Study Points to Methamphetamine Crisis Among American Indians, Alaska Natives
There was a fivefold increase in methamphetamine overdose deaths from 2011 to 2018 among U.S. adults aged 25 to 54, with American Indians and Alaska Natives experiencing the highest death rates, according to areport published Wednesday inJAMA Psychiatry.“While much attention is focused on the opioid crisis, a methamphetamine crisis has been quietly, but actively, gaining steam—particularly among American Indians and Alaska Natives, who are disproportionately affected by a number of health conditions,” said Nora D. Volkow, M.D., director of th e National Institute on Drug Abuse and a senior author of the r...
Source: Psychiatr News - January 21, 2021 Category: Psychiatry Tags: Alaska Natives American Indians JAMA Psychiatry methamphetamine NIDA Nora Volkow overdose death Source Type: research

HHS Takes Steps to Encourage More Physicians to Prescribe Buprenorphine
Physicians with a Drug Enforcement Administration (DEA) registration number may no longer be required to apply for a separate waiver to prescribe buprenorphine to patients with opioid use disorder (OUD), according to newpractice guidelines by the Department of Health and Human Services (HHS). This waiver is referred to as X-waiver of the Controlled Substances Act (CSA).Physicians who dispense narcotic drugs to individuals for maintenance treatment or detoxification treatment have been required to complete additional certifications underTitle 21 of the CSA.“The Office of the Assistant Secretary for Health in HHS has d...
Source: Psychiatr News - January 19, 2021 Category: Psychiatry Tags: buprenorphine Controlled Substances Act HHS opioid use opioid use disorder Patrice Harris regulations waivers Source Type: research

APA Issues Apology for History of Racism Contributing to Discrimination, MH Care Inequities
The APA Board of Trustees today issued anapology for APA ’s history of racism and for “enabling discriminatory and prejudicial actions within APA and racist practices in psychiatric treatment for Black, Indigenous, and People of Color (BIPOC).” The statement of apology—addressed to members, patients, their families, and the public—is accompanied by adocumentoutlining specific practices and policies (including failures to speak out and protest racist practices) that have damaged BIPOC patients and their families dating to the time of the founding of APA.“The Board is issuing this document...
Source: Psychiatr News - January 18, 2021 Category: Psychiatry Tags: and People of Color APA APA's founders apology BIPOC black health care inequities Indigenous Jeffrey Geller racist practices in psychiatry Saul Levin structural racism Task Force on Structural Racism Source Type: research

Insulin Levels, BMI in Youth May Be Linked to Psychosis, Depression Risk in Adulthood
Disrupted insulin sensitivity in childhood and adolescence may be a shared risk factor for cardiometabolic disorders and psychosis in adulthood, astudy inJAMA Psychiatry has found. The study also found that a major increase in BMI around puberty may indicate a greater risk for adult depression.Benjamin I. Perry, M.R.C.Psych., of the University of Cambridge School of Clinical Medicine in Cambridge, United Kingdom, and colleagues examined data from people aged 1 to 24 years in the Avon Longitudinal Study of Parents and Children, a prospective study of approximately 15,000 British people. They obtained data on fasting insulin...
Source: Psychiatr News - January 15, 2021 Category: Psychiatry Tags: BMI body mass index cardiometabolic disorders depression first-episode psychosis glucose insulin JAMA Psychiatry Source Type: research

Naltrexone-Bupropion Combination May Help People With Methamphetamine Use Disorder
A combination of naltrexone plus bupropion can reduce methamphetamine use in people with moderate to severe methamphetamine use disorder, reports astudy in theNew England Journal of Medicine. In a randomized clinical trial of over 400 adults, 13.6% of participants who took extended-release naltrexone/bupropion significantly reduced or stopped their methamphetamine use compared with 2.5% of those who took placebo.“Methamphetamine use disorder is a serious illness and is associated with medical conditions and mental health issues, marked functional impairment, and frequent relapses,” wrote Madhukar Trivedi, M.D.,...
Source: Psychiatr News - January 14, 2021 Category: Psychiatry Tags: bupropion methamphetamine methamphetamine use disorder naltrexone New England Journal of Medicine side effects substance use disorder Source Type: research

Suicide and Suicide Attempts Higher Among People With Autism Spectrum Disorder
People with autism spectrum disorder (ASD) have higher rates of suicide and suicide attempts than people without ASD, astudy published today inJAMA Network Open has found.Kairi K õlves, Ph.D., of Griffith University in Mt. Gravatt, Queensland, Australia, and colleagues analyzed data collected by the Danish Civil Registration System between January 1995 and December 2016 for more than 6.5 million people in Denmark aged 10 years or older. Among those individuals, 35,020 had r eceived a diagnosis of ASD. There were 64,109 suicide attempts among all registered individuals, 587 of them by people with ASD, and there were ...
Source: Psychiatr News - January 12, 2021 Category: Psychiatry Tags: autism autism spectrum disorder females JAMA Network Open psychiatric comorbidity suicide suicide attempt Source Type: research

