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Mobile Phone-Based Mental Health Interventions Show Positive – but Modest – Results

Mobile phone-based mental health interventions have gained popularity as a potential solution to the cost and access issues of traditional mental health care. A new study analyzed previous research on such interventions, including 145 studies involving 48,000 participants, to determine whether they benefit users as designed. Overall, the study found modest positive results for certain conditions – such as anxiety and depression – but little evidence that mobile-phone based interventions are as effective or more effective than traditional care. More rigorous studies, including a full exploration of potential negative outcomes, are necessary to understand the impact of these interventions. To learn more, see the study in PLOS Digital Health.

Mental Health Impacts Persist Five Years After Start of Flint, Michigan Water Crisis

To understand how environmental disasters impact mental health outcomes, researchers surveyed nearly 2,000 residents from Flint, Michigan five years after the onset of the water crisis. Approximately one quarter of respondents met diagnostic criteria for depression (22%) and posttraumatic stress disorder (24%) within the past year. Despite the community’s growing need for psychological care, just over one third of Flint residents (35%) were offered mental health services. Individuals with prior exposure to traumatic events were also more likely to report higher rates indicating the cumulative effects of trauma. The findings emphasize the need to advocate for psychiatric support for victims of environmental disasters. To learn more, see the study in JAMA Network Open.
 

Long-Acting Injectable Antipsychotics Associated with Improved Outcomes Compared to Oral Antipsychotics in Treatment of Schizophrenia

New research from Hong Kong examines the effectiveness of schizophrenia treatment approaches by comparing the clinical impacts of long-acting injectable antipsychotics (LAIAs) versus oral antipsychotics. In an analysis of more than 70,000 Chinese individuals with schizophrenia, researchers found that LAIAs were associated with 48% fewer hospitalizations for psychiatric disorders, 47% fewer hospitalizations for schizophrenia, 44% fewer suicide attempts, and 37% fewer hospitalizations overall. Further analysis also showed that individuals who began treatment with LAIAs sooner in the course of illness experienced improved outcomes compared to those who began treatment with LAIAs later on. While further research is needed, LAIAs continue to show promise as an effective treatment approach for schizophrenia. To learn more, see the study in JAMA Psychiatry.

Higher Levels of Oxidative Stress Damage Found in Individuals with Psychiatric Disorders

A systematic review and meta-analysis of 82 studies involving more than 20,000 people provides further insights into the interaction between psychiatric disorders and physical health at the molecular level. Compared to control individuals, those with psychiatric disorders had higher rates of biomarkers associated with DNA and RNA damage due to oxidative stress. These findings suggest that damage from oxidative stress may adversely influence the physical health of individuals with psychiatric disorders and contribute to disease co-morbidities and aging. To learn more, see the study in JAMA Psychiatry.

Genetic Testing Shows Promise for Medication Selection for MDD

Antidepressants are often one of the first treatment approaches for individuals with depressive disorders, but many struggle with side effects and finding the appropriate medication or dosage. Recent findings from a randomized controlled trial indicate that pharmacogenomic testing could be helpful in medication selection for patients with major depressive disorder (MDD). Participants who were prescribed medication and dosage based on their genetic testing results were less likely to present drug-gene interactions and more likely to experience remission over 24 weeks. However, the researchers note that the participants' improvements are not significant compared to the control group at the the 24-week mark. Pharmacogenic testing is an evolving field, and more research is needed to fully understand its efficacy for individuals with mental health conditions. To learn more, see the study in JAMA.

Early Intervention for Psychosis Associated with Reduced Health Costs Over Time

Early intervention has been shown to improve outcomes for individuals with psychosis, and new research suggests the strategy has economic advantages as well. Researchers found that early intervention treatment after an initial psychotic episode reduced health care costs by more than $50,000 per quality-adjusted life year, and individuals experienced fewer hospitalizations and more years of employment. Investing in timely, targeted mental health care is not only critical to individual well-being, but economically worthwhile for individuals and the health care system overall. To learn more, see the study in Psychiatric Services.

COVID-19 Diagnosis Associated with Onset of Mental Health Conditions in Youth

To understand how COVID-19 affects youth mental health outcomes, researchers analyzed over 3 million records of children with no prior history of mental illness who had received either a positive diagnosis or negative test of COVID-19. Overall, 7.1 % of children with a positive COVID-19 diagnosis experienced onset of a mental illness – twice the rate of those without a COVID-19 diagnosis. The findings further detail the mental health implications of the COVID-19 pandemic and emphasize the need for appropriate supports in response. To learn more, see the study in Psychiatric Services.

Combination Therapy May Be Effective First Line Treatment of Obsessive-Compulsive Disorder in Some Populations, but Potential for Optimization Remains

For individuals with obsessive-compulsive disorder (OCD), psychotherapies such as cognitive behavioral therapy (CBT) are often the first approaches to treatment. Medication or a combination of psychotherapy and medication may be introduced if significant improvement does not occur. In a recent review of treatment guidelines and prior research, the authors note that combination therapy may also be used as a first line treatment, primarily when symptoms are severe. Evidence suggests this protocol may be appropriate due to the potential effectiveness of combination therapy over monotherapy. However, more research is needed to determine which therapeutic approach is appropriate at various points in a person’s treatment. The authors indicate that early diagnosis may be a key factor in treatment success and outcomes. To learn more, see the study in Comprehensive Psychiatry. 

Combination Ketamine-Behavioral Therapy Shows Heightened, Prolonged Antidepressant Effects

Ketamine has been found to be highly effective for treatment-resistant depression, but its fast-acting effects typically do not last more than one to two weeks. A randomized clinical trial of 154 adults with moderate to severe depression measured how a behavioral therapy known as “active automated self-association training” (ASAT) influenced the antidepressant effects of intravenous ketamine infusion. After 30 days, adults who received a ketamine infusion with ASAT reported the lowest depression scores compared to either adults who received ketamine with placebo ASAT or sham ketamine with ASAT. The findings suggest that the antidepressant effects of ketamine may be strengthened and lengthened in combination with behavioral therapy. To learn more, see the study in the American Journal of Psychiatry.
 

CDC Releases National Survey on High School Student Mental Health

This month, the CDC released results from the 2021 Adolescent Behaviors and Experiences Survey (ABES), the first national survey analyzing the wellbeing of high school students during the COVID-19 pandemic. The report shows how high school students’ mental health has worsened with 37.1% reporting poor mental health during the pandemic. A sense of school connectedness to peers and adults – even virtually – was identified as a protective factor against poor mental health, feelings of hopelessness, suicidal ideation, and suicide attempts. The report highlights the pivotal role schools can play in supporting youth mental health outcomes and calls for increased support. To learn more, see the reports from the 2021 Adolescent Behaviors and Experiences Survey.  

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