Tag Archives: psychiatry

Link between fetal alcohol syndrome and autism spectrum disorder may point to novel treatment methods

Fetal alcohol spectrum disorder (FASD) and autism spectrum disorder (ASD), both conditions that are neurodevelopmental in origin, may share some similar molecular vulnerabilities, according to a new rodent study published in Alcoholism: Clinical & Experimental Research. When researchers from Northwestern Medicine in Chicago, Ill., exposed pregnant rats to alcohol, they found their offspring experienced symptoms of social impairment and altered-levels of genes that have been previously linked to autism in humans. “The novel finding here is that these two disorders share molecular vulnerabilities, and if we understand those, we are closer to finding treatments,” Eva Redei, the senior author of the study and professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine, said in a press release. Furthermore, study authors found that when the pregnant, alcohol-exposed rats were given low doses of the thyroid hormone thyroxin, they were able to lessen some of the effects of alcohol damage and reverse the expression of autism-related genes in offspring. Though more research needs to be done, Dr. Manny Alvarez, senior managing health editor for FoxNews.com, hopes these findings will lead researchers to explore the potential for thyroxin to be utilized in patients who are at risk for having an autistic child. “We’re still poor at identifying patients at risk for autism, but now we now there is family history, sibling history and some genetic deletions strongly associated with autism,” Alvarez said. “One could argue that perhaps in patients at risk for having an autistic child, after more human studies, the prophylactic use of thyroxin can help prevent the neural behavioral changes of autism.”source : http://www.foxnews.com/health/2013/06/14/link-between-fetal-alcohol-syndrome-and-autism-spectrum-disorder-may-point-to/

Infections linked to mood disorders

Infections and autoimmune disorders may increase the risk of developing a mood disorder such as depression later in life, a new study from Denmark suggests. In the study, which included more than 3 million people, those who were hospitalized for infections were 62 percent more likely to subsequently develop a mood disorder compared with people not hospitalized for infections. And those hospitalized for an autoimmune disease were 45 percent more likely to subsequently develop a mood disorder. Autoimmune diseases are those in which the immune system goes awry and attacks the body's own cells or tissues. The risk of mood disorders increased with the number of times a person was hospitalized. Those who were hospitalized three times with infections during the study had double the risk of a mood disorder, and those who were hospitalized seven times had triple the risk, compared to those not hospitalized with infections. The findings support the hypothesis that inflammation, from either an infection or autoimmune disease, may affect the brain in a way that raises the risk of mood disorders, the researchers say. If the link is confirmed in further studies, the researchers said, their estimates show that infections could be responsible for up to 12 percent of mood disorders. However, the study found an association, and cannot prove that infections or autoimmune diseases are the cause of mood disorders. It's possible that other factors, such as stress or the experience of hospitalization, may explain the link, said Ian Gotlib, a professor of psychology at Stanford University, who was not involved in the study. The study is published June 12 in the journal JAMA Psychiatry. Infections and mood disorders The study included people born in Denmark between 1945 and 1996 who were followed until the end of 2010. During the study, more than 91,000 people visited a hospital for a mood disorder, including bipolar disorder or depression. Of these, about 32 percent visited hospitals for an infection before their mood disorder, and 5 percent visited the hospital for an autoimmune disease before their mood disorder. The risk of a mood disorder was greatest in the first year following an infection or autoimmune disease. People who visited a hospital for both an infection and an autoimmune disease had a greater risk of developing a mood disorder than those who visited a hospital for either of the two conditions alone. This may indicate the two conditions interact to increase the risk of mood disorder, the researchers said. Because the study looked at information from only people hospitalized with infections, autoimmune disorders and mood disorders, its not clear whether the findings may apply to people with less severe infections, or mood disorders. What's the cause? Gotlib called the study “impressive” and said it raises important questions. Previous studies have shown that people with depression have lower numbers of T cells (a type of immune cell), and are at increased risk for autoimmune diseases, Gotlib said. But there are also many other risk factors for mood disorders that were not taken into account in this study, such as smoking and socioeconomic status, Gotlib said. Future studies should attempt to untangle whether infections are really the cause of mood disorders, or if the two just happen to occur together. In addition, studies should investigate how, on a biological level, infections and autoimmune diseases might affect the brain to cause mood disorders, Gotlib said. Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.source : http://www.foxnews.com/health/2013/06/12/infections-linked-to-mood-disorders/

