#jamapsych

Dr. Zhongshang Yuan Yuan, Zhongshang PhD Department of Biostatistics School of Public Health Shandong University Jinan, Shandong, China What is the background for this study? Response: Comorbidities and genetic correlations between gastrointestinal tract diseases and psychiatric disorders have been widely reported, with the gut-brain axis (GBA) hypothesized as a potential biological basis. However, it is unclear the degree to which the shared genetic determinants contribute to these associations underlying GBA. What are the main findings? Response: This study focused on 4 gastrointestinal tract disease (inflammatory bowel disease, irritable bowel syndrome, peptic ulcer disease, and gastro-oesophageal reflux disease) and 6 psychiatric disorders (schizophrenia, bipolar disorder, major depressive disorder, attention deficit hyperactivity disorder, posttraumatic stress disorder, and anorexia nervosa), resulting in 24 trait pairs, to explore the underlying shared genetic determinants. We found extensive genetic correlations and genetic overlaps among 22 out of 24 trait pairs. A total of 2,910 significant potential pleiotropic SNPs were identified in 19 trait pairs, with 83 pleiotropic loci and 24 colocalized loci detected. A total of 158 unique candidate pleiotropic genes were identified, which were highly enriched in certain GBA-related phenotypes and tissues, pathway enrichment analysis further highlighted biological pathways primarily involving cell adhesion, synaptic structure and function, and immune cell differentiation. Several identified pleiotropic loci also shared causal variants with gut microbiomes. Mendelian randomization analysis further illustrated vertical pleiotropy across 8 pairwise traits. Notably, many pleiotropic loci were identified for multiple pairwise traits, such as 1q32.1 (INAVA), 19q13.33 (FUT2), 11q23.2 (NCAM1), and 1p32.3 (LRP8). What should readers take away from your report? Response: The cutting-edge genome-wide pleiotropic analysis pipeline under the conceptual framework of GBA is highlighted. The pleiotropic variants and loci, genes as well as pathways shared between gastrointestinal tract diseases and psychiatric disorders were reported. What recommendations do you have for future research as a result of this study? Response: The results are mainly obtained from the genome-wide pleiotropic association analysis, , further experimental study is warranted to validate these findings. Is there anything else you would like to add? Any disclosures? Response: I have no conflicts of interest or other disclosures to report. Citation: Gong W, Guo P, Li Y, et al. Role of the Gut-Brain Axis in the Shared Genetic Etiology Between Gastrointestinal Tract Diseases and Psychiatric Disorders: A Genome-Wide Pleiotropic Analysis. JAMA Psychiatry. Published online February 08, 2023. doi:10.1001/jamapsychiatry.2022.4974 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.     Read the full article

Dr. Harris MedicalResearch.com Interview with: Rebecca Arden Harris, MD, MSc Assistant Professor of Family Medicine and Community Health at the Hospital of the University of Pennsylvania Senior Fellow, Leonard Davis Institute of Health Economics Perelman School of Medicine, University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: The impact of the nationwide overdose epidemic on Black women has received little attention from policy-makers, researchers, or the press. MedicalResearch.com: What are the main findings? Response:  Over the 7-year study period, preventable overdose deaths among Black women resulted in nearly 0.75 million years of life lost (YLL). Women aged 25-34 have suffered a rising proportion of this burden. MedicalResearch.com: What should readers take away from your report? Response: Our findings document an unacceptably high and growing overdose mortality burden for Black women in the US, with overdoses now ranking as the fourth leading cause of death among Black women, exceeded only by cancer, heart disease, and COVID-19.  MedicalResearch.com: What recommendations do you have for future research as a results of this study? Response: This study underscores the urgent need for accessible, gender- and race-sensitive drug treatment and harm reduction programs for Black female individuals. No disclosures to report. Citation: Harris RA, Mandell DS. Years of Life Lost to Drug Overdose Among Black Female Individuals in the US, 2015-2021. JAMA Psychiatry. Published online December 14, 2022. doi:10.1001/jamapsychiatry.2022.4194 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.     Read the full article

