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Singh B, Parikh SV, Voort JLV, Pazdernik VK, Achtyes ED, Goes FS, Yocum AK, Nykamp L, Becerra A, Smart L, Greden JF, Bobo WV, Frye MA, Burdick KE, Ryan KA. Change in neurocognitive functioning in patients with treatment-resistant depression with serial intravenous ketamine infusions: The Bio-K multicenter trial. Psychiatry Res 2024; 335:115829. [PMID: 38479192 DOI: 10.1016/j.psychres.2024.115829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/06/2024] [Accepted: 02/25/2024] [Indexed: 04/14/2024]
Abstract
This nonrandomized, multicenter, open-label clinical trial explored the impact of intravenous (IV) ketamine on cognitive function in adults (n = 74) with treatment-resistant depression (TRD). Patients received three IV ketamine infusions during the acute phase and, if remitted, four additional infusions in the continuation phase (Mayo site). Cognitive assessments using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were conducted at baseline, end of the acute phase, and end of the continuation phase (Mayo site). Results showed a significant 53 % (39/74) remission rate in depression symptoms after the acute phase. In adjusted models, baseline language domain score was associated with a higher odd of remission (Odds Ratio, 1.09, 95 % CI = 1.03-1.17, p = 0.004) and greater improvement in MADRS at the end of the acute phase (β =-0.97; 95 % CI, -1.74 to -0.20; P = 0.02). The likelihood of remission was not significantly associated with baseline immediate or delayed memory, visuospatial/constructional, or attention scores. In the continuation phase, improvements in immediate and delayed memory and attention persisted, with additional gains in visuospatial and language domains. Limitations included an open-label design, potential practice effects, and ongoing psychotropic medication use. Overall, the study suggests cognitive improvement, not deterioration, associated with serial IV ketamine administrations for TRD. These findings encourage future studies with larger sample sizes and longer follow-up periods to examine any potential for deleterious effect with recurrent ketamine use for TRD. Trial Registration: ClinicalTrials.gov: NCT03156504.
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Affiliation(s)
- Balwinder Singh
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
| | - Sagar V Parikh
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Eric D Achtyes
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Anastasia K Yocum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Louis Nykamp
- Pine Rest Christian Mental Health Services, Michigan State University, Grand Rapids, MI, USA
| | - Alexis Becerra
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - LeAnn Smart
- Pine Rest Christian Mental Health Services, Michigan State University, Grand Rapids, MI, USA
| | - John F Greden
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - William V Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Kelly A Ryan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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2
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Müller F, Abdelnour AM, Rutaremara DN, Arnetz JE, Achtyes ED, Alshaarawy O, Holman HT. Association between sociodemographic factors, clinic characteristics and mental health screening rates in primary care. PLoS One 2024; 19:e0301125. [PMID: 38547139 PMCID: PMC10977679 DOI: 10.1371/journal.pone.0301125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 03/08/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Screening for mental health problems has been shown to be effective to detect depression and initiate treatment in primary care. Current guidelines recommend periodic screening for depression and anxiety. This study examines the association of patient sociodemographic factors and clinic characteristics on mental health screening in primary care. DESIGN In this retrospective cohort study, electronic medical record (EMR) data from a 14-month period from 10/15/2021 to 12/14/2022 were analyzed. Data were retrieved from 18 primary care clinics from the Corewell Health healthcare system in West Michigan. The main outcome was documentation of any Patient Health Questionnaire (PHQ-4/PHQ-9/GAD-7) screening in the EMR within the 14-month period at patient level. General linear regression models with logit link function were used to assess adjusted odds ratio (aOR) of having a documented screening. RESULTS In total, 126,306 unique patients aged 16 years or older with a total of 291,789 encounters were included. The prevalence of 14-month screening was 79.8% (95% CI, 79.6-80.0). Regression analyses revealed higher screening odds for patients of smaller clinics (<5,000 patients, aOR 1.88; 95% CI 1.80-1.98 vs. clinics >10.000 patients), clinics in areas with mental health provider shortages (aOR 1.69; 95% CI 1.62-1.77), frequent visits (aOR 1.80; 95% CI, 1.78-1.83), and having an annual physical / well child visit encounter (aOR 1.52; 95% CI, 1.47-1.57). Smaller positive effect sizes were also found for male sex, Black or African American race, Asian race, Latinx ethnicity (ref. White/Caucasians), and having insurance through Medicaid (ref. other private insurance). DISCUSSION The 14-month mental health screening rates have been shown to be significantly lower among patients with infrequent visits seeking care in larger clinics and available mental health resources in the community. Introducing and incentivizing mandatory mental health screening protocols in annual well visits, are viable options to increase screening rates.
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Affiliation(s)
- Frank Müller
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States of America
- Spectrum Health Family Medicine Clinic, Grand Rapids, MI, United States of America
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Alyssa M. Abdelnour
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States of America
| | - Diana N. Rutaremara
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States of America
| | - Judith E. Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States of America
| | - Eric D. Achtyes
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States of America
| | - Omayma Alshaarawy
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, United States of America
| | - Harland T. Holman
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States of America
- Spectrum Health Family Medicine Clinic, Grand Rapids, MI, United States of America
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3
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Monteith S, Glenn T, Geddes JR, Whybrow PC, Achtyes ED, Bauer M. Implications of Online Self-Diagnosis in Psychiatry. Pharmacopsychiatry 2024; 57:45-52. [PMID: 38471511 DOI: 10.1055/a-2268-5441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Online self-diagnosis of psychiatric disorders by the general public is increasing. The reasons for the increase include the expansion of Internet technologies and the use of social media, the rapid growth of direct-to-consumer e-commerce in healthcare, and the increased emphasis on patient involvement in decision making. The publicity given to artificial intelligence (AI) has also contributed to the increased use of online screening tools by the general public. This paper aims to review factors contributing to the expansion of online self-diagnosis by the general public, and discuss both the risks and benefits of online self-diagnosis of psychiatric disorders. A narrative review was performed with examples obtained from the scientific literature and commercial articles written for the general public. Online self-diagnosis of psychiatric disorders is growing rapidly. Some people with a positive result on a screening tool will seek professional help. However, there are many potential risks for patients who self-diagnose, including an incorrect or dangerous diagnosis, increased patient anxiety about the diagnosis, obtaining unfiltered advice on social media, using the self-diagnosis to self-treat, including online purchase of medications without a prescription, and technical issues including the loss of privacy. Physicians need to be aware of the increase in self-diagnosis by the general public and the potential risks, both medical and technical. Psychiatrists must recognize that the general public is often unaware of the challenging medical and technical issues involved in the diagnosis of a mental disorder, and be ready to treat patients who have already obtained an online self-diagnosis.
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Affiliation(s)
- Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, Michigan, USA
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, California, USA
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, California, USA
| | - Eric D Achtyes
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus Medical Faculty, Technische Universität Dresden, Dresden, Germany
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Cunningham JE, Bluhm R, Achtyes ED, McCright AM, Cabrera LY. Guideline-based care for psychiatric electroceuticals: Results from a National Survey of Board-Certified Psychiatrists. J Eval Clin Pract 2024; 30:290-295. [PMID: 38050435 DOI: 10.1111/jep.13948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/09/2023] [Accepted: 10/19/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Joshua E Cunningham
- College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Robyn Bluhm
- Department of Philosophy, Lyman Briggs College, Michigan State University, East Lansing, Michigan, USA
| | - Eric D Achtyes
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
| | - Aaron M McCright
- Department of Sociology, Michigan State University, East Lansing, Michigan, USA
| | - Laura Y Cabrera
- Department of Engineering Science and Mechanics, Center for Neural Engineering, Pennsylvania State University, University Park, Pennsylvania, USA
- Rock Ethics Institute, Pennsylvania State University, University Park, Pennsylvania, USA
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5
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Magura S, Lee-Easton MJ, Abu-Obaid R, Reed P, Allgaier B, Fish E, Maletta AL, Amaratunga P, Lorenz-Lemberg B, Levitas M, Achtyes ED. Prevalence and drug use correlates of inadvertent fentanyl exposure among individuals misusing drugs in seven U.S. states. J Addict Dis 2024:1-9. [PMID: 38355422 DOI: 10.1080/10550887.2023.2293643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Fentanyl has emerged as the leading cause of fatal drug overdoses in the U.S. Individuals misusing drugs may not always be aware of exposure to fentanyl. To determine the prevalence of fentanyl use and extent of awareness of fentanyl exposure among a national sample of treatment-seeking individuals with opioid use disorder (n = 1098). Participants provided oral fluid and urine specimens, which were tested for drugs by liquid chromatography/tandem mass spectrometry. Participants also provided self-reports of fentanyl use. 49.5% tested positive for fentanyl in oral fluid, urine, or both. Of those testing positive for fentanyl, 29.8% were unaware that they had been exposed to fentanyl. Participants testing positive for opioids methadone, and specifically 6-monoacetylmorphine (6-MAM), a unique metabolite of heroin, were significantly more likely to be unaware of fentanyl exposure than participants testing negative for these substances, with a similar trend for oxycodone and tramadol. These findings may be due to fentanyl's effect being difficult to distinguish from that of other opioids, whereas when other types of drugs are adulterated with fentanyl, the differences in effects are likely to be readily discernable. These results support the importance of expanded drug-checking services.
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Affiliation(s)
- S Magura
- The Evaluation Center at Western Michigan University, Kalamazoo, MI, USA
| | - M J Lee-Easton
- The Evaluation Center at Western Michigan University, Kalamazoo, MI, USA
| | - R Abu-Obaid
- The Evaluation Center at Western Michigan University, Kalamazoo, MI, USA
| | - P Reed
- Forensic Fluids Laboratories, Kalamazoo, MI, USA
| | - B Allgaier
- Forensic Fluids Laboratories, Kalamazoo, MI, USA
| | - E Fish
- Forensic Fluids Laboratories, Kalamazoo, MI, USA
| | - A L Maletta
- Forensic Fluids Laboratories, Kalamazoo, MI, USA
| | - P Amaratunga
- Forensic Fluids Laboratories, Kalamazoo, MI, USA
| | | | - M Levitas
- Forensic Fluids Laboratories, Kalamazoo, MI, USA
| | - E D Achtyes
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
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Cunningham JE, Bluhm R, Achtyes ED, McCright AM, Cabrera LY. The differential effects of psychiatrists' and patients' prior experiences on views about psychiatric electroceutical interventions. J Psychiatr Res 2024; 170:11-18. [PMID: 38101204 PMCID: PMC10872233 DOI: 10.1016/j.jpsychires.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 10/19/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023]
Abstract
The aim of this study is to examine ways in which prior experiences and familiarity with psychiatric electroceutical interventions (PEI) shape psychiatrists' and patients' views about these interventions. We administered a national survey, with an embedded experiment, to psychiatrists (n = 505) and adults diagnosed with depression (n = 1050). We randomly assigned respondents to one of 8 conditions using a full factorial experimental design: 4 PEI modalities [ECT, rTMS, DBS, or adaptive brain implants (ABIs)] by 2 depression severity levels [moderate or severe]. We analyzed the survey data with ANOVA and OLS linear regression models. Patients having experience with any PEI reported more positive affect toward, but also greater perceived risk from, their assigned PEI than did patients with no such experience. Psychiatrists who referred or administered any PEI reported more positive affect toward and greater perceived influence on self and perceived benefit from their assigned PEI than did psychiatrists with no such familiarity. Limitations of our study include that our participants were randomly assigned to a PEI, not necessarily to the one they had experience with. Moreover, our study did not directly ask about the kind of experiences participants had with a given PEI. Overall, our survey data shows that greater experience with PEIs elicits more positive affect in both stakeholder groups. Beyond this, prior PEI experience shapes attitudes towards these interventions in complex ways. Further research linking different types of experience with a given PEI would help better understand factors shaping attitudes about specific PEIs.
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Affiliation(s)
| | - Robyn Bluhm
- Lyman Briggs College and Department of Philosophy, Michigan State University, East Lansing, MI, USA
| | - Eric D Achtyes
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Aaron M McCright
- Department of Sociology, Michigan State University, East Lansing, MI, USA
| | - Laura Y Cabrera
- Center for Neural Engineering, Department of Engineering Science and Mechanics, Rock Ethics Institute, and Huck Institute of Life Sciences, Pennsylvania State University, University Park, PA, USA.
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7
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Cortright MK, Bluhm R, Achtyes ED, McCright AM, Cabrera LY. Perceived Barriers to Using Neurostimulation: A National Survey of Psychiatrists, Patients, Caregivers, and the General Public. J ECT 2024:00124509-990000000-00138. [PMID: 38265758 DOI: 10.1097/yct.0000000000000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
OBJECTIVES Neurostimulation interventions often face heightened barriers limiting patient access. The objective of this study is to examine different stakeholders' perceived barriers to using different neurostimulation interventions for depression. METHODS We administered national surveys with an embedded experiment to 4 nationwide samples of psychiatrists (n = 505), people diagnosed with depression (n = 1050), caregivers of people with depression (n = 1026), and members of the general public (n = 1022). We randomly assigned respondents to 1 of 8 conditions using a full factorial experimental design: 4 neurostimulation modalities (electroconvulsive therapy [ECT], repetitive transcranial magnetic stimulation [rTMS], deep brain stimulation [DBS], or adaptive brain implants [ABIs]) by 2 depression severity levels (moderate or severe). We asked participants to rank from a list what they perceived as the top 3 barriers to using their assigned intervention. We analyzed the data with analysis of variance and logistic regression. RESULTS Nonclinicians most frequently reported "limited evidence of the treatment's effectiveness" and "lack of understanding of intervention" as their top 2 most important practical barriers to using ECT and TMS, respectively. Compared with nonclinicians, psychiatrists were more likely to identify "stigma about treatment" for ECT and "lack of insurance coverage" for TMS as the most important barriers. CONCLUSIONS Overall, psychiatrists' perceptions of the most important barriers to using neurostimulation interventions were significantly different than those of nonclinicians. Perceived barriers were significantly different for implantable DBS and ABI) versus nonimplantable (rTMS and ECT) neurostimulation interventions. Better understanding of how these barriers vary by neurostimulation and stakeholder group could help us address structural and attitudinal barriers to effective use of these interventions.
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Affiliation(s)
| | - Robyn Bluhm
- From the Lyman Briggs College, Michigan State University, East Lansing
| | - Eric D Achtyes
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI
| | - Aaron M McCright
- Department of Sociology, Michigan State University, East Lansing, MI
| | - Laura Y Cabrera
- Department of Engineering and Mechanics and Rock Ethics Institute, Pennsylvania State University, University Park, PA
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8
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Yao B, Rolfs M, Slate R, Roberts D, Fattal J, Achtyes ED, Tso IF, Diwadkar VA, Kashy D, Bao J, Thakkar KN. Abnormal Oculomotor Corollary Discharge Signaling as a Trans-diagnostic Mechanism of Psychosis. Schizophr Bull 2024:sbad180. [PMID: 38245499 DOI: 10.1093/schbul/sbad180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
BACKGROUND AND HYPOTHESIS Corollary discharge (CD) signals are "copies" of motor signals sent to sensory areas to predict the corresponding input. They are a posited mechanism enabling one to distinguish actions generated by oneself vs external forces. Consequently, altered CD is a hypothesized mechanism for agency disturbances in psychosis. Previous studies have shown a decreased influence of CD signals on visual perception in individuals with schizophrenia-particularly in those with more severe positive symptoms. We therefore hypothesized that altered CD may be a trans-diagnostic mechanism of psychosis. STUDY DESIGN We examined oculomotor CD (using the blanking task) in 49 participants with schizophrenia or schizoaffective disorder (SZ), 36 bipolar participants with psychosis (BPP), and 40 healthy controls (HC). Participants made a saccade to a visual target. Upon saccade initiation, the target disappeared and reappeared at a horizontally displaced position. Participants indicated the direction of displacement. With intact CD, participants can make accurate perceptual judgements. Otherwise, participants may use saccade landing site as a proxy of pre-saccadic target to inform perception. Thus, multi-level modeling was used to examine the influence of target displacement and saccade landing site on displacement judgements. STUDY RESULTS SZ and BPP were equally less sensitive to target displacement than HC. Moreover, regardless of diagnosis, SZ and BPP with more severe positive symptoms were more likely to rely on saccade landing site. CONCLUSIONS These results suggest that altered CD may be a trans-diagnostic mechanism of psychosis.
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Affiliation(s)
- Beier Yao
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Martin Rolfs
- Department of Psychology, Humboldt University, Berlin, Germany
| | - Rachael Slate
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Dominic Roberts
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Jessica Fattal
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Eric D Achtyes
- Cherry Health, Grand Rapids, MI, USA
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Ivy F Tso
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University, Detroit, MI, USA
| | - Deborah Kashy
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Jacqueline Bao
- Department of Psychology, Michigan State University, East Lansing, MI, USA
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Katharine N Thakkar
- Department of Psychology, Michigan State University, East Lansing, MI, USA
- Department of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
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Chen SC, Bluhm R, Achtyes ED, McCright AM, Cabrera LY. Looking through the lens of stigma: Understanding and anticipating concerns about the responsible development and use of psychiatric electroceutical interventions (PEIs). SSM Ment Health 2023; 4:100261. [PMID: 38188866 PMCID: PMC10768967 DOI: 10.1016/j.ssmmh.2023.100261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Psychiatric electroceutical interventions (PEIs) show promise for treating depression, but few studies have examined stakeholders' views on them. Using interview data and survey data that analyzed the views of psychiatrists, patients, caregivers, and the general public, a conceptual map was created to represent stakeholders' views on four PEIs: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), and adaptive brain implants (ABIs). Stigma emerged as a key theme connecting diverse views, revealing that it is a significant factor in the acceptance and usage of PEIs. Stigma not only discourages seeking mental health services for depression but also inhibits the acceptance of PEIs. Addressing the pervasive and complex effects of stigma highlights the need to change societal attitudes toward mental illnesses and their treatments and to provide support to patients who may benefit from these interventions. The map also demonstrates the value of conceptual mapping for anticipating and mitigating ethical considerations in the development and use of PEIs.
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Affiliation(s)
| | - Robyn Bluhm
- Michigan State University, Lyman Briggs and Philosophy, USA
| | | | | | - Laura Y. Cabrera
- Pennsylvania State University, Department of Engineering and Mechanics and Rock Ethics Institute, USA
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Sha Q, Fu Z, Escobar Galvis ML, Madaj Z, Underwood MD, Steiner JA, Dwork A, Simpson N, Galfalvy H, Rozoklija G, Achtyes ED, Mann JJ, Brundin L. Integrative transcriptome- and DNA methylation analysis of brain tissue from the temporal pole in suicide decedents and their controls. Mol Psychiatry 2023:10.1038/s41380-023-02311-9. [PMID: 37938766 DOI: 10.1038/s41380-023-02311-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 11/09/2023]
Abstract
Suicide rates have increased steadily world-wide over the past two decades, constituting a serious public health crisis that creates a significant burden to affected families and the society as a whole. Suicidal behavior involves a multi-factorial etiology, including psychological, social and biological factors. Since the molecular neural mechanisms of suicide remain vastly uncharacterized, we examined transcriptional- and methylation profiles of postmortem brain tissue from subjects who died from suicide as well as their neurotypical healthy controls. We analyzed temporal pole tissue from 61 subjects, largely free from antidepressant and antipsychotic medication, using RNA-sequencing and DNA-methylation profiling using an array that targets over 850,000 CpG sites. Expression of NPAS4, a key regulator of inflammation and neuroprotection, was significantly downregulated in the suicide decedent group. Moreover, we identified a total of 40 differentially methylated regions in the suicide decedent group, mapping to seven genes with inflammatory function. There was a significant association between NPAS4 DNA methylation and NPAS4 expression in the control group that was absent in the suicide decedent group, confirming its dysregulation. NPAS4 expression was significantly associated with the expression of multiple inflammatory factors in the brain tissue. Overall, gene sets and pathways closely linked to inflammation were significantly upregulated, while specific pathways linked to neuronal development were suppressed in the suicide decedent group. Excitotoxicity as well as suppressed oligodendrocyte function were also implicated in the suicide decedents. In summary, we have identified central nervous system inflammatory mechanisms that may be active during suicidal behavior, along with oligodendrocyte dysfunction and altered glutamate neurotransmission. In these processes, NPAS4 might be a master regulator, warranting further studies to validate its role as a potential biomarker or therapeutic target in suicidality.
