Chapter 12. Psychopathology: The Biology of Behavioral Disorders

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By Dave Philipps David Metcalf’s last act in life was an attempt to send a message — that years as a Navy SEAL had left his brain so damaged that he could barely recognize himself. He died by suicide in his garage in North Carolina in 2019, after nearly 20 years in the Navy. But just before he died, he arranged a stack of books about brain injury by his side, and taped a note to the door that read, in part, “Gaps in memory, failing recognition, mood swings, headaches, impulsiveness, fatigue, anxiety, and paranoia were not who I was, but have become who I am. Each is worsening.” Then he shot himself in the heart, preserving his brain to be analyzed by a state-of-the-art Defense Department laboratory in Maryland. The lab found an unusual pattern of damage seen only in people exposed repeatedly to blast waves. The vast majority of blast exposure for Navy SEALs comes from firing their own weapons, not from enemy action. The damage pattern suggested that years of training intended to make SEALs exceptional was leaving some barely able to function. But the message Lieutenant Metcalf sent never got through to the Navy. No one at the lab told the SEAL leadership what the analysis had found, and the leadership never asked. It was not the first time, or the last. At least a dozen Navy SEALs have died by suicide in the last 10 years, either while in the military or shortly after leaving. A grass-roots effort by grieving families delivered eight of their brains to the lab, an investigation by The New York Times has found. And after careful analysis, researchers discovered blast damage in every single one. It is a stunning pattern with important implications for how SEALs train and fight. But privacy guidelines at the lab and poor communication in the military bureaucracy kept the test results hidden. Five years after Lieutenant Metcalf’s death, Navy leaders still did not know. Until The Times told the Navy of the lab’s findings about the SEALs who died by suicide, the Navy had not been informed, the service confirmed in a statement. © 2024 The New York Times Company

Keyword: Brain Injury/Concussion; Depression
Link ID: 29378 - Posted: 07.03.2024

By Janna Levin During traumatic periods and their aftermath, our brains can fall into habitual ways of thinking that may be helpful in the short run but become maladaptive years later. For the brain to readjust to new situations later in life, it needs to be restored to the malleable state it was in when the habits first formed. That is exactly what Gül Dölen, a neuroscientist and psychiatric researcher at the University of California, Berkeley, is working toward in her lab. What is her surprising tool? Psychedelics. JANNA LEVIN: Welcome to “The Joy of Why.” This is Janna Levin. On June 4th, an advisory panel for the Federal Drug Administration recommended against approving the use of the psychedelic drug MDMA as a treatment for post-traumatic stress disorder. Various concerns, some about safety, overshadowed the demonstrable value of the drug in the opinion of the panel. The path to approval for drug therapies is notoriously fraught with profound complexities, a high bar on proof in clinical trials, the medical injunction to “do no harm,” as well as social and political nuances. But, what’s the fundamental neuroscience behind the news story? Why are so many psychiatric researchers enthusiastic about the promise of psychedelics? We happened to take on this subject a few weeks ago with neuroscientist Gül Dölen. Here is that episode. New drug leads can come from practically anywhere. Penicillin’s discovery was spurred from mold spores that accidentally landed in a petri dish. Cancer treatments can be dredged from the bottom of the sea. And synthetic antibodies can now be engineered from scratch. But there’s a class of drugs that mainstream medicine has generally overlooked that could prove life-changing for many people facing addiction, depression, post-traumatic stress — if scientists embrace the potential power of psychedelics. © 2024 the Simons Foundation.

