TAG: "Mental health"

SSRI use during pregnancy associated with risk of autism in boys


Highest association found during first-trimester exposure for autism.

Irva Hertz-Picciotto, UC Davis

Prenatal exposure to selective serotonin reuptake inhibitors (SSRIs), medications frequently prescribed to treat depression, anxiety and other mental health disorders, is associated with a higher incidence of autism spectrum disorder (ASD) and developmental delays (DD) in male children, a study of nearly 1,000 mother-child pairs has found.

Published online today (April 14) in the journal Pediatrics, the study involved 966 mother-child pairs from the Childhood Autism Risks from Genetics and the Environment (CHARGE) study, a population-based, case-control study at the UC Davis MIND Institute led by professor Irva Hertz-Picciotto, chief of the Division of Environmental and Occupational Health in the UC Davis Department of Public Health Sciences.

“This study provides further evidence that in some children, prenatal exposure to SSRIs may influence their risk for developing an autism spectrum disorder,” Hertz-Picciotto said. “It also highlights the challenge for women and their physicians, to balance the risks vs. benefits from taking these medications, given that a mother’s underlying mental health conditions may also pose a risk to both herself and her child.”

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Facebook feelings are contagious, study shows


Positive posts beget positive posts; negative posts beget negative ones.

James Fowler, UC San Diego

You can’t catch a cold from a friend online. But can you catch a mood? It would seem so, according to new research from the University of California, San Diego.

Published in PLOS ONE, the study analyzes over a billion anonymized status updates among more than 100 million users of Facebook in the United States. Positive posts beget positive posts, the study finds, and negative posts beget negative ones, with the positive posts being more influential, or more contagious.

“Our study suggests that people are not just choosing other people like themselves to associate with but actually causing their friends’ emotional expressions to change,” said lead author James Fowler, professor of political science in the Division of Social Sciences and of medical genetics in the School of Medicine at UC San Diego. “We have enough power in this data set to show that emotional expressions spread online and also that positive expressions spread more than negative.”

There is abundant scientific literature on how emotion can spread among people – through direct contact, in person – not only among friends but also among strangers or near-strangers. Little is known, though, about emotional contagion in online social networks. Yet, in our digitally connected world, Fowler said, it is important to learn what can be transmitted through social media, too.

Fowler worked on the study with Lorenzo Coviello – a Ph.D. student in the electrical and computer engineering department of the UC San Diego Jacobs School of Engineering. Additional coauthors of the paper are: Yunkyu Sohn, political science graduate student at UC San Diego; Adam D. I. Kramer and Cameron Marlow of Facebook; Coviello’s graduate advisor, Massimo Franceschetti, also of the Jacobs School; and Nicholas Christakis of the departments of sociology and medicine at Yale University.

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UC Davis tests smartphone app to help patients with mental illness


Ginger.io enables individuals to actively record their symptoms on a daily and weekly basis.

Ginger.io app

Sacramento-area youth in the early stages of serious mental illness can receive a new smartphone app that helps them detect early warning signs of psychosis, through a one-year, $588,000 grant to the UC Davis Early Diagnosis and Preventive Treatment (EDAPT) Clinic from the Robert Wood Johnson Foundation, to study whether harnessing mobile technology improves patient care.

The app, called Ginger.io, enables individuals to actively record their symptoms on a daily and weekly basis, while information on their movements and daily social contacts, such as the number of incoming telephone calls and text messages, is gathered in the background.

“We are trying to identify the early warning signals that someone is struggling, so we can intervene earlier and hopefully prevent relapse,” said Tara Niendam, assistant professor in the Department of Psychiatry and Behavioral Sciences and director of operations for the EDAPT Clinic. “If an individual is having a bad week, we can reach out to them quickly, rather than waiting for them to call us or come in to the clinic for their next appointment.”

The early stages of psychotic illness, which affects an estimated 2 percent of Americans, represent critical periods for intervention. Eighty percent of individuals relapse within the first five years of receiving a diagnosis. Annual health care costs associated with psychosis are approximately $23 billion. Using Ginger.io, the UC Davis EDAPT clinic aims to improve early identification of symptom exacerbations, giving providers the ability to intervene early in the hope of preventing relapse.

Ginger.io’s three-part platform — patient app, behavioral analytics engine and provider dashboard — gives care providers a window into their patients’ health between office visits. The patient app and behavioral analytics use smartphone sensors to detect abnormalities in the patient’s sleep, communication and movement patterns. Any concerning changes in daily patterns are communicated to the provider via the dashboard, allowing clincians to deliver timely interventions. Ginger.io has offices in San Francisco and Cambridge, Mass.

