Adjunctive VNS Improves Long-Term Outcomes in Treatment-Resistant Depression

Adjunctive vagus nerve stimulation (VNS) can lead to better five-year clinical outcomes in patients with chronic, treatment-resistant depression, reports a study published March 31 inAJP in Advance.

These findings provide the first long-term evidence of the benefits of VNS.

VNS, which involves delivering electrical impulses to the vagus nerve via an implanted generator, was approved for treatment-resistant depression in 2005. As part of the approval, the Food and Drug Administration required a postmarketing surveillance study, which led to the formation of the Treatment-Resistant Depression Registry. The registry is an observational program carried out at 61 sites across the United States that has monitored a large cohort of patients with treatment-resistant depression for five years each.

There were 795 study participants. Treatment resistance was defined as ongoing unipolar or bipolar depression that lasted at least two years or recurred at least three times and failure on four or more depression treatments, including maintenance pharmacotherapy, psychotherapy, and ECT. Within the group, 494 patients received periodic VNS over five years in addition to usual treatments, and 301 received usual-treatment only.

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Intellectual Disability Still a Bar to Death Penalty, Says Supreme Court

The U.S. Supreme Court on March 28 reaffirmed that intellectual disability is a constitutional barrier to the death penalty. The ruling in the case of Moore v. Texas upheld two previous decisions.

APA had signed onto an amicus brief last year in support of Moore with the American Academy of Psychiatry and the Law, American Psychological Association, National Association of Social Workers, and National Association of Social Workers Texas Chapter.

“The Court, consistent with APA’s position, sent the case of Bobby Moore back to a lower court after finding that Texas failed to apply contemporary medical standards for making the diagnosis of intellectual disability,” Marvin Swartz, M.D., told Psychiatric News. Swartz is chair of APA’s Committee on Judicial Action and a professor of psychiatry and behavioral sciences at Duke University School of Medicine.

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Multipronged study of schizophrenia-associated syndrome receives $3.1 million NIH grant

A research team at Emory University is embarking on a multipronged study of 3q29 deletion syndrome, a genetic mutation associated with a 40-fold increased risk for schizophrenia and a range of other neuropsychiatric conditions including mild to moderate intellectual disability, autism and anxiety. The research is funded by a $3.1 million grant from the National Institute of Mental Health of the National Institutes of Health.

The researchers will produce the first neuronal model of the schizophrenia-associated syndrome, which results from the deletion of a region of 22 genes. By uncovering the specific biological processes disrupted by the mutation, they hope to provide a molecular window into the key developmental processes relevant to schizophrenia and other neuropsychiatric conditions. They also will integrate their research with other targets identified in genetic studies of schizophrenia, autism, and intellectual disability, potentially leading to new ways to treat affected patients.

Co-principal investigators for the project at Emory University School of Medicine are Jennifer Mulle, PhD, assistant professor of human genetics and Gary Basell, PhD, professor and chair of cell biology. Other project collaborators are in the Emory Department of Psychiatry and Behavioral Sciences, Emory Department of Pediatrics, Emory Department of Psychology, and the Marcus Autism Center.

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A Cause For Community

by Elizabeth Elfenbein, Columnist, February 3, 2017
We live in a patient-empowered world. People understand their healthcare challenges like never before. They become mini-experts during their journey to getting diagnosed. Yet, once a patient arrives at their diagnosis, they reach an inflection point and are suddenly alone with their experience. That’s where communities come in.
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Emptying the ‘New Asylums’

On February 6, 2017 the American Enterprise Institute presented a panel discussion, Emptying the ‘new asylums’: A model for moving mentally ill inmates out of jail.

Doris A. Fuller, chief of Research and Public Affairs for the Treatment Advocacy Center, presented the findings of Treatment Advocacy Center’s latest groundbreaking report, Emptying the ‘New Asylums. Doris and the distinguished panel of experts discussed how small changes to public policy can significantly reduce forensic bed wait times at relatively low cost, providing those in need with a bed. Panelists included:

Sally Satel, AEI
Doris A. Fuller, Treatment Advocacy Center
Kristen Lich, PhD, MHSA, the University of North Carolina
Judge Steve Leifman, Miami-Dade County Court Criminal Division
Matthew Chase, National Association of Counties
Mike Rezendes, The Boston Globe
If you would like to share the discussion with others, or if you missed the event, you will find the recording on AEI.org.

