Depression Shows Ties to Dementia
Depressive symptoms that occur in both mid- and late life are associated with an increased risk of developing vascular dementia, while symptoms that occur in late life only are more likely to be early signs of Alzheimer’s disease, according to a study published in the Archives of General Psychiatry.
The study is the first to examine whether mid- or late-life depression is more likely to lead to either Alzheimer’s disease or vascular dementia in the long term. The investigators examined the association between depressive symptoms and dementia over the course of 45 years in a longitudinal study of more than 13,000 long-term members of the Kaiser Permanente Northern California integrated care delivery system. The study population consisted of members who participated in a voluntary health examination called the Multiphasic Health Checkup in San Francisco and Oakland from 1964 to 1973 when they were ages 40 to 55.
Participants were evaluated for depressive symptoms in midlife as part of the Multiphasic Health Checkup and again in late life between 1994 and 2000. Between 2003 and 2009, 3,129 participants were diagnosed with dementia.
The findings suggest that depression beginning in late life may be an early symptom of Alzheimer’s disease, while chronic depression throughout life may reflect a long-term process of changes to blood flow in the brain associated with increased risk of vascular dementia.
Source.“Lifelong Depression May Increase Risk of Vascular Dementia, While Late-Life Depression May Signal Alzheimer’s Disease.” (2012, May 7). Retrieved May 23, 2012, from http://www.prnewswire.com/news-releases/lifelong-depression-may-increase-risk-of-vascular-dementia-while-late-life-depression-may-signal-alzheimers-disease-150480745.html.
Opioid Misuse Knows No Age Limit
An analysis from pain medication monitoring group Ameritox demonstrates that the older patient population is at risk for prescription misuse, abuse, and drug interactions. Data were presented at the American Pain Society’s annual meeting.
Although the common perception is that America’s prescription drug misuse concerns should focus on younger adults, data suggest that older pain patients have the same issues with potential nonadherence and medication misuse as the overall chronic pain population. The Ameritox study suggests health professionals should put aside age as a predictive indicator in evaluating medication adherence.
Extensive data of urine drug monitoring results taken from patient samples of adults 50 and older were submitted for analysis to Ameritox from October 1, 2009 to September 30, 2011, for a total of 725,679 samples. Results of this testing revealed:
- 7.6% had an illicit drug detected (e.g., marijuana, cocaine metabolite, heroin metabolite, PCP).
- 28.1% had a non-prescribed drug detected (e.g., opiates, benzodiazepines, barbiturates).
- 31.8% did not have a prescribed drug detected (e.g., a prescribed pain medication).
- 45.9% of samples had no abnormality found.
Source.“Large-Scale Meta-Analysis Shows Age Not a Social Barrier to Opioid Use and Misuse.” (2012, May 17). Retrieved May 23, 2012, from http://www.prnewswire.com/news-releases/large-scale-meta-analysis-shows-age-not-a-social-barrier-to-opioid-use-and-misuse-151889505.html.
Antipsychotic Use Increases in Children in Foster Care
A few months after the federal Government Accountability Office issued a report on the use of psychoactive drugs by children in foster care in five states, a national study from PolicyLab at The Children’s Hospital of Philadelphia describes prescription patterns over time in 48 states. The updated findings show the percentage of children in foster care taking antipsychotic agents continued to climb in the past decade. At the same time, a slight decline was seen in the use of other psychoactive medications, including the percentage of children receiving three or more classes of these medications at once. The findings have been published in Children and Youth Services Review.
As public scrutiny has increased about the use of psychoactive medication by children over the past decade, children in foster care continue to be prescribed these drugs at exceptionally high rates compared with the general population of U.S. children. According to the PolicyLab study, 1 in 10 school-aged children (ages 6 to 11) and 1 in 6 adolescents (ages 12 to 18) in foster care were taking antipsychotic agents by 2007.
The research team looked at the 686,000 foster-care children enrolled in Medicaid annually in 48 states from 2002 to 2007, and saw that both overall psychoactive agents use and polypharmacy increased from 2002 to 2004, and then began to decline from 2005 to 2007. Prescriptions for antipsychotic agents, on the other hand, increased each year from 2002 to 2007.
