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Roots of major depression revealed in all its genetic complexity

By Bill Hathaway A massive genome-wide association study (GWAS) of genetic and health records of 1.2 million people from four separate data banks has identified 178 gene variants linked to major depression, a disorder that will affect one of every five people during their lifetimes. The results of the study, led by the U.S. Department of Veterans Affairs (V.A.) researchers at Yale University School of Medicine and University of California-San Diego (UCSD), may one day help identify people most at risk of depression and related psychiatric disorders and help doctors prescribe drugs best suited to treat the disorder. The study was published May 27 in the journal Nature Neuroscience. For the study, the research team analyzed medical records and genomes collected from more than 300,000 participants in the V.A.’s Million Veteran Program (MVP), one of the largest and most diverse databanks of genetic and medical information in the world. These new data were combined in a meta-analysis with genetic and health records from the UK Biobank, FinnGen (a Finland-based biobank), and results from the consumer genetics company 23andMe. This part of the study included 1.2 million participants. The researchers crosschecked their findings from that analysis with an entirely separate sample of 1.3 million volunteers from 23andMe customers. When the two sets of data from the different sources were compared, genetic variants linked to depression replicated with statistical significance for most of the markers tested. Copyright © 2021 Yale University

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 13: Memory and Learning
Link ID: 27833 - Posted: 05.29.2021

The Psychedelic Revolution Is Coming. Psychiatry May Never Be the Same.

By Andrew Jacobs It’s been a long, strange trip in the four decades since Rick Doblin, a pioneering psychedelics researcher, dropped his first hit of acid in college and decided to dedicate his life to the healing powers of mind-altering compounds. Even as antidrug campaigns led to the criminalization of Ecstasy, LSD and magic mushrooms, and drove most researchers from the field, Dr. Doblin continued his quixotic crusade with financial help from his parents. Dr. Doblin’s quest to win mainstream acceptance of psychedelics took a significant leap forward on Monday when the journal Nature Medicine published the results of his lab’s study on MDMA, the club drug popularly known as Ecstasy and Molly. The study, the first Phase 3 clinical trial conducted with psychedelic-assisted therapy, found that MDMA paired with counseling brought marked relief to patients with severe post-traumatic stress disorder. The results, coming weeks after a New England Journal of Medicine study that highlighted the benefits of treating depression with psilocybin, the psychoactive ingredient in magic mushrooms, have excited scientists, psychotherapists and entrepreneurs in the rapidly expanding field of psychedelic medicine. They say it is only a matter of time before the Food and Drug Administration grants approval for psychoactive compounds to be used therapeutically — for MDMA as soon as 2023, followed by psilocybin a year or two later. After decades of demonization and criminalization, psychedelic drugs are on the cusp of entering mainstream psychiatry, with profound implications for a field that in recent decades has seen few pharmacological advancements for the treatment of mental disorders and addiction. The need for new therapeutics has gained greater urgency amid a national epidemic of opioid abuse and suicides. © 2021 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 4: Development of the Brain
Link ID: 27817 - Posted: 05.12.2021

