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

Growing up in poverty increases diagnoses of psychosis-spectrum mental illnesses

Growing up in impoverished urban neighborhoods more than doubles your chances over the average person of developing a psychosis-spectrum disorder by the time you reach middle adulthood, according to a new UC Davis and Concordia University study of nearly 4,000 families who were monitored over 30 years.

The results of the study suggest that intervention through social policies and investment in neighborhood improvements, as well as identifying those most in need of help by observing certain child behaviors, could prevent future debilitating illnesses and the societal and personal costs associated with them, said the study’s authors.

“One important message to take from this study is that the stresses and chronic day-to-day challenges of living in under-resourced or impoverished communities can undermine the well-being of individuals whether they seem to have a vulnerability or not,” said Paul D. Hastings, professor in the Department of Psychology at UC Davis and the lead author of the paper. He explained that while heredity is a major factor in predicting schizophrenia, bipolar disorder and other disorders involving psychoses — that is, breaks with reality, like delusional beliefs and hallucinations — this study provides clear evidence that environmental factors experienced in childhood also affect future mental health.

Full story at Science Daily

When neurons are out of shape, antidepressants may not work

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed medication for major depressive disorder (MDD), yet scientists still do not understand why the treatment does not work in nearly thirty percent of patients with MDD. Now, Salk Institute researchers have discovered differences in growth patterns of neurons of SSRI-resistant patients. The work, published in Molecular Psychiatry on March 22, 2019, has implications for depression as well as other psychiatric conditions such as bipolar disorder and schizophrenia that likely also involve abnormalities of the serotonin system in the brain.

“With each new study, we move closer to a fuller understanding of the complex neural circuitry underlying neuropsychiatric diseases, including major depression,” says Salk Professor Rusty Gage, the study’s senior author, president of the Institute, and the Vi and John Adler Chair for Research on Age-Related Neurodegenerative Disease. “This paper, along with another we recently published, not only provides insights into this common treatment, but also suggests that other drugs, such as serotonergic antagonists, could be additional options for some patients.”

Full story at Science Daily

Neuromelanin-Sensitive MRI Identified as a Potential Biomarker for Psychosis

Researchers have shown that a type of magnetic resonance imaging — called neuromelanin-sensitive MRI (NM-MRI) — is a potential biomarker for psychosis. NM-MRI signal was found to be a marker of dopamine function in people with schizophrenia and an indicator of the severity of psychotic symptoms in people with this mental illness. The study, funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health, appears in the Proceedings of the National Academy of Science.

“Disturbances affecting the neurotransmitter dopamine are associated with a host of mental and neurological disorders, such as schizophrenia and Parkinson’s disease,” said Joshua A. Gordon, M.D., Ph.D., director of NIMH. “Because of the role dopamine plays in these disorders, the ability to measure dopamine activity is critical for furthering our understanding of these disorders, including how to best diagnose and treat them.”

Neuromelanin is a dark pigment created within dopamine neurons of the midbrain — particularly in the substantia nigra, a brain area that plays a role in reward and movement. Neuromelanin accumulates over the lifespan and is only cleared away from cells following cell death, as occurs in neurodegenerative disorders such as Parkinson’s disease. Researchers have found that NM-MRI signal is lower in the substantia nigra of people with Parkinson’s disease, reflecting the cell death that occurs in these patients.

Full story at NIMH

Neuromelanin-Sensitive MRI Identified as a Potential Biomarker for Psychosis

Researchers have shown that a type of magnetic resonance imaging — called neuromelanin-sensitive MRI (NM-MRI) — is a potential biomarker for psychosis. NM-MRI signal was found to be a marker of dopamine function in people with schizophrenia and an indicator of the severity of psychotic symptoms in people with this mental illness. The study, funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health, appears in the Proceedings of the National Academy of Science.