Prescription rates for both antipsychotic agent use and polypharmacy varied widely from state to state. Over the 6-year period, antipsychotic agent use increased in all but three states. Conversely, 18 states showed an increase in polypharmacy, while 19 states showed decline, and 11 showed no change. In 2007, states reported prescriptions of antipsychotic agents ranging from 2.8% to 21.7% of the foster care population, and from 0.5% to 13.6% for children receiving multiple classes of psychoactive drugs.
Source.“New Research Expands Understanding of Psychoactive Medication use Among Children in Foster Care.” (2012, April 30). Retrieved May 24, 2012, from http://www.prnewswire.com/news-releases/new-research-expands-understanding-of-psychoactive-medication-use-among-children-in-foster-care-149480575.html.
Teens Speak Out Against Abusive Relationships
Noting that one in three adolescents has been hit, harassed, emotionally abused, or digitally stalked by a romantic partner, “Be Smart. Be Well.” asked 15 middle school, high school, and college students about their experiences with abusive relationships on camera. The resulting video, Teens Start Talking, now available on BeSmartBeWell.com, is an honest and courageous look at the risks of being young and in love in today’s fast-paced technological world.
Teens Start Talking explores teens’ views of dating abuse and provides tips—straight from teens—for how young people can escape an abusive relationship or help a friend who is in one. Produced in collaboration with LoveisRespect.org, the video is a frank and hopeful discussion of teen abuse from the teen perspective.
Sometimes teens can confuse controlling or abusive behavior with affection. At BeSmartBeWell.com, teens urge their peers to be attuned to signs of abuse, and the executive director of Break the Cycle, a national non-profit organization devoted to preventing dating abuse among teens and young people, provides practical advice for parents and friends of teens who suspect abuse.
Source.“Abusive Relationships: Straight Talk From Teens.” (2012, April 11). Retrieved May 24, 2012, from http://www.multivu.com/mnr/50832-be-smart-be-well-abusive-relationships-straight-talk-from-teens.
Long ED Waits Test Psychiatric Patients’ Patience
Patients having psychiatric emergencies wait 11.5 hours in the emergency department (ED), and those who are older, uninsured, or intoxicated wait even longer, according to a study published in Annals of Emergency Medicine. Overall, these patients wait approximately 42% longer in the ED than other emergency patients.
Researchers analyzed records for 1,092 adults with psychiatric emergencies. Patients discharged home spent an average of 8.6 hours in the ED, while patients admitted to a psychiatric unit within the hospital stayed 11 hours. Patients transferred to an outside unit within the local health care system stayed 12.9 hours, and those transferred to a facility outside the local health care system stayed 15 hours.
Younger patients waited less than older patients: In the 18-to-39 age group, the average length of stay was 10.7 hours, but patients older than 60 spent 12.6 hours in the ED. One third of the patients tested positive for alcohol, and these patients had average ED stays of 14.5 hours.
Source.“Psych Patients Need Patience in the ER, Wait on Average 11 Hours.” (2012, May 2). Retrieved May 24, 2012, from http://www.prnewswire.com/news-releases/psych-patients-need-patience-in-the-er-wait-on-average-11-hours-149810595.html.
Chronic Fatigue Syndrome Results in Fatigued ‘Reward Center’
Chronic fatigue syndrome (CFS) remains poorly understood despite decades of scientific study. In a new study discussed at the Experimental Biology 2012 meeting, researchers found differing brain responses in people with this condition compared with healthy controls, suggesting an association between a biological functional response and CFS.
The findings show that patients with CFS have decreased activation of the basal ganglia in response to reward. Additionally, the extent of this lowered activation was associated with each patient’s measured level of fatigue. The basal ganglia are at the base of the brain and are associated with a variety of functions, including motor activity and motivation. Diseases affecting basal ganglia are often associated with fatigue.
For the study, researchers recruited 18 patients with CFS, as well as 41 healthy volunteers with no symptoms of CFS. Each study participant underwent functional magnetic resonance imaging while they played a simple card game meant to stimulate feelings of reward. The participants were each told that they would win a small amount of money if they correctly guessed whether a preselected card was red or black. After making their choice, they were presented with the card while researchers measured blood flow to the basal ganglia during winning and losing hands.