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Chronic stress predisposes brain to mental illness, study shows


Findings could lead to new therapies to reduce risk of developing mental illness.

Myelin is stained blue in this cross section of a rat hippocampus. Myelin, which speeds electrical signals flowing through axons, is produced by oligodendrocytes, which increase in number as a result of chronic stress. New oligodendrocytes are shown in yellow.

University of California, Berkeley, researchers have shown that chronic stress generates long-term changes in the brain that may explain why people suffering chronic stress are prone to mental problems such as anxiety and mood disorders later in life.

Their findings could lead to new therapies to reduce the risk of developing mental illness after stressful events.

Doctors know that people with stress-related illnesses, such as post-traumatic stress disorder (PTSD), have abnormalities in the brain, including differences in the amount of gray matter versus white matter. Gray matter consists mostly of cells – neurons, which store and process information, and support cells called glia – while white matter is comprised of axons, which create a network of fibers that interconnect neurons. White matter gets its name from the white, fatty myelin sheath that surrounds the axons and speeds the flow of electrical signals from cell to cell.

How chronic stress creates these long-lasting changes in brain structure is a mystery that researchers are only now beginning to unravel.

In a series of experiments, Daniela Kaufer, UC Berkeley associate professor of integrative biology, and her colleagues, including graduate students Sundari Chetty and Aaron Freidman, discovered that chronic stress generates more myelin-producing cells and fewer neurons than normal. This results in an excess of myelin – and thus, white matter – in some areas of the brain, which disrupts the delicate balance and timing of communication within the brain.

“We studied only one part of the brain, the hippocampus, but our findings could provide insight into how white matter is changing in conditions such as schizophrenia, autism, depression, suicide, ADHD and PTSD,” she said.

The hippocampus regulates memory and emotions, and plays a role in various emotional disorders.

Kaufer and her colleagues published their findings in today’s (Feb. 11) issue of the journal Molecular Psychiatry.

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Brain trauma raises risk of later PTSD in active-duty Marines


Deployment-related injuries are biggest predictor, but not the only factor.

Dewleen Baker

Dewleen Baker

In a novel study of U.S. Marines investigating the association between traumatic brain injury (TBI) and the risk of post-traumatic stress disorder (PTSD) over time, a team of scientists led by researchers from the Veterans Affairs San Diego Healthcare System and UC San Diego School of Medicine report that TBIs suffered during active-duty deployment to Iraq and Afghanistan were the greatest predictor for subsequent PTSD, but found pre-deployment PTSD symptoms and high combat intensity were also significant factors.

The findings are published in the Dec. 11 online issue of JAMA Psychiatry.

The team, headed by principal investigator Dewleen G. Baker, M.D., research director at the VA Center of Excellence for Stress and Mental Health, professor in the Department of Psychiatry at UC San Diego and a practicing psychiatrist in the VA San Diego Healthcare System, analyzed 1,648 active-duty Marines and Navy servicemen from four infantry battalions of the First Marine Division based at Camp Pendleton in north San Diego County. The servicemen were evaluated approximately one month before a scheduled 7-month deployment to Iraq or Afghanistan, one week after deployment had concluded, and again three and six months later.

PTSD is a psychiatric condition in which stress reactions become abnormal, chronic and may worsen over time. The condition is linked to depression, suicidal tendencies, substance abuse, memory and cognition dysfunction and other health problems.

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Extended viewing of Boston Marathon bombings media coverage tied to acute stress


Six or more daily hours associated with more symptoms than direct exposure to blasts.

E. Alison Holman, UC Irvine

E. Alison Holman, UC Irvine

Stepping away from the television, computer screen or smartphone in the aftermath of terrorist attacks or mass shootings may be beneficial to your mental health. That’s the takeaway from a new study by UC Irvine researchers showing that six or more daily hours of exposure to media coverage of the Boston Marathon bombings in the week afterward was linked to more acute stress than having been at or near the marathon. Acute stress symptoms increased with each additional hour of bombing-related media exposure via television, social media, videos, print or radio.

“We were very surprised that repeated media exposure was so strongly associated with acute stress symptoms,” said E. Alison Holman, associate professor of nursing science at UC Irvine and the study’s lead author. “We suspect that there’s something about repeated exposure to violent images or sounds that keeps traumatic events alive and can prolong the stress response in vulnerable people. There is mounting evidence that live and video images of traumatic events can trigger flashbacks and encourage fear conditioning. If repeatedly viewing traumatic images reactivates fear or threat responses in the brain and promotes rumination, there could be serious health consequences.”

The study challenges key assumptions about how people react to collective traumas, such as the idea that individuals must be directly exposed to an event to be at risk for stress-related disorders. It also raises questions about the latest edition of the Diagnostic & Statistical Manual of Mental Disorders (DSM-5), which specifically excludes media-based exposure as a potential trigger for trauma response among nonprofessionals.