Keyword: Stress; Depression
Link ID: 29351 - Posted: 06.08.2024

By Ellen Barry Post-traumatic stress disorder diagnoses among college students more than doubled between 2017 and 2022, climbing most sharply as the coronavirus pandemic shut down campuses and upended young adults’ lives, according to new research published on Thursday. The prevalence of PTSD rose to 7.5 percent from 3.4 percent during that period, according to the findings. Researchers analyzed responses from more than 390,000 participants in the Healthy Minds Study, an annual web-based survey. “The magnitude of this rise is indeed shocking,” said Yusen Zhai, the paper’s lead author, who heads the community counseling clinic at the University of Alabama at Birmingham. His clinic had seen more young people struggling in the aftermath of traumatic events. So he expected an increase, but not such a large one. Dr. Zhai, an assistant professor in the Department of Human Studies, attributed the rise to “broader societal stressors” on college students, such as campus shootings, social unrest and the sudden loss of loved ones from the coronavirus. PTSD is a mental health disorder characterized by intrusive thoughts, flashbacks and heightened sensitivity to reminders of an event, continuing more than a month after it occurs. It is a relatively common disorder, with an estimated 5 percent of adults in the United States experiencing it in any given year, according to the most recent epidemiological survey conducted by the Department of Health and Human Services. Lifetime prevalence is 8 percent in women and 4 percent in men, the survey found. The new research also found a sharp rise in the prevalence of a similar condition, acute stress disorder, which is diagnosed less than a month after a trauma. Diagnoses rose to 0.7 percent among college students in 2022, up from 0.2 percent five years earlier. Use of mental health care increased nationally during the pandemic, as teletherapy made it far easier to see clinicians. Treatment for anxiety disorders increased most steeply, followed by PTSD, bipolar disorder and depression, according to economists who analyzed more than 1.5 million insurance claims for clinician visits between 2020 and 2022. © 2024 The New York Times Company

Keyword: Stress
Link ID: 29350 - Posted: 06.08.2024

Leyland Cecco in Toronto A leading federal scientist in Canada has alleged he was barred from investigating a mystery brain illness in the province of New Brunswick and said he fears more than 200 people affected by the condition are experiencing unexplained neurological decline. The allegations, made in leaked emails to a colleague seen by the Guardian, have emerged two years after the eastern province closed its investigation into a possible “cluster” of cases. “All I will say is that my scientific opinion is that there is something real going on in [New Brunswick] that absolutely cannot be explained by the bias or personal agenda of an individual neurologist,” wrote Michael Coulthart, a prominent microbiologist. “A few cases might be best explained by the latter, but there are just too many (now over 200).” New Brunswick health officials warned in 2021 that more than 40 residents were suffering from a possible unknown neurological syndrome, with symptoms similar to those of the degenerative brain disorder Creutzfeldt-Jakob disease. Those symptoms were varied and dramatic: some patients started drooling and others felt as though bugs were crawling on their skin. A year later, however, an independent oversight committee created by the province determined that the group of patients had most likely been misdiagnosed and were suffering from known illnesses such as cancer and dementia. The committee and the New Brunswick government also cast doubt on the work of neurologist Alier Marrero, who was initially referred dozens of cases by baffled doctors in the region, and subsequently identified more cases. The doctor has since become a fierce advocate for patients he feels have been neglected by the province. © 2024 Guardian News & Media Limited

Keyword: Alzheimers; Depression
Link ID: 29342 - Posted: 06.04.2024

By Andrew Jacobs and Christina Jewett The Food and Drug Administration on Friday raised concerns about the health effects of MDMA as a treatment for post-traumatic stress disorder, citing flaws in a company’s studies that could pose major obstacles to approval of a treatment anticipated to help people struggling with the condition. The agency said that bias had seeped into the studies because participants and therapists were readily able to figure out who got MDMA versus a placebo. It also flagged “significant increases” in blood pressure and pulse rates that could “trigger cardiovascular events.” The staff analysis was conducted for an independent advisory panel that will meet Tuesday to consider an application by Lykos Therapeutics for the use of MDMA-assisted therapy. The agency’s concerns highlight the unique and complex issues facing regulators as they weigh the therapeutic value of an illegal drug commonly known as Ecstasy that has long been associated with all-night raves and cuddle puddles. Approval would mark a seismic change in the nation’s tortuous relationship with psychedelic compounds, most of which the Drug Enforcement Administration classifies as illegal substances that have “no currently accepted medical use and a high potential for abuse.” Research like the current studies on MDMA therapy have corralled the support of various groups and lawmakers from both parties for treatment of PTSD, a condition affecting millions of Americans, especially military veterans who face an outsize risk of suicide. No new therapy has been approved for PTSD in more than 20 years. “What’s happening is truly a paradigm shift for psychiatry,” said David Olson, director of the U.C. Davis Institute for Psychedelics and Neurotherapeutics. “MDMA is an important step for the field because we really lack effective treatments, period, and people need help now.” © 2024 The New York Times Company

