Chapter 12. Psychopathology: The Biology of Behavioral Disorders

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By Nicholas Bakalar A mother’s psychological distress during pregnancy may increase the risk for asthma in her child, a new study suggests. Researchers had the parents of 4,231 children fill out well-validated questionnaires on psychological stress in the second trimester of pregnancy, and again three years later. The mothers also completed questionnaires at two and six months after giving birth. The study, in the journal Thorax, found that 362 of the mothers and 167 of the fathers had clinically significant psychological distress during the mothers’ pregnancies. When the children were 10 years old, parents reported whether their child had ever been diagnosed with asthma. As an extra measure, the researchers tested the children using forced expiratory volume, or FEV, a standard clinical test of lung function. After controlling for age, smoking during pregnancy, body mass index, a history of asthma and other factors, they found that maternal depression and anxiety during pregnancy was significantly associated with both diagnoses of asthma and poorer lung function in their children. There was no association between childhood asthma and parents’ psychological distress in the years after pregnancy, and no association with paternal psychological stress at any time. “Of course, this could be only one of many causes of asthma,” said the lead author, Dr. Evelien R. van Meel of Erasmus University in Rotterdam, “but we corrected for many confounders, and we saw the effect only in mothers. This seems to suggest that there’s something going on in the uterus. But this is an observational study, and we can’t say that it’s a causal effect.” © 2020 The New York Times Company

Keyword: Depression; Development of the Brain
Link ID: 27534 - Posted: 10.21.2020

By John Horgan One of the most impressive, disturbing works of science journalism I’ve encountered is Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, published in 2010. In the book, which I review here, award-winning journalist Robert Whitaker presents evidence that medications for mental illness, over time and in the aggregate, cause net harm. In 2012, I brought Whitaker to my school to give a talk, in part to check him out. He struck me as a smart, sensible, meticulous reporter whose in-depth research had led him to startling conclusions. Since then, far from encountering persuasive rebuttals of Whitaker’s thesis, I keep finding corroborations of it. If Whitaker is right, modern psychiatry, together with the pharmaceutical industry, has inflicted iatrogenic harm on millions of people. Reports of surging mental distress during the pandemic have me thinking once again about Whitaker’s views and wondering how they have evolved. Below he answers some questions. —John Horgan
 Horgan: When and why did you start reporting on mental health? Whitaker: It came about in a very roundabout way. In 1994, I had co-founded a publishing company called CenterWatch that covered the business aspects of the “clinical trials industry,” and I soon became interested in writing about how financial interests were corrupting drug trials. Risperdal and Zyprexa had just come to market, and after I used a Freedom of Information request to obtain the FDA’s review of those two drugs, I could see that psychiatric drug trials were a prime example of that corruption. In addition, I had learned of NIMH-funded research that seemed abusive of schizophrenia patients, and in 1998, I co-wrote a series for the Boston Globe on abuses of patients in psychiatric research. My interest was in that broader question of corruption and abuse in research settings, and not specific to psychiatry. © 2020 Scientific American

Keyword: Depression; Schizophrenia
Link ID: 27531 - Posted: 10.19.2020

By Lisa Grossman Clues from a chemical — Science News, October 3, 1970 An experimental drug’s effects on the sexual behavior of certain animals is arousing interest among investigators.… The drug, para-chlorophenylalanine … reduces the level of a naturally occurring neurochemical, serotonin, in the brain of rats, mice and dogs.… Little is known about how serotonin acts in the brain, and investigators quickly recognized that PCPA could be used to study this brain chemical. Update PCPA helped e­stablish serotonin’s role in regulating sexual desire, as well as sleep, appetite and mood. The chemical messenger has become key to one common class of antidepressant drugs called selective serotonin r­euptake inhibitors. Identified in 1974, SSRIs work by increasing the brain’s serotonin levels. But such drugs can hinder sexual desire. One SSRI that failed to relieve depression in humans found a second life as a treatment for sexual dysfunction. Approved by the U.S. Food and Drug Administration in 2015, this “little pink pill,” sold as Addyi, may boost sex drive in women by lowering serotonin in the brain’s reward centers. H.A. Croft. Understanding the role of serotonin in female hypoactive sexual desire disorder and treatment options. Journal of Sexual Medicine. Vol. 14, December 2017, p. 1575. Doi: 10.1016/j.jsxm.2017.10.068. © Society for Science & the Public 2000–2020.

