Since the beginning of Operations Iraqi Freedom and Enduring Freedom, there have been nearly 36,000 battle- injured warriors, of which approximately 82 percent suffer extremity trauma. Many of these injuries are complicated by the effects of improvised explosive devices which cause injury patterns distinct from civilian trauma. Traditional wound-management guidelines simply fall short. In an effort to address the increasing number and severity of extremity war injuries among the nation's warriors serving in Iraq and Afghanistan, the American Academy of Orthopaedic Surgeons (AAOS), the Society of Military Orthopaedic Surgeons (SOMOS), the Orthopaedic Trauma Association (OTA), and the Orthopaedic Research Society (ORS) will bring together the nation's top civilian and military orthopaedic trauma surgeons and researchers for a two-day symposium January 27 - 29 to discuss barriers of return of function and duty and develop treatment principles.
"Over the past several years, peer-reviewed orthopaedic research has been an essential element of our continued efforts to encourage researchers to focus on improving the treatment of high-energy extremity war injuries," said Michael Bosse, MD, CAPT, USNR (Ret.), past OTA President and co-chair of the EWI Symposium. "The EWI Symposium gives us a valuable opportunity to discuss this type of research and to learn more about helping our military orthopaedic surgeons discover new and innovative ways to best treat these complex injuries. To improve the quality of life for these injured troops, we have to recognize the need for sustained, robust investment in this type of research."
"The distinguished service of our military surgeons never ceases to amaze me," noted COL James R. Ficke, MD, current Chairman of the Department of Orthopaedic Surgery and Rehabilitation at Brooke Army Medical Center, the Orthopaedic Surgery Consultant to the US Army Surgeon General, and co-chair of the EWI Symposium. "The continued dedication of surgeons and the incredible courage of our patients inspires advances that enhance the treatment, research, and knowledge of blast injuries. The body of research to characterize these injuries demonstrates that the majority of battlefield wounds affect extremities. Extremity wounds are responsible for two-thirds of inpatient hospital and disability costs, and are the main reasons why up to one third of our warriors never fully recover. This underscores the fact that current therapy options are not capable of restoring full function after these devastating injuries."
In January 2006, AAOS, SOMOS, and OTA hosted the first Extremity War Injuries (EWI) symposium in Washington, DC, which defined current knowledge of the management of extremity war wounds and produced a prioritized list of objectives for future research. Now in its fifth year, the EWI symposium will focus on barriers to return of function and duty and will include a session on disaster preparedness and response. The session is co-moderated by Christopher T. Born, MD, Director of Orthopaedic Trauma at Rhode Island Hospital, who will discuss his recent experiences in Haiti after the earthquake disaster.
With more than 30,000 members, the American Academy of Orthopaedic Surgeons is the premier not-for-profit organization that provides education programs for orthopaedic surgeons and allied health professionals, champions the interests of patients and advances the highest quality musculoskeletal health. Orthopaedic surgeons and the Academy are the authoritative sources of information for patients and the general public on musculoskeletal conditions, treatments and related issues.
The Orthopaedic Research Society (ORS) was founded in 1954 and incorporated as a non-profit organization in 1982. The purposes of the ORS are to promote, support, develop and encourage research in orthopaedic surgery, musculoskeletal diseases, musculoskeletal injuries and disciplines related thereto; to provide, encourage, develop and sponsor educational activities related to the foregoing; and to provide forums for dissemination of knowledge in these fields. The intent of these efforts is to improve the care of patients with musculoskeletal diseases and injuries. The Society has approximately 2,400 members.
Founded twenty-five years ago, the Orthopaedic Trauma Association (OTA) continues to be the premier organization whose mission is to promote excellence in the care for the multiply injured patient through provision of scientific forums and support of musculoskeletal research and education. The OTA is adaptable, forward thinking and fiscally responsible and is composed of a diverse global membership who provide care and improve the knowledge base for the treatment of injured patients. OTA members provide worldwide leadership through education, research, disaster response and patient advocacy.
The Society of Military Orthopaedic Surgeons (SOMOS) serves as the specialty society leading the development of education, research and patient care in wartime, disaster, and austere environment orthopaedics. Founded over fifty years ago, SOMOS continues to serve, support and educate military orthopaedic surgeons as well as civilian physicians and to provide a forum for the exchange of medical information.
Source: American Academy of Orthopaedic Surgeons (AAOS)
воскресенье, 29 мая 2011 г.
понедельник, 16 мая 2011 г.
Organized Phone Therapy For Depression Found Cost-Effective
When people get brief, structured, phone-based cognitive behavioral psychotherapy soon after starting on antidepressant medication, significant benefits may persist two years after their first session, with only modest rises in cost. Over two years, this treatment is cost-effective, according to a randomized trial in the October 2009 Archives of General Psychiatry.
"The most important reason to treat depression is to reduce suffering and improve daily functioning," said Group Health psychiatrist Gregory E. Simon, MD, MPH, also a senior investigator at Group Health Research Institute (formerly called Group Health Center for Health Studies). "But our findings suggest that insurers or health care systems aiming to improve depression treatment in primary care should consider incorporating structured psychotherapy."
The Journal of the American Medical Association (JAMA) reported earlier results from the same 600-person trial, the largest to date of psychotherapy by phone - and one of the largest studies of psychotherapy ever.
Over two years, phone psychotherapy plus care management led to a gain of 46 depression-free days, with only a $397 increase in outpatient health care costs. The incremental net benefit of phone psychotherapy plus care management was positive, even if a day free of depression was valued as low as $9.
By contrast, phone care management alone, with no phone psychotherapy, led to a gain of only 29 days free of depression, with a $676 rise in outpatient health care costs. The incremental net benefit of phone care management alone was negative, even if a day free of depression was valued up to $20.
The trial enrolled 600 Group Health patients whose primary care doctors diagnosed their depression and (as is usual in primary care) prescribed their antidepressants without psychotherapy.
The patients were randomly assigned to receive either:
Usual primary care
Phone care management: usual care plus a phone-based care-management program including three outreach calls from a bachelors-level clinician (assessing patients' symptoms, antidepressant drug use, and side effects and referring to mental health specialty care if needed), with care coordination and feedback to the primary care doctor
Phone psychotherapy: usual care, plus phone care management, plus eight 30-40 minute sessions of structured cognitive-behavioral psychotherapy delivered by phone by a masters-level mental health clinician
The trial excluded people who were already seeing a therapist or intending to do so. The patients and mental health clinicians never met face to face, only over the phone. The mental health clinicians followed a structured protocol for psychotherapy. They encouraged the patients to identify and counter their negative thoughts (cognitive behavioral therapy), pursue activities they had enjoyed in the past (behavioral activation), and develop a plan to care for themselves.
Few of the patients who received phone-based therapy - even fewer than those who did not receive it - sought in-person therapy. Phone-based therapy is more convenient and acceptable to patients than in-person psychotherapy, said Dr. Simon.
Depression symptoms, including feeling discouraged and avoiding other people, can prevent people from seeking help, he added. Nationally, only about half of insured patients receiving depression treatment make any psychotherapy visit, and less than a third make four or more visits. By contrast, in this trial, three in four patients completed at least six phone therapy sessions.
The National Institute of Mental Health funded the trial. The other authors were Evette J. Ludman, PhD, senior research associate, and Carolyn M. Rutter, PhD, senior investigator at Group Health Research Institute.
"The most important reason to treat depression is to reduce suffering and improve daily functioning," said Group Health psychiatrist Gregory E. Simon, MD, MPH, also a senior investigator at Group Health Research Institute (formerly called Group Health Center for Health Studies). "But our findings suggest that insurers or health care systems aiming to improve depression treatment in primary care should consider incorporating structured psychotherapy."
The Journal of the American Medical Association (JAMA) reported earlier results from the same 600-person trial, the largest to date of psychotherapy by phone - and one of the largest studies of psychotherapy ever.
Over two years, phone psychotherapy plus care management led to a gain of 46 depression-free days, with only a $397 increase in outpatient health care costs. The incremental net benefit of phone psychotherapy plus care management was positive, even if a day free of depression was valued as low as $9.
By contrast, phone care management alone, with no phone psychotherapy, led to a gain of only 29 days free of depression, with a $676 rise in outpatient health care costs. The incremental net benefit of phone care management alone was negative, even if a day free of depression was valued up to $20.
The trial enrolled 600 Group Health patients whose primary care doctors diagnosed their depression and (as is usual in primary care) prescribed their antidepressants without psychotherapy.
The patients were randomly assigned to receive either:
Usual primary care
Phone care management: usual care plus a phone-based care-management program including three outreach calls from a bachelors-level clinician (assessing patients' symptoms, antidepressant drug use, and side effects and referring to mental health specialty care if needed), with care coordination and feedback to the primary care doctor
Phone psychotherapy: usual care, plus phone care management, plus eight 30-40 minute sessions of structured cognitive-behavioral psychotherapy delivered by phone by a masters-level mental health clinician
The trial excluded people who were already seeing a therapist or intending to do so. The patients and mental health clinicians never met face to face, only over the phone. The mental health clinicians followed a structured protocol for psychotherapy. They encouraged the patients to identify and counter their negative thoughts (cognitive behavioral therapy), pursue activities they had enjoyed in the past (behavioral activation), and develop a plan to care for themselves.
Few of the patients who received phone-based therapy - even fewer than those who did not receive it - sought in-person therapy. Phone-based therapy is more convenient and acceptable to patients than in-person psychotherapy, said Dr. Simon.
Depression symptoms, including feeling discouraged and avoiding other people, can prevent people from seeking help, he added. Nationally, only about half of insured patients receiving depression treatment make any psychotherapy visit, and less than a third make four or more visits. By contrast, in this trial, three in four patients completed at least six phone therapy sessions.
The National Institute of Mental Health funded the trial. The other authors were Evette J. Ludman, PhD, senior research associate, and Carolyn M. Rutter, PhD, senior investigator at Group Health Research Institute.
воскресенье, 15 мая 2011 г.
Collective Depression Syndrome Among Asylum-Seeking Detainees Highlighted In New Paper Published By Dove Medical Press
A new paper by William W Bostock from the School of Government, University of Tasmania, analysing the debate between the psychiatric profession and the Australian government over collective depression syndrome found among asylum-seeking detainees, has been published in the Dove Medical Press journal: Psychology Research and Behavior Management.
The open access publisher of medical and scientific journals has made the paper available here.
Psychiatrists have long had involvement with the political process, both individually and as a profession. They have made valuable contributions to debate over such issues as war, conflict, terrorism, torture, human rights abuse, drug abuse, suicide and other public health issues. However, they have also been complicit in some gross atrocities.
Over several years there has been debate over the Australian Government's treatment of asylum seekers, and the Royal Australian and New Zealand College of Psychiatrists took the unusual step of publicly criticising the Australian Government's policy on grounds of its toxicity leading to a diagnosis of collective depression syndrome, particularly among child detainees, but also adult detainees.
The official Ministerial response was to deny that collective depression exists and to assert that the concept is meaningless. Can this intervention by psychiatrists be interpreted as a product of earlier political behaviors by psychiatrists? The willingness of psychiatrists to cooperate with other professions, notably psychologists, pediatricians, physicians and lawyers, is noted, as is presence of minority voices within the Australian psychiatric profession.
The significance of the debate over the mental condition of asylum-seeking detainees is that its outcome has implications for how Australia sees itself and is seen by the rest of the world, that is, its national identity.
Read the full paper The psychiatric profession and the Australian government: the debate over collective depression syndrome among asylum-seeking detainees by William W Bostock.
Source
Dove Medical Press Ltd
The open access publisher of medical and scientific journals has made the paper available here.
Psychiatrists have long had involvement with the political process, both individually and as a profession. They have made valuable contributions to debate over such issues as war, conflict, terrorism, torture, human rights abuse, drug abuse, suicide and other public health issues. However, they have also been complicit in some gross atrocities.
Over several years there has been debate over the Australian Government's treatment of asylum seekers, and the Royal Australian and New Zealand College of Psychiatrists took the unusual step of publicly criticising the Australian Government's policy on grounds of its toxicity leading to a diagnosis of collective depression syndrome, particularly among child detainees, but also adult detainees.
The official Ministerial response was to deny that collective depression exists and to assert that the concept is meaningless. Can this intervention by psychiatrists be interpreted as a product of earlier political behaviors by psychiatrists? The willingness of psychiatrists to cooperate with other professions, notably psychologists, pediatricians, physicians and lawyers, is noted, as is presence of minority voices within the Australian psychiatric profession.
The significance of the debate over the mental condition of asylum-seeking detainees is that its outcome has implications for how Australia sees itself and is seen by the rest of the world, that is, its national identity.
Read the full paper The psychiatric profession and the Australian government: the debate over collective depression syndrome among asylum-seeking detainees by William W Bostock.
Source
Dove Medical Press Ltd
Genetic Variations May Predispose Some Men To Suicidal Thoughts During Treatment For Depression
Genetic variations may help explain why some men with depression develop suicidal thoughts and behaviors after they begin taking antidepressant medications, while most do not, according to a report in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Although most patients with depression respond favorably to antidepressant medications, a very small subgroup may experience worse symptoms after beginning treatment, according to background information in the article. "Regardless of treatment specificity, nearly all antidepressant medication studies find that some patients experience suicidality [suicidal thoughts and behaviors] after treatment initiation," the authors write. "Identification of this subpopulation before treatment would have tremendous clinical utility."
Roy H. Perlis, M.D., of Massachusetts General Hospital and Harvard Medical School, Boston, and colleagues studied 1,447 individuals with depression who were part of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, which was conducted from July 2001 to September 2006, and who did not express suicidal thoughts at the beginning of the study. The participants were men and women ages 18 to 75 years who had been diagnosed with non-psychotic major depressive disorder. They took the antidepressant citalopram hydrobromide for up to 12 weeks, following a protocol that advised follow-up treatment visits at two, four, six, nine and 12 weeks, with an optional visit at 14 weeks if needed. The patients' DNA was analyzed for common types of mutations nearby or within the CREB1 gene, which codes for a protein previously suggested to be involved in both antidepressant effects and suicide.
Of the 1,447 patients, 123 (8.5 percent) reported suicidal thoughts or behaviors during at least one follow-up visit, including 54 (10 percent) of the 539 men. Two of five single nucleotide polymorphisms (SNPs) - variations that occur when a single building block of DNA is altered - were significantly and strongly associated with the onset of suicidality in men, but not in women.
The researchers performed additional analyses suggesting these variations are not linked to suicidal thoughts and behaviors in men before treatment. "No statistically significant association was noted between any SNP and the presence or absence of baseline suicidality," the authors write. "Likewise, no evidence of association was noted between any SNP and history of lifetime suicide attempt."
Studies that link genes to illnesses are most compelling when there is additional evidence of that gene's function, the authors note. "We recently observed an association between the same CREB1 polymorphisms and a measure of anger expression among males but not females in a sample of 94 patients with major depressive disorder; hostility and anger expression have also been associated with suicide," they write.
"If replicated, this finding would suggest that pharmacogenetic testing could facilitate the identification of the small subset of individuals at greater risk during short-term antidepressant treatment," the authors conclude.
(Arch Gen Psychiatry. 2007;64:689-697)
The STAR*D study is supported by federal funds from the National Institute of Mental Health. Dr. Perlis is supported by a National Institute of Mental Health grant, a NARSAD Young Investigator Award and a grant from the Bowman Family Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Contact: Sue McGreevey
JAMA and Archives Journals
Although most patients with depression respond favorably to antidepressant medications, a very small subgroup may experience worse symptoms after beginning treatment, according to background information in the article. "Regardless of treatment specificity, nearly all antidepressant medication studies find that some patients experience suicidality [suicidal thoughts and behaviors] after treatment initiation," the authors write. "Identification of this subpopulation before treatment would have tremendous clinical utility."
Roy H. Perlis, M.D., of Massachusetts General Hospital and Harvard Medical School, Boston, and colleagues studied 1,447 individuals with depression who were part of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, which was conducted from July 2001 to September 2006, and who did not express suicidal thoughts at the beginning of the study. The participants were men and women ages 18 to 75 years who had been diagnosed with non-psychotic major depressive disorder. They took the antidepressant citalopram hydrobromide for up to 12 weeks, following a protocol that advised follow-up treatment visits at two, four, six, nine and 12 weeks, with an optional visit at 14 weeks if needed. The patients' DNA was analyzed for common types of mutations nearby or within the CREB1 gene, which codes for a protein previously suggested to be involved in both antidepressant effects and suicide.
Of the 1,447 patients, 123 (8.5 percent) reported suicidal thoughts or behaviors during at least one follow-up visit, including 54 (10 percent) of the 539 men. Two of five single nucleotide polymorphisms (SNPs) - variations that occur when a single building block of DNA is altered - were significantly and strongly associated with the onset of suicidality in men, but not in women.
The researchers performed additional analyses suggesting these variations are not linked to suicidal thoughts and behaviors in men before treatment. "No statistically significant association was noted between any SNP and the presence or absence of baseline suicidality," the authors write. "Likewise, no evidence of association was noted between any SNP and history of lifetime suicide attempt."
Studies that link genes to illnesses are most compelling when there is additional evidence of that gene's function, the authors note. "We recently observed an association between the same CREB1 polymorphisms and a measure of anger expression among males but not females in a sample of 94 patients with major depressive disorder; hostility and anger expression have also been associated with suicide," they write.