Keyword: Drug Abuse; Depression
Link ID: 29332 - Posted: 06.02.2024

Rodrigo Duarte Around 8% of human DNA is made up of genetic sequences acquired from ancient viruses. These sequences, known as human endogenous retroviruses (or Hervs), date back hundreds of thousands to millions of years – with some even predating the emergence of Homo sapiens. Our latest research suggests that some ancient viral DNA sequences in the human genome play a role in susceptibility to psychiatric disorders such as schizophrenia, bipolar disorder and major depressive disorder. Hervs represent the remnants of these infections with ancient retroviruses. Retroviruses are viruses that insert a copy of their genetic material into the DNA of the cells they infect. Retroviruses probably infected us on multiple occasions during our evolutionary past. When these infections occurred in sperm or egg cells that generated offspring, the genetic material from these retroviruses was passed on to subsequent generations, becoming a permanent part of our lineage. Initially, scientists considered Hervs to be “junk DNA” – parts of our genome with no discernible function. But as our understanding of the human genome has advanced, it’s become evident that this so-called junk DNA is responsible for more functions than originally hypothesised. First, researchers found that Hervs can regulate the expression of other human genes. A genetic feature is said to be “expressed” if its DNA segment is used to produce RNA (ribonucleic acid) molecules. These RNA molecules can then serve as intermediaries leading to the production of specific proteins, or help to regulate other parts of the genome. Initial research suggested that Hervs regulate the expression of neighbouring genes with important biological functions. One example of this is a Herv that regulates the expression of a gene involved in modifying connections between brain cells. © 2010–2024, The Conversation US, Inc.

Keyword: Depression; Schizophrenia
Link ID: 29330 - Posted: 05.29.2024

By Steven Strogatz For decades, the best drug therapies for treating depression, like SSRIs, have been based on the idea that depressed brains don’t have enough of the neurotransmitter serotonin. Yet for almost as long, it’s been clear that simplistic theory is wrong. Recent research into the true causes of depression is finding clues in other neurotransmitters and the realization that the brain is much more adaptable than scientists once imagined. Treatments for depression are being reinvented by drugs like ketamine that can help regrow synapses, which can in turn restore the right brain chemistry and improve whole body health. In this episode, John Krystal, a neuropharmacologist at the Yale School of Medicine, shares the new findings in mental health research that are revolutionizing psychiatric medication. STEVEN STROGATZ: According to the World Health Organization, 280 million people worldwide suffer from depression. For decades, people with chronic depression have been told their problem lies with a chemical imbalance in the brain, specifically a deficit in a neurotransmitter called serotonin. And based on this theory, many have been prescribed antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, to correct this chemical imbalance. This theory has become the common narrative, yet almost from the beginning, researchers have questioned the role of serotonin in depression, even though SSRIs do seem to bring a lot of relief to many people. So, if bad brain chemistry isn’t at the root of chronic depression, what is? If the thinking behind SSRIs is wrong, why do they seem to help? And is it possible that as we get closer to the true cause of depression, we may find better treatments for other conditions as well? © 2024 the Simons Foundation.