Dr. Han Beth Han, M.D., Ph.D., M.P.H. Epidemiologist, Science Policy Branch of the National Institute on Drug Abuse (NIDA), National Institutes of Health MedicalResearch.com: What is the background for this study? Response: In the U.S., overdose deaths involving psychostimulants with abuse potential other than cocaine (i.e. largely methamphetamine), increased dramatically during the past decade. Psychostimulant-involved overdose deaths also often involved opioids (50% in 2017). However, it was still undetermined how trends in methamphetamine use among vulnerable populations and specific patterns of use may contribute to greater risk for overdose mortality. Moreover, understanding characteristics that are associated with methamphetamine use, frequent use, MUD, and injection is of value in guiding strategies to address the root causes for the recent surge in methamphetamine overdose deaths. MedicalResearch.com: What are the main findings? Response: Based on the 2015-2019 National Vital Statistics System’s Multiple Cause of Death Files and the 2015-2019 National Surveys on Drug Use and Health (NSDUH) data, among persons aged 18-64 during 2015-2019, overdose deaths involving methamphetamine increased 180% from 5,526 to 15,489; methamphetamine use increased 43% from 1.4 million to 2.0 million; frequent methamphetamine use increased 66% from 615,000 to 1,021,000, methamphetamine and cocaine use increased 60% from 402,000 to 645,000; Methamphetamine Use Disorder without injection increased 105% from 397,000 to 815,000. Prevalence of MUD or injection (MUD/injection) surpassed prevalence of methamphetamine use without MUD/injection in each year during 2017-2019. Adults with MUD/injection were 1.6-1.7 times more likely to use methamphetamine frequently. During 2015-2019, adjusted prevalence of Methamphetamine Use Disorder without injection more than tripled among heterosexual women and lesbian/bisexual women and more than doubled among heterosexual men and gay/bisexual men. It increased over 10-fold among non-Hispanic Blacks, nearly tripled among non-Hispanic whites, and more than doubled among Hispanics. Characteristics associated with methamphetamine use, frequent use, MUD, and injection included lower education, lower income, being uninsured, housing instability, criminal justice involvements, and having co-morbidities (e.g., HIV/AIDS, HBV/HCV, depression), suicidal ideation, and polysubstance use.  MedicalResearch.com: What should readers take away from your report? Response: There are four main takeaways that we would like to highlight from this study: (1). During 2015-2019, among adults aged 18-64, increases in methamphetamine-involved overdose mortality exceeded increases in methamphetamine use.   This study’s findings of increases in higher risk patterns of methamphetamine use (frequent use, MUD, and polysubstance use) may help explain the marked increases in related overdose deaths during the study period. (2). Populations at increased risk for MUD diversified rapidly during 2015-2019, particularly among those with socioeconomic risk factors and co-morbidities. Our results are consistent with increases in methamphetamine-related treatment admissions among non-Hispanic white, Black, American Indian or Alaska Native (AIAN) and Hispanic patients during 2007-2018, with the fastest increase among Black patients. (3). Our results highlighted key risk factors, including lower education, lower household income, being uninsured, housing instability, criminal justice involvements, and having co-morbidities (e.g., HIV/AIDS, hepatitis B or C, sexually transmitted infection, major depressive episode), suicidal ideation, and polysubstance use. Co-use of opioids (knowingly or unknowingly) is a particularly important factor, given the increasing overlap of synthetic opioids (i.e., fentanyl-related agents) with methamphetamine-involved overdose deaths. (4). Effective prevention and treatment interventions are needed to address methamphetamine use and Methamphetamine Use Disorder. Additionally, since fentanyl contaminated methamphetamine is also contributing to increase in methamphetamine overdose, prevention interventions that include access to drug checking services, such as fentanyl test strips, may be useful.  MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: A major challenge in addressing the high rates of methamphetamine-related morbidity and mortality is the lack of FDA-approved medications for Methamphetamine Use Disorder treatment, highlighting the urgency for further research and investments in MUD medication development. In addition, research on implementation of evidence-based prevention interventions and on public policies is needed to effectively respond to the surge in methamphetamine use and related harms. For example, expansion of community-based interventions to reduce injection drug use-related harms and overdoses such as comprehensive syringe services programs could help mitigate overdose risks and the additional spread of infectious diseases such as hepatitis B or C and HIV. MedicalResearch.com: Is there anything else you would like to add? Response: Given indicators of increasing methamphetamine use during the COVID-19 pandemic, prevalence of Methamphetamine Use Disorder and injection may have further accelerated during 2020-2021. It is also important to note that estimates of overdose deaths do not include most people who die from methamphetamine-related