Exposure to Valproate in the Womb May Increase Risk of Autism, ADHD
Valproate, which is used to treat epilepsy, migraines, and bipolar disorder, has previously been linked to neural tube birth defects if taken during pregnancy. Anarticle appearing in theJanuary issue ofPsychiatric News reports new findings that children exposed to valproate in the womb had an elevated risk of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) compared with those who were not exposed to the medication in the womb.The research was conducted by a team at Indiana University along with colleagues at Sweden ’s Karolinska Institutet. The team used Swedish birth and medical re...
Source: Psychiatr News - January 11, 2021 Category: Psychiatry Tags: ADHD anticonvulsant ASD autism epilepsy Indiana University Karolinska Institutet Kelsey Wiggs pregnancy seizure valproate Veerle Bergink Source Type: research

Study Confirms Well-Known Suicide Risk Factors, Identifies New Risks
Financial distress, feeling downhearted, and doing activities less carefully were identified through machine learning as risk factors for suicide, according to astudy published inJAMA Psychiatry.“[M]ost of the published literature on nonfatal suicide attempt prediction has focused on high-risk patients who have received mental health treatment,” wrote Ángel García de la Garza, B.A., of Columbia University, Carlos Blanco, M.D., Ph.D., of the National Institute on Drug Abuse, and collea gues. “These findings underscore the importance of extending suicide attempt prediction models beyond high-r...
Source: Psychiatr News - January 8, 2021 Category: Psychiatry Tags: algorithm JAMA Psychiatry machine learning risk factors suicidal thoughts suicide suicide attempts Source Type: research

APA Condemns Violent Attack on U.S. Capitol, Warns of Long-Term Effects of Recurring Trauma
APA todaycondemned the violent action of a pro-Trump mob who on Wednesday stormed the halls of Capitol, forcing the evacuation of both chambers of Congress during the ceremonial reading of the electoral college votes for President-elect Joe Biden.“Yesterday’s violence and the rhetoric that incited it are seditious,” said APA President Jeffrey Geller, M.D., M.P.H., in a statement that called attention to the stark contrast between the government’s strongarm response to Black Lives Matter protesters this summer and fall and the respons e yesterday as predominantly white rioters broke down barricades, ...
Source: Psychiatr News - January 7, 2021 Category: Psychiatry Tags: anxiety APA capitol attack COVID-19 electoral college vote Jeffrey Geller pro-Trump mob professional help racism resources Saul Levin stress trauma Source Type: research

Initial Effects of Liking, Wanting Alcohol Linked to Later Development of Alcohol Use Disorder
Young adults who are particularly sensitive to the pleasurable effects of alcohol appear more likely to develop alcohol use disorder (AUD) within a decade than those who do not experience these feelings as young adults, according to astudy inAJP in Advance. The study also found that people who developed AUD over the 10-year period reported increases in wanting alcohol over time.“[M]arked stimulant-like, pleasurable, and appetitive effects after consuming alcohol are risk factors for the development and maintenance of addiction,” wrote lead author Andrea King, Ph.D., of the University of Chicago and colleagues.K...
Source: Psychiatr News - January 6, 2021 Category: Psychiatry Tags: ajp in advance alcohol use disorder AUD Chicago Social Drinking Project liking wanting Source Type: research

Repeated Ketamine Infusions May Rapidly Reduce Chronic PTSD Symptoms
Repeated ketamine infusions may lead to rapid symptom improvement in people with chronic posttraumatic stress disorder (PTSD), suggests astudy inAJP in Advance. Participants who received six ketamine infusions over a two-week period experienced greater drops in PTSD symptoms and comorbid depressive symptoms compared with participants who received the sedative midazolam.The findings are “an important next step in our quest to develop novel pharmacologic interventions for this chronic and disabling disorder, as a large number of individuals are not sufficiently helped by currently available treatments,” said lead...
Source: Psychiatr News - January 5, 2021 Category: Psychiatry Tags: AJP CAPS-5 depression infusion ketamine midazolam Montgomery- Åsberg Depression Rating Scale posttraumatic stress disorder PTSD Source Type: research

Youth With Congenital Heart Disease at Elevated Risk of Depression, Anxiety, ADHD, Study Finds
Children and adolescents with a congenital heart disease are at greater risk than those without of developing depression, anxiety, or attention-deficit/hyperactivity disorder (ADHD), according to areport inPediatrics.“Our data support the notion that the population of patients with [congenital heart disease], regardless of disease severity, would likely benefit from mental health screening and evidence-based therapy earlier in childhood,” wrote Vincent Gonzalez, M.D., of Baylor College of Medicine and collea gues.Gonzalez and colleagues compiled electronic health record data from 118,785 youth aged 4 to 17 year...
Source: Psychiatr News - January 4, 2021 Category: Psychiatry Tags: ADHD anxiety attention-deficit/hyperactivity disorder congenital heart disease depression emergency department hospitalized pediatrics Source Type: research