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Affiliation(s)
- Qiong Sha
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Zhen Fu
- Bioinformatics & Biostatistics Core, Van Andel Institute, Grand Rapids, MI, USA
| | | | - Zach Madaj
- Bioinformatics & Biostatistics Core, Van Andel Institute, Grand Rapids, MI, USA
| | - Mark D Underwood
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Jennifer A Steiner
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Andrew Dwork
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
- Department of Pathology and Cell Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Macedonian Academy of Sciences and Arts, Skopje, Macedonia
| | - Norman Simpson
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, USA
| | - Gorazd Rozoklija
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Eric D Achtyes
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - J John Mann
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Lena Brundin
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA.
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Müller F, Munagala A, Arnetz JE, Achtyes ED, Alshaarawy O, Holman HT. Racial disparities in emergency department utilization among patients with newly diagnosed depression. Gen Hosp Psychiatry 2023; 85:163-170. [PMID: 37926052 DOI: 10.1016/j.genhosppsych.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/25/2023] [Accepted: 10/28/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To test the hypothesis that racial and ethnic minorities have increased emergency department visit rates, despite being established with a primary care provider. METHODS In this retrospective cohort study, ED visits without hospital admission in a 12-month period among patients with a new primary care provider-issued diagnosis of depression were assessed. Electronic medical record (EMR) data was obtained from 47 family medicine clinics in a large Michigan-based healthcare system. General linear regression models with Poisson distribution were used to predict frequency of ED visits. RESULTS A total of 4159 patients were included in the analyses. In multivariable analyses, Black / African American race was associated with an additional 0.90 (95% CI 0.64, 1.16) ED visits and American Indian or Alaska Native race was associated with an additional 1.39 (95% CI 0.92, 1.87) ED visits compared to White or Caucasians (null value 0). These risks were only exceeded by patients who received a prescription for a typical antipsychotic drug agent. CONCLUSION Despite being established patients at primary care providers and having follow-up encounters, Black / African American and American Indian or Alaska Native patients with depression were considerably more likely to seek ED treatment compared to White/Caucasian patients with depression.
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Affiliation(s)
- Frank Müller
- Department of Family Medicine, Michigan State University, Grand Rapids, MI, USA; Corewell Health Family Medicine Residency Clinic, Grand Rapids, MI, USA; Department of General Practice, University Medical Center Göttingen, Göttingen, Germany.
| | - Akhilesh Munagala
- Department of Family Medicine, Michigan State University, Grand Rapids, MI, USA.
| | - Judith E Arnetz
- Department of Family Medicine, Michigan State University, Grand Rapids, MI, USA.
| | - Eric D Achtyes
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA.
| | - Omayma Alshaarawy
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
| | - Harland T Holman
- Department of Family Medicine, Michigan State University, Grand Rapids, MI, USA; Corewell Health Family Medicine Residency Clinic, Grand Rapids, MI, USA.
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12
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Monteith S, Glenn T, Geddes JR, Achtyes ED, Whybrow PC, Bauer M. Challenges and Ethical Considerations to Successfully Implement Artificial Intelligence in Clinical Medicine and Neuroscience: a Narrative Review. Pharmacopsychiatry 2023; 56:209-213. [PMID: 37643732 DOI: 10.1055/a-2142-9325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
This narrative review discusses how the safe and effective use of clinical artificial intelligence (AI) prediction tools requires recognition of the importance of human intelligence. Human intelligence, creativity, situational awareness, and professional knowledge, are required for successful implementation. The implementation of clinical AI prediction tools may change the workflow in medical practice resulting in new challenges and safety implications. Human understanding of how a clinical AI prediction tool performs in routine and exceptional situations is fundamental to successful implementation. Physicians must be involved in all aspects of the selection, implementation, and ongoing product monitoring of clinical AI prediction tools.
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Affiliation(s)
- Scott Monteith
- Department of Psychiatry, Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Eric D Achtyes
- Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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13
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Achtyes ED, Hopkins SC, Dedic N, Dworak H, Zeni C, Koblan K. Ulotaront: review of preliminary evidence for the efficacy and safety of a TAAR1 agonist in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2023; 273:1543-1556. [PMID: 37165101 PMCID: PMC10465394 DOI: 10.1007/s00406-023-01580-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/26/2023] [Indexed: 05/12/2023]
Abstract
Ulotaront is a trace amine-associated receptor 1 (TAAR1) agonist in Phase 3 clinical development for the treatment of schizophrenia. Ulotaront was discovered through a unique, target-agnostic approach optimized to identify drug candidates lacking D2 and 5-HT2A receptor antagonism, while demonstrating an antipsychotic-like phenotypic profile in vivo. The mechanism of action (MOA) of ulotaront is thought to be mediated by agonism at TAAR1 and serotonin 5-HT1A receptors. Ulotaront has completed two Phase 2 trials (4-week acute study and 26-week open-label extension) which led to Breakthrough Therapy Designation from the US Food and Drug Administration for the treatment of schizophrenia. In the double-blind, placebo-controlled, acute study, ulotaront was associated with significant (p < 0.001) improvement in Positive and Negative Syndrome Scale (PANSS) total score (effect size [ES]: 0.45), with improvements vs. placebo also observed across secondary endpoints. Post-hoc analyses of the acute trial revealed additional evidence to support the effect of ulotaront on negative symptoms. In the 4-week study, ulotaront was well-tolerated, with an incidence of adverse events (AEs) numerically lower compared to placebo (45.8% vs. 50.4%; with a number needed to harm [NNH] for individual ulotaront AEs all > 40). The open-label extension demonstrated further improvement across schizophrenia symptoms and confirmed the tolerability of ulotaront, with a 6-month completion rate of 67%. Based on current data, ulotaront shows potential to be a first-in-class TAAR1 agonist for the treatment of schizophrenia with a safety and efficacy profile distinct from current antipsychotics.
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Affiliation(s)
- Eric D Achtyes
- WMU Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | | | - Nina Dedic
- Sunovion Pharmaceuticals Inc., Marlborough, MA, USA
| | | | - Courtney Zeni
- Sunovion Pharmaceuticals Inc., Marlborough, MA, USA.
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14
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Magura S, Lee-Easton MJ, Abu-Obaid R, Reed P, Allgaier B, Amaratunga P, Lorenz-Lemberg B, Levitas M, Achtyes ED. Comparing presumptive with direct-to-definitive drug testing in oral fluid vs. urine for a U.S. national sample of individuals misusing drugs. Drug Alcohol Depend 2023; 250:110894. [PMID: 37481872 PMCID: PMC10530259 DOI: 10.1016/j.drugalcdep.2023.110894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND The aims are to compare the results of presumptive drug testing with confirmation of positives vs. direct-to-definitive drug testing, combined with investigation of urine vs. oral fluid as test matrices. METHODS Paired oral fluid and urine specimens were collected voluntarily and anonymously from 1098 individuals applying for methadone treatment in 11 clinics across 7 U.S. states. All specimens were analyzed by immunoassay (IA) and liquid chromatography-tandem mass spectrometry (LC-MS-MS). RESULTS Confirmed IA prevalences for urine were significantly higher than for oral fluid for 7 out of 10 drug classes - benzodiazepines, cannabis, cocaine, methadone, opiates, oxycodone and tramadol. Drug prevalences by direct-to-definitive LC-MS-MS were either the same or higher than prevalences by confirmed IA. Drug prevalences by LC-MS-MS were higher in urine for two drug classes (cocaine, methadone) and higher in oral fluid for two drug classes (buprenorphine, tramadol), but were equivalent in urine and oral fluid when averaged over all 10 drug classes. Certain drugs of special concern such as heroin and buprenorphine were more frequently detected in oral fluid than urine. CONCLUSIONS Urine analysis showed some technical advantage over oral fluid in sensitivity to several drug classes within a confirmed IA testing protocol, but this may be outweighed if there is reason to believe that tampering with urine specimens is a significant problem. Overall drug detection by direct-to-definitive testing was similar for oral fluid and urine, but one matrix may be preferable if there is a particular drug of clinical or epidemiological interest.
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Affiliation(s)
| | | | | | - Pete Reed
- Forensic Fluids Laboratories, Inc, USA
| | | | | | | | | | - Eric D Achtyes
- Western Michigan University Homer Stryker M.D. School of Medicine, USA
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15
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Homan P, Schooler NR, Brunette MF, Rotondi A, Ben-Zeev D, Gottlieb JD, Mueser KT, Achtyes ED, Gingerich S, Marcy P, Meyer-Kalos P, Hauser M, John M, Robinson DG, Kane JM. Relapse prevention through health technology program reduces hospitalization in schizophrenia. Psychol Med 2023; 53:4114-4120. [PMID: 35634965 DOI: 10.1017/s0033291722000794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Psychiatric hospitalization is a major driver of cost in the treatment of schizophrenia. Here, we asked whether a technology-enhanced approach to relapse prevention could reduce days spent in a hospital after discharge. METHODS The Improving Care and Reducing Cost (ICRC) study was a quasi-experimental clinical trial in outpatients with schizophrenia conducted between 26 February 2013 and 17 April 2015 at 10 different sites in the USA in an outpatient setting. Patients were between 18 and 60 years old with a diagnosis of schizophrenia, schizoaffective disorder, or psychotic disorder not otherwise specified. Patients received usual care or a technology-enhanced relapse prevention program during a 6-month period after discharge. The health technology program included in-person, individualized relapse prevention planning with treatments delivered via smartphones and computers, as well as a web-based prescriber decision support program. The main outcome measure was days spent in a psychiatric hospital during 6 months after discharge. RESULTS The study included 462 patients, of which 438 had complete baseline data and were thus used for propensity matching and analysis. Control participants (N = 89; 37 females) were enrolled first and received usual care for relapse prevention followed by 349 participants (128 females) who received technology-enhanced relapse prevention. During 6-month follow-up, 43% of control and 24% of intervention participants were hospitalized (χ2 = 11.76, p<0.001). Days of hospitalization were reduced by 5 days (mean days: b = -4.58, 95% CI -9.03 to -0.13, p = 0.044) in the intervention condition compared to control. CONCLUSIONS These results suggest that technology-enhanced relapse prevention is an effective and feasible way to reduce rehospitalization days among patients with schizophrenia.
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Affiliation(s)
- Philipp Homan
- Center for Psychiatric Neuroscience, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH, Zurich, Switzerland
| | - Nina R Schooler
- Department of Psychiatry, SUNY Downstate Medical School, Brooklyn, NY, USA
| | - Mary F Brunette
- Department of Psychiatry, Dartmouth-Hitchcock, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Armando Rotondi
- Department of Critical Care Medicine, Clinical and Translational Sciences Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh, PA, USA
| | - Dror Ben-Zeev
- Department of Psychiatry and Behavioral Sciences, Behavioral Research in Technology and Engineering (BRiTE) Center, University of Washington School of Medicine, Seattle, WA, USA
| | - Jennifer D Gottlieb
- Cambridge Health Alliance, Division of Population Behavioral Health Innovation and Harvard Medical School Department of Psychiatry, Cambridge, MA, USA
| | - Kim T Mueser
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
| | - Eric D Achtyes
- Cherry Health and Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Susan Gingerich
- Independent Consultant and Trainer in Narberth, Narberth, Pennsylvania, USA
| | | | - Piper Meyer-Kalos
- University of Minnesota Medical School, Department of Psychiatry & Behavioral Sciences, Minneapolis, MN, USA
| | | | - Majnu John
- Center for Psychiatric Neuroscience, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Mathematics, Hofstra University, Hempstead, NY, USA
| | - Delbert G Robinson
- Center for Psychiatric Neuroscience, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - John M Kane
- Center for Psychiatric Neuroscience, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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16
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Bauer M, Glenn T, Achtyes ED, Alda M, Agaoglu E, Altınbaş K, Andreassen OA, Angelopoulos E, Ardau R, Aydin M, Ayhan Y, Baethge C, Bauer R, Baune BT, Balaban C, Becerra-Palars C, Behere AP, Behere PB, Belete H, Belete T, Belizario GO, Bellivier F, Belmaker RH, Benedetti F, Berk M, Bersudsky Y, Bicakci Ş, Birabwa-Oketcho H, Bjella TD, Brady C, Cabrera J, Cappucciati M, Castro AMP, Chen WL, Cheung EYW, Chiesa S, Crowe M, Cuomo A, Dallaspezia S, Del Zompo M, Desai P, Dodd S, Etain B, Fagiolini A, Fellendorf FT, Ferensztajn-Rochowiak E, Fiedorowicz JG, Fountoulakis KN, Frye MA, Geoffroy PA, Gitlin MJ, Gonzalez-Pinto A, Gottlieb JF, Grof P, Haarman BCM, Harima H, Hasse-Sousa M, Henry C, Hoffding L, Houenou J, Imbesi M, Isometsä ET, Ivkovic M, Janno S, Johnsen S, Kapczinski F, Karakatsoulis GN, Kardell M, Kessing LV, Kim SJ, König B, Kot TL, Koval M, Kunz M, Lafer B, Landén M, Larsen ER, Lenger M, Licht RW, Lopez-Jaramillo C, MacKenzie A, Madsen HØ, Madsen SAKA, Mahadevan J, Mahardika A, Manchia M, Marsh W, Martinez-Cengotitabengoa M, Martini J, Martiny K, Mashima Y, McLoughlin DM, Meesters Y, Melle I, Meza-Urzúa F, Mikolas P, Mok YM, Monteith S, Moorthy M, Morken G, Mosca E, Mozzhegorov AA, Munoz R, Mythri SV, Nacef F, Nadella RK, Nakanotani T, Nielsen RE, O'Donovan C, Omrani A, Osher Y, Ouali U, Pantovic-Stefanovic M, Pariwatcharakul P, Petite J, Petzold J, Pfennig A, Ruiz YP, Pinna M, Pompili M, Porter RJ, Quiroz D, Rabelo-da-Ponte FD, Ramesar R, Rasgon N, Ratta-Apha W, Ratzenhofer M, Redahan M, Reddy MS, Reif A, Reininghaus EZ, Richards JG, Ritter P, Rybakowski JK, Sathyaputri L, Scippa AM, Simhandl C, Smith D, Smith J, Stackhouse PW, Stein DJ, Stilwell K, Strejilevich S, Su KP, Subramaniam M, Sulaiman AH, Suominen K, Tanra AJ, Tatebayashi Y, Teh WL, Tondo L, Torrent C, Tuinstra D, Uchida T, Vaaler AE, Vieta E, Viswanath B, Yoldi-Negrete M, Yalcinkaya OK, Young AH, Zgueb Y, Whybrow PC. Exploratory study of ultraviolet B (UVB) radiation and age of onset of bipolar disorder. Int J Bipolar Disord 2023; 11:22. [PMID: 37347392 DOI: 10.1186/s40345-023-00303-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/16/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Sunlight contains ultraviolet B (UVB) radiation that triggers the production of vitamin D by skin. Vitamin D has widespread effects on brain function in both developing and adult brains. However, many people live at latitudes (about > 40 N or S) that do not receive enough UVB in winter to produce vitamin D. This exploratory study investigated the association between the age of onset of bipolar I disorder and the threshold for UVB sufficient for vitamin D production in a large global sample. METHODS Data for 6972 patients with bipolar I disorder were obtained at 75 collection sites in 41 countries in both hemispheres. The best model to assess the relation between the threshold for UVB sufficient for vitamin D production and age of onset included 1 or more months below the threshold, family history of mood disorders, and birth cohort. All coefficients estimated at P ≤ 0.001. RESULTS The 6972 patients had an onset in 582 locations in 70 countries, with a mean age of onset of 25.6 years. Of the onset locations, 34.0% had at least 1 month below the threshold for UVB sufficient for vitamin D production. The age of onset at locations with 1 or more months of less than or equal to the threshold for UVB was 1.66 years younger. CONCLUSION UVB and vitamin D may have an important influence on the development of bipolar disorder. Study limitations included a lack of data on patient vitamin D levels, lifestyles, or supplement use. More study of the impacts of UVB and vitamin D in bipolar disorder is needed to evaluate this supposition.