health problems (e.g., strokes, myocardial infarction, pulmonary hypertension, HIV/AIDS, hepatitis B or C). Methamphetamine-related mortality and harms are likely to be markedly underestimated when only considering overdose deaths. And finally, this study has several limitations. - The cross-sectional nature of NSDUH data precludes drawing causal relationships. - This study may underestimate prevalence of methamphetamine use, use frequency, MUD, and injection because the NSDUH sample does not include people experiencing homelessness not living in shelters and institutionalized populations (e.g., jail/prison populations) who often have more drug use than the general population and may be at increased risk of methamphetamine overdose deaths. - NSDUH is a self-report survey and is subject to recall and social-desirability bias. - Approximately 85-90% of death certificates involving psychostimulants other than cocaine mentioned methamphetamine. We may have underestimated mortality because some overdose death certificates did not report the specific drugs involved (e.g., 6% in 2019). Despite these limitations, this study found that consistent with increases in overdose mortality, higher risk patterns of methamphetamine use increased; and populations at increased MUD risk diversified rapidly, particularly among those with socioeconomic risk factors and co-morbidities. Combating the surges in methamphetamine use, Methamphetamine Use Disorder, and associated mortality warrants the implementation of evidence-based prevention and treatment interventions. Dr. Han has nothing to disclose. Citation: Han B, Compton WM, Jones CM, Einstein EB, Volkow ND. Methamphetamine Use, Methamphetamine Use Disorder, and Associated Overdose Deaths Among US Adults. JAMA Psychiatry. Published online September 22, 2021. doi:10.1001/jamapsychiatry.2021.2588   The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

Dr. Wen Hefei Wen, PhD Assistant Professor, Department of Health Management & Policy University of Kentucky College of Public Health  MedicalResearch.com: What is the background for this study? Response: Medicaid is the principal payer of behavioral health services in the U.S. and expected to play an increasing role in financing behavioral health services following Medicaid expansions under the ACA. MedicalResearch.com: What are the main findings? Response: We found that psychiatrists were less likely than other physicians to accept Medicaid patients throughout the study period of 2010~2015. Moreover, the likelihood of psychiatrists accepting Medicaid declined significantly from 48 percent during 2010~2011 to 35.4 percent during 2014~2015, equivalent to a 26 percent decline. This significant decline was considerably larger than the changes we observed in Medicaid acceptance among primary care physicians and non-psychiatry specialists. Furthermore, Medicaid expansion was not associated with a discernible change in Medicaid acceptance among psychiatrists.   MedicalResearch.com: What should readers take away from your report? Response: We found that psychiatrists were less likely than other physicians to accept Medicaid patients throughout the study period of 2010~2015. Moreover, the likelihood of psychiatrists accepting Medicaid declined significantly from 48 percent during 2010~2011 to 35.4 percent during 2014~2015, equivalent to a 26 percent decline. This significant decline was considerably larger than the changes we observed in Medicaid acceptance among primary care physicians and non-psychiatry specialists. Furthermore, Medicaid expansion was not associated with a discernible change in Medicaid acceptance among psychiatrists. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: Future research is needed to explore the reasons behind psychiatrists' low participation in Medicaid and identify interventions, such as team-based care coordination approaches, to increase Medicaid capacity to care for patients with behavioral health care needs. No disclosures Citation: Wen H, Wilk AS, Druss BG, Cummings JR. Medicaid Acceptance by Psychiatrists Before and After Medicaid Expansion. JAMA Psychiatry. Published online June 05, 2019. doi:10.1001/jamapsychiatry.2019.0958       The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

MedicalResearch.com Interview with: Dr. Wen Hefei Wen, PhD Assistant Professor, Department of Health Management & Policy University of Kentucky College of Public Health  MedicalResearch.com: What is the background for this study? Response: Medicaid is the principal payer of behavioral health services in the U.S. and expected to play an increasing role in financing behavioral health services following Medicaid expansions under the ACA. MedicalResearch.com: What are the main findings? Response: We found that psychiatrists were less likely than other physicians to accept Medicaid patients throughout the study period of 2010~2015. Moreover, the likelihood of psychiatrists accepting Medicaid declined significantly from 48 percent during 2010~2011 to 35.4 percent during 2014~2015, equivalent to a 26 percent decline. This significant decline was considerably larger than the changes we observed in Medicaid acceptance among primary care physicians and non-psychiatry specialists. Furthermore, Medicaid expansion was not associated with a discernible change in Medicaid acceptance among psychiatrists.   