"If replicated, this finding would suggest that pharmacogenetic testing could facilitate the identification of the small subset of individuals at greater risk during short-term antidepressant treatment," the authors conclude.
(Arch Gen Psychiatry. 2007;64:689-697)
The STAR*D study is supported by federal funds from the National Institute of Mental Health. Dr. Perlis is supported by a National Institute of Mental Health grant, a NARSAD Young Investigator Award and a grant from the Bowman Family Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Contact: Sue McGreevey
JAMA and Archives Journals
NY Health Department Launches MySpace Campaign To Help Young New Yorkers Cope
The Health Department today announced a new online campaign to engage teenagers grappling with depression, drugs, and violence, and to encourage them to seek help. NYC Teen Mindspace, posted on MySpace, is the agency's first effort to promote health through Web-based social networking - a medium with great potential because of its popularity with young people. To see the campaign, visit myspace/nycteen_mindspace.
Mental health issues are common among teens. Nearly one-third of New York City high school students say they experience sadness that keeps them from daily activities (30%), and 8% report attempting suicide during the past year. In addition, some 11% say they experienced dating violence during the past year - up from 7% in 1999. About 15% of teens report binge drinking, and 12% say they smoke marijuana. (Both rates have fallen slightly in recent years.)
Though many teens experience mental health issues, they are often reluctant to acknowledge them and seek help. When asked who they are most likely to talk with when they feel sad, more than 20% of teens said they talk to no one, one-third said they would talk to a friend only (31%), and just one-third said they would talk to an adult (32%). The Mindspace page responds to these issues with interactive features that raise awareness and combat stigma by helping teens identify with peers and prompting them to seek help.
-- Video blogs for teen characters. Mindspace features fictional, composite personalities, such as "Kyle," "Nicole," and "Stephanie," who chronicle their struggles through video posts. Their stories about using drugs or suffering from depression unfold through updates. Any teen who visits the site can "friend" the characters and follow their stories. Additional characters will be added in coming weeks.
-- Opportunities to reach out for help. By sending a confidential message to a mental health counselor from LifeNet, a service offered by the Mental Health Association of New York City, teens can get help and referrals to treatment. Mindspace does not offer live assistance, but it encourages teens who need support to call 800-LifeNet - where counselors are available 24 hours a day, seven days a week - or they can call 911 in an emergency.
-- Quizzes, polls, games, and fact sheets. "Have you ever felt the need to harm yourself or others?" Teens can use questions like these to test their knowledge and compare their feelings with those of their peers. Fact sheets, quizzes, and games that focus on stress and abuse offer guidance and perspective - and they can be forwarded to friends.
-- Music downloads. A standard piece of any popular page, this feature invites teens to express themselves by playing music to fit their moods.
"Social networking sites present a unique opportunity to help teenagers with mental health problems," said Dr. David Rosin, Deputy Commissioner for Mental Hygiene. "By reaching out to young people where they socialize, in a style they can relate to, we make it easier for them to talk and seek help."
Social networking has become a fact of teen life. Research from the Pew Research Center shows that 93% of U.S. teens use the Internet and 85% of them visit social networking sites, with half of them visiting their personal profiles daily to interact with a larger online community. These sites provide an opportunity not only to share information, but to shift social norms. Young people who visit Mindspace will see that the featured characters address their issues by talking to a counselor or calling LifeNet, and some will be inspired to reach out themselves.
"Many teens are reluctant to seek help," said Dr. Myla Harrison, Assistant Commissioner for Child and Adolescent Services. "Engaging with these characters may help teens express their feelings, connect with others and realize that help is available. They may also realize that they don't have to take risks and endanger themselves. Instead, they will see the characters think about how to direct their own lives in a safer, healthier way."
The Health Department drew on data from the city's biannual survey of public high school students in developing the focus areas for the campaign. The Department convened a teen advisory panel to guide the look and feel of the page and shape the profiles and experiences of the teen characters.
For more statistics about New York City teens, please see these reports:
-- Mental Health of New York City Youth (PDF)
-- Teen Safety in New York City (PDF)
-- Substance Use Among New York City Youth (PDF)
New York City Department of Health and Mental Hygiene
nyc/html/doh/html/home/home.shtml
Mental health issues are common among teens. Nearly one-third of New York City high school students say they experience sadness that keeps them from daily activities (30%), and 8% report attempting suicide during the past year. In addition, some 11% say they experienced dating violence during the past year - up from 7% in 1999. About 15% of teens report binge drinking, and 12% say they smoke marijuana. (Both rates have fallen slightly in recent years.)
Though many teens experience mental health issues, they are often reluctant to acknowledge them and seek help. When asked who they are most likely to talk with when they feel sad, more than 20% of teens said they talk to no one, one-third said they would talk to a friend only (31%), and just one-third said they would talk to an adult (32%). The Mindspace page responds to these issues with interactive features that raise awareness and combat stigma by helping teens identify with peers and prompting them to seek help.
-- Video blogs for teen characters. Mindspace features fictional, composite personalities, such as "Kyle," "Nicole," and "Stephanie," who chronicle their struggles through video posts. Their stories about using drugs or suffering from depression unfold through updates. Any teen who visits the site can "friend" the characters and follow their stories. Additional characters will be added in coming weeks.
-- Opportunities to reach out for help. By sending a confidential message to a mental health counselor from LifeNet, a service offered by the Mental Health Association of New York City, teens can get help and referrals to treatment. Mindspace does not offer live assistance, but it encourages teens who need support to call 800-LifeNet - where counselors are available 24 hours a day, seven days a week - or they can call 911 in an emergency.
-- Quizzes, polls, games, and fact sheets. "Have you ever felt the need to harm yourself or others?" Teens can use questions like these to test their knowledge and compare their feelings with those of their peers. Fact sheets, quizzes, and games that focus on stress and abuse offer guidance and perspective - and they can be forwarded to friends.
-- Music downloads. A standard piece of any popular page, this feature invites teens to express themselves by playing music to fit their moods.
"Social networking sites present a unique opportunity to help teenagers with mental health problems," said Dr. David Rosin, Deputy Commissioner for Mental Hygiene. "By reaching out to young people where they socialize, in a style they can relate to, we make it easier for them to talk and seek help."
Social networking has become a fact of teen life. Research from the Pew Research Center shows that 93% of U.S. teens use the Internet and 85% of them visit social networking sites, with half of them visiting their personal profiles daily to interact with a larger online community. These sites provide an opportunity not only to share information, but to shift social norms. Young people who visit Mindspace will see that the featured characters address their issues by talking to a counselor or calling LifeNet, and some will be inspired to reach out themselves.
"Many teens are reluctant to seek help," said Dr. Myla Harrison, Assistant Commissioner for Child and Adolescent Services. "Engaging with these characters may help teens express their feelings, connect with others and realize that help is available. They may also realize that they don't have to take risks and endanger themselves. Instead, they will see the characters think about how to direct their own lives in a safer, healthier way."
The Health Department drew on data from the city's biannual survey of public high school students in developing the focus areas for the campaign. The Department convened a teen advisory panel to guide the look and feel of the page and shape the profiles and experiences of the teen characters.
For more statistics about New York City teens, please see these reports:
-- Mental Health of New York City Youth (PDF)
-- Teen Safety in New York City (PDF)
-- Substance Use Among New York City Youth (PDF)
New York City Department of Health and Mental Hygiene
nyc/html/doh/html/home/home.shtml
Vigorous Housework Good For Your Mental Health
If you clean your house vigorously for twenty minutes non-stop once a week, your anxiety, distress or depression may improve, according to a study published in the British Journal of Sports Medicine.
The study also stresses that any type of vigorous physical exercise, sustained for a 20-minute period can have a good impact on your mental health. The scientists, from University College London, say that the more vigorous and frequent the activity, the greater the impact.
The study examined a survey of 20,000 men and women who were quizzed for the Scottish Health Survey about their state of mind and how much weekly physical activity they engaged in. Over 3,000 participants were deemed to be suffering from stress and/or anxiety. They found that people who did sports at least once a week were 33% less likely to suffer from mental health problems. Those who did vigorous housework once a week regularly were 20% less likely to suffer from mental health problems. This drop in risk held even after taking into account such factors as age, gender, and the presence of a long term condition.
The researchers stressed that vigorous housework does not include some little light dusting. As well as lasting at least 20 minutes, the activity has to make you feel at least slightly breathless.
The scientists explain that physical activity reduces inflammation, glucose intolerance and cardiovascular problems, all biological factors which are linked to depression risk. They believe these biological factors are probably key to helping physically active people enjoy better mental health. On the other hand, they accepted that it is possible it might be the other way round - people with mental health problems perhaps do not exercise as much.
Mark Hamer, University College London, research team member, explained that several studies seemed to show a link between better mental health and physical activity. This is the first study that quantifies the amount of activity needed to have an impact. He added "But it is a chicken and egg issue - as those who suffer from stress or anxiety may be less likely to take part in physical activity in the first place."
"Dose-response relationship between physical activity and mental health: the Scottish Health Survey."
Online First Br J Sports Med 2008; doi 10.1136/bjsm.2008.046243
Click here to view abstract online
Written by -
The study also stresses that any type of vigorous physical exercise, sustained for a 20-minute period can have a good impact on your mental health. The scientists, from University College London, say that the more vigorous and frequent the activity, the greater the impact.
The study examined a survey of 20,000 men and women who were quizzed for the Scottish Health Survey about their state of mind and how much weekly physical activity they engaged in. Over 3,000 participants were deemed to be suffering from stress and/or anxiety. They found that people who did sports at least once a week were 33% less likely to suffer from mental health problems. Those who did vigorous housework once a week regularly were 20% less likely to suffer from mental health problems. This drop in risk held even after taking into account such factors as age, gender, and the presence of a long term condition.
The researchers stressed that vigorous housework does not include some little light dusting. As well as lasting at least 20 minutes, the activity has to make you feel at least slightly breathless.
The scientists explain that physical activity reduces inflammation, glucose intolerance and cardiovascular problems, all biological factors which are linked to depression risk. They believe these biological factors are probably key to helping physically active people enjoy better mental health. On the other hand, they accepted that it is possible it might be the other way round - people with mental health problems perhaps do not exercise as much.
Mark Hamer, University College London, research team member, explained that several studies seemed to show a link between better mental health and physical activity. This is the first study that quantifies the amount of activity needed to have an impact. He added "But it is a chicken and egg issue - as those who suffer from stress or anxiety may be less likely to take part in physical activity in the first place."
"Dose-response relationship between physical activity and mental health: the Scottish Health Survey."
Online First Br J Sports Med 2008; doi 10.1136/bjsm.2008.046243
Click here to view abstract online
Written by -
Stress And Depression Vary By Region, According To New Study
Frequent Mental Distress (FMD), defined as having 14 or more days in the previous month when stress, depression and emotional problems were not good , is not evenly distributed across the United States. In fact, certain geographic areas have consistently high or consistently low FMD incidence, as shown in a study published in the June 2009 issue of the American Journal of Preventive Medicine.
Combining data from annual large-scale surveys in 1993-2001 and 2003-2006 by the Centers for Disease Control and Prevention, researchers found that the adult prevalence of FMD was 9.4% overall, ranging from 6.6% in Hawaii to 14.4% in Kentucky. FMD prevalence varied both over time and by geographic area within states. From the earlier period to the later period, the mean prevalence of FMD increased by at least 1 percentage point in 27 states and by more than 4 percentage points in Mississippi, Oklahoma and West Virginia. The Appalachian and the Mississippi Valley regions had high and increasing FMD prevalence, and the upper Midwest had low and decreasing FMD prevalence.
The state-based Behavioral Risk Factor Surveillance System (BRFSS) has asked questions about mental health since 1993 and collects data from random telephone surveys of adult residents across the U.S. More than 1.2 million people were surveyed in each of the two periods. FMD prevalence was determined by county, and the results were smoothed to reduce variation from random sampling due to small sample sizes in less populous counties.
For the 1993 period, the smoothed FMD prevalence was less than 8% in 31.8% of the 3112 counties analyzed and was ?‰?12.0% in 4.8% of the counties. For the 2003 period, the smoothed FMD prevalence was < 8% in 15.9% of the 3113 counties analyzed and was ?‰? 12.0% in 16.1% of the counties. Consistent multicounty geographic patterns were evident for both periods - including areas where smoothed FMD prevalence was < 8% in adjoining parts of several states in the upper Midwest region (ND, SD, NE, KS, MN, IA, MO, WI, IL) and an area where FMD prevalence was ?‰?12% that was centered on Kentucky (IN, OH, KY, WV, VA, TN). Differences in physical conditions (like disability or diabetes mellitus), stressful life events (like job loss), and social circumstances (like income) may be associated with differences in FMD prevalence.
"Because FMD often indicates potentially unmet health and social service needs, programs for public health, community mental health and social services whose jurisdictions include areas with high FMD levels should collaborate to identify and eliminate the specific preventable sources of this distress," said Dr. Matthew M. Zack, the study's lead investigator. "With the growing scientific literature linking FMD to treatable mental illnesses and preventable mental health problems, the increased use of these surveillance data in community mental health decision making is especially warranted. The continued surveillance of mental distress may help these programs to identify unmet needs and disparities, to focus their policies and interventions and to evaluate their performance over time."
Notes:
The article is "Geographic Patterns of Frequent Mental Distress: U.S. Adults, 1993 / 2003" by David G. Moriarty, BS, Matthew M. Zack, MD, MPH, James B. Holt, PhD, Daniel P. Chapman, PhD, MSc and Marc A. Safran, MD, MPA, DFAPA, FACPM. It appears in the American Journal of Preventive Medicine, Volume 36, Issue 6 (June 2009) published by Elsevier.
Combining data from annual large-scale surveys in 1993-2001 and 2003-2006 by the Centers for Disease Control and Prevention, researchers found that the adult prevalence of FMD was 9.4% overall, ranging from 6.6% in Hawaii to 14.4% in Kentucky. FMD prevalence varied both over time and by geographic area within states. From the earlier period to the later period, the mean prevalence of FMD increased by at least 1 percentage point in 27 states and by more than 4 percentage points in Mississippi, Oklahoma and West Virginia. The Appalachian and the Mississippi Valley regions had high and increasing FMD prevalence, and the upper Midwest had low and decreasing FMD prevalence.
The state-based Behavioral Risk Factor Surveillance System (BRFSS) has asked questions about mental health since 1993 and collects data from random telephone surveys of adult residents across the U.S. More than 1.2 million people were surveyed in each of the two periods. FMD prevalence was determined by county, and the results were smoothed to reduce variation from random sampling due to small sample sizes in less populous counties.
For the 1993 period, the smoothed FMD prevalence was less than 8% in 31.8% of the 3112 counties analyzed and was ?‰?12.0% in 4.8% of the counties. For the 2003 period, the smoothed FMD prevalence was < 8% in 15.9% of the 3113 counties analyzed and was ?‰? 12.0% in 16.1% of the counties. Consistent multicounty geographic patterns were evident for both periods - including areas where smoothed FMD prevalence was < 8% in adjoining parts of several states in the upper Midwest region (ND, SD, NE, KS, MN, IA, MO, WI, IL) and an area where FMD prevalence was ?‰?12% that was centered on Kentucky (IN, OH, KY, WV, VA, TN). Differences in physical conditions (like disability or diabetes mellitus), stressful life events (like job loss), and social circumstances (like income) may be associated with differences in FMD prevalence.
"Because FMD often indicates potentially unmet health and social service needs, programs for public health, community mental health and social services whose jurisdictions include areas with high FMD levels should collaborate to identify and eliminate the specific preventable sources of this distress," said Dr. Matthew M. Zack, the study's lead investigator. "With the growing scientific literature linking FMD to treatable mental illnesses and preventable mental health problems, the increased use of these surveillance data in community mental health decision making is especially warranted. The continued surveillance of mental distress may help these programs to identify unmet needs and disparities, to focus their policies and interventions and to evaluate their performance over time."
Notes:
The article is "Geographic Patterns of Frequent Mental Distress: U.S. Adults, 1993 / 2003" by David G. Moriarty, BS, Matthew M. Zack, MD, MPH, James B. Holt, PhD, Daniel P. Chapman, PhD, MSc and Marc A. Safran, MD, MPA, DFAPA, FACPM. It appears in the American Journal of Preventive Medicine, Volume 36, Issue 6 (June 2009) published by Elsevier.
Double Trouble: Hopelessness Key Component Of Mood Disorder
There's depression, and then there's double depression.
Sound bad? It is, according to Thomas Joiner, Florida State University Distinguished Research Professor and the Bright-Burton Professor of Psychology, who has identified hopelessness as a distinguishing feature of double depression in a new paper published in the Journal of Affective Disorders. The finding could help therapists diagnose and treat the mood disorder.
Double depression occurs when an individual who suffers from dysthymia, a persistent case of mild depression marked by low energy, falls into a major depressive state. It is not a new concept, but psychologists know little about the characteristics that distinguish double depression from dysthymia or major depression alone, according to Joiner.
"It's clinically important because it is under-recognized and harder to treat than either dysthymia or major depression by themselves," Joiner said. "The hopelessness result is significant, and it suggests that therapists should especially focus on this feature early and often in the treatment of double-depressed patients."
