TAG: "Mental health"

UC Davis launches Research Center for Behavioral Health


Sacramento campus receives $7.5M for new research hub; UCLA launching similar center.

The launch of the Behavioral Health Center of Excellence at UC Davis featured a ceremonial ribbon-cutting. Pictured (from left) are UC Davis Provost Ralph Hexter, patient advocate Bonnie Hotz, UC Davis Vice Dean Fred Meyers, Sen. Darrell Steinberg, UC Davis Vice Chancellor and Dean Julie Freischlag, and UCLA professor Peter Whybrow. Hidden from view is UC Davis professor Cameron Carter, who's expected to become the executive director of the new center.

UC Davis Health System officials and California Senate leader Darrell Steinberg today (Oct. 1) announced the founding of a unique academic research center designed to improve mental health in California and serve as a national model for advancing innovative research in neuroscience, as well as the prevention of and early interventions in mental illness.

Known as the Behavioral Health Center of Excellence at UC Davis, the $7.5 million project will become the university’s hub for bringing together its wide-ranging research, education, clinical care and community engagement as they relate to neuroscience, mental health and public health improvement.

The new center will be located on the university’s Sacramento campus. It will complement a similar, $7.5 million center that is being established in Southern California at UCLA.

“Mental health is an issue that knows no partisan lines. Its impacts and suffering escape no race, class, gender, age, or sexual orientation. It affects every other agenda we address in the Legislature.” Steinberg said. “Having dedicated behavioral health centers in the state will be the catalyst for improving our understanding of the human mind and finding answers for individuals and their families.”

Grant funding for the two centers was approved by the state’s Mental Health Services Oversight and Accountability Commission earlier this year. UC Davis plans call for researchers to explore everything from telehealth delivery of behavioral health care and the economics of prevention to how medical and mental-health services might be better integrated in clinical settings.

“This center is so promising because it enables UC Davis to work from its core strengths in brain research, new technologies for clinical care, reducing health disparities and effectively engaging communities,” said Frederick Meyers, vice dean of UC Davis School of Medicine and who will serve as director of the new center. “We plan to closely measure and evaluate our research results so that we can identify and translate into practice the best ways to achieve behavioral-health improvement.”

Meyers said the UC Davis center will be a catalyst for developing more research expertise in behavioral health, as well as better techniques and training to address wellness, recovery and resilience to mental illness. The university plans to partner in its research efforts with other health organizations and government-related institutions, including counties throughout Northern California.

The new center’s leadership team, which includes Cameron Carter, a UC Davis professor of psychiatry and behavioral sciences specializing in the early diagnosis and treatment of schizophrenia and other cognitive mental disorders, will also study community programs, alternatives to hospitalization, shared services with jails, hospitals and courts, and identify new approaches to reducing mental health stigmas.

“The center of excellence in behavioral health is one product of the work we started many years ago with Proposition 63 and the state’s Mental Health Services Act,” said Steinberg, a longtime leader on mental health issues. “Like the UC Davis’ MIND Institute, which has earned international recognition for its work in autism, the Behavioral Health Center of Excellence at UC Davis can bring together in one place the academic skills, talent and experience that we need to address some of the most challenging problems that many California families are facing.”

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Project launched to develop depression care for older adults


UC Davis and University of Washington receive $2.5M grant from Archstone Foundation.

Ladson Hinton, UC Davis

UC Davis and the University of Washington are implementing a project to develop innovative new models of care for depression in older adults through a $2.5 million grant from the California-based Archstone Foundation, a private grant-making organization whose mission is to contribute toward the preparation of society in meeting the needs of an aging population. The grant launches Archstone Foundation’s Depression in Late Life Initiative to improve the quality of life for older adults suffering from depression.

The work of this grant is based on a one-year systematic review of the literature and current practice. It will advance care for late-life depression by supporting innovative approaches to promote partnership and collaboration among primary care clinics, family members, friends and community-based organizations. Through the Archstone Foundation’s Depression in Late Life Initiative, a number of organizations will also be funded to carry out this effort in California.

Depression is common among older adults and comes at a high cost to patients and their families. Major depression affects 2 to 5 percent of older adults in the community, 5 to 10 percent of older adults in primary-care settings, and as many as 50 percent in nursing homes.

The UC Davis group will be led by Ladson Hinton, professor in the Department of Psychiatry and Behavioral Sciences and a nationally recognized expert in minority mental health and aging. Hinton is the director of the Latino Aging Research Resource Center and the education core of the UC Davis Alzheimer’s Disease Center. The University of Washington group is led by Jürgen Unützer, chair of the Department of Psychiatry at the University of Washington, and the developer of the Improving Mood–Promoting Access to Collaborative Treatment (IMPACT) model, the leading collaborative care program for late-life depression, which has been implemented in more than 500 clinics around the country.

“This initiative will help build on the success of collaborative care and include important partners, such as family members and community-based organizations,” Hinton said.

“While we have evidence-based treatments for depression in primary care, such as collaborative care, very little work has been done to mobilize community agencies (i.e. adult-day health programs, senior centers, meals on wheels, faith-based organizations) and families to help in the process,” he said. “Archstone Foundation’s Depression in Late Life Initiative addresses this important gap in the field, and may also help to engage groups at risk for under-treatment of their depression, such as ethnic minority elders and older men.”

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Depression questionnaires could lead to unneeded antidepressant prescriptions


Study highlights need for research to determine how best to apply such questionnaires.

Anthony Jerant examines a patient in the Family & Community Medicine Clinic of UC Davis Health System.

Short questionnaires used to identify patients at risk for depression are linked with antidepressant medications being prescribed when they may not be needed, according to new research from UC Davis Health System to be published in the September-October issue of the Journal of the American Board of Family Medicine.

Known as “brief depression symptom measures,” the self-administered questionnaires are used in primary care settings to determine the frequency and severity of depression symptoms among patients. Several questionnaires have been developed to help reduce untreated depression, a serious mental illness that can jeopardize relationships, employment and quality of life and increase the risks of heart disease, drug abuse and suicide.

The UC Davis team was concerned that the questionnaires might lead to prescriptions for antidepressant medication being given to those who aren’t depressed. Antidepressants are effective in treating moderate-to-severe depression but can have significant side effects, including sexual dysfunction, sedation and anxiety. They also have to be taken over several months to be effective.

“It is important to treat depression, but equally important to make sure those who get treatment actually need it,” said Anthony Jerant, professor of family and community medicine at UC Davis and lead author of the study.

The exploratory study included 595 patients of primary care offices affiliated with Kaiser Permanente in Sacramento, San Francisco VA Medical Center, Sutter Medical Group in Sacramento, UC Davis, UC San Francisco and VA Northern California Healthcare System.

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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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