Chapter 12. Psychopathology: The Biology of Behavioral Disorders
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By Christina Caron It’s not uncommon for our minds to unleash a torrent of difficult feelings under the cover of darkness: sadness and negative thoughts may surface at night, making sleep hard to come by. On social media and elsewhere people often refer to this as “nighttime depression.” But is that really a thing? And if so, why do some people get blue at night? Feeling down after dusk doesn’t necessarily mean that you have a mental health condition, experts said. Understanding why it happens can help you take steps to feel better. What is nighttime depression? Nighttime depression is a colloquial term for depressive symptoms that either appear or worsen late at night. It is not itself a diagnosis. While anxiety can also ramp up at night, and tends to make people feel agitated, tense and restless, nighttime depression is best characterized as a low mood. “It’s a sense of sadness,” said Dr. Theresa Miskimen Rivera, a clinical professor of psychiatry at Rutgers University and president-elect of the American Psychiatric Association. “It’s that feeling of: There’s no joy. My life is so blah.” Nighttime depression can also feel uncomfortable — “not only in your mind, but in your body,” Dr. Rivera added, especially if these feelings interfere with getting enough sleep. © 2024 The New York Times Company
Keyword: Depression; Sleep
Link ID: 29506 - Posted: 10.05.2024
By Elie Dolgin The first schizophrenia medication in decades with a new mechanism of action won US regulatory approval today. The approval offers the hope of an antipsychotic that would be more effective and better tolerated than current therapies. The drug, known as KarXT, targets proteins in the brain known as muscarinic receptors, which relay neurotransmitter signals between neurons and other cells. Activating these receptors dampens the release of the chemical dopamine, a nervous-system messenger that is central to the hallmark symptoms of schizophrenia, such as hallucinations and delusions. But muscarinic signalling also modulates other brain circuits involved in cognition and emotional processing. This mode of action provides KarXT with a more comprehensive therapeutic effect than other schizophrenia treatments, which mainly blunt dopamine activity alone. In clinical trials, KarXT not only alleviated core symptoms of schizophrenia, but also showed signs of improving cognitive function, all while avoiding many of the burdensome side effects commonly associated with older antipsychotics. “This will be a revolution of the treatment of psychosis, and I’m not saying this lightly,” says Christoph Correll, a psychiatrist at the Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York, who helped to analyse data from the trials. “Now we will now be able to treat people who haven’t been helped with traditional antipsychotics. That’s highly exciting.” KarXT is just the first of many next-generation drug candidates designed to engage muscarinic receptors in the brain. Several follow-on schizophrenia therapies are already in or nearing clinical trials, showing promise for improved tolerability and more convenient dosing schedules. This progress is leading clinicians and drug developers to imagine a future in which schizophrenia treatment becomes more tailored to individual needs — providing an alternative for the many people who don’t benefit from current therapies or abandon them owing to intolerable side effects. © 2024 Springer Nature Limited
Keyword: Schizophrenia
Link ID: 29498 - Posted: 09.28.2024
By Mariana Lenharo There’s a bar in Baltimore, Maryland, that very few people get to enter. It has a cocktail station, beer taps and shelves stacked with spirits. But only scientists or drug-trial volunteers ever visit, because this bar is actually a research laboratory. Here, in a small room at the US National Institutes of Health (NIH), scientists are harnessing the taproom ambience to study whether blockbuster anti-obesity drugs might also curb alcohol cravings. Evidence is mounting that they could. Animal studies and analyses of electronic health records suggest that the latest wave of weight-loss drugs — known as glucagon-like peptide 1 (GLP-1) receptor agonists — cut many kinds of craving or addiction, from alcohol to tobacco use. “We need randomized clinical trials as the next step,” says Lorenzo Leggio, an addiction researcher at the NIH in Baltimore. In the trial he is leading, volunteers sit at the bar and get to see, smell and hold their favourite drinks, while going through tests such as questions about their cravings; separately, participants will have their brains scanned while looking at pictures of alcohol. Some will be given the weight-loss drug semaglutide (marketed as Wegovy) and others will get a placebo. George Koob and Lorenzo Leggio pose for a photograph in a research laboratory designed as a bar inside the National Institutes of Health’s hospital. Curbing addiction isn’t the only potential extra benefit of GLP-1 drugs. Other studies have suggested they can reduce the risk of death, strokes and heart attacks for people with cardiovascular disease1 or chronic kidney ailments2, ease sleep apnoea symptoms3 and even slow the development of Parkinson’s disease4. There are now hundreds of clinical trials testing the drugs for these conditions and others as varied as fatty liver disease, Alzheimer’s disease, cognitive dysfunction and HIV complications (see ‘Diseases that obesity drugs might treat’ at the end of this article). © 2024 Springer Nature Limited
