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Folate, Vitamin D Found Lower in People Who Have Experienced First-Episode Psychosis
Patients who have experienced first-episode psychosis (FEP) appear to have significantly lower levels of folate and vitamin D in their blood compared with individuals with no psychiatric diagnosis, according to areport inSchizophrenia Bulletin.Understanding nutritional deficits that exist from illness onset could lead to nutrient-based interventions to improve diet and possibly reduce symptoms in people with FEP, the authors wrote.Previous studies have suggested that individuals with schizophrenia have low levels of B vitamins (B12 and folate), antioxidant vitamins (C and E), and vitamin D. However, which nutritional defic...
Source: Psychiatr News - December 13, 2017 Category: Psychiatry Tags: first-episode psychosis folate Joseph Firth nutrition Schizophrenia Bulletin vitamin C vitamin D Source Type: research

Incorporating Social Therapy Into Early Psychosis Intervention Improves Social Engagement
Despite considerable evidence showing the benefit of early intervention services on social recovery in people with first-episode psychosis, many will continue to experience severe and persistent social impairments. Astudy published yesterday inLancet Psychiatry suggests that combining early psychosis intervention with social recovery therapy may help to further improve patient outcomes, particularly in individuals who lack the motivation or ability to engage in existing psychosocial interventions.The social recovery program examined in the study was a three-step approach aimed at (1) establishing a working therapeutic rela...
Source: Psychiatr News - December 12, 2017 Category: Psychiatry Tags: David Fowler first-episode psychosis Lancet Psychiatry social recovery Source Type: research

Pregnant Women With Dissociative Subtype of PTSD Have Higher Levels of Cortisol, Study Finds
Pregnant women with a severe subtype of posttraumatic stress disorder (PTSD) appear to have higher levels of the stress hormone cortisol than other pregnant women with a history of trauma, reports astudy inthe Journal ofObstetric,Gynecological,and Neonatal Nursing. Such high levels of cortisol may contribute to adverse health conditions in the next generation, according to the study authors.“Exposure to early relational trauma that predisposes a person to dissociation and PTSD may affect that individual’s short- and long-term cortisol patterns,” wrote Julia S. Seng, Ph.D., of the University of Michigan an...
Source: Psychiatr News - December 11, 2017 Category: Psychiatry Tags: & Neonatal Nursing childhood maltreatment Gynecological Journal of Obstetric Julia Seng posttraumatic stress disorder pregnancy PTSD Source Type: research

APA Paper Describes How Psychiatrists Can Improve Health of SMI Patients
Psychiatrists should routinely screen patients with serious mental illness (SMI) for common medical conditions, counsel them on lifestyle modifications to reduce cardiovascular risk factors, and coordinate with their primary care physicians to narrow the longevity gap between this group and the general population. These were some of the conclusions in awhite paper that APA issued yesterday at a Capitol Hill briefing.More than a decade has passed since researchers found that people with SMI treated in the public mental health system are dying on average 25 years earlier than the general population. “The majority of th...
Source: Psychiatr News - December 8, 2017 Category: Psychiatry Tags: lifestyle intervention medical training physical health primary care risk modification serious mental illness SMI Source Type: research

ABPN to Pilot New Test Format as Alternative to 10-Year Proctored MOC Exam
The American Board of Psychiatry and Neurology (ABPN) is piloting a new open-book, journal article –based assessment beginning in 2019 as an alternative to the proctored 10-year Maintenance of Certification (MOC) examination.Eligible diplomates who choose to participate in this pilot program will be required to read and answer questions on between 30 and 40 journal articles. Diplomates may choose from a library of articles that have been selected for the test by the ABPN Pilot Project Test Writing Committees. The pilot project will run for three years, from 2019-2021. If approved by the American Board of Medical Spec...
Source: Psychiatr News - December 7, 2017 Category: Psychiatry Tags: 10-Year Proctored MOC Exam ABPN American Board of Psychiatry and Neurology maintenance of certification open book test pilot project Source Type: research

Adjunctive Ketamine Appears to Reduce Suicidal Thoughts in Depressed Patients for Up to Six Weeks
A single adjunctive infusion of ketamine appears to reduce suicidal thoughts in depressed patients within 24 hours, according to astudy published yesterday inAJP in Advance. This improvement was maintained for six weeks with standard, optimized pharmacotherapy.While previous studies have suggested ketamine rapidly reduces suicidal ideation in some patients, whether similar effects would be seen in patients with major depression and high levels of suicidal ideation was less clear.Researchers from Columbia University Medical Center and the New York State Psychiatric Institute randomly assigned 80 adults with major depressive...
Source: Psychiatr News - December 6, 2017 Category: Psychiatry Tags: ajp in advance antidepressant depression dissociative effects high blood pressure infusion ketamine Michael F. Grunebaum midazolam suicide Source Type: research

