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Distinct mood, apathy profiles found in bipolar disorder patients
Neuroimaging
called parallel independent component analysis, or pICA, reported Wenhau Jiang and his associates.
pICA is a technique that enables researchers to analyze several modalities and the interconnections between them. The approach, which is considered fairly new, has been applied most often to neuropsychiatric disorders (Front Genet. 2015;6:276). The pICA involves using structural MRI and the Positive and Negative Syndrome Scale (PANSS) scores to assess the relationship between gray matter concentration in different areas of the brain and bipolar mood characteristics.
In the current study, published in NeuroImage: Clinical, Mr. Jiang and his associates used data from 110 patients with bipolar I and bipolar II from a large study conducted at the Norwegian Center for Mental Disorders Research in Oslo.
All patients were aged 18-65 years and had an IQ of over 70, and none had a history of severe head trauma. Most of the patients were women, about half had at least one psychotic episode, and all provided PANSS scores, reported Mr. Jiang of the department of psychology at Georgia State University in Atlanta and his associates.
After the patients were scanned, pICA was used to examine the preprocessed structural images and the PANSS item scores. The pICA showed two distinct profiles. One group showed preserved gray matter concentration in the right middle/superior temporal gyrus on the rMRI. These participants had more anxiety, and guilty feelings on the PANSS. Overall, participants with higher preserved gray matter concentration in bilateral, frontal, and parietal and left temporal regions show milder severity of these characteristics.
In the second pICA profile, participants with higher preserved gray matter concentration in bilateral front, parietal, and left temporal regions showed milder severity of several characteristics including blunted affect, emotional withdrawal, and passive/apathetic social withdrawal.
The investigators noted: “The mood profile was correlated with reductions in the right temporal gyrus, while the apathy/asocial profile correlated with a more widespread network including frontal, temporal, and parietal regions. It implicated the GM [gray matter] deficits in regional temporal lobe and frontal-temporal-parietal circuits that were separately related to clinical profiles as mood and apathy.”
The study was supported by the National Institutes of Health, the Research Council of Norway, the South-East Norway Health Authority, and the European Community’s Seventh Framework Programme. No author disclosures were stated.
SOURCE: Jiang W et al. Neuroimage Clin. 2019 Aug 19. doi: 10.1016/j.nicl.2019.101989.
Neuroimaging
Neuroimaging
called parallel independent component analysis, or pICA, reported Wenhau Jiang and his associates.
pICA is a technique that enables researchers to analyze several modalities and the interconnections between them. The approach, which is considered fairly new, has been applied most often to neuropsychiatric disorders (Front Genet. 2015;6:276). The pICA involves using structural MRI and the Positive and Negative Syndrome Scale (PANSS) scores to assess the relationship between gray matter concentration in different areas of the brain and bipolar mood characteristics.
In the current study, published in NeuroImage: Clinical, Mr. Jiang and his associates used data from 110 patients with bipolar I and bipolar II from a large study conducted at the Norwegian Center for Mental Disorders Research in Oslo.
All patients were aged 18-65 years and had an IQ of over 70, and none had a history of severe head trauma. Most of the patients were women, about half had at least one psychotic episode, and all provided PANSS scores, reported Mr. Jiang of the department of psychology at Georgia State University in Atlanta and his associates.
After the patients were scanned, pICA was used to examine the preprocessed structural images and the PANSS item scores. The pICA showed two distinct profiles. One group showed preserved gray matter concentration in the right middle/superior temporal gyrus on the rMRI. These participants had more anxiety, and guilty feelings on the PANSS. Overall, participants with higher preserved gray matter concentration in bilateral, frontal, and parietal and left temporal regions show milder severity of these characteristics.
In the second pICA profile, participants with higher preserved gray matter concentration in bilateral front, parietal, and left temporal regions showed milder severity of several characteristics including blunted affect, emotional withdrawal, and passive/apathetic social withdrawal.
The investigators noted: “The mood profile was correlated with reductions in the right temporal gyrus, while the apathy/asocial profile correlated with a more widespread network including frontal, temporal, and parietal regions. It implicated the GM [gray matter] deficits in regional temporal lobe and frontal-temporal-parietal circuits that were separately related to clinical profiles as mood and apathy.”
The study was supported by the National Institutes of Health, the Research Council of Norway, the South-East Norway Health Authority, and the European Community’s Seventh Framework Programme. No author disclosures were stated.
SOURCE: Jiang W et al. Neuroimage Clin. 2019 Aug 19. doi: 10.1016/j.nicl.2019.101989.
called parallel independent component analysis, or pICA, reported Wenhau Jiang and his associates.
pICA is a technique that enables researchers to analyze several modalities and the interconnections between them. The approach, which is considered fairly new, has been applied most often to neuropsychiatric disorders (Front Genet. 2015;6:276). The pICA involves using structural MRI and the Positive and Negative Syndrome Scale (PANSS) scores to assess the relationship between gray matter concentration in different areas of the brain and bipolar mood characteristics.
In the current study, published in NeuroImage: Clinical, Mr. Jiang and his associates used data from 110 patients with bipolar I and bipolar II from a large study conducted at the Norwegian Center for Mental Disorders Research in Oslo.
All patients were aged 18-65 years and had an IQ of over 70, and none had a history of severe head trauma. Most of the patients were women, about half had at least one psychotic episode, and all provided PANSS scores, reported Mr. Jiang of the department of psychology at Georgia State University in Atlanta and his associates.
After the patients were scanned, pICA was used to examine the preprocessed structural images and the PANSS item scores. The pICA showed two distinct profiles. One group showed preserved gray matter concentration in the right middle/superior temporal gyrus on the rMRI. These participants had more anxiety, and guilty feelings on the PANSS. Overall, participants with higher preserved gray matter concentration in bilateral, frontal, and parietal and left temporal regions show milder severity of these characteristics.
In the second pICA profile, participants with higher preserved gray matter concentration in bilateral front, parietal, and left temporal regions showed milder severity of several characteristics including blunted affect, emotional withdrawal, and passive/apathetic social withdrawal.
The investigators noted: “The mood profile was correlated with reductions in the right temporal gyrus, while the apathy/asocial profile correlated with a more widespread network including frontal, temporal, and parietal regions. It implicated the GM [gray matter] deficits in regional temporal lobe and frontal-temporal-parietal circuits that were separately related to clinical profiles as mood and apathy.”
The study was supported by the National Institutes of Health, the Research Council of Norway, the South-East Norway Health Authority, and the European Community’s Seventh Framework Programme. No author disclosures were stated.
SOURCE: Jiang W et al. Neuroimage Clin. 2019 Aug 19. doi: 10.1016/j.nicl.2019.101989.