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Affiliation(s)
- Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - Eric D Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Esen Agaoglu
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kürsat Altınbaş
- Department of Psychiatry, Selcuk University Faculty of Medicine, Mazhar Osman Mood Center, Konya, Turkey
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elias Angelopoulos
- Department of Psychiatry, National and Capodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Raffaella Ardau
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Memduha Aydin
- Department of Psychiatry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Yavuz Ayhan
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Christopher Baethge
- Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany
| | - Rita Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ceylan Balaban
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt Am Main, Frankfurt Am Main, Germany
| | | | - Aniruddh P Behere
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, MI, USA
| | - Prakash B Behere
- Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, India
| | - Habte Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tilahun Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gabriel Okawa Belizario
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique, Hôpitaux de Paris, INSERM UMR-S1144, Université Paris Cité, Fondation FondaMental, Paris, France
| | - Robert H Belmaker
- Division of Psychiatry, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Francesco Benedetti
- University Vita-Salute San Raffaele, Milan, Italy
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Michael Berk
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
- Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Yuly Bersudsky
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Şule Bicakci
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
| | | | - Thomas D Bjella
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Conan Brady
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Jorge Cabrera
- Mood Disorders Clinic, Dr. Jose Horwitz Psychiatric Institute, Santiago de Chile, Chile
| | | | - Angela Marianne Paredes Castro
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Wei-Ling Chen
- Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
| | | | - Silvia Chiesa
- Department of Mental Health and Substance Abuse, Piacenza, Italy
| | - Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Sara Dallaspezia
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Del Zompo
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Pratikkumar Desai
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Seetal Dodd
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Bruno Etain
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique, Hôpitaux de Paris, INSERM UMR-S1144, Université Paris Cité, Fondation FondaMental, Paris, France
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Jess G Fiedorowicz
- Department of Psychiatry, School of Epidemiology and Public Health, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
| | - Kostas N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Pierre A Geoffroy
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat, Claude Bernard, 75018, Paris, France
- GHU Paris, Psychiatry and Neurosciences, 1 Rue Cabanis, 75014, Paris, France
- Université de Paris, NeuroDiderot, Inserm, FHU I2D2, 75019, Paris, France
| | - Michael J Gitlin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Ana Gonzalez-Pinto
- BIOARABA, Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - John F Gottlieb
- Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul Grof
- Mood Disorders Center of Ottawa and the Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Bartholomeus C M Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hirohiko Harima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Mathias Hasse-Sousa
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Programa de Pós-Graduação em Psicologia, Departamento de Psicologia do Desenvolvimento e da Personalidade, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Chantal Henry
- Department of Psychiatry, GHU Paris Psychiatrie and Neurosciences, Université de Paris, F-75014, F-75006, Paris, France
| | - Lone Hoffding
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Josselin Houenou
- Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, APHP, Mondor Univ Hospitals, Fondation FondaMental, F-94010, Créteil, France
- Université Paris Saclay, CEA, Neurospin, F-91191, Gif-Sur-Yvette, France
| | | | - Erkki T Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
| | - Maja Ivkovic
- Clinic for Psychiatry, University Clinical Center of Serbia, Belgrade, Serbia
| | - Sven Janno
- Department of Psychiatry, University of Tartu, Tartu, Estonia
| | - Simon Johnsen
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark
| | - Flávio Kapczinski
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gregory N Karakatsoulis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mathias Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark
| | - Seong Jae Kim
- Department of Psychiatry, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Barbara König
- BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
| | - Timur L Kot
- Khanty-Mansiysk Clinical Psychoneurological Hospital, Khanty-Mansiysk, Russia
| | - Michael Koval
- Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Mauricio Kunz
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beny Lafer
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erik R Larsen
- Mental Health Department Odense, University Clinic and Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Rasmus W Licht
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Carlos Lopez-Jaramillo
- Mood Disorders Program, Hospital Universitario San Vicente Fundación, Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Alan MacKenzie
- Forensic Psychiatry, University of Glasgow, NHS Greater Glasgow and Clyde, Glasgow, UK
| | | | | | - Jayant Mahadevan
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Agustine Mahardika
- Department of Psychiatry, Faculty of Medicine, Mataram University, Mataram, Indonesia
| | - Mirko Manchia
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Wendy Marsh
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Monica Martinez-Cengotitabengoa
- Osakidetza, Basque Health Service, BioAraba Health Research Institute, University of the Basque Country, Bilbao, Spain
- The Psychology Clinic of East Anglia, Norwich, UK
| | - Julia Martini
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Klaus Martiny
- Psychiatric Centre Copenhagen, Copenhagen University Hospitals, Copenhagen, Denmark
| | - Yuki Mashima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Declan M McLoughlin
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Ybe Meesters
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fátima Meza-Urzúa
- Department of Child and Adolescent Psychiatry Und Psychotherapy, SHG Klinikum, Idar-Oberstein, Germany
| | - Pavol Mikolas
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Yee Ming Mok
- Department of Mood and Anxiety Disorders, Institute of Mental Health, Singapore City, Singapore
| | - Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - Muthukumaran Moorthy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Gunnar Morken
- Department of Mental Health, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Enrica Mosca
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | | | - Rodrigo Munoz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Starlin V Mythri
- Makunda Christian Leprosy and General Hospital, Bazaricherra, Assam, 788727, India
| | - Fethi Nacef
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Ravi K Nadella
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Takako Nakanotani
- Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-Ku, Tokyo, 150-0013, Japan
| | - René Ernst Nielsen
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Adel Omrani
- Tunisian Bipolar Forum, Érable Médical Cabinet 324, Lac 2, Tunis, Tunisia
| | - Yamima Osher
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Uta Ouali
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | | | - Pornjira Pariwatcharakul
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Joanne Petite
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Johannes Petzold
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | | | - Marco Pinna
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Danilo Quiroz
- Deparment of Psychiatry, Diego Portales University, Santiago de Chile, Chile
| | | | - Raj Ramesar
- SA MRC Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, Institute of Infectious Diseases and Molecular, Medicine, University of Cape Town, Cape Town, South Africa
| | - Natalie Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Woraphat Ratta-Apha
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Michaela Ratzenhofer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Maria Redahan
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - M S Reddy
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt Am Main, Frankfurt Am Main, Germany
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Jenny Gringer Richards
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Leela Sathyaputri
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Angela M Scippa
- Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
| | - Christian Simhandl
- Bipolar Zentrum Wiener Neustadt, Sigmund Freud Privat Universität, Vienna, Austria
| | - Daniel Smith
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | - José Smith
- AREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
| | - Paul W Stackhouse
- Science Directorate/Climate Science Branch, NASA Langley Research Center, Hampton, VA, USA
| | - Dan J Stein
- Department of Psychiatry, MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Kellen Stilwell
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Sergio Strejilevich
- AREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
| | - Kuan-Pin Su
- College of Medicine, China Medical University (CMU), Taichung, Taiwan
- An-Nan Hospital, China Medical University, Tainan, Taiwan
| | | | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kirsi Suominen
- Department of Social Services and Health Care, Psychiatry, City of Helsinki, Helsinki, Finland
| | - Andi J Tanra
- Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Yoshitaka Tatebayashi
- Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-Ku, Tokyo, 150-0013, Japan
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Leonardo Tondo
- McLean Hospital-Harvard Medical School, Boston, MA, USA
- Mood Disorder Lucio Bini Centers, Cagliari e Rome, Italy
| | - Carla Torrent
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Daniel Tuinstra
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Takahito Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Arne E Vaaler
- Department of Mental Health, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Eduard Vieta
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Biju Viswanath
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Maria Yoldi-Negrete
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
| | - Oguz Kaan Yalcinkaya
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yosra Zgueb
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Bluhm R, Sipahi ED, Achtyes ED, McCright AM, Cabrera LY. Stakeholders' Ethical Concerns Regarding Psychiatric Electroceutical Interventions: Results from a US Nationwide Survey. AJOB Empir Bioeth 2023; 15:11-21. [PMID: 37343219 PMCID: PMC10733552 DOI: 10.1080/23294515.2023.2224592] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
BACKGROUND Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat mental disorders and may raise different ethical concerns than other therapies such as medications or talk therapy. Yet little is known about stakeholders' perceptions of, and ethical concerns related to, these interventions. We aimed to better understand the ethical concerns of a variety of stakeholder groups (patients with depression, caregivers of patients, members of the public, and psychiatrists) regarding four PEIs: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation (DBS), and adaptive brain implants (ABI). METHODS We conducted a national survey of these four stakeholder groups, using an embedded video vignette experiment depicting a patient with treatment-resistant depression and her psychiatrist discussing the possibility of treatment with one of the four PEIs. RESULTS Participants' ethical concerns varied by stakeholder group, by PEI, and by the interaction of the two. The three non-clinician groups tended to have similar ethical concerns, but to differ from psychiatrists. Similar concerns were raised with regard to the two implantable technologies, DBS and ABI. Overall, there was relatively little concern about the involuntary use of PEIs, though some expressed concern about the adequacy of information provided during the consent process. There was also significant concern that patients may not receive helpful therapies. CONCLUSIONS To our knowledge, this is the first national survey that includes multiple stakeholder groups and multiple PEI modalities. A better understanding of the ethical concerns of stakeholders can help to shape clinical practice and health care policy regarding PEIs.
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Affiliation(s)
- R Bluhm
- Philosophy and Lyman Briggs College, Michigan State University, East Lansing, MI, USA
| | - E D Sipahi
- College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - E D Achtyes
- School of Human Medicine, Western Michigan University, Kalamazoo, MI, USA
| | - A M McCright
- Sociology, Michigan State University, East Lansing, MI, USA
| | - L Y Cabrera
- Center for Neural Engineering, Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA, USA
- Rock Ethics Institute, The Pennsylvania State University, University Park, PA, USA
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Achtyes ED, Glenn T, Monteith S, Geddes JR, Whybrow PC, Martini J, Bauer M. Telepsychiatry in an Era of Digital Mental Health Startups. Curr Psychiatry Rep 2023; 25:263-272. [PMID: 37166622 PMCID: PMC10172730 DOI: 10.1007/s11920-023-01425-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE OF REVIEW Telepsychiatry practiced by psychiatrists is evidence-based, regulated, private, and effective in diverse settings. The use of telemedicine has grown since the COVID-19 pandemic as people routinely obtain more healthcare services online. At the same time, there has been a rapid increase in the number of digital mental health startups that offer various services including online therapy and access to prescription medications. These digital mental health firms advertise directly to the consumer primarily through digital advertising. The purpose of this narrative review is to contrast traditional telepsychiatry and the digital mental health market related to online therapy. RECENT FINDINGS In contrast to standard telepsychiatry, most of the digital mental health startups are unregulated, have unproven efficacy, and raise concerns related to self-diagnosis, self-medicating, and inappropriate prescribing. The role of digital mental health firms for people with serious mental illness has not been determined. There are inadequate privacy controls for the digital mental health firms, including for online therapy. We live in an age where there is widespread admiration for technology entrepreneurs and increasing emphasis on the role of the patient as a consumer. Yet, the business practices of digital mental health startups may compromise patient safety for profits. There is a need to address issues with the digital mental health startups and to educate patients about the differences between standard medical care and digital mental health products.
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Affiliation(s)
- Eric D Achtyes
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA.
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - John R Geddes
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Julia Martini
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus Medical Faculty, Technische Universität Dresden, Dresden, Germany
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Tyron JM, Bluhm R, Achtyes ED, McCright AM, Cabrera LY. The influence of prior awareness on views about psychiatric electroceutical interventions among non-clinician stakeholders. Npj Ment Health Res 2023; 2:6. [PMID: 38609645 PMCID: PMC10955864 DOI: 10.1038/s44184-023-00028-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/18/2023] [Indexed: 04/14/2024]
Abstract
Psychiatric electroceutical interventions (PEIs) are emerging interventions in the treatment of depression and other mood disorders. The uptake of PEIs is strongly influenced by public, caregiver, and patient views. This study examines the influence of prior awareness and of trust in the medico-scientific establishment with respect to non-clinicians' views on PEI among a cohort of U.S. respondents. About 3098 U.S. caregivers, patients, and members of the general public completed an online survey with an embedded experiment to evaluate PEI views by stakeholder, modality, and disease severity. ANOVA statistical tests and logistic regression models were used to identify significant differences between groups and moderating factors. Overall, respondents had greater awareness of antidepressant medication (73-84%) and psychotherapy (68-76%) than of any PEI, and ECT garnered the most prior awareness (29-40%) within each group. Non-clinical respondents most often used websites or social media as information sources, and the least trusted sources included those with notable financial interests. Considering the low awareness level among non-clinicians, the implementation of programs to target and advance awareness levels about the use of PEIs in depression among this population may contribute to reducing negative views around these interventions. Fostering trust in the medico-scientific establishment may also increase public support for PEIs as well as uptake of these treatment modalities.
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Affiliation(s)
- J M Tyron
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, 49548, USA
| | - R Bluhm
- Lyman Briggs and Philosophy, Michigan State University, East Lansing, MI, 48824, USA
| | - E D Achtyes
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, 49548, USA
- Division of Psychiatry & Behavioral Medicine, Michigan State University, Grand Rapids, MI, 49503, USA
| | - A M McCright
- Sociology, Michigan State University, East Lansing, MI, 48824, USA
| | - L Y Cabrera
- Center for Neural Engineering, Department of Engineering Science and Mechanics, Rock Ethics Institute, and Huck Institute of Life Sciences, Pennsylvania State University, University Park, PA, 16802, USA.
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Cabrera LY, Achtyes ED, Bluhm R, McCright AM. Views about neuromodulation interventions for depression by stakeholder group, treatment modality, and depression severity. Compr Psychiatry 2023; 122:152365. [PMID: 36702062 PMCID: PMC9993717 DOI: 10.1016/j.comppsych.2023.152365] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/06/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The past few decades have seen the emergence both of new neuromodulation treatment protocols and novel applications of standard neuromodulation interventions in psychiatry. Yet little is known about different stakeholders' views about these interventions. METHODS We administered an online survey with an embedded video vignette experiment to four national samples: the general public (N = 1022), caregivers for people with depression (N = 1026), patients living with depression (N = 1050), and board-certified psychiatrists (N = 505). We randomly assigned subjects to one of eight conditions in our full factorial design: four neuromodulation interventions [electroconvulsive therapy, repetitive transcranial magnetic stimulation, deep brain stimulation, or adaptive brain implants] by two depression severity levels [moderate or severe]. In this paper we present results from ANOVA and linear regression models explaining how views about these four neuromodulation interventions-as measured in five attitudinal scales (general affect, perceived influence on self, perceived benefit, perceived risk, and perceived invasiveness)-vary by (1) intervention, (2) depression severity, and/or (3) stakeholder group. RESULTS Our results provide evidence that psychiatrists views differ significantly in important ways from other stakeholder groups. Type of intervention also shaped participants' attitudes, including perceptions of invasiveness, effectiveness, and safety. CONCLUSIONS Given the differing affective valence among stakeholders and the differences found by modality and stakeholder groups across the different scales, future targeted educational initiatives could be developed to help address key misunderstandings and misinformed perceptions.
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Affiliation(s)
- L Y Cabrera
- Pennsylvania State University, University Park, PA 18602, USA.
| | - E D Achtyes
- Michigan State University, Grand Rapids, MI 49503, USA.
| | - R Bluhm
- Michigan State University, 368 Farm Lane, East Lansing, MI 48824, USA.
| | - A M McCright
- Michigan State University, 509 East Circle Drive, Room 317, East Lansing, MI 48824, USA.
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Bluhm R, Cortright M, Achtyes ED, Cabrera LY. "They Are Invasive in Different Ways.": Stakeholders' Perceptions of the Invasiveness of Psychiatric Electroceutical Interventions. AJOB Neurosci 2023; 14:1-12. [PMID: 34387539 PMCID: PMC10424189 DOI: 10.1080/21507740.2021.1958098] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Medical interventions are usually categorized as "invasive" when they involve piercing the skin or inserting an object into the body. Beyond this standard definition, however, there is little discussion of the concept of invasiveness in the medical literature, despite evidence that the term is used in ways that do not reflect the standard definition of medical invasiveness. We interviewed psychiatrists, patients with depression, and members of the public without depression to better understand their views on the invasiveness of several psychiatric electroceutical interventions (treatments that involve electrical or magnetic stimulation of the brain) for the treatment of depression. Our study shows that people recognize several kinds of invasiveness: physical, emotional, and lifestyle. In addition, several characteristics of therapies influence how invasive they are perceived to be; these include the perceived capacity of an intervention to result in harm; how localized the effects of the intervention are; the amount of control retained by the person receiving the intervention; how permanent its effects are perceived as being; and how familiar it seemed to participants. Our findings contribute to a small literature on the concept of invasiveness, which emphasizes that categorizing an intervention as invasive, or as noninvasive, evokes a variety of other normative considerations, including the potential harm it poses and how it compares to other potential therapies. It may also draw attention away from other salient features of the intervention.
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Affiliation(s)
| | | | - Eric D. Achtyes
- Michigan State University
- Pine Rest Christian Mental Health Services
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22
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Müller F, Abdelnour AM, Rutaremara DN, Arnetz JE, Achtyes ED, Alshaarawy O, Holman HT. Mental Health Screening Differences in Non-English Speaking Patients: Results From a Retrospective Cohort Study. J Prim Care Community Health 2023; 14:21501319231200304. [PMID: 37714820 PMCID: PMC10504842 DOI: 10.1177/21501319231200304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/17/2023] Open
Abstract
PURPOSE To assess differences in mental health screening based on patient's preferred language. METHODS For this retrospective cohort study, data for 85 725 unique patients from 10 primary care clinics in West Michigan were analyzed if patients received at least 1 mental health screening with the Patient Health Questionnaire 4 (PHQ-4) within a 12-month period (10/15/2021-10/14/2022). A general linear regression model was used to assess the adjusted odds ratios (aOR) of being screened. RESULTS Patients having a preferred language other than English (n = 2755) had an 87.0% chance of receiving the recommended mental health screening, compared to 76.7% of English-speaking patients (P < .001). A multivariable model revealed decreased screening odds for Kinyarwanda (aOR 0.29, 95% CI 0.19-0.45) and Persian/Dari/Pashto (aOR 0.46, 95% CI 0.23-0.91) speaking patients and higher screening odds for Spanish (aOR 1.45, 95% CI 1.19-1.77), Bosnian (aOR 2.13, 95% CI 1.11-4.11), and Vietnamese (aOR 2.25 95% CI 1.64-3.08) speaking patients compared to English speaking patients. CONCLUSIONS Results highlight the inequities between the language groups that are probably the result of the challenges to access multilingual depression and anxiety screening instruments. Furthermore, providers may be prone to bias about who they think "needs" a mental health screening. We suggest that measures are implemented to ensure consistency in mental health screening regardless of a patients' preferred language.
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Affiliation(s)
- Frank Müller
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
- Corewell Health Family Medicine Residency Clinic, Grand Rapids, MI, USA
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Alyssa M. Abdelnour
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Diana N. Rutaremara
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Judith E. Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Eric D. Achtyes
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Omayma Alshaarawy
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Harland T. Holman
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
- Corewell Health Family Medicine Residency Clinic, Grand Rapids, MI, USA
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23
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Fattal J, Brascamp JW, Slate RE, Lehet M, Achtyes ED, Thakkar KN. Blunted pupil light reflex is associated with negative symptoms and working memory in individuals with schizophrenia. Schizophr Res 2022; 248:254-262. [PMID: 36115190 PMCID: PMC9613610 DOI: 10.1016/j.schres.2022.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 08/21/2022] [Accepted: 09/05/2022] [Indexed: 10/14/2022]
Abstract
Two largely separate lines of research have documented altered pupillary dynamics in individuals diagnosed with schizophrenia. An older set of studies has demonstrated reductions in the pupillary light reflex (PLR) in individuals with schizophrenia; however, clinical and cognitive correlates of this blunted PLR have been relatively unexplored. More recently, a large body of work has demonstrated reductions in pupillary dilation in response to cognitive demands in individuals with schizophrenia, and the degree of this blunted pupil dilation has been related to more severe cognitive deficits and motivational negative symptoms. These clinically relevant alterations in the cognitive modulation of pupil size have been interpreted as reflecting insufficient information processing resources or inappropriate effort allocation. To begin to bridge these two lines of work, we investigated the PLR in 34 individuals with schizophrenia and 30 healthy controls and related the amplitude of the PLR to motivational negative symptoms and cognitive performance. Consistent with prior work, we found that the PLR was reduced in individuals with schizophrenia, and furthermore, that these measurements were highly reliable across individuals. Blunted constriction was associated with more severe motivational negative symptoms and poorer working memory among individuals with schizophrenia. These observed correlates provide a bridge between older literature documenting an altered PLR and more recent work reporting associations between negative symptoms, cognition, and blunted pupillary dilation in response to cognitive demands in individuals with schizophrenia. We provide possible mechanistic interpretations of our data and consider a parsimonious explanation for reduced cognitive- and light-related modulation of pupil size.
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Affiliation(s)
- Jessica Fattal
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America
| | - Jan W Brascamp
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America
| | - Rachael E Slate
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America
| | - Matthew Lehet
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America
| | - Eric D Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, United States of America; Cherry Health, Grand Rapids, MI, United States of America
| | - Katharine N Thakkar
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America; Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, United States of America.
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Bauer M, Glenn T, Achtyes ED, Alda M, Agaoglu E, Altınbaş K, Andreassen OA, Angelopoulos E, Ardau R, Aydin M, Ayhan Y, Baethge C, Bauer R, Baune BT, Balaban C, Becerra-Palars C, Behere AP, Behere PB, Belete H, Belete T, Belizario GO, Bellivier F, Belmaker RH, Benedetti F, Berk M, Bersudsky Y, Bicakci Ş, Birabwa-Oketcho H, Bjella TD, Brady C, Cabrera J, Cappucciati M, Castro AMP, Chen WL, Cheung EYW, Chiesa S, Crowe M, Cuomo A, Dallaspezia S, Del Zompo M, Desai P, Dodd S, Etain B, Fagiolini A, Fellendorf FT, Ferensztajn-Rochowiak E, Fiedorowicz JG, Fountoulakis KN, Frye MA, Geoffroy PA, Gonzalez-Pinto A, Gottlieb JF, Grof P, Haarman BCM, Harima H, Hasse-Sousa M, Henry C, Høffding L, Houenou J, Imbesi M, Isometsä ET, Ivkovic M, Janno S, Johnsen S, Kapczinski F, Karakatsoulis GN, Kardell M, Kessing LV, Kim SJ, König B, Kot TL, Koval M, Kunz M, Lafer B, Landén M, Larsen ER, Lenger M, Lewitzka U, Licht RW, Lopez-Jaramillo C, MacKenzie A, Madsen HØ, Madsen SAKA, Mahadevan J, Mahardika A, Manchia M, Marsh W, Martinez-Cengotitabengoa M, Martiny K, Mashima Y, McLoughlin DM, Meesters Y, Melle I, Meza-Urzúa F, Mok YM, Monteith S, Moorthy M, Morken G, Mosca E, Mozzhegorov AA, Munoz R, Mythri SV, Nacef F, Nadella RK, Nakanotani T, Nielsen RE, O'Donovan C, Omrani A, Osher Y, Ouali U, Pantovic-Stefanovic M, Pariwatcharakul P, Petite J, Pfennig A, Ruiz YP, Pinna M, Pompili M, Porter R, Quiroz D, Rabelo-da-Ponte FD, Ramesar R, Rasgon N, Ratta-Apha W, Ratzenhofer M, Redahan M, Reddy MS, Reif A, Reininghaus EZ, Richards JG, Ritter P, Rybakowski JK, Sathyaputri L, Scippa ÂM, Simhandl C, Smith D, Smith J, Stackhouse PW, Stein DJ, Stilwell K, Strejilevich S, Su KP, Subramaniam M, Sulaiman AH, Suominen K, Tanra AJ, Tatebayashi Y, Teh WL, Tondo L, Torrent C, Tuinstra D, Uchida T, Vaaler AE, Vieta E, Viswanath B, Yoldi-Negrete M, Yalcinkaya OK, Young AH, Zgueb Y, Whybrow PC. Association between polarity of first episode and solar insolation in bipolar I disorder. J Psychosom Res 2022; 160:110982. [PMID: 35932492 PMCID: PMC7615104 DOI: 10.1016/j.jpsychores.2022.110982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/14/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Circadian rhythm disruption is commonly observed in bipolar disorder (BD). Daylight is the most powerful signal to entrain the human circadian clock system. This exploratory study investigated if solar insolation at the onset location was associated with the polarity of the first episode of BD I. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area of the Earth. METHODS Data from 7488 patients with BD I were collected at 75 sites in 42 countries. The first episode occurred at 591 onset locations in 67 countries at a wide range of latitudes in both hemispheres. Solar insolation values were obtained for every onset location, and the ratio of the minimum mean monthly insolation to the maximum mean monthly insolation was calculated. This ratio is largest near the equator (with little change in solar insolation over the year), and smallest near the poles (where winter insolation is very small compared to summer insolation). This ratio also applies to tropical locations which may have a cloudy wet and clear dry season, rather than winter and summer. RESULTS The larger the change in solar insolation throughout the year (smaller the ratio between the minimum monthly and maximum monthly values), the greater the likelihood the first episode polarity was depression. Other associated variables were being female and increasing percentage of gross domestic product spent on country health expenditures. (All coefficients: P ≤ 0.001). CONCLUSION Increased awareness and research into circadian dysfunction throughout the course of BD is warranted.