Keyword: Depression; Sexual Behavior
Link ID: 27497 - Posted: 09.30.2020

By Elizabeth Landau At dinnertime, 10-year-old Clive Rodgers used to wrap his arms around his plate because he was afraid of germs at the table. “I was really scared, and if somebody tried to move my arm, I would, like, get really angry and stuff,” says Clive, who lives in San Diego with his parents and two younger siblings. Clive is just one of many young people who have struggled with obsessive-compulsive disorder. OCD affects about 1 in every 200 children and teenagers, which is similar to the prevalence of diabetes in this age group. The hallmarks of OCD are intrusive, unwanted thoughts and repetitive behaviors in response to those thoughts, a cycle that may cause significant anxiety and hamper daily activities. As the coronavirus pandemic rages on, it’s a tough time for any kid who has to stay home all day, studying remotely instead of going to school, unable to enjoy normal social activity with friends. Such stressors are making OCD symptoms worse in some children, even those who didn’t specifically fear germs before, doctors say. Andy Rodgers and his son, Clive, of in San Diego. Clive is just one of many youths who has struggled with obsessive-compulsive disorder. OCD affects about 1 in every 200 children and teenagers, which is similar to the prevalence of diabetes in this age group. “Their rituals and obsessions are just worse because their general mental health is worse,” said Suzan Song, director of the Division of Child/Adolescent & Family Psychiatry at George Washington University. Fears of contamination and illness are generally common among people with OCD, but usually their concerns are not in line with likely threats, said Joseph McGuire, assistant professor of psychiatry and behavioral sciences at Johns Hopkins Medicine. With the coronavirus, which causes the disease covid-19, there is actual danger present. He is seeing a “rekindling” of symptoms in many patients who received treatment in the past, and need a refresher.

Keyword: OCD - Obsessive Compulsive Disorder; Stress
Link ID: 27471 - Posted: 09.14.2020

By Linda Searing A growing number of U.S. adults are struggling with mental health issues linked to worry and stress over the novel coronavirus, increasing from 32 percent in March to 53 percent in July, according to a new report from the Kaiser Family Foundation. Those experiencing symptoms of anxiety or depression, for example, reached 40 percent this summer, up from 11 percent a year ago. In addition, a similar assessment from the Centers for Disease Control and Prevention found that, by late June, 13 percent of adults had started or increased alcohol consumption or drug use to help cope with pandemic-related woes, and 11 percent had seriously considered suicide in the past month — a number that reached 25 percent among those ages 18 to 24. Social isolation, loneliness, job loss and economic worries as well as fear of contracting the virus are among factors cited as contributing to people’s mental health problems. Kaiser researchers found that 59 percent of those who have lost income because of the pandemic experienced at least one adverse effect on their mental health and well-being, as did 62 percent of those with higher-than-average risk for covid-19 because of such chronic conditions as lung disease, asthma, diabetes or serious heart disease. Overall, both reports found that negative mental health effects from the stress of coronavirus were more common among women than men. Suicidal ideation, however, was more common among men. Also, the CDC report says that people described as “unpaid caregivers,” meaning they care for other adults at home, are considerably more likely than others to start or increase substance use to cope with coronavirus-related stress or to have suicidal thoughts.

