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Mental Illness in Teens: The Latest Stats & Why They Matter

July 9, 2012

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Many adult psychiatric illnesses originate in childhood or adolescence. Researchers have known about this for some time, and over the years they have conducted several regional, national, and cross-national surveys on youth mental health. Yet, it was only two years ago that data from a large-scale U.S. survey of adolescents—assessing a broad range of mental disorders with in-depth diagnostic interviews—became available. This 2010 data revealed that more than one in five U.S. youth aged 13 to 18 is likely to have experienced a mental disorder with severe impairment at some point.

This year, two studies published in the Archives of General Psychiatry have expanded upon the analysis of that survey, known as the National Comorbidity Survey Replication Adolescent Supplement (NCS-A).  A major finding, adding to the evidence that mental health problems often start in youth, was that within a 12-month time period, 8% of U.S. teens experienced serious emotional disturbances (SEDs), and just over 40% experienced some sort of mental disorder. Anxiety disorders were most common, followed by behavior, mood, and substance disorders.

Mental disorders were defined as disorders appearing in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), developed by the American Psychiatric Association. SEDs were defined as mental disorders producing significant impairment in family, school, or community activities—as described by the federal government.

Overall, the number of mental health diagnoses a teen had was more important than which diagnoses he or she had, in terms of risk of falling into the SED category.

I interviewed Ronald Kessler, PhD, McNeil Family Professor of Health Care Policy at Harvard Medical School, lead author on both recent studies, to find out what the goals of surveys like the NCS-A are, and how the latest statistics might guide the design of interventions. Here’s what I learned:

Read more…

Seven Major Biotech Companies Join Hands to Support Pre-Clinical Neuroscience

July 2, 2012

Last week at the 2012 BIO International Convention, Massachusetts Governor Deval Patrick and seven well-known biotech companies – Abbott, Biogen Idec, EMD Serono, Janssen Research & Development, LLC, Merck, Pfizer, and Sunovion – announced the launch of the Massachusetts Neuroscience Consortium.

As reported in the Boston Globe and on the Governor’s website, this new consortium aims to foster collaborations between industry and academia by funding pre-clinical neuroscience research in the state’s colleges and universities. The total initial funding is $1.75 million. In addition to leaders from the state government and pharmaceutical industry, the announcement at BIO was attended by academic leaders such as the Dean of Harvard Medical School, individuals suffering from illnesses such as multiple sclerosis and Alzheimer’s, and heads of patient advocacy groups such as the Alzheimer’s Association.

Michael Ehlers, Chief Scientific Officer for Pfizer Neuroscience, commented on the importance of this collaboration for those suffering from mental illness as well as other nervous system disorders, saying in a prepared statement, “This collaboration is a step forward in our effort to address the urgent need for therapies in neurologic and psychiatric disease.”

Picower Talks on Early Life Stress & Mental Health Now Online

May 8, 2012

Courtesy of Picower Institute

If you’re interested in the links between childhood adversity and brain science, but didn’t have a chance to attend the Spring 2012 Picower Symposium, “New Insights on Early Life Stress & Mental Health,” at MIT last month, you’re in luck.

All 12 scientists’ talks are now online. And it’s the perfect time to watch them, as May 6-12 is National Children’s Mental Health Awareness Week.

Here are the direct links:

Matt Wilson: Opening Remarks

Jane Isaacs-Lowe: Rewiring the Trajectory for Vulnerable Children: A Foundation Perspective

Bruce McEwen: The Brain on Stress:  Adaptive Plasticity in Response to the Social Environment

John Eckenrode: Preventing early adversity and improving the life chances of socially disadvantaged children & families

Michael Meaney: Effects of maternal care on gene regulation and behavior

Robert Anda: The Lifelong Impact of Adverse Childhood Experiences on Health and Society. Neurobiology & Epidemiology Converge

Andrew Garner: Translating Developmental Science into Healthy Lives

Kay Tye: Activating dopamine neurons acutely rescues a stress-induced depression phenotype

Moshe Szyf: The DNA methylation landscape of early life adversity

Li-Huei TsaiThe convergence of epigenetics and stress in cognitive impairment and repair

Jack P. Shonkoff: Leveraging the Biology of Adversity to Shape the Future of Early Childhood Policy

Steve HymanClosing Remarks

3 Interesting Characters in ADHD History

April 27, 2012

In the heated climate of today’s discussions on attention deficit hyperactivity disorder (ADHD), one of the areas we sometimes lose sight of is the history of this disorder. Although frequently discussed in the context of our fast-paced, high-tech modern lives, the symptoms of ADHD are by no means unique to our time.

Fidgety Phil, often seen as an allegory for ADHD. Illustration from a book written in 1846 by physician Heinrich Hoffmann. Courtesy of Project Gutenberg.