“Disturbances affecting the neurotransmitter dopamine are associated with a host of mental and neurological disorders, such as schizophrenia and Parkinson’s disease,” said Joshua A. Gordon, M.D., Ph.D., director of NIMH. “Because of the role dopamine plays in these disorders, the ability to measure dopamine activity is critical for furthering our understanding of these disorders, including how to best diagnose and treat them.”

Neuromelanin is a dark pigment created within dopamine neurons of the midbrain — particularly in the substantia nigra, a brain area that plays a role in reward and movement. Neuromelanin accumulates over the lifespan and is only cleared away from cells following cell death, as occurs in neurodegenerative disorders such as Parkinson’s disease. Researchers have found that NM-MRI signal is lower in the substantia nigra of people with Parkinson’s disease, reflecting the cell death that occurs in these patients.

Full story at NIMH

The ways of wisdom in schizophrenia

While wisdom is closely linked to improved health and well-being, its role and impact among persons with schizophrenia, possibly the most devastating of mental illnesses, is not known.

In a new paper, publishing February 14, 2019 in Schizophrenia Research, researchers at University of California San Diego School of Medicine report that, on average, persons with schizophrenia (PwS) obtained lower scores on a wisdom assessment than non-psychiatric comparison participants (NPCPs), but that there was considerable variability in levels of wisdom. Nearly one-third of PwS had scores in the “normal” range, and these PwS with higher levels of wisdom displayed fewer psychotic symptoms as well as better cognitive performance and everyday functioning.

“Taken together, our findings argue for the value of assessing wisdom in persons with schizophrenia because increasing wisdom may help improve their social and neuro-cognition, and vice versa,” said senior author Dilip Jeste, MD, Distinguished Professor of Psychiatry and Neurosciences and director of the Stein Institute for Research on Aging at UC San Diego School of Medicine.

Full story at Science Daily

Have researchers found a new risk factor for schizophrenia?

Scientists have located an intriguing link between schizophrenia and the Epstein-Barr virus, a type of herpes virus. Now, they need to determine which way the risk lies.

Schizophrenia, a condition characterized by a confused perception of reality, delusions, and altered behavior, affects more than 21 million people globally.

In a new study, specialists from Johns Hopkins Medicine in Baltimore, MD, and the Sheppard Pratt Health System in Townson, MD, found evidence that links schizophrenia with the Epstein-Barr virus.

This is a herpes virus that causes infectious mononucleosis, or glandular fever.

Full story at Medical News Today

Brains of people with schizophrenia-related disorders aren’t all the same

A new multi-site brain imaging study in The American Journal of Psychiatry shows that sub-groups of people use their brains differently when imitating emotional faces — a task that reflects their ability to interact socially. Interestingly, individuals with schizophrenia do not have categorically different social brain function than those without mental illness, but fall into different sub-groups that may respond to different types of treatments. These findings call into question the most common research approaches in mental health.

“We know that, on average, people with schizophrenia have more social impairment than people in the general population,” says senior author Dr. Aristotle Voineskos in the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health (CAMH) in Toronto. “But we needed to take an agnostic approach and let the data tell us what the brain-behavioural profiles of our study participants looked like. It turned out that the relationship between brain function and social behaviour had nothing to do with conventional diagnostic categories in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).”

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

Hyperconnectivity in a brain circuit may predict psychosis

National Institute of Mental Health (NIMH)-funded scientists have discovered a pattern in the way a brain circuit works that may help predict the onset of psychosis. High levels of chatter, or “hyperconnectivity,” in a circuit involving the cerebellum, thalamus, and cortex emerged as a potential “neural signature” in a functional magnetic resonance imaging (fMRI) study by Tyrone Cannon, Ph.D.of Yale University and colleagues.

The degree of hyperconnectivity within this circuit predicted the length of time it took for an individual to convert from a state of risk to full psychosis – hallucinations, delusions, and disorganized thought and behavior. The researchers also found this same pattern of hyperactivity in a separate group of individuals with schizophrenia.

Full story at NIMH