MedicalResearch.com: What should readers take away from your report? Response: We found that psychiatrists were less likely than other physicians to accept Medicaid patients throughout the study period of 2010~2015. Moreover, the likelihood of psychiatrists accepting Medicaid declined significantly from 48 percent during 2010~2011 to 35.4 percent during 2014~2015, equivalent to a 26 percent decline. This significant decline was considerably larger than the changes we observed in Medicaid acceptance among primary care physicians and non-psychiatry specialists. Furthermore, Medicaid expansion was not associated with a discernible change in Medicaid acceptance among psychiatrists. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: Future research is needed to explore the reasons behind psychiatrists' low participation in Medicaid and identify interventions, such as team-based care coordination approaches, to increase Medicaid capacity to care for patients with behavioral health care needs. No disclosures Citation: Wen H, Wilk AS, Druss BG, Cummings JR. Medicaid Acceptance by Psychiatrists Before and After Medicaid Expansion. JAMA Psychiatry. Published online June 05, 2019. doi:10.1001/jamapsychiatry.2019.0958       The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

Joanne B. Newbury, PhD ESRC Postdoctoral Fellow King’s College London Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology & Neuroscience London, United Kingdom MedicalResearch.com: What is the background for this study? Response: Urban living is one of the most well-established risk factors for adult psychotic disorders such as schizophrenia. However, less is known about the role of the urban environment in subclinical psychotic experiences in childhood and adolescence, such as hearing voices and extreme paranoia. These early psychotic experiences are a developmental risk factor for adult psychotic disorders and a range of other serious mental health problems such as depression and anxiety. It is therefore important that we understand what factors might contribute to the development of early psychotic experiences so that we might be able to intervene and prevent their onset and progression. In a cohort of over 2000 UK-born children (The Environmental Risk Longitudinal Twin Study), we have previously shown that subclinical psychotic experiences are also around twice as common among children and teenagers raised in urban versus rural settings. We have also shown that this appears to be partly explained by social features in urban neighbourhoods such as higher crime levels and lower levels of social cohesion. However, no studies have examined the potential link between air pollution and psychotic experiences. This is despite air pollution being a major health problem worldwide (particularly in cities), and despite emerging evidence linking air pollution to the brain.  MedicalResearch.com: What are the main findings? Response: We therefore linked high-resolution annualized estimates of four outdoor air pollutants (nitrogen dioxide , nitrogen oxides , particulate matter with a diameter of less than 2.5 micrometres , and particulate matter with a diameter of less than 10 micrometres ) to the addresses of E-Risk participants at age 17. We found that psychotic experiences were significantly more common among adolescents exposed to the highest quartile of NO2, NOx, and PM2.5 after controlling for a range of potential confounders including family socioeconomic status, family psychiatric history, maternal psychosis, adolescent tobacco smoking, cannabis and alcohol dependence, and neighbourhood factors such as deprivation, crime levels, and social cohesion and disorder. Put simply, teenagers who were exposed to the highest (top quartile) level of NO2, NOx, and PM2.5 had respectively, a 71%, 72%, and 45% greater odds for psychotic experiences compared to those with lower exposure. Furthermore, adolescents living in the most urban settings had a 94% greater odds for psychotic experiences compared to adolescents living in rural settings. We found that NO2 and NOx statistically explained around 60% of this association between urban living and adolescent psychotic experiences.  MedicalResearch.com: What should readers take away from your report? Response: The main thing to take from this report is that it is the first study to provide evidence linking air pollution to subclinical psychotic experiences. However, the findings need to be replicated in other studies before we can draw any conclusions or make recommendations about interventions. Readers should also interpret the findings with caution, as the study is observational (so we cannot know the causality of the findings), and it is also cross-sectional. In addition, we were not able to take into account other factors that are correlated with air pollution such as noise pollution.  