Joiner, along with FSU doctoral student Kathryn Gordon, Joan Cook from the Veterans Affairs Medical Center in Philadelphia and Michel Herson from Pacific University in Oregon, studied the psychological assessments of 54 adults who entered a community-based psychiatric outpatient facility for non-psychotic adults ages 55 and older. Questionnaires were given to patients before starting treatment to measure depression, hopelessness, anxiety and their sense of control over their own lives.
They found that double-depressed patients had high levels of hopelessness, whereas patients with either major depression or dysthymia alone showed more moderate levels of hopelessness.
"A patient who is hopeless has really just given up," Joiner said. "They feel that the world is against them, the future is bleak and they are incapable of fighting back."
This entrenched sense of hopelessness is one likely reason why double depression is so hard to treat, according to Joiner. The chronic nature of the underlying dysthymia is another.
"Any chronic condition is harder to treat than a less chronic one, and that is true for medical and psychiatric conditions alike," he said. "Second, people with dysthymia come to view depression as just part of who they are, and so they don't come in to treatment as often, even when they dip down into a major depression. When they do come in, issues of motivation to do the treatment are common."
In addition to differences in the level of hopelessness, the researchers found that people with dysthymia alone and those with double depression felt little control over their own lives. People with these conditions felt that external forces -- other people or fate -- determined their future. Those suffering from major depression alone did not have this characteristic.
Joiner cautioned that the study's findings must be interpreted in light of the study's limitations, namely its small sample size. Still, the results could have important implications for treatment of double depression. Cognitive therapy, which focuses on changing negative thinking patterns, and antidepressant drugs are particularly helpful in treating symptoms of hopelessness and perceptions of a lack of control over one's own life, he said.
For more stories about FSU, visit our news site at fsu
Sound bad? It is, according to Thomas Joiner, Florida State University Distinguished Research Professor and the Bright-Burton Professor of Psychology, who has identified hopelessness as a distinguishing feature of double depression in a new paper published in the Journal of Affective Disorders. The finding could help therapists diagnose and treat the mood disorder.
Double depression occurs when an individual who suffers from dysthymia, a persistent case of mild depression marked by low energy, falls into a major depressive state. It is not a new concept, but psychologists know little about the characteristics that distinguish double depression from dysthymia or major depression alone, according to Joiner.
"It's clinically important because it is under-recognized and harder to treat than either dysthymia or major depression by themselves," Joiner said. "The hopelessness result is significant, and it suggests that therapists should especially focus on this feature early and often in the treatment of double-depressed patients."
Joiner, along with FSU doctoral student Kathryn Gordon, Joan Cook from the Veterans Affairs Medical Center in Philadelphia and Michel Herson from Pacific University in Oregon, studied the psychological assessments of 54 adults who entered a community-based psychiatric outpatient facility for non-psychotic adults ages 55 and older. Questionnaires were given to patients before starting treatment to measure depression, hopelessness, anxiety and their sense of control over their own lives.
They found that double-depressed patients had high levels of hopelessness, whereas patients with either major depression or dysthymia alone showed more moderate levels of hopelessness.
"A patient who is hopeless has really just given up," Joiner said. "They feel that the world is against them, the future is bleak and they are incapable of fighting back."
This entrenched sense of hopelessness is one likely reason why double depression is so hard to treat, according to Joiner. The chronic nature of the underlying dysthymia is another.
"Any chronic condition is harder to treat than a less chronic one, and that is true for medical and psychiatric conditions alike," he said. "Second, people with dysthymia come to view depression as just part of who they are, and so they don't come in to treatment as often, even when they dip down into a major depression. When they do come in, issues of motivation to do the treatment are common."
In addition to differences in the level of hopelessness, the researchers found that people with dysthymia alone and those with double depression felt little control over their own lives. People with these conditions felt that external forces -- other people or fate -- determined their future. Those suffering from major depression alone did not have this characteristic.
Joiner cautioned that the study's findings must be interpreted in light of the study's limitations, namely its small sample size. Still, the results could have important implications for treatment of double depression. Cognitive therapy, which focuses on changing negative thinking patterns, and antidepressant drugs are particularly helpful in treating symptoms of hopelessness and perceptions of a lack of control over one's own life, he said.
For more stories about FSU, visit our news site at fsu
Identification Of Biological Link Between Stress, Anxiety And Depression
Scientists at The University of Western Ontario have discovered the biological link between stress, anxiety and depression. By identifying the connecting mechanism in the brain, this high impact research led by Stephen Ferguson of Robarts Research Institute shows exactly how stress and anxiety could lead to depression. The study also reveals a small molecule inhibitor developed by Ferguson, which may provide a new and better way to treat anxiety, depression and other related disorders. The findings are published online in the journal Nature Neuroscience.
Ferguson, Ana Magalhaes and their colleagues used a behavioural mouse model and a series of molecular experiments to reveal the connection pathway and to test the new inhibitor. "Our findings suggest there may be an entire new generation drugs and drug targets that can be used to selectively target depression, and therefore treat it more effectively, " says Ferguson, the director of the Molecular Brain Research Group at Robarts, and a professor in the Department of Physiology & Pharmacology at Western's Schulich School of Medicine & Dentistry. "We've gone from mechanism to mouse, and the next step is to see whether or not we can take the inhibitor we developed, and turn it into a pharmaceutical agent."
The research was conducted in collaboration with Hymie Anisman at Carleton University, and funded through the Canadian Institutes of Health Research (CIHR). "According to the World Health Organization, depression, anxiety and other related mood disorders now share the dubious distinction of being the most prevalent causes of chronic illness," says Anthony Phillips, the scientific director of the CIHR Institute of Neurosciences, Mental Health and Addiction. "Using the power of molecular biology, Stephen Ferguson and colleagues provide novel insights that may be the key to improving the lives of so many individuals coping with these forms of mental ill health."
The linking mechanism in the study involves the interaction between corticotropin releasing factor receptor 1 (CRFR1) and specific types of serotonin receptors (5-HTRs). While no one has been able to connect these two receptors on a molecular level, the study reveals that CRFR1 works to increase the number of 5-HTRs on cell surfaces in the brain, which can cause abnormal brain signaling. Since CRFR1 activation leads to anxiety in response to stress, and 5-HTRs lead to depression, the research shows how stress, anxiety and depression pathways connect through distinct processes in the brain. Most importantly, the inhibitor developed by the Ferguson lab blocks 5-HTRs in the pathway to combat anxious behaviour, and potentially depression, in mice.
While major depressive disorder often occurs together with anxiety disorder in patients, the causes for both are strongly linked to stressful experiences. Stressful experiences can also make the symptoms of anxiety and depression more severe. By discovering and then blocking a pathway responsible for the link between stress, anxiety and depression, Ferguson not only provides the first biological evidence for a connection, but he also pioneers the development of a potential drug for more effective treatment.
Ferguson, Ana Magalhaes and their colleagues used a behavioural mouse model and a series of molecular experiments to reveal the connection pathway and to test the new inhibitor. "Our findings suggest there may be an entire new generation drugs and drug targets that can be used to selectively target depression, and therefore treat it more effectively, " says Ferguson, the director of the Molecular Brain Research Group at Robarts, and a professor in the Department of Physiology & Pharmacology at Western's Schulich School of Medicine & Dentistry. "We've gone from mechanism to mouse, and the next step is to see whether or not we can take the inhibitor we developed, and turn it into a pharmaceutical agent."
The research was conducted in collaboration with Hymie Anisman at Carleton University, and funded through the Canadian Institutes of Health Research (CIHR). "According to the World Health Organization, depression, anxiety and other related mood disorders now share the dubious distinction of being the most prevalent causes of chronic illness," says Anthony Phillips, the scientific director of the CIHR Institute of Neurosciences, Mental Health and Addiction. "Using the power of molecular biology, Stephen Ferguson and colleagues provide novel insights that may be the key to improving the lives of so many individuals coping with these forms of mental ill health."
The linking mechanism in the study involves the interaction between corticotropin releasing factor receptor 1 (CRFR1) and specific types of serotonin receptors (5-HTRs). While no one has been able to connect these two receptors on a molecular level, the study reveals that CRFR1 works to increase the number of 5-HTRs on cell surfaces in the brain, which can cause abnormal brain signaling. Since CRFR1 activation leads to anxiety in response to stress, and 5-HTRs lead to depression, the research shows how stress, anxiety and depression pathways connect through distinct processes in the brain. Most importantly, the inhibitor developed by the Ferguson lab blocks 5-HTRs in the pathway to combat anxious behaviour, and potentially depression, in mice.
While major depressive disorder often occurs together with anxiety disorder in patients, the causes for both are strongly linked to stressful experiences. Stressful experiences can also make the symptoms of anxiety and depression more severe. By discovering and then blocking a pathway responsible for the link between stress, anxiety and depression, Ferguson not only provides the first biological evidence for a connection, but he also pioneers the development of a potential drug for more effective treatment.
Multiple Sclerosis More Linked To Depression In Minorities
Multiple sclerosis (MS) can cause significant physical impairment, including fatigue, pain, muscle spasms, tremors and dizziness. For many with MS, the disease wreaks havoc with emotional well-being, too, and according to a new study, minorities might especially be at risk for developing depressive symptoms.
Of study participants with the neurological condition, 44.2 percent of Latinos and 45.8 percent of African-Americans reported at least mild depression, compared with 38.7 percent of whites with MS. However, more Latinos never received mental health care, compared to whites or African-Americans with MS, according to lead study author Robert Buchanan, Ph.D.
Buchan is a professor in the department of political science and public administration at Mississippi State University. For the study in the December 2010 issue of the journal Ethnicity & Disease, authors used data from a registry of 26,967 white, 715 Latino and 1,313 African- American MS patients.
"Depression is even more common in people with MS," said Staley Brod, M.D., director of the Multiple Sclerosis Research Group Clinic at the University of Texas-Houston. "In general it is a treatable problem and, in most cases, the neurologist that's seeing the patient can deal with it effectively," he said.
However, compared to African-Americans and whites, Latinos were significantly less likely to get mental health services, obtain medical care from a specialist or receive occupational therapy or home health care assistance.
"A surprising finding to me is that despite these inequities in mental health, rehabilitation and other medical subspecialties, there's no disparity in treatment," Brod said. Similar percentages of whites, Latinos and African-Americans received multiple sclerosis therapies, called disease-modifying therapies, which treat flares and prevent symptoms.
In terms of functioning and disability levels, Latinos with MS fared better than other ethnic groups, the study reported. More Latinos reported normal function for mobility, bladder and bowel function and vision, compared to whites and African-Americans.
Buchanan said that because the study results rely on the responses of voluntary participants, not a random data sample, the applicability of the findings to the larger MS population might be limited.
The National Multiple Sclerosis Society provided funding for the study.
Buchanan, RJ, et al. Comparisons of Latinos, African Americans, and Caucasians with multiple sclerosis. Ethnicity Dis 20(4), 2010.
Of study participants with the neurological condition, 44.2 percent of Latinos and 45.8 percent of African-Americans reported at least mild depression, compared with 38.7 percent of whites with MS. However, more Latinos never received mental health care, compared to whites or African-Americans with MS, according to lead study author Robert Buchanan, Ph.D.
Buchan is a professor in the department of political science and public administration at Mississippi State University. For the study in the December 2010 issue of the journal Ethnicity & Disease, authors used data from a registry of 26,967 white, 715 Latino and 1,313 African- American MS patients.
"Depression is even more common in people with MS," said Staley Brod, M.D., director of the Multiple Sclerosis Research Group Clinic at the University of Texas-Houston. "In general it is a treatable problem and, in most cases, the neurologist that's seeing the patient can deal with it effectively," he said.
However, compared to African-Americans and whites, Latinos were significantly less likely to get mental health services, obtain medical care from a specialist or receive occupational therapy or home health care assistance.
"A surprising finding to me is that despite these inequities in mental health, rehabilitation and other medical subspecialties, there's no disparity in treatment," Brod said. Similar percentages of whites, Latinos and African-Americans received multiple sclerosis therapies, called disease-modifying therapies, which treat flares and prevent symptoms.
In terms of functioning and disability levels, Latinos with MS fared better than other ethnic groups, the study reported. More Latinos reported normal function for mobility, bladder and bowel function and vision, compared to whites and African-Americans.
Buchanan said that because the study results rely on the responses of voluntary participants, not a random data sample, the applicability of the findings to the larger MS population might be limited.
The National Multiple Sclerosis Society provided funding for the study.
Buchanan, RJ, et al. Comparisons of Latinos, African Americans, and Caucasians with multiple sclerosis. Ethnicity Dis 20(4), 2010.
For Bipolar Depression, Surveyed Experts Indicate That Current And Emerging Therapies Have No Advantage Over Seroquel In Decreasing The Syptoms
Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that surveyed psychiatrists identify a therapy's effect on decrease in severity of depressive symptoms as the attribute that most influences their prescribing decisions in bipolar depression. Clinical data and the opinions of interviewed thought leaders indicate that current and emerging therapies have no advantage in this attribute over AstraZeneca's Seroquel, the sales-leading agent in the market.
The new report entitled Bipolar Depression: Despite Negative Results, Physicians Still Hopeful About Aripiprazole also finds that an oral therapy that carries a lower risk of weight gain than Seroquel would earn a 21 percent patient share in bipolar depression in the United States and a 30 percent patient share in Europe, according to surveyed U.S. and European psychiatrists. The report also finds that, despite the failure of Bristol-Myers Squibb/Otsuka Pharmaceutical's Abilify (aripiprazole) in bipolar depression clinical trials, most interviewed thought leaders believe that Abilify is still an efficacious therapy for bipolar depression.
In 2008, Decision Resources' proprietary clinical gold standard for bipolar depression was lamotrigine (GlaxoSmithKline's Lamictal, generics). Based on available data and expert opinion, lamotrigine will retain gold standard status through 2017. While some therapies in development for bipolar depression hold promise, most have efficacy, safety and tolerability, and/or delivery features that are inferior when compared with lamotrigine.
"Owing to its efficacy and tolerability advantages, lamotrigine edged out Seroquel, its closest competitor, to become the clinical gold standard," said Decision Resources Analyst Sandra Chow, M.Sc. "Despite its slow onset of action, interviewed thought leaders were particularly impressed with lamotrigine's side-effect profile and better evidence of efficacy as a long term mood stabilizer."
About the Report
Bipolar Depression: Despite Negative Results, Physicians Still Hopeful About Aripiprazole is a DecisionBase 2009 report. DecisionBase 2009 is a decision-support tool that provides in-depth analysis of unmet need, physician expectations of new therapies and commercial dynamics to help pharmaceutical companies optimize their investments in drug development.
The report can be purchased by contacting Decision Resources. Members of the media may request an interview with an analyst.
The new report entitled Bipolar Depression: Despite Negative Results, Physicians Still Hopeful About Aripiprazole also finds that an oral therapy that carries a lower risk of weight gain than Seroquel would earn a 21 percent patient share in bipolar depression in the United States and a 30 percent patient share in Europe, according to surveyed U.S. and European psychiatrists. The report also finds that, despite the failure of Bristol-Myers Squibb/Otsuka Pharmaceutical's Abilify (aripiprazole) in bipolar depression clinical trials, most interviewed thought leaders believe that Abilify is still an efficacious therapy for bipolar depression.
In 2008, Decision Resources' proprietary clinical gold standard for bipolar depression was lamotrigine (GlaxoSmithKline's Lamictal, generics). Based on available data and expert opinion, lamotrigine will retain gold standard status through 2017. While some therapies in development for bipolar depression hold promise, most have efficacy, safety and tolerability, and/or delivery features that are inferior when compared with lamotrigine.
"Owing to its efficacy and tolerability advantages, lamotrigine edged out Seroquel, its closest competitor, to become the clinical gold standard," said Decision Resources Analyst Sandra Chow, M.Sc. "Despite its slow onset of action, interviewed thought leaders were particularly impressed with lamotrigine's side-effect profile and better evidence of efficacy as a long term mood stabilizer."
About the Report
Bipolar Depression: Despite Negative Results, Physicians Still Hopeful About Aripiprazole is a DecisionBase 2009 report. DecisionBase 2009 is a decision-support tool that provides in-depth analysis of unmet need, physician expectations of new therapies and commercial dynamics to help pharmaceutical companies optimize their investments in drug development.
The report can be purchased by contacting Decision Resources. Members of the media may request an interview with an analyst.
Bypassing The Blues: Treatment For Depression After Bypass Surgery Improves Quality Of Life And Reduces Cardiac Symptoms
Coronary artery bypass graft (CABG) patients who were screened for depression after surgery and then cared for by a nurse-led team of health care specialists reported better quality of life and improved physical function than those who received their doctors' usual care, according to a study from the University of Pittsburgh School of Medicine. The main outcomes of the study will be presented publicly for the first time at the American Psychosomatic Society's 67th annual meeting in Chicago this week.
CABG surgery is one of the most frequently performed and costly medical procedures performed in the United States. Although the procedure clearly benefits many individuals, depressive symptoms are common following CABG surgery and associated with worse clinical outcomes, including poorer quality of life, continued chest pains and higher risk of re-hospitalization and death.
