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Research round-up
Insight
Research round-up Erlangsen and colleagues have assessed links between the suicide of a spouse and mental health in the bereaved partner. The authors analysed nationwide Danish registry-based data, including 3·5 million men, of whom 4814 had a spouse who had died by suicide; and 3·5 million women, of whom 10 793 had experienced bereavement due to spousal suicide. Compared with the general population, experiencing the loss of a spouse due to suicide was associated with greater risk of mental disorders during 5-year follow-up in surviving male partners (incidence rate ratio 1·8, 95% CI 1·6–2·0) and female partners (1·7, 1·6–1·8); the increased risk remained even when analysis was restricted to comparisons with individuals who had experienced the loss of a spouse due to other causes.
EASY-Extension trial follow-up
The effect of a 3-year early inter vention programme for first-episode psychosis has been evaluated in a single-blind clinical trial by Chang and colleagues. Having already taken part in a 2-year early intervention programme, participants with firstepisode psychosis were subsequently randomly allocated to an additional 1-year extension of the service (n=82) or to step-down care (n=78). 2 years after cessation of the intervention, researchers found that the primary outcome of measure of psychosocial functioning did not significantly differ between the extended intervention and step-down care groups, and neither did secondary measures, including service use outcomes, relapse rate, and treatment characteristics.
rtMRI-nf training for depression
In their double blind, placebocontrolled clinical trial, Young and colleagues have studied the role of increasing positive memory associated www.thelancet.com/psychiatry Vol 4 June 2017
haemodynamic response in the amygdala (a brain region involved in emotional processing) in people with depression. Participants were randomly allocated to real-time functional MRI neurofeedback (rtfMRI-nf) training from the amygdala (2 sessions, 1 week apart; n=19) or to a control treatment (rtfMRI-nf training from a cerebral region not associated with regulation of emotion; n=17). One week after the first rtMRI-nf session, researchers noted that depression symptom scores (Montgomery-Åsberg Depression Rating Scale) were significantly lower in the treatment group than in the control group (14·4 [SD 9·8] vs 22·6 [8·4]; p<0·05), with differences also apparent 5–7 days after the second session (11·9 [9·0] vs 21·9 [8·1]; p<0·05).
ADHD: functional brain connectivity and methylphenidate
In their study of 40 boys with attention deficit hyperactivity disorder (ADHD), Silberstein and colleagues provided some insight into the influence of initial brain changes from methyl phenidate and symptomatic responses. Researchers measured initial response to methylphenidate using steady state visually evoked potential event related partial coherence (to assess brain functional connectivity), with the assessment done while the participants were doing a continuous performance task. Participants were assessed before and 90 min after the administration of the first dose of medication. At 3-month assess ment, the authors noted that improvement in parentrated hyperactivity scores correlated with first-dose methylphenidateassociated decrease in functional connectivity in the frontal-prefrontal regions (R²=0·3484), and that improve ments in parent-rated inattention scores were associated with first-dose methylphenidate-associated decrease in functional connectivity in occipitoparietal regions (R²=0·3736).
Adjunctive yoga for depression
In their randomised clinical trial, Uebelacker and colleagues have assessed the effect of adjunctive hatha yoga in the treatment of symptomatic depression. Participants, who were receiving antidepressant medication, were randomly allocated to weekly yoga (n=63) or control (health education classes; n=59) for 10 weeks. At 10 weeks, the primary outcome of Quick Inventory of Depression Symptomatology (QIDS)—Clinician Rating did not significantly differ between the intervention and control groups (p=0·30). Of interest, from week 10 through to 3-month and 6-month follow-up, the authors noted that the odds of achieving a 50% or more reduction on QIDS was higher in the yoga treated group (adjusted odds ratio 2·46, 95% CI 1·12–5·37; p=0·03).
Bullying and suicidality in young people
In their cross-sectional questionnaire study of 11 110 young people attending school, Barzilay and colleagues have investigated associations between different types of bullying victimisation and suicidality. Of the three types of bullying victimisation measured, verbal was most prevalent (overall 36%; boys 38% vs girls 35%), followed by relational (33%; boys 26% vs girls 38%), and then physical (9%; boys 14% vs girls 6%). The odds of suicidal ideation was particularly pronounced with physical victimisation (odds ratio [OR] 1·39, 95% CI 1·06–1·96), and the odds of suicide attempts were particularly increased in people who had experienced relational bullying (1·26, 1·10–1·45). Further analysis indicated that decreased parental support in young people who were verbally victimised was associated with an increase in the odds of both suicidal ideation and suicide attempts.
Burger/Phanie/Science Photo Library
Spousal suicide: impact on the bereaved
For more on the impact of spousal suicide on the bereaved see JAMA Psychiatry 2017, published online March 22. http://dx.doi.org/10.1001/ jamapsychiatry.2017.0226 For more on the EASY-Extension trial follow-up see Br J Psychiatry 2017, published online April 6. http://dx.doi.org/10.1192/bjp. bp.117.198929 For more on real-time MRI neurofeedback training for depression see Am J Psychiatry 2017, published online April 14. http://dx.doi.org/10.1176/appi. ajp.2017.16060637 For more on functional brain connectivity and methylphenidate in ADHD see Biol Psychiatry 2017, published online April 5. http://dx.doi.org/10.1016/j. biopsych.2017.03.022 For more on adjunctive yoga for depression see Psychol Med 2017, published online April 6. http://dx.doi.org/10.1017/ S0033291717000575 For more on bullying and suicidality in young people see J Adolesc Health 2017, published online April 5. http://dx.doi.org/10.1016/j. jadohealth.2017.02.002
Seema Kang 443
Research round-up Erlangsen and colleagues have assessed links between the suicide of a spouse and mental health in the bereaved partner. The authors analysed nationwide Danish registry-based data, including 3·5 million men, of whom 4814 had a spouse who had died by suicide; and 3·5 million women, of whom 10 793 had experienced bereavement due to spousal suicide. Compared with the general population, experiencing the loss of a spouse due to suicide was associated with greater risk of mental disorders during 5-year follow-up in surviving male partners (incidence rate ratio 1·8, 95% CI 1·6–2·0) and female partners (1·7, 1·6–1·8); the increased risk remained even when analysis was restricted to comparisons with individuals who had experienced the loss of a spouse due to other causes.