New Geriatric Cognition Chart May Improve Dementia Monitoring
Researchers at Laval University in Quebec and colleagues have devised an assessment chart called QuoCo (for cognitive quotient) to track patient cognition, offering a new method they say can help identify dementia during the earliest stages. Thestudy was published yesterday in theCanadian Medical Association Journal.“Similar to the ‘growth charts’ that are used in pediatrics, cognitive charts allow physicians to position any patient based on age, education, and Mini-Mental State Examination [MMSE] scores, and simply track the longitudinal profile of cognitive decline over time,” wrote lead study aut...
Source: Psychiatr News - December 5, 2017 Category: Psychiatry Tags: Canadian Medical Association Journal cognition dementia Mini-Mental State Examination Patrick Bernier QuoCo Source Type: research

Long-Term SSRI Treatment May Delay Progression From Mild Cognitive Impairment to Alzheimer ’s Dementia
Long-term treatment with selective serotonin reuptake inhibitors (SSRIs) may benefit elderly patients with mild cognitive impairment (MCI) and a history of depression, even after depressive symptoms have resolved, suggested astudy published inAJP in Advance.In patients with MCI and a history of depression, long-term treatment with SSRIs (for more than four years) was associated with a delayed progression to Alzheimer ’s dementia by about three years, compared with those who used SSRIs only short term or who had no treatment.Delaying the progression from MCI to Alzheimer ’s dementia would not only reduce the pre...
Source: Psychiatr News - December 4, 2017 Category: Psychiatry Tags: ajp in advance Alzheimer's antidepressants Claudia Bartels cognition dementia depression health care costs MCI SSRI Source Type: research

FDA Approves First Once-Monthly Injectable Buprenorphine for Opioid Use Disorder
The Food and Drug Administration (FDA) has approved Sublocade, the first once-monthly injectable buprenorphine product for the treatment of moderate-to-severe opioid use disorder (OUD) in adults who have initiated treatment with a transmucosal (absorbed through mucus membrane) buprenorphine-containing product. Sublocade is indicated for patients who have been on a stable dose of buprenorphine treatment for a minimum of seven days and is meant to be used as part of a complete treatment program that includes counseling and psychosocial support.“Sublocade provides a new treatment option for patients in recovery who...
Source: Psychiatr News - December 1, 2017 Category: Psychiatry Tags: boxed warnings buprenorphine FDA hydromorphone Individor opioid use disorder Risk Evaluation and Mitigation Strategy Sublocade Source Type: research

Insurance Company Practices Limit Access to MH Care, Finds New Report
This report echoes what APA has been saying for the past several years—that insurers are not maintaining adequate networks of mental health providers for patients and that psychiatrists are reimbursed less than primary care doctors for the same services,” Levin said. “We call upon state and federal regulators to ensure that insurance companies are abiding by parity laws already on the books.” For related information, see thePsychiatric News article “Enforcement of Parity Law Broadens to Include New Areas of Insurer Violations.”(Image: iStock/123light)For previous news alerts,click h...
Source: Psychiatr News - November 30, 2017 Category: Psychiatry Tags: access to care mental health parity Milliman out-of-network care parity law phantom networks physician reimbursement Saul Levin Source Type: research

Substance Use-Induced Psychosis Highly Correlated With Later Schizophrenia, Bipolar Disorder
As many as a third of all patients with substance use-induced psychosis may go on to develop schizophrenia or bipolar disorder within five years, according to areport published yesterday inAJP in Advance. The highest risk of conversion to either schizophrenia or bipolar disorder was for patients who experienced cannabis-induced psychosis, which had a conversion rate of 47.4%.The findings suggest the need for early identification and rapid treatment. “It is important to diagnose new cases of schizophrenia and bipolar disorder as soon as possible and to initiate treatment without delay, because prolonged psychosis with...
Source: Psychiatr News - November 29, 2017 Category: Psychiatry Tags: ajp in advance bipolar disorder cannabis conversion to schizophrenia Marie Stefanie Kejser Starzer self-harm substance use-induced psychosis Source Type: research

Denying Certain Requests May Reduce Patient Satisfaction
Patient satisfaction is acknowledged as an important part of patient-centered care; however, some controversy exists regarding how honoring patients ’ requests fits into this paradigm. Astudy published yesterday inJAMA Internal Medicine found that denial of several types of patient requests is associated with lower patient-satisfaction ratings of the physician. Specifically, denials of requests for referral, pain medication, other new medications, and laboratory tests were associated with significantly worse patient satisfaction.“In an era of satisfaction score–driven compensation of clinicians, the findi...
Source: Psychiatr News - November 28, 2017 Category: Psychiatry Tags: Anthony Jerant imaging tests JAMA Internal Medicine Joseph S. Ross lab tests pain medication patient satisfaction Source Type: research

Saliva Biomarkers May Help Predict Post-Concussion Syndrome in Youth
Biomarkers in saliva may help identify youth who are likely to take more time to recover following a concussion, according to astudy published in JAMA Pediatrics.Steven Hicks, M.D., Ph.D., and colleagues at Penn State College of Medicine found that measuring the salivary levels of five microRNAs (miRNAs) —small, noncoding RNA molecules that influence protein production throughout the body—can identify children with post-concussion syndrome (PCS) with about 85% accuracy. In comparison, the Sport Concussion Assessment Tool (SCAT3), the tool currently used to determine PCS, was about 65% accurate.“The miRNAs...
Source: Psychiatr News - November 27, 2017 Category: Psychiatry Tags: concussion JAMA Pediatrics miRNA post-concussion syndrome saliva Sport Concussion Assessment Tool Steven Hicks Source Type: research

