TAG: "Mental health"

Schizophrenia and happiness


UC San Diego research suggests that mental illness doesn’t preclude enjoying life.

Dilip Jeste, UC San Diego

Schizophrenia is among the most severe forms of mental illness, yet some people with the disease are as happy as those in good physical and mental health according to a study led by researchers at the UC San Diego School of Medicine.

The study is published online this week in the journal Schizophrenia Research.

“People tend to think that happiness in schizophrenia is an oxymoron,” said senior author Dilip V. Jeste, M.D., Distinguished Professor of Psychiatry and Neurosciences.

“Without discounting the suffering this disease inflicts on people, our study shows that happiness is an attainable goal for at least some schizophrenia patients,” said Jeste, who is also the Estelle and Edgar Levi Chair in Aging and director of the Sam and Rose Stein Institute for Research on Aging at UC San Diego.  “This means we can help make these individuals’ lives happier.”

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3 of 4 California children with mental health needs don’t get treatment


Barriers to care persist, even though 95 percent have health insurance.

More than 300,000 California children between the ages 4 and 11 need mental health care, but only one in four is treated, according to a new policy brief from the UCLA Center for Health Policy Research — this, despite the Centers for Disease Control and Prevention recommending early-childhood intervention as a critical step in reducing the severity of mental health problems in adulthood.

“Without early assessment, you miss warning signs, as well as opportunities to intervene,” said D. Imelda Padilla-Frausto, a researcher at the center and lead author of the study. “Waiting can lead to more serious problems later.”

While about 8.5 percent of all California children in the 4-to-11 age group are identified as having mental health care issues — including conduct problems, emotional symptoms, hyperactivity and problems with peers — parents reported that 70.8 percent of these children went without emotional or psychological counseling over the previous year, according to the study, which used California Health Interview Survey (CHIS) data from 2007–09.

The study looked at a number of factors that contribute to mental health needs among children and obstacles that may contribute to a lack of treatment.

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New direction suggested for treating mental health disorders


Experts urge new discipline combining benefits of neuroscience, psychology treatments.

Michelle Craske, UCLA

When a patient talks with a psychological therapist, what changes occur in the patient’s brain that relieve mental disorders? UCLA psychology professor Michelle Craske says the honest answer is that we don’t know. But, according to Craske and two colleagues, we need to find out.

Mental health disorders — such as depression, schizophrenia, post-traumatic stress disorder, obsessive–compulsive disorder and eating disorders — affect 1 in 4 people worldwide. Psychological treatments “hold the strongest evidence base for addressing many such conditions,” but they need improvement, according to a study by Craske, Cambridge University professor Emily Holmes and MIT professor Ann Graybiel.

Their article was published online July 16 in the journal Nature.

For some conditions, such as bipolar disorder, psychological treatments are not effective or are in their infancy, the life scientists report, and a “culture gap” between neuroscientists and clinical scientists has hindered the progress of mental health treatments. The authors call on scientists from both disciplines to work together to advance the understanding and treatment of psychological disorders.

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Depression associated with lower survival rates in men with prostate cancer


UCLA study finds patients are often diagnosed later, receive less effective therapies.

Jim Hu, UCLA

Depressed men with localized prostate cancer are more likely to be diagnosed with more aggressive cancer, receive less effective treatments and survive for shorter times than prostate cancer patients who are not depressed, a UCLA study has found.

The study’s lead author, UCLA professor Dr. Jim Hu, said the negative outcomes may be the result of several factors, including bias against people with mental illness, depression’s impact on cancer’s biological processes, the patient’s lack of investment in his general health and disinterest in more effective care, and missed opportunities by physicians to educate patients about prostate cancer screening and treatment.

The population-based observational study used data from the Surveillance, Epidemiology and End Results Medicare database. Researchers focused on 41,275 men diagnosed with localized prostate cancer between 2004 and 2007 and observed through 2009, of whom 1,894 had a depressive disorder that had been discovered in the two years before the cancer was diagnosed.

“Men with intermediate- or high-risk prostate cancer and a recent diagnosis of depression are less likely to undergo definitive treatment and experience worse overall survival,” said Hu, UCLA’s Henry E. Singleton Professor of Urology and director of robotic and minimally invasive surgery at the David Geffen School of Medicine at UCLA. “The effect of depressive disorders on prostate cancer treatment and survivorship warrants further study, because both conditions are relatively common in men in the United States.”

The study was published online by the Journal of Clinical Oncology, a peer-reviewed journal of the American Society of Clinical Oncology.

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Gun violence and mental illness: Study addresses perception vs. reality


Gun violence can be reduced with risk-based approach to firearms possession, purchases.

Vickie Mays, UCLA

Recent mass killings in Isla Vista and elsewhere have again raised concern among lawmakers and the media about the possible connection between mental illness and gun violence. A new study sets the record straight and recommends an evidence-based approach to limiting firearms fatalities.