FROM NEUROIMAGE: CLINICAL
FGF21 could be tied to psychopathology of bipolar mania
Patients’ fibroblast growth factor–21 levels dropped after 4 weeks of taking antipsychotics
Fibroblast growth factor–21 (FGF21), a protein that regulates carbohydrate and lipid metabolism, could be a biomarker in patients with bipolar mania, a new study suggests.
“In addition, our data indicates that FGF21 may monitor and/or prevent metabolic abnormalities induced by psychotropic drugs,” wrote Qing Hu of Xiamen City Xianyue Hospital, in Fujian, China, and associates. The study was published in Psychiatry Research.
To investigate how the expression of FGF21 changes in response to psychotropics taken by patients with bipolar mania, the researchers recruited 99 inpatients with bipolar mania with or without psychosis and 99 healthy controls. Eighty-two of the patients received psychotropics only, and 17 received psychotropics and lipid-lowering or hypotensive agents. Those in the smaller group were later excluded from follow-up.
At baseline, no significant differences were found between the patients and controls on several metabolic measures, such as cholesterol and apolipoprotein. The patients with bipolar mania had higher uric acid and triglyceride levels, although the latter was not statistically significant. However, compared with the FGF21 serum levels of the controls.
After 4 weeks of taking the antipsychotics, the patients experienced increases in several metabolic measures, such as BMI (23.68 kg/m2 vs. 24.02 kg/m2), LDL cholesterol (2.61 mg/dL vs. 2.98 mg/dL), and glucose (4.74 mg/dL vs. 4.88 mg/dL). However, their FGF21 levels declined, from 279.45 pg/mL to 215.12 pg/mL.
“In light of these findings, our future research will focus on investigating whether ... the change in FGF21 expression is a causal factor or a consequence of bipolar disorder,” the investigators wrote.
They cited several limitations. One is that psychotropic dosages were not discussed, and another is that evaluation data from the Young Mania Rating Scale were missing.
The researchers reported no conflicts of interest.
SOURCE: Hu Q et al. Psychiatry Res. 2019;272:643-8.
Patients’ fibroblast growth factor–21 levels dropped after 4 weeks of taking antipsychotics
Patients’ fibroblast growth factor–21 levels dropped after 4 weeks of taking antipsychotics
Fibroblast growth factor–21 (FGF21), a protein that regulates carbohydrate and lipid metabolism, could be a biomarker in patients with bipolar mania, a new study suggests.
“In addition, our data indicates that FGF21 may monitor and/or prevent metabolic abnormalities induced by psychotropic drugs,” wrote Qing Hu of Xiamen City Xianyue Hospital, in Fujian, China, and associates. The study was published in Psychiatry Research.
To investigate how the expression of FGF21 changes in response to psychotropics taken by patients with bipolar mania, the researchers recruited 99 inpatients with bipolar mania with or without psychosis and 99 healthy controls. Eighty-two of the patients received psychotropics only, and 17 received psychotropics and lipid-lowering or hypotensive agents. Those in the smaller group were later excluded from follow-up.
At baseline, no significant differences were found between the patients and controls on several metabolic measures, such as cholesterol and apolipoprotein. The patients with bipolar mania had higher uric acid and triglyceride levels, although the latter was not statistically significant. However, compared with the FGF21 serum levels of the controls.
After 4 weeks of taking the antipsychotics, the patients experienced increases in several metabolic measures, such as BMI (23.68 kg/m2 vs. 24.02 kg/m2), LDL cholesterol (2.61 mg/dL vs. 2.98 mg/dL), and glucose (4.74 mg/dL vs. 4.88 mg/dL). However, their FGF21 levels declined, from 279.45 pg/mL to 215.12 pg/mL.
“In light of these findings, our future research will focus on investigating whether ... the change in FGF21 expression is a causal factor or a consequence of bipolar disorder,” the investigators wrote.
They cited several limitations. One is that psychotropic dosages were not discussed, and another is that evaluation data from the Young Mania Rating Scale were missing.
The researchers reported no conflicts of interest.
SOURCE: Hu Q et al. Psychiatry Res. 2019;272:643-8.
Fibroblast growth factor–21 (FGF21), a protein that regulates carbohydrate and lipid metabolism, could be a biomarker in patients with bipolar mania, a new study suggests.
“In addition, our data indicates that FGF21 may monitor and/or prevent metabolic abnormalities induced by psychotropic drugs,” wrote Qing Hu of Xiamen City Xianyue Hospital, in Fujian, China, and associates. The study was published in Psychiatry Research.
To investigate how the expression of FGF21 changes in response to psychotropics taken by patients with bipolar mania, the researchers recruited 99 inpatients with bipolar mania with or without psychosis and 99 healthy controls. Eighty-two of the patients received psychotropics only, and 17 received psychotropics and lipid-lowering or hypotensive agents. Those in the smaller group were later excluded from follow-up.
At baseline, no significant differences were found between the patients and controls on several metabolic measures, such as cholesterol and apolipoprotein. The patients with bipolar mania had higher uric acid and triglyceride levels, although the latter was not statistically significant. However, compared with the FGF21 serum levels of the controls.
After 4 weeks of taking the antipsychotics, the patients experienced increases in several metabolic measures, such as BMI (23.68 kg/m2 vs. 24.02 kg/m2), LDL cholesterol (2.61 mg/dL vs. 2.98 mg/dL), and glucose (4.74 mg/dL vs. 4.88 mg/dL). However, their FGF21 levels declined, from 279.45 pg/mL to 215.12 pg/mL.
“In light of these findings, our future research will focus on investigating whether ... the change in FGF21 expression is a causal factor or a consequence of bipolar disorder,” the investigators wrote.
They cited several limitations. One is that psychotropic dosages were not discussed, and another is that evaluation data from the Young Mania Rating Scale were missing.
The researchers reported no conflicts of interest.
SOURCE: Hu Q et al. Psychiatry Res. 2019;272:643-8.
FROM PSYCHIATRY RESEARCH
Motivational interviewing may beat relaxation for OCD symptoms
Benefits of the intervention appear to end at 12-month follow-up
Patients with obsessive-compulsive disorder who participate in a motivational interviewing (MI) intervention before treatment with exposure and response prevention (ERP) get better short-term results, compared with those who participate in a relaxation intervention before ERP, a small study shows.
“These findings suggest that MI prior to ERP may confer a small but meaningful benefit for enhancing treatment outcome post ERP,” wrote Randi E. McCabe, PhD, of the department of psychiatry and behavioral neurosciences at McMaster University, Hamilton, Ont., and associates. The study was published in the Journal of Obsessive-Compulsive and Related Disorders.