Keyword: Stress; Depression
Link ID: 27456 - Posted: 09.07.2020

Adam Piore archive page Long before the world had ever heard of covid-19, Kay Tye set out to answer a question that has taken on new resonance in the age of social distancing: When people feel lonely, do they crave social interactions in the same way a hungry person craves food? And could she and her colleagues detect and measure this “hunger” in the neural circuits of the brain? “Loneliness is a universal thing. If I were to ask people on the street, ‘Do you know what it means to be lonely?’ probably 99 or 100% of people would say yes,” explains Tye, a neuroscientist at the Salk Institute of Biological Sciences. “It seems reasonable to argue that it should be a concept in neuroscience. It’s just that nobody ever found a way to test it and localize it to specific cells. That’s what we are trying to do.” In recent years, a vast scientific literature has emerged linking loneliness to depression, anxiety, alcoholism, and drug abuse. There is even a growing body of epidemiological work showing that loneliness makes you more likely to fall ill: it seems to prompt the chronic release of hormones that suppress healthy immune function. Biochemical changes from loneliness can accelerate the spread of cancer, hasten heart disease and Alzheimer’s, or simply drain the most vital among us of the will to go on. The ability to measure and detect it could help identify those at risk and pave the way for new kinds of interventions. In the months ahead, many are warning, we’re likely to see the mental-health impacts of covid-19 play out on a global scale. Psychiatrists are already worried about rising rates of suicide and drug overdoses in the US, and social isolation, along with anxiety and chronic stress, is one likely cause. “The recognition of the impact of social isolation on the rest of mental health is going to hit everyone really soon,” Tye says. “I think the impact on mental health will be pretty intense and pretty immediate.”

Keyword: Emotions; Depression
Link ID: 27454 - Posted: 09.05.2020

By Jenny Marder In May, a 15-year-old boy set up a socially distanced visit with a friend. They met on opposite sides of a sidewalk — a full six feet apart — and talked. But when the teenager returned home, he brought with him a new set of Covid-19 fears, according to John Duffy, the boy’s therapist and a child psychologist in Chicago. How could he be sure six feet was a safe distance?, the teenager wanted to know. He began washing his hands more frequently. He stopped touching countertops. And he hasn’t wanted to see friends since. The pandemic has understandably intensified our need for good hygiene and safety precautions. But for some children and teens, these precautions have crossed the line from careful to compulsive. And for parents, it can sometimes be hard to distinguish between a reasonable reaction to a very real threat and something more concerning. There’s little data available yet on the toll the pandemic has taken on the mental health of children. But Eric Storch, an expert on obsessive-compulsive disorder and a professor at the Baylor College of Medicine, said calls to the university’s O.C.D. program have jumped significantly, by about 25 percent, since March. He attributed it in part to telemedicine improving access, and in part to worsening mental health concerns. Dr. Duffy said the number of his patients experiencing O.C.D.-like symptoms has tripled during this time. About 500,000 children and teens in the United States have obsessive-compulsive disorder, according to the International OCD Foundation. Obsessive-compulsive disorder has two main components. Obsessions take the form of uncontrollable thoughts, urges, feelings or uncomfortable sensations. Compulsions are behaviors repeated over and over. These can include excessive handwashing, showering or sanitizing, but also checking things, putting things in order, tapping, touching, seeking reassurance or asking the same question repeatedly. © 2020 The New York Times Company

Keyword: OCD - Obsessive Compulsive Disorder; Stress
Link ID: 27445 - Posted: 09.02.2020

Chris Woolston Signs of depression among graduate students in the United States have apparently doubled during the COVID-19 pandemic, according to a survey that drew responses from more than 15,000 graduate and 30,000 undergraduate students at 9 US research universities. The survey, conducted by the Student Experience in the Research University (SERU) Consortium — a collaboration between the University of California, Berkeley (UC Berkeley), and the University of Minnesota Twin Cities in Minneapolis — found that indications of anxiety among graduate students rose by 50% this year compared with last year. “It’s very alarming that so many students are suffering from mental-health issues,” says Igor Chirikov, director of SERU and a senior researcher in higher education with the Center for Studies in Higher Education at UC Berkeley. “The pandemic has obviously had a big impact.” The survey, which ran from 18 May to 20 July, used simple two-item questionnaires — the Generalized Anxiety Disorder-2 and Patient Health Questionnaire-2 — to screen for symptoms of anxiety disorders and major depression. Thirty-nine per cent of graduate students (a group that includes law- and medical-school students) screened positive for anxiety, and 32% screened positive for depression. When the same screening questions were asked in March to July 2019, 26% of graduate students had signs of anxiety and 15% showed depression symptoms. © 2020 Springer Nature Limited

