Factors that Differentiate OCD and OCPD

From Psychiatric News Alert: Although obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) share some characteristics, a new study indicates they are distinct disorders. Both are impairing disorders marked by compulsive behaviors, but they can be differentiated by the presence of obsessions in OCD and by the capacity to delay reward in OCPD. The study’s senior researcher was H. Blair Simpson, M.D., Ph.D., a professor of psychiatry at Columbia University. The results appear in Biological Psychiatry.

Information about OCD’s description and classification in DSM-5 can be found in the American Psychiatric Publishing book Obsessive-Compulsive Spectrum Disorders: Refining the Research Agenda for DSM-5.

Although individuals with OCPD are often impaired in psychosocial functioning and quality of life, they sometimes also achieve remarkable successes. A prime example is Noah Webster who was  driven by a need for order and who, for 30 years, worked at creating a dictionary of the English language. Read more about him in the Psychiatric News article“Biographer Explores Character, Pathology, and Achievement.”

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The Directing Change Student Video Contest

FROM NAMI California: Students throughout California are invited to Direct Change by submitting 60-second videos in two categories: “Suicide Prevention” and “Ending the Silence about Mental Illness”. The winning teams and their associated schools will win cash prizes, qualify to win mental health or suicide prevention programs for their schools, and will be recognized at an award ceremony at the end of the 2013-14 school year.

Visit the campaign website for contest rules and information: www.directingchange.org.

Submission Deadline: February 1, 2014

Please help spread the word:  Print and post this flier.

Adolescence Serves a Valuable Function

From: Psychiatric News Alert: As frustrating as it can be to deal with teenagers’ often challenging behaviors such as risk taking, sensation seeking, or choice of friends, adolescence bestows some strong benefits on humanity, psychiatrist Jay Giedd, M.D., declared at a symposium of the Brain and Behavior Research Foundation(BBRF) in New York City.

Giedd, chief of the Brain Imaging Section of the Child Psychiatry Branch at the National Institute of Mental Health, is also the recipient of the BBRF’s 2013 Ruane Prize for Outstanding Achievement in Child and Adolescent Psychiatric Research.

The major benefit of adolescence, Giedd explained, is a slowly maturing brain that makes humans more adaptable and more open to change than if their brains had matured more rapidly. The Neanderthals, in contrast, had a less-protected period of adolescence. Their brains matured rapidly, and they quickly grew into adults, yet the downside was that they did not adapt well and eventually became extinct, he said. Moreover, because the adolescent brain is in the process of maturing, teens tend to be much more adaptable and more at home with the dizzying advances of the digital revolution than adults are, Giedd noted.

More information about human adolescence and Giedd’s view of this developmental stage is in the Psychiatric News article “Prolonged Adolescence Helps Build a Better Brain.”  Information about adolescent development from a psychodynamic perspective can be found in the new American Psychiatric Publishing book Normal Child and Adolescent Development: A Psychodynamic Primer.

Eating Disorder Gene Mutations

Scientist have discovered two gene mutations that they believe are associated with an increased risk of eating disorders.

Anorexia nervosa and bulimia often run in families, but these eating disorders are complex, and it has proven difficult to identify the paths. But, using two families with very high incidences of eating disorders, scientists say they found rare mutations, one in each family, that were associated with the people who had the disorders.

The study suggests that mutations that decrease the activity of a protein that turns on the expression of other genes – called a transcription factor which increase risk. That transcription factor is estrogen-related receptor alpha, or ESRRA.

Anorexia nervosa and bulimia are debilitating and occur in 1% to 3% of women, less frequently among men. They are among the deadliest of psychiatric diseases. They are thought to occur as a result of a predisposition and environmental factors.

Study: Cognitive Loss Common After ICU Stay

Two-thirds of patients sick enough to land in a hospital intensive care unit come away from the experience with substantial mental deficits, a new study finds.