Dr. McCabe and associates randomized 40 patients aged 18-65 years to the MI intervention and relaxation groups. All participants had a diagnosis of OCD as defined by the Structured Clinical Interview for DSM-IV. They also scored 16 or higher on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and said they were interested in the ERP treatment. After a few participants dropped out, 18 were left in the MI group and 17 were in the relaxation group.
The MI intervention consisted of three sessions that focused on raising awareness about the emotional and financial impact of the illness on patients’ lives, and addressing their concerns about ERP – which is a form of cognitive-behavioral therapy tailored to meet the needs of people with OCD. Meanwhile, the relaxation therapy was a three-session protocol consisting of progressive muscle relaxation.
Participants in both groups experienced reductions in symptoms in the short term, but the symptom reductions were more significant for participants in the MI group. For example, Y-BOCS scores were significantly lower among participants in the MI group posttreatment, compared with those in the relaxation intervention (13.72 vs. 16.20 at 3-month follow-up and 13.81 vs. 14.00 at 6-month follow-up). “Whereas Y-BOCS scores decreased from the severe range to the moderate range in the relaxation group, scores decreased from the severe to the mild range in the MI group,” the investigators wrote. Similar trends were found on other measures, including the DASS-21 depression scale and the DASS-21 anxiety stress scale. At the 12-month follow-up, however, “both groups looked similar,” Dr. McCabe and associates reported.
Several limitations were cited, including the small study size and the baseline differences in the participants’ self-reported OCD symptoms.
Nevertheless, the results suggest that intervening with they wrote.
Dr. McCabe and her associates reported no disclosures.
SOURCE: McCabe RE et al. J Obsessive Compuls Relat Disord. 2019. doi: 10.1016/j.jocrd.2019.1004466.
Benefits of the intervention appear to end at 12-month follow-up
Benefits of the intervention appear to end at 12-month follow-up
Patients with obsessive-compulsive disorder who participate in a motivational interviewing (MI) intervention before treatment with exposure and response prevention (ERP) get better short-term results, compared with those who participate in a relaxation intervention before ERP, a small study shows.
“These findings suggest that MI prior to ERP may confer a small but meaningful benefit for enhancing treatment outcome post ERP,” wrote Randi E. McCabe, PhD, of the department of psychiatry and behavioral neurosciences at McMaster University, Hamilton, Ont., and associates. The study was published in the Journal of Obsessive-Compulsive and Related Disorders.
Dr. McCabe and associates randomized 40 patients aged 18-65 years to the MI intervention and relaxation groups. All participants had a diagnosis of OCD as defined by the Structured Clinical Interview for DSM-IV. They also scored 16 or higher on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and said they were interested in the ERP treatment. After a few participants dropped out, 18 were left in the MI group and 17 were in the relaxation group.
The MI intervention consisted of three sessions that focused on raising awareness about the emotional and financial impact of the illness on patients’ lives, and addressing their concerns about ERP – which is a form of cognitive-behavioral therapy tailored to meet the needs of people with OCD. Meanwhile, the relaxation therapy was a three-session protocol consisting of progressive muscle relaxation.
Participants in both groups experienced reductions in symptoms in the short term, but the symptom reductions were more significant for participants in the MI group. For example, Y-BOCS scores were significantly lower among participants in the MI group posttreatment, compared with those in the relaxation intervention (13.72 vs. 16.20 at 3-month follow-up and 13.81 vs. 14.00 at 6-month follow-up). “Whereas Y-BOCS scores decreased from the severe range to the moderate range in the relaxation group, scores decreased from the severe to the mild range in the MI group,” the investigators wrote. Similar trends were found on other measures, including the DASS-21 depression scale and the DASS-21 anxiety stress scale. At the 12-month follow-up, however, “both groups looked similar,” Dr. McCabe and associates reported.
Several limitations were cited, including the small study size and the baseline differences in the participants’ self-reported OCD symptoms.
Nevertheless, the results suggest that intervening with they wrote.
Dr. McCabe and her associates reported no disclosures.
SOURCE: McCabe RE et al. J Obsessive Compuls Relat Disord. 2019. doi: 10.1016/j.jocrd.2019.1004466.
Patients with obsessive-compulsive disorder who participate in a motivational interviewing (MI) intervention before treatment with exposure and response prevention (ERP) get better short-term results, compared with those who participate in a relaxation intervention before ERP, a small study shows.
“These findings suggest that MI prior to ERP may confer a small but meaningful benefit for enhancing treatment outcome post ERP,” wrote Randi E. McCabe, PhD, of the department of psychiatry and behavioral neurosciences at McMaster University, Hamilton, Ont., and associates. The study was published in the Journal of Obsessive-Compulsive and Related Disorders.
Dr. McCabe and associates randomized 40 patients aged 18-65 years to the MI intervention and relaxation groups. All participants had a diagnosis of OCD as defined by the Structured Clinical Interview for DSM-IV. They also scored 16 or higher on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and said they were interested in the ERP treatment. After a few participants dropped out, 18 were left in the MI group and 17 were in the relaxation group.
The MI intervention consisted of three sessions that focused on raising awareness about the emotional and financial impact of the illness on patients’ lives, and addressing their concerns about ERP – which is a form of cognitive-behavioral therapy tailored to meet the needs of people with OCD. Meanwhile, the relaxation therapy was a three-session protocol consisting of progressive muscle relaxation.
Participants in both groups experienced reductions in symptoms in the short term, but the symptom reductions were more significant for participants in the MI group. For example, Y-BOCS scores were significantly lower among participants in the MI group posttreatment, compared with those in the relaxation intervention (13.72 vs. 16.20 at 3-month follow-up and 13.81 vs. 14.00 at 6-month follow-up). “Whereas Y-BOCS scores decreased from the severe range to the moderate range in the relaxation group, scores decreased from the severe to the mild range in the MI group,” the investigators wrote. Similar trends were found on other measures, including the DASS-21 depression scale and the DASS-21 anxiety stress scale. At the 12-month follow-up, however, “both groups looked similar,” Dr. McCabe and associates reported.
Several limitations were cited, including the small study size and the baseline differences in the participants’ self-reported OCD symptoms.
Nevertheless, the results suggest that intervening with they wrote.
Dr. McCabe and her associates reported no disclosures.
SOURCE: McCabe RE et al. J Obsessive Compuls Relat Disord. 2019. doi: 10.1016/j.jocrd.2019.1004466.
FROM THE JOURNAL OF OBSESSIVE-COMPULSIVE AND RELATED DISORDERS
Probiotics tied to reduced cognitive reactivity in mild, moderate depression
The consumption of some probiotic supplements appears linked to a reduced susceptibility to depressive symptoms, preliminary results of a randomized trial of 71 participants show.