Keyword: Obesity; Drug Abuse
Link ID: 29494 - Posted: 09.25.2024
Natasha May Young people with severe depression experience disruptions in the way regions of their brain communicate with each other which are distinct from those observed in adults, a study has found. The research published on Tuesday in Nature Mental Health could be used to identify potential targets for brain stimulation therapies, extending their existing application from adults to youth. The study analysed the brain scans of 810 young people aged 12-25, of which 440 had major depressive disorder (MDD) and 370 were healthy comparison individuals. The study led by the University of Melbourne found that in those with MDD, some densely connected regions of the brain (known as hubs) showed stronger connectivity and others showed weaker connectivity compared with youth without depression. Young woman running at sunset on Australian beach Nutrition and exercise as good as therapy for mild and moderate depression, study says Prof Andrew Zalesky, the supervising researcher, said they found the connectivity was particularly strong in the part of the brain associated with someone’s internalised thoughts and rumination. “We see that in youth with depression, the default mode is more strongly connected, it’s more activated, which suggests that there is a greater focus on self-thought and self-reflection,” Zalesky said. The study, whose first author was third-year PhD student at the University of Melbourne, Nga (Connie) Yan Tse, also found the extent of these differences could reliably predict how severe a person’s depressive symptoms were. © 2024 Guardian News & Media Limited
Keyword: Depression; Brain imaging
Link ID: 29491 - Posted: 09.25.2024
By Christina Caron Julianna McLeod, 26, had her first psychotic episode while taking Vyvanse for attention deficit hyperactivity disorder last year. Ms. McLeod, who lives in Ontario, Canada, had taken the drug before but paused while pregnant with her first child and didn’t start taking it again until six months postpartum. Although the dose was 40 milligrams, she often forgot when she had last taken a pill. So she took one whenever she remembered — and may have ended up taking more than her prescribed daily dose. The delusions that she experienced made her feel euphoric and highly energetic. “I felt like my brain was exploding with connections,” she said. In her mind, she was a “super detective” who was uncovering the people and organizations that were secretly engaging in child sex trafficking. She even began to believe that someone was drugging her and her baby. Psychosis and mania are each known side effects of stimulant medications, and the Food and Drug Administration has added warnings to the medications’ labels saying that they may cause symptoms like hallucinations, delusional thinking or mania. But these side effects are considered rare — experienced by an estimated 1 in 1,000 patients — and have not been extensively researched. It can take months for someone to fully recover. A new study published on Thursday in The American Journal of Psychiatry suggests that dosage may play a role. It found that among people who took high doses of prescription amphetamines such as Vyvanse and Adderall, there was a fivefold increased risk of developing psychosis or mania for the first time compared with those who weren’t taking stimulants. The researchers defined a high dose as more than 40 milligrams of Adderall, 100 milligrams of Vyvanse or 30 milligrams of dextroamphetamine. The medium dosage (20 to 40 milligrams of Adderall, 50 to 100 milligrams of Vyvanse or 16 to 30 milligrams of dextroamphetamine) was associated with a 3.5 times higher risk of psychosis or mania. There was no increased risk of psychosis or mania among those who used methylphenidate drugs, like Concerta or Ritalin, regardless of the dose. © 2024 The New York Times Company
Keyword: ADHD; Schizophrenia
Link ID: 29478 - Posted: 09.14.2024
By Frieda Klotz For five years, Clare Dolman took lithium to manage her bipolar disorder. The medicine kept her happy and well with few side effects, and she described it as a wonder drug. But when she began to plan for a pregnancy, her psychiatrist advised her to go off the medication to protect the fetus. This was 1988, and it was the standard guidance at the time. While Dolman experienced some stresses during the pregnancy, her mood remained stable. But soon after giving birth, she began to experience mild hallucinations. “I thought, yes, there’s something wrong here,” she recalled. “But I had the insight still to see that I was getting ill, and my husband knew I was getting ill because he had seen me really bad.” She went on to spend five weeks in the hospital. Clare Dolman at the launch of the Bipolar Commission at the U.K. Parliament. Dolman, who has bipolar disorder, stopped taking lithium during her own pregnancies more than 30 years ago. She later became a mental health advocate and has studied the experiences of pregnant women with the illness. Visual: Courtesy of Clare Dolman Bipolar disorder involves extreme fluctuations in mood and is classified into different types according to symptoms and severity. For women with the condition, pregnancy can be a fraught endeavor as they balance the health of their growing fetus with their own mental state. Many, like Dolman, stop taking the medications that keep them well — which can lead to a recurrence of symptoms — and some avoid pregnancy altogether.