The new research, which quantifies a phenomenon long observed by critical-care physicians, found that three months after leaving the hospital, 4 in 10 patients continue to have cognitive problems on a par with those seen in cases of moderate traumatic brain injury. And more than a quarter experience a decline in mental function akin to that seen in patients with mild Alzheimer’s disease.

For 58% of patients who’ve experienced a stay in ICU, those intellectual deficits are still there a year after they have been released from the hospital.

The latest research published recently found that the sudden decline in mental function was as likely to affect young patients as it was those who were older. And it was no more likely in patients who were ill even before their hospitalization than it was in those who had been healthy.

In fact, only one factor appeared to predict which patients would sustain mental deficits after an ICU stay: the length of time the patient experienced delirium, a common occurrence among the hospitalized critically ill. The study tracked for a year 821 patients who landed in the ICU from a wide range of circumstances. Some were admitted following surgery; others came to intensive care after suffering a stroke, a sudden turn in an ongoing illness, or injury.

While suspicion has long fallen on the widespread use of powerful painkillers and sedatives in the ICU, they found few clear links between medications and patients who go to the ICU units.

REF Science Daily

The Importance of Developing Tools to Make Early Psychosis Intervention a Reality

Raquel Gur, M.D.

From Psychiatric News Alert: Early identification of schizophrenia and other psychoses should not just be a priority for clinicians—it should be a national priority, says psychiatrist Raquel Gur, M.D., a leading schizophrenia researcher. Speaking at the APA Institute on Psychiatric Services, Gur pointed out that despite the illness’s complexity, early psychosis identification is becoming more likely thanks to a growing research base linking genetic, neurodevelopmental, and behavioral findings about how psychosis progresses over time. Such early identification must follow the pattern that made it routine for diabetes, cardiovascular disease, and other disorders.

“It is no different for psychosis. When someone presents with a risk, we cannot send them away until they meet DSM criteria for schizophrenia.”

Pursuing the path of other illnesses, however, will not be simple, she added, in large part because of the stubborn stigma that attaches to mental illness and the complexity of the brain. But:

“the train toward psychosis leaves the station early, and we are trying to capture it before it derails.”

She cited several examples of research that is advancing the knowledge needed for early psychosis identification, including the Philadelphia Neurodevelopmental Cohort, which is seeking to describe how genetics impact trajectories of brain development and cognitive functioning in adolescence and understand how abnormal trajectories of development are associated with psychiatric symptoms. In this study, nearly 10,000 youth presenting at Children’s Hospital of Philadelphia for nonpsychiatric reasons have received a comprehensive genetic, psychiatric, and cognitive assessment, with a subsample of these participants receiving multimodal neuroimaging.

Read more about this and other studies laying the groundwork for early psychosis intervention in the Psychiatric News article “Expert Says Early Identification of Psychosis Should Be Priority.”

Ending the Silence of Mental Illness in High School

From NAMI blog

By Colleen Duewel, NAMI Director of Education

I am delighted to announce that NAMI has added NAMI Ending the Silence as a signature education program.NAMI Ending the Silence is an in-school presentation about mental health designed for high school students. Students can learn about mental illness directly from the family members and individuals living with mental illness themselves.

Although only a short, 50 minute presentation, NAMI Ending the Silence is effective at raising awareness, encouraging early identification and intervention and giving a human face to mental illness. By providing a realistic view of recovery and starting a dialog with the students, this program removes the fear and mystery that is often the result of the silence surrounding what can feel like a scary topic.

The goal of this program is to create a generation of students that are well-positioned to eradicate the stigma associated with mental illness through education, support and advocacy. In NAMI Ending the Silence, presenters are trained to “share” as opposed to “teach” the material. The tone set with this attitude is critical. Presenters talk to the students, not at them. They make eye contact with the individual students, chat with them upon entering the classroom and hang around after class is over to visit briefly. As a result, students realize that NAMI Ending the Silence presenters really care about them.

In the presentation, students learn about the signs and symptoms of mental illness, recovery and coping strategies, how to help friends, how to reduce stigma and other important topics that can help spread awareness and knowledge of mental illness.

For the rest of this article, visit NAMI blog.