Wednesday, March 15, 2017

More Cutting Edge (but With an Amazingly Dull Knife) Research

As I did on my posts of November 30, 2011,  October 2, 2012,September 17, 2013June 3, 2014, February 24, 2015, December 15, 2015, and September 13, 2016, it’s time once again to look over the highlights of the latest issue of one of my two favorite psychiatry journals, Duh! and No Sh*t, Sherlock. We'll take a look at the unsurprising findings published in the latest issue of the former. My comments are in bronze.

As I pointed out in those earlier posts, research dollars are very limited and therefore precious. Why waste good money trying to study new, cutting edge or controversial ideas that might turn out to be wrong, when we can study things that that are already known to be true but have yet to be "proven"? Such an approach increases the success rate of studies almost astronomically. And studies with positive results are far more likely to be published than those that come up negative.

Clinical Psychiatric News article, June, 2016Data from a longitudinal study reported at the World Congress on Osteoarthritis show that weight gain in young women is an independent predictor of future low back pain. Well, maybe their backs would do better if they carried around a sack of bricks slung over their shoulders 24 hours a day.

7/21/16. Apparently these researchers don't watch the evening news. Addiction To Prescription Opioids May Be Tied To Creation Of Market For Cheaper, Potent Heroin, Analysis Suggests. The Washington Post (7/20, Humphreys) “Wonkblog” reports that the relationship between restricting access to prescription opioids and increasing heroin use is more complicated than some critics of the Comprehensive Addiction and Recovery Act believe, according to a systemic analysis of the matter that was published in the New England Journal of Medicine. The analysis was led by the National Institute on Drug Abuse’s Wilson Compton who says that restricting access to prescription opioids does not automatically increase heroin use, but that having many people addicted to prescription opioids may be tied to the creation of a market for cheap, potent heroin that appeals to people addicted to prescription opioids, which may explain the increase in heroin use in recent years.

7/21/16.  And these researchers apparently don't get out much. Alcohol Intoxication Increases Aggression While Cannabis Use Reduces Such Feelings, Study Finds. The Washington Post (7/20) reports research published in the journal Psychopharmacology suggest “alcohol intoxication increased subjective aggression” while those who smoke marijuana “became less aggressive when they were high.” Researchers concluded that the “results in the present study support the hypothesis that acute alcohol intoxication increases feelings of aggression and that acute cannabis intoxication reduces feelings of aggression.” The findings are in line with other research.

7/25/16. People exposed to addictive substances found to have higher chance of getting addicted to them. Greater Pain Found to Increase Risk of Opioid Use Disorder. Researchers have long suspected that the level of pain experienced by a patient may increase his or her risk of developing an opioid use disorder. A study in AJP in Advance has for the first time taken a prospective look at this link, revealing a significant association between pain and prescription opioid use disorder at baseline and three years later. The researchers found that people with moderate or severe pain had a 41 percent higher risk of developing prescription opioid use disorders than those without, independent of demographics or other potential contributing factors. Males, younger adults (of either gender), and those with a family history of antisocial personality disorder were also found to be more likely to develop opioid use disorder.
8/2/16. Being sedentary bad for the heart? Who knew? Watching TV longer increases risk of fatal blood clot, study finds. The New York Times (8/1, Bakalar) reports a new study published in the journal Circulation by Japanese researchers analyzing “86,024 generally healthy people who filled out questionnaires with items about health and lifestyle, including time spent watching television,” found that more time watching television increases the risk for a fatal blood clot. Researchers estimated that, after adjusting for other factors, “watching for two and a half to five hours increased the risk for a fatal clot by 70 percent, and watching more than five hours increased the risk by 250 percent,” compared to watching for less than two and half hours each day.


8/2/16. Less serious disorders found to have better prognosis. Predictors of outcomes in outpatients with anorexia nervosa: Results from the ANTOP study. Psychiatry Research, 08/01/2016  Clinical Article. Wild B, et al. – Researchers explored the factors that may predict outcomes in outpatients with anorexia nervosa (AN). They concluded that better outcome was achieved in those who had a higher baseline BMI [Body Mass Index] and shorter illness duration.