Keyword: Schizophrenia; Sexual Behavior
Link ID: 29475 - Posted: 09.11.2024
By Olivia Gieger Unlike traditional antidepressants, ketamine acts quickly to relieve depression symptoms, and its effects last long after the drug has cleared the system. Researchers have puzzled over what ketamine is doing in the brain to achieve these results. For one thing, the drug acts on N-methyl-D-aspartate (NMDA) glutamate receptors, which appear on neurons all over the brain. “Then the question is: Does the drug hit on all these brain regions simultaneously?” says Hailan Hu, professor of brain science at Zhejiang University. Or does it affect one region first, which sets off a series of downstream antidepressant effects? The answer is the latter, Hu and her colleagues report in a new study. Ketamine acts first on neurons in the lateral habenula, they found, in mice with depression-like symptoms. The structure—known as the “anti-reward” center—is hyperactive in people with depression and in mice modeling the condition, previous work has shown. That activity makes it highly susceptible to the drug’s effects, Hu and her colleagues discovered. Ketamine binds the NMDA receptors of cells in the lateral habenula and renders them inactive, which in turn interrupts downstream mechanisms of depression. The findings, published in Science in August, help explain how the known targets of ketamine are involved in such a rapid antidepressant response, explains Christophe Proulx, associate professor of psychiatry and neuroscience at Laval University. Proulx was not involved in the work but co-authored a Perspective article on it. Spotlighting the lateral habenula’s role also represents a new way of thinking about ketamine’s effects on depression—involving a shift away from a focus on weakened circuits and impaired plasticity, says Todd Gould, professor of psychiatry and neurobiology at the University of Maryland School of Medicine, who was not affiliated with the study. “[The work provides] additional strong evidence supporting a different view about how ketamine may be working.” Although ketamine inactivated NMDA receptors in the lateral habenula of the depressive-like mice, it had less impact in the CA1 region of the hippocampus, Hu and her colleagues observed using in-vitro slice electrophysiology and electrode recordings in awake animals. © 2024 Simons Foundation
Keyword: Depression
Link ID: 29472 - Posted: 09.11.2024
Nicola Davis Science correspondent Researchers have gained new insight into how and why some people experience depression after finding a particular brain network is far bigger in people living with the condition. The surface of the brain is a communication junction box at which different areas talk to each other to carry out particular processes. But there is a finite amount of space for these networks to share. Now researchers say that in people with depression, a larger part of the brain is involved in the network that controls attention to rewards and threats than in those without depression. “It’s taking up more real estate on the brain surface than we see is typical in healthy controls,” said Dr Charles Lynch, a co-author of the research, from Weill Cornell Medicine in New York. He added that expansion meant the size of other – often neighbouring – brain networks were smaller. Writing in the journal Nature, Lynch and colleagues report how they used precision functional mapping, a new approach to brain imaging that analyses a host of fMRI (functional MRI) scans from each individual. The team applied this method to 141 people with depression and 37 people without it, enabling them to measure accurately the size of each participant’s brain networks. They then took the average size for each group. They found that a part of the brain called the frontostriatal salience network was expanded by 73% on average in participants with depression compared with healthy controls. © 2024 Guardian News & Media Limited
Keyword: Depression; Brain imaging
Link ID: 29468 - Posted: 09.07.2024