Study Highlights Need for PTSD Interventions for Cancer Patients
Research on adult cancer patients in Southeast Asia found a striking prevalence of posttraumatic stress disorder (PTSD), with about 1 in 5 (21.7%) experiencing symptoms of PTSD six months after being diagnosed with cancer. Thestudy was published Monday inCancer.Although participants ’ rates of PTSD declined with time, the data underscore the risk of developing persistent PTSD even years after cancer diagnosis and treatment, according to the authors of the study. About one-third of patients (34.1%) initially diagnosed with PTSD or some of its symptoms went on to develop chroni c or worsening PTSD four years later.&nbs...
Source: Psychiatr News - November 22, 2017 Category: Psychiatry Tags: breast cancer Caryn Mei Hsien Chan post-traumatic stress disorder PTSD Source Type: research

Long-Term Treatment of Tardive Dyskinesia With Valbenazine Appears Safe, Effective
Long-term treatment with valbenazine for tardive dyskinesia (TD) appears to be safe and well-tolerated while maintaining treatment effects seen in an earlier short-term trial, according to areport in theJournal of Clinical Psychiatry. In April, the Food and Drug Administrationapproved Ingrezza (valbenazine) capsules to treat adults with TD —a serious side effect associated with chronic use of antipsychotics—making it the first FDA-approved product for the condition. This approval was based in part on the results of asix-week trial, which compared changes in involuntary movements in patients with moderate-t...
Source: Psychiatr News - November 21, 2017 Category: Psychiatry Tags: efficacy Ingrezza Journal of Clinical Psychiatry safety and tolerability Stuart A. Factor tardive dyskinesia TD valbenazine Source Type: research

Hormonal Contraception May Increase Risk of Suicide, Study Suggests
Women who use hormonal birth control may be more likely to attempt or die by suicide than those who never use the medication, according to astudy of women aged 15 to 33 in Denmark. The findings were published inAJP in Advance.“Adolescent women experienced the highest relative risk,” wrote Charlotte Wessel Skovlund, Ph.D., and colleagues of the University of Copenhagen. “Patch, vaginal ring, and progestin-only products were associated with higher risks than oral combined [estrogen and progestin] products, and a simi lar association was suggested for suicide.”To assess associations between their use o...
Source: Psychiatr News - November 20, 2017 Category: Psychiatry Tags: adolescent women ajp in advance antidepressants Charlotte Wessel Skovlund Denmark hormonal contraception suicide suicide attempts Source Type: research

FDA Expands Indication of Electric Stimulation Device to Treat Opioid Withdrawal Symptoms
The Food and Drug Administration (FDA) hasapproved the use of an electric stimulation device to help to reduce the symptoms of opioid withdrawal, marking the first time a device has been indicated for withdrawal symptoms.The NSS-2 Bridge is a small device placed behind the patient ’s ear that emits electrical pulses to stimulate cranial nerves. These stimulations provide relief from common withdrawal symptoms during the first few days of drug abstinence; these include sweating, tremors, stomach problems, insomnia, and joint pain.“Given the scope of the epidemic of opioid addiction, we need to find innovative ne...
Source: Psychiatr News - November 17, 2017 Category: Psychiatry Tags: electric stimulator FDA medication-assisted treatment NSS-2 Bridge opioid use disorder opioid withdrawal Source Type: research

APA, Five Other Medical Groups Voice Opposition to Senate Proposal to Remove Individual Mandate
Repeal of the mandate under the Affordable Care Act (ACA) to buy health insurance is likely to raise premiums and increase the number of uninsured Americans, APA and five other medical specialty organizations said in astatement released today responding to provisions in the Senate tax reform bill that would eliminate the mandate.“The Congressional Budget Office (CBO) estimates that repeal of the individual mandate will result in 13 million people becoming uninsured by 2027,” APA and the five other groups said. “Furthermore, repealing the mandate will increase premiums and destabilize the individual and sm...
Source: Psychiatr News - November 16, 2017 Category: Psychiatry Tags: Affordable Care Act group of six statement individual mandate Senate tax reform bill Source Type: research

Naltrexone, Buprenorphine-Naloxone Found Equally Effective in OUD Patients Who Initiate Treatment
Extended-release naltrexone and sublingual buprenorphine-naloxone appear to be equally safe and effective at preventing opioid relapse in patients with opioid use disorder (OUD). However, it can be harder to initiate patients actively using opioids on naltrexone (due to required detox period) than buprenorphine-naloxone. These two findings were reported in astudy published yesterday inThe Lancet.“Both medications are effective treatments for opioid use disorders versus counseling-only approaches or compared to placebo. What is now clear is how similar the outcomes are for those initiating treatment with either medica...
Source: Psychiatr News - November 15, 2017 Category: Psychiatry Tags: buprenorphine-naloxone extended-release naltrexone Joshua D. Lee NIDA Nora D. Volkow opioid use disorder The Lancet Source Type: research