Major Depressive Disorders Have an Enormous Economic Impact

By Paul E. Greenberg Since the early 1990s, I, together with my colleagues, have been studying the economic burden of adults with major depressive disorders (MDD). Over that time, we have tracked shifts in the prevalence of this disease; in the makeup of those suffering from it; and in the nature of treatment both for the disease itself and for the host of comorbidities, such as pain and anxiety disorders, that accompany it. We have then used these data as the basis for calculating the incremental economic burden of adults with MDD—that is, the additional costs traceable to those suffering from the disease in terms of both medical treatment and workplace productivity impacts. Our most recent study was just published in a special issue of PharmacoEconomics (which I also co-edited) that presents new research on the economics of MDD. By focusing on one year during the Great Recession (2010) and another after a long macroeconomic expansion (2018), our analysis provides a helpful profile of the changing economic effects of this widespread and pernicious illness. We report our latest estimates showing that the incremental economic burden of adults with MDD was $326 billion in 2018, 38 percent higher than in 2010. But our work goes deeper than simply providing an economic calculator. This research offers a multifaceted lens through which we can gain a better understanding of how the myriad effects of the illness manifest themselves. Importantly, we find that only 11 percent of the overall burden of illness was attributable to the direct medical costs of treating MDD itself, while the costs of treating comorbid medical conditions made up 24 percent. Another 4 percent was due to suicide-related costs, while fully 61 percent of the total burden in 2018 resulted from a combination of elevated workplace absenteeism and presenteeism (that is, reduced productivity as a result of working while sick). This striking imbalance between medical expenditures to treat either MDD or its comorbidities on the one hand and workplace-related costs on the other is one aspect of the story that has changed dramatically since 2010, when medical costs were equivalent to workplace costs. © 2021 Scientific American,

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 27806 - Posted: 05.08.2021

Therapy on Aisle 7: Retailers Are Entering the Mental Health Market

By Christina Caron Finding a therapist can be a tough and time-consuming process involving multiple phone calls, waiting lists and insurance hurdles. But what if you were able to walk into your corner drugstore for a bottle of shampoo and also had the option of scheduling a walk-in session for mental health treatment? That’s the future that CVS, the largest retail pharmacy in the United States, is envisioning. Since January the company has added licensed clinical social workers trained in cognitive behavioral therapy to 13 locations in the Houston, Philadelphia and Tampa metro areas. The providers will offer mental health assessments, referrals and counseling either in person or via telehealth, a CVS spokeswoman said, and this spring the company plans to expand to 34 locations in those same regions. The social workers are available during the day, and also on evenings and weekends in the company’s MinuteClinics, which provide a variety of nonemergency health care services either via walk-in or by appointment. The hours are more flexible than what therapists might normally offer, and the social workers partner with the clinic’s nurse practitioners and pharmacists to give prescriptions when needed, said Dr. Daniel Knecht, the vice president of clinical product at CVS Health. CVS is just one of a growing number of retailers who are recognizing the unmet need for mental health providers and hoping to fill the gap. On Thursday, Walmart announced it is acquiring MeMD, which offers online medical and mental health care. Walmart currently provides counseling via Walmart Health, a health center located in a separate building alongside Walmart Supercenters. In Georgia, Walmart Health offers in-person mental health counseling and in Arkansas customers can receive online counseling. Later this year, counseling services will become available at Walmart Health locations in Illinois and Florida, a spokeswoman said. © 2021 The New York Times Company

Covid-19 linked to depression and dementia, study suggests

By Rachel Schraer People diagnosed with Covid-19 in the previous six months were more likely to develop depression, dementia, psychosis and stroke, researchers have found. A third of those with a previous Covid infection went on to develop or have a relapse of a psychological or neurological condition. But those admitted to hospital or in intensive care had an even higher risk. The study authors pointed to both the effects of stress, and the virus having a direct impact on the brain. UK scientists looked at the electronic medical records of more than half a million patients in the US, and their chances of developing one of 14 common psychological or neurological conditions, including: Anxiety and mood disorders were the most common diagnosis among those with Covid, and these were more likely to be down to the stress of the experience of being very ill or taken to hospital, the researchers explained. Conditions like stroke and dementia were more likely to be down to the biological impacts of the virus itself, or of the body's reaction to infection in general. Covid-19 was not associated with an increased risk of Parkinson's or Guillain-Barré syndrome (a risk from flu). Cause and effect The study, published in the Lancet Psychiatry journal, was observational. So the researchers couldn't say whether Covid had caused any of the diagnoses - and some people would have had a stroke or depression in the next six months regardless. But by comparing a group of people who had had Covid-19 with two groups - with flu and with other respiratory infections respectively - the researchers at the University of Oxford concluded Covid was associated with more subsequent brain conditions than other respiratory illnesses. © 2021 BBC.

Science Plays the Long Game. But People Have Mental Health Issues Now.