By Jessica Silver-Greenberg and Katie Thomas Acadia Healthcare is one of America’s largest chains of psychiatric hospitals. Since the pandemic exacerbated a national mental health crisis, the company’s revenue has soared. Its stock price has more than doubled. But a New York Times investigation found that some of that success was built on a disturbing practice: Acadia has lured patients into its facilities and held them against their will, even when detaining them was not medically necessary. In at least 12 of the 19 states where Acadia operates psychiatric hospitals, dozens of patients, employees and police officers have alerted the authorities that the company was detaining people in ways that violated the law, according to records reviewed by The Times. In some cases, judges have intervened to force Acadia to release patients. Some patients arrived at emergency rooms seeking routine mental health care, only to find themselves sent to Acadia facilities and locked in. A social worker spent six days inside an Acadia hospital in Florida after she tried to get her bipolar medications adjusted. A woman who works at a children’s hospital was held for seven days after she showed up at an Acadia facility in Indiana looking for therapy. And after police officers raided an Acadia hospital in Georgia, 16 patients told investigators that they had been kept there “with no excuses or valid reason,” according to a police report. Acadia held all of them under laws meant for people who pose an imminent threat to themselves or others. But none of the patients appeared to have met that legal standard, according to records and interviews. Most doctors agree that people in the throes of a psychological crisis must sometimes be detained against their will to stabilize them and prevent harm. These can be tough calls, balancing patients’ safety with their civil rights. But at Acadia, patients were often held for financial reasons rather than medical ones, according to more than 50 current and former executives and staff members. © 2024 The New York Times Company
Keyword: Schizophrenia; Depression
Link ID: 29464 - Posted: 09.04.2024
By Elyse Weingarten In 2016, Canada enacted the Medical Assistance in Dying, or MAID, law, allowing individuals with a terminal illness to receive help from a medical professional to end their life. Following a superior court ruling, the legislation was expanded in 2021 to include nearly anyone with a “grievous and irremediable medical condition” causing “enduring physical or psychological suffering that is intolerable to them.” Whether mental illnesses such as depression, schizophrenia, and addiction should be considered “grievous and irremediable” quickly emerged as the subject of intense debate. Initially slated to go into effect in March 2023, a new mental health provision of the law was postponed a year due to public outcry both in Canada and abroad. Then, in February, Health Minister Mark Holland announced it had been delayed again — this time until 2027 — to allow more time for the country’s health care system to prepare. I was horrified by the news of the law’s latest expansion — a reaction that surprised me. Having grown up with a seriously mentally ill family member, I know first-hand how destructive mental illness can be, and I have no illusion that it is always treatable. Additionally, I support assisted suicide in cases of grave and terminal physical illness, so why do I find it so unacceptable to offer it to people who are intractably mentally ill? For nearly half a century, the Western understanding of mental illness has been shaped to adhere to the larger biomedical concepts of disease and wellness. Biological psychiatry, or the biomedical model, views mental illnesses as organically based disorders of the brain, physiologically indistinguishable from other diseases. The Canadian MAID law’s inclusion of mental illness is the culmination of this framework. Yet the widespread condemnation that the amendment received (that the bill’s previous iterations did not) demonstrates that mental and physical illness — though worthy of the same respect — are in no way equivalent, and that we can recognize this intuitively.