FDA Approves Abilify Pill With Embedded Digital Sensor to Track Ingestion
The Food and Drug Administration (FDA) on Mondayapproved Abilify MyCite —aripiprazole tablets with a sensor that digitally tracks if patients have ingested their medication.The product is approved for the treatment of schizophrenia, acute treatment of manic and mixed episodes associated with bipolar I disorder, and for use as an add-on treatment for depression in adults.According to an FDA press release, the system works by sending a message from the pill ’s sensor to a wearable patch. The patch transmits the information to a mobile application so that patients can track the ingestion of the medication on ...
Source: Psychiatr News - November 14, 2017 Category: Psychiatry Tags: Abilify MyCite digital health feedback system digital sensor Food and Drug Administration John Kane Proteus Digital Health treatment adherence Source Type: research

ADHD Medication Use During Pregnancy Poses Modest Birth Risks
The use of attention-deficit/hyperactivity disorder (ADHD) medications during pregnancy can modestly increase the risk of some negative birth outcomes, according to astudy published Friday inPediatrics. Ulrika N örby, Ph.D., of Lund University in Sweden and colleagues found that infants exposed to ADHD medications during pregnancy were about 50% more likely of being admitted to a neonatal intensive care unit (NICU) than infants whose mothers never took these medications and about 20% more likely to require care in a NICU than infants whose mothers used these medications before or after but not during pregnancy.In...
Source: Psychiatr News - November 13, 2017 Category: Psychiatry Tags: atomoxetine attention-deficit/hyperactivity disorder (ADHD) CNS disorders Kimberly Yonkers NICU pediatrics pregnancy preterm birth stimulants Ulrika N örby Source Type: research

Antipsychotics May Increase Risk of Aspiration Pneumonia in Older Adults
Antipsychotics are commonly used in hospitals for non-psychiatric purposes, particularly to manage delirium in older hospitalized patients. Astudy published in the Journal of the American Geriatrics Society found that patients who received antipsychotics for a non-psychiatric purpose had about 40%-50% increased risk of aspiration pneumonia —an infection that occurs following the ingestion of solids or liquids into the lungs—than hospital patients without antipsychotic exposure.“This association was robust through multiple analytical approaches and persisted when focusing on individuals with discharge diag...
Source: Psychiatr News - November 9, 2017 Category: Psychiatry Tags: antipsychotic aspiration pneumonia delirium geriatric psychiatry off-label prescribing Shoshana Herzig Source Type: research

Guided Online CBT Program May Enhance Collaborative Care for Depression, Anxiety
Incorporating a computerized cognitive-behavioral therapy (CCBT) into a collaborative care program may lead to symptom improvements in patients with depression and anxiety beyond those reported by patients receiving usual care from a primary care physician (PCP), according to astudy published today inJAMA Psychiatry. “Our report confirms the effectiveness of guided CCBT, highlights the critical importance of patient engagement with online interventions, and provides high-quality evidence about the limits and potential benefits of these emerging technologies,” wrote Bruce L. Rollman, M.D., M.P.H., of the Un...
Source: Psychiatr News - November 8, 2017 Category: Psychiatry Tags: anxiety Bruce Rollman care manager CBT collaborative care depression internet support group JAMA Psychiatry primary care Source Type: research

APA, Responding to Trump on Shooting, Seeks Action on Mental Health
In response to remarks by President Donald Trump this week that the deadly shooting in a Texas church Sunday morning was “a mental health problem,” APA called on the administration and Congress to strengthen and improve access to quality mental health care.“We are deeply saddened by the senseless violence in a house of worship this weekend,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A., in astatement following the shooting in which 26 people were killed and more than 20 injured when a gunman opened fire at a Baptist church. “We extend our deepest sympathies to the victims, the fa...
Source: Psychiatr News - November 7, 2017 Category: Psychiatry Tags: Affordable Care Act APA CEO and Medical Director Saul Levin APA statement essential health benefits mental illness stigma substance use disorders Texas shooting Source Type: research

High Rates of Polypharmacy Found Among Adults With Intellectual Disability Seeking Psychiatric Care
In this study and a prior study, polypharmacy rates were not associated with the severity of intellectual disability or autism spectrum disorder.The study sample consisted of 517 outpatients (199 females; 318 males) aged 15 to 73 in an urban, tertiary-level mental health care facility in Ontario, Canada. Before receiving specialist care, these individuals with intellectual disability received their medications from either family physicians or general psychiatrists. Of the 70% of the study patients prescribed at least one psychotropic medication, 146 (40%) had no psychiatric diagnosis on their intake form. One hundred ...
Source: Psychiatr News - November 6, 2017 Category: Psychiatry Tags: anxiety disorders Canada intellectual disabilities mood disorders polypharmacy Psychiatric Services in Advance psychotic disorders Yona Lunsky Source Type: research