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Affiliation(s)
- Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - Eric D Achtyes
- Michigan State University College of Human Medicine, Division of Psychiatry & Behavioral Medicine, Grand Rapids, MI, USA; Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Esen Agaoglu
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kürşat Altınbaş
- Department of Psychiatry, Selcuk University Faculty of Medicine, Mazhar Osman Mood Center, Konya, Turkey
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elias Angelopoulos
- Department of Psychiatry, National and Capodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Raffaella Ardau
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Memduha Aydin
- Department of Psychiatry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Yavuz Ayhan
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Christopher Baethge
- Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany
| | - Rita Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ceylan Balaban
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | | | - Aniruddh P Behere
- Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, MI, USA
| | - Prakash B Behere
- Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, India
| | - Habte Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tilahun Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gabriel Okawa Belizario
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris, INSERM UMR-S1144, Université de Paris, FondaMental Foundation, Paris, France
| | - Robert H Belmaker
- Professor Emeritus of Psychiatry, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Francesco Benedetti
- University Vita-Salute San Raffaele, Milan, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Yuly Bersudsky
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Şule Bicakci
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey; Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
| | | | - Thomas D Bjella
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Conan Brady
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Jorge Cabrera
- Mood Disorders Clinic, Dr. Jose Horwitz Psychiatric Institute, Santiago de Chile, Chile
| | | | - Angela Marianne Paredes Castro
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Wei-Ling Chen
- Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
| | | | - Silvia Chiesa
- Department of Mental Health and Substance Abuse, Piacenza, Italy
| | - Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Sara Dallaspezia
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Del Zompo
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | | | - Seetal Dodd
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
| | - Bruno Etain
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique - Hôpitaux de Paris, INSERM UMR-S1144, Université de Paris, FondaMental Foundation, Paris, France
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Jess G Fiedorowicz
- Department of Psychiatry, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kostas N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018 Paris, France; GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France; Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, F-75019 Paris, France
| | - Ana Gonzalez-Pinto
- BIOARABA. Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - John F Gottlieb
- Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul Grof
- Mood Disorders Center of Ottawa and the Department of Psychiatry, University of Toronto, Canada
| | - Bartholomeus C M Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Hirohiko Harima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Mathias Hasse-Sousa
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Chantal Henry
- Department of Psychiatry, GHU Paris Psychiatrie & Neurosciences, F-75014, Paris France, Université de Paris, F-75006 Paris, France
| | - Lone Høffding
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Josselin Houenou
- Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, APHP, Mondor Univ Hospitals, Fondation FondaMental, F-94010 Créteil, France; Université Paris Saclay, CEA, Neurospin, F-91191 Gif-sur-Yvette, France
| | | | - Erkki T Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
| | - Maja Ivkovic
- University Clinical Center of Serbia, Clinic for Psychiatry, Belgrade, Serbia
| | - Sven Janno
- Department of Psychiatry, University of Tartu, Tartu, Estonia
| | - Simon Johnsen
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark
| | - Flávio Kapczinski
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gregory N Karakatsoulis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mathias Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Seong Jae Kim
- Department of Psychiatry, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Barbara König
- BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
| | - Timur L Kot
- Khanty-Mansiysk Clinical Psychoneurological Hospital, Khanty-Mansiysk, Russia
| | - Michael Koval
- Department of Neuroscience, Michigan State University, East Lansing, MI, USA
| | - Mauricio Kunz
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beny Lafer
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erik R Larsen
- Mental Health Department Odense, University Clinic and Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Ute Lewitzka
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Rasmus W Licht
- Psychiatry - Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Carlos Lopez-Jaramillo
- Mood Disorders Program, Hospital Universitario San Vicente Fundación, Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Alan MacKenzie
- Forensic Psychiatry, University of Glasgow, NHS Greater Glasgow and Clyde, Glasgow, UK
| | | | | | - Jayant Mahadevan
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Agustine Mahardika
- Department of Psychiatry, Faculty of Medicine, Mataram University, Mataram, Indonesia
| | - Mirko Manchia
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada; Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Wendy Marsh
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Monica Martinez-Cengotitabengoa
- Osakidetza, Basque Health Service, BioAraba Health Research Institute, University of the Basque Country, Spain; The Psychology Clinic of East Anglia, Norwich, United Kingdom
| | - Klaus Martiny
- Copenhagen University Hospitals, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Yuki Mashima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Declan M McLoughlin
- Dept of Psychiatry & Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Ybe Meesters
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fátima Meza-Urzúa
- Department of Child and Adolescent Psychiatry und Psychotherapy, SHG Klinikum, Idar-Oberstein, Germany
| | - Yee Ming Mok
- Department of Mood and Anxiety disorders, Institute of Mental Health, Singapore City, Singapore
| | - Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - Muthukumaran Moorthy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Gunnar Morken
- Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway; Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Enrica Mosca
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | | | - Rodrigo Munoz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Starlin V Mythri
- Makunda Christian Leprosy and General Hospital, Bazaricherra, Assam 788727, India
| | - Fethi Nacef
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Ravi K Nadella
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Takako Nakanotani
- Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - René Ernst Nielsen
- Psychiatry - Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Adel Omrani
- Tunisian Bipolar Forum, Érable Médical Cabinet 324, Lac 2, Tunis, Tunisia
| | - Yamima Osher
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Uta Ouali
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | | | - Pornjira Pariwatcharakul
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Joanne Petite
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | | | - Marco Pinna
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy; Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Danilo Quiroz
- Deparment of Psychiatry, Diego Portales University, Santiago de Chile, Chile
| | | | - Raj Ramesar
- SA MRC Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, South Africa
| | - Natalie Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Woraphat Ratta-Apha
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Michaela Ratzenhofer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Maria Redahan
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - M S Reddy
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Jenny Gringer Richards
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Leela Sathyaputri
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Ângela M Scippa
- Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
| | - Christian Simhandl
- Bipolar Zentrum Wiener Neustadt, Sigmund Freud Privat Universität, Vienna, Austria
| | - Daniel Smith
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | - José Smith
- AREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
| | - Paul W Stackhouse
- Science Directorate/Climate Science Branch, NASA Langley Research Center, Hampton, VA, USA
| | - Dan J Stein
- Department of Psychiatry, MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Kellen Stilwell
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Sergio Strejilevich
- AREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
| | - Kuan-Pin Su
- College of Medicine, China Medical University (CMU), Taichung, Taiwan; An-Nan Hospital, China Medical University, Tainan, Taiwan
| | | | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kirsi Suominen
- Department of Social Services and Health Care, Psychiatry, City of Helsinki, Helsinki, Finland
| | - Andi J Tanra
- Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Yoshitaka Tatebayashi
- Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore
| | - Leonardo Tondo
- McLean Hospital-Harvard Medical School, Boston, MA, USA; Mood Disorder Lucio Bini Centers, Cagliari e Roma, Italy
| | - Carla Torrent
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Daniel Tuinstra
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Takahito Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Arne E Vaaler
- Department of Mental Health, Norwegian University of Science and Technology - NTNU, Trondheim, Norway; Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Eduard Vieta
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Biju Viswanath
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Maria Yoldi-Negrete
- Subdirección de Investigaciones Clínicas. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
| | - Oguz Kaan Yalcinkaya
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yosra Zgueb
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Medeiros GC, Gould TD, Prueitt WL, Nanavati J, Grunebaum MF, Farber NB, Singh B, Selvaraj S, Machado-Vieira R, Achtyes ED, Parikh SV, Frye MA, Zarate CA, Goes FS. Blood-based biomarkers of antidepressant response to ketamine and esketamine: A systematic review and meta-analysis. Mol Psychiatry 2022; 27:3658-3669. [PMID: 35760879 PMCID: PMC9933928 DOI: 10.1038/s41380-022-01652-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 05/17/2022] [Accepted: 05/31/2022] [Indexed: 02/08/2023]
Abstract
(R,S)-ketamine (ketamine) and its enantiomer (S)-ketamine (esketamine) can produce rapid and substantial antidepressant effects. However, individual response to ketamine/esketamine is variable, and there are no well-accepted methods to differentiate persons who are more likely to benefit. Numerous potential peripheral biomarkers have been reported, but their current utility is unclear. We conducted a systematic review/meta-analysis examining the association between baseline levels and longitudinal changes in blood-based biomarkers, and response to ketamine/esketamine. Of the 5611 citations identified, 56 manuscripts were included (N = 2801 participants), and 26 were compatible with meta-analytical calculations. Random-effect models were used, and effect sizes were reported as standardized mean differences (SMD). Our assessments revealed that more than 460 individual biomarkers were examined. Frequently studied groups included neurotrophic factors (n = 15), levels of ketamine and ketamine metabolites (n = 13), and inflammatory markers (n = 12). There were no consistent associations between baseline levels of blood-based biomarkers, and response to ketamine. However, in a longitudinal analysis, ketamine responders had statistically significant increases in brain-derived neurotrophic factor (BDNF) when compared to pre-treatment levels (SMD [95% CI] = 0.26 [0.03, 0.48], p = 0.02), whereas non-responders showed no significant changes in BDNF levels (SMD [95% CI] = 0.05 [-0.19, 0.28], p = 0.70). There was no consistent evidence to support any additional longitudinal biomarkers. Findings were inconclusive for esketamine due to the small number of studies (n = 2). Despite a diverse and substantial literature, there is limited evidence that blood-based biomarkers are associated with response to ketamine, and no current evidence of clinical utility.
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Affiliation(s)
- Gustavo C. Medeiros
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Todd D. Gould
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.,Departments of Pharmacology and Anatomy & Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA.,Veterans Affairs Maryland Health Care System, Baltimore, MD, USA
| | | | - Julie Nanavati
- Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael F. Grunebaum
- Columbia University Irving Medical Center and New York State Psychiatric Institute, New York City, NY, USA
| | - Nuri B. Farber
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Balwinder Singh
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Sudhakar Selvaraj
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Rodrigo Machado-Vieira
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Eric D. Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA.,Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Sagar V. Parikh
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Mark A. Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Carlos A. Zarate
- Experimental Therapeutics & Pathophysiology Branch, NIMH-NIH, Bethesda, MD, USA
| | - Fernando S. Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Correspondence and requests for materials should be addressed to Fernando S. Goes.,
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26
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Cabrera LY, Gilbert MMC, Achtyes ED, McCright AM, Bluhm R. Jumping through the hoops: Barriers and other ethical concerns regarding the use of psychiatric electroceutical interventions. Psychiatry Res 2022; 313:114612. [PMID: 35584563 PMCID: PMC10516532 DOI: 10.1016/j.psychres.2022.114612] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/14/2022] [Accepted: 04/16/2022] [Indexed: 11/19/2022]
Abstract
Stakeholders' perceptions of barriers to and other ethical concerns about using psychiatric electroceutical interventions (PEIs), interventions that use electrical or magnetic stimuli to treat psychiatric conditions like treatment-resistant depression (TRD), may influence the uptake of these interventions. This study examined such perceptions among psychiatrists, patients with depression, and members of the public. We conducted semi-structured qualitative interviews with 16 members of each group to examine their views on practical barriers and ethical concerns. We used qualitative content analysis to identify relevant themes, and compared findings across stakeholder groups. Access limitations to the interventions, including cost and availability of the interventions, cut across all PEIs-including those that are still experimental, and were raised by all groups. Most participants across all groups raised concerns about informed consent, in terms of receiving adequate, appropriate, and understandable information. Our results suggest that these three stakeholder groups perceive similar structural and attitudinal barriers to, and have similar ethical concerns about, using PEIs for TRD. These results identify key issues that must be addressed for the full potential of PEIs to be realized. Future research with larger samples will help to better understand how to address these barriers to treatment for individuals with TRD.
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Affiliation(s)
- Laura Y Cabrera
- Center for Neural Engineering, Department of Science and Mechanics and Rock Ethics Institute, Pennsylvania State University, University Park, W-316 Millennium Science Complex, PA 16802, United States.
| | - Maryssa M C Gilbert
- College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Eric D Achtyes
- Division of Psychiatry & Behavioral Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States; Pine Rest Christian Mental Health Services, Grand Rapids, MI, United States
| | - Aaron M McCright
- Department of Sociology, College of Social Science, Michigan State University, East Lansing, MI, United States
| | - Robyn Bluhm
- Department of Philosophy, College of Arts and Letters, and Lyman Briggs College, Michigan State University, East Lansing, MI, United States
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27
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Mueser KT, Achtyes ED, Gogate J, Mancevski B, Kim E, Starr HL. Telehealth-Based Psychoeducation for Caregivers: The Family Intervention in Recent-Onset Schizophrenia Treatment Study. JMIR Ment Health 2022; 9:e32492. [PMID: 35436231 PMCID: PMC9055490 DOI: 10.2196/32492] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/22/2021] [Accepted: 01/20/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Schizophrenia is a lifelong illness that requires long-term treatment and caregiving. Family psychoeducation (FP) has been shown to lessen caregiver burden, improve caregiver functioning, and improve outcomes in patients. However, the impact of FP delivered specifically to caregivers on patient outcomes has not been well explored, particularly for early schizophrenia. Furthermore, there is a lack of research examining the benefits of telehealth-based psychoeducation for caregivers on either patient or caregiver outcomes. OBJECTIVE The Family Intervention in Recent-Onset Schizophrenia Treatment (FIRST) study is a randomized controlled trial of patients with schizophrenia spectrum disorders and their caregivers, which is designed to evaluate the effect of telehealth-based, caregiver-focused, study-provided psychoeducation versus usual care (UC) on patient treatment failure (TF). The impact of study-provided psychoeducation on caregiver burden is also investigated. METHODS Eligible patients and their designated caregivers were randomly assigned to either the study-provided psychoeducation (≤16 sessions of telehealth-based psychoeducation over 6 months) or UC group, stratified by antipsychotic treatment (paliperidone palmitate or oral antipsychotic). The major TF events (ie, psychiatric hospitalization or intervention, arrest or incarceration, and suicide attempts) were assessed at 3, 6, and 12 months after baseline. A proportional means model using mean cumulative function was used to assess between-group differences in the mean cumulative number of TF events over 12 months. Caregiver burden was assessed using the Involvement Evaluation Questionnaire and 12-item Short Form Health Survey. RESULTS A total of 148 pairs of participants were enrolled in the study, of whom 96 (64.9%) patients and 94 (63.5%) caregivers completed the 12-month follow-up. The mean number of sessions in the study-provided psychoeducation group was 7.7 (SD 5.9). No differences were observed between the study-provided psychoeducation and UC groups in patient outcomes (rates of TF: 70% vs 67%; P=.90) or measures of caregiver burden (assessment of caregiver distress and physical and mental health). However, post hoc analyses revealed lower relapse rates in patients who received paliperidone palmitate than in those who received oral antipsychotics at all time points. Although the FIRST study did not meet the primary end point, several key lessons were identified to inform future caregiver-focused, telehealth-based FP interventions. Lack of study-provided psychoeducation, focus on caregiver-only intervention, difficulties with enrollment, and caregiver-treatment team coordination may have affected the outcomes of the FIRST study. CONCLUSIONS Key insights from the FIRST study suggest the potential importance of supporting sufficient caregiver engagement; communication between clinicians, patients, and family members regarding treatment plans; and solidifying the relationship between clinicians providing psychoeducation to the caregiver and patient treatment team. TRIAL REGISTRATION ClinicalTrials.gov NCT02600741; http://clinicaltrials.gov/ct2/show/NCT02600741.
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Affiliation(s)
- Kim T Mueser
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, United States
| | - Eric D Achtyes
- Michigan State University College of Human Medicine, East Lansing, MI, United States.,Cherry Health, Grand Rapids, MI, United States
| | - Jagadish Gogate
- Janssen Research & Development, LLC, Titusville, NJ, United States
| | | | - Edward Kim
- Janssen Scientific Affairs, LLC, Titusville, NJ, United States
| | - H Lynn Starr
- Janssen Scientific Affairs, LLC, Titusville, NJ, United States
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28
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Stilwell K, Pelkey L, Platt T, Nguyen K, Monteith S, Pinheiro A, Achtyes ED. Survey of Primary Care Provider Comfort in Treating Psychiatric Patients in 2 Community Clinics: A Pilot Study. Prim Care Companion CNS Disord 2022; 24. [PMID: 35114740 DOI: 10.4088/pcc.21m03020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Context: Patients with mental health needs are often treated by primary care providers (PCPs). Little is known about current PCP attitudes and comfort level with mental health disorders and treatments despite their role in managing these illnesses. Objective: To quantify PCP comfort with the management of psychiatric disorders and treatments. Methods: PCPs in 2 community clinics were given a survey of psychiatric disorders, treatments, and perceived benefit of assistance from a mental health professional (data were collected during provider meetings in May 2017 and February 2021). Questions were ranked using a Likert scale from 1 to 5 with 1 being "least comfortable," 3 being "neutral," and 5 being "very comfortable." Survey responses about medications and disorders were averaged (ie, mean values were calculated) to approximate PCP comfort with providing psychiatric care with and without support. Results: A total of 71 surveys were sent, and 54 were completed. Overall, respondents indicated comfort greater than neutral in 4 of the 14 disorder-related questions (ie, for anxiety disorders, unipolar depression, attention-deficit/hyperactivity disorder [ADHD], and sleep disorders) and 7 of the 19 treatment-related questions (ie, for selective serotonin reuptake inhibitors [SSRIs]/serotonin-norepinephrine reuptake inhibitors [SNRIs], second-generation antipsychotics, other sleep medications, other antidepressants, stimulants, non-stimulant treatments for ADHD, and tricyclics). SSRIs/SNRIs were the only item with average comfort greater than 4. Mean overall PCP comfort was 2.73 without support. PCP comfort increased significantly with support from a therapist (3.24) or a psychiatrist (4.11) (P < .001), with backup from a psychiatrist providing significantly more comfort than a therapist (P < .001). Discussion: These data show ongoing low comfort levels of PCPs in treating psychiatric conditions, suggesting a need for ongoing educational and collaborative approaches to address this critical unmet need.