8/24/16.  Traumatic brain injuries seen in many domestic assault survivors. The AP (8/23, Tanner) reports that, according to the Centers for Disease Control and Prevention, “about one-quarter of U.S. women and 14 percent of men have experienced severe physical assaults by a partner in their lifetime, including hitting, punching, being slammed against something hard or pushed down stairs.” Meanwhile, according to a research review published this year in the journal Family & Community Health, “head and neck injuries are among the most common, and data suggest that domestic assaults may cause traumatic brain injuries in at least 60 percent of survivors.” Being assaulted can lead to head trauma! OH NO!

9/6/16. Taking care of someone who can't tell you what's wrong should be a breeze! Relatives Who Care For Patients With Dementia Often Experience Frustration Due To Poor Communication, Study Suggests. The Washington Post (9/4, Bluth) reported relatives who care for patients with advanced dementia often experience difficulty because they can no longer communicate with their loved ones, according to a study published in the American Journal of Alzheimer’s Disease & Other Dementias. Researchers found that many family caretakers were often frustrated with their relatives with dementia because they could no longer communicate what they needed or when they were in pain.

9/16/16. But what about all those codgers I see running out on the streets? Many older US adults are physically inactive, CDC study finds. The CBS News (9/15, Welch) website reports, “More than a quarter of Americans age 50 and older do not move beyond basic everyday activities,” research indicates. TIME (9/15, Oaklander) reports that according to an “analysis of 2014 surveillance data, 28% of Americans ages 50 and over are inactive – meaning that 31 million adults are moving no more than necessary to perform the most basic functions of daily life.” HealthDay (9/15, Dotinga) reports that such inactivity increases the risk for “heart disease, diabetes, and cancer,” researchers from the CDC’s Physical Activity and Health Branch found. What’s more, “the older Americans get, the less exercise they get,” investigators found. “Thirty-five percent of people aged 75 and older were inactive, as were 27 percent of those between 65 and 74, and 25 percent of those aged 50 to 64,” the study revealed. 

12/13/16. Risk For Opioid Relapse May Be Lower After Voluntary Treatment Than After Compulsory Treatment, Small Study Indicates. Healio (12/12, Oldt) reports patients “with opioid dependence who were treated in compulsory drug detention centers were significantly more likely to relapse after release than those treated with methadone in voluntary drug treatment centers,” researchers found after conducting “a parallel, two-arm, prospective observational study of individuals with opioid dependence treated in Malaysia.” The findings of the study, which included 184 participants, were published online Dec. 7 in The Lancet Global Health. The author of an accompanying editorial observed that the study findings “provide solid evidence in support of an urgent need to expand availability of, and access to, evidence-based voluntary drug-dependence treatment approaches to all individuals affected by drug dependence.” Because motivation for treatment is irrelevant to its success.

12/12/16. Pain is associated with poorer grades, reduced emotional well-being, and attention problems in adolescents The Clinical Journal of Pain, 12/12/2016  Clinical Article  - Voerman JS, et al. – Findings imply that the association between pain and Dutch adolescents grades is intervened by reduced emotional well–being and attention problems. The association between pain and math grades is mediated by emotional problems. The outcomes recommend that an intervention targeted at the pain in adolescents could have a positive effect on their emotional well–being, attention, and school performance. What a shock! Being in pain has effects on your emotional and cognitive functioning.

2/21/16. Impact of somatic severity on long-term mortality in anorexia nervosa 
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 12/21/2016  Clinical Article, Stheneur C, et al. – The present study sought to survey whether time in somatic intensive care unit, justified by a patient’s somatic condition in the course of hospital care, has any association with patient outcome in terms of mortality in the long term. The findings suggest that the clinical seriousness of the somatic condition during hospitalisation for AN is a risk factor for excess mortality in the medium term. In the present study, 195 patients were hospitalised for AN between April 1996 and May 2002, 97 were re-assessed 9 years later on average. Researchers observed that out of 195 patients hospitalised for AN between April 1996 and May 2002, 29 had required transfer to intensive care. Findings revealed that mortality at 9 years was 20 times higher in the group having been transferred to intensive care, irrespective of the duration of follow-up.  You mean, the sickest patients had the worst prognosis? How can that be?