Keyword: Depression
Link ID: 29325 - Posted: 05.25.2024

By Ellen Barry The annual gathering of the American Psychiatric Association is a dignified and collegial affair, full of scholarly exchanges, polite laughter and polite applause. So it was a shock, for those who took their seats in Room 1E08 of the Jacob K. Javits Convention Center in Manhattan, to watch a powerfully built 32-year-old man choke back tears as he described being slammed to the floor and cuffed to a stretcher in a psychiatric unit. Because the man, Matthew Tuleja, had been a Division I football player, he had a certain way of describing the circle of bodies that closed around him, the grabbing and grappling and the sensation of being dominated, pinned and helpless. He was on the ground in a small room filled with pepper spray. Then his wrists and ankles were cuffed to the sides of a stretcher, and his pants were yanked down. They gave him injections of Haldol, an antipsychotic medication he had repeatedly tried to refuse, as he howled in protest. Forcible restraints are routine events in American hospitals. One recent study, using 2017 data from the Centers for Medicare and Medicaid Services, estimated the number of restraints per year at more than 44,000. But it is rare to hear a first-person account of the experience, because it tends to happen to people who do not have a platform. Researchers who surveyed patients about restraint and seclusion have found that a large portion, 25 to 47 percent , met criteria for post-traumatic stress disorder. Listening, rapt, to Mr. Tuleja was a roomful of psychiatrists. It was a younger crowd — people who had entered the field at the time of the Black Lives Matter protests. Many of them lined up to speak to him afterward. “I still can’t forget the first time I saw someone restrained,” one doctor told him. “You don’t forget that.” © 2024 The New York Times Company

Keyword: Schizophrenia; Aggression
Link ID: 29317 - Posted: 05.21.2024

By Laura Sanders Everyone knows that the brain influences the heart. Stressful thoughts can set the heart pounding, sometimes with such deep force that we worry people can hear it. Anxiety can trigger the irregular skittering of atrial fibrillation. In more extreme and rarer cases, emotional turmoil from a shock — the death of a loved one, a cancer diagnosis, an intense argument — can trigger a syndrome that mimics a heart attack. But not everyone knows that the heart talks back. Subscribe to Science News Powerful signals travel from the heart to the brain, affecting our perceptions, decisions and mental health. And the heart is not alone in talking back. Other organs also send mysterious signals to the brain in ways that scientists are just beginning to tease apart. A bodywide perspective that seeks to understand our biology and behavior is relatively new, leaving lots of big, basic questions. The complexities of brain-body interactions are “only matched by our ignorance of their organization,” says Peter Strick, a neuroscientist at the University of Pittsburgh. Exploring the relationships between the heart, other organs and the brain isn’t just fascinating anatomy. A deeper understanding of how we sense and use signals from inside our bodies — a growing field called interoception — may point to new treatments for disorders such as anxiety. “We have forgotten that interactions with the internal world are probably as important as interactions with the external world,” says cognitive neuroscientist Catherine Tallon-Baudry of École Normale Supérieure in Paris. © Society for Science & the Public 2000–2024.

Keyword: Emotions; Depression
Link ID: 29313 - Posted: 05.18.2024

By Christina Caron Antidepressants are among the most prescribed medications in the United States. This is, in part, because the number of people diagnosed with depression and anxiety has been on the rise, and prescriptions jumped sharply among some age groups during the pandemic. Despite the prevalence of these medications, some patients have “significant misconceptions” about how the drugs work, said Dr. Andrew J. Gerber, a psychiatrist and the president and medical director of Silver Hill Hospital in New Canaan, Conn. About 80 percent of antidepressants are prescribed by primary care doctors who have not had extensive training in managing mental illness. Dr. Paul Nestadt, an associate professor of psychiatry at the Johns Hopkins School of Medicine, said patients tell him, “‘You know, Doc, I’ve tried everything.’” But often, he said, “they never got to a good dose, or they were only on it for a week or two.” Here are some answers to frequently asked questions about antidepressants. How do antidepressants work? There are many types of antidepressants, and they all work a bit differently. In general, they initiate a change in the way brain cells — and different regions of the brain — communicate with one another, said Dr. Gerard Sanacora, a professor of psychiatry at the Yale School of Medicine. Clinical trials have shown that antidepressants are generally more effective with moderate, severe and chronic depression than with mild depression. Even then, it’s a modest effect when compared with placebo. © 2024 The New York Times Company