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Affiliation(s)
- Kellen Stilwell
- Michigan State University College of Human Medicine, Secchia Center, Grand Rapids, Michigan.,Cherry Health, Grand Rapids, Michigan.,Pine Rest Christian Mental Health Services, Grand Rapids, Michigan.,Corresponding author: Kellen Stilwell, MD, Pine Rest Christian Mental Health Services, 300 68th St, Grand Rapids, MI 49548
| | | | | | - Katie Nguyen
- Riverside Community Hospital, Riverside, California
| | - Scott Monteith
- Michigan State University College of Human Medicine, Secchia Center, Grand Rapids, Michigan
| | - Angela Pinheiro
- Michigan State University College of Human Medicine, Secchia Center, Grand Rapids, Michigan
| | - Eric D Achtyes
- Michigan State University College of Human Medicine, Secchia Center, Grand Rapids, Michigan.,Cherry Health, Grand Rapids, Michigan.,Pine Rest Christian Mental Health Services, Grand Rapids, Michigan
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29
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Sha Q, Madaj Z, Keaton S, Escobar Galvis ML, Smart L, Krzyzanowski S, Fazleabas AT, Leach R, Postolache TT, Achtyes ED, Brundin L. Cytokines and tryptophan metabolites can predict depressive symptoms in pregnancy. Transl Psychiatry 2022; 12:35. [PMID: 35078975 PMCID: PMC8789799 DOI: 10.1038/s41398-022-01801-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/05/2022] [Accepted: 01/12/2022] [Indexed: 02/06/2023] Open
Abstract
Depression during and after pregnancy affects up to 20% of pregnant women, but the biological underpinnings remain incompletely understood. As pregnancy progresses, the immune system changes to facilitate fetal development, leading to distinct fluctuations in the production of pro-inflammatory factors and neuroactive tryptophan metabolites throughout the peripartum period. Therefore, it is possible that depression in pregnancy could constitute a specific type of inflammation-induced depression. Both inflammatory factors and kynurenine metabolites impact neuroinflammation and glutamatergic neurotransmission and can therefore affect mood and behavior. To determine whether cytokines and kynurenine metabolites can predict the development of depression in pregnancy, we analyzed blood samples and clinical symptoms in 114 women during each trimester and the postpartum. We analyzed plasma IL-1β, IL-2, -6, -8, -10, TNF, kynurenine, tryptophan, serotonin, kynurenic- quinolinic- and picolinic acids and used mixed-effects models to assess the association between biomarkers and depression severity. IL-1β and IL-6 levels associated positively with severity of depressive symptoms across pregnancy and the postpartum, and that the odds of experiencing significant depressive symptoms increased by >30% per median absolute deviation for both IL-1β and IL-6 (both P = 0.01). A combination of cytokines and kynurenine metabolites in the 2nd trimester had a >99% probability of accurately predicting 3rd trimester depression, with an ROC AUC > 0.8. Altogether, our work shows that cytokines and tryptophan metabolites can predict depression during pregnancy and could be useful as clinical markers of risk. Moreover, inflammation and kynurenine pathway enzymes should be considered possible therapeutic targets in peripartum depression.
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Affiliation(s)
- Qiong Sha
- grid.251017.00000 0004 0406 2057Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI USA
| | - Zach Madaj
- grid.251017.00000 0004 0406 2057Bioinformatics & Biostatistics Core, Van Andel Institute, Grand Rapids, MI USA
| | - Sarah Keaton
- grid.251017.00000 0004 0406 2057Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI USA ,grid.17088.360000 0001 2150 1785Division of Psychiatry & Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI USA
| | - Martha L Escobar Galvis
- grid.251017.00000 0004 0406 2057Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI USA
| | - LeAnn Smart
- grid.415008.80000 0004 0429 718XPine Rest Christian Mental Health Services, Grand Rapids, MI USA
| | - Stanislaw Krzyzanowski
- grid.251017.00000 0004 0406 2057Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI USA
| | - Asgerally T. Fazleabas
- grid.17088.360000 0001 2150 1785Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, MI USA
| | - Richard Leach
- grid.17088.360000 0001 2150 1785Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, MI USA
| | - Teodor T. Postolache
- grid.411024.20000 0001 2175 4264Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD USA ,Rocky Mountain MIRECC for Suicide Prevention, Aurora, CO USA ,Military and Veteran Microbiome Consortium for Research and Education, Aurora, CO USA ,grid.484336.e0000 0004 0420 8773Capital MIRECC, VISN 5, Baltimore, MD USA
| | - Eric D. Achtyes
- grid.17088.360000 0001 2150 1785Division of Psychiatry & Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI USA ,grid.415008.80000 0004 0429 718XPine Rest Christian Mental Health Services, Grand Rapids, MI USA
| | - Lena Brundin
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA. .,Division of Psychiatry & Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA.
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30
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Cabrera LY, Gilbert MMC, McCright AM, Achtyes ED, Bluhm R. Beyond the Cuckoo's Nest: Patient and Public Attitudes about Psychiatric Electroceutical Interventions. Psychiatr Q 2021; 92:1425-1438. [PMID: 33864542 PMCID: PMC8531080 DOI: 10.1007/s11126-021-09916-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2021] [Indexed: 12/28/2022]
Abstract
Recent research emphasizes the role of psychiatric electroceutical interventions (PEIs), bioelectronic treatments that employ electrical stimulation to affect and modify brain function, to effectively treat psychiatric disorders. We sought to examine attitudes about three PEIs-electroconvulsive therapy, transcranial magnetic stimulation, and deep brain stimulation-among patients with depression and members of the general public. As part of a larger study to assess different stakeholders' attitudes about PEIs, we conducted semi-structured key informant interviews with 16 individuals living with depression and 16 non-depressive members of the general public. We used a purposive sampling approach to recruit potential participants based on eligibility criteria. We performed qualitative content analysis of interview transcripts. Participants from both groups expressed an overall cautionary attitude towards PEIs, yet there were mixed attitudes in both groups. Patients commonly described electroconvulsive therapy as scary, traumatic, or intense, while members of the general public often referenced the treatment's negative portrayal in One Flew over the Cuckoo's Nest. Patients and the general public saw transcranial magnetic stimulation as a potentially viable option, but in most cases only if medication was not effective. Deep brain stimulation attitudes were predominantly negative among patients and cautionary among public. The overall cautionary attitudes towards PEIs, together with the technological features and social aspects underlying those attitudes, highlight the need for unbiased education to fill the gaps in knowledge and inform perceptions of those who may benefit from these treatments.
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Affiliation(s)
- Laura Y Cabrera
- Center for Neural Engineering, Department of Engineering Science and Mechanics, Penn State University, University Park, W-319 Millennium Science Complex, State College, PA, 16802, USA. .,Rock Ethics Institute, Penn State University, University Park, State College, PA, USA.
| | | | - Aaron M McCright
- Department of Sociology, College of Social Science, Michigan State University, East Lansing, MI, USA
| | - Eric D Achtyes
- Division of Psychiatry & Behavioral Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA.,Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Robyn Bluhm
- Department of Philosophy, College of Arts and Letters, Michigan State University, East Lansing, MI, USA.,Lyman Briggs College, Michigan State University, East Lansing, MI, USA
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31
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Bluhm R, Castillo E, Achtyes ED, McCright AM, Cabrera LY. They Affect the Person, but for Better or Worse? Perceptions of Electroceutical Interventions for Depression Among Psychiatrists, Patients, and the Public. Qual Health Res 2021; 31:2542-2553. [PMID: 34672815 PMCID: PMC8579329 DOI: 10.1177/10497323211037642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Responding to reports of cases of personality change following deep brain stimulation, neuroethicists have debated the nature and ethical implications of these changes. Recently, this literature has been challenged as being overblown and therefore potentially an impediment to patients accessing needed treatment. We interviewed 16 psychiatrists, 16 patients with depression, and 16 members of the public without depression, all from the Midwestern United States, about their views on how three electroceutical interventions (deep brain stimulation, electroconvulsive therapy, and transcranial magnetic stimulation) used to treat depression might affect the self. Participants were also asked to compare the electroceuticals' effects on the self with the effects of commonly used depression treatments (psychotherapy and pharmaceuticals). Using qualitative content analysis, we found that participants' views on electroceuticals' potential effects on the self mainly focused on treatment effectiveness and side effects. Our results have implications for both theoretical discussions in neuroethics and clinical practice in psychiatry.
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Affiliation(s)
- Robyn Bluhm
- Michigan State University, East Lansing, Michigan, USA
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32
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Achtyes ED, Gega L, Linnaranta O. Editorial: mHealth: Self-Management and Complementary Psychiatric Treatment. Front Psychiatry 2021; 12:777090. [PMID: 34744848 PMCID: PMC8569125 DOI: 10.3389/fpsyt.2021.777090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Eric D. Achtyes
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, United States
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, United States
| | - Lina Gega
- Department of Health Sciences and Hull York Medical School, University of York, York, United Kingdom
| | - Outi Linnaranta
- Mental Health Team, Finnish Institute for Health and Welfare, Helsinki, Finland
- Faculty of Medicine, Department of Psychiatry, McGill University, Quebec City, QC, Canada
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33
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Landi I, Kaji DA, Cotter L, Van Vleck T, Belbin G, Preuss M, Loos RJF, Kenny E, Glicksberg BS, Beckmann ND, O'Reilly P, Schadt EE, Achtyes ED, Buckley PF, Lehrer D, Malaspina DP, McCarroll SA, Rapaport MH, Fanous AH, Pato MT, Pato CN, Bigdeli TB, Nadkarni GN, Charney AW. Prognostic value of polygenic risk scores for adults with psychosis. Nat Med 2021; 27:1576-1581. [PMID: 34489608 PMCID: PMC8446329 DOI: 10.1038/s41591-021-01475-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 07/22/2021] [Indexed: 12/31/2022]
Abstract
Polygenic risk scores (PRS) summarize genetic liability to a disease at the individual level, and the aim is to use them as biomarkers of disease and poor outcomes in real-world clinical practice. To date, few studies have assessed the prognostic value of PRS relative to standards of care. Schizophrenia (SCZ), the archetypal psychotic illness, is an ideal test case for this because the predictive power of the SCZ PRS exceeds that of most other common diseases. Here, we analyzed clinical and genetic data from two multi-ethnic cohorts totaling 8,541 adults with SCZ and related psychotic disorders, to assess whether the SCZ PRS improves the prediction of poor outcomes relative to clinical features captured in a standard psychiatric interview. For all outcomes investigated, the SCZ PRS did not improve the performance of predictive models, an observation that was generally robust to divergent case ascertainment strategies and the ancestral background of the study participants.
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Affiliation(s)
- Isotta Landi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Deepak A Kaji
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Liam Cotter
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tielman Van Vleck
- Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gillian Belbin
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Preuss
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ruth J F Loos
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eimear Kenny
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin S Glicksberg
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Noam D Beckmann
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul O'Reilly
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eric E Schadt
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Sema4, Stamford, CT, USA
| | - Eric D Achtyes
- Cherry Health, Grand Rapids, MI, USA
- Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Peter F Buckley
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Douglas Lehrer
- Department of Psychiatry, Wright State University, Dayton, OH, USA
| | - Dolores P Malaspina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven A McCarroll
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Mark H Rapaport
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Ayman H Fanous
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA
- VA New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Michele T Pato
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Carlos N Pato
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Tim B Bigdeli
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA
- VA New York Harbor Healthcare System, Brooklyn, NY, USA
| | - Girish N Nadkarni
- Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander W Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Bauer M, Glenn T, Achtyes ED, Alda M, Agaoglu E, Altınbaş K, Andreassen OA, Angelopoulos E, Ardau R, Vares EA, Aydin M, Ayhan Y, Baethge C, Bauer R, Baune BT, Balaban C, Becerra-Palars C, Behere AP, Behere PB, Belete H, Belete T, Belizario GO, Bellivier F, Belmaker RH, Benedetti F, Berk M, Bersudsky Y, Bicakci Ş, Birabwa-Oketcho H, Bjella TD, Brady C, Cabrera J, Cappucciati M, Castro AMP, Chen WL, Cheung EYW, Chiesa S, Crowe M, Cuomo A, Dallaspezia S, Del Zompo M, Desai P, Dodd S, Donix M, Etain B, Fagiolini A, Fellendorf FT, Ferensztajn-Rochowiak E, Fiedorowicz JG, Fountoulakis KN, Frye MA, Geoffroy PA, Gonzalez-Pinto A, Gottlieb JF, Grof P, Haarman BCM, Harima H, Hasse-Sousa M, Henry C, Høffding L, Houenou J, Imbesi M, Isometsä ET, Ivkovic M, Janno S, Johnsen S, Kapczinski F, Karakatsoulis GN, Kardell M, Kessing LV, Kim SJ, König B, Kot TL, Koval M, Kunz M, Lafer B, Landén M, Larsen ER, Lenger M, Lewitzka U, Licht RW, Lopez-Jaramillo C, MacKenzie A, Madsen HØ, Madsen SAKA, Mahadevan J, Mahardika A, Manchia M, Marsh W, Martinez-Cengotitabengoa M, Martiny K, Mashima Y, McLoughlin DM, Meesters Y, Melle I, Meza-Urzúa F, Ming MY, Monteith S, Moorthy M, Morken G, Mosca E, Mozzhegorov AA, Munoz R, Mythri SV, Nacef F, Nadella RK, Nakanotani T, Nielsen RE, O'Donovan C, Omrani A, Osher Y, Ouali U, Pantovic-Stefanovic M, Pariwatcharakul P, Petite J, Pfennig A, Ruiz YP, Pilhatsch M, Pinna M, Pompili M, Porter R, Quiroz D, Rabelo-da-Ponte FD, Ramesar R, Rasgon N, Ratta-Apha W, Ratzenhofer M, Redahan M, Reddy MS, Reif A, Reininghaus EZ, Richards JG, Ritter P, Rybakowski JK, Sathyaputri L, Scippa ÂM, Simhandl C, Severus E, Smith D, Smith J, Stackhouse PW, Stein DJ, Stilwell K, Strejilevich S, Su KP, Subramaniam M, Sulaiman AH, Suominen K, Tanra AJ, Tatebayashi Y, Teh WL, Tondo L, Torrent C, Tuinstra D, Uchida T, Vaaler AE, Veeh J, Vieta E, Viswanath B, Yoldi-Negrete M, Yalcinkaya OK, Young AH, Zgueb Y, Whybrow PC. Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder. Int J Bipolar Disord 2021; 9:26. [PMID: 34467430 PMCID: PMC8408297 DOI: 10.1186/s40345-021-00231-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/13/2021] [Indexed: 01/09/2023] Open
Abstract
Background Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun’s electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01. Conclusion A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed.
