Research round-up

Research round-up

Insight Research round-up Schizophrenia and IQ Results of a study showed that depression care for elderly patients at home by health-care nurses mig...

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Research round-up Schizophrenia and IQ

Results of a study showed that depression care for elderly patients at home by health-care nurses might be beneficial to a subset of elderly patients with moderate to severe depression. Home-health agencies were randomised to deliver enhanced usual care (nine agencies) or intervention (12 agencies) to 306 Medicare Home Health recipients (mean age 76·5 [SD 8·0] years) who tested positive for depression on screening. The intervention comprised an integrated depressionmanagement protocol delivered by trained nurses for 12 months. Only in patients with moderate to severe depression (ie, a baseline score of 10 or more on the Hamilton rating scale for depression), was the change in score from baseline to 12 months greater in the intervention group than in the enhanced usual care group (5·6 vs 3·1, p=0·02).

The link between IQ and schizophrenia has been investigated by researchers. With information from Swedish national registries, Kendler and colleagues assessed IQ in 1 204 983 Swedish men aged 18–20 years (born between 1951 and 1975) and followed them up for schizophrenia diagnosis until 2010. 0·49% (5948/1 204 983) of the participants developed schizophrenia during follow-up. For every one point decrease in IQ, there was an associated 3·8% increase in risk of schizophrenia. Data from a delayed follow-up period showed that the association was not a result of IQ being detrimentally affected by prodromal disease. ”Co-relative control analyses show that the IQ-schizophrenia association does not result from shared genetic or familial-environmental risk factors and may be causal,“ noted the authors.

Mental health in youth after detention Results from a new study emphasise the psychiatric vulnerability of young people who have been incarcerated. In a longitudinal study of 1829 young people from a detention centre in Chicago, IL, the prevalence of psychiatric disorders 5 years after detention was assessed. At baseline (mean age 14·9 years), 40% (457/1145) of male participants and 47% (301/639) of female participants had two or more psychiatric disorders. At the 5 year follow-up (mean age 20·2 years), the prevalence decreased to 27% (240/896) and 14% (69/503) for male and female participants, respectively. Even though the prevalence of comorbid psychiatric disorders in young people who had been incarcerated decreased over time, the rates of comorbid psychiatric disorders were higher than that found in the wider general population from other studies. Vol 2 January 2015

Genetics of verbal declarative memory Researchers for the CHARGE Consortium did a genome-wide association study to characterise the influence of genetics on verbal declarative memory, a predictor of Alzheimer’s disease. The discovery set of the study included data for 29 076 indi viduals (mean age 63·6 years), who had neither dementia nor a history of stroke and were tested for paragraph or word-list delayed recall. The replication cohort comprised 15 559 individuals (young and old adults). In both discovery and replication sets, analysis suggested that the SNP rs4420638 (located near APOEε4) was associated with weak delayed recall (p=5·57 × 10-10 and p=5·65 × 10-8, respectively). Two additional SNPs, rs11074779 (located near HS3ST4) and rs6813517 (located near SPOCK3), were significantly associated with delayed recall when data for subpopulations from both cohorts were combined.

Mindfulness therapy in primary care Results from a randomised trial in Sweden cast the spotlight on the potential use of mindfulness therapy in primary care. In an 8 week trial, 215 patients with depressive, panic, anxiety, stress, or adjustment disorders were randomised to treatment with mind fulness-based group therapy (2 hours per week) or usual care (psychotherapy or counselling). Intervention was delivered primarily by trained psychologists and social counsellors in the general practice setting, and pharmacotherapy was used as appropriate. Median scores on three self-rated scales for depression and anxiety significantly decreased from baseline to follow-up in both the intervention and control groups (p<0·001 for all comparisons). Overall, the effect of the mindfulness therapy on the self-rated scales did not significantly differ from that of usual care.

Comorbidity in anxiety disorders In a retrospective case-control study spanning 12·5 years of admissions to hospitals in Manchester, UK, comorbidities and in-hospital mortality in people with anxiety disorders were examined. Comorbidities in 11 481 patients with anxiety disorders admitted to hospital were compared with those of 114 810 matched controls. 1329 (11·6%) patients with anxiety disorders and 15 276 (13·3%) controls died in hospital during the study period. Patients with anxiety disorders had a higher burden of comorbid disorders than controls. Cases had higher rates of angina (7·2% vs 5·8%, p≤0·001) and atrial fibrillation (4·5% vs 4·0%, p≤0·01) than controls, and the effect of these conditions on in-hospital death was greater in patients with anxiety disorder than controls.

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Depression CAREPATH trial

For more on the Depression CAREPATH trial see JAMA Intern Med 2014; published online Nov 10. http://dx.doi. org/10.1001/jamaintern med.2014.5835 For more on mental health in youth after detention see JAMA Psychiatry 2014; published online Nov 2. http://dx.doi. org/10.1001/jamapsychiatry.20 14.1375 For more on schizophrenia and IQ see Am J Psychiatry 2014; published online Nov 7. DOI:10.1176/appi. ajp.2014.14040516 For more on genetics of verbal declarative memory see Biol Psychiatry 2014; published online Nov 25; http://dx.doi. org/10.1016/j.biopsych.2014. 08.027 For more on mindfulness therapy in primary care see Br J Psychiatry 2014; published online Nov 27. http://dx.doi. org/10.1192/bjp.bp.114.150243 For more on comorbidity in anxiety disorders see Eur Arch Psychiatry Clin Neurosci 2014; published online Dec 4. s00406-014-0566-9

Seema Kang 17