Keyword: Depression
Link ID: 29275 - Posted: 04.30.2024

By Nicole Rust We readily (and reasonably) accept that the causes of memory dysfunction, including Alzheimer’s disease, reside in the brain. The same is true for many problems with seeing, hearing and motor control. We acknowledge that understanding how the brain supports these functions is important for developing treatments for their corresponding dysfunctions, including blindness, deafness and Parkinson’s disease. Applying the analogous assertion to mood—that understanding how the brain supports mood is crucial for developing more effective treatments for mood disorders, such as depression—is more controversial. For brain researchers unfamiliar with the controversy, it can be befuddling. You might hear, “Mental disorders are psychological, not biological,” and wonder, what does that mean, exactly? Experts have diverse opinions on the matter, with paper titles ranging from “Brain disorders? Not really,” to “Brain disorders? Precisely.” Even though a remarkable 21 percent of adults in the United States will experience a mood disorder at some point in their lives, we do not fully understand what causes them, and existing treatments do not work for everyone. How can we best move toward an impactful understanding of mood and mood disorders, with the longer-term goal of helping these people? What, if anything, makes mood fundamentally different from, say, memory? The answer turns out to be complex and nuanced—here, I hope to unpack it. I also ask brain and mind researchers with diverse perspectives to chime in. Among contemporary brain and mind researchers, I have yet to find any whose position is driven by the notion that some force in the universe beyond the brain, like a nonmaterial soul, gives rise to mood. Rather, the researchers generally agree that our brains mediate all mental function. If everyone agrees that both memory and mood disorders follow from things that happen in the brain, why would the former but not the latter qualify as “brain disorders”? © 2024 Simons Foundation

Keyword: Depression; Learning & Memory
Link ID: 29251 - Posted: 04.11.2024

By Esther Landhuis When Angela Tang’s teenage son came down with a baffling illness, few households could have been better equipped to deal with it. The family lives in a wealthy Los Angeles suburb. Both parents are doctors — Tang in internal medicine, her husband in infectious disease — and their son, a straight-A student well-liked at school, had been cared for by the family’s pediatrician since birth. Still, the parents worried as their son’s symptoms appeared, seemingly out of the blue, in September 2018: He’d meticulously line up pencils in groups of five, recite prayers unrelentingly, make homework illegible as he had to erase or cross out every C, D, and F. Eating, too, became a chore. If he had a contaminating thought while taking a bite, he’d have to spit out the food, wash his mouth, and try again, but the new bite couldn’t have touched the old one. It got to the point where he could only eat mushy or semi-liquid foods carefully placed “in little aliquots on his plate, so that if one bite got contaminated,” it wouldn’t touch the others, Tang said. Before long, she and her husband were working around the clock just to get him through the day. In a panic, Tang consulted their pediatrician, and recalls the doctor asking an intriguing question: “Has he had any unusual infections recently — because you know about PANDAS, right?” At the time, Tang knew nothing about PANDAS. She had completed her own medical residency two years before the illness — short for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections — was first outlined in a 1998 paper. That publication detailed how a child’s behavior could change alarmingly after a strep infection, and may include symptoms of obsessive-compulsive behavior and tics. It has also stirred controversy: Many doctors hesitate to diagnose or treat the condition even today.

Keyword: OCD - Obsessive Compulsive Disorder; Neuroimmunology
Link ID: 29241 - Posted: 04.04.2024