Keyword: Depression; Stress
Link ID: 27427 - Posted: 08.20.2020

By Jan Hoffman The collateral damage from the pandemic continues: Young adults, as well as Black and Latino people of all ages, describe rising levels of anxiety, depression and even suicidal thoughts, and increased substance abuse, according to findings reported by the Centers for Disease Control and Prevention. In a research survey, U.S. residents reported signs of eroding mental health in reaction to the toll of coronavirus illnesses and deaths, and to the life-altering restrictions imposed by lockdowns. The researchers argue that the results point to an urgent need for expanded and culturally sensitive services for mental health and substance abuse, including telehealth counseling. In the online survey completed by some 5,400 people in late June, the prevalence of anxiety symptoms was three times as high as those reported in the second quarter of 2019, and depression was four times as high. The effects of the coronavirus outbreaks were felt most keenly by young adults ages 18 to 24. According to Mark Czeisler, a psychology researcher at Monash University in Melbourne, Australia, nearly 63 percent had symptoms of anxiety or depression that they attributed to the pandemic and nearly a quarter had started or increased their abuse of substances, including alcohol, marijuana and prescription drugs, to cope with their emotions. “It’s ironic that young adults who are at lower risk than older adults of severe illness caused by Covid-19 are experiencing worse mental health symptoms,” said Mr. Czeisler. A survey of about 5,000 people done in April, during the earlier days of the pandemic, Mr. Czeisler said, suggested that tremors in the mental health firmament were beginning to surface. Already in April, high percentages of respondents reported they were spending more time on screens and less time outside than before the pandemic, which translated into more virtual interactions and far fewer in person. They noted upheavals to family, school, exercise and work routines, and to their sleeping patterns. All of these are factors that can contribute to the robustness of mental health. © 2020 The New York Times Company

Keyword: Stress; Neuroimmunology
Link ID: 27421 - Posted: 08.15.2020

Jon Hamilton The Food and Drug Administration has approved a variant of the anesthetic and party drug ketamine for suicidal patients with major depression. The drug is a nasal spray called Spravato and it contains esketamine, a chemical cousin of ketamine. In 2019, the FDA approved Spravato for patients with major depressive disorder who hadn't responded to other treatments. Now, the agency is adding patients who are having suicidal thoughts or have recently attempted to harm themselves or take their own lives. "Spravato is the first approved antidepressant medication that's been able to demonstrate a reduction in symptoms of major depressive disorder within 24 hours after the first dose," says Dr. Michelle Kramer, a psychiatrist and vice president of U.S. neuroscience, medical affairs at Janssen Pharmaceuticals, which makes the drug. Janssen is part of Johnson & Johnson. The drug's quick action is potentially important for suicidal patients because "existing drugs typically can take weeks or longer before you really get noticeable clinical benefit," says Dr. Gerard Sanacora, a professor of psychiatry at Yale University and director of Yale's depression research program. He was involved in the studies leading to the FDA approval and has consulted for Janssen. So a dose of esketamine "could potentially get a person out of a difficult, horrible situation when they're feeling so overwhelmed," says Dr. Charles Conway, a professor of psychiatry at Washington University School of Medicine in St. Louis who wasn't involved in the study. "This could be a significant improvement in how we can help people who have intense suicidal thinking." © 2020 npr

