Notes on NIMH Alliance for Research Progress Summer Meeting

Pin It

Representatives of SARDAA attended a day long presentation of the latest
research recently conducted or sponsored by the National Institute of Mental
Health (“NIMH”) in Bethesda, Maryland on July 12, 2013. The NIMH is the
component of the NIH that is the world’s largest funded of research on
mental disorders.

The group invited to hear these presentations is called the “Alliance for
Research Progress” and consists of representatives of all of the major
organizations in the U.S. advocating for people with mental illness and
related research, treatment and policy needs such as SARDAA, the Brain and
Behavior Research Foundation and the National Alliance on Mental Illness.

Thomas R. Insel, M.D., the Director of the NIMH, led the meeting with
initial remarks about mental disorders, explaining that while some are
“highly heritable”, such as autism, bipolar and schizophrenia, some of the
genetic markers also occur “de novo,” for the first time. The research
challenge is that there are not too few genes involved, but that, especially
in schizophrenia, that there are too many genes.

Dr. Insel also commented on the flurry of controversy that arose with the
recent issuance of the fifth edition of the new DSM–the diagnostic and
statistical manual of mental disorders–used by mental health professionals
in providing treatment treatment. He stated his belief that the DSM
classifications & criteria are, for now, where they needed to be, but
that with the NIMH’s more neuroscience-oriented research approach to mental
disorders (example: the BRAIN initiative) the DSM is likely to evolve as
well.

Dr. Insel gave the representatives of the Alliance for Research Progress
an update on the NIH’s vision for its BRAIN initiative (Brain Research
through Advancing Innovative Neurotechnologies). The goal of the BRAIN
initiative is to create and apply new tools for the understanding of brain
activity. Dr. Insel pointed out that we know more about the biology of
cancer than the biology of mental illness and that this needs to change. The
BRAIN initiative will be launched with a proposal for federal funding,
endorsed by President Obama, of just over $100 million in the next fiscal
year, led by NIH & other govt and private partners. Dr. Insel predicts that
the BRAIN initiative will produce insights into brain disorders that will
lead to better diagnostics, prevention and treatment for schizophrenia and
other brain disorders.

With the promise of the BRAIN initiative in the future, Dr. Insel then
introduced the first of four presenters doing research in the present. Dr.
Gail L. Daumit, an internist and professor at Johns Hopkins gave the results
of her 2012 NIMH-funded behavioral weight loss trial including people with
serious mental illness. She noted that many people w/ serious mental illness
take a variety of psychotropic medications that cause weight gain through
increased appetite and other mechanisms (and that this weight gain can have
a significant impact on a person’s cardiovascular health risk, among
others). Recruiting overweight or obese adults from community psych rehab
outpatient programs in the Baltimore area, the participates in the
intervention group received weight management sessions, nutrition guidance
and group exercise sessions over a period of 18 months. Of 291 participants,
58% had schizophrenia or schizo-affective disorder. The study concluded that
with this kind of guidance, people w/ serious mental illness can achieve
significant weight loss, physical health change and a better overall
self-perception.

The next speaker was Scott Santarella, the president and C.E.O. of the
Bonnie J. Addario Lung Cancer Foundation, an organization founded by Ms.
Addario, a lung-cancer survivor and set up to advocate to give a voice to
people w/ lung cancer. While 80% of people who get lung cancer are
non-smokers, stigma still attaches to the disease–something that people w/
mental disorders understand all too well. He spoke about the importance of
empowering people w/ illness to unite to advocate for themselves, something
that SARDAA does for people w/ schizophenia & related diseases.

The Alliance for Research Progress was particularly excited to hear next
from Helen S. Mayberg, M.D., a highly regarded professor of psychiatry,
neurology and radiology at Emory University who heads up a
multi-disciplinary depression research program that studies the brain
circuits in depression in an effort to learn which treatment, for example,
an antidepressant or cognitive behavioral therapy (or both) will be most
effective bars on the structure and imaging of a person’s brain. The goal of
her team’s research (reported in JAMA psychiatry, June 12, 2013) is to
develop reliable bio-marchers that match an individual patient to the most
optimal treatment option (and avoid the trial & error approach of using
unsuccessful options).