By Benedict Carey When I joined the Science staff in 2004, reporters in the department had a saying, a reassuring mantra of sorts: “People will always come to the science section, if only to read about progress.” I think about that a lot as I say goodbye to my job, covering psychiatry, psychology, brain biology and big-data social science, as if they were all somehow related. The behavior beat, as it’s known, allowed tremendous freedom: I wrote about the mental upsides of binge drinking, playing the lotto and sports fandom. I covered basic lab research, the science of learning and memory, the experience of recurrent anguish, through the people who had to live with it. And much, much more. Like most science reporters, I had wanted to report on something big, to have a present-at-the-creation run that would shake up our understanding of mental health problems. At minimum, I expected research that would help people in distress improve their lives. But during my tenure, the science informing mental health care did not proceed smoothly along any trajectory. On the one hand, the field attracted enormous scientific talent, and there were significant discoveries, particularly in elucidating levels of consciousness in brain injury patients who appear unresponsive; and in formulating the first persuasive hypothesis of a cause for schizophrenia, based in brain biology. On the other hand, the science did little to improve the lives of the millions of people living with persistent mental distress. Almost every measure of our collective mental health — rates of suicide, anxiety, depression, addiction deaths, psychiatric prescription use — went the wrong direction, even as access to services expanded greatly. What happened? After 20 years covering the field, here and at The Los Angeles Times, I have a few theories, and some ideas on what might be required to turn things around. © 2021 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 27757 - Posted: 04.03.2021

How to Spot Depression in Young Children

By Perri Klass, M.D. When parents bring their children in for medical care these days, there is no such thing as a casual, “Hey, how’s it going?” We doctors walk into every exam room prepared to hear a story of sadness and stress, or at the very least, of coping and keeping it together in this very hard year, full of isolation, loss, tragedy and hardship, with routines disrupted and comfort hard to come by. Parents have carried heavy burdens of stress and responsibility, worrying about themselves but also watching their children struggle, and there is worldwide concern about depression and suicidality among young people. But it isn’t only the adults and the young adults and teenagers who are suffering and sad; young children can also experience depression, but it can look very different, which makes it challenging for parents — or doctors — to recognize it and provide help. Rachel Busman, a clinical psychologist at the Child Mind Institute in New York City, said that it can be hard to think about depression in younger children because we picture childhood as a time of innocence and joy. But as many as 2 to 3 percent of children ages 6 to 12 can have serious depression, she said. And children with anxiety disorders, which are present in more than 7 percent of children aged 3 to 17, are also at risk for depression. Dr. Helen Egger, until recently the chair of child and adolescent psychiatry at N.Y.U. Langone Health, said that according to her epidemiologic research, between 1 and 2 percent of young children — as young as 3 — are depressed Depression was originally conceived of as an adult problem. Maria Kovacs, professor of psychiatry at the University of Pittsburgh School of Medicine, said that in the 1950s and ’60s, there were child psychiatrists who believed that children did not have sufficient ego development to feel depression, but that research that she and other colleagues did in the ’70s showed that “school age children can suffer from diagnosable depression.” © 2021 The New York Times Company

‘The ketamine blew my mind’: can psychedelics cure addiction and depression?

Alexandra Jones In the summer of 1981, when he was 13, Grant crashed a trail motorbike into a wall at his parents’ house in Cambridgeshire. He’d been hiding it in the shed, but “it was far too powerful for me, and on my very first time starting it in the garden, I smashed it into a wall”. His mother came outside to find the skinny teenager in a heap next to the crumpled motorbike. “I was in a lot of trouble.” Grant hadn’t given this childhood memory much thought in the intervening years, but one hot August day in 2019, it came back to him with such clarity that, at 53, now a stocky father of two, he suddenly understood it as a clue to his dangerously unhealthy relationship with alcohol. The day before, a team of specialists at the Royal Devon and Exeter hospital had given him an intravenous infusion of ketamine, a dissociative hallucinogen, in common use as an anaesthetic since the 1970s, and more recently one of a group of psychedelic drugs being hailed as a silver bullet in the fight to save our ailing mental health. To date, more than 100 patients with conditions as diverse as depression, PTSD and addiction have been treated in research settings across the UK, using a radical new intervention that combines psychedelic drugs with talking therapy. What was once a fringe research interest has become the foundation of a new kind of healthcare, one that, for the first time in modern psychiatric history, purports to not only treat but actually cure mental ill health. And if advocates are to be believed, that cure will be available on the NHS within the next five years. © 2021 Guardian News & Media Limited

