PsychAntenna

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Medscape Medical News

According to experts, 44 million Americans are affected by some type of mood disorder each year. The disorders include depression and bipolar disorder and as a whole are one of the most common form of illness.

The disorders are believed to result from a chemical imbalance in the brain with environmental factors often triggering or buttressing outbreaks.

Researchers are now focusing on these neurobiological mechanisms with the initiative the centerpiece of a new Center of Excellence located at The University of Texas Medical School at Houston.

“We need to link those discoveries to a better way to treat the disease. In the new center, we’ll be able to combine high-level care with research,” says Jair Soares, M.D., co-director of the center and chairman of the Department of Psychiatry and Behavioral Sciences.

“All of us, if we don’t have a family member with a mood disorder, we have a friend or co-worker who suffers from one,” said Soares, who is executive director of the UT Harris County Psychiatric Center and chief of psychiatry at LBJ General Hospital and Memorial Hermann-Texas Medical Center.

“New research is showing that a mood disorder has nothing to do with will. These conditions are brain diseases.”

“Mood disorders ruin lives; break up families; shorten lives through suicide and medical illnesses. Every phase of life is affected by mood disorders,” said Alan Swann, M.D., professor and co-director of the UT Center on Mood Disorders.

“There’s a tremendous need for this center. We will evaluate people, treat and conduct research in a single place. We will be able to educate our students and residents, our patients and their families, and the general public.”

Giovana Zunta-Soares, M.D., assistant professor of psychiatry and behavioral science at the medical school, said researchers including those at the UT Medical School at Houston are beginning to learn more about the relationship between changes in the brain and mood disorders.

“We know bipolar patients have subtle abnormalities in key brain regions involved in modulation of emotions, but we don’t know why,” Zunta-Soares said.

“We would like to eventually have a way to diagnose the disease physiologically just as we do in other diseases such as high blood pressure, for example.”

The new Center will focus research on area including brain imaging, cognitive neuropsychology, neurophysiology and genetics. Specifically the Center will address:

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• Adult patients with bipolar disorder. They are being recruited for an imaging study that will look for changes in the brain that may indicate how mood-stabilizing medications help them.
• Children ages 7 to 17 who either have been diagnosed with bipolar disorder or aFor an imaging study looking at the anatomy and biology of important areas of the developing brain, researchers are seeking children ages 7 to 17 who have been diagnosed with bipolar disorder as well as healthy children of the same age. The children with bipolar disease will be treated with mood-stabilizing medications.

  – A double-blind, placebo-controlled medication trial is studying uridine, a naturally occurring chemical made by the liver that is involved in many of the body’s processes, including the use of energy by cells. Researchers are testing uridine for safety and to assess whether it is beneficial for the depressive symptoms of bipolar disease in adults.

  – Researchers will analyze blood levels from the new Serum Markers of Ilness Pathophysiology in Mood Disorders, a repository of samples, in search of biochemical and genetic abnormalities to help understand biological conditions associated with bipolar disorder.

  – Anatomical and biochemical measurements of certain brain regions will be taken in an imaging study looking at the differences along the bipolar spectrum, which includes bipolar disorder type I, bipolar disorder type II, cyclothymia and bipolar disorder not otherwise specified.

  – Two studies will look at families. The first is enrolling parents diagnosed with bipolar disease and their children age 7 to 17 regardless of whether the children have the disease. The second is recruiting a family member with bipolar disease and a non-affected, first-degree relative (sibling, parent or child).

  – Researchers will investigate neurophysiological and neurochemical studies of bipolar disorder and its relationships to impulsivity, personality disorders and substance-use disorders. In addition to mood disorders, the faculty practice at UT Physicians’ clinics of the Department of Psychiatry and Behavioral Sciences treats patients with anxiety disorders, childhood disorders, personality disorders, schizoaffective disorder, schizophrenia and substance-related disorders.

Source: University of Texas Health Science Center at Houston

New research supports family therapy as a method to reduce suicidal thoughts and depression in adolescents.

Researchers from The Children’s Hospital of Philadelphia report family therapy had stronger and faster reduction of symptoms when compared to standard treatment in the community.

The findings are found in the Journal of the American Academy of Child and Adolescent Psychiatry.

Adolescents with suicidal thoughts and elevated depression had stronger and faster reduction of symptoms when treated with family therapy than with standard treatment in the community.

According to background information in the article, suicide is the third leading cause of death in American adolescents, accounting for more than 1,300 deaths in youths between the ages of 12 and 18 in 2005.

An additional one million teens attempt suicide each year, leading to high emotional and financial costs to families and the health care system. Unfortunately, very few treatment studies have focused on this vulnerable age group or identified treatments with proven results.