The results showed that patients with CFS experienced significantly less change in basal ganglia blood flow between winning and losing than the healthy volunteers. When the researchers looked at scores for the Multidimensional Fatigue Inventory, a survey often used to document fatigue for CFS and various other conditions, they also found that the extent of a patient’s fatigue was tightly tied with the change in brain activity between winning and losing. Those with the most fatigue had the smallest change.
Source.“Study Finds Chronic Fatigue Syndrome Patients Had Reduced Activity in Brain’s ‘Reward Center.’” (2012, April 17). Retrieved May 24, 2012, from http://www.newswise.com/articles/study-finds-chronic-fatigue-syndrome-patients-had-reduced-activity-in-brain-s-reward-center.
Researchers Desire Personalized Antidepressant Prescribing
University of Texas (UT) Southwestern Medical Center psychiatrists are leading a national clinical trial to find biomarkers that can better predict how people diagnosed with depression will respond to medications so physicians eventually can personalize treatments.
The previous study, STAR*D (Sequenced Treatment Alternatives to Relieve Depression), revealed that as many as 1 in 3 depressed patients try multiple antidepressant medications before finding one that works. The researchers found that only approximately 33% of those depressed go into remission in the first 12 weeks of treatment with antidepressant medication.
The new trial is an effort to bring clinical solutions to the issues raised by the STAR*D study, which showed that most depressed patients must make multiple attempts before finding an antidepressant agent that works best for them.
UT Southwestern researchers plan to enroll approximately 100 of the 400 people needed for the current follow-up clinical study, called EMBARC (Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care). Funded by the National Institute of Mental Health, EMBARC also involves researchers at Columbia University in New York, Massachusetts General Hospital in Boston, and the University of Michigan in Ann Arbor.
The EMBARC study will examine multiple carefully selected clinical and biological markers, using both existing state-of-the-art technologies and pioneering, innovative approaches. Participants will initially undergo magnetic and electroencephalogic brain imaging and blood, DNA, hormonal, chemical, cognitive, and behavioral tests. The 16-week trial will then compare a widely used antidepressant medication to a placebo to trace differences using the same testing technologies.
Those who wish to participate in the EMBARC trial can call 214-648-4357 or visit http://embarc.utsouthwestern.edu.
Source.“UT Southwestern Psychiatrist Leads National Trial for Biomarkers to Better Match Depressed Patients with Best Antidepressant.” (2012, May 15). Retrieved May 24, 2012, from http://www.newswise.com/articles/ut-southwestern-psychiatrist-leads-national-trial-for-biomarkers-to-better-match-depressed-patients-with-best-antidepressant.
Young Adult Tobacco Smokers Smoking Marijuana
Half of young adult tobacco smokers have also smoked marijuana in the past 30 days, according to a recent Facebook-based survey conducted by University of California, San Francisco (UCSF) researchers, indicating a greater prevalence of marijuana and tobacco co-use among smokers ages 18 to 25 than previously reported. The study appears in Addiction Science and Clinical Practice.
Survey participants were recruited solely online, a departure from traditional surveys that rely on face-to-face interviews, telephone interviews, or completing questionnaires. The UCSF researchers primarily used Facebook through a series of paid advertisements, in addition to Craigslist and a survey sampling company to reach out to young adults. The results, the researchers stated, indicate young adults might be more inclined to answer honestly via anonymous online sampling.
The first phase of the survey was used to identify tobacco smoking patterns only. A second stage asked participants to answer the tobacco and marijuana use survey, which employed data encryption to ensure anonymity and prevent multiple entries. Of the 3,500 individuals who completed the marijuana and tobacco co-use survey, usage was highest amongst Caucasians, people from the Northeast, people in rural areas, and among the non-student population. Of the 68% who were daily smokers, 53% had used marijuana in the past month, indicating that smoking cessation programs aimed at this age group should take into account the effect of marijuana use in their programs.
The next phase of the research is to adapt behavioral and cognitive principles for smoking cessation, such as counseling, to Facebook. The researchers plan to use social media such as Facebook, in which participants will be able to contact not only the clinicians for support, but also other smokers within the online community. Motivational Facebook messages and formal moderated groups online will also be integrated into treatment.
Source.“Marijuana Use Higher in Young Adult Smokers than Previously Reported.” (2012, April 17). Retrieved May 24, 2012, from http://www.newswise.com/articles/marijuana-use-higher-in-young-adult-smokers-than-previously-reported.