MedicalResearch.com: What recommendations do you have for future research as a result of this work?  Response: We now need to replicate these findings in other studies, and use a longitudinal design to explore the potential link between early-life exposure to air pollution and psychotic experiences. We also need to explore the potential link between noise pollution and psychotic experiences, which could be associated since noise pollution disrupts sleep and is stressful. Lastly, we need to explore potential mechanisms which might link air pollution to psychotic experiences, such as inflammation.  MedicalResearch.com: Is there anything else you would like to add? Response: I have no disclosures. You can download and read the full article here:https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2729441 Citation: Newbury JB, Arseneault L, Beevers S, et al. Association of Air Pollution Exposure With Psychotic Experiences During Adolescence. JAMA Psychiatry. Published online March 27, 2019. doi:10.1001/jamapsychiatry.2019.0056  The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

Jeremy Fine Jeremy Fine B.A. in Philosophy, Neuroscience, and Psychology Washington University in St. Louis, Class of 201 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Alongside increasingly permissive marijuana use attitudes and laws, the prevalence of marijuana use among pregnant mothers has increased substantially (by 75% between 2002 and 2016), with some evidence that pregnant women may be using cannabis to combat pregnancy-related nausea. Our data came from the Adolescent Brain Cognitive Development (ABCD) Study, which included over 4,000 subjects with data on maternal marijuana use during pregnancy. Our main finding was that the children of mothers who used marijuana after learning they were pregnant had a small but significant increase in risk for psychosis in their future. MedicalResearch.com: What should readers take away from your report? Response: This is one of the first studies to report that marijuana use during pregnancy may negatively impact the psychiatric outcomes of offspring. Clinically, we recommend that mothers should not use marijuana if they know they are pregnant. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response:  I have two recommendations for future research. First, our finding should be replicated in larger and more robust samples. Second, research must be done to elucidate the mechanism of how this increase in psychosis may occur. The mothers in our sample who used marijuana after learning of their pregnancy found out that they were pregnant at around 7.7 weeks. This roughly correlates to when the Endocannabinoid Type 1 Receptor, upon which THC exerts its effect, is expressed in the fetal brain. Studies should be done to see if dysregulation of this pathway is what is generating our findings.  MedicalResearch.com: Is there anything else you would like to add?  Response:    There are a few important limitations in our study. The sample size of mothers who reported using marijuana after knowledge of pregnancy was small (n=63). Additionally, we were unable to control for marijuana related variables like strain, method of ingestion, quantity, and potency. Lastly, we did not have a psychosis proneness metric for the mothers, so we used family history of psychosis as a proxy for this variable.   Citation: Fine JD, Moreau AL, Karcher NR, et al. Association of Prenatal Cannabis Exposure With Psychosis Proneness Among Children in the Adolescent Brain Cognitive Development (ABCD) Study. JAMA Psychiatry. Published online March 27, 2019. doi:10.1001/jamapsychiatry.2019.0076    The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

From CDC:Long Bone Radiograph of Knees - "lead lines" in three-year old girl with BLL of 0.6 µg/dL. Notice the increased density on the metaphysis growth plate of the knee, especially in the femur (Photo courtesy of Dr. Celsa López, Clinical Epidemiologic Research Unit, IMSS, Torreón, México). Response: One thing we are hoping to evaluate more in the future is the extent to which lead stored in the bone (which has a half-life of many years to many decades) may re-circulate as individuals age (such as during menopause and osteoporosis) and may then lead to greater acute exposures. We know this can happen, but we do not know to what extent it can be large enough to contribute to new problems in life. If so, nutritional supplementation to prevent bone loss could, hypothetically, improve health outcomes. But that is still speculative.   Citation: Reuben A, Schaefer JD, Moffitt TE, et al. Association of Childhood Lead Exposure With Adult Personality Traits and Lifelong Mental Health. JAMA Psychiatry. Published online January 23, 2019. doi:10.1001/jamapsychiatry.2018.4192 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article