Keyword: Depression; Drug Abuse
Link ID: 27416 - Posted: 08.12.2020

Elizabeth Landau Carmen Sandi recalls the skepticism she faced at first. A behavioral neuroscientist at the Swiss Federal Institute of Technology in Lausanne, she had followed a hunch that something going on inside critical neural circuits could explain anxious behavior, something beyond brain cells and the synaptic connections between them. The experiments she began in 2013 showed that neurons involved in anxiety-related behaviors showed abnormalities: Their mitochondria, the organelles often described as cellular power plants, didn’t work well — they produced curiously low levels of energy. Those results suggested that mitochondria might be involved in stress-related symptoms in the animals. But that idea ran contrary to the “synapto-centric” vision of the brain held by many neuroscientists at the time. Her colleagues found it hard to believe Sandi’s evidence that in anxious individuals — at least in rats — mitochondria inside key neurons might be important. “Whenever I presented the data, they told me, ‘It’s very interesting, but you got it wrong,’” Sandi said. Yet a growing number of scientists have joined her during the past decade or so in wondering whether mitochondria might be fundamental not just to our general physical well-being but specifically to our mental health. In particular, they have explored whether mitochondria affect how we respond to stress and conditions like anxiety and depression. Carmen Sandi, a behavioral neuroscientist at the Swiss Federal Institute of Technology in Lausanne, suspected that a deficit in cellular energy might explain the lack of motivation that anxiety-prone people experience. © 2020 Simons Foundation

Keyword: Stress; Depression
Link ID: 27414 - Posted: 08.11.2020

By Hannah Sparks For communities with a low rate of depression and suicide, there may be something in the water, according to a new study. A comprehensive analysis of findings from previous studies has revealed that regions where the public drinking water contains a high level of naturally occurring lithium — a mineral used most often for the treatment of depression and bipolar disorder — also boast a lower rate of suicide than other areas. The review included all prior research on the effects of lithium, as well as regional water samples and suicide data from 1,286 locales in Austria, Greece, Italy, Lithuania, the UK, Japan and the United States. “Naturally occurring lithium in drinking water may have the potential to reduce the risk of suicide and may possibly help in mood stabilization, particularly in populations with relatively high suicide rates and geographical areas with a greater range of lithium concentration in the drinking water,” the authors concluded in their report. Denoted as “Li” on the periodic table, the element is found in varying concentrations in crops, rocks, soil and ground water — thus how it seeps into our water supply. In a statement on the King’s College London website, lead study author and chairman of epidemiology and public health at Brighton and Sussex Medical School Anjum Memon said, “It is promising that higher levels of trace lithium in drinking water may exert an anti-suicidal effect and have the potential to improve community mental health.” The results, published in the British Journal of Psychiatry, “are also consistent with the finding in clinical trials that lithium reduces suicide and related behaviors in people with a mood disorder,” said Allan Young, a professor at King’s College’s Institute of Psychiatry, Psychology & Neuroscience.

Keyword: Depression; Schizophrenia
Link ID: 27408 - Posted: 08.08.2020

Viviana Gradinaru Despite the wealth and quality of basic neuroscience research, there is still little we can do to treat or prevent most brain disorders. Industry efforts, meanwhile, have shied away from this field, particularly after a series of major drug candidates for the treatment of Alzheimer's disease failed to meet expectations (1). My previous research, which entailed developing and using optogenetics (2, 3) to understand how deep brain stimulation works in Parkinson's disease (PD) (4, 5), resulted in two key insights: We need to look and intervene earlier in brain disease progression, and we need to be able to access relevant cell populations with noninvasive yet precise tools to investigate, prevent, contain, or even reverse the course of disease. Accumulating evidence has highlighted a third insight: We may need to look beyond the brain to fully understand brain disorders (6, 7). My goal has been to develop an effective toolkit for neuromodulation so we can start to bridge the gap between what we know and what we can do to treat the brain. To achieve minimally invasive optogenetic-mediated modulation, we need to be able to penetrate the blood–brain barrier (BBB) so that vectors can be delivered systemically rather than through intracranial injections and address the poor reach of visible light through tissue so that large tissue volumes can be recruited without implantation of optical fibers. For early intervention, we need to get past the neuronal and brain-centric view of neurological disease. © 2020 American Association for the Advancement of Science

