Wednesday, February 25, 2015

Different Mental Disorders Show Similar Gray Matter Loss

That is the title of this article I am writing about. "Researchers have discovered a common pattern of gray matter loss in a spectrum of psychiatric disorders, ranging from schizophrenia to depression to addiction, according to a new meta-analysis of brain-imaging studies by Stanford University School of Medicine.
'The idea that these disorders share some common brain architecture and that some functions could be abnormal across so many of them is intriguing,' said Thomas Insel, M.D., director of the National Institute of Mental Health.
Previously, brain imaging studies tended to focus on one psychiatric disorder in isolation, whereas the Stanford researchers “have stepped back from the trees to look at the forest and see a pattern in that forest that wasn’t apparent when you just look at the trees,” Insel said.  The analysis of 193 peer-reviewed papers shows a loss of gray matter in three brain structures that, although physically separate, participate in a network associated with high-level functions, including planning and decision-making. The findings call into question the common practice of distinguishing psychiatric disorders by their symptoms rather than their underlying brain pathology."  This is very important to the people that lose some high-level functions.  We have come far in research now we have to find ways to use it to help people.
The article goes on to say:"'In many of these published studies we reviewed, researchers have tended to interpret their biological findings in terms of the one disorder they’re focusing on,' said Amit Etkin, M.D., Ph.D., an assistant professor of psychiatry and behavioral sciences at Stanford and the study’s senior author.
'We tried to ask a basic question that hasn’t been asked: Is there any common biological basis for mental illness?'
To find out, he and his research team gathered data from 193 separate studies containing, in all, magnetic-resonance images of the brains of 7,381 patients falling into six diagnostic categories: schizophrenia, bipolar disorder, major depression, addiction, obsessive-compulsive disorder and a cluster of related anxiety disorders.
They compared the images with those from 8,511 healthy control subjects, and identified three separate brain structures, several centimeters apart from one another, with a diminished volume of gray matter, the brain tissue that serves to process information. Gray matter loss in the three brain structures was similar across patients with different mental disorders, the researchers found." if they can find out why these people with mental illness lose that gray matter it would be great.  Especially if they can stop it from happening.
The article ends with:"These structures can be viewed as the alarm bell of the brain, Etkin said. “They work together, signaling to other brain regions when reality deviates from expectations — that something important and unpredicted has happened, or something important has failed to happen.”
Further analysis showed that gray-matter shrinkage in the three implicated brain structures was independent of any medication effects or overlapping psychiatric conditions.
In addition to the gray-matter loss in those three key areas, people with major depression also had gray-matter loss in other structures, including the hippocampus and amygdala, two important regions involved in storing memories and processing emotion, respectively.
Schizophrenia also featured reduced gray matter in several other structures, as well as an increase in gray matter in a region called the striatum, which Etkin suggested may be due more to the antipsychotic medications than the disease itself." Well the medication is not making this happen.  We have to find a way to stop it from happening than people can lead healthier and better lives.