Keyword: Depression; Schizophrenia
Link ID: 29449 - Posted: 08.22.2024
By Sara Reardon Last week’s decision by the US Food and Drug Administration (FDA) to reject MDMA, also known as ecstasy, as a psychiatric treatment surprised many researchers. Lykos Therapeutics, the company that has been testing MDMA, plans to ask the FDA to reconsider the decision, but scientists are now wondering what the agency’s ruling will mean for other potential psychedelic therapies. In a press release posted on 9 August, Lykos, which is based in San Jose, California, said that the FDA had sent a letter requesting that the company undertake another large-scale trial of the drug in people with post-traumatic stress disorder (PTSD) and resubmit its application. “The FDA request for another study is deeply disappointing,” Lykos chief executive Amy Emerson said in the press release, adding that the company plans to work with the agency to “resolve scientific disagreements”. Conducting another study “would take several years”, she said, adding that Lykos has already addressed many of the FDA’s concerns. In an e-mail to Nature, Lykos declined to provide the complete letter detailing the agency’s specific concerns and directed the news team instead to its press release. Experts say that without access to the letter, it’s hard to determine why the FDA reached the decision it did. “We really are going off incomplete information,” says Mason Marks, who studies drug policy at Florida State University in Tallahassee, adding that he was “a little surprised” by the agency’s decision. Trial concerns But Marks points out that the FDA typically follows the advice of its independent advisory committees — and the one that evaluated MDMA in June overwhelmingly voted against approving the drug, citing problems with clinical trial design that the advisers felt made it difficult to determine the drug’s safety and efficacy. One concern was about the difficulty of conducting a true placebo-controlled study with a hallucinogen: around 90% of the participants in Lykos’s trials guessed correctly whether they had received the drug or a placebo, and the expectation that MDMA should have an effect might have coloured their perception of whether it treated their symptoms. © 2024 Springer Nature Limited
Keyword: Drug Abuse; Depression
Link ID: 29433 - Posted: 08.15.2024
By Sara Reardon Stress can make people feel sick, and bacteria in the gut might be to blame, according to a study1 in mice. The research suggests that a stressed brain directly shuts down specific glands in the gut, affecting gut bacteria and the body’s broader immune system. The study “is a technical tour de force”, says neuroscientist John Cryan at University College Cork in Ireland, who reviewed the study. Most work on the gut–brain connection has focused on how bacteria affect the brain, so Cryan welcomes research into how psychological states can exert ‘top-down’ control of bacteria. “It’s a really cool part of the puzzle”, he says. The research was published on 8 August in Cell. Researchers have long known that the gut and brain ‘talk’ to each other. Under stress, the brain spurs the release of hormones that can trigger gut conditions such as inflammatory bowel disease. And certain bacteria in the gut can release chemical signals that affect the brain and behaviour. Your brain could be controlling how sick you get — and how you recover But the neural communication pathways are less well understood. To find out more, neuroscientist Ivan de Araujo at the Max Planck Institute for Biological Cybernetics in Tübingen, Germany, and his colleagues focused on small organs called Brunner’s glands that are found in the walls of the small intestine. Little is known about these glands, other than that they produce mucus and contain numerous neurons. De Araujo’s team found that removing the Brunner’s glands of mice made the animals more susceptible to infection. It also raised markers of inflammation, a flood of immune chemicals and cells that can damage tissues. The team saw a similar effect in humans: people who’d had tumours removed from the part of the gut containing Brunner’s glands had higher levels of white blood cells — a marker of inflammation — than people who’d had tumours removed from other areas. © 2024 Springer Nature Limited
Keyword: Stress; Neuroimmunology
Link ID: 29432 - Posted: 08.13.2024