In an NIH-funded study, Dr. Helen S. Mayberg of Emory university, was
able, through pre-treatment imaging using a PET scan on persons w/
depression, to locate parts of the brain which predicted a person’s
response to Cognitive Behavioral Therapy or to a specific SSRI
antidepressant. She learned that if a patient’s pre-treatment resting brain
activity was low on the front of an area called the “insula” on the right
side of the brain, then there was a significant likelihood of a good
response/higher rate of remission with CBT and a poorer rate of response to
the antidepressant med. Conversely, if the insula showed pre-treatment
hyper-activity, the person was more likely to have a good response/remission
with a treatment of the antidepressant med – and a poor response to CBT. If
these findings can be reproduced in a larger study, Dr. Mayberg foresees
their use in personalized predictions in a clinical setting as to evict
treatments will work the best for patients w/ major depression.

Dr. Helen Mayberg also told the Alliance for Research Progress group of
an ongoing trial (200 patients) at Emory University involving persons w/
treatment-resistant depression who over years had no improvement from
multiple meds, therapies and treatments. Her team studied an area of the
brain known as “area 25″ which was hyperactive w/ sadness. Using “deep brain
stimulation” (DBS), Dr. Robert Gross, an Emory surgeon, was able to implant
a battery-operated electrode in the brain to essentially switch-off the
hyperactive mechanism. 64% of the patients undergoing this surgery have
responded well over 6 years. When asked why the procedure was not effective
on all patients, she referred to the micro-anatomy of the brain’s circuits
and the growing understanding of the need to precisely place the implant for
the greatest impact. She explained to the group that to extend the potential
of this treatment strategy would not be to conduct invasive brain surgery on
a wide-scale but to develop bio-markers that could lead to targeted meds.

The last speaker at NIMH’s “Alliance for Progress” meeting on 7/12/13 was
clearly a “rising star”, being only 34 years-old yet conducting major
research at Duke. Kafui Dzirasa, M.D., with a Ph.D. in neurobiology, spoke
about the “new frontier of neuropsychiatric diagnostics and therapeutics.”
Dr. Dzirasa and his team studied the brains of mice to demonstrate the
involvement of certain brain circuits in major depressive disorder. He, like
Dr. Mayberg at Emory, is studying the brain to find bio-markers to help
pinpoint treatments for mental disorders.

TrustCircle Offers SARDAA Consumers and Caregivers Chance to Pilot New Product

SARDAA consumers and caregivers are invited by our partner TrustCircle for a unique opportunity to pilot their product.

TrustCircle is the world’s first peer-centered mental health network for consumers, caregivers, and healthcare experts. TrustCircle aims to revolutionize timely access to trustworthy community support and mental healthcare professionals by leveraging technology innovations to enable fast, quality mental healthcare to those impacted by any mental health issue.

www.trustcircle.co is in its final lap of development and testing. TrustCircle is focused on building a community for peers and caregivers impacted by schizophrenia and related disorders. Please sign-up at signup.trustcircle.co

You will be able to do the following:

Find Peers: Users can experience the magic of meeting with someone who is facing similar challenges and is determined to fight like they do. Learn from them, get inspired, take action, and build their “Circle of Trust.”

Share & Learn: Peers and caregivers can share, like, comment, upload videos, photos etc.

Search & Add Providers: Users can add providers they would like others to know about–who can help. Users will be able to search as well.

Ask Questions: Users will be able to ask questions from experienced community members and get answers in no time.

Join TrustCircle on Facebook and Twitter!

Like Us On FacebookFollow Us On Twitter

Cessation Corner…

Tobacco use rates among the homeless population are significantly higher than the general population. Between 70-80% of homeless individuals use tobacco, according to the National Coalition for the Homeless. Here are some useful resources and important information on tobacco use among this population.
Research Paper - Marketing to the marginalized: tobacco industry targeting of the homeless and mentally ill

Fact Sheet - Drug Interactions with Smoking

Toolkit - Tobacco-Free Toolkit for Community Health Facilities 

Facts and Resources - The Tobacco Epidemic Among People with Behavioral Health Disorders

Benefits of Vitamin B for Bipolar Disorder

Bipolar disorder patients should pay particular attention to amount of vitamin B they are consuming each day. Vitamins B1, B6, and B12, in particular, have been shown to decrease the symptoms of bipolar disorder such as mood swings, depression, anxiety, fatigue, irritability, the inability to focus, and a loss of appetite, which can also be caused by some bipolar medications.