U.S. Senators, MH Advocates Among Recipients of American Psychiatric Excellence (APEX) Awards
APA today recognized five leaders in politics, journalism, and advocacy for drawing attention to the needs of people with mental illness and substance use disorders during the second American Psychiatric Excellence (APEX) Awards presentation in Washington, D.C.Honorees included Resident Commissioner Jenniffer Gonz ález-Colón (R-Puerto Rico; pictured at left with APA Assembly Speaker Theresa Miskimen, M.D.); Kathryn Farinholt, executive director of NAMI Maryland; U.S. Sen. Brian Schatz (D-Hawaii); U.S. Sen. Debbie Stabenow (D-Mich.); and Eric Eyre, a reporter for theCharleston Gazette-Mail.As resident commissi...
Source: Psychiatr News - November 3, 2017 Category: Psychiatry Tags: 2017 APEX Awards Jenniffer Gonzalez-Colon (R.PR) Kathryn Farinholt NAMI Maryland; U.S. Brian Schatz (D-HI) reporter for the Charleston Gazette-Mail. U.S. Debbie Stabenow (D-MI); Eric Eyre Source Type: research

APA Pledges Support of Efforts to Address Opioid Crisis
Following the release of thefinal report by the President ’s Commission on Combating Drug Abuse and the Opioid Crisis on Wednesday, APApledged its support to work with the Trump administration, Congress, and states to address the nation ’s opioid crisis.“The APA welcomes the final report because it helps bring much-needed attention to this crisis,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. "Our organization trains thousands of clinicians each year in the diagnosis and treatment of those with opioid use disorders. Additionally, we are an active partner in the Providers’ Cl...
Source: Psychiatr News - November 2, 2017 Category: Psychiatry Tags: mental health parity opioid crisis President ’s Commission on Combating Drug Abuse and the Opioid Crisis samhsa Saul Levin stigma Trump administration Source Type: research

Long-Term Use of Hypnotics Up Significantly From 1999 to 2014, Study Finds
Long-term use of benzodiazepine (BZD) and non-benzodiazepine hypnotics (NBH) appears to have grown significantly during a 15-year period between 1999 and 2014, independent of demographic shifts, according to areport today inPsychiatric Services in Advance.Because clinical guidelines suggest that both types of medications should be used on a short-term basis, the findings highlight “the pressing need for better delineation of appropriate medium- and long-term use of these medications,” wrote lead author Christopher Kaufmann, Ph.D., M.H.S., of the University of California, San Diego, and colleagues.The researcher...
Source: Psychiatr News - November 1, 2017 Category: Psychiatry Tags: benzodiazepines hypnotics long-term use non-benzodiazepine hypnotics sleep problems Source Type: research

Alleviating Conflict Between Work, Home Life May Improve Physician Mental Health
The medical internship year can be a challenging time for many physician trainees. Astudy published yesterday inJAMA Internal Medicine found that female medical interns are more likely than male medical interns to experience symptoms of depression. The study also found that the sex disparity in depression during the internship year may be driven in part by increasing conflict between work and personal obligations (work-family conflict). “Systemic modifications to alleviate conflict between work and family life may improve physician mental health and reduce the disproportionate depression disease burden for femal...
Source: Psychiatr News - October 31, 2017 Category: Psychiatry Tags: Anita Everett burnout Constance Guille depression internship JAMA Internal Medicine Judy Shea Lisa Bellini PHQ-9 physician wellness trainees work-family conflict Source Type: research

Niacin Skin Test May Identify Some Patients With Schizophrenia
Researchers may be one step closer to determining how a topical niacin test —which rapidly causes the skin to flush—might be used to objectively identify some patients with schizophrenia, according to astudy published inSchizophrenia Bulletin. Previous studies have observed a link between a diminished niacin response and schizophrenia, but due to small sample sizes it has been difficult to pinpoint a quantitative cutoff that can accurately distinguish patients. In the current study, Chunling Wan, Ph.D., of Shanghai Jiao Tong University in China and colleagues calculated the degree of inflammatory response ...
Source: Psychiatr News - October 30, 2017 Category: Psychiatry Tags: arachidonic acid niacin schizophrenia schizophrenia diagnosis skin reaction Source Type: research

E-Cigarette Use Can Lead to Smoking Tobacco Cigarettes, Study Suggests
E-cigarette vaping can lead adolescents eventually to smoking combustible cigarettes, according to astudy published this week inJAMA Pediatrics.“Adolescents who use e-cigarettes with higher levels of nicotine may be at greater risk for developing a tolerance to and dependence on nicotine that could contribute to the persistence and progression of vaping as well as use of combustible tobacco products,” wrote corresponding author Adam M. Leventhal, Ph.D., of the University of Southern California Keck School of Medicine and colleagues. In this cohort of 181 adolescent e-cigarette users (96 boys and 85 girls),...
Source: Psychiatr News - October 27, 2017 Category: Psychiatry Tags: Adam Leventhal adolescents combustible cigarettes E-cigarettes JAMA Pediatrics nicotine smoking vaping youth Source Type: research