Bruce L. Rollman, M.D., M.P.H., associate professor of medicine and psychiatry, Center for Research on Health Care, University of Pittsburgh School of Medicine and the study's principal investigator, and Bea Herbeck Belnap, senior research associate, Department of Medicine, University of Pittsburgh School of Medicine, will present early data showing that a collaborative care strategy for CABG is effective in a one-hour symposium at 4:15 p.m., Thursday, March 5 entitled, "The Bypassing the Blues Trial: Telephone-Delivered Collaborative Care for Treating Post-CABG Depression."
Bypassing the Blues is the first trial to examine the impact of a collaborative care strategy, an intervention that included active weekly telephone follow-up by a nurse guided by an evidence-based treatment protocol for depression and who collaborated with the patients' primary care physicians and the study's clinical management team, composed of a psychiatrist, psychologist and internist. This approach has proven effective for treating major depression in primary care settings but had never before been applied to a population with cardiac disease.
"Dozens of studies have described a link between depression and heart disease, and the latest guidelines from the American Heart Association recommend screening all patients with heart disease for depression," said Dr. Rollman. "However, few depression treatment trials have been conducted in patients with cardiac disease, and none used the collaborative care model or examined the impact of treating post-CABG depression on quality of life, re-hospitalizations or health care costs, as we did."
Investigators recruited 453 post-CABG patients at seven Pittsburgh-area hospitals, from 2004 through 2007. They included 302 depressed patients who were randomly assigned to either an eight-month course of telephone-delivered collaborative care or to their doctors' usual care for depression. Investigators also randomly sampled an additional 151 non-depressed, post-CABG patients to facilitate comparisons to depressed patients. They tracked these patients for up to four years to monitor quality of life, physical functioning, mood symptoms, re-hospitalizations, health care costs and deaths. Analysis of the data is ongoing.
Co-authors of the study include Wishwa N. Kapoor, M.D., M.P.H., professor of medicine, Division of General Internal Medicine, and director, Center for Research on Health Care, Charles F. Reynolds III, M.D., department of psychiatry, Western Psychiatric Institute and Clinic, Sati Mazumdar, Ph.D., professor of biostatistics, Graduate School of Public Health, Patty Houck, M.D., statistical services administrator, Graduate School of Public Health, and Peter Counihan, M.D., associate professor of medicine, Cardiovascular Institute, all of the University of Pittsburgh; and Herbert C. Schulberg, Ph.D., psychiatry, Weill Cornell Medical School, and professor emeritus of psychiatry at the University of Pittsburgh.
Dr. Rollman is supported by funding from the National Heart, Lung, and Blood Institute, part of the National Institutes of Health.
The University of Pittsburgh School of Medicine is one of the nation's leading medical schools, renowned for its curriculum that emphasizes both the science and humanity of medicine and its remarkable growth in National Institutes of Health (NIH) grant support, which has more than doubled since 1998. For fiscal year 2007, the University ranked sixth out of more than 3,000 entities receiving NIH support with respect to the research grants awarded to its faculty. As one of the university's six Schools of the Health Sciences, the School of Medicine is the academic partner to the University of Pittsburgh Medical Center (UPMC). Their combined mission is to train tomorrow's health care specialists and biomedical scientists, engage in groundbreaking research that will advance understanding of the causes and treatments of disease and participate in the delivery of outstanding patient care.
University of Pittsburgh Medical Center
U.S. Steel Tower, 600 Grant St., 57th Floor, Pittsburgh, PA 15213 United States
upmc
CABG surgery is one of the most frequently performed and costly medical procedures performed in the United States. Although the procedure clearly benefits many individuals, depressive symptoms are common following CABG surgery and associated with worse clinical outcomes, including poorer quality of life, continued chest pains and higher risk of re-hospitalization and death.
Bruce L. Rollman, M.D., M.P.H., associate professor of medicine and psychiatry, Center for Research on Health Care, University of Pittsburgh School of Medicine and the study's principal investigator, and Bea Herbeck Belnap, senior research associate, Department of Medicine, University of Pittsburgh School of Medicine, will present early data showing that a collaborative care strategy for CABG is effective in a one-hour symposium at 4:15 p.m., Thursday, March 5 entitled, "The Bypassing the Blues Trial: Telephone-Delivered Collaborative Care for Treating Post-CABG Depression."
Bypassing the Blues is the first trial to examine the impact of a collaborative care strategy, an intervention that included active weekly telephone follow-up by a nurse guided by an evidence-based treatment protocol for depression and who collaborated with the patients' primary care physicians and the study's clinical management team, composed of a psychiatrist, psychologist and internist. This approach has proven effective for treating major depression in primary care settings but had never before been applied to a population with cardiac disease.
"Dozens of studies have described a link between depression and heart disease, and the latest guidelines from the American Heart Association recommend screening all patients with heart disease for depression," said Dr. Rollman. "However, few depression treatment trials have been conducted in patients with cardiac disease, and none used the collaborative care model or examined the impact of treating post-CABG depression on quality of life, re-hospitalizations or health care costs, as we did."
Investigators recruited 453 post-CABG patients at seven Pittsburgh-area hospitals, from 2004 through 2007. They included 302 depressed patients who were randomly assigned to either an eight-month course of telephone-delivered collaborative care or to their doctors' usual care for depression. Investigators also randomly sampled an additional 151 non-depressed, post-CABG patients to facilitate comparisons to depressed patients. They tracked these patients for up to four years to monitor quality of life, physical functioning, mood symptoms, re-hospitalizations, health care costs and deaths. Analysis of the data is ongoing.
Co-authors of the study include Wishwa N. Kapoor, M.D., M.P.H., professor of medicine, Division of General Internal Medicine, and director, Center for Research on Health Care, Charles F. Reynolds III, M.D., department of psychiatry, Western Psychiatric Institute and Clinic, Sati Mazumdar, Ph.D., professor of biostatistics, Graduate School of Public Health, Patty Houck, M.D., statistical services administrator, Graduate School of Public Health, and Peter Counihan, M.D., associate professor of medicine, Cardiovascular Institute, all of the University of Pittsburgh; and Herbert C. Schulberg, Ph.D., psychiatry, Weill Cornell Medical School, and professor emeritus of psychiatry at the University of Pittsburgh.
Dr. Rollman is supported by funding from the National Heart, Lung, and Blood Institute, part of the National Institutes of Health.
The University of Pittsburgh School of Medicine is one of the nation's leading medical schools, renowned for its curriculum that emphasizes both the science and humanity of medicine and its remarkable growth in National Institutes of Health (NIH) grant support, which has more than doubled since 1998. For fiscal year 2007, the University ranked sixth out of more than 3,000 entities receiving NIH support with respect to the research grants awarded to its faculty. As one of the university's six Schools of the Health Sciences, the School of Medicine is the academic partner to the University of Pittsburgh Medical Center (UPMC). Their combined mission is to train tomorrow's health care specialists and biomedical scientists, engage in groundbreaking research that will advance understanding of the causes and treatments of disease and participate in the delivery of outstanding patient care.
University of Pittsburgh Medical Center
U.S. Steel Tower, 600 Grant St., 57th Floor, Pittsburgh, PA 15213 United States
upmc
During Pregnancy Acupuncture Found To Lessen Depression Symptoms, Stanford Study Shows
Acupuncture appears to be an effective way to reduce depression symptoms during pregnancy, according to a first-of-its-kind study from Stanford University School of Medicine researchers.
The study authors, led by Rachel Manber, PhD, professor of psychiatry and behavioral sciences, said they hope the results will raise awareness of the problem of depression during pregnancy and provide patients and physicians an alternative to antidepressants. "This standardized acupuncture protocol could be a viable treatment option for depression during pregnancy," they wrote in a paper that will appear in the March issue of Obstetrics & Gynecology.
Up to 14 percent of pregnant women may have major depressive disorder, a condition characterized by feelings of dread, gloom and hopelessness, and a loss of interest in normally pleasurable activities. Some women suffer from depression before becoming pregnant, stop taking their medication and then experience a relapse; in other women, pregnancy itself may cause depression.
Clinicians aren't exactly sure how pregnancy leads to the disorder, but an influx of hormones could be the culprit. Some women might also feel overwhelmed by the major changes in their life, which could trigger depression. "Pregnancy just by its nature can bring out some underlying psychiatric and emotional issues," said co-author Deirdre Lyell, MD, assistant professor of obstetrics and gynecology.
Depression, if left untreated, can pose risks to both mother and baby. The mom-to-be could stop taking care of herself or her fetus, and might even engage in self-destructive behavior. Studies have also linked depression during pregnancy to poor birth outcomes and postpartum depression. "Treatment of depression during pregnancy is critically important so that a woman can maintain her sense of well-being and take good care of herself, her fetus and, someday, her child," said Lyell.
The use of antidepressants during pregnancy doubled between 1999 and 2003, according to a 2007 American Journal of Obstetrics and Gynecology study, but many women avoid taking medication because of safety concerns. In fact, Manber said, 94 percent of the depressed women involved in her study expressed reluctance to take antidepressants.
"Because there's this concern about medication among pregnant women and their physicians, it's important to find an alternative," said Manber.
For this study, the researchers recruited 150 women whose pregnancies were between 12 and 30 weeks gestation and who met the criteria for major depressive disorder. The women were randomized to receive one of three treatments: acupuncture specific for depression; control acupuncture, during which needles were inserted in points not known to help alleviate depressive symptoms; or massage. All of the women received eight weeks of therapy and were assessed for depression at the four- and eight-week marks by an interviewer who was unaware of the treatment each woman received.
The researchers found that women who received the depression-specific acupuncture experienced a bigger reduction in depression symptoms than the women in the other groups. The response rate - defined as having a 50 percent or greater reduction in symptoms - was 63 percent for the women receiving depression-specific acupuncture, compared with 44 percent for the women in the other two treatment groups combined.
The researchers weren't surprised by what they found - a pilot study yielded similar results, and other studies have shown acupuncture is an effective treatment for depression in the general public - but they were pleased with the results.
"I don't think that one-size-fits-all treatments are appropriate for everyone, but acupuncture should be considered as an option," said Lyell. "I hope that people will respect the rigorous methodology used in this blinded, randomized, controlled trial and accept the result: Traditional acupuncture was associated with a significant improvement in depression."
Both Manber and Lyell said they plan to continue their research on women's health during pregnancy and postpartum. Lyell recently presented work showing that practitioners under-identify and under-acknowledge depression during pregnancy, and she's now analyzing birth-outcome data to look for correlations between depression, treatment and obstetric outcomes.
This study was funded by the Agency for Healthcare Research & Quality. Other Stanford authors on the study include Rosa Schnyer, DAOM; Andrea Chambers, PhD; Maurice Druzin, MD; Erin Carlyle; Christine Celio; Jenna Gress; Mary Huang; Tasha Kalista and Robin Martin-Okada.
The study authors, led by Rachel Manber, PhD, professor of psychiatry and behavioral sciences, said they hope the results will raise awareness of the problem of depression during pregnancy and provide patients and physicians an alternative to antidepressants. "This standardized acupuncture protocol could be a viable treatment option for depression during pregnancy," they wrote in a paper that will appear in the March issue of Obstetrics & Gynecology.
Up to 14 percent of pregnant women may have major depressive disorder, a condition characterized by feelings of dread, gloom and hopelessness, and a loss of interest in normally pleasurable activities. Some women suffer from depression before becoming pregnant, stop taking their medication and then experience a relapse; in other women, pregnancy itself may cause depression.
Clinicians aren't exactly sure how pregnancy leads to the disorder, but an influx of hormones could be the culprit. Some women might also feel overwhelmed by the major changes in their life, which could trigger depression. "Pregnancy just by its nature can bring out some underlying psychiatric and emotional issues," said co-author Deirdre Lyell, MD, assistant professor of obstetrics and gynecology.
Depression, if left untreated, can pose risks to both mother and baby. The mom-to-be could stop taking care of herself or her fetus, and might even engage in self-destructive behavior. Studies have also linked depression during pregnancy to poor birth outcomes and postpartum depression. "Treatment of depression during pregnancy is critically important so that a woman can maintain her sense of well-being and take good care of herself, her fetus and, someday, her child," said Lyell.
The use of antidepressants during pregnancy doubled between 1999 and 2003, according to a 2007 American Journal of Obstetrics and Gynecology study, but many women avoid taking medication because of safety concerns. In fact, Manber said, 94 percent of the depressed women involved in her study expressed reluctance to take antidepressants.
"Because there's this concern about medication among pregnant women and their physicians, it's important to find an alternative," said Manber.
For this study, the researchers recruited 150 women whose pregnancies were between 12 and 30 weeks gestation and who met the criteria for major depressive disorder. The women were randomized to receive one of three treatments: acupuncture specific for depression; control acupuncture, during which needles were inserted in points not known to help alleviate depressive symptoms; or massage. All of the women received eight weeks of therapy and were assessed for depression at the four- and eight-week marks by an interviewer who was unaware of the treatment each woman received.
The researchers found that women who received the depression-specific acupuncture experienced a bigger reduction in depression symptoms than the women in the other groups. The response rate - defined as having a 50 percent or greater reduction in symptoms - was 63 percent for the women receiving depression-specific acupuncture, compared with 44 percent for the women in the other two treatment groups combined.
The researchers weren't surprised by what they found - a pilot study yielded similar results, and other studies have shown acupuncture is an effective treatment for depression in the general public - but they were pleased with the results.
"I don't think that one-size-fits-all treatments are appropriate for everyone, but acupuncture should be considered as an option," said Lyell. "I hope that people will respect the rigorous methodology used in this blinded, randomized, controlled trial and accept the result: Traditional acupuncture was associated with a significant improvement in depression."
Both Manber and Lyell said they plan to continue their research on women's health during pregnancy and postpartum. Lyell recently presented work showing that practitioners under-identify and under-acknowledge depression during pregnancy, and she's now analyzing birth-outcome data to look for correlations between depression, treatment and obstetric outcomes.
This study was funded by the Agency for Healthcare Research & Quality. Other Stanford authors on the study include Rosa Schnyer, DAOM; Andrea Chambers, PhD; Maurice Druzin, MD; Erin Carlyle; Christine Celio; Jenna Gress; Mary Huang; Tasha Kalista and Robin Martin-Okada.
Hewitt Hails Talking Therapy Pilots A Success And Announces More To Follow, UK
Following the success of the psychological therapies pilot programme
in Doncaster and Newham, Health Secretary Patricia Hewitt today
announced new funding for a further ten pathfinder projects.
At any one time, one in six adults experiences a mental health
problem - more than will suffer from cancer or heart disease - and
many of these suffer from more common problems such as anxiety or
depression. Clinical evidence shows that better access to Cognitive
Behavioural Therapy (CBT) can help cure depression and reduce time
off work due to ill-health. Patients also prefer talking therapy,
just one example of CBT, rather than being dependent on medication
alone.
The Department of Health Increasing Access to Psychological Therapies
programme currently has two demonstration sites which are linked to
regional networks of local improvement projects. The sites are
showing that quicker access to therapy services can help patients to
recover from illness and return to leading an independent lifestyle,
particularly in terms of returning to work or finding employment.
Speaking at the Improving Access to Psychological Therapies
conference in London, Patricia Hewitt announced that the ten new
pilots will lead the way in expanding access to talking therapies
across England, backed by investment of ??2 million.
Patricia Hewitt said:
"The blight of mental illness is an issue we are committed to
tackling. Central to our efforts is the ability for people who are
ill to be able to quickly get the right kind of therapy, instead of
being prescribed medication. Mental health services are improving but
we want to offer patients greater choice over how, when and where
they are treated.
"A year ago, I launched two demonstration sites to establish the best
way of providing therapy and to examine the benefits of this
treatment approach. One year on and PCTs are now obliged to provide
computerised CBT to patients.
"The demonstration sites are showing early signs that if you provide
quick access to therapy services, the time that patients are ill is
reduced and individuals are better able regain their independence -
for example by getting or keeping a job.
"I am pleased to announce today the next phase in the programme, with
the establishment of 10 more PCT-led demonstration sites across
England. We have a vision that, one day, people will have the choice
of quickly and conveniently accessing a range of therapy services,
for example via the internet or the local library. But for this to
happen, we need a range of different organisations - such as social
enterprises - to form partnerships with the health sector and apply
to run these new sites. Together we can help to reduce the impact of
mental illness."
The projects in Doncaster and Newham have proved highly successful -
the Doncaster project alone has already seen 2,500 patients, with
clinical outcomes exceeding the expectations set down by the National
Institute for Health and Clinical Excellence (NICE), and 9 out of 10
patients saying that they were highly satisfied with the service.
Ann, a patient at the Doncaster project who is speaking at the
conference, suffered from clinical depression. Two years ago, she
underwent a course of CBT and as a result, was able to come off
medication. She now uses CBT as part of an ongoing coping strategy.
Commenting on the benefits of CBT, Ann said:
"Psychological therapy has made a huge difference to my life and
basically helped me to keep functioning.
"CBT involves helping yourself by recognising and challenging
negative thoughts. It is now very much part of my every day existence
and has helped me to get an entirely new, far more positive outlook
on life."
Psychological therapies have more than a purely mental health
benefit. Helping people to cope better with anxiety and depression
can also have a positive effect on physical health, therefore leading
to fewer hospital admissions and less dependency on local GP services
for those who also have a long term condition. Investing in talking
therapies can reduce costs not only in primary and secondary care,
but can also impact other areas of people's lives, for example, by
helping them to get back to work.
