How stimulant treatment prevents serious outcomes of ADHD

An analysis of three previous studies of children and young adults with attention-deficit hyperactivity disorder (ADHD) quantifies for the first time the extent to which stimulant treatment reduces the development of mood disorders, school problems, conduct disorders, substance use disorders and other problems. The study led by Massachusetts General Hospital investigators is being published online in the Journal of Adolescent Health.

“Our study documents that early treatment with stimulant medication has very strong protective effects against the development of serious, ADHD-associated functional complications like mood and anxiety disorders, conduct and oppositional defiant disorder, addictions, driving impairments and academic failure,” says Joseph Biederman, MD, chief of the Pediatric Psychopharmacology and Adult ADHD Program at MGH and MassGeneral Hospital for Children. “In quantifying the improvement seen with stimulant treatment, it measures its potency in mitigating specific functional outcomes.”

Previous studies of stimulant treatment for ADHD have had limitations, such as only investigating outcomes in boys or not calculating the magnitude of the protective effects of treatment. The current study determined the number needed to treat (NNT) statistic, often used to show the effectiveness of an intervention. As the title indicates, NNT reflects the number of individuals receiving a medication or other treatment needed to prevent a specific unwanted outcome — the lower the NNT, the more effective the treatment.

Full story at Science Daily

Exercise: Psych patients’ new primary prescription

When it comes to inpatient treatment of a range of mental health and mood disorders — from anxiety and depression to schizophrenia, suicidality and acute psychotic episodes — a new study advocates for exercise, rather than psychotropic medications, as the primary prescription and method of intervention. Findings from the study reveal that physical exercise is so effective at alleviating patient symptoms that it could reduce patients’ time admitted to acute facilities and reliance on psychotropic medications.

“The general attitude of medicine is that you treat the primary problem first, and exercise was never considered to be a life or death treatment option. Now that we know it’s so effective, it can become as fundamental as pharmacological intervention,” explains David Tomasi, a lecturer at the University of Vermont, psychotherapist and inpatient psychiatry group therapist at the University of Vermont Medical Center and lead researcher of the study.

Practitioners at inpatient psychiatric facilities — often crowded, acute settings in which patients experience severe distress and discomfort — typically prescribe psychotropic medications first, rather than natural remedies like physical exercise, to alleviate patients’ symptoms such as anger, anxiety and depression. In fact, Tomasi estimates that only a handful of inpatient psychiatric hospitals in the U.S. provide psychotherapist-supported gym facilities exclusively for these patients. Instead, practitioners rely on classical psychotherapeutic and pharmacological frameworks to treat psychiatric symptoms, which they monitor to determine when a patient is ready to be discharged from the facility.

Full story at Science Daily

Targeted cognitive training benefits patients with severe schizophrenia

Schizophrenia is among the most difficult mental illnesses to treat, in part because it is characterized by a wide range of dysfunction, from hallucinations and mood disorders to cognitive impairment, especially verbal and working memory, which can be explained in part by abnormalities in early auditory information processing.

In recent years, targeted cognitive training (TCT) has emerged as a promising therapeutic intervention. TCT uses computerized training, such as sophisticated brain games, to target specific neural pathways, such as memory, learning and auditory-based senses, to beneficially alter the way they process information.

But while TCT has proven effective for mild to moderate forms of schizophrenia under carefully controlled conditions, it remains unclear whether the approach might benefit patients with chronic, refractory schizophrenia treated in non-academic settings, such as those cared for in locked residential rehabilitation centers.

Full story at Science Daily

Bipolar disorder: A good diet may boost treatment

Diet quality can affect many aspects of one’s physical health and psychological well-being. New research investigates whether or not these factors can also affect the effectiveness of treatments for mood disorders — particularly bipolar.

The moods of people who have bipolar disorder fluctuate between two extremes.

These are the “highs,” during which the person feels euphoric and may engage in dangerous behaviors, and the “lows,” characterized by depression and lethargy.

Since two opposite mood extremes characterize this disorder, it is often difficult to treat both the “highs” (or “manic episodes”) and the “lows” (or “depressive episodes”) with the same efficacy.

Full story at Medical News Today

Stress during pregnancy increases risk of mood disorders for female offspring

High maternal levels of the stress hormone cortisol during pregnancy increase anxious and depressive-like behaviors in female offspring at the age of 2, reports a new study in Biological Psychiatry. The effect of elevated maternal cortisol on the negative offspring behavior appeared to result from patterns of stronger communication between brain regions important for sensory and emotion processing. The findings emphasize the importance of prenatal conditions for susceptibility of later mental health problems in offspring.

Interestingly, male offspring of mothers with high cortisol during pregnancy did not demonstrate the stronger brain connectivity, or an association between maternal cortisol and mood symptoms.

“Many mood and anxiety disorders are approximately twice as common in females as in males. This paper highlights one unexpected sex-specific risk factor for mood and anxiety disorders in females,” said John Krystal, MD, Editor of Biological Psychiatry. “High maternal levels of cortisol during pregnancy appear to contribute to risk in females, but not males.”

Full story at Science Daily

Area of brain linked to bipolar disorder pinpointed

A volume decrease in specific parts of the brain’s hippocampus — long identified as a hub of mood and memory processing — was linked to bipolar disorder in a study led by researchers at The University of Texas Health Science Center at Houston (UTHealth). The research was published today in Molecular Psychiatry, part of the Nature Publishing Group.

“Our study is one of the first to locate possible damage of bipolar disorder in specific subfields within the hippocampus,” said Bo Cao, Ph.D., first and corresponding author and a postdoctoral fellow in the Department of Psychiatry and Behavioral Sciences at McGovern Medical School at UTHealth. “This is something that researchers have been trying to answer. The theory was that different subfields of the hippocampus may have different functions and may be affected differently in different mood disorders, such as bipolar disorder and major depression disorder.”

Full story of brain linked to bipolar disorder at Science Daily