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02
Mar
Mike Myers, MD

Stigma and the Ailing Physician

An inside look on how stigma may reinforce denial in ill doctors.

Thu
19
Feb
Mike Myers, MD

The Gift of Self-Disclosure

Ode to Dr. Quinn Leslie who has paved the path to accepting non-perfectionism.

Wed
04
Feb

Clinical pearls from the Psych Congress annual meeting.

Mon
12
Jan
Andrew Penn

Cannabis Exposure May Lead to Psychosis

Schizophrenia typically emerges in late adolescence and early adulthood, before the age of 25.

Spotlight

Asking the Right Questions to Assess Suicide Risk

J. John Mann, MD, of Columbia University, and Charles Raison, MD, Psych Congress Steering Committee member, discuss which questions clinicians should ask to best evaluate suicide risk.

Exclusives

Simple Tool Helps Track Memory, Will Aid Alzheimer's Disease Trials

Alzheimer's Disease Cooperative Study researchers have discovered a way to track changes in cognitive function in older adults.

Tue
03
Mar

Headaches Linked to a Wide Range of Mental Disorders

A broad range of mental health disorders can increase risk for severe or frequent headaches by 40%, according to a study published in a recent issue of The Journal of Pain.

Previous research has shown a significant association between depression and chronic headaches. To investigate the effect of other mental health disorders on headache risk, an international team of researchers evaluated global data from 19 World Health Organization World Mental Health Surveys involving more than 52,000 people.

After researchers adjusted for factors including sex, age, and mental disorder comorbidity, they discovered a moderate association between preexisting mood, anxiety, and impulse-control disorders and subsequent headaches.

Patients diagnosed with mental disorders before age 21 had a 21% higher risk for subsequent headaches than patients diagnosed with mental disorders later in life, researchers reported. In addition, patients with multiple mental disorders had a higher risk of subsequent headaches than patients with just 1 mental disorder.

“Our findings suggest a consistent and pervasive relationship between a wide range of preexisting mental disorders and the subsequent onset of headaches,” researchers reported. “This highlights the importance of assessing a broad range of mental disorders, not just depression, as specific risk factors for the subsequent onset of frequent or severe headaches.”

—Jolynn Tumolo

References

1. Bruffaerts R, Demyttenaere K, Kessler RC, et al. The associations between preexisting mental disorders and subsequent onset of chronic headaches: a worldwide epidemiologic perspective. The Journal of Pain. 2015;16:42-52.

2. Study assesses link of preexisting mental disorders with chronic headaches [press release]. Newswise: Charlottesville, VA; Feb. 24, 2015.

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02
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Mike Myers, MD

Stigma and the Ailing Physician

An inside look on how stigma may reinforce denial in ill doctors.

Fri
27
Feb

Homeless Children in Need of Mental Health Aid

North Carolina State University and Community Action Targeting Children who are Homeless, (CATCH), developed a study that observed homeless children in terms of their mental health to determine whether they are in need of support.

Mary Haskett, PhD, professor of psychology at NC State and Jenna Armstrong, PhD student at NC State have conducted the study and published their results in Early Childhood Education Journal. Haskett and Armstrong worked in conjunction with Jennifer Tisdale of CATCH.

The researches observed 328 children between the ages of 2 months old and 6 years old. They utilized data from CATCH to screen the children entering the homeless shelters in order to asses social, emotional, and developmental functioning. They concluded that of those children, 25% did need mental health aid.

The children observed have experienced or witnessed domestic/neighborhood violence, poverty, insufficient healthcare, or other traumatic events.

"As a result of their exposure to those difficult life circumstances—combined with living in a shelter—homeless children are at a much greater risk of developmental delays, social and emotional problems, and problems at school," says Armstrong, "and the scale of the problem is huge."

Through their research, it was also determined that children between 5 and 6 years old, both male and female, performed below average on language and academic testing.

The National Center on Family Homelessness found that 2.5 million children are homeless each year in the United States. "Children in shelters are often overlooked—they're basically invisible," Armstrong says. "But these findings highlight the importance of providing resources to meet the needs of these children. Twenty-five percent of 2.5 million is 625,000. So, we're talking about 625,000 children who need mental health support every year in the United States. We, as a society, can't afford to let these kids down."