Expert Offers Guidance on How to Talk With Patients About Getting Vaccinated for COVID-19
To end the COVID-19 pandemic, it is essential that citizens are willing to receive a vaccine. Yet vaccine hesitancy is becoming a growing problem. In anarticle in Psychiatric News, Joshua Morganstein, M.D., chair of the APA Committee on Psychiatric Dimensions of Disasters, outlined actions psychiatrists can take to prepare for and have conversations about COVID-19 vaccines with patients.Check your pulse:After the challenges that 2020 has brought, health care professionals are increasingly tired and frustrated. Yet burnout and extreme stress will make it only more difficult to start tough conversations with patients ab...
Source: Psychiatr News - December 31, 2020 Category: Psychiatry Tags: COVID-19 Joshua Morganstein Psychiatric News vaccine Source Type: research

Frail, Older Adults May Have Poorer Response to Antidepressant Treatment Than Non-Frail Adults
Older, depressed adults who are frail (experiencing deficits in strength and physical activity) may have a poorer response to antidepressant treatment than non-frail older adults with depression, according to areport in theJournal of Geriatric Psychiatry.“Frailty in the context of late-life depression may mean that antidepressant medications are necessary but not sufficient for the adequate treatment of frail adults,” wrote Patrick Brown, Ph.D., of the Neurobiology and Therapeutics of Aging Division at the New York State Psychiatric Institute (N YSPI) and colleagues. Physical therapy, behavioral strategies, and...
Source: Psychiatr News - December 30, 2020 Category: Psychiatry Tags: antidepressants depression fatigue frail grip strength Hamilton Depression Rating Scale Journal of Geriatric Psychiatry physical activity weight loss Source Type: research

Women With Mental Illness Are Less Likely to Receive Mammograms, Study Finds
Despite access to free health care services, women with mental illness may be less likely to receive breast cancer screenings than those without mental illness, according to astudy in theAmerican Journal of Preventive Medicine. The report focused on women living in the United Kingdom, who are regularly notified to get a breast cancer every three years between the ages of 50 and 70.Previous studies have suggested that U.S. women with mental illness, particularly serious mental illness, are less likely to get mammograms than those without mental illness. Less clear, however, has been whether this disparity extends to women l...
Source: Psychiatr News - December 29, 2020 Category: Psychiatry Tags: American Journal of Preventive Medicine antipsychotics Anxiolytics breast cancer health disparities mental illness screening United Kingdom Source Type: research

Childhood Depression, Tobacco Use May Increase Risk of Opioid Use in Early Adulthood
Youth with a history of childhood depression and/or tobacco use are at a greater risk of using opioids by the age of 30 than those without such a history, according to astudy published today inJAMA Pediatrics.“Childhood tobacco use and chronic depression may be associated with impaired reward system functioning, which may increase young adults’ vulnerability to opioid-associated euphoria,” wrote Lily Shanahan, Ph.D., of the University of Zurich and colleagues. “Known evidence-based prevention str ategies [for smoking and depression] could save lives, especially because mental health and substance us...
Source: Psychiatr News - December 28, 2020 Category: Psychiatry Tags: children depression dysthymia JAMA Pediatrics opioids tobacco use Source Type: research

Psychiatrists Outline Strategies to Achieve Antiracism in Medicine
From the devastating effects of COVID-19 on the Black community to the killings of Black Americans by police, 2020 is likely to be remembered in part for the stark reminder that racism and racist policies kill people. “Physicians’ responsibilities in addressing racism and racial violence toward Black Americans range from examining and taking steps to counter our own implicit and explicit biases to addressing policies and procedures that reproduce inequities within mental health delivery systems,” wrote psyc hiatrists Barbara Robles-Ramamurthy, M.D., Angela A. Coombs, M.D., Walter Wilson, M.D., and Sa...
Source: Psychiatr News - December 23, 2020 Category: Psychiatry Tags: antiracism clinicians educators Journal of the American Academy of Child & Adolescent Psychiatry medical administrators mental health overdiagnosis underdiagnosis Source Type: research

Congress Passes Legislative Package Including APA Model Parity Enforcement Bill
Congress yesterday passed the Strengthening Behavioral Health Parity Act (HR 7539), a bipartisan bill based on APA ’s model legislation for improving compliance with the federal mental health parity law.The bill was passed as part of a year-end funding package that combined annual appropriations legislation for federal agencies and a $900 billion COVID-relief package. The president is expected to sign the legislation later this week. HR 7539 gives the Department of Labor new powers to regulate and audit health plans to determine if they are in compliance with the 2008 Mental Health Parity and Addiction Equity Ac...
Source: Psychiatr News - December 22, 2020 Category: Psychiatry Tags: APA Congress COVID relief Jeffrey Geller mental health parity Saul Levin Strengthening Behavioral Health Parity Act Source Type: research

Bariatric Surgery May Increase Risk of Unhealthy Alcohol Use
Adults with no history of unhealthy alcohol use who undergo bariatric surgery to promote weight loss may be more likely to develop unhealthy alcohol use compared with adults who do not receive surgery, according to astudy appearing today inJAMA Network Open.“The clinical implications of these results suggest that patients undergoing bariatric surgical procedures should be cautioned that drinking alcohol can escalate after bariatric surgery, even in patients with no previous evidence of drinking alcohol above recommended limits,” wrote Matthew Macie jewski, Ph.D., of the Durham VA Medical Center and colleagues.&...
Source: Psychiatr News - December 21, 2020 Category: Psychiatry Tags: alcohol use AUDIT-C bariatric surgery JAMA Network Open laparoscopic sleeve gastrectomy LSG Roux-en-Y gastric bypass RYGB VA veterans Source Type: research