An ADHD-like disorder was actually described as early as 1798, by Scottish physician Sir Alexander Crichton. Writing a chapter “On Attention and its Diseases” in a three-book series entitled “An inquiry into the nature and origin of mental derangement,” Crichton spoke of a disease characterized by difficulty sustaining focus, a predisposition to distraction, restlessness, and possibly some type of impulsivity—highly reminiscent of the current DSM definition of ADHD (although lacking the hyperactivity component). Crichton even recognized the developmental nature of the disorder and understood that it might be due to neurological dysfunction. Read more…

ADHD & Controversy

April 27, 2012

Attention deficit hyperactivity disorder (ADHD) is one of the most controversial psychiatric diagnoses of our time. Unlike bipolar disorder or schizophrenia, which many accept as ‘real’ mental illnesses, as far as I can tell ADHD gets little respect outside of the scientific literature and community of affected families. Some view it less as a medical condition than an example of the flaws of modern life, with overstimulated children and parents who are too eager to medicate away behavior problems.

So it’s not all that surprising that earlier this year, a NY Times article questioning the value of psychostimulant therapy for ADHD, “Ritalin Gone Wrong” elicited an outpour of public commentary and generated heated discourse, both within and beyond the scientific community. Read more…

Unraveling the Mystery of ADHD

April 27, 2012

Psychiatrist Edward Hallowell, MD, EdD, will be presenting on “The ABCs of ADD” at the April 30 Conte-CBS Colloquium on Mental Health. In honor of his visit, let’s take a look at some common questions about this disorder.

 What is ADHD/ ADD and why it is important?

The acronym ADHD refers to Attention Deficit Disorder with Hyperactivity, and ADD refers to Attention Deficit Disorder. In his book Driven to Distraction (1994), Dr. Edward Hallowell, a Harvard-trained psychiatrist, who himself has both ADHD and dyslexia (a reading disorder), defines ADHD as an early onset biological disorder that is usually characterized by inattention and impulsivity, that may or may not include hyperactivity. He explains that as children who have these characteristics mature, they may be seen as having challenging behaviors or be seen as the “dreamers” in a classroom setting. Ultimately, the characteristics of ADHD and ADD may lead to academic failures, social dysfunction, and skill deficits.  In turn, according to Dr. Hallowell, “Under-achievement can lead to poor self-esteem, which can become the real enemy for those who are struggling to succeed.” Because risk factors associated with ADHD may include high rates of injuries, cigarette smoking, substance abuse, and in some cases delinquency, Dr. Hallowell stresses the importance of education, diagnosis, and treatment, which may or may not include medications, to help those in need turn their lives around.

What is the underlying neurobiology of ADHD/ADD?

According to an article by Thomas Spencer, M.D., and colleagues, “Overview and Neurobiology of Attention-Deficit/Hyperactivity Disorder” in the Journal of Clinical Psychiatry (2002), ADHD is highly heritable and may be associated with deficits in the prefrontal cortex and related subcortical system. Read more…

The Tough Journey “From DSM to DNA”

March 22, 2012

It's a tough trail from the symptom checklists for mental illness in the DSM to the genes that influence susceptibility - and one that requires a lot of teamwork. (Image courtesy of Patsy Annala. Shows the Crag Rat mountain climbing team of Hood River, Oregon on Mt. Hood circa 1926.)

Nineteen countries. Over 60 institutions. More than 200 authors per paper.

The large scale of these numbers gives a clue as to just how hard it is to study the genetics of mental illness. They describe the scope of collaborations conducted by the Psychiatric Genomics Consortium, a group that does meta-analyses of genome-wide association studies (GWAS) focused on psychiatric disorders.

GWAS, first reported in 2002, are a way to comb through the genome in an unbiased fashion, looking for genetic variations—often in the form of single nucleotide polymorphisms, or single-letter differences in the DNA code—associated with a specific trait or medical condition. The Consortium began in 2007 with a teleconference among scientists studying ADHD, bipolar disorder, major depressive disorder, and schizophrenia. Autism researchers joined the team soon after.

A leader in the Consortium, Jordan Smoller, MD, ScD, Director of Psychiatric Genetics and Associate Vice Chair in the Department of Psychiatry at Massachusetts General Hospital and author of the upcoming book The Other Side of Normal, will be speaking in next Tuesday’s Conte-CBS Colloquium on the genetics of mood disorders. Smoller is also an associate professor of psychiatry at Harvard Medical School.

Smoller and his colleagues sometimes describe their work as a journey “from DSM to DNA”— from the symptom checklists for mental illnesses in the Diagnostic and Statistical Manual of Mental Disorders (the holy book of psychiatry) to the genes that influence susceptibility, and may eventually lead us to the biological roots of the disorders. Here we take a look at the role of GWAS in this important journey, the challenges associated with them, and what they’ve taught us so far.

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