In this study, Attachment-based Family Therapy (ABFT), found that patients with severe suicidal thinking were at least four times more likely to have no suicide thinking at the end of the treatment or three months after treatment, than patients treated in the community.

Patients in ABFT also showed a more rapid decrease in depression symptoms and were retained in treatment longer than in community care, even with additional supports provided by the study. This is the first treatment study for teen suicidal ideation to show robust and statistically significant improvement over treatment as usual.

“Most treatment models mainly work with the adolescents alone, helping them to learn new coping and problem solving strategies,” says study leader Guy S. Diamond, Ph.D., director of the Center for Family Intervention Science at the Children’s Hospital of Philadelphia.

“But adolescents are highly influenced by their parents. Family conflict, chaos, and strife can contribute to youth suicide, while at the same time family love, trust, and communication can buffer against it. This therapy aims to resolve family conflicts and promote family strengths so that the appropriate bond of attachment can protect youth from self harm.”

The researchers studied 66 children between the ages of 12 and 17 who presented in primary care or emergency rooms with severe suicidal thinking and depressive symptoms. The average age was 15, about three quarters were African American and 83 percent were female. Parent participation was required.

“Parents are not viewed as the problem, but as the curative medicine,” Diamond says.

“They are the key to keeping lines of communication open in order to monitor against suicidal behavioral. And while no treatment is perfect for all patients, helping any family through a youth’s suicide crisis is important.”

Diamond says his team’s future studies will focus on a broader population of patients, stronger comparison treatments, and long term outcomes to better assess treatment benefits.

Source: The Children’s Hospital of Philadelphia

A provocative new research study suggests children whose mothers suffer from depression during pregnancy are more likely than others to show antisocial behavior later in life.

Scientists also found that women who are aggressive and disruptive in their own teen years are more likely to become depressed in pregnancy, so that the moms’ history predicts their own children’s antisocial behavior.

The findings emanate from a longitudinal study conducted by researchers at Cardiff University, King’s College London, and the University of Bristol.

The research appears in the January/February 2010 issue of the journal Child Development.

The study considered the role of mothers’ depression during pregnancy by looking at 120 British youth from inner-city areas.

“Much attention has been given to the effects of postnatal depression on young infants,” notes Dale F. Hay, professor of psychology at Cardiff University in Wales, who worked on the study, “but depression during pregnancy may also affect the unborn child.”

The youths’ mothers were interviewed while they were pregnant, after they gave birth, and when their children were 4, 11, and 16 years old.

The study found that mothers who became depressed when pregnant were four times as likely to have children who were violent at 16. This was true for both boys and girls. The mothers’ depression, in turn, was predicted by their own aggressive and disruptive behavior as teens.

The link between depression in pregnancy and the children’s violence couldn’t be explained by other factors in the families’ environments, such as social class, ethnicity, or family structure; the mothers’ age, education, marital status, or IQ; or depression at other times in the children’s lives.

“Although it’s not yet clear exactly how depression in pregnancy might set infants on a pathway toward increased antisocial behavior, our findings suggest that women with a history of conduct problems who become depressed in pregnancy may be in special need of support,” according to Hay.

Source: Society for Research in Child Development

A new study discovers stress is not always bad for children — with the qualification determined by the degree of support the child receives from parents.

Researchers have known that children who are especially reactive to stress are more vulnerable to adversity and have more behavioral and health problems than their peers.

However, a new longitudinal study suggests that highly reactive children are also more likely to do well when they’re raised in supportive environments.

The study appears in the January/February 2010 issue of the journal Child Development.

“Parents and teachers may find that sensitive children, like orchids, are more challenging to raise and care for, but they can bloom into individuals of exceptional ability and strength when reared in a supportive, nurturing, and encouraging environment,” according to Jelena Obradović, an assistant professor in the School of Education at Stanford University.

A combined research team looked at 338 kindergarteners, as well as their teachers and families, to determine how family adversity and biological reactivity contribute to healthy development.

They found that children who had significantly stronger biological reactions to a series of mildly stressful tasks designed to look like challenges in their daily lives were more affected by their family contexts, both bad and good. This means that highly reactive children were more likely to have developmental problems when growing up in adverse, stressful family settings.

But contrary to expectation, such children were also more likely to thrive when they were raised in caring, low-stress families because of their sensitivities to the supportive and nurturing qualities of such environments.

“The study tells us that when children are highly susceptible to stress, it’s not always bad news, but rather should be considered in terms of the type of environment they live in,” explains Obradović.

Source: Society for Research in Child Development

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