NIH-funded Study Shows Disrupted Cell Layering Process in the Developing Brain

The architecture of the autistic brain is speckled with patches of abnormal neurons, according to research partially funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health. Published in the New England Journal of Medicine on March 27, 2014, this study suggests that brain irregularities in children with autism can be traced back to prenatal development.

“While autism is generally considered a developmental brain disorder, research has not identified a consistent or causative lesion,” said Thomas R. Insel, M.D., director of NIMH. “If this new report of disorganized architecture in the brains of some children with autism is replicated, we can presume this reflects a process occurring long before birth. This reinforces the importance of early identification and intervention.”

–National Institute of Mental Health

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Therapists’ Apps Aim To Help With Mental Health Issues

Games like Flappy Bird and Candy Crush have helped many of us de-stress during long waits at the doctor’s office and crowded Metro rides. But what if an app could actually help with mental health?

….”What this game is doing is trying to train your attention toward the positive,” says Tracy Dennis, a professor of psychology at Hunter and the lead researcher behind the game. It’s modeled after a cognitive treatment for anxiety called attention-bias modification training, Dennis tells Shots. The idea is that if people can learn to ignore threatening stimuli and focus on the good, they’ll feel less anxious in stressful situations.

by Maanvi Singh, NPR

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African Americans Less Likely to Receive Follow-Up Care After Psychiatric Admission, Study Finds

Poor integration of follow-up treatment into the continuum of psychiatric care leaves many individuals, particularly blacks, with poor-quality treatment.

….Rates of follow-up were generally low, particularly rates of adequate treatment, which were on average less than 26%. Outpatient treatment prior to inpatient care was a strong predictor of follow-up. After adjustment for need and socioeconomic status, the analyses showed that blacks were less likely than whites to receive any treatment or begin adequate follow-up within 30 days of discharge.

–Psychiatric News Alert

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SARDAA Executive, Linda Stalters, Will be Interviewed on Small Business Today Internet Radio April 16th 4 – 5 PM Central Time

Access radio live (or listen to archive afterwards): www.mjwjtalkradio.com

Call-in with questions and comments: 281-809-4856 or 800-970-8716

 

Growing Evidence That A Party Drug Can Help Severe Depression

Teens call it “Special K,” a club drug that produces hallucinatory, out-of-body effects. But evidence is mounting that it’s also a fast-acting treatment for patients with severe depression.

The latest study shows that ketamine, an FDA-approved anesthetic, can act in a matter of days for some people who don’t respond to traditional antidepressants. Those drugs don’t work for 40 percent of patients.

by Linda Poon, NPR

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Shooting Unfairly Links Violence With Mental Illness — Again

With the Army’s disclosure that Army Spc. Ivan Lopez was being evaluated for post-traumatic stress disorder before he went on a shooting rampage Wednesday, there were once again questions about whether the Army could have prevented the violence at Fort Hood.

Experts in mental health say (even as more facts about Lopez emerge) that it’s highly unlikely the violence could have been predicted. Just raising that question, psychologists and psychiatrists say, shows how much Americans misunderstand the link between mental illness and violence.

One national survey in 2006 found that most Americans — 60 percent — believed people with schizophrenia were likely to be violent. But the vast majority of people with psychiatric disorders are not violent. In fact, another study found they are far more likely to be the victims of violence, and that 1 in 4 experience violence every year.

by Joseph Shapiro, NPR

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KU Wichita Clinical Trial Seeking Adults with Schizophrenia

Researchers at the KU School of Medicine–Wichita are seeking adults, age 18-40, with schizophrenia to participate in a study of cognitive impairment associated with schizophrenia (CIAS).

The study is aimed at testing the theory that a virus is the cause of CIAS and is testing an anti-infective agent for this component of the disease.

Participants who qualify will receive study-related medications and procedures at no cost and will receive compensation for each visit.

Those interested in learning more about the study may call 316-293-1833.

Schizophrenics and Home Care

Home treatment for schizophrenics overseen by local health workers is more effective than institutionalization, a recent large study in India has found.

The study — a clinical trial involving 282 patients at three sites in India — found that supervised home treatment, with limited hospitalization available, was somewhat better at reducing patients’ disability and much better at getting them to stay on their medications.

In poor countries with doctors overwhelmed by the struggle against physical diseases, mental disease is often ignored. In extreme cases, those with mental illness are simply kept in chains.

Many effective anti-psychotic drugs are too old to patent, so if they were available, even the poorest countries could offer some treatment, the study suggested. The health workers needed only six weeks of training.

Still, in the India study, home care was about $150 per patient more expensive than hospitalization or psychiatric care. Travel costs for the workers was a major factor.

by Donald G. McNEIL Jr., The New York Times

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Value-Based Financially Sustainable Behavioral Health Components in Patient-Centered Medical Homes

Because a high percentage of primary care patients have behavioral problems, patient-centered medical homes (PCMHs) that wish to attain true comprehensive whole-person care will find ways to integrate behavioral health services into their structure. Yet in today’s health care environment, the incorporation of behavioral services into primary care is exceptional rather than usual practice. In this article, we discuss the components considered necessary to provide sustainable, value added integrated behavioral health care in the PCMH. These components are to:(1) combine medical and behavioral benefits into one payment pool; (2) target complex patients for priority behavioral health care; (3) use proactive onsite behavioral “teams;” (4) match behavioral professional expertise to the need for treatment escalation inherent in stepped care; (5) define, measure, and systematically pursue desired outcomes; (6) apply evidence-based behavioral treatments; and (7) use cross-disciplinary care managers in assisting the most complicated and vulnerable. By adopting these 7 components, PCHMs will augment their ability to achieve improved health in their patients at lower cost in a setting that enhances ease of access to commonly needed services.

Roger G. Kathol, MD1,2

Frank deGruy, MD3

Bruce L. Rollman, MD, MPH4

Published in the Annals of Family Medicine

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Video — Integrating Mental and Physical Healthcare: Roger Kathol

How would your healthcare experience be different if you could obtain best-practices mental healthcare and physical healthcare in one place? This topic has been pretty buzzworthy in recent mental health advocacy. For example, Mary Palafox’s essay from IMHRO’s 2013 Brainstorm Essay Contest, Reclassify All Organic Brain Diseases Under Medicine, explores some of the reasons why integrating healthcare might benefit people with severe mental illness. Now, with the provisions of the Affordable Care Act, this integration is gaining steam. One doctor who has dedicated much of his career to this integration process is Roger Kathol, M.D., C.P.E. He joins us on this month’s Brain Waves segment to discuss the whys and hows of healthcare integration, as well as why some stakeholders oppose it.

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–International Mental Health Research Organization