“Results from the current study provide further evidence that some probiotic mixtures can influence thinking and cognition,” reported Bahia Chahwan of the University of Technology Sydney in New South Wales, Australia, and associates. “Although probiotics did not appear to have had a direct effect on depressive symptoms, our results suggest that probiotics potentially act on cognitive processes contributing to depression.” The study was published in the Journal of Affective Disorders.
To conduct the study, the investigators recruited 71 adults over a 12-month period. A nondepressed control group consisting of 20 adults was recruited over 2 months. Across both groups, about 70% of the participants were women, 67% were white, 80% had no abdominal conditions, 78% did not smoke, and 92% did not consume alcohol above the daily recommended intake. The participants were randomly assigned to either the probiotic or placebo group. Members of both groups received instructions on how to consume their respective product, which was a 2-g freeze-dried powder mixture, twice a day over 8 weeks, and were scheduled for weekly monitoring visits.
Several pre- and postintervention measures of depression were compared using several scales, including the MINI International Neuropsychiatric Interview, the Depression Anxiety Stress Scale-21, and the Beck Anxiety Inventory.
Participants in both groups experienced a reduction in depressive symptoms during the trial period. “This is in line with the evidence suggesting that , which forms the basis of activity scheduling as a component for [cognitive-behavioral therapy] for depression,” they wrote.
However, in contrast to the investigators’ hypotheses, participants in the probiotics group did not experience a greater reduction in depressive symptoms than did those on placebo. Instead, the differences between the groups were seen on a measure for depression called cognitive reactivity. Specifically, people with mild/moderate depression who took the probiotics reported lower psychological test scores on cognitive reactivity, compared with controls (45.00 vs. 53.78).
Additional research is needed to look at the impact of differences in gut microbiota strains on people with depressive symptoms, the researchers said. In the meantime, clinicians might do well to consider probiotics as an adjunctive intervention. “Probiotics may be a useful adjunct to potentiate the effects of therapies, such as CBT, which changes cognitive patterns.”
One of the authors, Saskia van Hemert, is an employee of Winclove Probiotics. The other authors reported having no conflicts of interest.
SOURCE: Chahwan B et al. J Affect Disord. 2019. doi: 10.1016/j.jad.2019.04.97.
The consumption of some probiotic supplements appears linked to a reduced susceptibility to depressive symptoms, preliminary results of a randomized trial of 71 participants show.
“Results from the current study provide further evidence that some probiotic mixtures can influence thinking and cognition,” reported Bahia Chahwan of the University of Technology Sydney in New South Wales, Australia, and associates. “Although probiotics did not appear to have had a direct effect on depressive symptoms, our results suggest that probiotics potentially act on cognitive processes contributing to depression.” The study was published in the Journal of Affective Disorders.
To conduct the study, the investigators recruited 71 adults over a 12-month period. A nondepressed control group consisting of 20 adults was recruited over 2 months. Across both groups, about 70% of the participants were women, 67% were white, 80% had no abdominal conditions, 78% did not smoke, and 92% did not consume alcohol above the daily recommended intake. The participants were randomly assigned to either the probiotic or placebo group. Members of both groups received instructions on how to consume their respective product, which was a 2-g freeze-dried powder mixture, twice a day over 8 weeks, and were scheduled for weekly monitoring visits.
Several pre- and postintervention measures of depression were compared using several scales, including the MINI International Neuropsychiatric Interview, the Depression Anxiety Stress Scale-21, and the Beck Anxiety Inventory.
Participants in both groups experienced a reduction in depressive symptoms during the trial period. “This is in line with the evidence suggesting that , which forms the basis of activity scheduling as a component for [cognitive-behavioral therapy] for depression,” they wrote.
However, in contrast to the investigators’ hypotheses, participants in the probiotics group did not experience a greater reduction in depressive symptoms than did those on placebo. Instead, the differences between the groups were seen on a measure for depression called cognitive reactivity. Specifically, people with mild/moderate depression who took the probiotics reported lower psychological test scores on cognitive reactivity, compared with controls (45.00 vs. 53.78).
Additional research is needed to look at the impact of differences in gut microbiota strains on people with depressive symptoms, the researchers said. In the meantime, clinicians might do well to consider probiotics as an adjunctive intervention. “Probiotics may be a useful adjunct to potentiate the effects of therapies, such as CBT, which changes cognitive patterns.”
One of the authors, Saskia van Hemert, is an employee of Winclove Probiotics. The other authors reported having no conflicts of interest.
SOURCE: Chahwan B et al. J Affect Disord. 2019. doi: 10.1016/j.jad.2019.04.97.
The consumption of some probiotic supplements appears linked to a reduced susceptibility to depressive symptoms, preliminary results of a randomized trial of 71 participants show.
“Results from the current study provide further evidence that some probiotic mixtures can influence thinking and cognition,” reported Bahia Chahwan of the University of Technology Sydney in New South Wales, Australia, and associates. “Although probiotics did not appear to have had a direct effect on depressive symptoms, our results suggest that probiotics potentially act on cognitive processes contributing to depression.” The study was published in the Journal of Affective Disorders.
To conduct the study, the investigators recruited 71 adults over a 12-month period. A nondepressed control group consisting of 20 adults was recruited over 2 months. Across both groups, about 70% of the participants were women, 67% were white, 80% had no abdominal conditions, 78% did not smoke, and 92% did not consume alcohol above the daily recommended intake. The participants were randomly assigned to either the probiotic or placebo group. Members of both groups received instructions on how to consume their respective product, which was a 2-g freeze-dried powder mixture, twice a day over 8 weeks, and were scheduled for weekly monitoring visits.
Several pre- and postintervention measures of depression were compared using several scales, including the MINI International Neuropsychiatric Interview, the Depression Anxiety Stress Scale-21, and the Beck Anxiety Inventory.
Participants in both groups experienced a reduction in depressive symptoms during the trial period. “This is in line with the evidence suggesting that , which forms the basis of activity scheduling as a component for [cognitive-behavioral therapy] for depression,” they wrote.
However, in contrast to the investigators’ hypotheses, participants in the probiotics group did not experience a greater reduction in depressive symptoms than did those on placebo. Instead, the differences between the groups were seen on a measure for depression called cognitive reactivity. Specifically, people with mild/moderate depression who took the probiotics reported lower psychological test scores on cognitive reactivity, compared with controls (45.00 vs. 53.78).
Additional research is needed to look at the impact of differences in gut microbiota strains on people with depressive symptoms, the researchers said. In the meantime, clinicians might do well to consider probiotics as an adjunctive intervention. “Probiotics may be a useful adjunct to potentiate the effects of therapies, such as CBT, which changes cognitive patterns.”