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Affiliation(s)
- Michael Bauer
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - Eric D Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Esen Agaoglu
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kürşat Altınbaş
- Department of Psychiatry, Selcuk University Faculty of Medicine, Mazhar Osman Mood Center, Konya, Turkey
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elias Angelopoulos
- Department of Psychiatry, National and Capodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Raffaella Ardau
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | - Edgar Arrua Vares
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Memduha Aydin
- Department of Psychiatry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Yavuz Ayhan
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Christopher Baethge
- Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany
| | - Rita Bauer
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Munster, Germany.,Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia.,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ceylan Balaban
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | | | - Aniruddh P Behere
- Child and Adolescent Psychiatry, Helen DeVos Children's Hospital, Michigan State University-CHM, Grand Rapids, MI, USA
| | - Prakash B Behere
- Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, India
| | - Habte Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tilahun Belete
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gabriel Okawa Belizario
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Frank Bellivier
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique-Hôpitaux de Paris, INSERM UMR-S1144, Université de Paris, FondaMental Foundation, Paris, France
| | - Robert H Belmaker
- Professor Emeritus of Psychiatry, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Francesco Benedetti
- University Vita-Salute San Raffaele, Milan, Italy.,Psychiatry and Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Michael Berk
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Yuly Bersudsky
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Şule Bicakci
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey.,Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
| | | | - Thomas D Bjella
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Conan Brady
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Jorge Cabrera
- Mood Disorders Clinic, Dr. Jose Horwitz Psychiatric Institute, Santiago de Chile, Chile
| | | | - Angela Marianne Paredes Castro
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Wei-Ling Chen
- Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
| | | | - Silvia Chiesa
- Department of Mental Health and Substance Abuse, Piacenza, Italy
| | - Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Sara Dallaspezia
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Maria Del Zompo
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | | | - Seetal Dodd
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.,Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Markus Donix
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Bruno Etain
- Département de Psychiatrie et de Médecine Addictologique, Assistance Publique-Hôpitaux de Paris, INSERM UMR-S1144, Université de Paris, FondaMental Foundation, Paris, France
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | | | - Jess G Fiedorowicz
- Department of Psychiatry, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kostas N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Pierre A Geoffroy
- Département de Psychiatrie et d'addictologie, AP-HP, Hopital Bichat-Claude Bernard, Paris, France.,GHU Paris-Psychiatry and Neurosciences, 75014, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France
| | - Ana Gonzalez-Pinto
- BIOARABA, Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - John F Gottlieb
- Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul Grof
- Mood Disorders Center of Ottawa and the Department of Psychiatry, University of Toronto, Ottawa, Canada
| | - Bartholomeus C M Haarman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hirohiko Harima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Mathias Hasse-Sousa
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Chantal Henry
- Department of Psychiatry, GHU Paris Psychiatrie & Neurosciences, 75014, Paris, France.,Université de Paris, 75006, Paris, France
| | - Lone Høffding
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Josselin Houenou
- Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94010, Créteil, France.,Université Paris Saclay, CEA, Neurospin, 91191, Gif-sur-Yvette, France
| | | | - Erkki T Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,National Institute for Health and Welfare, Helsinki, Finland
| | - Maja Ivkovic
- University Clinical Center of Serbia, Clinic for Psychiatry, Belgrade, Serbia
| | - Sven Janno
- Department of Psychiatry, University of Tartu, Tartu, Estonia
| | - Simon Johnsen
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark
| | - Flávio Kapczinski
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gregory N Karakatsoulis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mathias Kardell
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Seong Jae Kim
- Department of Psychiatry, Cheongju Hospital, Cheongju, South Korea
| | - Barbara König
- BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
| | - Timur L Kot
- Khanty-Mansiysk Clinical Psychoneurological Hospital, Khanty-Mansiysk, Russia
| | - Michael Koval
- Department of Neuroscience, Michigan State University, East Lansing, MI, USA
| | - Mauricio Kunz
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beny Lafer
- Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erik R Larsen
- Mental Health Department Odense, University Clinic and Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Ute Lewitzka
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Rasmus W Licht
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Carlos Lopez-Jaramillo
- Mood Disorders Program, Hospital Universitario San Vicente Fundación, Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Alan MacKenzie
- Forensic Psychiatry, University of Glasgow, NHS Greater Glasgow and Clyde, Glasgow, UK
| | | | | | - Jayant Mahadevan
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Agustine Mahardika
- Department of Psychiatry, Faculty of Medicine, Mataram University, Mataram, Indonesia
| | - Mirko Manchia
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.,Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Wendy Marsh
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Klaus Martiny
- Copenhagen University Hospitals, Psychiatric Centre Copenhagen, Copenhagen, Denmark
| | - Yuki Mashima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Declan M McLoughlin
- Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - Ybe Meesters
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fátima Meza-Urzúa
- National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Mok Yee Ming
- Department of General Psychiatry, Mood Disorders Unit, Institute of Mental Health, Singapore City, Singapore
| | - Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - Muthukumaran Moorthy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Gunnar Morken
- Department of Mental Health, Norwegian University of Science and Technology-NTNU, Trondheim, Norway.,Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Enrica Mosca
- Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
| | | | - Rodrigo Munoz
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | | | - Fethi Nacef
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Ravi K Nadella
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Takako Nakanotani
- Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - René Ernst Nielsen
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Adel Omrani
- Tunisian Bipolar Forum, Érable Médical Cabinet 324, Lac 2, Tunis, Tunisia
| | - Yamima Osher
- Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Uta Ouali
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | | | - Pornjira Pariwatcharakul
- Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Joanne Petite
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Maximilian Pilhatsch
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Elblandklinikum Radebeul, Radebeul, Germany
| | - Marco Pinna
- Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.,Lucio Bini Mood Disorder Center, Cagliari, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Danilo Quiroz
- Deparment of Psychiatry, Diego Portales University, Santiago de Chile, Chile
| | | | - Raj Ramesar
- SA MRC Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Natalie Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Woraphat Ratta-Apha
- Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Michaela Ratzenhofer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Maria Redahan
- Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
| | - M S Reddy
- Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
| | - Jenny Gringer Richards
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Leela Sathyaputri
- Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Ângela M Scippa
- Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
| | - Christian Simhandl
- Bipolar Zentrum Wiener Neustadt, Sigmund Freud Privat Universität, Vienna, Austria
| | - Emanuel Severus
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Daniel Smith
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | - José Smith
- Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina
| | - Paul W Stackhouse
- Science Directorate/Climate Science Branch, NASA Langley Research Center, Hampton, VA, USA
| | - Dan J Stein
- Department of Psychiatry, MRC Unit On Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Kellen Stilwell
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Sergio Strejilevich
- Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina
| | - Kuan-Pin Su
- College of Medicine, China Medical University (CMU), Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan
| | | | - Ahmad Hatim Sulaiman
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kirsi Suominen
- Department of Social Services and Health Care, Psychiatry, City of Helsinki, Helsinki, Finland
| | - Andi J Tanra
- Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Yoshitaka Tatebayashi
- Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Leonardo Tondo
- McLean Hospital-Harvard Medical School, Boston, MA, USA.,Mood Disorder Lucio Bini Centers, Cagliari e Roma, Italy
| | - Carla Torrent
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Daniel Tuinstra
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Takahito Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Arne E Vaaler
- Department of Mental Health, Norwegian University of Science and Technology-NTNU, Trondheim, Norway.,Department of Psychiatry, St Olavs' University Hospital, Trondheim, Norway
| | - Julia Veeh
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Eduard Vieta
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Biju Viswanath
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Maria Yoldi-Negrete
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
| | - Oguz Kaan Yalcinkaya
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yosra Zgueb
- Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Voytenko VL, VanOrman BT, Jaarsma RD, Bishop TW, Mavis BE, Achtyes ED. Getting involved in training the next generation of physicians: Examples of practicing psychologists in psychiatry and family medicine residency programs. Professional Psychology: Research and Practice 2021. [DOI: 10.1037/pro0000346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Thakkar KN, Ghermezi L, Silverstein SM, Slate R, Yao B, Achtyes ED, Brascamp JW. Stronger tilt aftereffects in persons with schizophrenia. J Abnorm Psychol 2020; 130:186-197. [PMID: 33301337 DOI: 10.1037/abn0000653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Individuals with schizophrenia may fail to appropriately use temporal context and apply past environmental regularities to the interpretation of incoming sensory information. Here we use the visual system as a test bed for investigating how prior experience shapes perception in individuals with schizophrenia. Specifically, we use visual aftereffects, illusory percepts resulting from prior exposure to visual input, to measure the influence of prior events on current processing. At a neural level, visual aftereffects arise due to attenuation in the responses of neurons that code the features of the prior stimulus (neuronal adaptation) and subsequent disinhibition of neurons signaling activity at the opposite end of the feature dimension. In the current study, we measured tilt aftereffects and negative afterimages, 2 types of aftereffects that reflect, respectively, adaptation of cortical orientation-coding neurons and adaptation of subcortical and retinal luminance-coding cells in persons with schizophrenia (PSZ; n = 36) and demographically matched healthy controls (HC; n = 22). We observed stronger tilt aftereffects in PSZ compared to HC, but no difference in negative afterimages. Stronger tilt aftereffects were related to more severe negative symptoms. These data suggest oversensitivity to recent regularities, in the form of stronger visual adaptation, at cortical, but not subcortical, levels in schizophrenia. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Kane JM, Schooler NR, Marcy P, Correll CU, Achtyes ED, Gibbons RD, Robinson DG. Effect of Long-Acting Injectable Antipsychotics vs Usual Care on Time to First Hospitalization in Early-Phase Schizophrenia: A Randomized Clinical Trial. JAMA Psychiatry 2020; 77:1217-1224. [PMID: 32667636 PMCID: PMC7364341 DOI: 10.1001/jamapsychiatry.2020.2076] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Long-acting injectable antipsychotics (LAIs) can potentially reduce hospitalization risk by enhancing medication adherence but are rarely considered for early-phase schizophrenia treatment. OBJECTIVE To determine whether encouraging use of a LAI compared with usual care delays the time to first hospitalization with patients with early-phase illness. DESIGN, SETTING, AND PARTICIPANTS The Prevention of Relapse in Schizophrenia (PRELAPSE) trial was cluster randomized with a follow-up duration of 2 years. The study began in December 2014, was completed in March 2019, and was conducted in 39 mental health centers in 19 US states. Site randomization assigned 19 clinics to encourage treatment with long-acting aripiprazole monohydrate (aripiprazole once monthly [AOM] condition) and 20 to provide treatment as usual (clinician's choice [CC] condition). Participant eligibility criteria included (1) schizophrenia diagnosis confirmed by a structured clinical interview, (2) fewer than 5 years of lifetime antipsychotic use, and (3) age 18 to 35 years. The AOM sites identified 576 potentially eligible participants, of whom 234 (40.6%) enrolled; CC sites identified 685 potentially eligible participants, of whom 255 (37.2%) enrolled. INTERVENTIONS There were no restrictions on treatment at CC sites (including using LAIs) or at AOM sites with the exception that aripiprazole monohydrate had to be prescribed within US Food and Drug Administration-approved guidelines. MAIN OUTCOMES AND MEASURES The primary outcome was time to first psychiatric hospitalization based on participant interviews every 2 months, the service use resource form administered every 4 months, and other sources (eg, health records) as available. Potential events were adjudicated by an independent committee masked to treatment assignment. RESULTS The 489 participants (368 men [75.3%]) had a mean (SD) age of 25.2 (4.2) years and 225 (46.0%) had 1 year or less lifetime antipsychotic use. Fifty-two AOM (22%) and 91 CC participants (36%) had at least 1 hospitalization. The mean survival time until first hospitalization was 613.7 days (95% CI, 582.3-645.1 days) for AOM participants and 530.6 days (95% CI, 497.3-563.9 days) for CC participants. For time to first hospitalization, the hazard ratio was 0.56 (95% CI, 0.34- 0.92; P = .02), favoring AOM. Survival probabilities were 0.73 (95% CI, 0.65-0.83) for AOM participants and 0.58 (95% CI, 0.50-0.67) for CC participants. The number needed to treat to prevent 1 additional hospitalization was 7 participants treated with AOM compared with CC. CONCLUSIONS AND RELEVANCE Long-acting injectable antipsychotic use by patients with early-phase schizophrenia can significantly delay time to hospitalization, a personally and economically important outcome. Clinicians should more broadly consider LAI treatment for patients with early-phase illness. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02360319.
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Affiliation(s)
- John M. Kane
- Departments of Psychiatry and Molecular Medicine, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York,The Feinstein Institutes for Medical Research, Institute of Behavioral Science, Northwell Health, Manhasset, New York,The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, New York
| | | | | | - Christoph U. Correll
- Departments of Psychiatry and Molecular Medicine, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York,The Feinstein Institutes for Medical Research, Institute of Behavioral Science, Northwell Health, Manhasset, New York,The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, New York,Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany
| | - Eric D. Achtyes
- Cherry Health, Grand Rapids, Michigan,Michigan State University College of Human Medicine, Grand Rapids
| | | | - Delbert G. Robinson
- Departments of Psychiatry and Molecular Medicine, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York,The Feinstein Institutes for Medical Research, Institute of Behavioral Science, Northwell Health, Manhasset, New York,The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, New York
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Bigdeli TB, Fanous AH, Li Y, Rajeevan N, Sayward F, Genovese G, Gupta R, Radhakrishnan K, Malhotra AK, Sun N, Lu Q, Hu Y, Li B, Chen Q, Mane S, Miller P, Cheung KH, Gur RE, Greenwood TA, Braff DL, Achtyes ED, Buckley PF, Escamilla MA, Lehrer D, Malaspina DP, McCarroll SA, Rapaport MH, Vawter MP, Pato MT, Pato CN, Zhao H, Kosten TR, Brophy M, Pyarajan S, Shi Y, O’Leary TJ, Gleason T, Przygodzki R, Muralidhar S, Gaziano JM, Huang GD, Concato J, Siever LJ, Aslan M, Harvey PD. Genome-Wide Association Studies of Schizophrenia and Bipolar Disorder in a Diverse Cohort of US Veterans. Schizophr Bull 2020; 47:517-529. [PMID: 33169155 PMCID: PMC7965063 DOI: 10.1093/schbul/sbaa133] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Schizophrenia (SCZ) and bipolar disorder (BIP) are debilitating neuropsychiatric disorders, collectively affecting 2% of the world's population. Recognizing the major impact of these psychiatric disorders on the psychosocial function of more than 200 000 US Veterans, the Department of Veterans Affairs (VA) recently completed genotyping of more than 8000 veterans with SCZ and BIP in the Cooperative Studies Program (CSP) #572. METHODS We performed genome-wide association studies (GWAS) in CSP #572 and benchmarked the predictive value of polygenic risk scores (PRS) constructed from published findings. We combined our results with available summary statistics from several recent GWAS, realizing the largest and most diverse studies of these disorders to date. RESULTS Our primary GWAS uncovered new associations between CHD7 variants and SCZ, and novel BIP associations with variants in Sortilin Related VPS10 Domain Containing Receptor 3 (SORCS3) and downstream of PCDH11X. Combining our results with published summary statistics for SCZ yielded 39 novel susceptibility loci including CRHR1, and we identified 10 additional findings for BIP (28 326 cases and 90 570 controls). PRS trained on published GWAS were significantly associated with case-control status among European American (P < 10-30) and African American (P < .0005) participants in CSP #572. CONCLUSIONS We have demonstrated that published findings for SCZ and BIP are robustly generalizable to a diverse cohort of US veterans. Leveraging available summary statistics from GWAS of global populations, we report 52 new susceptibility loci and improved fine-mapping resolution for dozens of previously reported associations.
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Affiliation(s)
- Tim B Bigdeli
- VA New York Harbor Healthcare System, Brooklyn, NY,Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | - Ayman H Fanous
- VA New York Harbor Healthcare System, Brooklyn, NY,Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | - Yuli Li
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Nallakkandi Rajeevan
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Frederick Sayward
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Giulio Genovese
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA,Department of Genetics, Harvard Medical School, Boston, MA
| | - Rishab Gupta
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | - Krishnan Radhakrishnan
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,College of Medicine, University of Kentucky, Lexington, KY
| | - Anil K Malhotra
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY,Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY,Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY
| | - Ning Sun
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Qiongshi Lu
- Department of Medicine, Yale School of Medicine, New Haven, CT,Department of Biostatistics & Medical Informatics, University of Wisconsin-Madison, Madison, WI
| | - Yiming Hu
- Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Boyang Li
- Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Quan Chen
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Shrikant Mane
- Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Perry Miller
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Kei-Hoi Cheung
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Raquel E Gur
- Departments of Psychiatry and Child & Adolescent Psychiatry and Lifespan Brain Institute, University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA
| | | | - David L Braff
- Department of Psychiatry, University of California, La Jolla, San Diego, CA,VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA
| | | | - Eric D Achtyes
- Cherry Health and Michigan State University College of Human Medicine, Grand Rapids, MI
| | - Peter F Buckley
- School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Michael A Escamilla
- Department of Psychiatry, School of Medicine, University of Texas Rio Grande Valley, Harlingen, TX
| | - Douglas Lehrer
- Department of Psychiatry, Wright State University, Dayton, OH
| | - Dolores P Malaspina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Steven A McCarroll
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA,Department of Genetics, Harvard Medical School, Boston, MA
| | - Mark H Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA
| | - Marquis P Vawter
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA
| | - Michele T Pato
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | - Carlos N Pato
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY
| | | | - Hongyu Zhao
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Thomas R Kosten
- Departments of Psychiatry, Neuroscience, Pharmacology, and Immunology and Rheumatology, Baylor College of Medicine, Houston, TX
| | - Mary Brophy
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain, MA,Section of Hematology and Medical Oncology, Boston University School of Medicine, Boston, MA
| | - Saiju Pyarajan
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain, MA
| | - Yunling Shi
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain, MA
| | - Timothy J O’Leary
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Theresa Gleason
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Ronald Przygodzki
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - Sumitra Muralidhar
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - J Michael Gaziano
- Massachusetts Area Veterans Epidemiology, Research, and Information Center (MAVERIC), Jamaica Plain, MA,Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | - Grant D Huang
- Office of Research and Development, Veterans Health Administration, Washington, DC
| | - John Concato
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Larry J Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY,University of Miami Miller School of Medicine, James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Mihaela Aslan
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA Connecticut Healthcare System, West Haven, CT,Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Philip D Harvey
- Research Service Bruce W. Carter VA Medical Center, Miami, FL,Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL,To whom correspondence should be addressed; Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1450 Miami, FL 33136, USA; tel: (305)-243-4094, fax: (305)-243-1619, e-mail:
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Kopec K, Janney CA, Johnson B, Spykerman K, Ryskamp B, Achtyes ED. Rapid Transition to Telehealth in a Community Mental Health Service Provider During the COVID-19 Pandemic. Prim Care Companion CNS Disord 2020; 22. [PMID: 33002350 DOI: 10.4088/pcc.20br02787] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
| | - Carol A Janney
- Division of Psychiatry & Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA.,Pine Rest Christian Mental Health Services, Grand Rapids, Michigan, USA
| | - Benjamin Johnson
- Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| | | | | | - Eric D Achtyes
- Network180, Grand Rapids, Michigan, USA.,Division of Psychiatry & Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA.,Pine Rest Christian Mental Health Services, Grand Rapids, Michigan, USA.,Network180, 790 Fuller Ave, Grand Rapids, MI 49503.
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40
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Soda T, McLoughlin DM, Clark SR, Oltedal L, Kessler U, Haavik J, Bousman C, Smith DJ, Bioque M, Clements CC, Loo C, Vila-Rodriguez F, Minelli A, Mickey BJ, Milev R, Docherty AR, Langan Martin J, Achtyes ED, Arolt V, Redlich R, Dannlowski U, Cardoner N, Clare E, Craddock N, Di Florio A, Dmitrzak-Weglarz M, Forty L, Gordon-Smith K, Husain M, Ingram WM, Jones L, Jones I, Juruena M, Kirov G, Landén M, Müller DJ, Nordensköld A, Pålsson E, Paul M, Permoda A, Pliszka B, Rea J, Schubert KO, Sonnen JA, Soria V, Stageman W, Takamiya A, Urretavizacaya M, Watson S, Zavorotny M, Young AH, Vieta E, Rybakowski JK, Gennarelli M, Zandi PP, Sullivan PF, Baune BT. International Consortium on the Genetics of Electroconvulsive Therapy and Severe Depressive Disorders (Gen-ECT-ic). Eur Arch Psychiatry Clin Neurosci 2020; 270:921-932. [PMID: 31802253 PMCID: PMC7385979 DOI: 10.1007/s00406-019-01087-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 11/16/2019] [Indexed: 02/05/2023]
Abstract
Recent genome-wide association studies have demonstrated that the genetic burden associated with depression correlates with depression severity. Therefore, conducting genetic studies of patients at the most severe end of the depressive disorder spectrum, those with treatment-resistant depression and who are prescribed electroconvulsive therapy (ECT), could lead to a better understanding of the genetic underpinnings of depression. Despite ECT being one of the most effective forms of treatment for severe depressive disorders, it is usually placed at the end of treatment algorithms of current guidelines. This is perhaps because ECT has controlled risk and logistical demands including use of general anaesthesia and muscle relaxants and side-effects such as short-term memory impairment. Better understanding of the genetics and biology of ECT response and of cognitive side-effects could lead to more personalized treatment decisions. To enhance the understanding of the genomics of severe depression and ECT response, researchers and ECT providers from around the world and from various depression or ECT networks, but not limited to, such as the Psychiatric Genomics Consortium, the Clinical Alliance and Research in ECT, and the National Network of Depression Centers have formed the Genetics of ECT International Consortium (Gen-ECT-ic). Gen-ECT-ic will organize the largest clinical and genetic collection to date to study the genomics of severe depressive disorders and response to ECT, aiming for 30,000 patients worldwide using a GWAS approach. At this stage it will be the largest genomic study on treatment response in depression. Retrospective data abstraction and prospective data collection will be facilitated by a uniform data collection approach that is flexible and will incorporate data from many clinical practices. Gen-ECT-ic invites all ECT providers and researchers to join its efforts.
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Affiliation(s)
- Takahiro Soda
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Declan M McLoughlin
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Scott R Clark
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Leif Oltedal
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Radiology, Mohn Medical Imaging and Visualization Centre, Haukeland University Hospital, Bergen, Norway
| | - Ute Kessler
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Haukeland University Hospital, Bergen, Norway
| | - Jan Haavik
- Haukeland University Hospital, Bergen, Norway
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Chad Bousman
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Daniel J Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Miquel Bioque
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | | | - Colleen Loo
- School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
- Sydney Neurostimulation Centre, Black Dog Institute, Randwick, NSW, Australia
| | - Fidel Vila-Rodriguez
- Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Brian J Mickey
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Roumen Milev
- Departments of Psychiatry and Psychology, Queen's University, Kingston, ON, Canada
- Providence Care Hospital, Kingston, ON, Canada
| | - Anna R Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Eric D Achtyes
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Ronny Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Narcis Cardoner
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut D'INVESTIGACIÓ i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Emily Clare
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nick Craddock
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Arianna Di Florio
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | - Liz Forty
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | | | - Wendy M Ingram
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lisa Jones
- Psychological Medicine, University of Worcester, Worcester, UK
| | - Ian Jones
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Mario Juruena
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - George Kirov
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
| | - Daniel J Müller
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Axel Nordensköld
- Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden
| | - Erik Pålsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
| | - Meethu Paul
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Agnieszka Permoda
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartlomiej Pliszka
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jamie Rea
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Klaus O Schubert
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Northern Adelaide Mental Health Service, Salisbury, SA, Australia
| | - Joshua A Sonnen
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Virginia Soria
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Will Stageman
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Institute of Neuroscience, Newcastle University and NTW NHS Trust, Newcastle, UK
| | - Akihiro Takamiya
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Stuart Watson
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Institute of Neuroscience, Newcastle University and NTW NHS Trust, Newcastle, UK
| | - Maxim Zavorotny
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Allan H Young
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
- Department of Psychiatric Nursing, Poznan University of Medical Sciences, Poznan, Poland
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Genetic Unit, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patrick F Sullivan
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
- Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany.
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia.
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia.