–Magpie Media

Full Article

Deployment Factors Are Not Related to Rise in Military Suicides, Study Finds

In the largest study of its kind, military medical researchers have concluded that deployments to war zones and exposure to combat were not major factors behind a significant increase in suicides among military personnel from 2001 to 2008, according to a paper published on Tuesday.

The study, published online by The Journal of the American Medical Association, corroborates what many military medical experts have been saying for years: that the forces underlying the spike in military suicides are similar to those in the civilian world. They include mental illness, substance abuse, and financial and relationship problems.

….“We so often just link military suicide to combat trauma,” said Kim Ruocco, the director of postvention for TAPS. “But there are many others: long hours, separation from supports systems, sleeplessness. All are stressors. All add to increases in mental health issues.”

By James Dao, The New York Times

Full Article

Mental Health: US vs UK

The Affordable Care Act (ACA) will begin this fall in the United States, with the health care exchange signups at the state level. So it’s a good time to pause and reflect. What would an ideal American mental health system eventually look like, and could we get an idea or two from our friends? (We will not be fully serving the mental health needs of the U.S by 2014, when the law becomes operational, but we will be much closer than before.)

There are definite distinctions between the two countries, something those in positions of policy and advocacy in both systems certainly refer to and highlight.

Every person in the U.K. indeed has some form of health coverage. (This in itself, even before dissecting mental health services, is of course distinctive and cannot be stressed enough.) Their definition of health coverage, more to the point, has included mental health.

by Lisa Miles, PsychCentral

Full Article

New Data Reveal Extent of Genetic Overlap Between Major Mental Disorders

Schizophrenia, bipolar disorder share the most common genetic variation

The largest genome-wide study of its kind has determined how much five major mental illnesses are traceable to the same common inherited genetic variations. Researchers funded in part by the National Institutes of Health found that the overlap was highest between schizophrenia and bipolar disorder; moderate for bipolar disorder and depression and for ADHD and depression; and low between schizophrenia and autism. Overall, common genetic variation accounted for 17-28 percent of risk for the illnesses.

Common inherited genetic variation (single nucleotide polymorphisms, or SNPs) accounted for up to about 29 percent of the risk for some disorders, such as ADHD (dark green). Among pairs of disorders (light green), schizophrenia and bipolar disorder (SCZ-BPD) shared about 16 percent of the same common genetic variation (coheritabilities). Source: Cross-Disorder Group of the Psychiatric Genomics Consortium

“Since our study only looked at common gene variants, the total genetic overlap between the disorders is likely higher,” explained Naomi Wray, Ph.D., University of Queensland, Brisbane, Australia, who co-led the multi-site study by the Cross Disorders Group of the Psychiatric Genomics Consortium (PGC), which is supported by the NIH’s National Institute of Mental Health (NIMH). “Shared variants with smaller effects, rare variants, mutations, duplications, deletions, and gene-environment interactions also contribute to these illnesses.”

Dr. Wray, Kenneth Kendler, M.D., of Virginia Commonwealth University, Richmond, Jordan Smoller, M.D., of Massachusetts General Hospital, Boston, and other members of the PGC group report on their findings August 11, 2013 in the journal Nature Genetics.

“Such evidence quantifying shared genetic risk factors among traditional psychiatric diagnoses will help us move toward classification that will be more faithful to nature,” said Bruce Cuthbert, Ph.D., director of the NIMH Division of Adult Translational Research and Treatment Development and coordinator of the Institute’s Research Domain Criteria (RDoC) project, which is developing a mental disorders classification system for research based more on underlying causes.

Earlier this year, PGC researchers — more than 300 scientists at 80 research centers in 20 countries — reported the first evidence of overlap between all five disorders. People with the disorders were more likely to have suspect variation at the same four chromosomal sites. But the extent of the overlap remained unclear. In the new study, they used the same genome-wide information and the largest data sets currently available to estimate the risk for the illnesses attributable to any of hundreds of thousands of sites of common variability in the genetic code across chromosomes. They looked for similarities in such genetic variation among several thousand people with each illness and compared them to controls — calculating the extent to which pairs of disorders are linked to the same genetic variants.

