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Adverse childhood experiences (ACEs) are potentially traumatic events that occur during childhood and can negatively impact mental health and well-being into adulthood. Recent data from the 2021 Adolescent Behaviors and Experiences Survey (ABES) showed that nearly three-quarters (73%) of U.S. high school students reported at least one ACE during the COVID-19 pandemic. Students with four or more ACEs were about four times more likely to have poor current mental health and 25 times more likely to have past-year suicide attempts compared to those without any ACEs. Identifying vulnerable youth early and providing them with trauma-informed care can help address the mental health needs brought on by ACEs and the COVID-19 pandemic. To learn more, see the report from the CDC.  

Despite being effective for treatment-resistant schizophrenia, clozapine is underutilized. To increase prescriptions, a clozapine community clinic with a multidisciplinary team of health practitioners was established in 2015. Providers utilized the best practice alert (BPA) to identify ideal patient candidates for clozapine treatment and since its inception, the number of patients receiving clozapine treatment increased from 57 to 124. Patients received weekly group support, education, telehealth, and access to a centralized clozapine resource toolkit. Intervention programs also evaluated existing attitudes and awareness regarding clozapine and provided education to healthcare providers. To learn more, see the article in Psychiatric Services.  

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.