Minneapolis St. Paul Mental Health Blog

Eating Disorders | Taking note of patients that have lost weight could be a signal that there is a lot more going on such as an eating disorder.

According to new research, adolescents with atypical anorexia nervosa (AN) have psychological and physical morbidity that may be just as severe as that among adolescents with full-threshold AN, according to new research.

In atypical AN, a person loses a significant amount of weight but does not become underweight, Dr. Susan M. Sawyer of the University of Melbourne in Australia and her colleagues explain in their report, published online March 29 in Pediatrics.

"We have observed a striking increase in this type of presentation among adolescent inpatients," they write. "Remarkably, of patients admitted to hospital with restrictive eating disorders, the proportion who were not underweight rose from 8% to 47% over a six-year period."

Adolescents with atypical AN have behaviors and cognitions similar to those of patients with AN, the researchers add, and similar acute physical complications. To investigate further, the researchers compared 42 patients with atypical AN and 118 with full-threshold AN who presented to a specialist pediatric eating disorder program.

Among the atypical patients, 71% were overweight or obese, versus 12% of the full-threshold patients. Average weight loss was 17.6 kg for the atypical AN group, compared to 11 kg for the AN patients, and the atypical patients also lost weight over a longer period of time (13.3 versus 10.2 months).

Frequency of bradycardia and orthostatic instability were similar for the atypical AN and AN groups. There were also no significant differences in the frequencies of psychiatric comorbidities or suicidal ideation.

According to a recent study in Journal of the American Academy of Child & Adolescent Psychiatry, Adolescents with prior lifetime mental disorders had high rates of both alcohol (10.3%) and illicit drug (14.9%) abuse, with or without dependence.

By age 18, approximately one-third of adolescents with preexisting mental disorders were regular alcohol drinkers or illicit drug users.

Screen time is a reality of modern childhood, with kids of every age spending hours upon hours in front of iPads, smartphones and televisions. So, what does this mean for overall development?

Bipolar disorder is one of the most important psychiatric illnesses because it is fairly common - affecting between 1 and 3 percent of the population - and quite debilitating. So, what about genetic profiling?

When parents suffer depression, there can be a negative effects on their children. When Mom gets better, the children get better.

Observation studies on the relationship between coffee intake / risk of depression

...and the relationship between caffeine consumption and depression remain controversial, here are some relevant findings:

The Centers for Disease Control and Prevention (CDC) has issued a guideline with 12 recommendations for primary care clinicians who prescribe opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.

Specifically, the recommendations cover when to initiate or continue opioid treatment, which opioids should be used and for how long, and how to address potential harms associated with treatment.

Prescriptions for benzodiazepine and overdose deaths increased considerably from 1996 to 2013, according to a study published in the American Journal of Public Health.

Marcus A. Bachhuber, MD, MSHP, from the Albert Einstein College of Medicine in Bronx, N.Y., and colleagues examined data from the Medical Expenditure Panel Survey and multiple-cause-of-death data from the U.S. Centers for Disease Control and Prevention to describe trends in benzodiazepine prescriptions and overdose deaths among adults.

According to information found at the New England Journal of Medicine, Emergency Department visits from cannabis related consumption are up for more than just locals.

When voters approved the legalization of medical marijuana in 2000, medical licensure and use increased in 2009, voters approved the legalization of retail marijuana in 2012, and retail sales began in 2014. Given the reports of marijuana tourism (i.e., visits to the state with the purpose of marijuana product consumption), the Northwestern University Feinberg School of Medicine sought to determine whether the rates of emergency department (ED) visits possibly related to cannabis use have increased disproportionately among out-of-state residents, as compared with Colorado residents.

We conducted a cross-sectional study in the setting of an urban academic hospital in Aurora, Colorado, that has approximately 100,000 ED visits per year and compared the rates of ED visits with International Classification of Diseases, Ninth Revision (ICD-9), codes of cannabis use between out-of-state residents and Colorado residents from 2012 through 2014.

Residency was determined by the ZIP Codes given by the patients when they registered in the ED. The rates of visits with ICD-9 codes for cannabis use were adjusted for the volume of annual visits, and consecutive years were compared with the use of the two-sample z-test of proportions. We confirmed our findings with the use of data from more than 100 hospitals reported to the Colorado Hospital Association from 2011 through 2014.

At our institution, the rate of ED visits possibly related to cannabis use among out-of-state residents doubled from 85 per 10,000 visits in 2013 to 168 per 10,000 visits in 2014, which was the first year of retail marijuana sales (rate ratio, 1.98; P=0.001).

Among Colorado residents, the rate of ED visits possibly related to cannabis use did not change significantly between 2013 and 2014 (106 per 10,000 visits in 2013 and 112 per 10,000 visits in 2014; rate ratio, 1.05; P=0.26). The rates did not change significantly between 2012 and 2013 among out-of-state residents or Colorado residents (from Colorado Department of Public Health and Environment, Denver, CO). Clinical and demographic data are provided in the Supplementary Appendix, available with the full text of this letter at NEJM.org.

The data from the Colorado Hospital Association did not show a significant change from 2011 to 2012 in the rate of ED visits with ICD-9 codes of cannabis use among out-of-state residents; however, from 2012 to 2014, the statewide rate among out-of-state residents rose from 78 per 10,000 visits in 2012 to 112 per 10,000 visits in 2013 to 163 per 10,000 visits in 2014 (rate ratios, 1.44 [2012 to 2013] and 1.46 [2013 to 2014]; P<0.001 for both comparisons). Among Colorado residents, from 2011 to 2014, the rate of ED visits possibly related to cannabis use increased from 61 to 70 to 86 to 101, respectively, per 10,000 visits (rate ratios, 1.14 [2011 to 2012], 1.24 [2012 to 2013], and 1.17 [2013 to 2014]

The flattening of the rates of ED visits possibly related to cannabis use among Colorado residents in an urban hospital may represent a learning curve during the period when marijuana was potentially available to Colorado residents for medical use (medical marijuana period) but was largely inaccessible to out-of-state residents.

according to the University of Colorado School of Medicine, Aurora, CO, It is possible that reporting bias in the era after legalization has confounded these findings; however, we previously found that the reporting on marijuana use among Colorado residents during the medical marijuana period was reliable.

ED visits related to cannabis use appear to be increasing more rapidly among out-of-state residents than among Colorado residents. The initial educational efforts through mass media have focused primarily on Colorado residents. These data underscore the importance of point-of-sale education for visitors regarding the safe and appropriate use of marijuana products.

The point of all this is that legalization of Marijuana in other states may have implications that go outside of local. States need to make sure that they’re ready for this learning curve with education, knowledge and how it will impact communities.

Excessive synaptic pruning in the maturing brains of adolescents may help to explain the biological cause of schizophrenia.

According to a landmark study published in Nature, the study builds on population-level research that has shown that the strongest genetic associations for schizophrenia are variations in the major histocompatibility complex (MHC) locus.