By Andrew Jacobs The journal Psychopharmacology has retracted three papers about MDMA-assisted therapy based on what the publication said was unethical conduct at one of the study sites where the research took place. Several of the papers’ authors are affiliated with Lykos Therapeutics, the drug company whose application for MDMA-assisted therapy to treat post-traumatic stress disorder was rejected last week by the Food and Drug Administration. The company said the research in the retracted papers was not part of its application to the F.D.A. In declining to approve Lykos’s application, the agency cited concerns about missing data and problems with the way the company’s study was designed, according to a statement released by Lykos on Friday. The F.D.A. has asked Lykos to conduct an additional clinical trial of its MDMA-assisted therapy, which would have been the first psychedelic medicine to win approval by federal regulators. Lykos has said it would appeal the decision. The journal retraction was first reported by Stat, the health and medical news website. On Sunday, Lykos said that it disagreed with Psychopharmacology’s decision and that it would file an official complaint with the Committee on Publication Ethics, a nonprofit that sets guidelines for academic publications. “The articles remain scientifically sound and present important contributions to the study of potential treatments for PTSD,” the company said in the statement. The incident cited by Psychopharmacology has been well documented. © 2024 The New York Times Company
Keyword: Stress; Drug Abuse
Link ID: 29431 - Posted: 08.13.2024
Ross Ellenhorn and Dimitri Mugiani Earlier this month, an advisory panel rejected MDMA-assisted therapy for PTSD, possibly dooming US Food and Drug Administration (FDA) approval of the drug commonly called ecstasy. In a public meeting alongside FDA staff, panel members said that the research neither adequately accounted for abuse risks nor proved the drug’s efficacy in combination with psychotherapy. This decision dealt a major blow to Lykos Therapeutics, the for-profit public benefit corporation of the non-profit Multidisciplinary Association for Psychedelic Studies (Maps), which sponsored the trials. More broadly, the rejection has been described as a drastic setback for the psychedelic movement as a whole. For several years now, it seemed that greater acceptance and new legal spaces for psychedelics were a certainty. Then, scientists appeared at the FDA hearing and everything went dark. As practitioners and leaders in the realm of human transformation, and in creating and running organizations that serve individuals experiencing complex psychiatric symptoms, we believe in psychedelics as a force for good. Yet, to us, this FDA decision is the natural and expected outcome of a basic and fatal conceptual error that our brothers and sisters in the movement have adopted. By joining larger trends within the behavioral health milieu that focus on the elimination of distinct symptoms by drugs and by expert-driven techniques, today’s psychedelic movement is teetering on the edge of becoming unpsychedelic. What do we mean by this? Psychedelics free our minds to novelty, liberating us from habitual patterns. The common term for this property is “brain plasticity”, and it may be the core reason these substances can also affect areas of psychological suffering related to habits of the mind – those that experienced psychiatrists label as depression, anxiety, addiction and, yes, PTSD. Psychedelics are pro-imagination, pro-creativity, pro-innovation – qualities that research shows are at the very root of personal growth. © 2024 Guardian News & Media Limited
Keyword: Stress; Drug Abuse
Link ID: 29424 - Posted: 08.11.2024
By Ellen Barry In recent decades, mental health providers began screening for “adverse childhood experiences” — generally defined as abuse, neglect, violence, family dissolution and poverty — as risk factors for later disorders. But what if other things are just as damaging? Researchers who conducted a large study of adults in Denmark, published on Wednesday in the journal JAMA Psychiatry, found something they had not expected: Adults who moved frequently in childhood have significantly more risk of suffering from depression than their counterparts who stayed put in a community. In fact, the risk of moving frequently in childhood was significantly greater than the risk of living in a poor neighborhood, said Clive Sabel, a professor at the University of Plymouth and the paper’s lead author. “Even if you came from the most income-deprived communities, not moving — being a ‘stayer’ — was protective for your health,” said Dr. Sabel, a geographer who studies the effect of environment on disease. “I’ll flip it around by saying, even if you come from a rich neighborhood, but you moved more than once, that your chances of depression were higher than if you hadn’t moved and come from the poorest quantile neighborhoods,” he added. The study, a collaboration by Aarhus University, the University of Manchester and the University of Plymouth, included all Danes born between 1982 and 2003, more than a million people. Of those, 35,098, or around 2.3 percent, received diagnoses of depression from a psychiatric hospital. Are you concerned for your teen? If you worry that your teen might be experiencing depression or suicidal thoughts, there are a few things you can do to help. Dr. Christine Moutier, the chief medical officer of the American Foundation for Suicide © 2024 The New York Times Company