EASY-Extension trial follow-up
The effect of a 3-year early inter vention programme for first-episode psychosis has been evaluated in a single-blind clinical trial by Chang and colleagues. Having already taken part in a 2-year early intervention programme, participants with firstepisode psychosis were subsequently randomly allocated to an additional 1-year extension of the service (n=82) or to step-down care (n=78). 2 years after cessation of the intervention, researchers found that the primary outcome of measure of psychosocial functioning did not significantly differ between the extended intervention and step-down care groups, and neither did secondary measures, including service use outcomes, relapse rate, and treatment characteristics.
rtMRI-nf training for depression
In their double blind, placebocontrolled clinical trial, Young and colleagues have studied the role of increasing positive memory associated www.thelancet.com/psychiatry Vol 4 June 2017
haemodynamic response in the amygdala (a brain region involved in emotional processing) in people with depression. Participants were randomly allocated to real-time functional MRI neurofeedback (rtfMRI-nf) training from the amygdala (2 sessions, 1 week apart; n=19) or to a control treatment (rtfMRI-nf training from a cerebral region not associated with regulation of emotion; n=17). One week after the first rtMRI-nf session, researchers noted that depression symptom scores (Montgomery-Åsberg Depression Rating Scale) were significantly lower in the treatment group than in the control group (14·4 [SD 9·8] vs 22·6 [8·4]; p<0·05), with differences also apparent 5–7 days after the second session (11·9 [9·0] vs 21·9 [8·1]; p<0·05).
ADHD: functional brain connectivity and methylphenidate
In their study of 40 boys with attention deficit hyperactivity disorder (ADHD), Silberstein and colleagues provided some insight into the influence of initial brain changes from methyl phenidate and symptomatic responses. Researchers measured initial response to methylphenidate using steady state visually evoked potential event related partial coherence (to assess brain functional connectivity), with the assessment done while the participants were doing a continuous performance task. Participants were assessed before and 90 min after the administration of the first dose of medication. At 3-month assess ment, the authors noted that improvement in parentrated hyperactivity scores correlated with first-dose methylphenidateassociated decrease in functional connectivity in the frontal-prefrontal regions (R²=0·3484), and that improve ments in parent-rated inattention scores were associated with first-dose methylphenidate-associated decrease in functional connectivity in occipitoparietal regions (R²=0·3736).
Adjunctive yoga for depression
In their randomised clinical trial, Uebelacker and colleagues have assessed the effect of adjunctive hatha yoga in the treatment of symptomatic depression. Participants, who were receiving antidepressant medication, were randomly allocated to weekly yoga (n=63) or control (health education classes; n=59) for 10 weeks. At 10 weeks, the primary outcome of Quick Inventory of Depression Symptomatology (QIDS)—Clinician Rating did not significantly differ between the intervention and control groups (p=0·30). Of interest, from week 10 through to 3-month and 6-month follow-up, the authors noted that the odds of achieving a 50% or more reduction on QIDS was higher in the yoga treated group (adjusted odds ratio 2·46, 95% CI 1·12–5·37; p=0·03).
Bullying and suicidality in young people
In their cross-sectional questionnaire study of 11 110 young people attending school, Barzilay and colleagues have investigated associations between different types of bullying victimisation and suicidality. Of the three types of bullying victimisation measured, verbal was most prevalent (overall 36%; boys 38% vs girls 35%), followed by relational (33%; boys 26% vs girls 38%), and then physical (9%; boys 14% vs girls 6%). The odds of suicidal ideation was particularly pronounced with physical victimisation (odds ratio [OR] 1·39, 95% CI 1·06–1·96), and the odds of suicide attempts were particularly increased in people who had experienced relational bullying (1·26, 1·10–1·45). Further analysis indicated that decreased parental support in young people who were verbally victimised was associated with an increase in the odds of both suicidal ideation and suicide attempts.
Burger/Phanie/Science Photo Library
Spousal suicide: impact on the bereaved
For more on the impact of spousal suicide on the bereaved see JAMA Psychiatry 2017, published online March 22. http://dx.doi.org/10.1001/ jamapsychiatry.2017.0226 For more on the EASY-Extension trial follow-up see Br J Psychiatry 2017, published online April 6. http://dx.doi.org/10.1192/bjp. bp.117.198929 For more on real-time MRI neurofeedback training for depression see Am J Psychiatry 2017, published online April 14. http://dx.doi.org/10.1176/appi. ajp.2017.16060637 For more on functional brain connectivity and methylphenidate in ADHD see Biol Psychiatry 2017, published online April 5. http://dx.doi.org/10.1016/j. biopsych.2017.03.022 For more on adjunctive yoga for depression see Psychol Med 2017, published online April 6. http://dx.doi.org/10.1017/ S0033291717000575 For more on bullying and suicidality in young people see J Adolesc Health 2017, published online April 5. http://dx.doi.org/10.1016/j. jadohealth.2017.02.002
Seema Kang 443