Tuesday, February 17, 2015

Eight Different Types of Schizophrenia

That is the title of this article I am writing about. "A group of researchers from Spain and the U.S. have found that schizophrenia is actually a group of eight genetically different types of diseases, each of which presents its own set of symptoms.
Scientists from the universities of Granada (Spain) and Washington in St. Louis have published their research in the American Journal of Psychiatry.
Experts believe this could be an important first step towards a better diagnosis and treatment of this disease, which affects approximately one percent of the world’s population.
Researchers were aware that approximately 80 percent of the risk of suffering from schizophrenia was hereditary, although scientists have struggled for years to identify which specific genes lead to it.
The new study included 4196 patients diagnosed with schizophrenia and 3200 healthy patients. Experts were, for the first time, able to identify the different genes networks that contribute to the existence of eight different types of schizophrenia.
'Genes do not operate on their own, in an isolated manner,' said Igor Zwir, Ph.D., a researcher at the university of Granada and co-author of his article, pointed out, “they rather work with each other as an orchestra. To understand how they work, we must not just know what each member of this orchestra is like, but also how they interact with each other.'" I always knew that paranoid schizophrenia and regular schizophrenia were different.  I am glad they are getting somewhere and announcing it.  Although about it being hereditary I don't know about that no one in my family has it except a cousin.  Although now that my brother is studying our past relatives it would be nice to find out.
The article goes on to say: "This genetic analysis leads to 95 percent certainty in predicting the onset of schizophrenia.
In another group, they found that incongruent speech and disorganized behavior are specifically associated with a DNA variations network that leads to a 100 percent risk of suffering schizophrenia.
Researchers divided the patients according to the type and seriousness of positive symptoms (such as different types of hallucinations or deliriums), or negative symptoms (such as lack of initiative, troubles in organizing thoughts, or lack of connection between emotion and thought).
Scientists also classified the profiles of these symptoms into eight qualitative types of different diseases according to the underlying genetic conditions.
'In the past, scientists had searched for associations between individual genes and schizophrenia — researchers point out. What was lacking was the idea that these genes do not act independently, but that they work as a group instead, to disturb the structure and the functions of the brain, thus causing the disease.'" My positive symptoms were bad.  I do know that I never want to suffer that again.  That is why I always take my medicine.
The article ends:"Although individual genes only present weak, inconsistent associations with schizophrenia, the interaction networks of gene groups pose a high risk of suffering from the disease, between 70 and 100 percent, 'which makes it almost impossible that individuals with those genetic variation networks will avoid schizophrenia'
Researchers found a total of 42 genes groups that influenced in a variety of ways the risk of suffering schizophrenia.
They also replicated their finds in two independent samples of individuals with schizophrenia, an index that these networks are a valid path for the exploration and improvement of the diagnosis and treatment of this disease.
'The identification of gene networks and their related symptoms in individual patients may allow clinicians to develop localized treatment for the specific paths that cause schizophrenia,' Zwir said."If it can improve diagnosis that would be great.  A group of genes cause schizophrenia.  As long as I take my medication I really have nothing to worry about now.  Although I do worry about the future as I get older and what I will lose like especially my memory which I continue to work on.  When I was in school I had a hard time with math and I use to be good at that.

Tuesday, February 10, 2015

Schizophrenia, depression, addiction: Different mental disorders cause same brain-matter loss