By Charles Digges My default mode for writing term papers during my student days was the all-night slog, and I recall the giddy, slap-happy feeling that would steal over me as the sun rose. There was a quality of alert focus that came with it, as well as a gregariousness that would fuel bonding sessions with my other all-night companions. After we’d turned in the products of our midnight oil to our professors, we would all head out for pancakes. Then I’d go home and sleep the magic off. For years, I’d wondered if there was any basis for this temporary euphoria that I—though certainly not all my classmates—experienced after those sleepless nights. That I should feel so expansive and goofy after skipping sleep while many of them turned into drowsy grouches seemed to defy logic. Going without sleep isn’t supposed to be a good thing, especially for folks who experience depression, as I have. But it turns out this paradox has been the subject of inquiry for at least two centuries. In 1818, University of Leipzig psychiatrist Johann Christian August Heinroth was reportedly the first to suggest that partial or total sleep deprivation could be temporarily effective against “melancholia,” as depression was called in those days. He found this to be true only in a certain subset of patients—around 60 percent. More than a hundred years later, in the 1970s, evidence emerged that a “resynchronization” of disturbed circadian rhythms could be responsible for the improved moods of depressed patients after a night without sleep. And more recently, researchers have found that a neurotransmitter involved in reward known as dopamine may play a role in this effect, as may neuroplasticity—the nervous system’s ability to rearrange itself in response to stimuli. But the precise neural mechanisms responsible have remained unclear. © 2024 NautilusNext Inc.,

Keyword: Sleep; Depression
Link ID: 29220 - Posted: 03.28.2024

By David Adam The drug ketamine is enjoying a second life. First developed as an anaesthetic that was used widely by US battlefield surgeons during the Vietnam war, it is growing in popularity as a treatment for depression and other mental-health conditions. And this week, the drug got its highest-profile endorsement yet. In an interview with US journalist Don Lemon that was released online on Monday, Elon Musk, founder of SpaceX and head of social-media platform X (formerly Twitter), spoke about his own experiences of using the drug to manage what he called a “negative chemical state” similar to depression. Musk said he has a prescription for the drug from “a real doctor” and uses “a small amount once every other week or something like that”. His comments follow the fatal drowning of Friends actor Matthew Perry last October, an incident that an investigation blamed on the drug’s acute effects. It’s complicated. Approved as an anaesthetic by the US Food and Drug Administration in 1970, the drug was delivered intravenously to people undergoing surgery. Ketamine is often still given that way for depression. That requires supervision — typically people attend a private clinic and are monitored by an anaesthetist as well as the prescribing psychiatrist and members of the support staff. Because it’s long out of patent, there’s little commercial interest in developing new versions of the drug. Some companies are trying to package it into more-convenient oral lozenges, but that’s a challenging formulation. “The problem with ketamine is if you take it orally, by and large it doesn’t get through to the system because it’s got low bioavailability,” says Allan Young, a consultant psychiatrist at King’s College London who studies mood disorders.

Keyword: Depression; Drug Abuse
Link ID: 29210 - Posted: 03.23.2024

By Sara Reardon For the past few decades, scientists studying candidate antidepressant drugs have had a convenient animal test: how long a rodent dropped in water keeps swimming. Invented in 1977, the forced swim test (FST) hinged on the idea that a depressed animal would give up quickly. It seemed to work: Antidepressants and electroconvulsive therapy often made the animal try harder. The test remains popular, appearing in about 600 papers per year. But researchers have recently begun to question the assumption that the test really gauges depression and is a good predictor of human responses to drugs. Opposition to the test is snowballing, driven in part by concerns it is unnecessarily cruel given its spotty results. This month, following similar moves by the Australian government, the United Kingdom’s Home Office announced it would require U.K. researchers to justify the use of the test and would encourage other U.K. ministries that regulate animal research to “completely eliminate” it. Such changes add urgency to efforts to develop better animal tests of psychiatric drugs’ effects. Neurobiologist Anne Mallien of Heidelberg University, who studies the effects of the FST on rodents’ well-being, says she would love to have other options. “The thing is that alternatives are somewhat missing.” In the FST, researchers put a mouse or rat in a container of water, usually for about 5 minutes, and time how long it exerts itself before giving up and simply floating. Rodents will often swim longer when treated with psychiatric drugs. “But does that mean something for [human medicine]?” says neuroscientist Carole Morel at the Icahn School of Medicine at Mount Sinai. The rodents’ high stress levels could complicate the results, and an intelligent animal quickly learns that researchers will rescue it once it gives up.