The overlap in heritability attributable to common genetic variation was about 15 percent between schizophrenia and bipolar disorder, about 10 percent between bipolar disorder and depression, about 9 percent between schizophrenia and depression, and about 3 percent between schizophrenia and autism.

The newfound molecular genetic evidence linking schizophrenia and depression, if replicated, could have important implications for diagnostics and research, say the researchers. They expected to see more overlap between ADHD and autism, but the modest schizophrenia-autism connection is consistent with other emerging evidence.

The study results also attach numbers to molecular evidence documenting the importance of heritability traceable to common genetic variation in causing these five major mental illnesses. Yet this still leaves much of the likely inherited genetic contribution to the disorders unexplained — not to mention non-inherited genetic factors. For example, common genetic variation accounted for 23 percent of schizophrenia, but evidence from twin and family studies estimate its total heritability at 81 percent. Similarly, the gaps are 25 percent vs. 75 percent for bipolar disorder, 28 percent vs. 75 percent for ADHD, 14 percent vs. 80 percent for autism, and 21 percent vs. 37 percent for depression.

Among other types of genetic inheritance known to affect risk and not detected in this study are contributions from rare variants not associated with common sites of genetic variation. However, the researchers say that their results show clearly that more illness-linked common variants with small effects will be discovered with the greater statistical power that comes with larger sample sizes.

“It is encouraging that the estimates of genetic contributions to mental disorders trace those from more traditional family and twin studies. The study points to a future of active gene discovery for mental disorders” said Thomas Lehner, Ph.D., chief of the NIMH Genomics Research Branch, which funds the project.

–National Institutes of Health

Full Article

 

I Thought I Was a Prophet

After my schizophrenic break, I couldn’t even trust my own mind–and it would be a long road back from the abyss.

On the day I realized I was a prophet, I left my home in Colorado and began to hitch-hike to the U.N. I needed to save the world from its various evils. And I needed to go — now.

I spent the next several days wandering around the northeast, trying to decipher messages. I found codes in places where codes didn’t exist. I finally found my way back home, thanks to a quiet and generous woman who lived somewhere in rural Massachusetts, and when I got back, I explained to my parents that I was on a mission and this was God’s will. I’m sure there was some stuff about aliens and conspiracies in there, too.

And so, a week after my adventure began, I woke up in the psych ward of Boulder Community Hospital, and I spent the next seven days condemned to a hospital bed with waterproof sheets in a ward with eight other people who either didn’t talk or rambled so incoherently that it was impossible to understand them.

by Michael Hedrick

Full Article

 

August 13th Webinar: “Ketamine & Next Generation Therapies”

 

Meet the Scientist logoTuesday, August 13, 2:00 p.m.–3:00 p.m. EST

 

Carlos A. Zarate, M.D., a NARSAD Independent Investigator Grantee (2005), has pioneered revolutionary studies that have led to novel treatments for mood disorders such as depression and bipolar disorder that begin working much faster than previous options. With a strong focus on the pathophysiology of severe mental illnesses, his goal is to develop better treatments particularly for patients living with depression, bipolar disorder and/or other mood disorders. His research into a drug called Ketamine has resulted in rapid-acting depression treatments that work within hours and last 3-5 days or more. Because of the speed at which this drug reacts within the body and the duration of its effects, it is possible that emergency room doctors may have a possible treatment for those suffering from depression and acute suicidality.

 

Information and Registration

Ferguson Executed In Florida Despite Mental Illness Pleas

A man convicted of murdering eight people in Miami-Dade County in the late 1970s was executed Monday night at the Florida State Prison, despite his lawyers’ pleas that he was too mentally ill to be put to death.

John Errol Ferguson, 65, died at 6:17 p.m., following a lethal injection.

The execution came less than two hours after the U.S. Supreme Court denied a final request for a stay.

Ferguson made a brief statement before 25 witnesses, including family members of the victims.

“I just want everyone to know that I am the prince of God and will rise again,” he said calmly.

by Tamara Lush, Huffington Post

Full Article