That is the title of this article I am writing about today.  "  A meta-analysis of 193 brain-imaging studies shows similar gray-matter loss in the brains of people with diagnoses as different as schizophrenia, depression and addiction.  In a study analyzing whole-brain images from nearly 16,000 people, researchers at the Stanford University School of Medicine identified a common pattern across a spectrum of psychiatric disorders that are widely perceived to be quite distinct.
The meta-analysis of 193 peer-reviewed papers, published Feb. 4 in JAMA Psychiatry, reports a loss of gray matter in three brain structures that, although physically separate, participate in a network associated with high-level functions, including planning and decision-making.
The findings call into question a longstanding tendency to distinguish psychiatric disorders chiefly by their symptoms rather than their underlying brain pathology.
In any given year, nearly one in five Americans meets the criteria for a diagnosis of psychiatric illness. 'The idea that these disorders share some common brain architecture and that some functions could be abnormal across so many of them is intriguing,' said Thomas Insel, MD, director of the National Institute of Mental Health, who wasn't involved in the study but is familiar with its contents.
The researchers drew on component studies that have been around for some time, said Insel. But these studies tended to focus on one or another psychiatric disorder in isolation, whereas the Stanford investigators 'have stepped back from the trees to look at the forest and see a pattern in that forest that wasn't apparent when you just look at the trees,' Insel said.
'In many of these published studies we reviewed, researchers have tended to interpret their biological findings in terms of the one disorder they're focusing on,' said Amit Etkin, MD, PhD, an assistant professor of psychiatry and behavioral sciences at Stanford and the study's senior author. Lead authorship is shared by Madeleine Goodkind, PhD, a postdoctoral scholar in Etkin's group, and Simon Eickhoff, DrMed, a professor of clinical neuroscience and medical psychology at Heinrich-Heine University Dusseldorf." This looks like a good study about how different the gray matter is in people with different symptoms.  I would like to know more how studying this can help diagnosis different schizophrenia people.
The article goes on to say: "Similar gray-matter loss
Despite experienced clinicians' intuitive grasp of the blurred lines separating diverse psychiatric conditions, there's nonetheless often an assumption that these disorders, traditionally classified on the basis of predominant symptoms, are discrete in reality, noted Etkin, who is also an investigator at the Sierra-Pacific Mental Illness Research and Clinical Center at the Veterans Affairs Palo Alto Health Care System. "We tried to ask a basic question that hasn't been asked: Is there any common biological basis for mental illness?"
We tried to ask a basic question that hasn't been asked: Is there any common biological basis for mental illness?
To address that question, he and his colleagues pooled data from 193 separate studies containing, in all, magnetic-resonance images of the brains of 7,381 patients falling into six diagnostic categories: schizophrenia, bipolar disorder, major depression, addiction, obsessive-compulsive disorder and a cluster of related anxiety disorders. Comparing the images with those from 8,511 healthy control subjects, the research team identified three separate brain structures, several centimeters apart from one another, with a diminished volume of gray matter, the brain tissue that serves to process information. These structures -- the left and right anterior insula and the dorsal anterior cingulate -- are known to be parts of a larger network in the brain whose component parts tend to fire in synchrony. This network is associated with higher-level executive functions such as concentrating in the face of distractions, multitasking or task-switching, planning and decision-making, and inhibition of counterproductive impulses.
Gray matter loss in the three brain structures was similar across patients with different psychiatric conditions, the researchers found.
These structures can be viewed as the alarm bell of the brain, Etkin said. "They work together, signaling to other brain regions when reality deviates from expectations -- that something important and unpredicted has happened, or something important has failed to happen." That signaling guides future behavior in directions more likely to obtain desired results."  It still does not answer the question why some people with schizophrenia keep all these skills even when they have it.  Some people lose all three of these skills.
The article ends with: "Some incongruities
In addition to gray-matter loss in these three structures, people diagnosed with major depression also had gray-matter loss in other structures, including the hippocampus and amygdala, two key areas involved in storing memories and processing emotion, respectively. Schizophrenia was marked by reduced gray matter in several other structures, as well as an increase in gray matter in a region called the striatum, which Etkin suggested may be due more to the antipsychotic medications prescribed for schizophrenia than to the disease process itself.
Further analysis showed that gray-matter shrinkage in the three implicated brain structures was independent of any medication effects or overlapping psychiatric conditions.
Next, Etkin and his colleagues turned to three large databases containing both structural and functional MRI scans of healthy subjects. Among healthy people, gray-matter volume in the right and left anterior insula and the dorsal anterior cingulate correlated with performance on classic tests of executive function. Such a test might involve, for example, asking the test-taker to note the color of the word "blue," displayed in a color other than blue, after seeing it briefly flashed on a screen. This finding strengthens evidence that among psychiatric patients, the generally observed gray-matter loss in brain structures associated with executive function is behaviorally significant.
The discovery that psychiatric disorders typically studied in isolation from one another turn out to share a common structural deficit mirrors, in some respects, a genetic analysis conducted in 2013 by researchers at Massachusetts General Hospital that showed shared genetic glitches among several categories of mental illness, said Insel. But this is the first imaging study to do so, he said.
'I wouldn't have expected these results. I've been working under the assumption that we can use neuroimaging to help classify the different forms of mental illness,' Insel said. 'This makes it harder.'
Other Stanford study co-authors are Desmond Oathes, PhD, a psychiatry and behavioral sciences instructor; postdoctoral scholar Ying Jiang, MD; graduate student Andrew Chang; and research assistants Laura Jones-Hagata, Brissa Ortega, Yevgeniya Zaiko and Erika Roach."Well they cannot tell different forms of schizophrenia although this is still a very good study, now if they can figure out how to stop people with the three mental illness from losing that gray matter.  People with major depression from losing memories and emotions.