The British Psychological Society's President, Professor Pam Maras
said:
"We welcome any opportunity for qualified applied psychologists to
make significant contributions in the expansion of evidence-based
psychological therapies, and to deliver those services in ways that
guarantee high quality and effectiveness for all mental health
problems."
1. Improving access to talking therapies has the potential to save
the economy millions of pounds by helping people with mild to
moderate depression to get back into employment and off incapacity
benefit. About one in three of the 1.3 million people claiming
long-term incapacity benefit in the UK have a mental health problem,
mostly mild to moderate depression.
2. The pilots will provide real evidence of the benefits that can be
gained from increasing access to psychological therapies, both to the
individual and to the local economy. The first two pilot
demonstration sites were given ??3.7 million funding over two years
from the Department of Health.
3. Local people will benefit from the pilots by having:
- Access to coping strategies and support as an alternative to taking
sick leave from work due to depression;
- Better support in the work place from Occupational Health;
- Retaining employment, even where the individual may suffer from
stress, anxiety or depression;
- Enabling people on benefits to return to work more quickly; and
- More choice over their care and treatment.
4. The process for applying for pathfinder site status is as follows:
initial expressions of interest to bid to be one of the pilot sites
should be submitted to the Department of Health by 31 May. These will
then be followed up by local Regional Development Centre leads who
will help sites to develop final, full, applications to be submitted
by 29 June. The successful sites will be confirmed by 20 July. It is
expected that new services should be operational by September.
5. A positive practice guide to increasing access to psychological
therapies was also launched at the conference. Commissioning a
Brighter Future explains why the Government is committed to
increasing access and highlights examples of best practice from
across England. To download Commissioning a Brighter Future and the
other documents launched on the day, visit dh.uk/mentalhealth
dh.uk
in Doncaster and Newham, Health Secretary Patricia Hewitt today
announced new funding for a further ten pathfinder projects.
At any one time, one in six adults experiences a mental health
problem - more than will suffer from cancer or heart disease - and
many of these suffer from more common problems such as anxiety or
depression. Clinical evidence shows that better access to Cognitive
Behavioural Therapy (CBT) can help cure depression and reduce time
off work due to ill-health. Patients also prefer talking therapy,
just one example of CBT, rather than being dependent on medication
alone.
The Department of Health Increasing Access to Psychological Therapies
programme currently has two demonstration sites which are linked to
regional networks of local improvement projects. The sites are
showing that quicker access to therapy services can help patients to
recover from illness and return to leading an independent lifestyle,
particularly in terms of returning to work or finding employment.
Speaking at the Improving Access to Psychological Therapies
conference in London, Patricia Hewitt announced that the ten new
pilots will lead the way in expanding access to talking therapies
across England, backed by investment of ??2 million.
Patricia Hewitt said:
"The blight of mental illness is an issue we are committed to
tackling. Central to our efforts is the ability for people who are
ill to be able to quickly get the right kind of therapy, instead of
being prescribed medication. Mental health services are improving but
we want to offer patients greater choice over how, when and where
they are treated.
"A year ago, I launched two demonstration sites to establish the best
way of providing therapy and to examine the benefits of this
treatment approach. One year on and PCTs are now obliged to provide
computerised CBT to patients.
"The demonstration sites are showing early signs that if you provide
quick access to therapy services, the time that patients are ill is
reduced and individuals are better able regain their independence -
for example by getting or keeping a job.
"I am pleased to announce today the next phase in the programme, with
the establishment of 10 more PCT-led demonstration sites across
England. We have a vision that, one day, people will have the choice
of quickly and conveniently accessing a range of therapy services,
for example via the internet or the local library. But for this to
happen, we need a range of different organisations - such as social
enterprises - to form partnerships with the health sector and apply
to run these new sites. Together we can help to reduce the impact of
mental illness."
The projects in Doncaster and Newham have proved highly successful -
the Doncaster project alone has already seen 2,500 patients, with
clinical outcomes exceeding the expectations set down by the National
Institute for Health and Clinical Excellence (NICE), and 9 out of 10
patients saying that they were highly satisfied with the service.
Ann, a patient at the Doncaster project who is speaking at the
conference, suffered from clinical depression. Two years ago, she
underwent a course of CBT and as a result, was able to come off
medication. She now uses CBT as part of an ongoing coping strategy.
Commenting on the benefits of CBT, Ann said:
"Psychological therapy has made a huge difference to my life and
basically helped me to keep functioning.
"CBT involves helping yourself by recognising and challenging
negative thoughts. It is now very much part of my every day existence
and has helped me to get an entirely new, far more positive outlook
on life."
Psychological therapies have more than a purely mental health
benefit. Helping people to cope better with anxiety and depression
can also have a positive effect on physical health, therefore leading
to fewer hospital admissions and less dependency on local GP services
for those who also have a long term condition. Investing in talking
therapies can reduce costs not only in primary and secondary care,
but can also impact other areas of people's lives, for example, by
helping them to get back to work.
The British Psychological Society's President, Professor Pam Maras
said:
"We welcome any opportunity for qualified applied psychologists to
make significant contributions in the expansion of evidence-based
psychological therapies, and to deliver those services in ways that
guarantee high quality and effectiveness for all mental health
problems."
1. Improving access to talking therapies has the potential to save
the economy millions of pounds by helping people with mild to
moderate depression to get back into employment and off incapacity
benefit. About one in three of the 1.3 million people claiming
long-term incapacity benefit in the UK have a mental health problem,
mostly mild to moderate depression.
2. The pilots will provide real evidence of the benefits that can be
gained from increasing access to psychological therapies, both to the
individual and to the local economy. The first two pilot
demonstration sites were given ??3.7 million funding over two years
from the Department of Health.
3. Local people will benefit from the pilots by having:
- Access to coping strategies and support as an alternative to taking
sick leave from work due to depression;
- Better support in the work place from Occupational Health;
- Retaining employment, even where the individual may suffer from
stress, anxiety or depression;
- Enabling people on benefits to return to work more quickly; and
- More choice over their care and treatment.
4. The process for applying for pathfinder site status is as follows:
initial expressions of interest to bid to be one of the pilot sites
should be submitted to the Department of Health by 31 May. These will
then be followed up by local Regional Development Centre leads who
will help sites to develop final, full, applications to be submitted
by 29 June. The successful sites will be confirmed by 20 July. It is
expected that new services should be operational by September.
5. A positive practice guide to increasing access to psychological
therapies was also launched at the conference. Commissioning a
Brighter Future explains why the Government is committed to
increasing access and highlights examples of best practice from
across England. To download Commissioning a Brighter Future and the
other documents launched on the day, visit dh.uk/mentalhealth
dh.uk
Head Injury Could Amplify Psychiatric Impact Of Torture
Depression and other emotional symptoms in survivors of torture and other traumatic experiences may be exacerbated by the effects of head injuries, according to a study from the Harvard Program in Refugee Trauma (HPRT), based in the Massachusetts General Hospital (MGH) Department of Psychiatry. In the November 2009 Archives of General Psychiatry, the researchers report finding structural changes in the brains of former South Vietnamese political detainees who had suffered head injuries and clearly link those changes to psychiatric symptoms often seen in survivors of torture.
"This is the first study since the 1950s to demonstrate brain changes in survivors of extreme violence. That work looked at Holocaust survivors, and now we are the first to connect similar brain damage with mental health issues in survivors of political torture," says Richard Mollica, MD, director of the HPRT and leader of the study. "We believe, although it has not yet been proven, that these physical effects may help explain why survivors of both torture and traumatic head injury often don't do well with standard therapies for depression and anxiety."
Studies by Mollica's team and others have documented the fact that head injures are a common form of torture among prisoners of war and political detainees. But no previous work has investigated whether the neurologic effects of head injuries were related to the chronic psychiatric disorders often reported in torture survivors. The current study analyzed information from 42 Vietnamese immigrants, now resettled in the U.S., who had been detained in so-called "re-education camps" and 15 Vietnamese immigrants of similar ages who had not been detained.
All study participants completed questionnaires regarding any history of head injuries and on their exposure to torture or other traumatic experiences before being interviewed by study investigators to assess current symptoms of depression and post-traumatic stress disorder. Comprehensive magnetic resonance imaging studies measured the size and thickness of brain structures that previous reports have associated with depression, anxiety and post-traumatic stress disorder (PTSD) and also have suggested could be affected by traumatic head injuries.
Among the former detainees, 16 reported having experienced head injuries at some time, and 26 did not. Not only were detainees with a history of head injury more likely than those without to report symptoms of depression, the imaging studies showed they had significant reductions in the thickness of the frontal and temporal lobes of the cerebral cortex, reductions not seen in non-head-injured detainees. Participants whose head injuries were more severe had even greater structural changes and more debilitating depression symptoms. These head-injury-associated effects were independent of the effects of other forms of torture or trauma participants had experienced. While head-injured ex-detainees did not have a greater risk of being diagnosed with PTSD, their PTSD symptoms were more severe.
"It's well known in neuropsychology that the frontal and temporal lobes affect executive function - which includes planning, learning, self-monitoring, and flexibility in social interactions," Mollica explains. "It could be that torture survivors who don't do well with standard therapies have head-injury-based cognitive deficits that interfere with standard approaches like behavioral or exposure therapy. It's very rare for patients to relate subsequent health problems to a head injury or to recognize that a head injury is affecting their emotions.
"In some cultures," he adds, "patients and families are relieved to learn that emotional problems are related to a physical injury and may become more committed to working with programs specially designed to treat head injury patients. We hope that our documenting physical effects of brain damage in a group of torture survivors will provide evidence leading to improved diagnostic and treatment approaches. The next steps should be clinical trials comparing the results of head-injury-specific treatment programs with more traditional therapies for emotional disorders in patients with a history of both trauma and head injury."
Mollica also notes the need to improve training for the physicians most likely to treat such patients in the community. "Most primary care physicians are not prepared to identify mild traumatic head injury either in patients who may have experienced trauma or torture - including veterans or refugees - or in survivors of assaults or even auto accidents." He is a professor of Psychiatry at Harvard Medical School.
Co-authors of the study - supported by grants from the U.S. National Institute of Health and the Ministry of Education, Science and Technology of South Korea - are James Lavelle, LICSW, HRTP and MGH Psychiatry; In Kyoon Lyoo, MD, PhD, McLean Hospital; Miriam Chernoff, PhD, Harvard School of Public Health; Hoan Bui, Vietnamese-American Civic Association, Dorchester, Mass.; Sujung Yoon, MD, PhD, Catholic University Medical College, Seoul; Jieun Kim, MD, Seoul National University; and Perry Renshaw, MD, PhD, University of Utah.
"This is the first study since the 1950s to demonstrate brain changes in survivors of extreme violence. That work looked at Holocaust survivors, and now we are the first to connect similar brain damage with mental health issues in survivors of political torture," says Richard Mollica, MD, director of the HPRT and leader of the study. "We believe, although it has not yet been proven, that these physical effects may help explain why survivors of both torture and traumatic head injury often don't do well with standard therapies for depression and anxiety."
Studies by Mollica's team and others have documented the fact that head injures are a common form of torture among prisoners of war and political detainees. But no previous work has investigated whether the neurologic effects of head injuries were related to the chronic psychiatric disorders often reported in torture survivors. The current study analyzed information from 42 Vietnamese immigrants, now resettled in the U.S., who had been detained in so-called "re-education camps" and 15 Vietnamese immigrants of similar ages who had not been detained.
All study participants completed questionnaires regarding any history of head injuries and on their exposure to torture or other traumatic experiences before being interviewed by study investigators to assess current symptoms of depression and post-traumatic stress disorder. Comprehensive magnetic resonance imaging studies measured the size and thickness of brain structures that previous reports have associated with depression, anxiety and post-traumatic stress disorder (PTSD) and also have suggested could be affected by traumatic head injuries.
Among the former detainees, 16 reported having experienced head injuries at some time, and 26 did not. Not only were detainees with a history of head injury more likely than those without to report symptoms of depression, the imaging studies showed they had significant reductions in the thickness of the frontal and temporal lobes of the cerebral cortex, reductions not seen in non-head-injured detainees. Participants whose head injuries were more severe had even greater structural changes and more debilitating depression symptoms. These head-injury-associated effects were independent of the effects of other forms of torture or trauma participants had experienced. While head-injured ex-detainees did not have a greater risk of being diagnosed with PTSD, their PTSD symptoms were more severe.
"It's well known in neuropsychology that the frontal and temporal lobes affect executive function - which includes planning, learning, self-monitoring, and flexibility in social interactions," Mollica explains. "It could be that torture survivors who don't do well with standard therapies have head-injury-based cognitive deficits that interfere with standard approaches like behavioral or exposure therapy. It's very rare for patients to relate subsequent health problems to a head injury or to recognize that a head injury is affecting their emotions.
"In some cultures," he adds, "patients and families are relieved to learn that emotional problems are related to a physical injury and may become more committed to working with programs specially designed to treat head injury patients. We hope that our documenting physical effects of brain damage in a group of torture survivors will provide evidence leading to improved diagnostic and treatment approaches. The next steps should be clinical trials comparing the results of head-injury-specific treatment programs with more traditional therapies for emotional disorders in patients with a history of both trauma and head injury."
Mollica also notes the need to improve training for the physicians most likely to treat such patients in the community. "Most primary care physicians are not prepared to identify mild traumatic head injury either in patients who may have experienced trauma or torture - including veterans or refugees - or in survivors of assaults or even auto accidents." He is a professor of Psychiatry at Harvard Medical School.
Co-authors of the study - supported by grants from the U.S. National Institute of Health and the Ministry of Education, Science and Technology of South Korea - are James Lavelle, LICSW, HRTP and MGH Psychiatry; In Kyoon Lyoo, MD, PhD, McLean Hospital; Miriam Chernoff, PhD, Harvard School of Public Health; Hoan Bui, Vietnamese-American Civic Association, Dorchester, Mass.; Sujung Yoon, MD, PhD, Catholic University Medical College, Seoul; Jieun Kim, MD, Seoul National University; and Perry Renshaw, MD, PhD, University of Utah.
'Brain Injury' Is Newest Disability Intensive Course Introduced To College Of Direct Support Curriculum
The College of Direct Support (CDS), an internet-based college for Direct Support Professionals (DSPs) and managed in partnership by Elsevier/MC Strategies and the University of Minnesota's Research and Training Center, has introduced its fourth Disability Intensive Course (DIC) into the CDS Curriculum "Brain Injury."
This newest DIC course in the CDS curriculum joins the courses on "Autism and Autism Spectrum Disorders," "Cerebral Palsy," and "Depression."
Jennifer Hall-Lande and Michelle Trotter, Research Assistants at the Institute on Community Integration (ICI) at the University of Minnesota, co-authored this course. The ICI team creates and authors all CDS courses. A DIC is a specialized course within the CDS that focuses on one disability or condition. Unlike other CDS courses, they have only one lesson. Each course defines and describes the nature of a specific condition. It has information about the causes, characteristics, and symptoms and shares some stories of people who have this condition.
This course will give Direct Support Professionals (DSPs) and others an overview of brain injury and covers the challenges someone with a brain injury may face. It will help them understand the short and long-term effects of brain injury and cover some of the most common causes of brain injury.
Brain injury is a greater problem than most people think. Someone in the United States sustains a brain injury every 21 seconds, according to the Brain Injury Association of America. These injuries can result in short-term issues. But they can also result in lifelong challenges. Chances are a learner will be taking this course because they support someone who has a brain injury. They may be a DSP, a family member or a friend of someone with a brain injury.
The leading causes of Brain Injury are: Falls 28%; Motor Vehicle Accidents 20%; Collisions or being hit by an object 19%; Unknown or other 16%; Assault 11%; Bicycle accident 3%; Other transport 2%; and Suicide 1%.
This newest DIC course in the CDS curriculum joins the courses on "Autism and Autism Spectrum Disorders," "Cerebral Palsy," and "Depression."
Jennifer Hall-Lande and Michelle Trotter, Research Assistants at the Institute on Community Integration (ICI) at the University of Minnesota, co-authored this course. The ICI team creates and authors all CDS courses. A DIC is a specialized course within the CDS that focuses on one disability or condition. Unlike other CDS courses, they have only one lesson. Each course defines and describes the nature of a specific condition. It has information about the causes, characteristics, and symptoms and shares some stories of people who have this condition.
This course will give Direct Support Professionals (DSPs) and others an overview of brain injury and covers the challenges someone with a brain injury may face. It will help them understand the short and long-term effects of brain injury and cover some of the most common causes of brain injury.
Brain injury is a greater problem than most people think. Someone in the United States sustains a brain injury every 21 seconds, according to the Brain Injury Association of America. These injuries can result in short-term issues. But they can also result in lifelong challenges. Chances are a learner will be taking this course because they support someone who has a brain injury. They may be a DSP, a family member or a friend of someone with a brain injury.
The leading causes of Brain Injury are: Falls 28%; Motor Vehicle Accidents 20%; Collisions or being hit by an object 19%; Unknown or other 16%; Assault 11%; Bicycle accident 3%; Other transport 2%; and Suicide 1%.