Keyword: Depression; Stress
Link ID: 29395 - Posted: 07.18.2024
By Dave Philipps David Metcalf’s last act in life was an attempt to send a message — that years as a Navy SEAL had left his brain so damaged that he could barely recognize himself. He died by suicide in his garage in North Carolina in 2019, after nearly 20 years in the Navy. But just before he died, he arranged a stack of books about brain injury by his side, and taped a note to the door that read, in part, “Gaps in memory, failing recognition, mood swings, headaches, impulsiveness, fatigue, anxiety, and paranoia were not who I was, but have become who I am. Each is worsening.” Then he shot himself in the heart, preserving his brain to be analyzed by a state-of-the-art Defense Department laboratory in Maryland. The lab found an unusual pattern of damage seen only in people exposed repeatedly to blast waves. The vast majority of blast exposure for Navy SEALs comes from firing their own weapons, not from enemy action. The damage pattern suggested that years of training intended to make SEALs exceptional was leaving some barely able to function. But the message Lieutenant Metcalf sent never got through to the Navy. No one at the lab told the SEAL leadership what the analysis had found, and the leadership never asked. It was not the first time, or the last. At least a dozen Navy SEALs have died by suicide in the last 10 years, either while in the military or shortly after leaving. A grass-roots effort by grieving families delivered eight of their brains to the lab, an investigation by The New York Times has found. And after careful analysis, researchers discovered blast damage in every single one. It is a stunning pattern with important implications for how SEALs train and fight. But privacy guidelines at the lab and poor communication in the military bureaucracy kept the test results hidden. Five years after Lieutenant Metcalf’s death, Navy leaders still did not know. Until The Times told the Navy of the lab’s findings about the SEALs who died by suicide, the Navy had not been informed, the service confirmed in a statement. © 2024 The New York Times Company
Keyword: Brain Injury/Concussion; Depression
Link ID: 29378 - Posted: 07.03.2024
By Janna Levin During traumatic periods and their aftermath, our brains can fall into habitual ways of thinking that may be helpful in the short run but become maladaptive years later. For the brain to readjust to new situations later in life, it needs to be restored to the malleable state it was in when the habits first formed. That is exactly what Gül Dölen, a neuroscientist and psychiatric researcher at the University of California, Berkeley, is working toward in her lab. What is her surprising tool? Psychedelics. JANNA LEVIN: Welcome to “The Joy of Why.” This is Janna Levin. On June 4th, an advisory panel for the Federal Drug Administration recommended against approving the use of the psychedelic drug MDMA as a treatment for post-traumatic stress disorder. Various concerns, some about safety, overshadowed the demonstrable value of the drug in the opinion of the panel. The path to approval for drug therapies is notoriously fraught with profound complexities, a high bar on proof in clinical trials, the medical injunction to “do no harm,” as well as social and political nuances. But, what’s the fundamental neuroscience behind the news story? Why are so many psychiatric researchers enthusiastic about the promise of psychedelics? We happened to take on this subject a few weeks ago with neuroscientist Gül Dölen. Here is that episode. New drug leads can come from practically anywhere. Penicillin’s discovery was spurred from mold spores that accidentally landed in a petri dish. Cancer treatments can be dredged from the bottom of the sea. And synthetic antibodies can now be engineered from scratch. But there’s a class of drugs that mainstream medicine has generally overlooked that could prove life-changing for many people facing addiction, depression, post-traumatic stress — if scientists embrace the potential power of psychedelics. © 2024 the Simons Foundation.