Federal Judge Sees New York State Conspiracy to Thwart Care for Mentally Ill

A federal judge in Brooklyn has accused state officials of secretly trying to subvert a landmark court order to improve care for thousands of mentally ill residents of New York City.

Three years ago, U.S. District Judge Nicholas Garaufis ended a prolonged lawsuit against New York state by ordering the Department of Health to begin moving as many as 4,000 mentally ill residents housed in group homes to less restrictive environments where they could live more independently. As part of his order, the judge had laid out a timetable for the state to meet its obligations to men and women who had long lived in homes marked by neglect and abuse.

But at a hearing last month, Garaufis angrily charged that officials with the Department of Health appeared to have hatched a plan with the operators of the troubled group homes to get out from under his court order.

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Higher Death Rate Among Youth with First Episode Psychosis

A new study shows that young people experiencing first episode psychosis have a much higher death rate than previously thought. Researchers analyzed data on approximately 5,000 individuals aged 16-30 with commercial health insurance who had received a new psychosis diagnosis, and followed them for the next 12 months. They found that the group had a mortality rate at least 24 times greater than the same age group in the general population, in the 12 months after the initial psychosis diagnosis. This study, funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health, underscores that young people experiencing psychosis warrant intensive and proactive treatments, services and supports.

The research, led by Michael Schoenbaum, Ph.D., Senior Advisor for Mental Health Services, Epidemiology, and Economics at NIMH, was published online April 6, 2017 in the journal Schizophrenia Bulletin.

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Emptying the ‘New Asylums’

On February 6, 2017 the American Enterprise Institute presented a panel discussion, Emptying the ‘new asylums’: A model for moving mentally ill inmates out of jail.

Doris A. Fuller, chief of Research and Public Affairs for the Treatment Advocacy Center, presented the findings of Treatment Advocacy Center’s latest groundbreaking report, Emptying the ‘New Asylums. Doris and the distinguished panel of experts discussed how small changes to public policy can significantly reduce forensic bed wait times at relatively low cost, providing those in need with a bed. Panelists included:
Sally Satel, AEI
Doris A. Fuller, Treatment Advocacy Center
Kristen Lich, PhD, MHSA, the University of North Carolina
Judge Steve Leifman, Miami-Dade County Court Criminal Division
Matthew Chase, National Association of Counties
Mike Rezendes, The Boston Globe
If you would like to share the discussion with others, or if you missed the event, you will find the recording on AEI.org.

A Cause For Community

by Elizabeth Elfenbein, Columnist, February 3, 2017
We live in a patient-empowered world. People understand their healthcare challenges like never before. They become mini-experts during their journey to getting diagnosed. Yet, once a patient arrives at their diagnosis, they reach an inflection point and are suddenly alone with their experience. That’s where communities come in.

Shared experiences empower individuals and communities

Advocacy groups and communities for all kinds of disease states have the ability to ignite an individual and the greater community. And when we refer to communities, we’re referring to patients with a specific disease, the healthcare professionals who care for and treat them, and the caregivers who support them.

The power of these communities to help build understanding and awareness about a particular disease, educate, and bring together a group of people who are going through a shared experience is unbelievable. It has the ability to drive a cause and change behavior by getting people to fight for their health and their life. It has the power to effect industry change with research that attempts to find a cure, and it also has the potential to change legislation.

 

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Impaired Glucose Homeostasis in First-Episode Schizophrenia; A Systematic Review and Meta-analysis

Findings  In this meta-analysis of 14 case-control studies comprising 1345 participants, individuals with first-episode schizophrenia had elevated fasting plasma glucose levels, elevated plasma glucose levels after an oral glucose tolerance test, and elevated fasting plasma insulin levels,as well as greater insulin resistance compared with healthy individuals serving as controls.

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