A group of international scholars, including co-author Vickie Mays of UCLA, analyzed dozens of epidemiological studies on gun violence and mental illness and compared the results to media-fueled public perceptions about the dangerousness of mentally ill individuals.

The researchers found that mass murderers with mental health problems, while they receive a tremendous amount of media attention, are not typical of those who commit violent crimes, and the vast majority of those with serious mental illness do not engage in violent acts.

Still, the study authors stress, gun violence can be reduced by instituting policies at the federal and state level that prohibit firearms possession among individuals who display clear risk factors for violence.

The new research is published online in the journal Annals of Epidemiology and will be published in an upcoming print edition.

“We need more evidence-based policies to effectively prevent gun violence,” said Mays, a professor of psychology and health services who directs the Center for Research, Education, Training and Strategic Communication on Minority Health Disparities in the UCLA College. “We also need to expand mental health services and improve access to treatment — some people are slipping through the cracks. But mental illness is not the main cause of violence in society. Policies should focus more on limiting access to firearms for people with behavioral risk factors for violence during specific times when there is evidence that risk is elevated.”

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Poor health, lifestyle factors linked to memory complaints


Early complaints often precursors to significant decline in later life, UCLA/Gallup study says.

Gary Small, UCLA

If you’re depressed, don’t get enough exercise or have high blood pressure, you may find yourself complaining more about memory problems, even if you’re a young adult, according to a new UCLA study.

UCLA researchers and the Gallup organization polled more than 18,000 people about their memory and a variety of lifestyle and health factors previously shown to increase the risk of Alzheimer’s disease and dementia. They found that many of these risk factors increased the likelihood of self-perceived memory complaints across all adult age groups.

The findings, published in today’s (June 4) edition of the journal PLOS ONE, may help scientists better identify how early lifestyle and health choices impact memory later in life. Examining these potential relationships, researchers say, could also help to pinpoint interventions aimed at lowering the risk of memory issues.

The 18,552 individuals polled ranged in age from 18 to 99. The known risk factors the researchers focused on included depression, lower education levels, physical inactivity, high blood pressure, diabetes, obesity and smoking. They were surprised by the prevalence of memory issues among younger adults, said the study’s senior author, Dr. Gary Small, UCLA’s Parlow–Solomon Professor on Aging and director of the UCLA Longevity Center.

“In this study, for the first time, we determined these risk factors may also be indicative of early memory complaints, which are often precursors to more significant memory decline later in life,” said Small, who is also a professor of psychiatry and biobehavioral sciences at the Semel Institute for Neuroscience and Human Behavior at UCLA.

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Study suggests depression, early death among seniors with disabilities linked


Depressed people less likely to adhere to prescribed medications, diet, exercise.

Carol Mangione, UCLA

People with diabetes have about double the risk of premature death as people of the same age without diabetes. Studies also have shown that they have about twice the odds of suffering from depression, which further increases their mortality risk.

A new UCLA-led study published in the Journal of the American Geriatrics Society found that among adults 65 and older with diabetes, depression is linked with a far greater chance for early death compared with people of the same age who do not have depression.

The researchers suggest that the higher mortality rate among those with depression could stem from the fact that depressed people are less likely than their non-depressed counterparts to adhere to their prescribed medications, diet, exercise and glucose self-monitoring.

The link between depression and mortality among people with diabetes has been the subject of many other studies, but this is the first to specifically compare the phenomenon as it affects those 65 and older with how it affects younger people, said Lindsay Kimbro, project director in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA, and the study’s lead author.

Each participant was given a baseline survey and was contacted for a follow-up survey six to seven years after the initial interview.

“We found that depression mainly increases the risk of mortality among older persons with diabetes,” she said. “Although depression is an important clinical problem for people of all ages, when you split the different age groups, depression in the younger group doesn’t lead to increased mortality six to seven years later.”

A significant number of previous reports have linked diabetes and depression with an increased risk for premature death, but Kimbro said it now appears that those results may have been influenced by a focus on elderly patients.

The researchers analyzed information on 3,341 people with diabetes. Their data came from Translating Research Into Action for Diabetes, a study that collected health insurance claims, medical chart review, and phone interviews from 10 health plans in eight states.

The UCLA-led team reviewed information for patients 65 and older (1,402 people) and those who were 18 to 64 (1,939 participants), and measured mortality risk as the number of days until death since the time of the interview. The researchers controlled for age, gender, race and ethnicity, income, and co-morbidities such as heart and kidney disease associated with diabetes.

As in previous studies, the results revealed that the risk for early death among depressed people with diabetes was 49 percent higher than among those without depression. However, the correlation was even more pronounced among older adults: Researchers found a 78 percent higher mortality risk among those 65 and older than they did among non-depressed people with diabetes within that age group. For the younger participants with diabetes, the effect of depression on their risk for early death was not statistically significant.