Depression, Anxiety Three Times More Likely in People with Cannabis Use Disorder
Rates of comorbid major depressive disorder and generalized anxiety disorder are three times higher in people who have cannabis use disorder, ameta-analysis in theJournal of Affective Disorders has found.Vivian N. Onaemo, Ph.D., M.P.H., M.B.B.S., of the Government of Saskatchewan Ministry of Health in Reginia, Canada, and colleagues analyzed data from eight articles from six epidemiological surveys published from January 1980 through July 2020. There were approximately 177,000 respondents among all six surveys, and the surveys were largely conducted in the United States and Australia.The odds of having major depression wer...
Source: Psychiatr News - December 18, 2020 Category: Psychiatry Tags: cannabis cannabis use disorder depression general anxiety disorder Journal of Affective Disorders meta-analysis Source Type: research

Parkinson ’s Disease Associated With Increased Risk of Suicide, Study Finds
Suicide risk is about two times higher in patients with Parkinson ’s disease than the general population, even after adjusting for physical and mental comorbidities, according to astudy published Wednesday inJAMA Psychiatry. “Approximately 40% to 50% of patients with [Parkinson’s] are affected by depression, and 30% to 40% are affected by anxiety disorders,” wrote Ying-Yeh Chen, M.D., Sc.D., of the Taipei City Psychiatric Center in Taiwan and colleagues. “In addition to the long-established associations between mental disorders and suicide, the physical limitations caused by [Parkinson&rs...
Source: Psychiatr News - December 17, 2020 Category: Psychiatry Tags: depression integrated care JAMA Psychiatry Parkinson's disease suicide Source Type: research

Psychiatrists May Play Important Role in Facilitating Uptake of COVID-19 Vaccine by Patients With SMI
People with serious mental illness (SMI) should be among the high-priority groups to receive the COVID-19 vaccine, wrote Nicola Warren, M.B.B.S., of the University of Queensland, Australia, and colleagues in aneditorial inJAMA Psychiatry.In the article —appearing just days after health care workers in Europe, the United Kingdom, and the United States began receiving the first COVID-19 vaccines—the authors outline obstacles to immunization confronting people with SMI and strategies for overcoming them.“Mental health clinicians have a key role in advocating for priority access to a COVID-19 vaccination for ...
Source: Psychiatr News - December 16, 2020 Category: Psychiatry Tags: barriers to care cost COVID-19 education flu vaccines serious mental illness SMI transportation Source Type: research

Youth Depression Associated With Somatic Diseases, Mortality
Children and adolescents with depression are at higher risk for a host of somatic diseases and premature death in early adulthood, according to astudypublished inJAMA Psychiatry.These findings support the hypothesis that youth depression is linked to more than other psychiatric and neurologic disorders, impacting their quality of life and posing public health challenges, according to corresponding author Sarah E. Bergen, Ph.D., of the Karolinska Institutet in Sweden and colleagues. “Consequentially, clinical efforts to comprehensively manage both psychiatric and somatic diagnoses are needed.”Bergen and colleagu...
Source: Psychiatr News - December 15, 2020 Category: Psychiatry Tags: depression endocrine disorders genitourinary infections JAMA Psychiatry obesity premature death self-harm somatic disorders Swedish registries thyroid disease Source Type: research

Depression, Not Burnout, Associated With Greater Suicidal Ideation in Physicians
Depression, but not burnout, appears to be associated with greater suicidal ideation in U.S. physicians, according to astudy inJAMA Network Open. In contrast, burnout, but not depression, was associated with self-reported medical errors.“Approximately 1 in 10 medical students, 1 in 4 interns, and 1 in 16 practicing physicians report some degree of suicidal ideation,” wrote senior author Mickey T. Trockel, M.D., Ph.D., of Stanford University School of Medicine and colleagues. “Addressing physician well-being and reducing suici de risk require understanding the associations between physician distress, inclu...
Source: Psychiatr News - December 14, 2020 Category: Psychiatry Tags: burnout depression JAMA Network Open medical errors suicidal ideation suicide trainees Source Type: research

Anxiety, Depression May Increase Risk of Acute Exacerbation in COPD
Patients with chronic obstructive pulmonary disease (COPD) may experience an acute exacerbation of their illness if they have depression and/or anxiety, suggests astudy in theJournal of Affective Disorders.Guangxi Li, M.D., Ph.D., of Guang'anmen Hospital at the China Academy of Chinese Medical Sciences in Beijing and colleagues interviewed 504 adults with COPD who visited the pulmonary clinic at the hospital from January 2012 through July 2013. The patients completed the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) to screen for depression and anxiety symptoms. Those with an SAS score of 50 or mor...
Source: Psychiatr News - December 11, 2020 Category: Psychiatry Tags: acute exacerbation of COPD anxiety chronic obstructive pulmonary disease depression Journal of Affective Disorders Source Type: research