Keyword: Depression; Animal Rights
Link ID: 29201 - Posted: 03.21.2024

By Elizabeth Landau Electroconvulsive therapy has a public relations problem. The treatment, which sends electric currents through the brain to induce a brief seizure, has barbaric, inhumane connotations — for example, it was portrayed as a sadistic punishment in the film One Flew Over the Cuckoo’s Nest. But for patients with depression that does not improve with medications, electroconvulsive therapy (ECT) can be highly effective. Studies have found that some 50% to 70% of patients with major depressive disorder see their symptoms improve after a course of ECT. In comparison, medications aimed at altering brain chemistry help only 10% to 40% of depression patients. Still, even after many decades of use, scientists don’t know how ECT alters the brain’s underlying biology. Bradley Voytek, a neuroscientist at the University of California, San Diego, said a psychiatrist once told him that the therapy “reboots the brain” — an explanation he found “really unsatisfying.” Recently, Voytek and his collaborators paired their research into the brain’s electrical patterns with patient data to explore why inducing seizures has antidepressant effects. In two studies published last fall, the researchers observed that ECT and a related seizure therapy increased the unstructured background noise hiding behind well-defined brain waves. Neuroscientists call this background noise “aperiodic activity.” The authors suggested that induced seizures might help restore the brain’s balance of excitation and inhibition, which could have an overall antidepressant effect. “Every time that I talk to someone who’s not in this field about this work they’re like, ‘They still do that? They still use electroshock? I thought that was just in horror movies,’” said Sydney Smith, a graduate student in neuroscience in Voytek’s lab and the first author of the new studies. “Dealing with the stigma around it has become even more of a motivation to figure out how it works.” © 2024 Simons Foundation.

Keyword: Depression; Attention
Link ID: 29199 - Posted: 03.19.2024

By Ben Seal When Oregon’s first psilocybin service center opened in June 2023, allowing those over 21 to take mind-altering mushrooms in a state-licensed facility, the psychedelic revival that had been unfolding over the past two decades entered an important new phase. Psilocybin is still illegal on the federal level. But now, as researchers explore the therapeutic potential of psilocybin and other psychedelics, including LSD and MDMA (also known as Molly or ecstasy), legal reform efforts are spreading across the country — raising tensions between state and federal laws. As a class, psychedelic drugs were outlawed in the United States by the Controlled Substances Act of 1970. The act designated psychedelics as Schedule I drugs — the most restrictive classification, indicating a high potential for abuse and no accepted medical use. That status limits research to federally approved scientific studies and restricts federal funding to research with “significant medical evidence of a therapeutic advantage.” Despite these limitations, researchers have demonstrated the potential of psychedelics in the treatment of post-traumatic stress disorder, major depressive disorder, anxiety and addiction. A 2020 systematic review of recent research found that psychedelics can lessen symptoms linked to a variety of mental health conditions. While that review found no serious, long-term adverse physical or psychological effects from ingesting psychedelics, more research is needed on the latter. Today, decades after research on the effects of hallucinogens on the brain was sidelined by the act, academic and cultural interest in psychedelics is on the rise. More than 60 percent of Americans now support regulated therapeutic use of psychedelics, while nearly half support decriminalization, and nearly 45 percent support spiritual and religious use. An estimated 5.5 million US adults use psychedelics each year.