Impaired Social Functioning Appears To Be Most Common In Schizophrenia, Study Indicates.

Healio (1/4, Oldt) reports that among people “with schizophrenia spectrum disorders, major depressive disorder with psychosis and bipolar disorder with psychosis, impaired social functioning was most common in schizophrenia,” researchers found in a study including “individuals with schizophrenia spectrum disorders (n = 269), major depressive disorder with psychosis (n = 77), bipolar disorder with psychosis (n = 139), and a comparison group without psychotic disorders.” Participants were followed for 20 years. The findings were published online Dec. 16 in the American Journal of Psychiatry, a publication of the American Psychiatric Association. Have these people ever even been to a psychiatric ward?

1/11/17. And here we thought booze was a cure all: Using Alcohol To Deal With Unpleasant Memories May Worsen Certain Mental Health Conditions, Mouse Study Indicates. The New York Daily News (1/10, Jagannathan) reports that instead of easing the pain of “distressing memories,” alcohol may “actually make it more difficult to cope with distressing memories,” researchers found.  Medical Daily (1/10, Dovey) reports that using alcohol as a coping mechanism “to deal with unpleasant memories...doesn’t work, and may actually worsen certain mental health conditions, such as” post-traumatic stress disorder (PTSD), researchers found. Working with mice, investigators found that “alcohol consumption did not help to ease fearful emotional memories, and may have strengthened them.”

1/23/17. Because no one ever drinks to forget. Spousal Loss Found to Increase Risk of Alcohol Use Disorder.  Spousal loss due to divorce or death appears to be associated with an enduring risk of alcohol use disorder (AUD), but remarriage may help to reduce this risk, according to a study published today in AJP in Advance. “The pronounced elevation in AUD risk following divorce or widowhood, and the protective effect of both first marriage and remarriage against subsequent AUD, speaks to the profound impact of marriage on problematic alcohol use and the importance of clinical surveillance for AUD among divorced or widowed individuals,” lead author Kenneth Kendler, M.D., of Virginia Commonwealth University and colleagues wrote.  And on a related note: Getting A Divorce May Increase The Risk Of Developing An Alcohol Use Disorder For Both Genders, Study Indicates. Medscape (1/26, Anderson) reports, “Getting a divorce increases the risk of developing an alcohol use disorder (AUD) by more than sevenfold for women and almost sixfold for men,” researchers found after identifying and then following “942,366 individuals born in Sweden between 1960 and 1990 who were married and residing with their spouse in or after 1990 and who had no AUD prior to marriage.” The findings were published online Jan. 20 in the American Journal of Psychiatry, a publication of the American Psychiatric Association.

1/24/17. Stress and anxiety were always thought to be totally unrelated. Stress Of Managing Breast Cancer Care May Provoke Symptoms Of Anxiety In Partners, Caregivers, Study Suggests. HealthDay (1/23, Thompson) reports that research suggests “the stress of managing breast cancer care provokes symptoms of anxiety in more than 42 percent of partners and caregivers.” Investigators found that “this stress-induced anxiety can last years after their loved one’s illness.” Investigators came to these conclusions after surveying “289 partners of patients diagnosed with breast cancer at age 40 or younger.” The findings are scheduled to be presented at a meeting of the American Society for Clinical Oncology. 

A Lancet study reports that deprivation and neglect in early childhood can have a lasting psychological effect into adulthood. Using findings from a study that assessed children adopted from Romanian institutions into families in the United Kingdom, The Lancet reports that deprivation and neglect in early childhood can have a lasting psychological effect into adulthood.