One of the authors, Saskia van Hemert, is an employee of Winclove Probiotics. The other authors reported having no conflicts of interest.
SOURCE: Chahwan B et al. J Affect Disord. 2019. doi: 10.1016/j.jad.2019.04.97.
FROM THE JOURNAL OF AFFECTIVE DISORDERS
Siblings of bipolar disorder patients at higher cardiometabolic disease risk
The siblings of patients with bipolar disorder have a higher prevalence of dyslipidemia and higher rates of ischemic stroke than do controls, results of a longitudinal cohort study suggest.
, wrote Wen-Yen Tsao, MD, of the department of psychiatry at Taipei Veterans General Hospital in Taiwan, and associates. Previous research has identified several overlapping genes between cardiometabolic diseases and mood disorders. In addition, polymorphisms of several genes tied to obesity have been associated with bipolar disorder.
In the current study, Dr. Tsao and associates analyzed the Taiwan National Health Insurance Research Database, which includes health care data from more than 99% of the Taiwanese population (J Affect Disord. 2019 Jun 15. doi: 10.1016/j.jad.2019.04.094). Adults born before 1990 who had no psychiatric disorders, a sibling with bipolar disorder, and a metabolic disorder were enrolled as the study cohort. A control group was identified randomly. By way of ICD-9-CM codes, people with type 2 diabetes, hypertension, dyslipidemia, and obesity were identified in both cohorts. The investigators followed the metabolic status of 7,225 unaffected siblings of bipolar disorder patients and 28,900 controls from 1996 to 2011.
Dr. Tsao and associates found that the family members who had siblings with bipolar disorder had a higher prevalence of dyslipidemia (5.4% vs. 4.5%; P = .001), compared with controls. The group with siblings with bipolar disorder also were diagnosed with type 2 diabetes at a younger age (34.81 vs. 37.22; P = .024), and had a higher prevalence of any stroke (1.5 vs. 1.1%; P = .007) and ischemic stroke (0.7% vs. 0.4%, P = .001), compared with controls.
A subanalysis showed that the higher risk of any stroke (odds ratio, 1.38; 95% confidence interval, 1.02-1.85) and ischemic stroke (OR, 2.43; 95% CI, 1.60-3.70) pertained only to male siblings. That gender-specific finding might be attributed to differences in plasma triglyceride clearance between men and women, the researchers wrote.
The findings might not be generalizable to other populations, the investigators noted. In addition, they said, the prevalence of cardiometabolic disease in the groups studied might be underestimated.
“Our results may motivate additional studies to evaluate genetic factors, psychosocial factors, and other pathophysiology of bipolar disorder,” they wrote.
The study was funded by Taiwan’s Ministry of Science and Technology, and Taipei Veterans General Hospital. The researchers cited no conflicts of interest.
The siblings of patients with bipolar disorder have a higher prevalence of dyslipidemia and higher rates of ischemic stroke than do controls, results of a longitudinal cohort study suggest.
, wrote Wen-Yen Tsao, MD, of the department of psychiatry at Taipei Veterans General Hospital in Taiwan, and associates. Previous research has identified several overlapping genes between cardiometabolic diseases and mood disorders. In addition, polymorphisms of several genes tied to obesity have been associated with bipolar disorder.
In the current study, Dr. Tsao and associates analyzed the Taiwan National Health Insurance Research Database, which includes health care data from more than 99% of the Taiwanese population (J Affect Disord. 2019 Jun 15. doi: 10.1016/j.jad.2019.04.094). Adults born before 1990 who had no psychiatric disorders, a sibling with bipolar disorder, and a metabolic disorder were enrolled as the study cohort. A control group was identified randomly. By way of ICD-9-CM codes, people with type 2 diabetes, hypertension, dyslipidemia, and obesity were identified in both cohorts. The investigators followed the metabolic status of 7,225 unaffected siblings of bipolar disorder patients and 28,900 controls from 1996 to 2011.
Dr. Tsao and associates found that the family members who had siblings with bipolar disorder had a higher prevalence of dyslipidemia (5.4% vs. 4.5%; P = .001), compared with controls. The group with siblings with bipolar disorder also were diagnosed with type 2 diabetes at a younger age (34.81 vs. 37.22; P = .024), and had a higher prevalence of any stroke (1.5 vs. 1.1%; P = .007) and ischemic stroke (0.7% vs. 0.4%, P = .001), compared with controls.
A subanalysis showed that the higher risk of any stroke (odds ratio, 1.38; 95% confidence interval, 1.02-1.85) and ischemic stroke (OR, 2.43; 95% CI, 1.60-3.70) pertained only to male siblings. That gender-specific finding might be attributed to differences in plasma triglyceride clearance between men and women, the researchers wrote.
The findings might not be generalizable to other populations, the investigators noted. In addition, they said, the prevalence of cardiometabolic disease in the groups studied might be underestimated.
“Our results may motivate additional studies to evaluate genetic factors, psychosocial factors, and other pathophysiology of bipolar disorder,” they wrote.
The study was funded by Taiwan’s Ministry of Science and Technology, and Taipei Veterans General Hospital. The researchers cited no conflicts of interest.
The siblings of patients with bipolar disorder have a higher prevalence of dyslipidemia and higher rates of ischemic stroke than do controls, results of a longitudinal cohort study suggest.
, wrote Wen-Yen Tsao, MD, of the department of psychiatry at Taipei Veterans General Hospital in Taiwan, and associates. Previous research has identified several overlapping genes between cardiometabolic diseases and mood disorders. In addition, polymorphisms of several genes tied to obesity have been associated with bipolar disorder.
In the current study, Dr. Tsao and associates analyzed the Taiwan National Health Insurance Research Database, which includes health care data from more than 99% of the Taiwanese population (J Affect Disord. 2019 Jun 15. doi: 10.1016/j.jad.2019.04.094). Adults born before 1990 who had no psychiatric disorders, a sibling with bipolar disorder, and a metabolic disorder were enrolled as the study cohort. A control group was identified randomly. By way of ICD-9-CM codes, people with type 2 diabetes, hypertension, dyslipidemia, and obesity were identified in both cohorts. The investigators followed the metabolic status of 7,225 unaffected siblings of bipolar disorder patients and 28,900 controls from 1996 to 2011.
Dr. Tsao and associates found that the family members who had siblings with bipolar disorder had a higher prevalence of dyslipidemia (5.4% vs. 4.5%; P = .001), compared with controls. The group with siblings with bipolar disorder also were diagnosed with type 2 diabetes at a younger age (34.81 vs. 37.22; P = .024), and had a higher prevalence of any stroke (1.5 vs. 1.1%; P = .007) and ischemic stroke (0.7% vs. 0.4%, P = .001), compared with controls.