Keyword: Schizophrenia; Depression
Link ID: 27407 - Posted: 08.08.2020

By Matthew Sitman As I read George Scialabba’s new book How To Be Depressed, I recalled that I’d been introduced to his writing almost a decade ago by a schizophrenic, manic-depressive homeless man. R. might have protested that term—technically, he lived in a small garage that a fellow parishioner at the church we all attended let him use. It was shocking to visit him there for the first time; nearly every square inch of the place was filled with musty stacks of the New York Review of Books, assorted newspapers, and books, leaving only a narrow path that led to a mattress. Before adding something to one of these piles, he’d open his latest acquisition and run his finger down its pages, searching for matches or “sparks” that might cause a destructive fire—a phobia caused by a traumatic incident in R.’s childhood. My friends and I tried to look after R., taking him to dinner or paying his phone bill or letting him do laundry in our homes. I was drawn to R. partly because I couldn’t help but see some of myself in him, and had a gnawing fear that his plight would one day be my own. He was, in his way, an intellectual, who actually read at least a few of the periodicals he collected and enjoyed arguing about politics. I’d often see him in the local used bookstore I frequented, and that must have been where he pressed Scialabba’s What Are Intellectuals Good For? into my hands. “This is the good shit,” he solemnly professed, and he was right. R. had been an alcoholic, and I’d gleaned that when he finally kicked booze the withdrawal caused a breakdown from which he’d never quite recovered. I knew I sometimes drank too much, too, and for the wrong reasons—enough to watch myself. We shared both hypochondria and a dread of visiting the doctor. I wasn’t a manic depressive, but for much of the time I knew R. I was in the throes of the worst severe depression of my life. © 2020 Commonweal Magazine.

Keyword: Depression
Link ID: 27365 - Posted: 07.15.2020

Amy Fleming Taking a stroll with Shane O’Mara is a risky endeavour. The neuroscientist is so passionate about walking, and our collective right to go for walks, that he is determined not to let the slightest unfortunate aspect of urban design break his stride. So much so, that he has a habit of darting across busy roads as the lights change. “One of life’s great horrors as you’re walking is waiting for permission to cross the street,” he tells me, when we are forced to stop for traffic – a rude interruption when, as he says, “the experience of synchrony when walking together is one of life’s great pleasures”. He knows this not only through personal experience, but from cold, hard data – walking makes us healthier, happier and brainier. We are wandering the streets of Dublin discussing O’Mara’s book, In Praise of Walking, a backstage tour of what happens in our brains while we perambulate. Our jaunt begins at the grand old gates of his workplace, Trinity College, and takes in the Irish famine memorial at St Stephen’s Green, the Georgian mile, the birthplace of Francis Bacon, the site of Facebook’s new European mega-HQ and the salubrious seaside dwellings of Sandymount. O’Mara, 53, is in his element striding through urban landscapes – from epic hikes across London’s sprawl to more sedate ambles in Oxford, where he received his DPhil – and waxing lyrical about science, nature, architecture and literature. He favours what he calls a “motor-centric” view of the brain – that it evolved to support movement and, therefore, if we stop moving about, it won’t work as well. © 2020 Read It Later, Inc.