Tuesday, February 3, 2015

Diet, nutrition essential for mental health

That is the title of the article I am writing about. "Evidence is rapidly growing showing vital relationships between both diet quality and potential nutritional deficiencies and mental health, a new international collaboration led by the University of Melbourne and Deakin University has revealed. Lead author, Dr. Jerome Sarris from the university of Melbourne and a member of the International Society for Nutritional Psychiatry Research (ISNPR), said psychiatry is at a critical stage, with the current medically-focused model having achieved only modest benefits in addressing the global burden of poor health.  'While the determinants of mental health are complex, the emerging and compelling evidence for nutrition as a key factor in the high prevalence and incidence of mental disorders suggests that nutrition is as important to psychiatry as it is to cardiology, endocrinology and gastroenterology,' Dr Sarris said.  'In the last few years, significant links have been established between nutritional quality and mental health. Scientifically rigorous studies have made important contributions to our understanding of the role of nutrition in mental health,' he said. No one wants to die younger from a mental illness.  Nutrition is very important to health.
The article goes on to say:"Findings of the review revealed that in addition to dietary improvement, evidence now supports the contention that nutrient-based prescription has the potential to assist in the management of mental disorders at the individual and population level.
Studies show that many of these nutrients have a clear link to brain health, including omega-3s, B vitamins (particularly folate and B12), choline, iron, zinc, magnesium, S-adenosyl methionine (SAMe), vitamin D, and amino acids.  'While we advocate for these to be consumed in the diet where possible, additional select prescription of these as nutraceuticals (nutrient supplements) may also be justified,' Dr Sarris said.  Associate Professor Felice Jacka, a Principal Research Fellow from Deakin University and president of the ISNPR noted that many studies have shown associations between healthy dietary patterns and a reduced prevalence of and risk for depression and suicide across cultures and age groups." It works for the better of mental health.  I do not eat much fish so I take fish oil. Also take a multi-vitamin.
The article ends:"'Maternal and early-life nutrition is also emerging as a factor in mental health outcomes in children, while severe deficiencies in some essential nutrients during critical developmental periods have long been implicated in the development of both depressive and psychotic disorders,' she said.  A systematic review published in late 2014 has also confirmed a relationship between 'unhealthy' dietary patterns and poorer mental health in children and adolescents. Given the early age of onset for depression and anxiety, these data point to dietary improvement as a way of preventing the initial incidence of common mental disorders.
Dr Sarris, an executive member of the ISNPR, believes that it is time to advocate for a more integrative approach to psychiatry, with diet and nutrition as key elements.  'It is time for clinicians to consider diet and additional nutrients as part of the treating package to manage the enormous burden of mental ill health,' he said."  We all have to eat right. I know I do not have high cholesterol so I must be doing something right. I just wish I could lose more weight than I have so far.

Tuesday, January 27, 2015

Rate of Nicotine Metabolism May Predict Best Way to Quit Smoking

That is the title of this article I am writing about. "How quickly a smoker metabolizes nicotine could determine which type of cessation strategy has the best chance of success, according to a new study that represents one of the largest pharmacogentic analyses of tobacco dependence to date. The study found that smokers with normal metabolism levels had better quit rates with varenicline therapy, which does not involve nicotine replacement, compared to a nicotine patch. For people with slow metabolism, the patch may be the better option." I quit seventeen years ago.  I used wellbutrin and did it have the side effects.  It had so many side effects that I did not even notice or crave cigarettes. My mouth was something awful tasting.  The was one of the only medicines that I had so many side effects.  My friend gave me a list of the side effects because he had taken a class on stopping smoking. I had every one on that list.
The article goes on to say: "It has been known that smokers clear nicotine from their bodies at different rates, but until now it wasn't known if this measurable trait -- the nicotine metabolite ratio (NMR) -- could be used to optimize treatment and improve outcomes.  The study researchers randomly assigned 1,246 smokers (662 slow metabolizers and 584 normal metabolizers) to 11 weeks of the nicotine patch and placebo pill, varenicline and placebo patch, or double placebo; all participants also received behavioral counseling." I know I had never tried to quit before that one I did.  I know when I used to go to jail I could not be without my cigarettes.  I would buy two for one or if no one had any smokes but roll your owns that is what I would smoke .  The idea that I would quit never came to mind. I finally quit because I wanted to seem my granddaughter at my house and daughter did not want her around smoke.  It was time anyway because I had a bad cough and this guy in the elevator told me I would not live that long if I kept smoking so it seemed like the right time.      
The article ends witth: "After 11 weeks of treatment, normal metabolizers taking varencline were about twice likely not to smoke as those using the nicotine patch.  And while slow metabolizers displayed similar effectiveness rates on varencline or the patch, they reported far fewer side effects for patch therapy." Those side effects can be rough.  That is why people with mental illness do not always take their medication because of all the side effects especially weight gain.                                                                                                                     