Traces of psychedelics make you feel good, but so does placebo, finds unusual ‘self-blinding’ st

By Cathleen O’Grady People who take tiny amounts of LSD, “magic mushrooms,” and related drugs report a range of benefits, from more creativity to improved psychological well-being. But do these microdoses—typically less than 10% of the amount that causes a true psychedelic experience—actually benefit the mind? That’s been a hard question to answer. Placebo-controlled trials are tricky to pull off, because psychedelics are so tightly regulated. Now, researchers have come up with a creative workaround: They’ve enlisted microdosing enthusiasts to hide their drugs in gel capsules and mix them up with empty capsules. The upshot of this “self-blinding” study: Microdosing did lead to improvements in psychological well-being—but so did the placebo capsules. “The benefits are real,” says lead author Balázs Szigeti, a neuroscientist at Imperial College London. “But they are not caused by the pharmacological effects of microdosing.” The findings, however, are “the least interesting thing about this study,” says Noah Haber, a study design specialist at Stanford University. The “very, very clever” method of self-blinding pushes the boundaries of what can be investigated using randomized placebo controls, he says. Getting the new study off the ground wasn’t easy. Obtaining ethical approval to enroll psychedelic-taking volunteers was a “long and difficult process,” Szigeti says. And then he had to go out and find those volunteers, which he did by reaching out to microdosing communities, giving talks at psychedelic societies, and holding an “ask me anything” discussion on Reddit. Szigeti eventually garnered more than 1600 sign-ups, but once potential participants realized they’d have to procure their own psychedelics, interest ebbed, and only 246 ended up in the experiment. © 2021 American Association for the Advancement of Science.

Related chapters from BN: Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology; Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 4: Development of the Brain; Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 27721 - Posted: 03.06.2021

A Better Way to Zap Our Brains

By Kim Tingley The brain is an electrical organ. Everything that goes on in there is a result of millivolts zipping from one neuron to another in particular patterns. This raises the tantalizing possibility that, should we ever decode those patterns, we could electrically adjust them to treat neurological dysfunction — from Alzheimer’s to schizophrenia — or even optimize desirable qualities like intelligence and resilience. Of course, the brain is so complex, and so difficult to access, that this is much easier to imagine than to do. A pair of studies published in January in the journal Nature Medicine, however, demonstrate that electrical stimulation can address obsessive-compulsive urges and symptoms of depression with surprising speed and precision. Mapping participants’ brain activity when they experienced certain sensations allowed researchers to personalize the stimulation and modify moods and habits far more directly than is possible through therapy or medication. The results also showed the degree to which symptoms that we tend to categorize as a single disorder — depression, for example — may involve electrical processes that are unique to each person. In the first study, a team from the University of California, San Francisco, surgically implanted electrodes in the brain of a woman whose severe depression had proved resistant to other treatments. For 10 days, they delivered pulses through the electrodes to different areas of the brain at various frequencies and had the patient record her level of depression, anxiety and energy on an iPad. The impact of certain pulses was significant and nuanced. “Within a minute, she would say, ‘I feel like I’m reading a good book,’” says Katherine W. Scangos, a psychiatrist and the study’s lead author. The patient described the effect of another pulse as “less cobwebs and cotton.” © 2021 The New York Times Company