Progesterone Modulator May Reduce Symptoms of Premenstrual Dysphoric Disorder
Ulipristal acetate (UPA), a progesterone-modulating medication used as an emergency contraceptive and treatment for uterine fibroids, might help alleviate the psychological symptoms of premenstrual dysphoric disorder (PMDD), according to astudy published today inAJP in Advance. An estimated 3% to 5% of women of reproductive age are believed to experience PMDD, which is characterized by mood swings, irritability, anxiety, depression, and physical symptoms in the days preceding menstruation.For the current study, Erika Comasco, Ph.D., of Sweden ’s Uppsala University and colleagues recruited women aged 18 to 46 who were...
Source: Psychiatr News - December 10, 2020 Category: Psychiatry Tags: ajp in advance anger antidepressants depression irritability PMDD premenstrual dysphoric disorder progesterone Ulipristal acetate Source Type: research

Consistent Use of Mental Health Services Uncommon Among Youth Treated Early for Anxiety
This study provides the first view of long-term mental health service use among youth previously treated for anxiety,” the researchers wrote. “It suggests that the type of evidence-based treatment and initial response do not influence subsequent decisions about care, and it raises important q uestions about how to encourage continued engagement and improve outcomes for chronically ill youth.”For related information, see thePsychiatric Newsarticle “Childhood Anxiety Can Be Treated —the Challenge is to Recognize It. ”Deadline to Submit New Research Posters for Annual Meeting Is TomorrowAPA...
Source: Psychiatr News - December 9, 2020 Category: Psychiatry Tags: adolescents anxiety CAMS CBT Child/Adolescent Anxiety Multimodal Study children cognitive-behavioral therapy Journal of the American Academy of Child and Adolescent Psychiatry remission sertraline SSRIs youth Source Type: research

PTSD, Depression May Increase Risk of Death in Women
Women with symptoms of posttraumatic stress disorder (PTSD) and depression are at an increased risk of death compared with women without trauma exposure or depression, according to astudy inJAMA Network Open.“Our findings are consistent with prior studies that found that co-occurring PTSD and depression are associated with worse health outcomes compared with either disorder alone,” wrote Andrea L. Roberts, Ph.D., of Harvard T.H. Chan School of Public Health and colleagues. For instance, previous stu dies show that people with PTSD are at an increased risk of chronic diseases, including cardiovascular disease an...
Source: Psychiatr News - December 8, 2020 Category: Psychiatry Tags: cardiovascular disease death depression diabetes JAMA Network Open Nurses ’ Health Study II PTSD suicide women Source Type: research

Selecting Antipsychotic Based on Genetic Screening Not Associated With Better Outcomes in Schizophrenia
Using pharmacogenetic data on metabolism status to guide antipsychotic prescribing for schizophrenia patients does not appear to improve symptoms or reduce side effects better than routine monitoring, according to astudy published today inJAMA Network Open. Gesche J ürgens, M.D., Ph.D., of Zealand University Hospital in Roskilde, Denmark, and colleagues conducted a clinical trial involving 311 adults diagnosed with schizophrenia. The participants were screened to see which variants of the drug-metabolizing cytochrome P450 (CYP) enzymes they had; based on their pharmacogenetic profile, they were classified as poor...
Source: Psychiatr News - December 7, 2020 Category: Psychiatry Tags: antipsychotic persistence antipsychotics CYP genetic testing JAMA Network Open metabolism side effects Source Type: research

New MOC Draft Standards to Be Released for Public Comment Next Spring
The release of new draft Standards for Board Continuing Certification by the American Board of Medical Specialties(ABMS), which had been scheduled for early next week,has been delayed until April 2021.Despite the delay, APA is proactively alerting members to this important development and will be urging members to review the standards when they are released and to submit their comments directly to ABMS. The deadline for submission of public comments will be announced when the draft standards are released, and APA will inform members about the date and submission process.These standards will shape the maintenance of certifi...
Source: Psychiatr News - December 4, 2020 Category: Psychiatry Tags: ABMS ABPN American Board of Medical Specialties American Board of Psychiatry and Neurology maintenance of certification MOC Saul Levin Source Type: research

Patients With Major Depression May Experience Insulin Resistance
Two biomarkers of insulin resistance appear to be associated with current, but not remitted, major depressive disorder (MDD), according to astudy published inJAMA Psychiatry.Insulin resistance “is a known risk factor for somatic and brain-based disorders, including cardiovascular disease, Alzheimer disease, and major depressive disorder,” wrote Kathleen Watson, Ph.D., of the Center for Neuroscience in Women’s Health at Stanford Medicine and colleagues. “However, there is little ev aluation of how [insulin resistance] is associated with specific features of major depression.”Watson and colleagu...
Source: Psychiatr News - December 3, 2020 Category: Psychiatry Tags: depression insulin resistance JAMA Psychiatry major depressive disorder MDD Source Type: research