Paris Jackson has long road to recovery ahead

An unnamed source who was at the hospital where Paris Jackson is recovering from a reported suicide attempt was quoted as saying, “She’s going to be OK.” Well, she isn’t going to be just fine—not without the very best psychiatry has to offer.  And that may or may not be enough. How can I say that without having evaluated Paris Jackson in person?   I can say it because I know human beings are not only emotionally sensitive, but also self-searching.  We need to know our authentic life stories and to have a firm grasp on our truth.  This makes us able to survive the real challenges that any life inevitably includes—such as the loss of loved ones, transitions through adolescence to adulthood, relationships that veer into conflict, people who don’t like us and say so, setbacks and challenges and traumas of every conceivable variety. When you are born to a talented musician addicted to plastic surgery, who conceived you with a woman he hardly knew, who appeared in public in costume, behind dark glasses, you are not going to be OK.  When you are born to a man who was accused by multiple people of being a pedophile, who himself spoke and acted frequently like a little boy, who dangled a child out a window several stories off the ground, you are not going to be OK.  You are going to have a long journey in search of your truth, fraught with pain.  And overcoming all of it will be a significant triumph. It is perhaps telling that Paris Jackson, born into Neverland Ranch as a live product of the entertainment industry, would tweet lyrics from songs as a way of trying to express herself.  “Yesterday, all my troubles seemed so far away.  Now, it looks as though they’re here to stay.”  Tweeting them is part of the problem, of course.  Who tweets when having survived a reported suicide attempt?

Brain surgery is an option for patients with severe OCD, study suggests

A type of brain surgery appears to be a relatively effective treatment for people with severe obsessive compulsive disorder (OCD) who have not responded to other treatments, a new study suggests. In the study, nearly half of patients showed at least some improvement in their OCD symptoms, and 15 percent fully recovered seven years after the surgery. The findings suggest surgery may be an effective treatment for patients with very severe OCD who have not been helped by other therapies, the researchers said. Patients in the study had not responded to several medications, including serotonin reuptake inhibitors (SRIs) and antipsychotic medications, as well as psychotherapy. On average, patients had experienced symptoms for 16 years, and one-third had attempted suicide. However, the surgery has significant risks. Two of the 19 patients experienced permanent complications from the surgery, including paralysis on one side of the body and cognitive impairment. Because of this, the procedure should be considered with caution, the researchers said. [See 5 Controversial Mental Health Treatments]. Future studies should examine which patients are most likely to be helped by the surgery, so that only those who stand to gain greatest benefit undergo the procedure, the researchers said. Surgery for OCD OCD is characterized by recurrent, intrusive thoughts and repetitive behaviors that patients feel compelled to carry out. Patients might perform these behaviors (such as hand washing) for hours, and some are unable to leave their homes. About 20 to 30 percent of patients are not helped by medication or behavioral therapies. Brain surgery for mental disorders, called psychosurgery, has been practiced since the 1930s, although it is very controversial. Early surgeries, such as lobotomies practiced in the 1940s and 1950s, had serious side effects, including personality changes. The practice of psychosurgery declined after psychiatric medications became available, although a small number of centers today continue perform psychosurgerical procedures. Today, psychosurgery is much more carefully regulated than it was in the past, and performed only after patients determined to be appropriate candidates for the treatment by a team of psychiatrists and neurologists, said Dr. Michael Schulder, vice chair of neurosurgery at North Shore University Hospital in Manhasset, NY. Brain imaging technology available today helps doctors more carefully select the surgery target, said Schulder, who was not invovled in the new study. The study, conducted by researcher at Universit Laval in Quebec, Canada, involved 19 patients who underwent a type of psychosurgery called bilateral capsulotomy between 1997 and 2009. The surgery damages tissue (by creating lesions) in a part of the brain called the internal capsule. Before the surgery, patients scored an average of 34 out of 40 points (extreme OCD) on a test designed to measure the severity of the condition. After surgery, the average score decreased to 23, which is considered moderate OCD. About 37 percent of patients responded fully to the surgery, meaning their score improved by at least 35 percent, and about 10 percent partially responded to the surgery, meaning their score improved by 25 percent. After seven years, three patients fully recovered from OCD, and three had minimal symptoms, the researchers said. Those who did not respond to the surgery were more likely to have had OCD for a longer time period (an average of 20 years) than those who did respond to surgery (an average of 12 years). Psychosurgery vs. deep brain stimulation The study did not have a control group, or a group of patients who did not undergo the procedure, so it's possible the improvement seen in the study was the result of a placebo effect. However, there is little evidence for spontaneous remission or placebo effect in patients with severe OCD, the researchers said. A more recent surgical procedure for OCD, called deep brain stimulation, involves implanting a device that sends electrical impulses into the brain. Unlike psychosurgery, deep brain stimulation is reversible, and does not permanently damage tissue. In 2009, the Food and Drug Administration approved the use of deep brain stimulation for OCD. However, patients with a deep brain stimulation implant may experience problems with the implant that need to be fixed right away, so they should live close to a health care center. Psychosurgery is less expensive than deep brain stimulation, and does not require that patients live close to a health care center, so there is still a place for the procedure in the field, the researchers said. Schulder said that while psychosurgery tends to have a higher complication rate than DBS, the latter procedure poses risks such as infection and erosion of the device through the skin. “There's still a good rational for doing lesioning in some patients. It's not like DBS is complication free,” Schulder said. The study is published June 3 in the Journal of Neurology, Neurosurgery, & Psychiatry. Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.source : http://www.foxnews.com/health/2013/06/04/brain-surgery-is-option-for-patients-with-severe-ocd-study-suggests/