Diagnosing Late-Onset ADHD May Require Ruling Out Substance Use, Other Disorders
Although some patients who screen positive for attention-deficit/hyperactivity disorder (ADHD) in adolescence or adulthood may represent valid late-onset cases, astudy inAJP in Advance suggests there may be other explanations for the emergence of ADHD symptoms later in life.After using a multistep assessment that took into consideration psychiatric symptoms, impairment, and substance use patterns from childhood to adulthood, Margaret Sibley, Ph.D., of Florida International University in Miami and colleagues concluded approximately 95% of the patients who initially screened positive on symptom checklists should not be diagn...
Source: Psychiatr News - October 26, 2017 Category: Psychiatry Tags: ADHD ajp in advance Margaret Sibley Multimodal Treatment Study of ADHD substance use disorder Source Type: research

Everett, Others Discuss Importance of MH Block Grants at Hill Briefing
Anita Everett, M.D., medical director of the Substance Abuse and Mental Health Services Administration (SAMHSA), participated in a Capitol Hill briefing yesterday on the importance of the agency ’sCommunity Mental Health Services Block Grant (MHBG) program.The MHBG program provides funds and technical assistance to all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and U.S. Pacific to support comprehensive, community mental health services. The program funds are divided among the states and territories based on the estimated at-risk population.“These block grants are a small but vita...
Source: Psychiatr News - October 25, 2017 Category: Psychiatry Tags: Anita Everett block grant Congress first episode psychosis Hill briefing NAMI samhsa schizophrenia Source Type: research

Extended-Release Naltrexone as Effective, Safe as Buprenorphine-Naloxone, Study Finds
Treatment with extended-release naltrexone appears to be as safe and effective as daily oral buprenorphine-naloxone in maintaining short-term abstinence from heroin and other illicit substances in newly detoxified individuals, according to astudy inJAMA Psychiatry. The findings were based on a 12-week, multicenter, outpatient, open-label trial conducted at five addiction clinics in Norway. After detoxification, 159 opioid-dependent adults (according toDSM-4) were randomly assigned to either daily oral flexible dose buprenorphine-naloxone (4 mg/d to 24 mg/d) or extended-release naltrexone hydrochloride (380 mg, adminis...
Source: Psychiatr News - October 24, 2017 Category: Psychiatry Tags: alcohol amphetamine buprenorphine-naloxone cannabis cocaine extended-release naltrexone JAMA Psychiatry Lars Tanum opioid dependence withdrawal Source Type: research

Technical, Clinical Advances Make ECT Safe, More Effective for More Patients
Electroconvulsive therapy (ECT) should be regarded as a valuable treatment for severe major depression based on severity of illness, “not just because all other treatments have failed,” said Charles Kellner, M.D., the director of the ECT service at Mount Sinai Hospital in New York City, during a workshop Saturday at APA’s fall meeting IPS: The Mental Health Services Conference in New Orleans.Technical and clinical advances have vastly improved the effectiveness and tolerability of ECT for patients with severe depression, and research is now beginning to elucidate how ECT works, he said. Kellner, who is al...
Source: Psychiatr News - October 23, 2017 Category: Psychiatry Tags: 2017 IPS: The Mental Health Services Conference; APA Charles Kellner ECT electroconvulsive therapy M.D. Source Type: research

IPS Town Hall Focuses on NIMH Goals, Call for Ideas
The National Institute of Mental Health ’s (NIMH) Division of Services and Intervention Research (DSIR) is “open for business,” said division director Robert Heinssen, Ph.D., at a special session yesterday at APA’s fall conference, IPS: The Mental Health Services Conference, in New Orleans.Heinssen noted that a combination of Congressional funding and a drive by new NIMH Director Joshua Gordon, M.D., to accelerate the institute ’s public health impact has led to the availability of resources for developing innovative interventions that can reach more people with mental illness. "We are lo...
Source: Psychiatr News - October 20, 2017 Category: Psychiatry Tags: Institute on Psychiatric Services Joshua Gordon NIAAA NIDA NIH NIMH Robert Heinssen Source Type: research

Pfister Award Winner Describes Brief Psychotherapy Modules for Hope in the Midst of Demoralization
Hope is a natural antidote to despair and demoralization experienced by psychiatric patients that can be encouraged and supported through brief “hope” interventions that can be employed in crisis situations, according to James L. Griffith, M.D. Griffith delivered APA’s 2017Oskar Pfister Award lecture today at IPS: The Mental Health Services Conference in New Orleans.Griffith, the chair of psychiatry at George Washington University (GWU) School of Medicine, described his work developing brief intervention modules that help patients practice hope in demoralizing life situations and that can be taught to tra...
Source: Psychiatr News - October 19, 2017 Category: Psychiatry Tags: 2017 IPS: The Mental Health Services Conference; APA George Washington University School of Medicine. James L. Griffith M.D. New Orleans Oscar Pfisker Award Source Type: research