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Bigdeli TB, Genovese G, Georgakopoulos P, Meyers JL, Peterson RE, Iyegbe CO, Medeiros H, Valderrama J, Achtyes ED, Kotov R, Stahl EA, Abbott C, Azevedo MH, Belliveau RA, Bevilacqua E, Bromet EJ, Byerley W, Carvalho CB, Chapman SB, DeLisi LE, Dumont AL, O’Dushlaine C, Evgrafov OV, Fochtmann LJ, Gage D, Kennedy JL, Kinkead B, Macedo A, Moran JL, Morley CP, Dewan MJ, Nemesh J, Perkins DO, Purcell SM, Rakofsky JJ, Scolnick EM, Sklar BM, Sklar P, Smoller JW, Sullivan PF, Macciardi F, Marder SR, Gur RC, Gur RE, Braff DL, Nicolini H, Escamilla MA, Vawter MP, Sobell JL, Malaspina D, Lehrer DS, Buckley PF, Rapaport MH, Knowles JA, Fanous AH, Pato MT, McCarroll SA, Pato CN. Contributions of common genetic variants to risk of schizophrenia among individuals of African and Latino ancestry. Mol Psychiatry 2020; 25:2455-2467. [PMID: 31591465 PMCID: PMC7515843 DOI: 10.1038/s41380-019-0517-y] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/01/2019] [Accepted: 04/24/2019] [Indexed: 11/10/2022]
Abstract
Schizophrenia is a common, chronic and debilitating neuropsychiatric syndrome affecting tens of millions of individuals worldwide. While rare genetic variants play a role in the etiology of schizophrenia, most of the currently explained liability is within common variation, suggesting that variation predating the human diaspora out of Africa harbors a large fraction of the common variant attributable heritability. However, common variant association studies in schizophrenia have concentrated mainly on cohorts of European descent. We describe genome-wide association studies of 6152 cases and 3918 controls of admixed African ancestry, and of 1234 cases and 3090 controls of Latino ancestry, representing the largest such study in these populations to date. Combining results from the samples with African ancestry with summary statistics from the Psychiatric Genomics Consortium (PGC) study of schizophrenia yielded seven newly genome-wide significant loci, and we identified an additional eight loci by incorporating the results from samples with Latino ancestry. Leveraging population differences in patterns of linkage disequilibrium, we achieve improved fine-mapping resolution at 22 previously reported and 4 newly significant loci. Polygenic risk score profiling revealed improved prediction based on trans-ancestry meta-analysis results for admixed African (Nagelkerke's R2 = 0.032; liability R2 = 0.017; P < 10-52), Latino (Nagelkerke's R2 = 0.089; liability R2 = 0.021; P < 10-58), and European individuals (Nagelkerke's R2 = 0.089; liability R2 = 0.037; P < 10-113), further highlighting the advantages of incorporating data from diverse human populations.
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Affiliation(s)
- Tim B. Bigdeli
- grid.262863.b0000 0001 0693 2202Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY USA ,grid.262863.b0000 0001 0693 2202Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY USA ,Department of Psychiatry, Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY USA
| | - Giulio Genovese
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA ,grid.38142.3c000000041936754XDepartment of Genetics, Harvard Medical School, Boston, MA USA
| | - Penelope Georgakopoulos
- grid.262863.b0000 0001 0693 2202Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY USA
| | - Jacquelyn L. Meyers
- grid.262863.b0000 0001 0693 2202Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY USA
| | - Roseann E. Peterson
- grid.224260.00000 0004 0458 8737Department of Psychiatry, Virginia Commonwealth University, Richmond, VA USA
| | - Conrad O. Iyegbe
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, King’s College London, London, UK
| | - Helena Medeiros
- grid.262863.b0000 0001 0693 2202Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY USA
| | - Jorge Valderrama
- grid.262863.b0000 0001 0693 2202Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY USA ,grid.262863.b0000 0001 0693 2202Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY USA
| | - Eric D. Achtyes
- grid.17088.360000 0001 2150 1785Cherry Health and Michigan State University College of Human Medicine, Grand Rapids, MI USA
| | - Roman Kotov
- grid.36425.360000 0001 2216 9681Department of Psychiatry, Stony Brook University, Stony Brook, NY USA
| | - Eli A. Stahl
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai, NY USA ,grid.59734.3c0000 0001 0670 2351Department of Genetics & Genomics, Icahn School of Medicine at Mount Sinai, Mount Sinai, NY USA
| | - Colony Abbott
- grid.42505.360000 0001 2156 6853Department of Psychiatry & Behavioral Sciences, University of Southern California, Los Angeles, CA USA
| | - Maria Helena Azevedo
- grid.8051.c0000 0000 9511 4342Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Coimbra, PT Portugal
| | - Richard A. Belliveau
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA
| | | | - Evelyn J. Bromet
- grid.36425.360000 0001 2216 9681Department of Psychiatry, Stony Brook University, Stony Brook, NY USA
| | - William Byerley
- grid.266102.10000 0001 2297 6811Department of Psychiatry, University of California, San Francisco, CA USA
| | - Celia Barreto Carvalho
- grid.7338.f0000 0001 2096 9474Faculty of Social and Human Sciences, University of Azores, Ponta Delgada, Portugal
| | - Sinéad B. Chapman
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Lynn E. DeLisi
- grid.410370.10000 0004 4657 1992VA Boston Healthcare System, Brockton, MA USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Ashley L. Dumont
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Colm O’Dushlaine
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Oleg V. Evgrafov
- grid.262863.b0000 0001 0693 2202Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY USA ,grid.262863.b0000 0001 0693 2202Department of Cell Biology, SUNY Downstate Medical Center, Brooklyn, NY USA
| | - Laura J. Fochtmann
- grid.36425.360000 0001 2216 9681Department of Psychiatry, Stony Brook University, Stony Brook, NY USA
| | - Diane Gage
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - James L. Kennedy
- grid.17063.330000 0001 2157 2938Neurogenetics Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health; Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Becky Kinkead
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Antonio Macedo
- grid.8051.c0000 0000 9511 4342Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Coimbra, PT Portugal
| | - Jennifer L. Moran
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Christopher P. Morley
- grid.411023.50000 0000 9159 4457Department of Public Health and Preventive Medicine, State University of New York, Upstate Medical University, Syracuse, NY USA ,grid.411023.50000 0000 9159 4457Department of Family Medicine, State University of New York, Upstate Medical University, Syracuse, NY USA ,grid.411023.50000 0000 9159 4457Department of Psychiatry and Behavioral Sciences, State University of New York, Upstate Medical University, Syracuse, NY USA
| | - Mantosh J. Dewan
- grid.411023.50000 0000 9159 4457Department of Psychiatry and Behavioral Sciences, State University of New York, Upstate Medical University, Syracuse, NY USA
| | - James Nemesh
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Diana O. Perkins
- grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA
| | - Shaun M. Purcell
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA ,grid.62560.370000 0004 0378 8294Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA USA
| | - Jeffrey J. Rakofsky
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Edward M. Scolnick
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Brooke M. Sklar
- grid.42505.360000 0001 2156 6853Department of Psychiatry & Behavioral Sciences, University of Southern California, Los Angeles, CA USA
| | - Pamela Sklar
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai, NY USA ,grid.59734.3c0000 0001 0670 2351Department of Genetics & Genomics, Icahn School of Medicine at Mount Sinai, Mount Sinai, NY USA
| | - Jordan W. Smoller
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA ,grid.32224.350000 0004 0386 9924Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Patrick F. Sullivan
- grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA ,grid.465198.7Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, SE Sweden
| | - Fabio Macciardi
- grid.266093.80000 0001 0668 7243Department of Psychiatry and Human Behavior, University of California, Irvine, CA USA
| | - Stephen R. Marder
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA USA
| | - Ruben C. Gur
- grid.25879.310000 0004 1936 8972Department of Psychiatry, University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972Child & Adolescent Psychiatry, University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972Lifespan Brain Institute, University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Raquel E. Gur
- grid.25879.310000 0004 1936 8972Department of Psychiatry, University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972Child & Adolescent Psychiatry, University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972Lifespan Brain Institute, University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - David L. Braff
- grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California, La Jolla, San Diego, CA USA ,grid.410371.00000 0004 0419 2708VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA USA
| | | | | | - Michael A. Escamilla
- grid.416992.10000 0001 2179 3554Department of Psychiatry, Texas Tech University Health Sciences Center, El Paso, TX USA
| | - Marquis P. Vawter
- grid.266093.80000 0001 0668 7243Department of Psychiatry and Human Behavior, University of California, Irvine, CA USA
| | - Janet L. Sobell
- grid.42505.360000 0001 2156 6853Department of Psychiatry & Behavioral Sciences, University of Southern California, Los Angeles, CA USA
| | - Dolores Malaspina
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai, NY USA ,grid.59734.3c0000 0001 0670 2351Department of Genetics & Genomics, Icahn School of Medicine at Mount Sinai, Mount Sinai, NY USA
| | - Douglas S. Lehrer
- grid.268333.f0000 0004 1936 7937Department of Psychiatry, Wright State University, Dayton, OH USA
| | - Peter F. Buckley
- grid.224260.00000 0004 0458 8737School of Medicine, Virginia Commonwealth University, Richmond, VA USA
| | - Mark H. Rapaport
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - James A. Knowles
- grid.262863.b0000 0001 0693 2202Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY USA ,grid.262863.b0000 0001 0693 2202Department of Cell Biology, SUNY Downstate Medical Center, Brooklyn, NY USA
| | | | - Ayman H. Fanous
- grid.262863.b0000 0001 0693 2202Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY USA ,grid.262863.b0000 0001 0693 2202Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY USA ,Department of Psychiatry, Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY USA
| | - Michele T. Pato
- grid.262863.b0000 0001 0693 2202Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY USA ,grid.262863.b0000 0001 0693 2202Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY USA
| | - Steven A. McCarroll
- grid.66859.34Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA USA ,grid.38142.3c000000041936754XDepartment of Genetics, Harvard Medical School, Boston, MA USA
| | - Carlos N. Pato
- grid.262863.b0000 0001 0693 2202Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY USA ,grid.262863.b0000 0001 0693 2202Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY USA
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Feng YCA, Howrigan DP, Abbott LE, Tashman K, Cerrato F, Singh T, Heyne H, Byrnes A, Churchhouse C, Watts N, Solomonson M, Lal D, Heinzen EL, Dhindsa RS, Stanley KE, Cavalleri GL, Hakonarson H, Helbig I, Krause R, May P, Weckhuysen S, Petrovski S, Kamalakaran S, Sisodiya SM, Cossette P, Cotsapas C, De Jonghe P, Dixon-Salazar T, Guerrini R, Kwan P, Marson AG, Stewart R, Depondt C, Dlugos DJ, Scheffer IE, Striano P, Freyer C, McKenna K, Regan BM, Bellows ST, Leu C, Bennett CA, Johns EM, Macdonald A, Shilling H, Burgess R, Weckhuysen D, Bahlo M, O’Brien TJ, Todaro M, Stamberger H, Andrade DM, Sadoway TR, Mo K, Krestel H, Gallati S, Papacostas SS, Kousiappa I, Tanteles GA, Štěrbová K, Vlčková M, Sedláčková L, Laššuthová P, Klein KM, Rosenow F, Reif PS, Knake S, Kunz WS, Zsurka G, Elger CE, Bauer J, Rademacher M, Pendziwiat M, Muhle H, Rademacher A, van Baalen A, von Spiczak S, Stephani U, Afawi Z, Korczyn AD, Kanaan M, Canavati C, Kurlemann G, Müller-Schlüter K, Kluger G, Häusler M, Blatt I, Lemke JR, Krey I, Weber YG, Wolking S, Becker F, Hengsbach C, Rau S, Maisch AF, Steinhoff BJ, Schulze-Bonhage A, Schubert-Bast S, Schreiber H, Borggräfe I, Schankin CJ, Mayer T, Korinthenberg R, Brockmann K, Kurlemann G, Dennig D, Madeleyn R, Kälviäinen R, Auvinen P, Saarela A, Linnankivi T, Lehesjoki AE, Rees MI, Chung SK, Pickrell WO, Powell R, Schneider N, Balestrini S, Zagaglia S, Braatz V, Johnson MR, Auce P, Sills GJ, Baum LW, Sham PC, Cherny SS, Lui CH, Barišić N, Delanty N, Doherty CP, Shukralla A, McCormack M, El-Naggar H, Canafoglia L, Franceschetti S, Castellotti B, Granata T, Zara F, Iacomino M, Madia F, Vari MS, Mancardi MM, Salpietro V, Bisulli F, Tinuper P, Licchetta L, Pippucci T, Stipa C, Minardi R, Gambardella A, Labate A, Annesi G, Manna L, Gagliardi M, Parrini E, Mei D, Vetro A, Bianchini C, Montomoli M, Doccini V, Marini C, Suzuki T, Inoue Y, Yamakawa K, Tumiene B, Sadleir LG, King C, Mountier E, Caglayan SH, Arslan M, Yapıcı Z, Yis U, Topaloglu P, Kara B, Turkdogan D, Gundogdu-Eken A, Bebek N, Uğur-İşeri S, Baykan B, Salman B, Haryanyan G, Yücesan E, Kesim Y, Özkara Ç, Poduri A, Shiedley BR, Shain C, Buono RJ, Ferraro TN, Sperling MR, Lo W, Privitera M, French JA, Schachter S, Kuzniecky RI, Devinsky O, Hegde M, Khankhanian P, Helbig KL, Ellis CA, Spalletta G, Piras F, Piras F, Gili T, Ciullo V, Reif A, McQuillin A, Bass N, McIntosh A, Blackwood D, Johnstone M, Palotie A, Pato MT, Pato CN, Bromet EJ, Carvalho CB, Achtyes ED, Azevedo MH, Kotov R, Lehrer DS, Malaspina D, Marder SR, Medeiros H, Morley CP, Perkins DO, Sobell JL, Buckley PF, Macciardi F, Rapaport MH, Knowles JA, Fanous AH, McCarroll SA, Gupta N, Gabriel SB, Daly MJ, Lander ES, Lowenstein DH, Goldstein DB, Lerche H, Berkovic SF, Neale BM. Ultra-Rare Genetic Variation in the Epilepsies: A Whole-Exome Sequencing Study of 17,606 Individuals. Am J Hum Genet 2019; 105:267-282. [PMID: 31327507 PMCID: PMC6698801 DOI: 10.1016/j.ajhg.2019.05.020] [Citation(s) in RCA: 168] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/29/2019] [Indexed: 12/20/2022] Open
Abstract
Sequencing-based studies have identified novel risk genes associated with severe epilepsies and revealed an excess of rare deleterious variation in less-severe forms of epilepsy. To identify the shared and distinct ultra-rare genetic risk factors for different types of epilepsies, we performed a whole-exome sequencing (WES) analysis of 9,170 epilepsy-affected individuals and 8,436 controls of European ancestry. We focused on three phenotypic groups: severe developmental and epileptic encephalopathies (DEEs), genetic generalized epilepsy (GGE), and non-acquired focal epilepsy (NAFE). We observed that compared to controls, individuals with any type of epilepsy carried an excess of ultra-rare, deleterious variants in constrained genes and in genes previously associated with epilepsy; we saw the strongest enrichment in individuals with DEEs and the least strong in individuals with NAFE. Moreover, we found that inhibitory GABAA receptor genes were enriched for missense variants across all three classes of epilepsy, whereas no enrichment was seen in excitatory receptor genes. The larger gene groups for the GABAergic pathway or cation channels also showed a significant mutational burden in DEEs and GGE. Although no single gene surpassed exome-wide significance among individuals with GGE or NAFE, highly constrained genes and genes encoding ion channels were among the lead associations; such genes included CACNA1G, EEF1A2, and GABRG2 for GGE and LGI1, TRIM3, and GABRG2 for NAFE. Our study, the largest epilepsy WES study to date, confirms a convergence in the genetics of severe and less-severe epilepsies associated with ultra-rare coding variation, and it highlights a ubiquitous role for GABAergic inhibition in epilepsy etiology.
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Nuttall AK, Thakkar KN, Luo X, Mueser KT, Glynn SM, Achtyes ED, Kane JM. Longitudinal associations of family burden and patient quality of life in the context of first-episode schizophrenia in the RAISE-ETP study. Psychiatry Res 2019; 276:60-68. [PMID: 31026764 PMCID: PMC6538431 DOI: 10.1016/j.psychres.2019.04.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 10/27/2022]
Abstract
The present study examined longitudinal associations between family member perceived burden and clinical correlates to understand potential covariation in change over time in the context of first-episode schizophrenia in the RAISE-ETP study (N = 282). Across 24 months, family burden, patient quality of life, and positive symptoms improved. Findings from the present study suggest covariation in change over time in quality of life and family burden. As patient quality of life improved, family burden decreased. However, initial levels of quality of life were not significantly associated with changes in family burden and vice versa. Initial levels of positive symptoms were significantly associated with initial levels of family burden. These findings have treatment implications by suggesting the potential for interventions aimed at improving quality of life to have a spillover effect on family burden, or alternatively, that reducing perceived family burden may improve patient quality of life.
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Affiliation(s)
- Amy K. Nuttall
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI,Center for Research in Autism, Intellectual and Other Neurodevelopmental Disabilities, Michigan State University, East Lansing, MI, USA,Corresponding Author: Amy K. Nuttall, phone +1 517 884-9443;
| | - Katharine N. Thakkar
- Center for Research in Autism, Intellectual and Other Neurodevelopmental Disabilities, Michigan State University, East Lansing, MI, USA,Department of Psychology, Michigan State University, East Lansing, MI, USA,Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Xiaochen Luo
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Kim T. Mueser
- Center for Psychiatric Rehabilitation and Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston, MA, USA,Departments of Psychological and Brain Sciences and Psychiatry, Boston University, Boston, MA, USA
| | | | - Eric D. Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, USA,Cherry Health, Grand Rapids, MI, USA
| | - John M. Kane
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, NY, USA,Feinstein Institute for Medical Research, NY, USA,The Zucker Hillside Hospital, Glen Oaks, NY, USA
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Kane JM, Schooler NR, Marcy P, Achtyes ED, Correll CU, Robinson DG. Patients With Early-Phase Schizophrenia Will Accept Treatment With Sustained-Release Medication (Long-Acting Injectable Antipsychotics): Results From the Recruitment Phase of the PRELAPSE Trial. J Clin Psychiatry 2019; 80. [PMID: 31050233 DOI: 10.4088/jcp.18m12546] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To document the acceptability of treatment with long-acting injectable (LAI) antipsychotic medication to early-phase schizophrenia patients as demonstrated by enrollment in a cluster-randomized LAI clinical trial. METHODS Eligible patients aged 18-35 years with a DSM-5 diagnosis of schizophrenia and less than 5 years of lifetime antipsychotic use were recruited between December 2014 and December 2016. Training for LAI antipsychotic site staff included education regarding the role of nonadherence in relapse/hospitalization and the rationale for LAI antipsychotic use with early-psychosis patients, training in shared decision-making and communication strategies, review of frequently asked questions about LAI antipsychotics, and role-playing to develop skills and solutions to overcoming LAI antipsychotic logistical barriers. Study prescribers also received training on prescribing guidelines. RESULTS At the 19 US outpatient clinics randomized to provide LAI antipsychotic treatment, 576 potential participants were identified who met inclusion criteria based on a screening interview. Of these, 83 (14.4%) declined participation because they would not consider LAI antipsychotic treatment and 165 (28.6%) declined for other reasons, resulting in 328 providing written study consent. The first post-consent visit included detailed evaluations to confirm inclusion/exclusion criteria. Thirty-nine participants who consented did not complete this evaluation and 55 were found to not meet criteria, resulting in a final sample of 234 participants. Two hundred thirteen (91.0%) accepted at least one LAI antipsychotic injection during their first 3 months of study participation. CONCLUSIONS Large numbers of early-phase patients with schizophrenia were willing to participate in an LAI antipsychotic trial and by inference in non-study LAI antipsychotic treatment. LAI antipsychotic-focused staff training has the potential to substantially enhance the use of LAI antipsychotics. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02360319.