Tuesday, January 20, 2015

United States: Mental health care lacking in state, federal prisons

That is the title of this article I am writing about. "significant portion of state and federal prisoners are not receiving treatment for mental health conditions, according to research by The University of Texas Health Science Center at Houston (UTHealth) School of Public Health. The study was published recently in the American Journal of Public Health.
Mental health disorders among prisoners have consistently exceeded rates of disorders in the general population. Twenty six percent of prisoners reported a mental health diagnosis in the study, compared to 18 percent in the general population in 2012, according to the National Institutes of Health.
State and federal courts mandate that inmates must have access to adequate health services in prison. However, that mandate usually covers only “severe or serious” mental illnesses, according to the paper.  'Individuals with untreated mental health conditions may be at higher risk for correctional rehabilitation treatment failure and future recidivism after release from prison,' said Jennifer Reingle, Ph.D., principal investigator and assistant professor in the Division of Epidemiology, Human Genetics and Environmental Sciences at UTHealth School of Public Health Dallas Regional campus."  That many in prison have mental health issues.  I have a mental illness and know from experience that all lot of these prisoners with mental health issues do not know they are acting out in prison.  Of course there is recidivism how can you treat someone who does not take their medication when they do not understand why.
The article goes on to say: "Data was obtained from a 2004 national sample of state and federal prisoners, which included 14,499 participants in state prisons and 3,686 in federal prisons. Participants self-reported whether they had been taking medication for a mental health condition upon entering the facility and whether they were still taking medication while in prison, marking treatment continuity.
At the time of admission, 18 percent of each sample was taking medication for a mental health condition, but only 52 percent of that subset of the population in federal prisons and 42 percent in state prisons received medication during their sentence.
Depression was the most prevalent mental health condition, reported by 20 percent of inmates, followed by mania, anxiety and post-traumatic stress disorder.
'Screening tools are not consistent across prisons and inmates could be diagnosed with different conditions or not diagnosed at all when they get transferred to a new location,' said Reingle. “A standardized mental health screening process could benefit the inmates and the prison system as a whole.”  They are not all taking medication.  They do not understand it would help them better.  It is a different atmosphere in prison than in the outside world.  You are just passing time make it go by.
The article ends with: "This study also found evidence of racial disparities in medication continuity. African American participants were 36 percent more likely than other inmates to have medication continuity in prison, regardless of their diagnosis. African Americans were also more likely to suffer from schizophrenia than Caucasians. Participants with schizophrenia were more than twice as likely to get medication in prison and have treatment continuity.
Since some mental health disorders such as schizophrenia influence behavior, those prisoners may receive medication to maintain security in the prison environment, Reingle said. Since depression does not pose a significant security risk, it’s less likely that depressed prisoners will be easily identified and treated, she added.
Previous studies suggest that former offenders who were diagnosed with a mental health condition were 70 percent more likely to return to prison, whereas in the general prison population, the rate is about 50 percent.
In the study, researchers concluded that of the participants who were taking medication for a mental health condition in prison, 61 percent used no other form of treatment. A more holistic, multidimensional approach to treatment, such as counseling or group therapy, may lead to better outcomes and lower recidivism rates in this population, said Reingle." I see at least the ones with schizophrenia are getting medication although all of them should without regard to their diagnosis.  I can see why they return what else are they going to do unless they receive help to adjust with medication and a chance to rehabilitate.