ADHD medications not tied to drug, alcohol abuse

Taking Ritalin and other drugs for attention-deficit/hyperactivity disorder (ADHD) doesn't affect a child's chances of trying or abusing alcohol and drugs later in life, a new review suggests. Researchers pooled data from 15 studies that included a total of 2,600 kids and teenagers with ADHD who were or were not medicated with stimulants and were followed for anywhere from 3 to 28 years. They found no clear difference in how many participants started using or abusing alcohol, cigarettes, marijuana or cocaine, based on how their ADHD was managed. “The scientific evidence suggests that the risk for alcohol and substance problems later in development, in adolescence or adulthood, doesn't seem to be strongly tied to whether or not children were previously… treated with stimulant medication,” said psychologist Steve Lee, who worked on the new study. That means parents should focus on discussing more immediate effects of stimulants with their child's doctor, such as sleep or appetite problems, he added. Kids with ADHD are known to be at higher risk of developing substance problems than those without the disorder. One analysis from 2003 suggested kids treated with stimulants were less likely to develop alcohol and drug problems than their peers with ADHD. Lee and his colleagues from the University of California, Los Angeles, wanted to see how that picture looked once more recent studies were taken into account. The researchers analyzed data related to substance use or abuse of each drug separately. For every category they looked at - alcohol, nicotine, marijuana, cocaine and other drugs - Ritalin and similar stimulants weren't tied to a clear increase or decrease in future use or abuse. That finding isn't the end of the story, the study team said. For example, it's not clear whether the effects of stimulants are different for boys and girls. And because kids in these studies were not randomly assigned to take stimulants or not, it's possible they varied in other ways that may have affected future drug and alcohol use, such as ADHD severity, the researchers write in JAMA Psychiatry. “What I say to parents when I'm talking to them about medication is, the medication is unlikely to have any adverse effects on substance use as far as we know right now,” said William Pelham, head of the Center for Children and Families at Florida International University in Miami, who wasn't involved in the new study. But, he said, “We don't have a lot of studies going into the full range of years when people (are most at risk for) substance abuse.” According to the U.S. Centers for Disease Control and Prevention, parent reports suggest that close to one in 10 kids and teens in the U.S. has ever been diagnosed with ADHD, and two-thirds of those with a current diagnosis are treated with medication such as stimulants. Those drugs can come with short-term side effects, including appetite loss and stomach aches. Because of that, “psychosocial, parent-management types of strategies probably ought to be the first line of treatment,” rather than medication, Lee said. In general, stimulants haven't been shown to have long-term side effects in the years after kids stop taking them, Pelham said - but they also don't seem to have long-term benefits. He agreed with Lee that parents should be looking to non-drug ways to improve the outlook for children with ADHD, including working closely with teachers as kids grow up. And because those youth are at higher risk of drug and alcohol problems due to their ADHD, they should have access to programs to improve decision-making skills and peer relationships, Pelham said.source : http://www.foxnews.com/health/2013/05/30/adhd-medications-not-tied-to-drug-alcohol-abuse/

Antidepressants may help with heart disease

For some patients with heart disease, taking antidepressants may reduce the risk of heart problems brought on by mental stress, a new study suggests. Researchers looked at patients with myocardial ischemia a condition in which the heart doesn't get enough blood as they preformed mentally stressful activities. All of the patients also had coronary heart disease, or a narrowing of the arteries that supply blood to the heart. Patients in the study who took the antidepressant escitalopram (sold as Lexapro) were about 2.5 times less likely than those who took a placebo to experience myocardial ischemia triggered by mental stress. The findings suggest that an antidepressant, or other treatments that help patients cope with stress, could improve symptoms for some people with coronary heart disease, said study researcher Dr. Wei Jiang, an associate professor of psychiatry and behavioral sciences at Duke University School of Medicine. However, future studies are needed to confirm the results, and to identify the people most likely to benefit from such treatment, Jiang said. Stress and the heart About 30 years ago, doctors observed that mental stress could bring on myocardial ischemia.tudies also have found that people with mental-stress-induced myocardial ischemia are at increased risk of dying from heart disease. Coronary heart disease is the leading cause of death in the United States and about 50 percent of patients with the condition experience mental-stress-induced myocardial ischemia yet few studies have attempted to find treatments. In the new study, 127 patients were randomly assigned to receive escitalopram or placebo for six weeks. Participants completed a number of tests at the beginning and end of the study, including a treadmill stress test, a math test and a test in which participants told a sad story in order to evoke emotion. During the tests, the researchers examined certain heart symptoms to diagnose myocardial ischemia, such as a reduction in blood pumped out of one of the heart's cambers. After six weeks, about 34 percent of participants taking the antidepressant did not experience myocardial ischemia during the mental-stress tests, compared with 17 percent in the placebo group. The antidepressant did not affect whether patients experienced myocardial ischemia during exercise. Dr. Andrew Freeman, a cardiologist at the National Jewish Health hospital in Denver, said it was not very surprising that drugs that blunt the brain's response to stress would also blunt the heart's response to stress. But what the findings mean for patients in the long term is not known, said Freeman, who was not involved in the study. Future studies are needed to see whether antidepressants might reduce the risk of cardiovascular events like heart attacks, Freeman said. How does it work?