Keyword: Depression
Link ID: 27364 - Posted: 07.15.2020

By Erica Rex In 2012, I had my first psychedelic experiences, as a subject in a clinical trial at Johns Hopkins University School of Medicine’s Behavioral Pharmacology Research Unit. I was given two doses of psilocybin spaced a month apart to treat my cancer-related depression. During one session, deep within the world the drug evoked, I found myself inside a steel industrial space. Women were bent over long tables, working. I became aware of my animosity towards my two living siblings. A woman seated at the end of a table wearing a net cap and white clothes, turned and handed me a tall Dixie cup. “You can put that in here,” she said. The cup filled itself with my bilious, sibling-directed feelings. “We’ll put it over there.” She turned and placed the cup matter-of-factly on a table at the back of the room. Then she went back to her tasks. Whenever I speak with her, Mary Cosimano, the director of guide/facilitator services at Johns Hopkins Center for Psychedelic and Consciousness Research, mentions the women in the chamber and the cup. My experience struck a chord. For me, the women in the chamber have become a transcendent metaphor for emotional healing. “I’ve thought about having a necklace made, with the cup, as a momento,” she said the last time I saw her at a conference. “Have you thought about it?” Prior to their 1971 prohibition, psilocybin and LSD were administered to approximately 40,000 patients, among them people with terminal cancer, alcoholics and those suffering from depression and obsessive-compulsive disorder. The results of the early clinical studies were promising, and more recent research has been as well. The treatment certainly helped me. Eight years after my sessions, researchers continue to prove the same point again and again in an ongoing effort to turn psychedelic drug therapy into FDA-sanctioned medical treatment. This can’t happen soon enough. © 2020 Scientific American,

Keyword: Depression; Drug Abuse
Link ID: 27361 - Posted: 07.14.2020

Research shows that adolescents who live in areas that have high levels of artificial light at night tend to get less sleep and are more likely to have a mood disorder relative to teens who live in areas with low levels of night-time light. The research was funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health, and is published in JAMA Psychiatry. “These findings illustrate the importance of joint consideration of both broader environmental-level and individual-level exposures in mental health and sleep research,” says study author Diana Paksarian, Ph.D., a postdoctoral research fellow at NIMH. Daily rhythms, including the circadian rhythms that drive our sleep-wake cycles, are thought to be important factors that contribute to physical and mental health. The presence of artificial light at night can disrupt these rhythms, altering the light-dark cycle that influences hormonal, cellular, and other biological processes. Researchers have investigated associations among indoor artificial light, daily rhythms, and mental health, but the impact of outdoor artificial light has received relatively little attention, especially in teens. In this study, Paksarian, Kathleen Merikangas, Ph.D., senior investigator and chief of the Genetic Epidemiology Research Branch at NIMH, and coauthors examined data from a nationally representative sample of adolescents in the United States, which was collected from 2001 to 2004 as part of the National Comorbidity Survey Adolescent Supplement (NCS-A). The dataset included information about individual-level and neighborhood-level characteristics, mental health outcomes, and sleep patterns for a total of 10,123 teens, ages 13 to 18 years old.

Keyword: Biological Rhythms; Depression
Link ID: 27348 - Posted: 07.08.2020

By Pam Belluck Kim Victory was paralyzed on a bed and being burned alive. Just in time, someone rescued her, but suddenly, she was turned into an ice sculpture on a fancy cruise ship buffet. Next, she was a subject of an experiment in a lab in Japan. Then she was being attacked by cats. Nightmarish visions like these plagued Ms. Victory during her hospitalization this spring for severe respiratory failure caused by the coronavirus. They made her so agitated that one night, she pulled out her ventilator breathing tube; another time, she fell off a chair and landed on the floor of the intensive care unit. “It was so real, and I was so scared,” said Ms. Victory, 31, now back home in Franklin, Tenn. To a startling degree, many coronavirus patients are reporting similar experiences. Called hospital delirium, the phenomenon has previously been seen mostly in a subset of older patients, some of whom already had dementia, and in recent years, hospitals adopted measures to reduce it. “All of that has been erased by Covid,” said Dr. E. Wesley Ely, co-director of the Critical Illness, Brain Dysfunction and Survivorship Center at Vanderbilt University and the Nashville Veteran’s Administration Hospital, whose team developed guidelines for hospitals to minimize delirium. Now, the condition is bedeviling coronavirus patients of all ages with no previous cognitive impairment. Reports from hospitals and researchers suggest that about two-thirds to three-quarters of coronavirus patients in I.C.U.’s have experienced it in various ways. Some have “hyperactive delirium,” paranoid hallucinations and agitation; some have “hypoactive delirium,” internalized visions and confusion that cause patients to become withdrawn and incommunicative; and some have both. © 2020 The New York Times Company

