Minneapolis St. Paul Mental Health Blog

Impulsivity w/ BiPolar Disorder

Mental Health |  Impulsivity in Bipolar Disorder, Borderline Personality Disorder, ADHD

Mental Health Matters | increase in impulsivity in BP patients...

Investigators observed that impulsivity increased in patients with bipolar disorder who also experienced a traumatic childhood experience.

Impulsivity is significantly associated with attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) and is indicated in bipolar disorder (BD) with the presence of traumatic childhood experiences.

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Mental health and Overdose

Mental Health | Top 10 Drugs Involved in Drug Overdose Deaths

Mental Health Update | A recent report from the Centers for Disease Control and Prevention (CDC) identified the 10 drugs most frequently mentioned in overdose deaths.

Using data from the 2011 to 2016 National Vital Statistics System-Mortality files, the authors conducted a literal text analysis of death certificates to identify drugs mentioned as contributing to the cause of overdose death. They used this information to calculate which drugs were most frequently involved.

“Deaths involving more than 1 drug (eg, a death involving both heroin and cocaine) were counted in all relevant drug categories (eg, the same death was included in counts of heroin deaths and in counts of cocaine deaths),” the authors explained.

Results showed that between 2011 and 2016, the 10 drugs most frequently mentioned in relation to a drug overdose death were: fentanyl (ranked first in 2016), heroin (ranked first from 2012-2015), hydrocodone, methadone, morphine, oxycodone (ranked first in 2011), alprazolam, diazepam, cocaine (consistently ranked second or third), and methamphetamine.

During the study period, the age-adjusted rate of overdose deaths involving heroin and methamphetamine tripled, while the rate of overdose deaths involving methadone decreased (1.4 per 100,000 in 2011 to 1.1 in 2016). As for fentanyl and its analogs, between 2013 and 2016, the rate of overdose deaths doubled each year (0.6 per 100,000 in 2013 to 1.3 in 2014, 2.6 in 2015, and 5.9 in 2016).

Fentanyl, heroin, and cocaine were the most frequently mentioned drugs in overdose deaths that were considered unintentional, while oxycodone, diphenhydramine, hydrocodone, and alprazolam were more likely to be involved in cases of suicide. In addition, many of the overdose deaths were linked to use of multiple drugs.

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Cannabis smoking or vaping?

Mental Health | Smoke or Vape Cannabis? Higher levels of THC

Mental Health | Vaping or Smoking Cannabis, how it effects infrequent users.

In a small study of infrequent cannabis users, Johns Hopkins Medicine researchers have shown that, compared with smoking cannabis, vaping it increased the rate of short-term anxiety, paranoia, memory loss and distraction when doses were the same.

The findings of the new study, described in the Nov. 30 edition of JAMA Network Open, highlight the importance of dose considerations with the perception that vaping is a safer alternative to smoking cannabis, the researchers say. And they ask regulators of medical and recreational cannabis dispensaries to take note.

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Mental Health ADHD

Impulsivity and ADHD, Bipolar, or Borderline Personality disorder

Mental Health | Impulsivity in ADHD, Bipolar Disorder, or Borderline Personality Disorder

ADHD is defined by early onset (before age 12) of persistent (six months or longer) symptoms of inattention and/or hyperactivity and impulsivity that are not consistent with development, causing impairment of normal functioning in at least two settings (home, school). It is the most common psychiatric disorder in children, mostly in school-age boys.

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Autism Test

Mental Health | New Blood Test Identifies Metabolic Subtypes Linked to Autism Spectrum Disorder

Autism Test | The NPDX AA test is available on a limited basis through NeuroPointDx's early access program.

NeuroPointDX announced the availability of the NPDX AA test, the first objective blood test that identifies metabolic subtypes associated with autism spectrum disorder in children as young as 18 months old.

The NPDX AA test works by detecting amine imbalances in a child's fasting blood sample with very precise thresholds that were identified and validated based on samples from the Children's Autism Metabolome Project (CAMP) study (N=1100) in patients aged 18 to 48 months.

The metabolic imbalances, which were seen in ~30% of children with ASD, are not currently identified by other tests on the market. The test also provides metabolic information that may help clinicians determine optimal treatment strategies for patients with ASD.