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Affiliation(s)
- John M Kane
- The Zucker Hillside Hospital, 75-59 263rd St, Glen Oaks, NY 11004. .,Departments of Psychiatry and of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA.,The Zucker Hillside Hospital, Glen Oaks, New York, USA
| | - Nina R Schooler
- Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | | | - Eric D Achtyes
- Cherry Health, Grand Rapids, Michigan, USA.,Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| | - Christoph U Correll
- Departments of Psychiatry and of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA.,The Zucker Hillside Hospital, Glen Oaks, New York, USA.,Charité Universitätsmedizin, Department of Child and Adolescent Psychiatry, Berlin, Germany
| | - Delbert G Robinson
- Departments of Psychiatry and of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA.,The Zucker Hillside Hospital, Glen Oaks, New York, USA
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Achtyes ED, Ben-Zeev D, Luo Z, Mayle H, Burke B, Rotondi AJ, Gottlieb JD, Brunette MF, Mueser KT, Gingerich S, Meyer-Kalos PS, Marcy P, Schooler NR, Robinson DG, Kane JM. Off-hours use of a smartphone intervention to extend support for individuals with schizophrenia spectrum disorders recently discharged from a psychiatric hospital. Schizophr Res 2019; 206:200-208. [PMID: 30551981 DOI: 10.1016/j.schres.2018.11.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 09/19/2018] [Accepted: 11/22/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Technology-delivered healthcare interventions may enhance dissemination of evidence-based treatments in low-resource areas. These interventions may be accessed 'on-demand,' including after hours. Patients with schizophrenia do engage with technological aids but when/how they would utilize these tools is not known. METHODS We conducted a large, prospective, ten-site, longitudinal study of four technology-assisted interventions for patients with schizophrenia spectrum disorders within 60 days of psychiatric hospital discharge, a high risk period. One tool employed was a smartphone intervention called 'FOCUS,' which could be used by patients as needed, providing help in five content areas: medications, mood, social, sleep and voices. Each login was date- and time-stamped as occurring during normal clinic hours, or 'off-hours,' and the pattern of use described. RESULTS 347 of 368 patients utilized FOCUS during the 6-month study. There were a total of 75,447 FOCUS logins; 35,739 (47.4%) were self-initiated and 38,139 (50.6%) were off-hours. 18,450 of the logins during off-hours were self-initiated (24.5%). No differences in average usage per month were found based on race/ethnicity. A subset of 'high utilizers' (n = 152, 43.8%) self-initiated use of all five FOCUS modules both on- and off-hours. They tended to be women, >35 years old, and had a high school diploma or greater. CONCLUSION Most patients with schizophrenia spectrum disorders recently discharged from the hospital utilized a smartphone intervention targeted to address troublesome residual symptoms. One quarter of the total smartphone utilization was self-initiated off-hours, indicating the potential utility of this tool to extend support for patients during periods of elevated risk.
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Affiliation(s)
- Eric D Achtyes
- Cherry Health, 100 Cherry Street, Grand Rapids, MI 49503, USA; Division of Psychiatry and Behavioral Medicine, Michigan State University, College of Human Medicine, Secchia Center, Rm 482, 15 Michigan Street, Grand Rapids, MI 49503, USA.
| | - Dror Ben-Zeev
- Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, 2 Pillsbury Street, Suite 401, Concord, NH 03301, USA.
| | - Zhehui Luo
- Department of Epidemiology and Biostatistics, Michigan State University, College of Human Medicine, B627 West Fee Hall, 909 Fee Road, East Lansing, MI 48824, USA.
| | - Heather Mayle
- Cherry Health, 100 Cherry Street, Grand Rapids, MI 49503, USA.
| | - Brandi Burke
- Division of Psychiatry and Behavioral Medicine, Michigan State University, College of Human Medicine, Secchia Center, Rm 482, 15 Michigan Street, Grand Rapids, MI 49503, USA.
| | - Armando J Rotondi
- Department of Critical Care Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA 15261, USA; Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, 151R-H, VA Pittsburgh Healthcare System, 7180 Highland Drive, Pittsburgh, PA 15206, USA.
| | - Jennifer D Gottlieb
- Center for Psychiatric Rehabilitation and Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, 940 Commonwealth Avenue West, Boston, MA 02215, USA; Departments of Psychological and Brain Sciences and Psychiatry, Boston University, 940 Commonwealth Avenue West, Boston, MA 02215, USA.
| | - Mary F Brunette
- Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, 2 Pillsbury Street, Suite 401, Concord, NH 03301, USA.
| | - Kim T Mueser
- Center for Psychiatric Rehabilitation and Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, 940 Commonwealth Avenue West, Boston, MA 02215, USA; Departments of Psychological and Brain Sciences and Psychiatry, Boston University, 940 Commonwealth Avenue West, Boston, MA 02215, USA.
| | - Susan Gingerich
- Independent Consultant, 14 Schiller Avenue, Narberth, PA 19072, USA.
| | - Piper S Meyer-Kalos
- University of Minnesota, School of Social Work, 170 Peters Hall, 1404 Gortner Avenue, St. Paul, MN 55108, USA.
| | - Patricia Marcy
- Vanguard Research Group, 75-59 263rd Street, Glen Oaks, NY 11004, USA.
| | - Nina R Schooler
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203, USA; The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, USA.
| | - Delbert G Robinson
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, USA; Feinstein Institute for Medical Research, 350 Community Dr, Manhasset, NY 11030, USA.; Department of Psychiatry, Hofstra Northwell School of Medicine, 500 Hofstra Blvd, Hempstead, NY 11549, USA..
| | - John M Kane
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, USA; Feinstein Institute for Medical Research, 350 Community Dr, Manhasset, NY 11030, USA.; Department of Psychiatry, Hofstra Northwell School of Medicine, 500 Hofstra Blvd, Hempstead, NY 11549, USA..
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Baumel A, Correll CU, Hauser M, Brunette M, Rotondi A, Ben-Zeev D, Gottlieb JD, Mueser KT, Achtyes ED, Schooler NR, Robinson DG, Gingerich S, Marcy P, Meyer-Kalos P, Kane JM. Health Technology Intervention After Hospitalization for Schizophrenia: Service Utilization and User Satisfaction. Psychiatr Serv 2016; 67:1035-8. [PMID: 27247171 DOI: 10.1176/appi.ps.201500317] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors examined patients' acceptance of the Health Technology Program (HTP), an integrative approach to relapse prevention after hospitalization of adults with schizophrenia or related disorders. The program combines use of digital tools with support from a mental health technology coach (MHTC). METHODS Patients with schizophrenia spectrum disorders received six months of treatment that began within 60 days of a psychiatric hospitalization and included the development of a personalized relapse prevention plan, three digital tools, and contacts with MHTCs. RESULTS A total of 200 patients (mean±SD age=34.6±10.6 years) had 28.2±2.0 contacts with the MHTC that lasted 38.3±14.2 minutes. The most discussed topic was case management (52%), and digital tools were discussed in 45% of meetings. Altogether, 87% of patients used at least one of the digital tools, with 96% of patients rating the HTP as satisfying to at least some extent. CONCLUSIONS These data suggest very high acceptance of the HTP, a program that integrates available human support with digital tools.
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Affiliation(s)
- Amit Baumel
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Christoph U Correll
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Marta Hauser
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Mary Brunette
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Armando Rotondi
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Dror Ben-Zeev
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Jennifer D Gottlieb
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Kim T Mueser
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Eric D Achtyes
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Nina R Schooler
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Delbert G Robinson
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Susan Gingerich
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Patricia Marcy
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Piper Meyer-Kalos
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - John M Kane
- Dr. Baumel, Dr. Correll, Dr. Hauser, Dr. Schooler, Dr. Robinson, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (e-mail: ). Dr. Baumel, Dr. Correll, Dr. Robinson, and Dr. Kane are also with Hofstra Northwell School of Medicine, Hempstead, New York. Dr. Hauser and Ms. Marcy are also with the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Brunette and Dr. Ben-Zeev are with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. Dr. Rotondi is with the Department of Critical Care Medicine, Clinical and Translational Sciences Institute, Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs Medical Center, Pittsburgh. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Achtyes is with Cherry Health and Michigan State University College of Human Medicine, East Lansing. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
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Ben-Zeev D, Scherer EA, Gottlieb JD, Rotondi AJ, Brunette MF, Achtyes ED, Mueser KT, Gingerich S, Brenner CJ, Begale M, Mohr DC, Schooler N, Marcy P, Robinson DG, Kane JM. mHealth for Schizophrenia: Patient Engagement With a Mobile Phone Intervention Following Hospital Discharge. JMIR Ment Health 2016; 3:e34. [PMID: 27465803 PMCID: PMC4999306 DOI: 10.2196/mental.6348] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 07/21/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND mHealth interventions that use mobile phones as instruments for illness management are gaining popularity. Research examining mobile phone‒based mHealth programs for people with psychosis has shown that these approaches are feasible, acceptable, and clinically promising. However, most mHealth initiatives involving people with schizophrenia have spanned periods ranging from a few days to several weeks and have typically involved participants who were clinically stable. OBJECTIVE Our aim was to evaluate the viability of extended mHealth interventions for people with schizophrenia-spectrum disorders following hospital discharge. Specifically, we set out to examine the following: (1) Can individuals be engaged with a mobile phone intervention program during this high-risk period?, (2) Are age, gender, racial background, or hospitalization history associated with their engagement or persistence in using a mobile phone intervention over time?, and (3) Does engagement differ by characteristics of the mHealth intervention itself (ie, pre-programmed vs on-demand functions)? METHODS We examined mHealth intervention use and demographic and clinical predictors of engagement in 342 individuals with schizophrenia-spectrum disorders who were given the FOCUS mobile phone intervention as part of a technology-assisted relapse prevention program during the 6-month high-risk period following hospitalization. RESULTS On average, participants engaged with FOCUS for 82% of the weeks they had the mobile phone. People who used FOCUS more often continued using it over longer periods: 44% used the intervention over 5-6 months, on average 4.3 days a week. Gender, race, age, and number of past psychiatric hospitalizations were associated with engagement. Females used FOCUS on average 0.4 more days a week than males. White participants engaged on average 0.7 days more a week than African-Americans and responded to prompts on 0.7 days more a week than Hispanic participants. Younger participants (age 18-29) had 0.4 fewer days of on-demand use a week than individuals who were 30-45 years old and 0.5 fewer days a week than older participants (age 46-60). Participants with fewer past hospitalizations (1-6) engaged on average 0.2 more days a week than those with seven or more. mHealth program functions were associated with engagement. Participants responded to prompts more often than they self-initiated on-demand tools, but both FOCUS functions were used regularly. Both types of intervention use declined over time (on-demand use had a steeper decline). Although mHealth use declined, the majority of individuals used both on-demand and system-prompted functions regularly throughout their participation. Therefore, neither function is extraneous. CONCLUSIONS The findings demonstrated that individuals with schizophrenia-spectrum disorders can actively engage with a clinically supported mobile phone intervention for up to 6 months following hospital discharge. mHealth may be useful in reaching a clinical population that is typically difficult to engage during high-risk periods.
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Brunette MF, Rotondi AJ, Ben-Zeev D, Gottlieb JD, Mueser KT, Robinson DG, Achtyes ED, Gingerich S, Marcy P, Schooler NR, Meyer-Kalos P, Kane JM. Coordinated Technology-Delivered Treatment to Prevent Rehospitalization in Schizophrenia: A Novel Model of Care. Psychiatr Serv 2016; 67:444-7. [PMID: 26725297 DOI: 10.1176/appi.ps.201500257] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite advances in schizophrenia treatment, symptom relapses and rehospitalizations impede recovery for many people and are a principal driver of the high cost of care. Technology-delivered or technology-enhanced treatment may be a cost-effective way to provide flexible, personalized evidence-based treatments directly to people in their homes and communities. However, evidence for the safety, acceptability, and efficacy of such interventions is only now being established. The authors of this Open Forum describe a novel, technology-based approach to prevent relapse after a hospitalization for psychosis, the Health Technology Program (HTP), which they developed. HTP provides in-person relapse prevention planning that directs use of tailored, technology-based treatment based on cognitive-behavioral therapy for psychosis, family psychoeducation for schizophrenia, and prescriber decision support through a Web-based program that solicits information from clients at every visit. Technology-based treatments are delivered through smartphones and computers.
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Affiliation(s)
- Mary F Brunette
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Armando J Rotondi
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Dror Ben-Zeev
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Jennifer D Gottlieb
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Kim T Mueser
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Delbert G Robinson
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Eric D Achtyes
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Susan Gingerich
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Patricia Marcy
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Nina R Schooler
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - Piper Meyer-Kalos
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
| | - John M Kane
- Dr. Brunette and Dr. Ben-Zeev are with the Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire (e-mail: ). They are also with the Center for Technology and Behavioral Health, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire. Dr. Rotondi is with the Clinical and Translational Sciences Institute, Department of Critical Care Medicine, University of Pittsburgh, and with the Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Pittsburgh, Pennsylvania. Dr. Gottlieb and Dr. Mueser are with the Center for Psychiatric Rehabilitation and with the Department of Occupational Therapy, Boston University. Dr. Robinson and Dr. Kane are with the Feinstein Institute for Medical Research, Manhasset, New York, and with the Department of Psychiatry and Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Dr. Achtyes is with Cherry Street and the Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Ms. Marcy is with Northwell Health, Great Neck, New York, and Vanguard Research Group, Glen Oaks, New York. Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, and with the Zucker Hillside Hospital, Glen Oaks, New York. Dr. Meyer-Kalos is with the Department of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul
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Thorndike AN, Achtyes ED, Cather C, Pratt S, Pachas GN, Hoeppner SS, Evins AE. Weight gain and 10-year cardiovascular risk with sustained tobacco abstinence in smokers with serious mental illness: a subgroup analysis of a randomized trial. J Clin Psychiatry 2016; 77:e320-6. [PMID: 27046320 DOI: 10.4088/jcp.15m10074] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/28/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE People with serious mental illness die earlier than those without mental illness, largely from cardiovascular disease due to high rates of smoking and obesity. The objective of this study was to determine whether the metabolic effects of postcessation weight gain among smokers with serious mental illness attenuated the cardiovascular benefit of tobacco abstinence. METHOD A subgroup analysis was conducted of 65 outpatient smokers with DSM-IV diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder from 10 community mental health centers in 6 states who enrolled between March 2008-April 2012 and completed a trial of varenicline for tobacco abstinence. The intervention included a 12-week open-label phase with varenicline followed by a 40-week randomized, placebo-controlled phase in 87 participants who achieved 12-week abstinence. Main outcome measures were smoking status and change from baseline in weight and 10-year Framingham cardiovascular risk score at end of intervention (week 52). RESULTS At week 52, 65 participants completed follow-up (33 abstinent; 32 relapsed). At baseline, the 2 groups did not differ in body mass index (mean = 31 kg/m(2)), blood pressure, serum glucose, or diagnoses of diabetes (31%) and hypertension (34%). Abstinent participants were older and had a higher mean baseline Framingham risk score (14.2% vs 10.3%, P = .002). At week 52, abstinent participants gained more weight than relapsed participants (4.8 vs 1.2 kg, P = .048) and, as a result of quitting smoking, had a greater reduction in Framingham risk score (-7.6% vs 0.0%, P < .001). There was no effect of study drug assignment on weight or Framingham risk score. CONCLUSIONS Sustained tobacco abstinence reduced 10-year cardiovascular risk in outpatients with serious mental illness despite significant postcessation weight gain and high prevalence of obesity, diabetes, and hypertension. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT00621777.
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Affiliation(s)
- Anne N Thorndike
- Massachusetts General Hospital, 50 Staniford St, 9th Fl, Boston, MA 02114
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Achtyes ED, Halstead S, Smart L, Moore T, Frank E, Kupfer DJ, Gibbons R. Validation of Computerized Adaptive Testing in an Outpatient Nonacademic Setting: The VOCATIONS Trial. Psychiatr Serv 2015; 66:1091-6. [PMID: 26030317 PMCID: PMC4910384 DOI: 10.1176/appi.ps.201400390] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Computerized adaptive testing (CAT) provides an alternative to fixed-length assessments. The study validated a suite of computerized adaptive tests for mental health (CAT-MH) in a community psychiatric sample. METHODS A total of 145 adults from a community outpatient clinic, including 19 with no history of a mental disorder (control group), were prospectively evaluated with CAT for depression (CAD-MDD and CAT-DI), mania (CAT-MANIA), and anxiety symptoms (CAT-ANX). Ratings were compared with gold-standard psychiatric assessments, including the Structured Clinical Interview for DSM-IV-TR (SCID), Hamilton Rating Scale for Depression (HAM-D-25), Patient Health Questionnaire (PHQ-9), Center for Epidemiologic Studies Depression Scale (CES-D), and Global Assessment of Functioning (GAF). RESULTS Sensitivity and specificity for CAD-MDD were .96 and .64, respectively (.96 and 1.00 for major depression versus the control group). CAT for depression severity (CAT-DI) correlated well with the HAM-D-25 (r=.79), PHQ-9 (r=.90), and CES-D (r=.90) and had an odds ratio (OR) of 27.88 across its range for current SCID major depressive disorder. CAT-ANX correlated with the HAM-D-25 (r=.73), PHQ-9 (r=.78), and CES-D (r=.81) and had an OR of 11.52 across its range for current SCID generalized anxiety disorder. CAT-MANIA did not correlate well with the HAM-D-25 (r=.31), PHQ-9 (r=.37), and CES-D (r=.39), but it had an OR of 11.56 across its range for a current SCID bipolar diagnosis. Participants found the CAT-MH acceptable and easy to use, averaging 51.7 items and 9.4 minutes to complete the full battery. CONCLUSIONS Compared with gold-standard diagnostic and assessment measures, CAT-MH provided an effective, rapidly administered assessment of psychiatric symptoms.
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Affiliation(s)
- Eric D Achtyes
- Dr. Achtyes, Dr. Halstead, and Ms. Smart are with Pine Rest Christian Mental Health Services, Grand Rapids, Michigan. Dr. Achtyes is also with the Department of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids (e-mail: ). Ms. Moore, Dr. Frank, and Dr. Kupfer are with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Dr. Gibbons is with the Departments of Medicine, Public Health Sciences, and Psychiatry and the Center for Health Statistics, University of Chicago, Illinois
| | - Scott Halstead
- Dr. Achtyes, Dr. Halstead, and Ms. Smart are with Pine Rest Christian Mental Health Services, Grand Rapids, Michigan. Dr. Achtyes is also with the Department of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids (e-mail: ). Ms. Moore, Dr. Frank, and Dr. Kupfer are with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Dr. Gibbons is with the Departments of Medicine, Public Health Sciences, and Psychiatry and the Center for Health Statistics, University of Chicago, Illinois
| | - LeAnn Smart
- Dr. Achtyes, Dr. Halstead, and Ms. Smart are with Pine Rest Christian Mental Health Services, Grand Rapids, Michigan. Dr. Achtyes is also with the Department of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids (e-mail: ). Ms. Moore, Dr. Frank, and Dr. Kupfer are with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Dr. Gibbons is with the Departments of Medicine, Public Health Sciences, and Psychiatry and the Center for Health Statistics, University of Chicago, Illinois
| | - Tara Moore
- Dr. Achtyes, Dr. Halstead, and Ms. Smart are with Pine Rest Christian Mental Health Services, Grand Rapids, Michigan. Dr. Achtyes is also with the Department of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids (e-mail: ). Ms. Moore, Dr. Frank, and Dr. Kupfer are with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Dr. Gibbons is with the Departments of Medicine, Public Health Sciences, and Psychiatry and the Center for Health Statistics, University of Chicago, Illinois
| | - Ellen Frank
- Dr. Achtyes, Dr. Halstead, and Ms. Smart are with Pine Rest Christian Mental Health Services, Grand Rapids, Michigan. Dr. Achtyes is also with the Department of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids (e-mail: ). Ms. Moore, Dr. Frank, and Dr. Kupfer are with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Dr. Gibbons is with the Departments of Medicine, Public Health Sciences, and Psychiatry and the Center for Health Statistics, University of Chicago, Illinois
| | - David J Kupfer
- Dr. Achtyes, Dr. Halstead, and Ms. Smart are with Pine Rest Christian Mental Health Services, Grand Rapids, Michigan. Dr. Achtyes is also with the Department of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids (e-mail: ). Ms. Moore, Dr. Frank, and Dr. Kupfer are with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Dr. Gibbons is with the Departments of Medicine, Public Health Sciences, and Psychiatry and the Center for Health Statistics, University of Chicago, Illinois
| | - Robert Gibbons
- Dr. Achtyes, Dr. Halstead, and Ms. Smart are with Pine Rest Christian Mental Health Services, Grand Rapids, Michigan. Dr. Achtyes is also with the Department of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids (e-mail: ). Ms. Moore, Dr. Frank, and Dr. Kupfer are with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Dr. Gibbons is with the Departments of Medicine, Public Health Sciences, and Psychiatry and the Center for Health Statistics, University of Chicago, Illinois
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