Research

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.  

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.  

A study of nearly 55,000 participants found that individuals with psychological distress markers before a COVID-19 diagnosis were nearly 1.5 times more likely to show symptoms of post-COVID-19 conditions (commonly referred to as long COVID). Depression, anxiety, worry about contracting COVID-19, loneliness and stress were associated with complications post-COVID-19 infection and impairment in daily living, even after adjusting for health-related factors. Individuals with two or more types of psychological distress were the most likely to present post-COVID-19 conditions. Future research should explore whether interventions to reduce psychological distress can help prevent or mitigate physical health conditions, such as long COVID. To learn more, see the study in JAMA Psychiatry.  

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.

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.

Research has shown that treatment of early psychosis improves clinical outcomes. In 2018, the Early Psychosis Intervention Network (EPINET) was established with the aim of conducting practice-oriented research to develop high quality care for treatment of first-episode psychosis (FEP). Currently, eight regional networks function through a learning health care (LHC) framework with diverse stakeholders, a research hub, and coordinated specialty care (CSC) programs. A national repository has also been created for collaboration in developing evidence-based practices, standardizing data collection, and producing assessments to inform policy. Researchers express interest in expanding access to LHC resources to non-EPINET CSC programs and working with international partners. To learn more, see the article in Psychiatric Services. 

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.

Firearms are responsible for the majority of suicide deaths in the U.S. In an effort to identify handgun purchasers at risk of suicide, researchers retroactively tested the reliability of a machine learning algorithm on a database of handgun purchases in the state of California from 1996-2015. Purchasing a revolver-style handgun, female gender, white race/ethnicity, and no previous firearm transaction were associated with firearm suicide within one year of purchase. Overall, the most important variables for accurately predicting firearm suicide within one year were handgun type, race/ethnicity, purchaser age, and month of purchase. These findings shed light on alternative methods of suicide prevention and may have implications for advocates and policymakers. To learn more, see the study in JAMA.