A subanalysis showed that the higher risk of any stroke (odds ratio, 1.38; 95% confidence interval, 1.02-1.85) and ischemic stroke (OR, 2.43; 95% CI, 1.60-3.70) pertained only to male siblings. That gender-specific finding might be attributed to differences in plasma triglyceride clearance between men and women, the researchers wrote.
The findings might not be generalizable to other populations, the investigators noted. In addition, they said, the prevalence of cardiometabolic disease in the groups studied might be underestimated.
“Our results may motivate additional studies to evaluate genetic factors, psychosocial factors, and other pathophysiology of bipolar disorder,” they wrote.
The study was funded by Taiwan’s Ministry of Science and Technology, and Taipei Veterans General Hospital. The researchers cited no conflicts of interest.
FROM THE JOURNAL OF AFFECTIVE DISORDERS
Psychiatry residents not getting training in treating chronic pain
SAN FRANCISCO –
Given the unique role of psychiatrists in helping chronic pain patients with coping strategies and managing comorbid psychiatric illness, this void is concerning, said Ali Ahsan Ali, MD, a resident psychiatrist at the Micah School of Medicine at Mount Sinai/Elmhurst Hospital Center in New York, in an interview at the annual meeting of the American Psychiatric Association.
In a video interview, Dr. Ali spoke with Ahmar M. Butt, MD, about how and why Dr. Ali and his colleagues conducted the survey of all 221 U.S. psychiatry residency programs in January 2019. They also discuss the implications of these trends for patients, particularly in light of the country’s opioid crisis.
Dr. Ali had no disclosures. Dr. Butt is board certified in general psychiatry, child and adolescent psychiatry, and preventive medicine, with a subspecialty in addiction medicine. Dr. Butt is interim program director of the psychiatry residency program at Broadlawns UnityPointe Health, Des Moines, Iowa. He had no disclosures.
SAN FRANCISCO –
Given the unique role of psychiatrists in helping chronic pain patients with coping strategies and managing comorbid psychiatric illness, this void is concerning, said Ali Ahsan Ali, MD, a resident psychiatrist at the Micah School of Medicine at Mount Sinai/Elmhurst Hospital Center in New York, in an interview at the annual meeting of the American Psychiatric Association.
In a video interview, Dr. Ali spoke with Ahmar M. Butt, MD, about how and why Dr. Ali and his colleagues conducted the survey of all 221 U.S. psychiatry residency programs in January 2019. They also discuss the implications of these trends for patients, particularly in light of the country’s opioid crisis.
Dr. Ali had no disclosures. Dr. Butt is board certified in general psychiatry, child and adolescent psychiatry, and preventive medicine, with a subspecialty in addiction medicine. Dr. Butt is interim program director of the psychiatry residency program at Broadlawns UnityPointe Health, Des Moines, Iowa. He had no disclosures.
SAN FRANCISCO –
Given the unique role of psychiatrists in helping chronic pain patients with coping strategies and managing comorbid psychiatric illness, this void is concerning, said Ali Ahsan Ali, MD, a resident psychiatrist at the Micah School of Medicine at Mount Sinai/Elmhurst Hospital Center in New York, in an interview at the annual meeting of the American Psychiatric Association.
In a video interview, Dr. Ali spoke with Ahmar M. Butt, MD, about how and why Dr. Ali and his colleagues conducted the survey of all 221 U.S. psychiatry residency programs in January 2019. They also discuss the implications of these trends for patients, particularly in light of the country’s opioid crisis.
Dr. Ali had no disclosures. Dr. Butt is board certified in general psychiatry, child and adolescent psychiatry, and preventive medicine, with a subspecialty in addiction medicine. Dr. Butt is interim program director of the psychiatry residency program at Broadlawns UnityPointe Health, Des Moines, Iowa. He had no disclosures.
REPORTING FROM APA 2019
Psychiatrists discuss work on climate change
SAN FRANCISCO –
“We can find reasons to hope even in dark times,” Dr. Van Susteren said. “We understand science. We have all the tools ... this is what we do for a living. We warn about behaviors that are going hurt us now and are going to be even worse down the road.”
In a video discussion, Dr. Van Susteren spoke with David A. Pollack, MD, about the accomplishments of the Climate Psychiatry Alliance, an organization they helped launch more than 2 years ago that warns the medical profession and the public about risks of climate change and the impact of climate disruption on mental health. One victory, for example, was getting the APA to vote to divest from fossil fuels.
Dr. Van Susteren and Dr. Pollack also discuss steps psychiatrists can take as individuals to provide care for patients suffering from the effects of climate change – such as prescribing “park therapy.” In their offices, physicians can look toward emerging solutions such as My Green Doctor and Health Care Without Harm, Dr. Pollack said.
Dr. Van Susteren has a private psychiatry private practice in Washington and has no disclosures. Dr. Pollack is affiliated with Oregon Health & Science University in Portland. He has no disclosures.
SAN FRANCISCO –
“We can find reasons to hope even in dark times,” Dr. Van Susteren said. “We understand science. We have all the tools ... this is what we do for a living. We warn about behaviors that are going hurt us now and are going to be even worse down the road.”
In a video discussion, Dr. Van Susteren spoke with David A. Pollack, MD, about the accomplishments of the Climate Psychiatry Alliance, an organization they helped launch more than 2 years ago that warns the medical profession and the public about risks of climate change and the impact of climate disruption on mental health. One victory, for example, was getting the APA to vote to divest from fossil fuels.
Dr. Van Susteren and Dr. Pollack also discuss steps psychiatrists can take as individuals to provide care for patients suffering from the effects of climate change – such as prescribing “park therapy.” In their offices, physicians can look toward emerging solutions such as My Green Doctor and Health Care Without Harm, Dr. Pollack said.
Dr. Van Susteren has a private psychiatry private practice in Washington and has no disclosures. Dr. Pollack is affiliated with Oregon Health & Science University in Portland. He has no disclosures.
SAN FRANCISCO –
“We can find reasons to hope even in dark times,” Dr. Van Susteren said. “We understand science. We have all the tools ... this is what we do for a living. We warn about behaviors that are going hurt us now and are going to be even worse down the road.”
In a video discussion, Dr. Van Susteren spoke with David A. Pollack, MD, about the accomplishments of the Climate Psychiatry Alliance, an organization they helped launch more than 2 years ago that warns the medical profession and the public about risks of climate change and the impact of climate disruption on mental health. One victory, for example, was getting the APA to vote to divest from fossil fuels.
