Nikolas Cruz, the 19-year-old whose alleged shooting rampage claimed 17 lives at Marjory Stoneman Douglas High School in Parkland, Fla., last month, was sick. His family knew it. His neighbors knew it. Local law enforcement and mental-health professionals knew it.
Yet, like so many tragedies involving the seriously mentally ill, no one was able to prevent the rampage. Why?
As the family member of someone with serious mental illness, and as someone who has spent 30 years helping other families with seriously ill members, the answer is clear: The system often prevents relatives from getting help for loved ones who have serious mental illness until after they have become a danger to themselves or others. Too often this means after someone — often a family member — is injured or killed.
Amid the outcry over the Florida school shooting, the Trump administration says it is “actively exploring” ways to help states expand inpatient mental health treatment using Medicaid funds.
President Donald Trump again brought up the issue of mental hospitals in a meeting with governors on Monday, invoking a time when states maintained facilities for mentally ill and developmentally disabled people.
“In the old days, you would put him into a mental institution,” Mr. Trump said, apparently referring to alleged shooter Nikolas Cruz, whose troubling behavior prompted people close to him to plead for help from authorities, without success. “We’re going to have to start talking about mental institutions …we have nothing between a prison and leaving him at his house, which we can’t do anymore.”
In an analysis of one of the largest electronic medical records databases in the world, researchers found that patients with acne had a significantly increased risk of developing major depression, but only in the first 5 years after being diagnosed with acne.
The British Journal of Dermatology analysis included data from The Health Improvement Network (THIN) (1986-2012), a large primary care database in the United Kingdom.
The investigators found that the risk for major depression was highest within 1 year of acne diagnosis — a 63% higher risk compared with individuals without acne — and decreased thereafter.
Antipsychotic drugs — which transformed mental health care following their chance discovery in the mid-20th Century — may finally be poised for a long-overdue makeover incorporating structure-based design. Scientists funded by the National Institutes of Health have achieved a landmark of psychiatric neuropharmacology: deciphering the molecular structure of a widely prescribed antipsychotic docked in its key receptor. They are hopeful that this discovery may hold secrets to designing better treatments for schizophrenia, bipolar disorder, and other mental illnesses.
“For the first time, we can understand precisely how atypical antipsychotic drugs bind to their primary molecular target in the human brain,” explained Dr. Laurie Nadler, chief of the neuropharmacology program at the National Institute of Mental Health (NIMH), which co-funded the study along with the National Institute of General Medical Sciences and the National Cancer Institute. “This discovery opens the way for the rational design of a new generation of antipsychotic drugs, hopefully with more desirable effects and fewer side effects.”
Feelings of shame may make the symptoms of post-traumatic stress disorder (PTSD) more severe in current and former members of the Armed Services.
That is the conclusion of research published in the British Journal of Clinical Psychology by a team led by Dr Katherine C. Cunningham from the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina.
In the forthcoming article, Dr Cunningham and colleagues say, “The military conflicts in Iraq and Afghanistan have resulted in increased awareness of the impact of war on military service members. Many returning service members and veterans have been diagnosed with PTSD, which is associated with poorer physical health, unemployment, legal problems, relationship conflict and reduced quality of life.”
A week after the government announced its review of mental health legislation, an expert report published by the British Psychological Society’s Division of Clinical Psychology on Friday 13 October challenges received wisdom about the nature of mental illness.
The report, Understanding Psychosis and Schizophrenia: Why people sometimes hear voices, believe things that others find strange or appear out of touch with reality, and what can help, has been written by a group of eminent clinical psychologists drawn from eight universities and six NHS trusts, together with people who have themselves experienced psychosis. It provides an accessible overview of the current state of knowledge, and its conclusions have profound implications both for the way we understand ‘mental illness’ and for the future of mental health services.
Many people believe that schizophrenia is a frightening brain disease that makes people unpredictable and potentially violent, and can only be controlled by medication. However this report — a revised version of one published in 2014 by the British Psychological Society’s Division of Clinical Psychology — suggests that this view is false.
Up to 75 percent of patients with systemic lupus erythematosus — an incurable autoimmune disease commonly known as lupus — experience neuropsychiatric symptoms. But so far, our understanding of the mechanisms underlying lupus’ effects on the brain has remained murky. Now, new research from Boston Children’s Hospital has shed light on the mystery and points to a potential new drug for protecting the brain from the neuropsychiatric effects of lupus and other central nervous system (CNS) diseases. The team has published its surprising findings in Nature.
“In general, lupus patients commonly have a broad range of neuropsychiatric symptoms, including anxiety, depression, headaches, seizures, even psychosis,” says Allison Bialas, PhD, first author on the study and a research fellow working in the lab of Michael Carroll, PhD, senior author on the study, who are part of the Boston Children’s Program in Cellular and Molecular Medicine. “But their cause has not been clear — for a long time it wasn’t even appreciated that these were symptoms of the disease.
A consortium of psychologists and psychiatrists has developed a new, evidence-based alternative to the mental health field’s long-established diagnostic tools for the classification, treatment, and research of mental disorders, according to a University at Buffalo psychologist who is one of the co-authors of a paper that explains the groundbreaking approach.
The Hierarchical Taxonomy of Psychopathology (HiTOP) addresses what the authors say are limitations to the reliability and validity of traditional models like the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association’s (APA) authoritative handbook used by clinicians and researchers around the world to diagnose and treat mental disorders.
“HiTOP is the first attempt by any group of individuals to put forth a classification and diagnostic system that has the features we’ve described,” says Leonard Simms, an associate professor in UB’s Department of Psychology and one of the 40 researchers who worked with team leaders Roman Kotov of Stony Brook University, Robert Krueger of University of Minnesota, and David Watson of University of Notre Dame on the study that appears in the latest issue of the Journal of Abnormal Psychology.
New UCL research has found no link between cat ownership and psychotic symptoms, casting doubt on previous suggestions that people who grew up with cats are at higher risk of mental illness.
Recent research has suggested that cat ownership might contribute to some mental disorders, because cats are the primary host of the common parasite Toxoplasma Gondii (T. Gondii), itself linked to mental health problems such as schizophrenia. However, the new study, published in Psychological Medicine, suggests that cat ownership in pregnancy and childhood does not play a role in developing psychotic symptoms during adolescence. The study looked at nearly 5000 people born in 1991 or 1992 who were followed-up until the age of 18. The researchers had data on whether the household had cats while the mother was pregnant and when the children were growing up.
New research conducted in adolescent rodents provides insights on the mechanisms behind anorexia nervosa and points to a potential treatment strategy.
In experiments involving food restriction and/or exercise, investigators found that the extent to which certain receptors are expressed in neurons in a particular region of the brain can influence whether an adolescent female rat develops anorexia nervosa-like behavior, such as to exercise, rather than eat, in spite of being hungry. The findings suggest that a risk factor for anorexia may be under-expression of these receptors, α4βδ-GABAA called receptors, following stress. Therefore, boosting the activity of these receptors may be a promising treatment strategy.
“Anorexia nervosa has the highest mortality rate of any mental illness, surpassing even that of depression, and currently, there are no accepted pharmacological treatments,” said Dr. Chiye Aoki, lead author of the Journal of Neuroscience Research article. “This makes the pursuit of effective medications particularly important. Rodent models enable scientists to separate cultural influences from the neurobiological basis of behaviors that are present in the illness.”