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.

Tuesday, January 6, 2015

High IQ May Protect Against Schizophrenia

That is the title of this article I am writing about. "In people with a genetic predisposition for schizophrenia, having high intelligence may help protect them from developing the severe mental disorder, according to a new study by researchers at Virginia Commonwealth University (VCU) and Lund University in Sweden.  In fact, people with a lower IQ (intelligence quotient) than their siblings had the greatest risk for developing schizophrenia.  The research appears to contradict the popular belief that schizophrenia and brilliance are typically linked.  'If you’re really smart, your genes for schizophrenia don’t have much of a chance of acting,' said first author Kenneth S. Kendler, M.D., professor of psychiatry and human and molecular genetics in the Department of Psychiatry, VCU School of Medicine." I do not know if I follow this belief.  John Nash is not the only one that has a high IQ also Ellen Saks.  If you follow Colorado and they do find James Holmes not guilty by reason of insanity there will be another.
The article goes on to say: "'What really predicted risk for schizophrenia is how much you deviate from the predicted IQ that we get from your relatives. If you’re quite a bit lower, that carries a high risk for schizophrenia. Not achieving the IQ that you should have based on your genetic constitution and family background seems to most strongly predispose for schizophrenia.'  Just like those without the disease, people with schizophrenia vary widely in their intelligence levels. Kendler added that low IQ is one of many risk factors for schizophrenia.  For the study, researchers assessed the IQs of more than 1.2 million Swedish males (ages 18-to-20) born between 1951 and 1975. Schizophrenia-related hospitalization was tracked for 24 years until 2010. Subjects with a lower IQ than their siblings were at the greatest risk for developing schizophrenia." If you have a lower IQ than your brothers and sisters than you have a greater chance of developing schizophrenia.
The article ends: "Kendler noted that environmental factors that may lower IQ, such as intrauterine experience, childhood trauma, or early drug use, could contribute to the increased risk.
Having a high IQ, however, doesn’t completely eliminate the risk for schizophrenia. In fact, there are several well-known, brilliant and creative people who have suffered from schizophrenia, including math prodigy John Nash, whose story was made famous in the film “A Beautiful Mind.”
'The question is, might we see some upward bump at that high level of intelligence where really brilliant people have increased risk for the disease and we show no such trend,' Kendler said.
Schizophrenia is one of the most severe and rarest of the mental health disorders, occurring in about one in 100 people. Symptoms of the disease include hallucinations, delusions, paranoia, cognitive impairment, social withdrawal, self-neglect, and loss of motivation and initiative." I never lost my motivation or I would not have been able to complete college. I lost some of my smarts though since I was in high school that is why I had a harder time in college. I believe that no matter what type of IQ you have it is still a bad disease and hard to tell when you are slipping into psychosis.