Dr. Van Susteren and Dr. Pollack also discuss steps psychiatrists can take as individuals to provide care for patients suffering from the effects of climate change – such as prescribing “park therapy.” In their offices, physicians can look toward emerging solutions such as My Green Doctor and Health Care Without Harm, Dr. Pollack said.
Dr. Van Susteren has a private psychiatry private practice in Washington and has no disclosures. Dr. Pollack is affiliated with Oregon Health & Science University in Portland. He has no disclosures.
REPORTING FROM APA 2019
Gender equity, sexual harassment in health care
SAN FRANCISCO – Women in health care are second only to those in arts and entertainment in contacting* the TIME’S UP Legal Defense Fund, according to two founding members of TIME’S UP Healthcare, which was recently launched to address gender inequity and sexual harassment in medicine.
“As a psychiatrist who has had physicians as patients ... I’d heard this stuff, and I knew it existed,” said Jessica Gold, MD. But to hear it from people who had choked it down ... I understand what it’s like to be a pharma rep and be told that you have to look pretty or wear a thong to get a doctor to look at you.”
In this video, Dr. Gold and Kali D. Cyrus, MD, MPH, sat down at the annual meeting of the American Psychiatric Association and discussed the goals of TIME’S UP Healthcare and the need to bring transgressions – mainly against women – out in the open. The group also wants to advocate for establishing meaningful standards and policies.
“I feel like [psychiatrists are] trained to look for these kinds of dynamics. We should be trained to intervene ... Dr. Cyrus said.
She wants to make sure that all women are equitably represented. We need “a procedure in place where people can voice their concerns.”
All of the group’s founding members are women, and men also need to participate as allies. “There are men who want to mentor women, Dr. Gold said. “We do need men to support us ... We also want to hear about their experiences,” Dr. Cyrus said.
Dr. Gold is assistant professor of psychiatry at Washington University in St. Louis. Dr. Cyrus is an assistant professor at Johns Hopkins University in Baltimore, and offers consultation services for conflict management of issues related to identity differences.
*This story was updated 6/3/2019.
SAN FRANCISCO – Women in health care are second only to those in arts and entertainment in contacting* the TIME’S UP Legal Defense Fund, according to two founding members of TIME’S UP Healthcare, which was recently launched to address gender inequity and sexual harassment in medicine.
“As a psychiatrist who has had physicians as patients ... I’d heard this stuff, and I knew it existed,” said Jessica Gold, MD. But to hear it from people who had choked it down ... I understand what it’s like to be a pharma rep and be told that you have to look pretty or wear a thong to get a doctor to look at you.”
In this video, Dr. Gold and Kali D. Cyrus, MD, MPH, sat down at the annual meeting of the American Psychiatric Association and discussed the goals of TIME’S UP Healthcare and the need to bring transgressions – mainly against women – out in the open. The group also wants to advocate for establishing meaningful standards and policies.
“I feel like [psychiatrists are] trained to look for these kinds of dynamics. We should be trained to intervene ... Dr. Cyrus said.
She wants to make sure that all women are equitably represented. We need “a procedure in place where people can voice their concerns.”
All of the group’s founding members are women, and men also need to participate as allies. “There are men who want to mentor women, Dr. Gold said. “We do need men to support us ... We also want to hear about their experiences,” Dr. Cyrus said.
Dr. Gold is assistant professor of psychiatry at Washington University in St. Louis. Dr. Cyrus is an assistant professor at Johns Hopkins University in Baltimore, and offers consultation services for conflict management of issues related to identity differences.
*This story was updated 6/3/2019.
SAN FRANCISCO – Women in health care are second only to those in arts and entertainment in contacting* the TIME’S UP Legal Defense Fund, according to two founding members of TIME’S UP Healthcare, which was recently launched to address gender inequity and sexual harassment in medicine.
“As a psychiatrist who has had physicians as patients ... I’d heard this stuff, and I knew it existed,” said Jessica Gold, MD. But to hear it from people who had choked it down ... I understand what it’s like to be a pharma rep and be told that you have to look pretty or wear a thong to get a doctor to look at you.”
In this video, Dr. Gold and Kali D. Cyrus, MD, MPH, sat down at the annual meeting of the American Psychiatric Association and discussed the goals of TIME’S UP Healthcare and the need to bring transgressions – mainly against women – out in the open. The group also wants to advocate for establishing meaningful standards and policies.
“I feel like [psychiatrists are] trained to look for these kinds of dynamics. We should be trained to intervene ... Dr. Cyrus said.
She wants to make sure that all women are equitably represented. We need “a procedure in place where people can voice their concerns.”
All of the group’s founding members are women, and men also need to participate as allies. “There are men who want to mentor women, Dr. Gold said. “We do need men to support us ... We also want to hear about their experiences,” Dr. Cyrus said.
Dr. Gold is assistant professor of psychiatry at Washington University in St. Louis. Dr. Cyrus is an assistant professor at Johns Hopkins University in Baltimore, and offers consultation services for conflict management of issues related to identity differences.
*This story was updated 6/3/2019.
REPORTING FROM APA 2019
Consider patients’ perceptions of tardive dyskinesia
SAN FRANCISCO – Stanley N. Caroff, MD, said at the annual meeting of the American Psychiatric Association.
“You really need to ask the patient a lot of questions – and the family and the caregivers – about how much tardive dyskinesia affects their lives,” he said.
Those were some of the early results of RE-KINECT, an ongoing study of patients with schizophrenia and schizoaffective disorder who were being treated with antipsychotic agents.
TD occurs in more than 25% of patients in outpatient practices who are exposed to dopamine receptor blockers. Symptoms can include involuntary movements of the tongue, hands, and feet; facial distortions; rapid eye blinking; and difficulty speaking. In some cases, the side effects resolve after patients stop taking the medications.
In this video, Dr. Caroff discussed the studies’ findings and their implications for everyday clinical practice. He also presented some of the early RE-KINECT findings in a poster at the meeting.
Dr. Caroff is professor of psychiatry at the University of Pennsylvania, Philadelphia. He also is affiliated with the Michael J. Crescenz VA Medical Center in Philadelphia. He disclosed working as a consultant for and receiving research funding from Neurocrine Biosciences. He also is a consultant for DisperSol Technologies, Osmotica Pharmaceuticals, Teva Pharmaceutical.
SAN FRANCISCO – Stanley N. Caroff, MD, said at the annual meeting of the American Psychiatric Association.
“You really need to ask the patient a lot of questions – and the family and the caregivers – about how much tardive dyskinesia affects their lives,” he said.
Those were some of the early results of RE-KINECT, an ongoing study of patients with schizophrenia and schizoaffective disorder who were being treated with antipsychotic agents.