Brain Pathway May Underlie Depression
High-speed camera snapshots may have pinpointed a spot in the brain that serves as a marker for depression. Investigators have observed that electrical chatter in the dentate gyrus-a C-shaped region of the hippocampus-contracts in depressed rats but expands again after the animals receive antidepressants.
The region may represent a common pathway or intersection for brain activity in those suffering from depression, offering a springboard from which to map that activity and better understand the condition, says Karl Deisseroth, a Stanford University neuroengineer and psychiatrist, who led the study published online this week by Science.
Finding a common depression pathway in humans that could guide the search for treatments remains a "holy grail" of psychiatry, he says. "One of the mysteries of depression is how there can be so many different causes ??¦ and so many different treatments." A common pathway would bridge them, he adds.
The researchers induced depressionlike symptoms in rats by blasting static noise or otherwise annoying the animals at unpredictable intervals for several weeks. The chronically stressed rats swam less vigorously in a tank of water, indicating their feelings of rodent hopelessness.
To analyze the rats' brains, the team extracted brain slices from depressed and normal animals, soaked them in voltage-sensitive dye, and prodded them with electrodes next to a high-speed camera. When the brain cells fired, they activated the dye.
The camera was trained on the hippocampus, a small peanut-shaped part of the brain known to play a role in learning and memory, including navigation, but also implicated in mood and depression. The team found a smaller aura of activity originating from the curved dentate gyrus than in normal rats.
"We can do the equivalent of looking at one circuit board in a computer and find something that predicts behavior," Deisseroth says.
The result fit with prior research indicating that accelerated growth of new brain cells in the dentate gyrus, in a process called neurogenesis, is necessary for antidepressants to cure rats of their depression. When fed fluoxetine (Prozac), the depressed rats experienced more rapid neurogenesis and the range of electrical signals from their dentate gyri spread as far as in normal rats, the group reports.
Matching up depressed behavior with hippocampal activity is "pretty amazing," says Helen Mayberg, professor of psychiatry and neurology at Emory University in Atlanta. "It tells us the hippocampus is very involved," she says, "but it doesn't tell us it's the origin of the problem."
The hippocampus sends and receives information to and from many other brain regions, and mapping those connections in depressed animals is the next step, she says.
The causes of depression remain elusive, but Deisseroth sees a connection between the disease and the way that damage to the hippocampus can prevent people from remembering where things are located.
Similarly, although depression sufferers may face the same obstacles as others, "they just can't seem to see a path forward," he says. With any luck, he adds, his group's finding will put researchers on a path to figuring out a way to help them.
"A crescent of electrical activity spotted in rats may allow researchers to map the depressed brain"
By JR Minkel
Scientific American
Click here to view article online
sciam
View drug information on Prozac Weekly.
The region may represent a common pathway or intersection for brain activity in those suffering from depression, offering a springboard from which to map that activity and better understand the condition, says Karl Deisseroth, a Stanford University neuroengineer and psychiatrist, who led the study published online this week by Science.
Finding a common depression pathway in humans that could guide the search for treatments remains a "holy grail" of psychiatry, he says. "One of the mysteries of depression is how there can be so many different causes ??¦ and so many different treatments." A common pathway would bridge them, he adds.
The researchers induced depressionlike symptoms in rats by blasting static noise or otherwise annoying the animals at unpredictable intervals for several weeks. The chronically stressed rats swam less vigorously in a tank of water, indicating their feelings of rodent hopelessness.
To analyze the rats' brains, the team extracted brain slices from depressed and normal animals, soaked them in voltage-sensitive dye, and prodded them with electrodes next to a high-speed camera. When the brain cells fired, they activated the dye.
The camera was trained on the hippocampus, a small peanut-shaped part of the brain known to play a role in learning and memory, including navigation, but also implicated in mood and depression. The team found a smaller aura of activity originating from the curved dentate gyrus than in normal rats.
"We can do the equivalent of looking at one circuit board in a computer and find something that predicts behavior," Deisseroth says.
The result fit with prior research indicating that accelerated growth of new brain cells in the dentate gyrus, in a process called neurogenesis, is necessary for antidepressants to cure rats of their depression. When fed fluoxetine (Prozac), the depressed rats experienced more rapid neurogenesis and the range of electrical signals from their dentate gyri spread as far as in normal rats, the group reports.
Matching up depressed behavior with hippocampal activity is "pretty amazing," says Helen Mayberg, professor of psychiatry and neurology at Emory University in Atlanta. "It tells us the hippocampus is very involved," she says, "but it doesn't tell us it's the origin of the problem."
The hippocampus sends and receives information to and from many other brain regions, and mapping those connections in depressed animals is the next step, she says.
The causes of depression remain elusive, but Deisseroth sees a connection between the disease and the way that damage to the hippocampus can prevent people from remembering where things are located.
Similarly, although depression sufferers may face the same obstacles as others, "they just can't seem to see a path forward," he says. With any luck, he adds, his group's finding will put researchers on a path to figuring out a way to help them.
"A crescent of electrical activity spotted in rats may allow researchers to map the depressed brain"
By JR Minkel
Scientific American
Click here to view article online
sciam
View drug information on Prozac Weekly.
Stress affects hormones which affect immune system which alters mental and physical disease
A panel of experts speaking at Experimental Biology 2004 reports on new understandings of the mechanisms and pathways through which the body's hormonal response to stress alters immune system function and influences susceptibility, onset and exacerbation of mental and physical diseases, including atherosclerotic heart disease, depression, infectious diseases, and autoimmune diseases such as multiple sclerosis.
Thanks to a growing understanding of this process, scientists and clinicians increasingly are identifying individuals' risk factors and are teaching people - from high level executives to young children - simple coping behaviors that can successfully buffer the effect of stress on immune function and health.
The panel on "Alteration of Health by the Hormonal Response to Stress" is made up of members of the PsychoNeuroImmunology Research Society. Chaired by Dr. Bruce S. Rabin, University of Pittsburgh, the symposium is part of the scientific sessions of The American Association of Immunologists, one of the six sponsoring societies of Experimental Biology 2004.
How does stress create damage? Dr. William B. Malarkey, Ohio State University, describes how the perception of stress activates the interface between the endocrine (or hormonal) system and the immune system, initiating a cascade of physiological events. If the perception of stress is short-term, these hormonal changes fade away.
But if the stressful sensory input persists, the resulting dysregulation of the immune system initiates an inflammatory state that, if not stabilized, leads to symptoms and then established disease processes.
Many of these stress-induced inflammatory immune responses are precursors to the chronic diseases of aging, says Dr. Malarkey.
As the immune system modifies in response to hormones produced by stress as perceived by the brain, it produces soluble factors that affect the brain itself. Dr. Andrew H. Miller, Emory University, describes data indicating how this two-way interaction between the brain and immune system has a significant impact on causing and maintaining clinical depression.
Further stressors make things worse. Scientists increasingly recognize that stress in childhood or early life can create a hypervigilancy and hyperresponse to stressors later in life.
This intense response to stress is associated with an increased vulnerability to develop clinically significant depression during chronic immune stimulation, such as occurs during immunotherapy for cancer.
The immune system also plays an important role in the onset and progression of artherosclerotic coronary artery disease, including heart attacks.
By now, most scientists and clinicians - and many lay people - understand that psychological factors can act as risk factors for coronary diseases. Dr. Willem J. Kop, USUHS, explains three types of psychological risk factors and the psychoneuroimmunolgical pathways involved in the progression of coronary disease.
In brief, chronic psychological risk factors, such as hostility and low-socioeconomic status, play important roles at early disease stages. In the transition from stable to unstable atherosclerotic plaques, episodic factors like depression and exhaustion become more important. And finally, acute psychological triggers - mental stress and anger, for example - can promote myocardial ischemia and plaque rupture.
Thus, he says, "the specific hormonal and immunological pathways by which psychological factors promote heart disease change with increasing stages of coronary atherosclerosis."
Dr. Bruce Rabin describes behaviors that help ameliorate hormonal response to stress and how these can be taught or learned on one's own.
At the University of Pittsburgh Medical Center's Healthy Lifestyle Program, which he directs, stress coping behaviors are taught to groups of all ages, from all socioeconomic and educational levels, and to people with autoimmune disease, cancer survivors, and the children of parents who have or have survived cancer.
Techniques include deep breathing, guided imagery using CDs or scripts, and expressive writing (15 minutes writing about a stressor, then discarding the writing without reading it).
Dr. Rabin says that across all groups, people who utilize stress coping behaviors report improvement in the problems they face and in many aspects of their lives, including less depression, improved sleep patterns, enhanced social interactions, and improved ability to be more compliant with diets and good nutrition.
In addition to describing these and other advances in the biopsychosocial approach to health and disease -- the usual exchange of new scientific information that characterizes the interdisciplinary Experimental Biology meetings, Dr. Rabin says he and other panel members believe it is important information personally for those scientists (and journalists) at the meeting whose own lives produce stress-related risks.
Contact: Sarah Goodwin
eb4pressbellsouth
770-270-0989
Federation of American Societies for Experimental Biology
Thanks to a growing understanding of this process, scientists and clinicians increasingly are identifying individuals' risk factors and are teaching people - from high level executives to young children - simple coping behaviors that can successfully buffer the effect of stress on immune function and health.
The panel on "Alteration of Health by the Hormonal Response to Stress" is made up of members of the PsychoNeuroImmunology Research Society. Chaired by Dr. Bruce S. Rabin, University of Pittsburgh, the symposium is part of the scientific sessions of The American Association of Immunologists, one of the six sponsoring societies of Experimental Biology 2004.
How does stress create damage? Dr. William B. Malarkey, Ohio State University, describes how the perception of stress activates the interface between the endocrine (or hormonal) system and the immune system, initiating a cascade of physiological events. If the perception of stress is short-term, these hormonal changes fade away.
But if the stressful sensory input persists, the resulting dysregulation of the immune system initiates an inflammatory state that, if not stabilized, leads to symptoms and then established disease processes.
Many of these stress-induced inflammatory immune responses are precursors to the chronic diseases of aging, says Dr. Malarkey.
As the immune system modifies in response to hormones produced by stress as perceived by the brain, it produces soluble factors that affect the brain itself. Dr. Andrew H. Miller, Emory University, describes data indicating how this two-way interaction between the brain and immune system has a significant impact on causing and maintaining clinical depression.
Further stressors make things worse. Scientists increasingly recognize that stress in childhood or early life can create a hypervigilancy and hyperresponse to stressors later in life.
This intense response to stress is associated with an increased vulnerability to develop clinically significant depression during chronic immune stimulation, such as occurs during immunotherapy for cancer.
The immune system also plays an important role in the onset and progression of artherosclerotic coronary artery disease, including heart attacks.
By now, most scientists and clinicians - and many lay people - understand that psychological factors can act as risk factors for coronary diseases. Dr. Willem J. Kop, USUHS, explains three types of psychological risk factors and the psychoneuroimmunolgical pathways involved in the progression of coronary disease.
In brief, chronic psychological risk factors, such as hostility and low-socioeconomic status, play important roles at early disease stages. In the transition from stable to unstable atherosclerotic plaques, episodic factors like depression and exhaustion become more important. And finally, acute psychological triggers - mental stress and anger, for example - can promote myocardial ischemia and plaque rupture.
Thus, he says, "the specific hormonal and immunological pathways by which psychological factors promote heart disease change with increasing stages of coronary atherosclerosis."
Dr. Bruce Rabin describes behaviors that help ameliorate hormonal response to stress and how these can be taught or learned on one's own.
At the University of Pittsburgh Medical Center's Healthy Lifestyle Program, which he directs, stress coping behaviors are taught to groups of all ages, from all socioeconomic and educational levels, and to people with autoimmune disease, cancer survivors, and the children of parents who have or have survived cancer.
Techniques include deep breathing, guided imagery using CDs or scripts, and expressive writing (15 minutes writing about a stressor, then discarding the writing without reading it).
Dr. Rabin says that across all groups, people who utilize stress coping behaviors report improvement in the problems they face and in many aspects of their lives, including less depression, improved sleep patterns, enhanced social interactions, and improved ability to be more compliant with diets and good nutrition.
In addition to describing these and other advances in the biopsychosocial approach to health and disease -- the usual exchange of new scientific information that characterizes the interdisciplinary Experimental Biology meetings, Dr. Rabin says he and other panel members believe it is important information personally for those scientists (and journalists) at the meeting whose own lives produce stress-related risks.
Contact: Sarah Goodwin
eb4pressbellsouth
770-270-0989
Federation of American Societies for Experimental Biology
AZILECT(R) Shown To Be A Selective MAO-B Inhibitor - Teva To Work With FDA To Modify The Azilect(R) Label
Teva Pharmaceutical Industries Ltd. (NASDAQ: TEVA) today announced results of a study in which Azilect® (rasagiline tablets) demonstrated selective MAO - B inhibition at the approved dose of 1mg. Non selective MAO inhibitors may have some contra indications with certain foods and drugs. These limitations are not associated with selective MAO inhibitors and therefore they can be broadly prescribed.
Based on these positive results, Teva will work with the U.S. Food and Drug Administration (FDA) to modify the AZILECT® label to reflect this data.
Selectivity was tested by evaluating the interaction between tyramine and rasagiline in healthy subjects. This double blind placebo controlled study was conducted in order to comply with the FDA's requirement for full characterization of rasagiline's selectivity. In the study, rasagiline was compared to phenelzine, a known non-selective inhibitor.
About Teva
Teva Pharmaceutical Industries Ltd., headquartered in Israel, is among the top 20 pharmaceutical companies in the world and is the world's leading generic pharmaceutical company. The Company develops, manufactures and markets generic and innovative human pharmaceuticals and active pharmaceutical ingredients, as well as animal health pharmaceutical products. Over 80 percent of Teva's sales are in North America and Europe. tevapharma
Safe Harbor Statement under the U. S. Private Securities Litigation Reform Act of 1995
This release contains forward-looking statements, which express the current beliefs and expectations of management. Such statements are based on management's current beliefs and expectations and involve a number of known and unknown risks and uncertainties that could cause our future results, performance or achievements to differ significantly from the results, performance or achievements expressed or implied by such forward-looking statements. Important factors that could cause or contribute to such differences include risks relating to: our ability to successfully develop and commercialize additional pharmaceutical products, the introduction of competing generic equivalents, the extent to which we may obtain U.S. market exclusivity for certain of our new generic products and regulatory changes that may prevent us from utilizing exclusivity periods, competition from brand-name companies that are under increased pressure to counter generic products, or competitors that seek to delay the introduction of generic products, the impact of consolidation of our distributors and customers, potential liability for sales of generic products prior to a final resolution of outstanding patent litigation, including that relating to the generic versions of Allegra® , Neurontin®, Lotrel® and Protonix®, the effects of competition on our innovative products, especially Copaxone® sales, the impact of pharmaceutical industry regulation and pending legislation that could affect the pharmaceutical industry, the difficulty of predicting U.S. Food and Drug Administration, European Medicines Agency and other regulatory authority approvals, the regulatory environment and changes in the health policies and structures of various countries, our ability to achieve expected results though our innovative R&D efforts, our ability to successfully identify, consummate and integrate acquisitions, including the pending acquisition of Barr Pharmaceuticals Inc., potential exposure to product liability claims to the extent not covered by insurance, dependence on the effectiveness of our patents and other protections for innovative products, significant operations worldwide that may be adversely affected by terrorism, political or economical instability or major hostilities, supply interruptions or delays that could result from the complex manufacturing of our products and our global supply chain, environmental risks, fluctuations in currency, exchange and interest rates, and other factors that are discussed in this report and in our other filings with the U.S. Securities and Exchange Commission ("SEC").
Teva Pharmaceutical Industries Ltd.
View drug information on Allegra; Copaxone; Neurontin.
Based on these positive results, Teva will work with the U.S. Food and Drug Administration (FDA) to modify the AZILECT® label to reflect this data.
Selectivity was tested by evaluating the interaction between tyramine and rasagiline in healthy subjects. This double blind placebo controlled study was conducted in order to comply with the FDA's requirement for full characterization of rasagiline's selectivity. In the study, rasagiline was compared to phenelzine, a known non-selective inhibitor.
About Teva
Teva Pharmaceutical Industries Ltd., headquartered in Israel, is among the top 20 pharmaceutical companies in the world and is the world's leading generic pharmaceutical company. The Company develops, manufactures and markets generic and innovative human pharmaceuticals and active pharmaceutical ingredients, as well as animal health pharmaceutical products. Over 80 percent of Teva's sales are in North America and Europe. tevapharma
Safe Harbor Statement under the U. S. Private Securities Litigation Reform Act of 1995
This release contains forward-looking statements, which express the current beliefs and expectations of management. Such statements are based on management's current beliefs and expectations and involve a number of known and unknown risks and uncertainties that could cause our future results, performance or achievements to differ significantly from the results, performance or achievements expressed or implied by such forward-looking statements. Important factors that could cause or contribute to such differences include risks relating to: our ability to successfully develop and commercialize additional pharmaceutical products, the introduction of competing generic equivalents, the extent to which we may obtain U.S. market exclusivity for certain of our new generic products and regulatory changes that may prevent us from utilizing exclusivity periods, competition from brand-name companies that are under increased pressure to counter generic products, or competitors that seek to delay the introduction of generic products, the impact of consolidation of our distributors and customers, potential liability for sales of generic products prior to a final resolution of outstanding patent litigation, including that relating to the generic versions of Allegra® , Neurontin®, Lotrel® and Protonix®, the effects of competition on our innovative products, especially Copaxone® sales, the impact of pharmaceutical industry regulation and pending legislation that could affect the pharmaceutical industry, the difficulty of predicting U.S. Food and Drug Administration, European Medicines Agency and other regulatory authority approvals, the regulatory environment and changes in the health policies and structures of various countries, our ability to achieve expected results though our innovative R&D efforts, our ability to successfully identify, consummate and integrate acquisitions, including the pending acquisition of Barr Pharmaceuticals Inc., potential exposure to product liability claims to the extent not covered by insurance, dependence on the effectiveness of our patents and other protections for innovative products, significant operations worldwide that may be adversely affected by terrorism, political or economical instability or major hostilities, supply interruptions or delays that could result from the complex manufacturing of our products and our global supply chain, environmental risks, fluctuations in currency, exchange and interest rates, and other factors that are discussed in this report and in our other filings with the U.S. Securities and Exchange Commission ("SEC").