Group Interventions May Reduce Self-Stigma in Patients With Serious Mental Illness
Two group interventions have been found to help reduce internalized stigma in people with serious mental illness (SMI), but one of the interventions showed superiority for participants who had psychotic symptoms, according to astudy inPsychiatric Services in Advance.“ ‘Internalized stigma’ or ‘self-stigma’ refers to the process by which one cognitively or emotionally absorbs negative messages about mental illness and comes to believe and apply them to one’s self,” wrote Amy L. Drapalski, Ph.D., and colleagues. “Internalized stigma has been linke d to many negative outcomes, i...
Source: Psychiatr News - December 2, 2020 Category: Psychiatry Tags: Ending Self-Stigma Health and Wellness intervention Psychiatric Services serious mental illness SMI veterans Source Type: research

Report Highlights Need to Educate Women With SMI About Risks of HIV, Other STDs
As people around the world stand in solidarity to recognize the millions living with HIV/AIDS today and the millions of lives lost to HIV/AIDS thisWorld AIDS Day, areport inPsychiatric Services highlights the need to educate women with serious mental illness (SMI) about the risks of the disease.“Women with serious mental illness (for example, schizophrenia and bipolar disorder) are eight times more likely than women in the general population to contract STDs,” wrote Joseph McEvoy, M.D., of the Department of Psychiatry and Health Behavior at the Medical College of Georgia at Augusta Uni versity and colleagues. T...
Source: Psychiatr News - December 1, 2020 Category: Psychiatry Tags: HIV/AIDS HPV Psychiatric Services serious mental illness sexually transmitted diseases STDs women Source Type: research

Medication Followed by Psychotherapy May Reduce Risk of Depression Relapse/Recurrence
A sequential approach to depression management that starts with medication and then transitions to psychotherapy can reduce the risk of relapse or recurrence, reports ameta-analysis inJAMA Psychiatry.“A sequential strategy may include maintenance of antidepressant drug treatment or its discontinuation. Thus, the sequential model offers a unique opportunity for antidepressant drug tapering and discontinuation, with the advantage of yielding enduring results while limiting exposure to [antidepre ssant medications],” wrote Jenny Guidi, Ph.D., of the University of Bologna and Giovanni Fava, M.D., of the University ...
Source: Psychiatr News - November 30, 2020 Category: Psychiatry Tags: antidepressants depression JAMA Psychiatry meta-analysis psychotherapy recurrence relapse Source Type: research

Older Adults May Be More Resilient During Pandemic Than Younger People
Older adults may be more resilient to the anxiety, depression, and stress-related mental disorders that are being reported by younger adults during the COVID-19 pandemic, according to anarticle inJAMA.“[S]tudies from different countries have shown that at least some older adults are not experiencing disproportionately increased negative mental health consequences commensurate with the elevated risks they faced during the first few months of the COVID-19 pandemic,” wrote Ipsit Vahia, M.D., med ical director of Geriatric Psychiatry Outpatient Services at McLean Hospital; past APA President Dilip Jeste, M.D., dire...
Source: Psychiatr News - November 25, 2020 Category: Psychiatry Tags: anxiety COVID-19 depression JAMA older adults resiliency stress trauma wisdom Source Type: research

Effects of Sertraline-Olanzapine on Weight, Cholesterol May Differ According to Patient Age
Older adults with psychotic depression may experience less weight gain and increases in total cholesterol than younger adults when taking a combination of sertraline and olanzapine over an extended period, suggests astudy in theAmerican Journal of Geriatric Psychiatry.The findings are from theStudy Pharmacotherapy of Psychotic Depression II (STOP-PD II). The original STOP-PD trial established that a combination therapy of the antidepressant sertraline plus the antipsychotic olanzapine was more likely to lead to remission of psychotic depression than olanzapine alone over 12 weeks of therapy. STOP-PD II examined the risks a...
Source: Psychiatr News - November 24, 2020 Category: Psychiatry Tags: age American Journal of Geriatric Psychiatry depression olanzapine psychotic depression sertraline STOP-PD II weight Source Type: research

Prazosin Can Reduce Drinking in AUD Patients With Severe Withdrawal Symptoms
Prazosin is effective at reducing alcohol consumption in adults with alcohol use disorder (AUD) and severe withdrawal symptoms such as sweating, headache, and nausea, reports astudy inAJP in Advance.In a 12-week, randomized clinical trial of 112 treatment-seeking adults with AUD, those with severe withdrawal symptoms who took prazosin had half as many drinking days and only one-fifth the number of heavy drinking days as adults with severe withdrawal symptoms taking placebo. In contrast, there was no difference in drinking days between participants taking prazosin who were experiencing few or no symptoms of alcohol withdraw...
Source: Psychiatr News - November 23, 2020 Category: Psychiatry Tags: alcohol alcohol use disorder AUD drinking withdrawal Source Type: research