Keyword: Schizophrenia
Link ID: 27336 - Posted: 06.29.2020

By Andrew McCormick The psychiatrist was bald, with kind eyes, a silver goatee and the air of exhaustion that follows a person who works hard in a difficult field. It was March 2019, and having let an old prescription expire months earlier, I had gone to the Veterans Affairs hospital in Manhattan — my first time at a V.A. — hoping to get antidepressants. In a small, sparsely decorated office, the doctor and I faced each other across a wide desk. He told me about various V.A. programs — counseling, group therapy, a veterans’ yoga class, each accompanied by a flier — and described at length the V.A.’s crisis hotline. I appreciated his care, but I wasn’t there to break any new emotional ground; I really just wanted a prescription and to be on my way. I answered briskly as he worked through the questions any mental health worker asks you on a first visit. Did I have a history of anxiety or depression? Yes. Had I had thoughts of hurting myself or of suicide? Not really. Did anyone in my family have a history of mental health issues? Suddenly, my brain went foggy and my thoughts failed to connect. My speech slowed, and I began struggling to form sentences. Weird, I thought. I hadn’t felt sick. I worried the doctor might think he’d hit a nerve, when in fact I had answered questions like these many times before, including in post-deployment health evaluations in the Navy. My vision blurred. Eyes aflutter, I motioned to the doctor to give me a minute. I think I laughed. With the calm dispassion of a man who’s seen it all, the doctor picked up a phone beside him: “I’m going to need some help,” he said. “He’s about to pass out. . . . Yeah, he looks like he might throw up.” I swallowed hard. I tried not to. “Yeah, he just threw up.” © 2020 The New York Times Company

Keyword: Depression; Stress
Link ID: 27319 - Posted: 06.24.2020

By Pooja Lakshmin After going through a harrowing bout of postpartum depression with her first child, my patient, Emily, had done everything possible to prepare for the postpartum period with her second. She stayed in treatment with me, her perinatal psychiatrist, and together we made the decision for her to continue Zoloft during her pregnancy. With the combination of medication, psychotherapy and a significant amount of planning, she was feeling confident about her delivery in April. And then, the coronavirus hit. Emily, whose name has been changed for privacy reasons, called me in late-March because she was having trouble sleeping. She was up half the night ruminating about whether she’d be able to have her husband with her for delivery and how to manage taking care of a toddler and a newborn without help. The cloud that we staved off for so long was returning, and Emily felt powerless to stop it. Postpartum depression and the larger group of maternal mental health conditions called perinatal mood and anxiety disorders are caused by neurobiological factors and environmental stressors. Pregnancy and the postpartum period are already vulnerable times for women due in part to the hormonal fluctuations accompanying pregnancy and delivery, as well as the sleep deprivation of the early postpartum period. Now, fears about the health of an unborn child or an infant and the consequences of preventive measures, like social distancing, have added more stress. As a psychiatrist who specializes in taking care of pregnant and postpartum women, I’ve seen an increase in intrusive worry, obsessions, compulsions, feelings of hopelessness and insomnia in my patients during the coronavirus pandemic. And I’m not alone in my observations: Worldwide, mental health professionals are concerned. A special editorial in a Scandinavian gynecological journal called attention to the psychological distress that pregnant women and new mothers will experience in a prolonged global pandemic. A report from Zhejiang University in China detailed the case of a woman who contracted Covid-19 late in her pregnancy and developed depressive symptoms. In the United States, maternal mental health experts have also described an increase in patients with clinical anxiety. © 2020 The New York Times Company

Keyword: Depression; Stress
Link ID: 27263 - Posted: 05.28.2020