Is there a link between metabolic deficiencies and treatment resistant depression? New research shows that this could be the case. The research shows that diagnosing and treating many metabolic disorders in patients with treatment resistant depression could lead to improved outcomes, or even complete remission from the depression in some cases. According to professor and University of Pittsburgh School of Medicine’s Department of Psychiatry chair David Lewis, M.D., “What’s really promising about these new findings is that they indicate that there may be physiological mechanisms underlying depression that we can use to improve the quality of life in patients with this disabling illness.” Approximately 15 million adults in the USA alone suffer from depression and the global numbers are much larger.
Treatment resistant depression is a big problem, and more than 65% of suicides are caused by major depressive disorder or what is commonly called depression. This is one of the most common mental disorders but many patients do not respond well to typical treatments. Pitt School of Medicine professor of psychiatry, and clinical and translational science Lisa Pan, M.D., was the lead study investigator. According to Dr. Pan “Major depressive disorder, usually referred to simply as depression, affects nearly 15 million American adults and is one of the most common mental disorders. Unfortunately, at least 15 percent of patients don’t find relief from conventional treatments, such as antidepressant medications and psychotherapy.” Pan explained that “Over a period of years, we tried every treatment available to help this patient, and yet he still found no relief from his depression symptoms. It’s really exciting that we now have another avenue to pursue for patients for whom our currently available treatments have failed, This is a potentially transformative finding for certain groups of people with depression.”
According to researchers the risk of developing PTSD increases after a mild traumatic brain injury. Researchers from a variety of organizations which included Washington University in St. Louis, the U.S. Centers for Disease Control and Prevention, San Francisco General Hospital, and the University of California, San Francisco performed evaluations on various factors that were related to mental health and functioning issues. The hope is that understanding how this type of injury affects mental health and contributes to PTSD and other mental disorders will lead to better screening, more accurate detection and diagnosis, and earlier treatment for post traumatic stress disorder. The impact that mTBI had was explored in emergency services providers who were civilians rather than evaluating the impact on military personnel. In the study roughly 27% of patients who had suffered mTBI screened positive for PTSD at a follow up screening 6 months after their injury.
The study on PTSD and mild traumatic brain injury was published in the Journal of Neurotrauma and the findings show the importance of following up after a mTBI. Medical College of Virginia Campus of Virginia Commonwealth University, Richmond, professor and Journal of Neurotrauma editor in chief John T. Povlishock, Ph.D. explained “This study represents yet another important communication originating from the CDC and the TRACK-TBI study group that now reframes PTSD within the context of civilian TBI. The finding of a relatively significant proportion of civilian patients experiencing PTSD following mild TBI calls for its more routine evaluation, particularly in those patients with the added comorbid factors identified in this report.”
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A recent research study shows that grandkids who have a multi generational history of MDD, or major depressive disorder, will have higher risks of developing depression as well. The study investigators determined that when an individual has both a parent and a grandparent with MDD the risk for the individual to develop depression is much higher. Knowing the increase in risk could help with identification so that grandkids who face these higher risks may benefit from early intervention. The full study details were published in the online journal JAMA Psychiatry. This is the first study published that looks at depression over 3 generations, and that uses direct interviews with all three generations of family members. The study looked at 251 grandkids, with an average age of 18, as well as the parents and grandparents of the grandchildren.
The study conclusion for the research on grandkids, generational history, and depression stated “In this study, biological offspring with two previous generations affected with major depression were at highest risk for major depression, suggesting the potential value of determining family history of depression in children and adolescents beyond two generations. Early intervention in offspring of two generations affected with moderate to severely impairing MDD seems warranted.” A well established fact is that parental depression raises the psychiatric disorder risks that the child faces. The latest research also shows how important it is to look further into the generational history than just the parents of a child because the risk is impacted by more than a single generation.
Recent research has suggested that specific neurological circuits in the brain that are associated with dopamine production may be able to inhibit binge eating in lab mice. At the current time the cause of binge eating is not known, and the neurological basis behind this disorder is unclear. The newest research brings some much needed clarity. Researchers at Texas Children’s Hospital and Baylor College of Medicine in Houston determined that some of the neural circuits in the brain may be able to inhibit binge eating although the how and why of this inhibition is still not completely clear. Senior paper author, Baylor College of Medicine associate professor of pediatrics Dr. Yong Xu, explained that “Human literature suggests that dysfunction of the serotonin system or dopamine system in the brain may be associated with developing binge-like eating behavior. However, mechanistically, there’s no direct evidence to show how this system affects behavior.”
Binge eating is a big problem, and the dopamine system in the brain is associated with this disorder but the processes involved are not yet clear. The research study was published in the Biological Psychiatry journal, and researchers managed to identify a neural circuit which involves serotonin neurons which project to dopamine neurons and cause these receptors to become activated. In the research study the mice experienced inhibition in binge eating when this circuit was activated. Identifying the specific receptors and circuits involved is an important first step to determining the causes of binge eating and developing effective treatments. The serotonin 2C receptor plays a role in preventing binge eating, that much researchers have identified, but there are also a number of other variables involved that need to be examined as well.
Treatment options for ADHD can run the gauntlet from behavioral modification to heavy medications that are basically pharmaceutical grade speed, and more people than ever before have been diagnosed with this mental disorder. Those diagnosed include a large number of children, some who may be as young as 4-5 or even younger. Some research has suggested that medicating ADHD symptoms with strong amphetamine drugs could be occurring far too often. Many parents, adults, and even mental health experts believe that treating ADHD with a combination of effective treatments that do not involve these dangerous medications may be the best route. When it comes to children many of the drugs being prescribed have not been approved for use in those under 18 years of age, but thousands of prescriptions are written for this age group every month by misguided but well meaning mental health professionals.
There are non drug treatment options for ADHD that can be used, and these treatments do not carry the same risks that the drugs designed to treat this condition can have. According to Los Angeles Semel Institute for Neuroscience and Human Behavior, University of California researcher Dr. James McCracken “ADHD is the most commonly diagnosed neuropsychiatric disorder in children, and we know full well the risks it poses for children’s future success in every area of functioning. Our current treatments clearly benefit most children in the short-term, but we’ve yet to find ways to protect those with ADHD from suffering many of the long-term risks.” Many adults are now being diagnosed with ADHD as well, and in many cases non drug therapy can be effective.
A new genome study for the very first time has identifies genome regions which seem to have an association with depression in people with European ancestry. The study researchers used an innovative way of enrolling people by analyzing data which people had already shared when they purchased their own individual DNA profile using an online service. These individuals then chose to participate in the research option. This method provided researchers with an enormous sample of DNA material to work with. According to co-corresponding study report author and Harvard Medical School associate professor of psychiatry Roy Perlis “Identifying genes that affect risk for a disease is a first step towards understanding the disease biology itself, which gives us targets to aim for in developing new treatments. More generally, finding genes associated with depression should help make clear that this is a brain disease, which we hope will decrease the stigma still associated with these kinds of illnesses.”
The genome study results could play a vital role in developing medical and genetic tests for depression. Perlis explained that “The neurotransmitter-based models we are currently using to treat depression are more than 40 years old, and we really need new treatment targets. We hope that finding these genes will point us toward novel treatment strategies. Another key takeaway from our study is that the traditional way of doing genetic studies is not the only way that works. Using existing large datasets or biobanks may be far more efficient and may be helpful for other psychiatric disorders, such as anxiety disorders, where traditional approaches also have not been successful.”