“In our prior work, we found that early and repeated exposure to violent images from the terrorist attacks of Sept. 11 and the Iraq War may have led to an increase in physical and psychological ailments up to three years [later],” said Roxane Cohen Silver, professor of psychology & social behavior, medicine and public health at UC Irvine and the study’s co-author. “Our new findings contribute to the growing body of research suggesting that there is no psychological benefit to repeated exposure to graphic images of horror.”

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Professor appointed to committee evaluating mental health care for veterans


UC Davis’ Peter Yellowlees joins IOM committee.

Peter Yellowlees, UC Davis

Peter Yellowlees, UC Davis

Peter Yellowlees, professor in the Department of Psychiatry and Behavioral Sciences, has been appointed to a prestigious national committee established by the Institute of Medicine that will assess the quality and availability of mental health care services for veterans who served in the U.S. Armed Forces during Operation Iraqi Freedom (the Iraq war), Operation New Dawn (the Iraq war after August 2010), and Operation Enduring Freedom (the war in Afghanistan).

Yellowlees is an expert in trauma and disaster recovery as well as in telemedicine and the provision of medical services to isolated and hard-to-access patients. He is in Washington, D.C., attending the first committee meeting at the Institute of Medicine.

“Through my membership on this committee, I hope to use my expertise to help improve the quality and accessibility of mental-health care services available to veterans now and in the future,” Yellowlees said. He said he is particularly interested in assisting those veterans suffering from post-traumatic stress disorder who, he believes, could be greatly aided by a variety of online and social networking approaches.

During the next three years, the committee will assess the spectrum of mental health services available across the U.S. Department of Veterans Affairs (VA). The scope of the assessment will include analysis of the quality and capacity of mental health care services within the VA as well as the barriers to care faced by patients using those services. The committee will provide a final report with recommendations to the secretary of the Veterans Administration on increasing effectiveness, improving efficiency and overcoming barriers to mental health care delivery in the VA.

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Interactive tool helps patients talk with physician about depression


Computer program helps users identify symptoms, facilitates discussions with physicians.

Anthony Jerant, UC Davis

Anthony Jerant, UC Davis

Patients who used an interactive computer program about depression while waiting to see their primary care doctor were nearly twice as likely to ask about the condition and significantly more likely to receive a recommendation for antidepressant drugs or a mental health referral from their physician, according to a new study by researchers at UC Davis.

The study, published online today (Nov. 5) in the Journal of the American Medical Association, was conducted to evaluate the effectiveness of a waiting-room intervention that encourages primary care patients to discuss depression symptoms and care with their physician. While patients who received treatment or a referral for depression did not report improved mental health 12 weeks later, the study did show that providing information to patients about depression is an effective way to start the conversation in a primary care setting about mental health.

“We have developed an easy-to-use tool to help people with depression identify the symptoms, feel more comfortable discussing it with a primary care provider and accept treatment if it is needed,” said Anthony Jerant, professor of family and community medicine at UC Davis and senior author of the study. “This brief and relatively inexpensive intervention could be easily and widely implemented in a variety of health care settings.”

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UC Davis awarded grant to help sexually exploited youth


Grant will provide participants with mental health screen, interview, group therapy sessions.

Anthony Urquiza, UC Davis

Anthony Urquiza, UC Davis

The Department of Justice’s Office of Justice Programs has awarded the UC Davis CAARE Center a two-year, $400,000 grant to provide assessment, group therapy, individual therapy and case management for underage youth and youth who are at risk of sexual exploitation.

The grant will provide participants with a mental health screen and interview. Participants will attend group therapy sessions to address trauma-related health symptoms, learn preliminary coping skills and encourage their involvement in future mental health services.

“California has recently been identified as having a disportionate number of sexually exploited youth, especially teens who have been arrested for prostitution or are at risk of re-victimization through prostitution,” said Anthony Urquiza, director of the UC Davis CAARE Center. “Research has repeatedly identified these youth as having a history of child sexual abuse, as well as other types of victimization. By identifying these youth and providing treatment options, we hope we can break the cycle of victimization and offer a pathway to a safer life.”

The grant will fund training for professionals who work with sexually exploited youth and community presentations to raise awareness and shift attitudes about sexually exploited victims and their pattern of victimization. A key focus of the training will be recognizing and treating the mental health issues specific to this patient population.

Underage youth will be identified through Sacramento County Juvenile Hall or referred through community partners of CAARE Center.

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UC to participate in study of schizophrenia in 22q11.2 deletion syndrome


International consortium encompasses 22 institutions in four continents.

