Research News

Research suggests that experiencing substance-induced psychosis increases the risk of developing a schizophrenia spectrum disorder (SSD), but less is known about substance use without psychosis. In a study including 10 million people, Canadian researchers found that individuals with an emergency department visit for substance-induced psychosis were 163 times more likely than the general population to develop a SSD within three years. However, visits for substance use without psychosis occurred more often and were associated with a higher absolute number of transitions to SSD. The findings emphasize the importance of early intervention for substance use concerns – with or without psychosis – to decrease risk of schizophrenia and related conditions. To learn more, see the study in JAMA.

A randomized clinical trial of 178 veterans with posttraumatic stress disorder (PTSD) found that written exposure therapy (WET) had similar effects in reducing symptoms as the traditionally used prolonged exposure therapy (PE). Veterans received either five to seven sessions of WET or eight to fifteen sessions of the lengthier PE treatment, and were assessed at baseline, 10, 20, and 30 weeks after the initial treatment session. Improvements in symptom severity from baseline to all later assessments were similar among Veterans receiving WET and PE, with the largest difference favoring WET at 10 weeks. Furthermore, veterans receiving WET were less likely to stop treatment, suggesting it may reduce barriers to engagement associated with other interventions. To learn more, read the article in JAMA.

The U.S. Federal Drug Administration (FDA) has approved the first oral medication, Zurzuvae , for the treatment of postpartum depression (PPD). Onset of PPD can occur during the late stages of pregnancy or after childbirth. Previously, PDD medication was only available via IV injection from a health care provider. The effectiveness of Zurzuvae was tested against placebos in two distinct, randomized, double-blind studies for a period of 14 days. In both studies, patients taking Zurzuvae showed a more significant decrease in depressive symptoms at study conclusion, and four weeks after, compared to placebo groups. The approval goes a long way in improving accessibility of PPD treatment for the many individuals the condition affects each year. To learn more, read the news release from the FDA.

Patients with bipolar disorder experience cyclic episodes of mania and depression which makes symptom management challenging. Common treatment practices include antidepressants and mood stabilizers or antipsychotics. An international clinical trial study of 177 patients with Bipolar I in remission from a depressive episode were randomly assigned to continue antidepressant use for 52 weeks or taper antidepressant use after six weeks and begin taking a placebo at eight weeks. Patients continuing antidepressant use were significantly less likely to experience a depressive episode (17%) compared to those taking a placebo (40%). However, 12% experienced a manic episode compared to 6% in the placebo group. Further research is needed to better understand the maintenance of manic and depressive episodes in patients with bipolar disorder. To learn more, read the article in the New England Journal of Medicine.

In April 2023, the American Psychological Association (APA) surveyed 2,500 American adults about mental health in the workplace. About 1 in 5 workers (19%) rated their workplace as being very or somewhat toxic. These workers were more than twice as likely to have fair or poor mental health (58%) than those who rated their workplace as healthy (21%). And while a majority of respondents are satisfied with the mental health support they receive from their employer, there are significant areas for improvement. Fewer than half of respondents (43%) reported that their employer provides health insurance with coverage for mental health and substance use disorders. To learn more, see the findings from the American Psychological Association. 

Childhood stress and adverse childhood experiences (ACEs) negatively impact the brain development of children as shown in decreased hippocampal volume. However, positive parenting strategies, such as expressions of warmth and support, may help protect against developmental deficits. Researchers compared  brain structures and behavioral health of children aged 10-17, as well as youth- and caregiver-reported positive parenting. Children who reported high levels of childhood stress and positive parenting did not show increased behavioral health concerns or decreased hippocampus volumes, as opposed to children who experienced high levels of childhood stress but not high levels of positive parenting. Notably, caregiver-reported positive parenting did not predict either behavioral concerns or hippocampal volume. The findings suggest that positive parenting can be a protective factor against adverse childhood experiences, and demonstrate the importance of including youth perspectives directly in research. To learn more, read the study in PNAS Nexus.  

The most recent update of results from SAMHSA’s 2021-2022 National Surveys on Drug Use and Health (NSDUH) highlights mental health disparities faced by sexual minority adults, particularly bisexual females. More than half of all bisexual females had any mental illness (AMI) in the past year (53.9%), compared to 38.7% of lesbian and 25.4% of straight females. 43.3% of bisexual males experienced AMI in the past year, compared to 37.5% of gay and 18.1% of straight males. About 1 in 5 (19.5%) bisexual females and 14.4% of bisexual males experienced serious mental illness in the past year. Future surveys will ask respondents about their sex assigned at birth, gender identity, and sexual identity regardless of age in hopes of better capturing the experiences of LGBTQI+ individuals. To learn more, view the report from SAMHSA.    

Compared to the general population, people diagnosed with serious mental illness (SMI) face a shorter life expectancy by approximately 10 to 25 years. In May, a virtual roundtable convened 40 individuals – many with firsthand or caregiving lived experience – to address this disparity. Participants drafted an eight-point ranked recommendation to increase the lifespan of people with SMI including, but not limited to,  understanding the impacts of trauma, furthering the role of support systems, redefining clinical education, and examining outcomes meaningful to those with SMI. The effort represents an important shift toward highlighting lived experience in identifying research priorities. To learn more, read the article in JAMA. 

Caring Letters is a suicide prevention intervention in which individuals receive letters of care and support with the goal of facilitating connection and lowering suicide risk. The Department of Veterans Affairs implemented a Caring Letters program in 2020 for all Veterans who contact the Veterans Crisis Line. A recent study adds to the evidence that the intervention is effective for this population. Researchers interviewed 23 Veterans who received nine letters over one year that included messages of support and mental health resources. Most participants reported that the letters had a positive impact, with some indicating they were more likely to engage with resources. However, they also offered areas for improvement. To learn more, see the study in Psychiatric Services.

The social determinants of health framework is commonly used to conceptualize the cultural and structural factors affecting mental health. A new review applies this framework specifically to psychosis-related health outcomes in communities of color, demonstrating that structural factors such as racial discrimination, food insecurity, and police violence are significant risk factors for psychosis within these communities. These findings inform a more nuanced understanding of the increased rates of psychosis and disparities in mental health treatment of Black and Latinx populations across the US – a critical step to developing policies and practice to address these issues. To learn more, read the article in Annual Review of Clinical Psychology.