Keyword: Stress; Depression
Link ID: 29351 - Posted: 06.08.2024
By Ellen Barry Post-traumatic stress disorder diagnoses among college students more than doubled between 2017 and 2022, climbing most sharply as the coronavirus pandemic shut down campuses and upended young adults’ lives, according to new research published on Thursday. The prevalence of PTSD rose to 7.5 percent from 3.4 percent during that period, according to the findings. Researchers analyzed responses from more than 390,000 participants in the Healthy Minds Study, an annual web-based survey. “The magnitude of this rise is indeed shocking,” said Yusen Zhai, the paper’s lead author, who heads the community counseling clinic at the University of Alabama at Birmingham. His clinic had seen more young people struggling in the aftermath of traumatic events. So he expected an increase, but not such a large one. Dr. Zhai, an assistant professor in the Department of Human Studies, attributed the rise to “broader societal stressors” on college students, such as campus shootings, social unrest and the sudden loss of loved ones from the coronavirus. PTSD is a mental health disorder characterized by intrusive thoughts, flashbacks and heightened sensitivity to reminders of an event, continuing more than a month after it occurs. It is a relatively common disorder, with an estimated 5 percent of adults in the United States experiencing it in any given year, according to the most recent epidemiological survey conducted by the Department of Health and Human Services. Lifetime prevalence is 8 percent in women and 4 percent in men, the survey found. The new research also found a sharp rise in the prevalence of a similar condition, acute stress disorder, which is diagnosed less than a month after a trauma. Diagnoses rose to 0.7 percent among college students in 2022, up from 0.2 percent five years earlier. Use of mental health care increased nationally during the pandemic, as teletherapy made it far easier to see clinicians. Treatment for anxiety disorders increased most steeply, followed by PTSD, bipolar disorder and depression, according to economists who analyzed more than 1.5 million insurance claims for clinician visits between 2020 and 2022. © 2024 The New York Times Company
Keyword: Stress
Link ID: 29350 - Posted: 06.08.2024
Leyland Cecco in Toronto A leading federal scientist in Canada has alleged he was barred from investigating a mystery brain illness in the province of New Brunswick and said he fears more than 200 people affected by the condition are experiencing unexplained neurological decline. The allegations, made in leaked emails to a colleague seen by the Guardian, have emerged two years after the eastern province closed its investigation into a possible “cluster” of cases. “All I will say is that my scientific opinion is that there is something real going on in [New Brunswick] that absolutely cannot be explained by the bias or personal agenda of an individual neurologist,” wrote Michael Coulthart, a prominent microbiologist. “A few cases might be best explained by the latter, but there are just too many (now over 200).” New Brunswick health officials warned in 2021 that more than 40 residents were suffering from a possible unknown neurological syndrome, with symptoms similar to those of the degenerative brain disorder Creutzfeldt-Jakob disease. Those symptoms were varied and dramatic: some patients started drooling and others felt as though bugs were crawling on their skin. A year later, however, an independent oversight committee created by the province determined that the group of patients had most likely been misdiagnosed and were suffering from known illnesses such as cancer and dementia. The committee and the New Brunswick government also cast doubt on the work of neurologist Alier Marrero, who was initially referred dozens of cases by baffled doctors in the region, and subsequently identified more cases. The doctor has since become a fierce advocate for patients he feels have been neglected by the province. © 2024 Guardian News & Media Limited
Keyword: Alzheimers; Depression
Link ID: 29342 - Posted: 06.04.2024
By Andrew Jacobs and Christina Jewett The Food and Drug Administration on Friday raised concerns about the health effects of MDMA as a treatment for post-traumatic stress disorder, citing flaws in a company’s studies that could pose major obstacles to approval of a treatment anticipated to help people struggling with the condition. The agency said that bias had seeped into the studies because participants and therapists were readily able to figure out who got MDMA versus a placebo. It also flagged “significant increases” in blood pressure and pulse rates that could “trigger cardiovascular events.” The staff analysis was conducted for an independent advisory panel that will meet Tuesday to consider an application by Lykos Therapeutics for the use of MDMA-assisted therapy. The agency’s concerns highlight the unique and complex issues facing regulators as they weigh the therapeutic value of an illegal drug commonly known as Ecstasy that has long been associated with all-night raves and cuddle puddles. Approval would mark a seismic change in the nation’s tortuous relationship with psychedelic compounds, most of which the Drug Enforcement Administration classifies as illegal substances that have “no currently accepted medical use and a high potential for abuse.” Research like the current studies on MDMA therapy have corralled the support of various groups and lawmakers from both parties for treatment of PTSD, a condition affecting millions of Americans, especially military veterans who face an outsize risk of suicide. No new therapy has been approved for PTSD in more than 20 years. “What’s happening is truly a paradigm shift for psychiatry,” said David Olson, director of the U.C. Davis Institute for Psychedelics and Neurotherapeutics. “MDMA is an important step for the field because we really lack effective treatments, period, and people need help now.” © 2024 The New York Times Company
Keyword: Drug Abuse; Depression
Link ID: 29332 - Posted: 06.02.2024