App Improves Mental Health Service Delivery to Pregnant Women With Symptoms of Depression
A smartphone application that tracks mood changes and alerts providers if symptoms worsen appears to improve service delivery and patient engagement among pregnant women with perinatal depression symptoms, according to areport inPsychiatric Services in Advance.  The findings suggest such an app “is a feasible option to improve mental health service delivery via monitoring at-risk patients between visits,” wrote Liisa Hantsoo, Ph.D., and colleagues at the University of Pennsylvania Perleman School of Medicine. “[T]his app also facilitated patient-provider contact when needed rather th an relying ...
Source: Psychiatr News - October 18, 2017 Category: Psychiatry Tags: App Liisa Hantsoo mood tracking smart phone application moods perinatal depressive symptoms pregnant women Psychiatric Services in Advance smartphone Source Type: research

Candidates Announced for APA's 2018 Election
The APA Nominating Committee, chaired by APA Immediate Past President Maria A. Oquendo, M.D., Ph.D., today announced the candidates for the Association's 2018 election.President-ElectGlenn A. Martin, M.D. Bruce J. Schwartz, M.D.Stephen M. Strakowski, M.D.TreasurerBrian Crowley, M.D. Gregory W. Dalack, M.D.Trustee-at-LargeRobert E. Feder, M.D. Richard F. Summers, M.D.Early Career Psychiatrists Trustee-at-LargeH éctor Colón-Rivera, M.D.Mark A. Haygood, D.O., M.S.Ayana Jordan, M.D., Ph.D.Area 1 TrusteeJohn M. De Figueiredo, M.D.Eric M. Plakun, M.D.Area 4 TrusteeRonald M. Burd, M.D.Cheryl D. Wills, M.D.Area 7 Tru...
Source: Psychiatr News - October 17, 2017 Category: Psychiatry Tags: American Psychiatric Association APA election APA's 2018 election Bruce Schwartz Glenn Martin Stephen Strakowski Source Type: research

Lurasidone Benefits Youth With Bipolar Depression Without Major Side Effects
This study included 347 pediatric patients aged 10 to 17 with bipolar I disorder and CDRS-R scores of at least 45. The participants were randomly assigned to either lurasidone (20-80 mg daily) or placebo. At the study endpoint, CDRS-R total scores dropped 21 points in the lurasidone group compared with 15.3 points in the placebo group. Overall response rates ( ≥50% reduction from baseline to week 6 in CDRS-R total score) were 59.5% and 36.5% for the lurasidone and placebo groups, respectively.DelBello and colleagues noted the improvements seen in the current study were comparable to those seen in a clinical trial of ola...
Source: Psychiatr News - October 16, 2017 Category: Psychiatry Tags: bipolar depression CDRS-R child and adolescent psychiatry global functioning lurasidone Source Type: research

APA Speaks Out Against the Administration ’s Latest Moves to Unravel ACA
APA and five other medical specialty organizations are strongly opposing actions taken yesterday by the Trump administration to undermine the Affordable Care Act.They say that a White House executive action allowing individuals and small employers to purchase certain types of low-cost health insurance plans and the halting of subsidies to health plans that help pay for coverage of low-income families will destabilize health insurance markets and prevent access to care by millions of Americans.The five other organizations are the American Academy of Family Physicians, the American Academy of Pediatrics, the American College...
Source: Psychiatr News - October 13, 2017 Category: Psychiatry Tags: Affordable Care Act cost-sharing reduction payments CSR payments President Trump Source Type: research

Insomnia Symptoms, Sleep Medications Increase Risk of Falls in Seniors
The more insomnia symptoms an older adult reports, the greater their risk of future falls, according to astudy published in the journalSleep. This risk appears to be even greater in older adults who took physician-recommended sleep medications.“Multiple insomnia complaints are common among older adults, and our findings suggest that investigating a single insomnia symptom may underestimate the impact of multiple co-existing insomnia symptoms on fall risk,” wrote Orfeu Buxton, Ph.D., and colleagues at the Pennsylvania State University Center for Healthy Aging.Buxton and colleagues analyzed data from the 2006 thr...
Source: Psychiatr News - October 12, 2017 Category: Psychiatry Tags: cbt-i fall injury Health and Retirement Study insomnia sleep medication Source Type: research

Spending More Time on Exposure Tasks During CBT May Improve Outcomes in Anxious Youth
Encouraging youth with anxiety disorders to gradually confront anxiety-provoking situations is recognized as a key component of cognitive-behavioral therapy (CBT), but few studies have examined specific exposure characteristics that predict treatment outcomes. Astudy published Monday in theJournal of the American Academy of Child and Adolescent Psychiatry suggests the number of CBT sessions in which exposure tasks are practiced may predict treatment outcomes.“[T]he findings support the importance of prioritizing exposure tasks within CBT sessions, revealing a positive link between the number of sessions in which expo...
Source: Psychiatr News - October 11, 2017 Category: Psychiatry Tags: anxiety cognitive-behavioral therapy exposure therapy Journal of the American Academy of Child and Adolescent Psychiatry Tara Peris Source Type: research