 -Alessia D’Anna

References

1. Haskett M, Armstrong J, Tisdale J. Developmental Status and Social-Emotional Functioning of Young Children Experiencing Homelessness. Early Childhood Education Journal. 2015 Feb 19.

2. Study: 25 percent of children who are homeless need mental health services    [press release]. EurekAlert!: Washington, DC; Feb 19, 2015.

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Fri
27
Feb

Simple Tool Helps Track Memory, Will Aid Alzheimer's Disease Trials

By Megan Brooks

Researchers with the Alzheimer's Disease Cooperative Study (ADCS) have developed a simple tool to track early changes in cognitive function in older adults without cognitive impairment at the outset.

In a longitudinal study, they found that subjective self and partner report of change in cognitive function on the Cognitive Function Instrument (CFI) was associated with traditional measures of cognitive decline; greater subjective report of memory concerns was associated with worse memory performance over time.

"This study helps to validate this simple test by showing that it moved along with other outcomes," Dr. Rebecca Amariglio, of the Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, told Reuters Health by phone.

"The ADCS is trying to anticipate where clinical trials are headed and develop these tests in advance of these trials that are purposefully designed to be simple and straightforward and that are sensitive prior to cognitive impairment," she explained.

The CFI seems to fit the bill. Patients and family members can complete it on their own, with minimal in-person contact, making it ideal for large, lengthy prevention trials.

The CFI asks the participant and partner (usually a family member) 14 questions that cover the "full realm" of early functional change, the researchers note in a report online this week in JAMA Neurology.

Among the "yes-no-maybe" questions: Compared to one year ago, do you feel that your memory (or the subject's memory) has declined substantially?; Do others tell you that you tend to repeat questions over and over? (Does the subject tend to do this?); Have you been misplacing things more often, or has the subject?.

Dr. Amariglio and colleagues assessed the utility of the CFI in tracking early cognitive decline in 468 cognitively healthy older adults (Clinical Dementia Rating scale global score 0 at baseline). All study participants and their partners completed the self and partner CFIs annually. Study participants also underwent concurrent annual neuropsychological assessment and APOE genotyping.

When comparing clinical progressors (CDR-G score > 0) to nonprogressors (CDR-G score 0), the researchers saw "significant separation" between groups, such that CDR-G progressors had higher CFI scores and a greater increase in the CFI scores over time relative to nonprogressors.

"These findings held for partner report and self-report. The combination of the self and partner CFI revealed a slight advantage over individual report, suggesting that both perspectives on decline might be valuable during a four-year observational period," they report.

"The CFI remained a predictor of CDR progression when objective cognitive performance was also added as a predictor, suggesting that it independently contributes to longitudinal outcomes but that the combination of both measures may be particularly predictive," they note.

There was also significant separation in CFI scores between APOE 4 carriers and noncarriers, with carriers having greater progression than noncarriers.

As the AD field moves toward prevention at the preclinical stages of disease, "many new hurdles emerge," Dr. Amariglio and colleagues note in their article. "In addition to identifying the appropriate target for disease modification, finding the right tools to detect the earliest evidence of clinical progression is challenging."

They continued, "Demonstrating long-term clinical benefit will be critical because maintaining independence in everyday functioning is what matters most to patients and their families. Subjective assessment of an individual's level of functioning over time with the CFI may prove to be a sensitive and efficient outcome for secondary prevention trials in preclinical AD."

The CFI will be used in the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) study, Dr. Amariglio told Reuters Health.

She said it could eventually be used in routine clinical practice. "There is the potential but much more work is needed first. We don't have cutoffs yet and we talked about coming up with some sort of cutoff now that we have longitudinal data. For example, if a patient endorses X amount of symptoms, than we might be more concerned that the patient might progress down the road or that they are more likely to have positive biomarkers for AD," she explained.

The study was funded by the Alzheimer's Association and the National Institutes of Health.

SOURCE: http://bit.ly/1Gqdysw

JAMA Neurol 2015.

(c) Copyright Thomson Reuters 2015. Click For Restrictions - http://about.reuters.com/fulllegal.asp

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