Suicidality Among Childbearing Women Found to Increase Over 12-Year Period
From 2006 to 2017, the prevalence of suicidal ideation and intentional self-harm among women in the year before or after birth increased substantially, according to astudy published this week inJAMA Psychiatry.“Maternal health experts note that the lack of consistent, inclusive data on suicidality before and after birth is alarming,” wrote Lindsay Admon, M.D., M.Sc., of the University of Michigan and colleagues. “Further, … suicidal ideation and intentional self-harm remain excluded from standard measures of severe maternal morbidity.”Admon and colleagues conducted the Maternal Behavioral Hea...
Source: Psychiatr News - November 20, 2020 Category: Psychiatry Tags: anxiety childbirth depression JAMA Psychiatry psychotic disorders self-harm suicidal ideation suicide women Source Type: research

COVID-19 Patients With Delirium in Emergency Department May Experience Worse Outcomes
Nearly 30% of adults aged 65 and older who are diagnosed and treated for COVID-19 in U.S. emergency departments (EDs) may present with delirium, suggests areport published today in JAMA Network Open. These patients appear to have worse outcomes, including longer stays in the intensive care unit (ICU) and in-hospital death than those with COVID-19 who do not show signs of delirium.“These findings suggest the clinical importance of including delirium on checklists of presenting signs and symptoms of COVID-19 that guide screening, testing, and evaluation,” wrote Maura Kennedy, M.D., M.P.H., of Massachusetts Genera...
Source: Psychiatr News - November 19, 2020 Category: Psychiatry Tags: CDC guidelines COVID-19 death delirium ED emergency department ICU length of stays medical records older adults Source Type: research

Specific Symptoms of Borderline Personality Disorder Linked to Suicide Risk
Certain symptoms of borderline personality disorder —especially chronic feelings of emptiness, fear of abandonment, and disturbances in one’s sense of identity—appear to be significantly associated with suicide attempts, according to areport published today inJAMA Psychiatry.“[T]he results of this study show the importance of assessing and targeting identity disturbance, abandonment, and emptiness in patients with BPD [borderline personality disorder] when considering suicide prevention, symptoms that may often be overshadowed by affective or behavioral features of BP D [borderline personality disor...
Source: Psychiatr News - November 18, 2020 Category: Psychiatry Tags: borderline personality disorder emptiness feeling of abandonment identity disturbance JAMA Psychiatry suicide suicide attempts suicide prevention Source Type: research

Impact of Racism Across Generations Discussed at APA Town Hall
The adverse effects of structural and interpersonal racism persist across generations, said panelists last night in thethird online town hall meeting hosted by APA ’s Presidential Task Force to Address Structural Racism Throughout Psychiatry.“This is a period of turbulence in our country, and we are all being forced to confront the disparities in the treatment of Black, indigenous, and people of color,” said moderator, task force member, and APA Trustee-at-Large Michele Reid, M.D. She is a clinical assistant professor in the Departm ent of Psychiatry and Behavioral Neurosciences at Wayne State University ...
Source: Psychiatr News - November 17, 2020 Category: Psychiatry Tags: Chuan-Mei Lee Ebony Dix Michele Reid Peter Ureste Presidential Task Force to Address Structural Racism Throughout Psychiatry stress transgender Source Type: research

Amisulpride Found More Effective Than Olanzapine or Aripiprazole
This study is interesting in that it was designed pragmatically to be more generalizable to the broader clinical population, yet it still produced dramatic results,” Stephen Marder, M.D., a professor of psychiatry and biobehavioral sciences at the University of California, Los Angeles, told Psychiatric News. Marder, who was not involved with the study, noted that the differences in PANSS scores between amisulpride and the other drugs corresponded to effect sizes of over 0.5 —significant changes that a physician would notice quickly. “I’m hopeful that studies like this may encourage industries to spo...
Source: Psychiatr News - November 16, 2020 Category: Psychiatry Tags: amisulpride antipsychotics aripiprazole Lancet Psychiatry negative symptoms olanzapine PANSS positive symptoms schizophrenia Source Type: research

Patient ’s Weight May Affect Response to Antidepressants
A patient ’s body mass index (BMI) may play a role in the effectiveness of treatment with certain antidepressants for major depressive disorder, suggests astudy published Thursday in theJournal of Affective Disorders.Le Xiao, M.D., Ph.D., of Capital Medical University in Beijing and colleagues analyzed data collected in a clinical trial that included 202 adults with major depressive disorder at five hospitals from 2011 to 2016. Patients were 18 to 60 years and had scores of at least 20 on the 17-item Hamilton Rating Scale for Depression (HAMD-17) upon enrollment. All patients initially received paroxetine, and those ...
Source: Psychiatr News - November 13, 2020 Category: Psychiatry Tags: antidepressants body mass index depression Journal of Affective Disorders mirtazapine paroxetine weight Source Type: research

FDA OKs App That Disrupts Nightmares Associated With PTSD
The Food and Drug Administration (FDA) hasapproved the marketing of NightWare —artificial intelligence software shown to reduce sleep disturbances in people experiencing nightmares related to posttraumatic stress disorder (PTSD) or nightmare disorder.In May 2019 NightWare received the FDA ’sbreakthrough device status designation, a process designed to expedite the development and review of devices that may provide for more effective treatment or diagnosis of life-threatening or irreversibly debilitating diseases or conditions.NightWare uses artificial intelligence software installed on an Apple Watch to monitor...
Source: Psychiatr News - November 12, 2020 Category: Psychiatry Tags: breakthrough device FDA nightmare disorder nightmares NightWare posttraumatic stress disorder PTSD Source Type: research

