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Patients are considered to have developed chronic critical illness when they experience acute illness requiring prolonged mechanical ventilation or other life-sustaining therapies but neither recover nor die within days to weeks. It is estimated that chronic critical illness affected 380,000 patients in the United States in 2009. Family members of patients in the intensive care unit ( ICU ) experience emotional distress including anxiety, depression, and posttraumatic stress disorder (PTSD). Palliative care specialists are trained to provide emotional support, share information, and engage patients and surrogate decision makers in discussions of patient values and goals of care. Shannon S. Carson, M.D., of the University of North Carolina School of Medicine, Chapel Hill, N.C., Judith E. Nelson, M.D., J.D., of the Memorial Sloan Kettering Cancer Center, New York, and colleagues randomly assigned adult patients requiring 7 days of mechanical ventilation and their family surrogate dec...

A new study in Biological Psychiatry supports this hypothesis, providing evidence that inflammation of the hippocampus, a region of the brain implicated in the genesis and maintenance of depression and in the pathology of multiple sclerosis, alters its function and contributes to symptoms of depression. "This study elegantly links hippocampal inflammation to depression," said Dr. John Krystal, Editor of Biological Psychiatry. The research was a collaboration between King's College London, Imperial College London, and Imanova Center for Imaging Sciences. Led by senior authors Paul Matthews and Eugenii Rabiner, the research team combined two complementary brain imaging techniques to study the relationship between hippocampal immune response, functional connections, and depressive symptoms in 13 patients with multiple sclerosis and 22 healthy control subjects. Positron emission tomography (PET) allowed for quantification of activated microglia , a measure of immune res...

Diabetic retinopathy (DR) is a common microvascular complication of diabetes. It is a progressive eye disease that is characterized by an asymptomatic non-proliferative stage (NPDR) and symptomatic proliferative stage (PDR). The PDR stage, together with diabetic macular edema (DME), which can develop at any stage, are the primary causes of vision loss in people with diabetes. Research is needed to clarify inconsistent findings regarding the association between diabetes-related eye complications and psychological well-being. This study included 519 participants with a median duration of diabetes of 13 years. Patients underwent a comprehensive eye examination in which images were obtained and graded for the presence and severity of DR and DME . Visual acuity was also assessed. Patients were screened for symptoms of depression and anxiety. Eighty individuals (15 percent) screened positive for depressive symptoms and 118 persons (23 percent) screened positive for symptoms of anxiety...

The assumption that people struggling with their marriages or other domestic issues are suffering from depression is not supported by the way depression is defined medically, said Jonathan M. Metzl, Frederick B. Rentschler II Professor of Sociology and Medicine, Health and Society at Vanderbilt and the study's lead author. The study, conducted using a Midwestern medical center's records from 1980 to 2000, appears in the current issue of the  Yale Journal of Biology and Medicine Notably, Metzl said, the time period of analysis followed a 1974 decision that removed the term "homosexuality" from the Diagnostic and  Statistical Manual of Mental Disorders  ( DSM ), the standard reference book of psychiatric illnesses. "As it became less acceptable to overtly diagnose homosexuality, it became increasingly acceptable to diagnose threats to female-male relationships as conditions that required psychiatric intervention," Metzl said. "Doctors increasingly ...

Scientists from the Florida campus of The Scripps Research Institute (TSRI) have shown for the first time that ensembles of genes within the striatum--a part of the brain that coordinates many primary aspects of our behavior, such as motor and action planning, motivation and reward perception--could be deeply involved in the disorder. Most modern studies of bipolar disorder have concentrated on the brain's cortex, the largest part of the brain in humans, associated with higher-level thought and action. "This is the first real study of gene expression in the striatum for bipolar disorder," said Ron Davis, chair of the Department of Neuroscience at TSRI, who directed the study. "We now have a snapshot of the genes and proteins expressed in that region." The study, published recently online ahead of print in the journal  Molecular Psychiatry , also points to several pathways as potential targets for treatment. Bipolar disorder is a mental illness that affec...

Previous research has shown that chronic exposure to trauma is associated with an increase in pro-inflammatory gene expression and a decrease in antibodies and antiviral responses in immune cells. Those molecular responses have been linked to cardiovascular and neurodegenerative diseases, cancer, infections and mental illnesses such as anxiety and depression. Brandon Kohrt, M.D., Ph.D., professor of psychiatry and global health at Duke, and colleagues conducted a five-year longitudinal study of former child soldiers exposed to the trauma of a decade-long civil war in Nepal. The findings were published during the week of July 11 in the  Proceedings of the National Academy of Sciences . "This study has important implications for responding to young people exposed to war, terrorism and natural disasters," Kohrt said. The researchers focused on 154 former child soldiers and 136 youths who experienced the war as civilians. They were evaluated using the Child PTSD (post-tra...

The investigators showed decreasing a set of proteins called HCN channels reduced depression-like behavior in mice. If replicated in humans, the findings could inform fresh therapies for millions of patients who do not respond to existing treatments for depression. "Drugs currently available for treating depression help most patients, but they stop working for some patients and don't work from the get-go for others," said senior author Dr. Dane Chetkovich, ?a professor of neurology and of physiology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine neurologist. "There is a real need for new therapies to help patients desperate for alternatives to the available therapeutic options." The study will be published July 12 in the journal  Molecular Psychiatry . Most existing antidepressants affect mood and emotions by increasing levels of neurotransmitters called monoamines, namely serotonin, dopamine and norepinephrine . But t...

The research provides some of the most conclusive evidence to date of fathers' importance to children's outcomes and reinforces the idea that early childhood programs such as Head Start should focus on the whole family, including mother and father alike. The findings are published online in two academic journals,  Early Childhood Research Quarterly  and  Infant and Child Development . "There's this whole idea that grew out of past research that dads really don't have direct effects on their kids, that they just kind of create the tone for the household and that moms are the ones who affect their children's development," said Claire Vallotton , associate professor and primary investigator on the research project. "But here we show that fathers really do have a direct effect on kids, both in the short term and long term." Using data from about 730 families that participated in a survey of Early Head Start programs at 17 sites across the natio...

Yi-Yuan Tang, the presidential endowed chair in neuroscience and a professor in the Department of Psychological Sciences, has developed a novel method of mindfulness meditation called Integrative Body-Mind Training (IBMT). "Meditation encompasses a family of complex practices that includes mindfulness meditation, mantra meditation, yoga, tai chi and chi gong," Tang said. "Of these practices, mindfulness meditation -- often described as nonjudgmental attention to present-moment experiences -- has received most attention in neuroscience research over the past two decades. For example, when we observe our thoughts or emotions in the mind, we are often involved in them. With IBMT practice, you distance your thoughts or emotions and realize they are not you, then you see the reality in an insightful and different way. Mindfulness helps you be aware of these mental processes at the present, and you just observe without judgment of these activities." IBMT avoids stru...

Professors Elaine Fox, from Oxford University, and Chris Beevers from the University of Texas at Austin reviewed a number of studies for their paper in  Molecular Psychiatry . They say that there is a need to combine studies in mental health genetics with those that look at cognitive biases. Professor Beevers said: ' Cognitive biases are when people consistently interpret situations though particular mental 'filters' -- when people have a cognitive bias that emphasises negative aspects or thoughts, they are more at risk of mental health disorders. There is a lot of research about these biases, and a lot of research about genes that may make people susceptible to mental ill health. However, we suggest that it could make more sense to bring together these two areas of research.' Professor Fox said: 'If you take a gene that is linked to mental illness, and compare people who have the same genetic variant, it becomes clear that what happens to their mental health ...