Evolution Could Explain Why Psychotherapy May Work for Depression

By Gary Stix A consensus has emerged in recent years that psychotherapies—in particular, cognitive behavioral therapy (CBT)—rate comparably to medications such as Prozac and Lexapro as treatments for depression. Either option, or the two together, may at times alleviate the mood disorder. In looking more closely at both treatments, CBT—which delves into dysfunctional thinking patterns—may have a benefit that could make it the better choice for a patient.The reason may be rooted in our deep evolutionary past. Scholars suggest humans may become depressed to help us focus attention on a problem that might cause someone to fall out of step with family, friends, clan or the larger society—an outcast status that, especially in Paleolithic times, would have meant an all-but-certain tragic fate. Depression, by this account, came about as a mood state to make us think long and hard about behaviors that may have caused us to become despondent because some issue in our lives is socially problematic. A recent article in American Psychologist, the flagship publication of the American Psychological Association, weighs what the possible evolutionary origins of depression might mean for arguments about the merits of psychotherapy versus antidepressants. In the article, Steven D. Hollon, a professor of psychology at Vanderbilt University, explores the implications of helping a patient come to grips with the underlying causes of a depression—which is the goal of CBT, and is also in line with an evolutionary explanation. The anodyne effects of an antidepressant, by contrast, may divert a patient from engaging in the reflective process for which depression evolved—a reason perhaps that psychotherapy appears to produce a more enduring effect than antidepressants. Scientific American spoke with Hollon about his ideas on the topic.

Prozac turns guppies into ‘zombies’

By Warren Cornwall Prozac might need a new warning label: “Caution: This antidepressant may turn fish into zombies.” Researchers have found that long-term exposure to the drug makes guppies act more alike, wiping out some of the typical behavioral differences that distinguish them. That could be a big problem when the medication—technically named fluoxetine—washes into streams and rivers, potentially making fish populations more vulnerable to predators and other threats. In recent decades, scientists have uncovered a plethora of ways that pharmaceuticals affect animals in the lab and in the wild, such as by altering courtship, migration, and anxiety. The drugs find their way into the environment through water that pours from sewage treatment plants, which is rarely filtered to remove the chemicals. But the findings are usually based on an average taken from combining measurements of all the individual animals in a group. Giovanni Polverino, a behavioral ecologist at the University of Western Australia, Perth, and colleagues wondered whether this calculation obscured important but subtle insights about individual animals. Did the drug change behavior similarly in all the creatures in a group? Or were certain kinds of “personalities” affected more strongly? To find out, Polverino’s team captured 3600 guppies (Poecilia reticulata)—a common silvery fish often used in labs that grows to half the length of an average human’s pinkie—from a creek in northeastern Australia. In the laboratory, the fish and their offspring—as many as six generations—spent 2 years in tanks filled with either freshwater, water with fluoxetine at levels common in the wild, or a higher dose similar to places near sewage outflows. © 2021 American Association for the Advancement of Science.

Sensor helps scientists spy on serotonin activity in mice in real time

by Peter Hess A new engineered protein that glows in the presence of serotonin enables researchers to track the neurotransmitter’s levels and location in the brains of living mice, according to a new study. This ‘serotonin sensor’ could help elucidate serotonin’s role in autism, experts say. Serotonin helps regulate mood, circulation and digestion, among other functions. Some people with autism have elevated levels of serotonin in their blood. Other evidence links serotonin to social behavior in mice. “Serotonin is wildly important both for basic research and human health. And for the longest time, ways to measure it were very indirect,” says co-lead researcher Loren Looger, professor of neuroscience at the University of California, San Diego. “Only with sensors like this can one follow it in vivo, which is critical.” Unlike other tools for measuring serotonin, the sensor can also show changes in serotonin activity over time, making it an exciting tool for autism research, says Jeremy Veenstra-VanderWeele, professor of psychiatry at Columbia University, who was not involved in the study. “This tool will make it possible to understand the relationships between serotonin release and complex behaviors, including in different genetic mouse models related to autism,” he says. “I imagine that this tool will come into fairly broad use.” Programmable protein: The new sensor originated from one described last year that detects a different neurotransmitter, acetylcholine. Looger and his team used a computer algorithm to redesign the acetylcholine-binding portion of the sensor protein so that it could attach to serotonin instead. © 2021 Simons Foundation