Tony Simon, UC Davis

Tony Simon, UC Davis

Researchers at the UC Davis MIND Institute and UCLA will participate in an international consortium spanning four continents that will study the genetics of schizophrenia and other psychiatric disorders in chromosome 22q11.2 deletion syndrome through a four-year, $12 million grant from the National Institute of Mental Health to the International Consortium on Brain and Behavior in 22q11.2 Deletion Syndrome.

The consortium encompasses 22 institutions in North America, Europe, Australia and South America. Researchers will collaborate on investigations of the genetic causes for the high rates of schizophrenia in children and adults with the disorder. Approximately 25 to 30 percent of teens and young adults with 22q11.2 deletion syndrome go on to develop schizophrenia, compared with only 1 percent of the general population.

“This funding will provide us with the opportunity to mount a virtually worldwide collaborative effort to identify the risk and protective factors for psychiatric illness in this very high-risk population,” said Tony J. Simon, a cognitive neuroscientist and professor in the Department of Psychiatry and Behavioral Sciences who directs the 22q11.2 deletion syndrome program at the MIND Institute.

“This consortium brings together 22 clinical and five basic science sites with extremely dedicated clinicians who are working together to improve patient care and long term-outcomes for people with 22q11.2 deletion syndrome,” he said.

The condition affects an estimated 1 in 2,000 to 4,000 people and is characterized by congenital heart defects that often require surgery, an opening in the roof of the mouth, immune system dysfunction, and significant feeding and swallowing issues. Most children have developmental delays or learning disabilities and delayed language acquisition.

Some children also may be diagnosed with autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder or anxiety. Later in life, people with 22q11.2 deletion syndrome are at an increased risk of developing psychiatric illnesses such as depression and anxiety, as well as schizophrenia.

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Varenicline helps smokers with depression to quit


Smoking-cessation drug helps some patients quit without worsening depressive symptoms.

Robert Anthenelli, UC San Diego

Robert Anthenelli, UC San Diego

About half of smokers seeking treatment for smoking cessation have a history of depression. Compared with smokers who are not depressed, those who suffer from a major depressive disorder (MDD) have greater difficulty quitting.

In a Pfizer-sponsored clinical trial to assess the effect of varenicline (Chantix) on smoking cessation, as well as mood and anxiety levels in smokers with current or a history of depression, researchers concluded that the drug does help some of these patients to quit smoking without worsening symptoms of depression or anxiety.

The study was led by Robert Anthenelli, M.D., associate chief of staff for mental health at VA San Diego Healthcare System and professor of psychiatry at UC San Diego School of Medicine, where he directs the Pacific Treatment and Research Center.  It will be published Sept. 17 in the journal Annals of Internal Medicine.

“Depression and smoking are among the leading causes of disability and death in the world, yet studies testing smoking cessation drugs generally exclude participants who are taking antidepressants, and relapse rates are high among those who do manage to quit,” said Anthenelli. “To our knowledge, this was the first randomized, controlled study of the prescription smoking-cessation drug, varenicline, which we found to help patients with depression quit smoking, without worsening their depressive symptoms.”

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Psychiatric patients who quit smoking less likely to be rehospitalized


UCSF study debunks myth that smoking can be helpful in mental health treatment.

Patients who participated in a smoking-cessation program during hospitalization for mental illness were able to quit smoking and were less likely to be hospitalized again for their psychiatric conditions, according to a new study by researchers at Stanford and UC San Francisco.

The findings counter a longstanding assumption held by many mental-health experts that smoking serves as a useful tool in treating some psychiatric patients.

Smoking among such patients has been embedded in the culture for decades, with cigarettes used as part of a reward system. Indeed, clinicians sometimes smoke alongside patients as a way of creating a rapport with them, said Judith Prochaska, Ph.D., M.P.H., associate professor of medicine at the Stanford Prevention Research Center who led the study while an associate professor at UCSF. The result is that psychiatric patients are among the country’s most prolific smokers and among those most likely to die of smoking-related ailments, Prochaska said.

Nearly half of the cigarettes sold in the United States are to people with psychiatric or addictive disorders, according to data from the U.S. Centers for Disease Control and Prevention. And the average life expectancy for people with severe mental illness is 25 years less than that of the general population, and their leading cause of death is chronic illness, mostly tobacco-related.

The study is the first to examine the impact of a stop-smoking intervention in adult psychiatric patients. It was published online Aug. 15 in the American Journal of Public Health.

Co-authors of the study are Stephen Hall, M.D., director of acute services at Langley Porter Psychiatric Institute; Kevin Delucchi, Ph.D., professor of biostatistics in psychiatry; and Sharon Hall, Ph.D., professor of psychiatry, all of UCSF.

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