and others, and it only appears to be getting worse. What can the medical community do to help address the growing problem? Is banning medication altogether a viable solution? Medscape recently invited Stephen M. Strakowski, MD, to moderate a virtual discussion among psychiatrists Roger D. Weiss, MD, Peter P. Roy-Byrne, MD, and Wilson M. Compton, MD, MPE, on how clinicians can help address this alarming epidemic.
Posted to Archived News on January 20, 2012
Antidepressant expert creates user-friendly book
Features Anthony Rothschild, MD, University of Massachusetts
Internationally renowned depression expert Anthony Rothschild, MD, the Irving S. and Betty Brudnick Endowed Chair in Psychiatry and professor of psychiatry, has created a user-friendly text that digests the current research into best practices with antidepressants to help clinicians who may or may not be mental health experts. The Evidence-Based Guide to Antidepressant Medications, published in December by American Psychiatric Publishing, Inc., is designed to be a comprehensive yet concise and understandable guide that meets the needs of a wide variety of clinicians, including those who may not specialize in mental health, and who may not be familiar with the extensive medical literature on the antidepressant pharmacopeia.
Posted to Archived News on January 20, 2012
Neuralstem’s NSI-189 Trial in Major Depressive Disorder Receives FDA Approval…
Features Maurizio Fava, MD, Massachusetts General Hospital
ROCKVILLE, Md., Dec. 27, 2011 /PRNewswire/ -- Neuralstem, Inc. (NYSE Amex: CUR) announced that it has been approved by the Food and Drug Administration to advance to Phase Ib in its ongoing clinical trial to test its novel neuroregenerative compound, NSI-189, for the treatment of major depressive disorder (MDD). Phase Ib will test the safety and tolerability of the drug in depressed patients. NSI-189 is a proprietary new chemical entity discovered by Neuralstem that stimulates new neuron growth in the hippocampus, an area of the brain that is believed to be involved in MDD as well as other diseases and conditions, such as Alzheimer's disease and post-traumatic stress disorder (PTSD).
Posted to Archived News on January 20, 2012
New book by University of Louisville professor offers personalized anti-depression plan
Features Jesse H. Wright, MD, University of Louisville
LOUISVILLE, Ky. – A new book co-authored by the director of the University of Louisville Depression Center recognizes that depression is different for everyone and provides techniques and strategies for each person to develop a personalized action plan to combat depression.
"Breaking Free from Depression: Pathways to Wellness" is available in paperback now from Guilford Press. An e-book version is currently being developed.
Its authors are Dr. Jesse Wright, director of the UofL Depression Center and professor of psychiatry, and his daughter, Dr. Laura McCray, a family physician with the University of Vermont. They have seen thousands of clinically depressed patients in their practices and understand that there is no one-size-fits-all universal cure.
Posted to Archived News on December 20, 2011
The National Network of Depression Centers: Progress Through Partnership
John F. Greden, MD, University of Michigan
THE CHALLENGE
The time has come to meaningfully transform our nation's strategies for counteracting the scourges of depressive and bipolar illnesses.
Hundreds of excellent studies confirm that major depressive disorders, bipolar illnesses, and related disorders afflict an estimated one of every five Americans, lead the United States and the world in disease burden and disability, and account for more than 30,000 U.S. citizens' deaths annually by suicide while thousands more die earlier because of associated medical consequences.
Read the full article here...
Posted to Archived News on December 16, 2011
2011 Conference Program
2011 Conference Program
Posted to Annual ConferenceArchived News on December 16, 2011
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