How ecstasy and psilocybin are shaking up psychiatry

Paul Tullis On a sunny day in London in 2015, Kirk Rutter rode the Tube to Hammersmith Hospital in hopes of finally putting an end to his depression. Rutter had lived with the condition off and on for years, but the burden had grown since the death of his mother in 2011, followed by a relationship break-up and a car accident the year after. It felt as if his brain was stuck on what he describes as “an automatic circuit”, repeating the same negative thoughts like a mantra: “‘Everything I do turns to crap.’ I actually believed that,” he recalls. The visit to Hammersmith was a preview. He would be returning the next day to participate in a study, taking a powerful hallucinogen under the guidance of Robin Carhart-Harris, a psychologist and neuroscientist at Imperial College London. Years of talking therapy and a variety of anti-anxiety medications had failed to improve Rutter’s condition, qualifying him for the trial. “Everyone was super nice, like really lovely, and especially Robin,” Rutter recalls. Carhart-Harris led him to a room with a magnetic resonance imaging (MRI) machine, so researchers could acquire a baseline of his brain activity. Then he showed Rutter where he would spend his time while on the drug. Carhart-Harris asked him to lie down and played him some of the music that would accompany the session. He explained that he would have on hand a drug that could neutralize the hallucinogen, if necessary. Then the two practised a grounding technique, to help calm Rutter in the event that he became overwhelmed. Without warning, Rutter burst into tears. “I think I knew this was going to be unpacking a lot — I was carrying a bit of a load at the time,” Rutter says. © 2021 Springer Nature Limited

Psychedelics as therapy

Research shows that hallucinogens can be highly effective treatments for anxiety, depression, addiction, and trauma. Here's everything you need to know: Aren't psychedelic drugs illegal? Under federal and most states' laws, they are, but a push to legalize or decriminalize the drugs is gaining momentum. On Election Day, Oregon voters made their state the first to legalize the active ingredient in "magic mushrooms" — psilocybin — for mental health therapy in a controlled setting with a therapist. Washington, D.C., voters passed Initiative 81, making the city at least the fifth to decriminalize magic mushrooms. Similar legislation has been proposed in California, Vermont, and Iowa. Last summer, Canada issued four terminally ill patients exemptions to take psilocybin for end-of-life anxiety and depression. British Columbia resident Mona Strelaeff, 67, got an exemption for treatment for trauma, addiction, depression, and anxiety. "All the unresolved trauma," Strelaeff said, "it came back and I was beyond terrified, shaking uncontrollably, and crying." She said that psilocybin therapy helped her conquer "those tough memories" and today she "ain't afraid of jack (s---)." How does psychedelic therapy work? Participants usually take psilocybin or LSD in a relaxing setting, lying down with blindfolds and headphones on, listening to music. Trained supervisors encourage them to "go inward and to kind of experience whatever is going to come up," said Alan Davis, who studies psychedelics at Johns Hopkins University. Bad psilocybin trips are rare — Johns Hopkins and NYU researchers conducted 500 sessions without observing any "serious adverse effects" — but they can occur. Advocates say careful dose control, supervision, and controlled settings are very important. Psilocybin sessions typically last between four and six hours, while LSD sessions go on for 12. Robin Carhart-Harris, who runs the Centre for Psychedelic Research at Imperial College in London, theorized that such sessions can "reboot" the brain in a way similar to a near-death or intense spiritual experience. ® 2021 The Week Publications Inc.,