TD occurs in more than 25% of patients in outpatient practices who are exposed to dopamine receptor blockers. Symptoms can include involuntary movements of the tongue, hands, and feet; facial distortions; rapid eye blinking; and difficulty speaking. In some cases, the side effects resolve after patients stop taking the medications.
In this video, Dr. Caroff discussed the studies’ findings and their implications for everyday clinical practice. He also presented some of the early RE-KINECT findings in a poster at the meeting.
Dr. Caroff is professor of psychiatry at the University of Pennsylvania, Philadelphia. He also is affiliated with the Michael J. Crescenz VA Medical Center in Philadelphia. He disclosed working as a consultant for and receiving research funding from Neurocrine Biosciences. He also is a consultant for DisperSol Technologies, Osmotica Pharmaceuticals, Teva Pharmaceutical.
SAN FRANCISCO – Stanley N. Caroff, MD, said at the annual meeting of the American Psychiatric Association.
“You really need to ask the patient a lot of questions – and the family and the caregivers – about how much tardive dyskinesia affects their lives,” he said.
Those were some of the early results of RE-KINECT, an ongoing study of patients with schizophrenia and schizoaffective disorder who were being treated with antipsychotic agents.
TD occurs in more than 25% of patients in outpatient practices who are exposed to dopamine receptor blockers. Symptoms can include involuntary movements of the tongue, hands, and feet; facial distortions; rapid eye blinking; and difficulty speaking. In some cases, the side effects resolve after patients stop taking the medications.
In this video, Dr. Caroff discussed the studies’ findings and their implications for everyday clinical practice. He also presented some of the early RE-KINECT findings in a poster at the meeting.
Dr. Caroff is professor of psychiatry at the University of Pennsylvania, Philadelphia. He also is affiliated with the Michael J. Crescenz VA Medical Center in Philadelphia. He disclosed working as a consultant for and receiving research funding from Neurocrine Biosciences. He also is a consultant for DisperSol Technologies, Osmotica Pharmaceuticals, Teva Pharmaceutical.
REPORTING FROM APA 2019
Patients with intellectual disability require nuanced care
SAN FRANCISCO – Some physicians are uncomfortable providing mental health care to patients with intellectual disability (ID) because many of the patients’ communications skills are limited. But many resources are available that can help.
In this video, Nita V. Bhatt, MD, MPH, interviews Julie P. Gentile, MD, about some of those resources and discusses how to approach psychiatric treatment interventions for patients with ID.
In addition to the DSM-5, Dr. Gentile said the National Association for the Dually Diagnosed has published the Diagnostic Manual – Intellectual Disability. Another resource is a practical reference manual originally proposed by one of Dr. Gentile’s residents.
“He came into my office for supervision one day and said, ‘You know, there’s all these nuances for psychiatric treatment in this patient population. So we should write a practice, quick reference manual to help clinicians who aren’t able to spend as much time concentrate on this patient population.’ ”
As a result, several residents and faculty members formed a team to produce an 18-chapter book published this year by Springer called the Guide to Intellectual Disabilities: A Clinical Handbook.
Dr. Bhatt is a staff psychiatrist at Twin Valley Behavioral Healthcare, the state psychiatric hospital in Columbus, Ohio. Dr. Gentile is professor and chair of the department of psychiatry at Wright State in Dayton. She is also serves as project director of Ohio’s Telepsychiatry Project for Intellectual Disability and has been awarded more than $7 million in grant funding to support her projects in the field of ID.
Dr. Gentile’s work has been funded by the Ohio Department of Developmental Disabilities and the Ohio Department of Mental Health and Addiction Services.
SAN FRANCISCO – Some physicians are uncomfortable providing mental health care to patients with intellectual disability (ID) because many of the patients’ communications skills are limited. But many resources are available that can help.
In this video, Nita V. Bhatt, MD, MPH, interviews Julie P. Gentile, MD, about some of those resources and discusses how to approach psychiatric treatment interventions for patients with ID.
In addition to the DSM-5, Dr. Gentile said the National Association for the Dually Diagnosed has published the Diagnostic Manual – Intellectual Disability. Another resource is a practical reference manual originally proposed by one of Dr. Gentile’s residents.
“He came into my office for supervision one day and said, ‘You know, there’s all these nuances for psychiatric treatment in this patient population. So we should write a practice, quick reference manual to help clinicians who aren’t able to spend as much time concentrate on this patient population.’ ”
As a result, several residents and faculty members formed a team to produce an 18-chapter book published this year by Springer called the Guide to Intellectual Disabilities: A Clinical Handbook.
Dr. Bhatt is a staff psychiatrist at Twin Valley Behavioral Healthcare, the state psychiatric hospital in Columbus, Ohio. Dr. Gentile is professor and chair of the department of psychiatry at Wright State in Dayton. She is also serves as project director of Ohio’s Telepsychiatry Project for Intellectual Disability and has been awarded more than $7 million in grant funding to support her projects in the field of ID.
Dr. Gentile’s work has been funded by the Ohio Department of Developmental Disabilities and the Ohio Department of Mental Health and Addiction Services.
SAN FRANCISCO – Some physicians are uncomfortable providing mental health care to patients with intellectual disability (ID) because many of the patients’ communications skills are limited. But many resources are available that can help.
In this video, Nita V. Bhatt, MD, MPH, interviews Julie P. Gentile, MD, about some of those resources and discusses how to approach psychiatric treatment interventions for patients with ID.
In addition to the DSM-5, Dr. Gentile said the National Association for the Dually Diagnosed has published the Diagnostic Manual – Intellectual Disability. Another resource is a practical reference manual originally proposed by one of Dr. Gentile’s residents.
“He came into my office for supervision one day and said, ‘You know, there’s all these nuances for psychiatric treatment in this patient population. So we should write a practice, quick reference manual to help clinicians who aren’t able to spend as much time concentrate on this patient population.’ ”
As a result, several residents and faculty members formed a team to produce an 18-chapter book published this year by Springer called the Guide to Intellectual Disabilities: A Clinical Handbook.
Dr. Bhatt is a staff psychiatrist at Twin Valley Behavioral Healthcare, the state psychiatric hospital in Columbus, Ohio. Dr. Gentile is professor and chair of the department of psychiatry at Wright State in Dayton. She is also serves as project director of Ohio’s Telepsychiatry Project for Intellectual Disability and has been awarded more than $7 million in grant funding to support her projects in the field of ID.
Dr. Gentile’s work has been funded by the Ohio Department of Developmental Disabilities and the Ohio Department of Mental Health and Addiction Services.
REPORTING FROM APA 2019