Testing is recommended for children who have failed screening for developmental milestones indicating risk for ASD (eg, M-CHAT, ASQ-3, PEDS, STAT, etc.), who have a family history such as a sibling diagnosed with ASD, or for those who have been diagnosed with ASD and want additional metabolic information to provide insight into the condition and therapy.

Results are provided within 2 weeks; a positive test result should be further evaluated by a neurodevelopmental specialist.
“We are continuing to mine data from the CAMP study to identify and validate additional metabolic subtypes in children with ASD,” said Bob Burrier, Chief Operating Officer and Vice President of Research & Development at NeuroPointDX.

“Our aim is to further build on the utility of this test to identify a greater percentage of children with additional metabolic subtypes. The metabolic biomarkers we have identified will serve as targets for new therapies ranging from pharmaceuticals to dietary supplements, bringing precision medicine to the diagnosis and treatment of this neurodevelopmental disorder.” NeuroPointDx plans to launch a second test panel to market in 2019.

The NPDX AA test is available on a limited basis through the Company's early access program and must be ordered by a physician. The test is currently not covered by insurance.

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Depression during Pregnancy

Mental Health and Depression | Why Depression During Pregnancy May Be on the Rise

Mental Health and Depression | A look at the surprising reasons why more young mothers-to-be may be feeling down.

Depression during pregnancy can have lasting consequences for mothers and babies.

WHILE POSTPARTUM depression gets a fair amount of attention, depression during pregnancy is often overlooked. And it may be becoming more common among expectant mothers.

After comparing prenatal symptoms of depression among two generations of women, researchers in the U.K. found that depression during pregnancy is 51 percent more common among the current generation of mothers-to-be, ages 19 to 24, than during their mothers' generation 25 years ago, according to a study in the July 13, 2018, issue of JAMA Network Open.

Interestingly, the study also found that the current generation of moms-to-be has a higher risk of depression during pregnancy if their mothers experienced depression during their pregnancies.

These findings "mirror the more general increase in depression among young women" that’s been reported, the researchers note. But other factors may be contributing to the rise among expectant mothers, in particular. With the average age of motherhood now slightly older than in the 1990s – in 1994 the median age was 23, compared to 26 today, according to a 2018 report from the Pew Research Center – today's young mothers may feel socially isolated.

"Being isolated and feeling judged are risk factors for depression, so the fact that this age range of mums is even further from the average age of pregnant women may [mean they] have fewer peers of similar age ranges to seek support from," says study lead author Rebecca Pearson, a lecturer in psychiatric epidemiology at the Centre for Academic Mental Health at the University of Bristol in the U.K.

What's more, the proportion of young women who are working has increased, and today's moms-to-be may be dealing with inflexible work situations and challenges related to balancing work-home responsibilities, challenges that can contribute to depression.

When you add financial pressures, heightened stress in the modern world, hormonal changes and sleep disturbances to the picture, "the impact of such changes may be amplified when a woman becomes pregnant," the researchers note.

To compound the problem, it's increasingly recognized that depression during pregnancy can have lasting consequences for mothers and babies alike. For one thing, prenatal depression is associated with an increased risk of postpartum depression – and it can affect the baby's emotional and cognitive development.

In a study in a 2016 issue of Translational Psychiatry, researchers found, using functional magnetic resonance imaging and diffusion MRI, that babies whose mothers were depressed while they were in the womb had alterations in the connectivity or wiring between the amygdala and prefrontal cortex, or PFC, in their brains.

This is noteworthy because "the PFC is critical for many higher-order cognitive functions such as impulse control, decision-making and planning of behaviors," explains study co-author Dr. Jonathan Posner, an associate professor of psychiatry at the Columbia University Irving Medical Center in New York City.

In addition, high levels of prenatal stress in the mother, "which often accompanies depression, is associated with greater rates of ADHD in the offspring," Posner notes. Other research has shown that "prenatal depression is associated with lower scores on early developmental tests of cognition, such as those looking at language development," notes Catherine Monk, a professor of medical psychology in the departments of obstetrics and gynecology and psychiatry at the Columbia University Irving Medical Center.

Meanwhile, a study in the July 19, 2018, issue of Psychoneuroendocrinology found that women who were diagnosed with major depressive disorder during pregnancy had elevated inflammatory biomarkers and cortisol levels in their third trimester and an eight-day shorter length of gestation on average.

Moreover, babies born to depressed moms-to-be had hyperactive cortisol responses to stress when they were a year old.

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