Tuesday, January 13, 2015

IQ takes a hit with longer lasting psychosis

That is the title of this article I am writing about. Last week I did on how the higher IQ the less chance to develop schizophrenia.  This one is about how we lose IQ by having psychosis longer. "A 10-year-long Scandinavian study has shed light on a small group of schizophrenic patients who suffer a greater decline in IQ over time than most patients.
Researchers at the University of Oslo and Yale have discovered that people who are diagnosed with schizophrenia often have a more positive illness trajectory than was previously thought. However, a subgroup of the study’s patients who experienced repeated psychosis after receiving treatment demonstrated significant deterioration of verbal recall and working memory ability over time. In other words, those who had a longer duration of psychosis after starting treatment saw their IQs drop more than those who experienced a shorter duration of psychosis.
These findings emphasize the need for patients at higher risk to be monitored more closely in order to detect episodes before they manifest themselves, according to secondary author and University of Oslo professor of neuropsychology Kjetil Sundet. He added that the ultimate goal in treating schizophrenic patients is to notice these warning signs before the onset of even the first psychotic episode." It is the longer you have psychosis after starting treatment.  I think we lose some just in having schizophrenia.  I know my IQ when I went to high school and when I started college were different.
The article continues: "So far, this study is the longest lasting of its kind to investigate whether the course of IQ is affected by duration of psychosis before treatment and duration of psychosis after treatment. Researchers found that the overall IQ of all 89 patients studied remained stable over time. But when they divided the sample into subgroups based on duration of untreated psychosis (DUP) and duration after treatment (DAT), they discovered that the length of DUP did not affect cognitive ability, while the length of DAT did correlate with cognitive decline. Patients with the longest DAT performed significantly worse on tests of intellectual ability over time compared to those with the shortest DAT. Some patients in the study saw a slight increase in IQ, which explains the overall consistency in IQ.
Additionally, the group with the longest DAT had a slightly lower baseline IQ at the start of the study than other groups, suggesting that lower IQ may indicate increased risk for a more severe course of illness.
This study was inspired by the Early Treatment and Intervention in Psychosis Study, led by co-primary investigators Svein Friis, professor of psychiatry at University of Oslo, and Thomas McGlashan, professor emeritus of psychiatry at Yale University. The main goal of that project was to find out if an Early Detection and Early Intervention program could reduce duration of untreated psychosis, and if that could improve quality of life outcomes, according to Friis.
'Without [McGlashan], this large-scale study would hardly have been possible,” Sundet said. “He inspired and enabled his colleagues to do this research.'" They need to treat people with psychosis sooner than.  That would explain to me why I lost some IQ.  I was put in jail with my psychoiss was going on and they did not give me medication until I was sentenced and went to the state hospital about six months down the road.
The article ends with: "
Although the results of this study do not provide any causal explanations of the relationship between longer illness duration after treatment and cognitive decline, the authors have offered several possible hypotheses. Because patients with greater intellectual impairments had a lower baseline IQ to begin with, they hypothesized that those patients may have possessed a lower cognitive reserve in general, hindering their ability to inhibit psychotic symptoms.
Alternatively, the researchers have proposed the existence of a distinct subtype of schizophrenia that causes more severe cognitive decline as well as longer psychotic episodes. That hypothesis is based on recent studies on certain patients’ genetic susceptibility to schizophrenia.
Though the findings of this study fall in line with previous schizophrenia-spectrum disorder studies, the study relied largely on human memory for its data, adding an element of uncertainty to the results.
According to Sundet, the general opinion of schizophrenia-spectrum disorders was much bleaker 20 years ago at the beginning of the study, when it was thought that having schizophrenia necessarily meant a major interference with normal life. However, nowadays most patients can live a good life with treatment and medication, and some people suffer only one episode their entire lives, he added.
According to the National Institute of Mental Health, schizophrenia affects 1.1 percent of the U.S. population ages 18 and older. "My memory of numbers is all I have that works great. Remembering anything else and I have to keep reminding myself to remember and that does not been I will. although with numbers I can remember them very well.