Psychedelics: Weighing the Healing Power

Kayt Sukel Psychedelic drugs conjure images of tie-dyed tee shirts, Woodstock, and Vietnam War protests. While early research into the properties of drugs like psilocybin (magic mushrooms) and lysergic acid diethylamide (LSD) during the middle of the 20th century suggested therapeutic potential for diverse mental health conditions, their role in the 1960s anti-war and counterculture movement made them suspect by law enforcement. Not long after American psychologist Timothy Leary called for people to “turn on, tune in, and drop out,” endorsing the regular use of psychedelic drugs for health and well-being, the federal Controlled Substances Act classified them as highly dangerous Schedule 1 compounds, or drugs with “no currently accepted medical use and a high potential for abuse.” “Initially, psychedelics showed quite a lot of promise for treating a wide range of mental health conditions—in particular, addiction and post-traumatic stress disorder (PTSD),” says Anil Seth, co-director of the Sackler Centre for Consciousness Science at the University of Sussex in the United Kingdom. “There’s long been a blame game going regarding what led to these drugs being outlawed, mostly focusing on people like Timothy Leary promoting indiscriminate use of what we know are quite powerful drugs. But the end result was that, despite their promise, it became nearly impossible for anyone to do any research at all on them.” Over the past decade, however, there has been a revival of psychopharmacology and neuroscience research into the effects of psychedelic drugs. In fact, despite continuing legal barriers and funding challenges involved with using these banned drugs in research studies—many researchers wait years for Food and Drug Administration approvals and require funding from non-governmental agencies to move forward—several unique research centers, including the Centre for Psychedelic Research at Imperial College London and Johns Hopkins University’s Center for Psychedelics and Consciousness Research, are now actively studying LSD, psilocybin, and dimethyltryptamine (DMT), from both basic science and clinical perspectives. © 2021 The Dana Foundation

Can an Algorithm Prevent Suicide?

By Benedict Carey At a recent visit to the Veterans Affairs clinic in the Bronx, Barry, a decorated Vietnam veteran, learned that he belonged to a very exclusive club. According to a new A.I.-assisted algorithm, he was one of several hundred V.A. patients nationwide, of six million total, deemed at imminent risk of suicide. The news did not take him entirely off guard. Barry, 69, who was badly wounded in the 1968 Tet offensive, had already made two previous attempts on his life. “I don’t like this idea of a list, to tell you the truth — a computer telling me something like this,” Barry, a retired postal worker, said in a phone interview. He asked that his surname be omitted for privacy. “But I thought about it,” Barry said. “I decided, you know, OK — if it’s going to get me more support that I need, then I’m OK with it.” For more than a decade, health officials have watched in vain as suicide rates climbed steadily — by 30 percent nationally since 2000 — and rates in the V.A. system have been higher than in the general population. The trends have defied easy explanation and driven investment in blind analysis: machine learning, or A.I.-assisted algorithms that search medical and other records for patterns historically associated with suicides or attempts in large clinical populations. Doctors have traditionally gauged patients’ risks by looking at past mental health diagnoses and incidents of substance abuse, and by drawing on experience and medical instinct. But these evaluations fall well short of predictive, and the artificially intelligent programs explore many more factors, like employment and marital status, physical ailments, prescription history and hospital visits. These algorithms are black boxes: They flag a person as at high risk of suicide, without providing any rationale. But human intelligence isn’t necessarily better at the task. “The fact is, we can’t rely on trained medical experts to identify people who are truly at high risk,” said Dr. Marianne S. Goodman, a psychiatrist at the Veterans Integrated Service Network in the Bronx, and a clinical professor of medicine at the Icahn School of Medicine at Mount Sinai. “We’re no good at it.” © 2020 The New York Times Company