Implementing Suicide Screening in VHA Settings Can Help Identify Veterans at Risk
When incorporated into Veterans Health Administration (VHA) medical settings, a population-level, suicide-risk screening may help identify veterans at risk of suicide who may not be receiving mental health treatment, according to astudy published inJAMA Network Open.“Emerging evidence suggests that suicide risk screening in AC [ambulatory care] and ED [emergency department] or UCC [urgent care center] settings may provide critical opportunities to identify risk among patients who are not receiving or seeking mental health treatment,” wrote Nazanin Bahraini, Ph.D., of the Rocky Mountain Regional Veterans Affairs...
Source: Psychiatr News - November 10, 2020 Category: Psychiatry Tags: access to care and Treatment Act Commander John Scott Hannon Veterans Mental Health Care Improvement Act screening suicidal ideation suicidal plan suicide Veterans Comprehensive Prevention VHA Source Type: research

APA Congratulates President-Elect Joe Biden and Vice President-Elect Kamala Harris
APA this weekend issued astatement congratulating President-Elect Joe Biden and Vice President-Elect Kamala Harris on their victory in the 2020 election. The Associated Press and numerous other media outlets called the election for Biden and Harris over the weekend.“[W]e welcome the opportunity to work with the Biden administration on concrete initiatives to increase access to high-quality mental health care for our patients,” APA President Jeffrey Geller, M.D., M.P.H., said in the statement. “APA has worked diligently this past year to expand the use of telehealth to address the COVID-19 pandemic, and we...
Source: Psychiatr News - November 9, 2020 Category: Psychiatry Tags: ACA Affordable Care Act APA Jeffrey Geller Joe Biden Kamala Harris president-elect Saul Levin U.S. Supreme Court vice president-elect Source Type: research

Psilocybin Paired With Psychotherapy May Help Patients With Major Depression
Psilocybin, also known as magic mushrooms, may be effective in treating major depressive disorder when paired with supportive psychotherapy, suggests astudy inJAMA Psychiatry. The study also found that the beneficial effects of psilocybin may last longer than those of ketamine.Alan K. Davis, Ph.D., of the Johns Hopkins School of Medicine and colleagues studied 24 adults aged 21 to 75 years with major depressive disorder who received gelcaps of psilocybin at two sessions roughly a week and a half apart. All patients had eight hours of in-person visits with session facilitators to prepare for their first psilocybin session, ...
Source: Psychiatr News - November 6, 2020 Category: Psychiatry Tags: depression GRID-Hamilton Depression Rating Scale JAMA Psychiatry psilocybin psychotherapy Source Type: research

For Smokers With Schizophrenia, Varenicline Found Most Effective at Achieving Abstinence
Smokers with schizophrenia who received pharmacotherapeutic smoking cessation aids, especially the medication varenicline, had significantly higher abstinence rates compared with smokers with schizophrenia who received a placebo, according to astudy published inPsychiatric Services.“Despite evidence of the safety and efficacy of first-line pharmacotherapeutic cessation aids in this population, clinicians report negative attitudes toward providing smoking cessation treatment for smokers with schizophrenia, and pharmacotherapy—particularly non-nicotine pharmacotherapy—is p articularly underutilized,” ...
Source: Psychiatr News - November 5, 2020 Category: Psychiatry Tags: abstinence buproprion nicotine replacement therapy Psychiatric Services schizophrenia smoking tobacco varenicline Source Type: research

District Court Issues Injunction Against UBH for Failure to Cover Mental Health/Substance Use Disorders
A federal district court yesterday ruled that United Behavioral Health (UBH) must use medical necessity criteria and assessment tools developed by mental health and substance use disorder specialty organizations when making coverage-related determinations.The ruling was part of a 10-year injunction against UBH issued by Judge Joseph Spero of the United States District Court for the Northern District of California inWit v. United Behavioral Health. The injunction also includes a requirement that UBH personnel be trained in the use of the court-ordered medical necessity criteria and that UBH reprocess nearly 67,000 mental he...
Source: Psychiatr News - November 4, 2020 Category: Psychiatry Source Type: research

NEJM Special Report Examines Future of U.S. Health Policy Following 2020 Election
What might the results of the 2020 presidential election mean for the future of health policy in the United States? Robert J. Blendon, Sc.D., and John M. Benson, M.A., of the Harvard T.H. Chan School of Public Health examine this question in aspecial report in theNew England Journal of Medicine.Blendon is the Richard L. Menschel Professor of Public Health and Professor of Health Policy and Political Analysis, Emeritus. Benson is a senior research scientist and is managing director of the Harvard Opinion Research Program.“Our analysis … is drawn from the results of 19 national public opinion polls [with sample ...
Source: Psychiatr News - November 3, 2020 Category: Psychiatry Tags: 2020 presidential election ACA COVID-19 drug costs health care costs NEJM public opinion polls Source Type: research