Teva Pharmaceutical Industries Ltd.
View drug information on Allegra; Copaxone; Neurontin.
Future Depression A Risk For Binge-Drinking Teens
Binge-drinking teenagers may be putting themselves at higher risk in adulthood for mood disorders such as anxiety and depression, Loyola University Health System researchers report.
A new Loyola study has found that exposing adolescent rats to binge amounts of alcohol permanently altered the system that produces hormones in response to stress. This disruption in stress hormones "might lead to behavioral and/or mood disorders in adulthood," researchers reported.
Senior author Toni Pak, PhD, and colleagues reported their findings at the annual meeting of the Society for Neuroscience in San Diego.
While results from animal studies don't directly translate to people, the findings do suggest a mechanism by which teenage binge drinking could cause mental health problems in adulthood, Pak said.
"Exposing young people to alcohol could permanently disrupt normal connections in the brain that need to be made to ensure healthy adult brain function," Pak said.
Binge drinking is defined as a woman having at least four drinks or a man having at least five drinks on one occasion. Heavy binge drinkers can consume 10 to 15 drinks. Binge drinking typically begins around age 13 and peaks between 18 and 22, before gradually decreasing. Thirty-six percent of youths ages 18 to 20 reported at least one binge-drinking episode during the past 30 days, according to the Substance Abuse and Mental Health Services Administration.
The Loyola study examined the long-term effects of alcohol on the production of the stress hormone corticosterone in rats. (The equivalent stress hormone in humans is cortisol).
Humans and rats produce stress hormones in response to physical or psychological stress. For example, in a "fight-or-flight" situation, a jolt of cortisol provides a burst of energy and a lower sensitivity to pain, while suppressing functions that aren't immediately needed, such as digestion. However, chronic exposure to cortisol and other stress hormones has been linked to depression, cardiovascular disease and other problems.
In the study, researchers exposed adolescent rats to an 8-day binge drinking pattern: three days of alcohol binging, two days off, then three more days of binging. On binge days, rats were injected with enough alcohol to raise their blood alcohol concentration to between 0.15 percent and 0.2 percent. (In humans such concentrations would be roughly 2 to 2.5 times higher than the 0.08 legal limit for driving.)A control group of rats received injections of saline.
One month later, when the rats were young adults, they were exposed to one of three regimens: saline injections, a one-time alcohol injection or a binge-pattern of alcohol exposure. Alcohol is a form of stress, so not surprisingly, the animals that had either a one-time or binge alcohol exposure produced more of the corticosterone stress hormone. A more significant finding is that among rats that had received alcohol during adolescence, there was a significantly larger spike in corticosterone when they received alcohol during adulthood. These rats also had a lower base level of corticosterone than rats that had remained sober during adolescence. These findings suggest that alcohol exposure during puberty permanently alters the system by which the brain triggers the body to produce stress hormones.
Pak is a molecular neurobiologist and an assistant professor in the Department of Cell and Molecular Physiology at Loyola University Chicago Stritch School of Medicine. Two members of her lab are co-authors of the study: first author Magdalena Przybycien-Szymanska, a PhD student and Roberta Gillespie, a research assistant.
A new Loyola study has found that exposing adolescent rats to binge amounts of alcohol permanently altered the system that produces hormones in response to stress. This disruption in stress hormones "might lead to behavioral and/or mood disorders in adulthood," researchers reported.
Senior author Toni Pak, PhD, and colleagues reported their findings at the annual meeting of the Society for Neuroscience in San Diego.
While results from animal studies don't directly translate to people, the findings do suggest a mechanism by which teenage binge drinking could cause mental health problems in adulthood, Pak said.
"Exposing young people to alcohol could permanently disrupt normal connections in the brain that need to be made to ensure healthy adult brain function," Pak said.
Binge drinking is defined as a woman having at least four drinks or a man having at least five drinks on one occasion. Heavy binge drinkers can consume 10 to 15 drinks. Binge drinking typically begins around age 13 and peaks between 18 and 22, before gradually decreasing. Thirty-six percent of youths ages 18 to 20 reported at least one binge-drinking episode during the past 30 days, according to the Substance Abuse and Mental Health Services Administration.
The Loyola study examined the long-term effects of alcohol on the production of the stress hormone corticosterone in rats. (The equivalent stress hormone in humans is cortisol).
Humans and rats produce stress hormones in response to physical or psychological stress. For example, in a "fight-or-flight" situation, a jolt of cortisol provides a burst of energy and a lower sensitivity to pain, while suppressing functions that aren't immediately needed, such as digestion. However, chronic exposure to cortisol and other stress hormones has been linked to depression, cardiovascular disease and other problems.
In the study, researchers exposed adolescent rats to an 8-day binge drinking pattern: three days of alcohol binging, two days off, then three more days of binging. On binge days, rats were injected with enough alcohol to raise their blood alcohol concentration to between 0.15 percent and 0.2 percent. (In humans such concentrations would be roughly 2 to 2.5 times higher than the 0.08 legal limit for driving.)A control group of rats received injections of saline.
One month later, when the rats were young adults, they were exposed to one of three regimens: saline injections, a one-time alcohol injection or a binge-pattern of alcohol exposure. Alcohol is a form of stress, so not surprisingly, the animals that had either a one-time or binge alcohol exposure produced more of the corticosterone stress hormone. A more significant finding is that among rats that had received alcohol during adolescence, there was a significantly larger spike in corticosterone when they received alcohol during adulthood. These rats also had a lower base level of corticosterone than rats that had remained sober during adolescence. These findings suggest that alcohol exposure during puberty permanently alters the system by which the brain triggers the body to produce stress hormones.
Pak is a molecular neurobiologist and an assistant professor in the Department of Cell and Molecular Physiology at Loyola University Chicago Stritch School of Medicine. Two members of her lab are co-authors of the study: first author Magdalena Przybycien-Szymanska, a PhD student and Roberta Gillespie, a research assistant.
1 In 4 Australian Children Have A Parent With A Mental Illness
Almost a quarter of Australian children are living with a parent who has a mental illness, according to new research published in the January issue of the Psychiatric Bulletin.
Of these, just over 1 % (or approximately 60,000 children) have a parent who has a severe mental illness, such as schizophrenia, manic depression or clinical depression.
The study of the prevalence of parental mental illness in Australian families was carried out by a team of researchers from Australia's Charles Sturt University and LaTrobe University.
To date, there have been few estimates of numbers of children in families with a parental mental illness in Australia. Instead, policy-makers have relied on American data, or small-scale Australian estimates.
In this study, the researchers used three methods to estimate the prevalence of parental mental illness. First, they combined figures from the Australian Bureau of Statistics mental health studies with family characteristics studies to establish a population estimate.
According to this estimate, 23.3% of all children in Australia have a parent with a non-substance mental illness. A smaller proportion - 1.3% - has a parent whose mental illness is severe.
The second approach examined the records of all mental health service users in the state of Victoria between 2003 and 2004 - 38,455 people in total. This showed that 7,829 service users (20.4%) had dependent children.
The final approach used data from a community study of over 700 8- to 12-year-old children living in three Australian states. Of these, 14.4% reported having at least one parent with a mental illness.
Writing in the Psychiatric Bulletin, the study authors said: "Unfortunately, although parental mental illness does not in itself guarantee poor outcomes for children, more severe parent disability has been associated with less sensitive and competent parenting, significantly greater mental illness in offspring, insecure infant attachment, and lower quality of the mother-child relationship.
"The estimate of just under 60,000 children living with a parent with a severe mental illness in Australia is likely to be very accurate as the figures are extrapolated to the Australian context from the 14,403 children of Victorian parents with a severe mental illness. This suggests a large number of children likely to be at risk owing to their parents' severe mental illness."
The authors believe their new estimates provide important information to developers of psychiatric policy and programmes. They said: "This provides basic evidence to governments and mental health support agencies of a large number of children, many of whom could be considered to be living in a high-risk family environment."
Reference:
Maybery DJ, Reupert AE, Patrick K, Goodyear M and Crase L (2009)
"Prevalence of parental mental illness in Australian families"
Psychiatric Bulletin, 33:22-26
About the Royal College of Psychiatrists
The Royal College of Psychiatrists is the professional and educational body for psychiatrists in the United Kingdom and the Republic of Ireland. We promote mental health by:
-- Setting standards and promoting excellence in mental health care
-- Improving understanding through research and education
-- Leading, representing, training and supporting psychiatrists
-- Working with patients, carers and their organisations
rcpsych.ac.uk
Of these, just over 1 % (or approximately 60,000 children) have a parent who has a severe mental illness, such as schizophrenia, manic depression or clinical depression.
The study of the prevalence of parental mental illness in Australian families was carried out by a team of researchers from Australia's Charles Sturt University and LaTrobe University.
To date, there have been few estimates of numbers of children in families with a parental mental illness in Australia. Instead, policy-makers have relied on American data, or small-scale Australian estimates.
In this study, the researchers used three methods to estimate the prevalence of parental mental illness. First, they combined figures from the Australian Bureau of Statistics mental health studies with family characteristics studies to establish a population estimate.
According to this estimate, 23.3% of all children in Australia have a parent with a non-substance mental illness. A smaller proportion - 1.3% - has a parent whose mental illness is severe.
The second approach examined the records of all mental health service users in the state of Victoria between 2003 and 2004 - 38,455 people in total. This showed that 7,829 service users (20.4%) had dependent children.
The final approach used data from a community study of over 700 8- to 12-year-old children living in three Australian states. Of these, 14.4% reported having at least one parent with a mental illness.
Writing in the Psychiatric Bulletin, the study authors said: "Unfortunately, although parental mental illness does not in itself guarantee poor outcomes for children, more severe parent disability has been associated with less sensitive and competent parenting, significantly greater mental illness in offspring, insecure infant attachment, and lower quality of the mother-child relationship.
"The estimate of just under 60,000 children living with a parent with a severe mental illness in Australia is likely to be very accurate as the figures are extrapolated to the Australian context from the 14,403 children of Victorian parents with a severe mental illness. This suggests a large number of children likely to be at risk owing to their parents' severe mental illness."
The authors believe their new estimates provide important information to developers of psychiatric policy and programmes. They said: "This provides basic evidence to governments and mental health support agencies of a large number of children, many of whom could be considered to be living in a high-risk family environment."
Reference:
Maybery DJ, Reupert AE, Patrick K, Goodyear M and Crase L (2009)
"Prevalence of parental mental illness in Australian families"
Psychiatric Bulletin, 33:22-26
About the Royal College of Psychiatrists
The Royal College of Psychiatrists is the professional and educational body for psychiatrists in the United Kingdom and the Republic of Ireland. We promote mental health by:
-- Setting standards and promoting excellence in mental health care
-- Improving understanding through research and education
-- Leading, representing, training and supporting psychiatrists
-- Working with patients, carers and their organisations
rcpsych.ac.uk
Healthcare Commission Needs To Raise The Bar For Mental Health Service Users, UK
Commenting on the Annual Health check, Lisa Rodrigues, Chair of the Mental Health Network of the NHS Confederation, and Chief Executive of Sussex Partnership NHS Foundation Trust said:
"This is the second year running that NHS mental health trusts have been rated as one of the best performing parts of the NHS, the strong performance in the areas of quality and the effective management of resources is particularly pleasing.
"As a mental health trust chief executive myself, I know how hard our staff have worked not only to offer excellent services, but also to provide the evidence for doing so.
"Members of the network will continue to work with the Health commission and its successor the Care Quality Commission (CQC) to develop indicators which more effectively measure outcomes for service users."
"Mental health services are coming increasingly under the public spotlight, and we welcome more scrutiny. We are not complacent, and we know that improvements must continue. The public should be reassured that mental health services are getting better year on year. There is no health without mental health."
The Mental Health Network represents the majority of mental health trusts. It was launched in spring 2007 to provide a distinct voice for providers of NHS mental health services.
The NHS Confederation represents more than 95% of the organisations that make up the NHS. Its members include the majority of NHS acute trusts, ambulance trusts, foundation trusts, mental health trusts, primary care trusts, special health authorities and strategic health authorities in England; trusts and local health boards in Wales; and health and social service trusts and boards in Northern Ireland.
More information on Lisa Rodrigues.
-- About the Mental Health Network
NHS Confederation
nhsconfed
"This is the second year running that NHS mental health trusts have been rated as one of the best performing parts of the NHS, the strong performance in the areas of quality and the effective management of resources is particularly pleasing.
"As a mental health trust chief executive myself, I know how hard our staff have worked not only to offer excellent services, but also to provide the evidence for doing so.
"Members of the network will continue to work with the Health commission and its successor the Care Quality Commission (CQC) to develop indicators which more effectively measure outcomes for service users."
"Mental health services are coming increasingly under the public spotlight, and we welcome more scrutiny. We are not complacent, and we know that improvements must continue. The public should be reassured that mental health services are getting better year on year. There is no health without mental health."
The Mental Health Network represents the majority of mental health trusts. It was launched in spring 2007 to provide a distinct voice for providers of NHS mental health services.
The NHS Confederation represents more than 95% of the organisations that make up the NHS. Its members include the majority of NHS acute trusts, ambulance trusts, foundation trusts, mental health trusts, primary care trusts, special health authorities and strategic health authorities in England; trusts and local health boards in Wales; and health and social service trusts and boards in Northern Ireland.
More information on Lisa Rodrigues.
-- About the Mental Health Network
NHS Confederation
nhsconfed
Stroke Patients Benefit From Non-Intense Physical Activity Which Reduces Depression And Boosts Recovery
You don't always need to build up a big sweat to reap the healing benefits of physical activity.
Research has found that even a low-intense exercise program can reduce depression symptoms and boost physical therapy results in recovering stroke patients.
"The power of physical activity to raise the spirits of recovering stroke patients is stronger than anyone suspected," Heart and Stroke Foundation researcher Dr. Jocelyn Harris told Canadian Stroke Congress, co-hosted by the Canadian Stroke Network, the Heart and Stroke Foundation, and the Canadian Stroke Consortium.
She says that many stroke survivors experience feelings of depression in the weeks and months following stroke, which can interfere with the recovery process. This may be due in part to the fact that depression can cause a lack of motivation, increased fatigue, and trouble concentrating.
Intense physical activity has a positive effect on reducing depression for most stroke patients. But some stroke patients undergoing medical treatments have special challenges and can't reach high activity levels, she says.
"Many stroke patients could never reach aerobic levels high enough to alleviate depressive symptoms," says Dr. Harris, who works at the Toronto Rehabilitation Institute.
Without that fitness boost, depression can become a perpetual, unwelcome guest for stroke patients and their caregivers.
This new study shows there is no reason for these patients to miss out on the benefits of physical activity.
The study followed 103 recovering stroke patients who were all receiving regular, standard treatment in hospital.
Fifty-three -just over half - of the patients were enrolled in an additional, experimental program for upper limb recovery called Graded Repetitive Arm Supplementary Program (GRASP). The remaining 50 patients carried on with regular treatments.
Patients in the GRASP group spent an extra 35 minutes four times a week doing non-intense arm exercises as part of rehabilitation activities, such as pouring water in a glass, buttoning up a shirt, or playing speed and accuracy games.
Depressive symptoms were measured by the Center for Epidemiology Depression Rating Scale (CES-D), which measures symptoms of depression.
The GRASP treatment program improved stroke-affected arm and hand function by 33 per cent as well as improving the amount that the patient used their arm and hands. "At four weeks, the GRASP patients also reported less depressive symptoms and greater change scores than those in the control group did," says Dr. Harris. "The GRASP patients all did better - much better." The effects lasted up to five months.
"Depression and depressive symptoms in the weeks following a stroke are very common. Depression may be a direct result of the damage to a region of brain and in addition, the sudden change in ability and life circumstances," says Heart and Stroke Foundation spokesperson Dr. Michael Hill. "It's important to know that depression is treatable. Patients and caregivers should mention depressive symptoms and seek treatment during follow-up visits with their neurologist, internist, or family physician."
Nobody knows for sure how many patients show depressive symptoms after stroke, says Dr. Harris. "In the literature, the rate ranges between 23 and 72 per cent. That is a huge difference."