How to keep your sadness from turning into depression

By Jelena Kecmanovic Across the spectrum, mental health problems seem to be on the rise. One-quarter of Americans reported moderate to severe depression this summer and another quarter said they suffered from mild depression, a recent study reported. These findings are similar to surveys done by the Census Bureau and the Centers for Disease Control and Prevention. A third of Americans now show signs of clinical anxiety or depression, Census Bureau finds. Former first lady Michelle Obama highlighted the problem for many when she said in August that she has been dealing with “low-grade depression.” As a psychologist, I hear almost daily how the combination of coronavirus, racial unrest, economic uncertainty and political crisis are leading many people to feel a lot worse than usual. “It is not at all surprising that we are seeing the significant increase in distress. It’s a normal reaction to an abnormal situation,” said Judy Beck, president of the Beck Institute for Cognitive Behavior Therapy in Philadelphia and author of the widely used mental health textbook “Cognitive Behavior Therapy: Basics and Beyond.” But an important difference exists between having depressive symptoms — such as sadness, fatigue and loss of motivation — and a full-blown major depressive episode that can affect your ability to function at work and home for weeks or months. The amount and duration of the symptoms, as well as the degree to which they impair one’s life all play a role in diagnosing clinical depression. Extensive research suggests that certain ways of thinking and behaving can hasten the plunge into clinical depression, while others can prevent it. As we head into winter, which can stress the coping skills of many people, here are some strategies that can help you resist the depressive downward spiral. 1. Reduce overthinking. When we feel down, we tend to think about the bad things repeatedly, often trying to figure out why they’ve happened. Research shows that some people are especially prone to this kind of “depressive rumination.” They overanalyze everything, hoping to think their way out of feeling bad, and fret about consequences of their sadness.

Postpartum depression may affect new mothers for at least three years after childbirth

By Linda Searing The “baby blues” that women can experience after giving birth usually go away within a week or two, but it now appears that more severe depressive symptoms, known as postpartum depression, may affect some new mothers for at least three years. Research from the National Institutes of Health, which tracked 4,866 women for three years after childbirth, found that about 25 percent of the women reported moderate to high levels of depressive symptoms at some point and that the remaining 75 percent experienced low-level depressive symptoms throughout the study. The “baby blues” typically include such symptoms as mood swings, anxiety and trouble sleeping, whereas postpartum depression symptoms — generally more intense and longer lasting — may include excessive crying, overwhelming fatigue, loss of appetite, difficulty bonding with the baby, feelings of inadequacy, hopelessness and more. The NIH research, published in the journal Pediatrics, encourages pediatricians to screen their tiny patients’ mothers for depressive symptoms during the children’s regular checkups, noting that “mothers’ mental health is critical to children’s well-being and development.” The researchers note that maternal depression increases a child’s risk for cognitive, emotional and behavioral problems. Getting treatment, however, should not only ease a mother’s symptoms but also improve her child’s odds for a favorable developmental outcome.

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 4: Development of the Brain
Link ID: 27573 - Posted: 11.10.2020

Depression in Pregnancy May Raise Risk of Childhood Asthma

By Nicholas Bakalar A mother’s psychological distress during pregnancy may increase the risk for asthma in her child, a new study suggests. Researchers had the parents of 4,231 children fill out well-validated questionnaires on psychological stress in the second trimester of pregnancy, and again three years later. The mothers also completed questionnaires at two and six months after giving birth. The study, in the journal Thorax, found that 362 of the mothers and 167 of the fathers had clinically significant psychological distress during the mothers’ pregnancies. When the children were 10 years old, parents reported whether their child had ever been diagnosed with asthma. As an extra measure, the researchers tested the children using forced expiratory volume, or FEV, a standard clinical test of lung function. After controlling for age, smoking during pregnancy, body mass index, a history of asthma and other factors, they found that maternal depression and anxiety during pregnancy was significantly associated with both diagnoses of asthma and poorer lung function in their children. There was no association between childhood asthma and parents’ psychological distress in the years after pregnancy, and no association with paternal psychological stress at any time. “Of course, this could be only one of many causes of asthma,” said the lead author, Dr. Evelien R. van Meel of Erasmus University in Rotterdam, “but we corrected for many confounders, and we saw the effect only in mothers. This seems to suggest that there’s something going on in the uterus. But this is an observational study, and we can’t say that it’s a causal effect.” © 2020 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 4: Development of the Brain
Link ID: 27534 - Posted: 10.21.2020

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