Computer-Assisted CBT for Depression Found Equivalent to Standard CBT
Patients with major depressive disorder who used a computer-assisted form of cognitive-behavioral therapy (CBT) in conjunction with visits with a therapist experienced similar remission rates as those who received traditional CBT for 16 weeks, according to areport inAJP in Advance.The computer-assisted CBT (CCBT) entailed fewer visits with a therapist than standard CBT, theoretically increasing efficiency and lowering costs. “With increasing utilization of computers in society, improvements in broadband speed and access, and continued work on enhancing the quality of online CCBT programs, computer-assisted metho...
Source: Psychiatr News - October 10, 2017 Category: Psychiatry Tags: AJP in Advance. CBT computer-assisted CBT depression non-inferior remission Source Type: research

Early Intervention Found to Promote Greater Adherence to Antidepressants
Patients who participated in a brief psychosocial intervention program were more likely to adhere to their prescribed medication for depression than patients who received treatment as usual, according to astudy published inJAMA Psychiatry.“The program helps patients address barriers [such as stigma, misconceptions, and fears], identify treatment benefits, and feel empowered to manage their medication regimen and communicate with the physician effectively,” wrote Jo Anne Sirey, Ph.D., a professor of clinical psychology in psychiat ry at Weill Cornell Medical College, and colleagues. A total of 231 adults ag...
Source: Psychiatr News - October 6, 2017 Category: Psychiatry Tags: adherence to medication antidepressant Brief Medication Questionnaire Hamilton Depression Rating Scale JAMA Psychiatry Jo Anne Sirey psychosocial intervention Source Type: research

Even Low Levels of Exercise May Prevent Later Depression, Study Finds
Regular leisure-time exercise may reduce the risk of future depression but not anxiety, according to alarge population study published inAJP in Advance. “The majority of this protective effect occurred at low levels of exercise and was observed regardless of [exercise] intensity,” wrote Samuel B. Harvey, Ph.D., an associate professor at the University of New South Wales, and colleagues. “Assuming there is no residual confounding in our final m odel and the observed relationship is causal, our results suggest that if all participants had exercised for at least one hour each week, 12% of the cases of d...
Source: Psychiatr News - October 5, 2017 Category: Psychiatry Tags: anxiety depression exercise HUNT study Samuel B. Harvey Source Type: research

Midday Light Therapy May Improve Depressive Symptoms in Patients With Bipolar Disorder
Adjunctive bright light therapy may help lower depressive symptoms in adults with bipolar disorder, reports astudy published yesterday inAJP in Advance.“Despite advances in drug treatment for mania, the development of effective pharmacotherapy for bipolar depression remains a challenge,” wrote Dorothy Sit, M.D., of the University of Pittsburgh and colleagues. “Given the limited treatment options, research to investigate novel therapeutics for bipolar depression is a high-priority public health concern.”Much like patients with major depression, people with bipolar disorder commonly report sleep probl...
Source: Psychiatr News - October 4, 2017 Category: Psychiatry Tags: ajp in advance bipolar depression bipolar disorder circadian rhythm Dorothy Kit light therapy SIGH-ADS sleep Source Type: research

Ketamine Found to Reduce Suicidal Thoughts in Depressed Patients
A single infusion of ketamine appears to significantly reduce suicidal thoughts in depressed patients in as little as one day, with benefits lasting for up to one week, according to ameta-analysis reported inAJP in Advance. Moreover, although change in severity of depressive symptoms was strongly correlated with change in suicidal ideation, after controlling for improvement in severity of depressive symptoms, ketamine ’s effects on suicidal ideation remained significant. “This suggests that ketamine has a specific effect on suicidal ideation that depends only partly on change in overall severity of de...
Source: Psychiatr News - October 3, 2017 Category: Psychiatry Tags: independent effect on suicidality ketamine major depression suicide Source Type: research

Caregivers of Individuals With Schizophrenia Experience High Levels of Distress, Study Finds
This study also contributes further evidence of the potential value of providing interventions to address caregiver hea lth, caregiving demands, financial burdens and emotional rewards, and access to social supports,” the authors concluded.To read more about this topic, see thePsychiatric News article “Factors Predicting Poor MH Health Identified in ICU Caregivers. ”(Image: iStock/PeopleImages)For previous news alerts,click here. (Source: Psychiatr News)
Source: Psychiatr News - October 2, 2017 Category: Psychiatry Tags: Debra Lerner distress Perceived Stress Scale Psychiatric Services in Advance schizoaffective disorder schizophrenia Source Type: research

Midlife Obesity Linked to Greater Risk of Dementia
Midlife obesity is a risk factor for dementia that could contribute to higher future dementia rates, according to astudy published inAlzheimer ’s& Dementia: The Journal of the Alzheimer ’s Association.The study found that a body mass index (BMI) of 30 or greater at age 50 years but not at 60 or 70 years was associated with an increased risk of dementia. “Taken together, the present data demonstrate that the association between obesity and dementia is modified by age at obesity measurement, such that midlife obesity is a risk factor for dementia, but BMI begins to decline in those with dementia in...
Source: Psychiatr News - September 29, 2017 Category: Psychiatry Tags: Alzheimer's and Dementia Archana Singh-Manoux BMI obesity World health organization Source Type: research