“Our findings highlight the importance of screening for depression among older adults with diabetes, and of encouraging treatment for those who screen positive,” said Dr. Carol Mangione, a study co-author who holds the Geffen School’s Barbara A. Levey, M.D., and Gerald S. Levey, M.D., endowed chair.

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Untangling brain circuits in mental illness


UCSF-UC Berkeley team leads $26M project, part of President Obama’s Brain Initiative.

Depression. Anxiety Disorders. Addiction.

They’re some of the most common conditions affecting people’s health, and for millions with the most severe cases, conventional treatments such as psychotherapy and medication don’t work adequately – or simply don’t work at all.

What if there were a treatment that could target the specific brain circuits that caused these conditions and offer patients a long-lasting solution?

A team of scientists and physicians led by UC San Francisco, in collaboration with UC Berkeley, is launching a $26 million project, funded by the Defense Advanced Research Projects Agency (DARPA), to map the human brain circuits that go awry in neuropsychiatric disorders and employ advanced technology to correct these patterns.

It’s one of the first projects launched in support of the $100 million Brain Initiative (Brain Research through Advancing Innovative Neurotechnologies), announced by President Barack Obama last year to support research on treating, preventing and perhaps curing brain disorders such as Alzheimer’s, schizophrenia, autism, epilepsy and traumatic brain injury. Because psychiatric conditions disproportionately affect soldiers and veterans, DARPA – a major partner in the Brain Initiative – is seeking the most original approaches to treatment-resistant mental illnesses.

“Human brain recording can now reveal aspects of mental illness that have been inaccessible to scientists and doctors,” said UCSF neurosurgeon Edward F. Chang, M.D., who is leading the project. “By analyzing patterns of interaction among brain regions known to be involved in mental illness we can get a more detailed look than ever before at what might be malfunctioning, and we can then develop technology to correct it.”

The technology itself already exists to help people with their motor skills.

For years, doctors have been doing deep brain stimulation to correct circuitry in movement disorders such as Parkinson’s disease.  And for patients who are paralyzed or are missing limbs, scientists at the Center for Neural Engineering and Prostheses (CNEP) – where Chang is co-director – have been working in the field of brain-machine interfaces to develop a tiny implantable device for the brain that can convert their thoughts into control commands for a robotic arm or exoskeleton.

This new project plans to leverage brain-machine interfaces to do the same for psychiatric patients – but instead of driving a robotic arm or exoskeleton, the device would be able to detect abnormal brain activity and deliver electrical stimulation within the brain to alleviate the symptoms.

And because of its natural plasticity, the brain eventually could “unlearn” these abnormal signaling patterns and the patient could potentially be cured.

The ambitious project will involve more than a dozen scientists, engineers and physicians at UC Berkeley, Lawrence Livermore National Laboratory, Cornell University and New York University, as well as industry partners Posit Science and Cortera Neurotechnologies.

Team members include Vikaas Sohal, M.D., Ph.D., assistant professor of psychiatry at UCSF; UCSF neurosurgeon Philip A. Starr, M.D., Ph.D.; José M. Carmena, Ph.D., CNEP co-director and UC Berkeley associate professor of electrical engineering and computer sciences and of neuroscience; and UC Berkeley colleagues Jonathan Wallis, Ph.D.,  and Robert Knight, M.D., professors of psychology and of neuroscience; Jan Rabaey, Ph.D., Elad Alon, Ph.D., and Michel Maharbiz, Ph.D., professor and associate professors, respectively, of electrical engineering and computer sciences; and Friedrich (Fritz) Sommer, Ph.D., adjunct associate professor at the Redwood Center for Theoretical Neuroscience.

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E-cigarettes and mental health


People with mental health conditions found more likely to use nicotine-delivery devices.

Researchers at the UC San Diego School of Medicine report that people living with depression, anxiety or other mental health conditions are twice as likely to have tried e-cigarettes and three times as likely to be current users of the controversial battery-powered nicotine-delivery devices, as people without mental health disorders.

They are also more susceptible to trying e-cigarettes in the future in the belief that doing so will help them quit, the scientists said. The FDA has not approved e-cigarettes as a smoking cessation aid.

The study will be published in today’s (May 13) online issue of Tobacco Control.

“The faces of smokers in America in the 1960s were the ‘Mad Men’ in business suits,” said lead author Sharon Cummins, Ph.D., assistant professor in the Department of Family and Preventive Medicine. “They were fashionable and had disposable income. Those with a smoking habit today are poorer, have less education, and, as this study shows, have higher rates of mental health conditions.”

By some estimates, people with psychiatric disorders consume approximately 30 to 50 percent of all cigarettes sold annually in the U.S.

“Since the safety of e-cigarettes is still unknown, their use by nonsmokers could put them at risk,” Cummins said. Another concern is that the widespread use of e-cigarettes could reverse the social norms that have made smoking largely socially unacceptable.

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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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