Keyword: Depression; Drug Abuse
Link ID: 29189 - Posted: 03.16.2024

By Ellen Barry Twins are a bonanza for research psychologists. In a field perpetually seeking to tease out the effects of genetics, environment and life experience, they provide a natural controlled experiment as their paths diverge, subtly or dramatically, through adulthood. Take Dennis and Douglas. In high school, they were so alike that friends told them apart by the cars they drove, they told researchers in a study of twins in Virginia. Most of their childhood experiences were shared — except that Dennis endured an attempted molestation when he was 13. At 18, Douglas married his high school girlfriend. He raised three children and became deeply religious. Dennis cycled through short-term relationships and was twice divorced, plunging into bouts of despair after each split. By their 50s, Dennis had a history of major depression, and his brother did not. Why do twins, who share so many genetic and environmental inputs, diverge as adults in their experience of mental illness? On Wednesday, a team of researchers from the University of Iceland and Karolinska Institutet in Sweden reported new findings on the role played by childhood trauma. Their study of 25,252 adult twins in Sweden, published in JAMA Psychiatry, found that those who reported one or more trauma in childhood — physical or emotional neglect or abuse, rape, sexual abuse, hate crimes or witnessing domestic violence — were 2.4 times as likely to be diagnosed with a psychiatric illness as those who did not. If a person reported one or more of these experiences, the odds of being diagnosed with a mental illness climbed sharply, by 52 percent for each additional adverse experience. Among participants who reported three or more adverse experiences, nearly a quarter had a psychiatric diagnosis of depressive disorder, anxiety disorder, substance abuse disorder or stress disorder. © 2024 The New York Times Company

Keyword: Depression; Genes & Behavior
Link ID: 29184 - Posted: 03.07.2024

NIH-funded study shows prenatal mental health support is effective for women living in low-resource settings. Results from a large clinical trial funded by the National Institutes of Health show that an intervention for anxiety provided to pregnant women living in Pakistan significantly reduced the likelihood of the women developing moderate-to-severe anxiety, depression, or both six weeks after birth. The unique intervention was administered by non-specialized providers who had the equivalent of a bachelor’s degree in psychology—but no clinical experience. The results suggest this intervention could be an effective way to prevent the development of postpartum mental health challenges in women living in low-resource settings. “In low resource settings, it can be challenging for women to access mental health care due to a global shortage of trained mental health specialists,” said Joshua A. Gordon, M.D., Ph.D., Director of the National Institute of Mental Health, part of NIH. “This study shows that non-specialists could help to fill this gap, providing care to more women during this critical period." Led by Pamela J. Surkan, Ph.D., Sc.D.(link is external), of Johns Hopkins Bloomberg School of Public Health, Baltimore, the study was conducted in the Punjab Province of Pakistan between April 2019 and January 2022. Pregnant women with symptoms of at least mild anxiety were randomly assigned to receive either routine pregnancy care or a cognitive behavioral therapy (CBT)-based intervention called Happy Mother-Healthy Baby. The researchers assessed the participants (380 women in the CBT group and 375 women in the routine care group) for anxiety and depression six weeks after the birth of their child.

Keyword: Depression; Sexual Behavior
Link ID: 29165 - Posted: 02.27.2024

Ayana Archie The monthly rate of antidepressants being dispensed to young people increased about 64% more quickly during the coronavirus pandemic, according to a study published Monday in the journal Pediatrics. Researchers used the IQVIA Longitudinal Prescription Database to examine a sample of about 221 million prescriptions written for millions of Americans between the ages 12 to 25, and from 2016 to 2022. Researchers additionally separated the data into before and after March 2020, when the pandemic started. The increase was prominent among young women and girls. The monthly rate increased about 130% faster among 12- to 17-year-old girls, and about 57% faster among young women between the ages of 18 and 25. The study hypothesizes this jump could be due to high rates of depression or anxiety, better access to health care, due to things such as telehealth, or people's reliance on prescriptions because of long waitlists for therapy during the pandemic. The dataset includes prescriptions dispensed from "retail, mail-order, and long-term care pharmacies in the United States," the study says, not exclusive health care systems, such as Kaiser Permanente. Conversely, during the pandemic, the monthly antidepressant dispensing rate decreased for boys between the ages of 12 to 17 and did not change for young men between 18 and 25. Though, data shows more male adolescents were sent to the emergency room for suspected suicide attempts in early 2021, compared to early 2019. Between 2019 and 2021, male high school students also reported constantly feeling sad or hopeless more often, according to the researchers. © 2024 npr

Keyword: Depression
Link ID: 29164 - Posted: 02.27.2024