These numbers point to the importance of planning for the needs of the baby boom generation who are currently poised to enter the high stroke risk stage, says Dr. Hill.
Dr. Harris wants to take the GRASP program out of the hospital and into the community.
"We need to create more meaning and purpose in the lives of stroke survivors," says Canadian Stroke Network spokesperson Dr. Antoine Hakim. "Whether it is gardening, enjoying the grandchildren, or going for a walk in a beautiful park, there are many focuses that can raise mood, alleviate depression, and improve recovery in stroke survivors."
Research has found that even a low-intense exercise program can reduce depression symptoms and boost physical therapy results in recovering stroke patients.
"The power of physical activity to raise the spirits of recovering stroke patients is stronger than anyone suspected," Heart and Stroke Foundation researcher Dr. Jocelyn Harris told Canadian Stroke Congress, co-hosted by the Canadian Stroke Network, the Heart and Stroke Foundation, and the Canadian Stroke Consortium.
She says that many stroke survivors experience feelings of depression in the weeks and months following stroke, which can interfere with the recovery process. This may be due in part to the fact that depression can cause a lack of motivation, increased fatigue, and trouble concentrating.
Intense physical activity has a positive effect on reducing depression for most stroke patients. But some stroke patients undergoing medical treatments have special challenges and can't reach high activity levels, she says.
"Many stroke patients could never reach aerobic levels high enough to alleviate depressive symptoms," says Dr. Harris, who works at the Toronto Rehabilitation Institute.
Without that fitness boost, depression can become a perpetual, unwelcome guest for stroke patients and their caregivers.
This new study shows there is no reason for these patients to miss out on the benefits of physical activity.
The study followed 103 recovering stroke patients who were all receiving regular, standard treatment in hospital.
Fifty-three -just over half - of the patients were enrolled in an additional, experimental program for upper limb recovery called Graded Repetitive Arm Supplementary Program (GRASP). The remaining 50 patients carried on with regular treatments.
Patients in the GRASP group spent an extra 35 minutes four times a week doing non-intense arm exercises as part of rehabilitation activities, such as pouring water in a glass, buttoning up a shirt, or playing speed and accuracy games.
Depressive symptoms were measured by the Center for Epidemiology Depression Rating Scale (CES-D), which measures symptoms of depression.
The GRASP treatment program improved stroke-affected arm and hand function by 33 per cent as well as improving the amount that the patient used their arm and hands. "At four weeks, the GRASP patients also reported less depressive symptoms and greater change scores than those in the control group did," says Dr. Harris. "The GRASP patients all did better - much better." The effects lasted up to five months.
"Depression and depressive symptoms in the weeks following a stroke are very common. Depression may be a direct result of the damage to a region of brain and in addition, the sudden change in ability and life circumstances," says Heart and Stroke Foundation spokesperson Dr. Michael Hill. "It's important to know that depression is treatable. Patients and caregivers should mention depressive symptoms and seek treatment during follow-up visits with their neurologist, internist, or family physician."
Nobody knows for sure how many patients show depressive symptoms after stroke, says Dr. Harris. "In the literature, the rate ranges between 23 and 72 per cent. That is a huge difference."
These numbers point to the importance of planning for the needs of the baby boom generation who are currently poised to enter the high stroke risk stage, says Dr. Hill.
Dr. Harris wants to take the GRASP program out of the hospital and into the community.
"We need to create more meaning and purpose in the lives of stroke survivors," says Canadian Stroke Network spokesperson Dr. Antoine Hakim. "Whether it is gardening, enjoying the grandchildren, or going for a walk in a beautiful park, there are many focuses that can raise mood, alleviate depression, and improve recovery in stroke survivors."
Gabriel Sciences Receives NIH SBIR Grant For Development Of Antidepressant
Gabriel Sciences, a Maryland biotech company founded by David Pickar MD, enters into a collaborative project, "Triple Re-Uptake Inhibitors: Potential Antidepressants." Candidate compounds synthesized by the research team of Professor Paul Carlier PhD at Virginia Tech, and tested by the research team of Professor Elliott Richelson MD at Mayo Clinic, show activity in preclinical tests that are predictive of antidepressant activity in humans. The grant will allow the selection of a lead compound to continue into preclinical toxicology testing for initial studies in humans. These potential antidepressant compounds have a novel mechanism of action - blockade of transporters for the neurotransmitters norepinephrine, serotonin, and dopamine. This novel "triple reuptake blockade" approach holds promise for a more effective and rapidly-acting antidepressant.
"This award is an example of the promising collaborative opportunities that can be developed between the biotech industry and academic medicine through the NIH SBIR or STTR mechanisms. Gabriel Sciences [Primary Awardee] brings agile drug development abilities to pioneering science from Mayo Clinic [Subawardee]," notes David Pickar MD, President of Gabriel Sciences and Principal Investigator for the grant. Dr. Richelson serves as the Mayo Clinic Investigator for this Grant.
About Gabriel Sciences
Gabriel Sciences (formerly Gabriel Pharma) is a biotech company with the mission to advance treatment and understanding of mental illness through its translational research, including collaborative opportunities with academic medicine. David Pickar MD, founder, is former Chief of the Experimental Therapeutics Branch at National Institute of Mental Health (NIMH) with current adjunct appointments as Professor of Psychiatry at Johns Hopkins University School of Medicine and Uniformed Services University of Health Sciences. Gabriel Sciences is the recipient of NIH SBIR Phase I and Phase II grants for the development of a clinical DNA database enabling predictors of antipsychotic drug response. The current antidepressant program, which is a collaborative project, adds to Gabriel Sciences' portfolio of drug development for the treatment of mental illness.
Gabriel Sciences
"This award is an example of the promising collaborative opportunities that can be developed between the biotech industry and academic medicine through the NIH SBIR or STTR mechanisms. Gabriel Sciences [Primary Awardee] brings agile drug development abilities to pioneering science from Mayo Clinic [Subawardee]," notes David Pickar MD, President of Gabriel Sciences and Principal Investigator for the grant. Dr. Richelson serves as the Mayo Clinic Investigator for this Grant.
About Gabriel Sciences
Gabriel Sciences (formerly Gabriel Pharma) is a biotech company with the mission to advance treatment and understanding of mental illness through its translational research, including collaborative opportunities with academic medicine. David Pickar MD, founder, is former Chief of the Experimental Therapeutics Branch at National Institute of Mental Health (NIMH) with current adjunct appointments as Professor of Psychiatry at Johns Hopkins University School of Medicine and Uniformed Services University of Health Sciences. Gabriel Sciences is the recipient of NIH SBIR Phase I and Phase II grants for the development of a clinical DNA database enabling predictors of antipsychotic drug response. The current antidepressant program, which is a collaborative project, adds to Gabriel Sciences' portfolio of drug development for the treatment of mental illness.
Gabriel Sciences
Improving health for mothers and children in South Asia
(Maternal and child health: is South Asia ready for change?)
bmj/cgi/content/full/328/7443/816
(Effect of maternal mental health on infant growth in low income countries: new evidence from South Asia)
bmj/cgi/content/full/328/7443/820
BMJ Volume 328, pp 820-3
(Integrating healthcare for mothers and children in refugee camps and at direct level)
bmj/cgi/content/full/328/7443/834
What can be done to improve the health of mothers and children in South Asia? Several articles in this week's BMJ review the evidence and suggest interventions that may make a difference.
A third of the world's child deaths occur in South Asia. The region is also home to more than half of all the underweight children in the world, and maternal death rates are high.
Female illiteracy, poverty, and lack of empowerment of women are major barriers to improvement, say doctors. Yet, they show how substantial improvements have been achieved in some places by focusing resources on low cost primary care strategies and tackling socioeconomic issues.
A second article reveals that high levels of postnatal depression among South Asian women are affecting their children's health and development.
The authors suggest that not only will nutritional programmes need to be strengthened to ensure that poor children and their mothers have access to an adequate diet, but interventions for preventing and treating postnatal depression may be required.
In the final article on this topic, researchers argue that health care for mothers and children is seriously inadequate, both in refugee camps and in the government hospitals of most poorly resourced countries. They call for the urgent integration of hospital and home based health care.
Contacts:
Zulfiqar Bhutta, Professor of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
Email: zulfiqar.bhuttaaku
Vikram Patel, Senior Lecturer, London School of Hygiene and Tropical Medicine and Chair, Sangath, Goa, India
Email: vikpat_goasancharnet.in
David Southall, Honorary Medial Director, Child Advocacy International, Newcastle under Lyme, UK
Email: davidsdoctors.uk
bmj/cgi/content/full/328/7443/816
(Effect of maternal mental health on infant growth in low income countries: new evidence from South Asia)
bmj/cgi/content/full/328/7443/820
BMJ Volume 328, pp 820-3
(Integrating healthcare for mothers and children in refugee camps and at direct level)
bmj/cgi/content/full/328/7443/834
What can be done to improve the health of mothers and children in South Asia? Several articles in this week's BMJ review the evidence and suggest interventions that may make a difference.
A third of the world's child deaths occur in South Asia. The region is also home to more than half of all the underweight children in the world, and maternal death rates are high.
Female illiteracy, poverty, and lack of empowerment of women are major barriers to improvement, say doctors. Yet, they show how substantial improvements have been achieved in some places by focusing resources on low cost primary care strategies and tackling socioeconomic issues.
A second article reveals that high levels of postnatal depression among South Asian women are affecting their children's health and development.
The authors suggest that not only will nutritional programmes need to be strengthened to ensure that poor children and their mothers have access to an adequate diet, but interventions for preventing and treating postnatal depression may be required.
In the final article on this topic, researchers argue that health care for mothers and children is seriously inadequate, both in refugee camps and in the government hospitals of most poorly resourced countries. They call for the urgent integration of hospital and home based health care.
Contacts:
Zulfiqar Bhutta, Professor of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
Email: zulfiqar.bhuttaaku
Vikram Patel, Senior Lecturer, London School of Hygiene and Tropical Medicine and Chair, Sangath, Goa, India
Email: vikpat_goasancharnet.in
David Southall, Honorary Medial Director, Child Advocacy International, Newcastle under Lyme, UK
Email: davidsdoctors.uk
Seroquel effective in treatment of agitation in elderly patients with dementia
Study shows SEROQUEL may be an effective treatment option in this patient population; analysis shows no evidence of an increased risk of cerebrovascular adverse events.
AstraZeneca announced important new data presented today at the 9th International Conference on Alzheimer's Disease and Related Disorders in Philadelphia, which show that elderly patients with dementia, including those with Alzheimer's disease, who were treated with the atypical antipsychotic SEROQUEL (quetiapine) experienced improvement in symptoms of agitation.1 Additionally, patients treated with SEROQUEL had no cerebrovascular adverse events (CVAEs), which have been associated with the use of some other atypical antipsychotics in this patient population.
Dementia is a term for various progressive brain disorders, the most common being Alzheimer's disease, vascular dementia and dementia with Lewy bodies, that result in a loss of brain function. Symptoms of dementia include memory loss, problems with reasoning, judgement and speech, and the inability to perform everyday tasks.2 Behavioural disturbances, including agitation, have been reported in up to 90% of patients with dementia, which can result in patients becoming distressed and aggressive, putting an immense strain on caregivers and affecting their ability to care for the individuals. 3,4
"Agitation is a significant issue for patients suffering from this condition and their caregivers. It is an aspect of dementia that is both difficult to manage and emotionally troubling for those who care for patients suffering from dementia," said Pierre Tariot, M.D., Professor of Psychiatry, Medicine and Neurology at the University of Rochester. "These new study results are helpful, informative, and justify further investigation of SEROQUEL for agitation in dementia patients."
The STAR trial, a 10-week, multicentred, double-blind, fixed-dose, 3-arm, placebo-controlled trial, randomised 333 institutionalised patients (mean age 83 years) to receive SEROQUEL 200mg/day, SEROQUEL 100mg/day or placebo. The key efficacy measures were the Positive and Negative Syndrome Scale-Excitement Component (PANSS-EC) and Clinicians' Global Impression of Change (CGI-C) scales. These efficacy measures were analysed in the Intent to Treat (ITT) and Per Protocol (PP) populations using the Last Observation Carried Forward (LOCF) and Observed Case (OC) methods. Trial results showed1:
-- patients receiving SEROQUEL 200mg/day experienced significantly reduced symptoms of agitation compared to placebo as measured by PANSS-EC scores in three analyses (p
-- the clinical relevance of the improvement in PANSS-EC is confirmed by the statistically significant improvement in CGI-C scores (p
AstraZeneca announced important new data presented today at the 9th International Conference on Alzheimer's Disease and Related Disorders in Philadelphia, which show that elderly patients with dementia, including those with Alzheimer's disease, who were treated with the atypical antipsychotic SEROQUEL (quetiapine) experienced improvement in symptoms of agitation.1 Additionally, patients treated with SEROQUEL had no cerebrovascular adverse events (CVAEs), which have been associated with the use of some other atypical antipsychotics in this patient population.
Dementia is a term for various progressive brain disorders, the most common being Alzheimer's disease, vascular dementia and dementia with Lewy bodies, that result in a loss of brain function. Symptoms of dementia include memory loss, problems with reasoning, judgement and speech, and the inability to perform everyday tasks.2 Behavioural disturbances, including agitation, have been reported in up to 90% of patients with dementia, which can result in patients becoming distressed and aggressive, putting an immense strain on caregivers and affecting their ability to care for the individuals. 3,4
"Agitation is a significant issue for patients suffering from this condition and their caregivers. It is an aspect of dementia that is both difficult to manage and emotionally troubling for those who care for patients suffering from dementia," said Pierre Tariot, M.D., Professor of Psychiatry, Medicine and Neurology at the University of Rochester. "These new study results are helpful, informative, and justify further investigation of SEROQUEL for agitation in dementia patients."
The STAR trial, a 10-week, multicentred, double-blind, fixed-dose, 3-arm, placebo-controlled trial, randomised 333 institutionalised patients (mean age 83 years) to receive SEROQUEL 200mg/day, SEROQUEL 100mg/day or placebo. The key efficacy measures were the Positive and Negative Syndrome Scale-Excitement Component (PANSS-EC) and Clinicians' Global Impression of Change (CGI-C) scales. These efficacy measures were analysed in the Intent to Treat (ITT) and Per Protocol (PP) populations using the Last Observation Carried Forward (LOCF) and Observed Case (OC) methods. Trial results showed1:
-- patients receiving SEROQUEL 200mg/day experienced significantly reduced symptoms of agitation compared to placebo as measured by PANSS-EC scores in three analyses (p
-- the clinical relevance of the improvement in PANSS-EC is confirmed by the statistically significant improvement in CGI-C scores (p
Antidepressant Medications are Effective for Use in Primary Care
The vast majority of patients with clinical depression are seen in a primary care setting. Yet most studies examining the effectiveness of antidepressant medications are done with patients who see a psychiatric specialist and who may have a different etiology, pathophysiology and natural history for their depression.
The first systematic review of antidepressants versus placebo in primary care, this study finds that both tricyclic antidepressants (TCA) and selective serotonin reuptake inhibitors (SSRI) are significantly more effective than placebo in primary care settings.
Additionally, the study finds that the relatively low doses of TCAs sometimes used in primary care may be effective.
Efficacy and Tolerability of Tricyclic Antidepressants and SSRIs Compared with Placebo in Primary Care Treated Depression. A Meta-analysis.
By Bruce Arroll, MBChB, PhD, et al
Annals of Family Medicine is a peer-reviewed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care discipline. Launched in May 2003, the journal is sponsored by six family medical organizations, including the American Academy of Family Physicians, the American Board of Family Medicine, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors and the North American Primary Care Research Group. Annals is published six times each year and contains original research from the clinical, biomedical, social and health services areas, as well as contributions on methodology and theory, selected reviews, essays and editorials. A board of directors with representatives from each of the sponsoring organizations oversees Annals. Complete editorial content and interactive discussion groups for each published article can be accessed free of charge on the journal's Web site, annfammed.
Kristin Robinson
kristinraafp
913-906-6000
American Academy of Family Physicians
aafp
Sept/Oct 2005 Annals of Family Medicine tip sheet
The first systematic review of antidepressants versus placebo in primary care, this study finds that both tricyclic antidepressants (TCA) and selective serotonin reuptake inhibitors (SSRI) are significantly more effective than placebo in primary care settings.
Additionally, the study finds that the relatively low doses of TCAs sometimes used in primary care may be effective.
Efficacy and Tolerability of Tricyclic Antidepressants and SSRIs Compared with Placebo in Primary Care Treated Depression. A Meta-analysis.
By Bruce Arroll, MBChB, PhD, et al
Annals of Family Medicine is a peer-reviewed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care discipline. Launched in May 2003, the journal is sponsored by six family medical organizations, including the American Academy of Family Physicians, the American Board of Family Medicine, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors and the North American Primary Care Research Group. Annals is published six times each year and contains original research from the clinical, biomedical, social and health services areas, as well as contributions on methodology and theory, selected reviews, essays and editorials. A board of directors with representatives from each of the sponsoring organizations oversees Annals. Complete editorial content and interactive discussion groups for each published article can be accessed free of charge on the journal's Web site, annfammed.
Kristin Robinson
kristinraafp
913-906-6000
American Academy of Family Physicians
aafp
Sept/Oct 2005 Annals of Family Medicine tip sheet
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