New research was presented at the American Psychiatric Association’s 165th Annual Meeting from May 5-9, 2012 in Philadelphia. The features below highlight just some of the studies that emerged from the conference.
Treating Sleep Disorders Benefits Psychiatric Patients
The Particulars: Research has shown that disturbances in quality and quantity of sleep can exacerbate underlying psychiatric illness. It has been hypothesized that treatment of sleep disorders might improve symptoms of psychiatric illness.
Data Breakdown: Investigators reviewed the charts of patients with and without psychiatric disorders at a sleep disorders clinic. They recorded outcomes at 6, 12, and 24 months in those with comorbid psychiatric disorders. Compliance with sleep disorder treatment was compared between those with and without comorbid psychiatric illness. When compared with baseline, psychiatric status progressively improved significantly, with no differences in treatment compliance observed between the groups.
Take Home Pearls: Treatment of comorbid sleep disorders in patients with comorbid psychiatric illness appears to significantly improve psychiatric disorder symptoms. Compliance with sleep disorder treatment does not appear to be affected by the presence of a psychiatric disorder.
Improving Metabolic Monitoring of Patients on Antipsychotics
The Particulars: Antipsychotic medications, particularly second generation antipsychotics (SGAs), have been linked to various metabolic changes that are associated with cardiovascular disease. Despite recommendations from the American Psychiatric Association and American Diabetes Association that patients on SGAs be monitored for metabolic changes, it is unknown how well these individuals are systematically monitored.
Data Breakdown: At a primary care network, multiple departments monitored metabolic syndrome in patients placed on SGAs more closely. All members of these departments were educated on the morbidity associated with SGA use and recommendations from available guidelines. An electronic medical record (EMR) system prompted users of the recommended monitoring guidelines at the time of SGA prescription. The rate of monitoring was low (30% to 40%) at baseline, but implementation of the educational program and EMR prompts led to an improvement in monitoring rates.
Take Home Pearl: An institution-wide program involving education of staff and EMR prompts appears to be successful in improving rates of metabolic monitoring in patients on SGAs.
ADHD & Chronic Lyme Disease Linked
The Particulars: Previous studies have linked chronic Lyme disease (CLD) with cognitive deficits, including anxiety and depression. The potential association between CLD and ADHD has not been well studied.
Data Breakdown: A survey was conducted of adults with and without CLD. Those with CLD reported significantly more inattentive and hyperactive symptoms of ADHD than those without CLD. Investigators suggested that the persistent pain and fatigue experienced by patients with CLD may actually be symptoms of ADHD.
Take Home Pearls: CLD appears to increase symptoms of ADHD in adults. Patients with CLD should be evaluated for a diagnosis of ADHD.
Eating Disorders Increase Mortality Risk
The Particulars: Numerous studies in the past have suggested a link between eating disorders and a high risk of mortality and suicide. Confirming this association over time in a large research study may help clinicians who treat patients with eating disorders or who are at risk for developing them.
Data Breakdown: A Finnish research team matched control patients with each of 2,329 women and 113 men treated at a specialized eating disorder clinic and compared their risks of mortality and suicide. When compared with controls, those with anorexia nervosa had a six-fold greater risk of dying from any cause. Additionally, those with bulimia nervosa had a three-fold greater mortality risk. The relative risk was 1.78 for those with a binge eating disorder.
Take Home Pearl: The risk of dying prematurely appears to be higher among patients with eating disorders when compared with those who do not have eating disorders.
Assessing a Suicide Attempt Via Social Media
The Particulars: More than 36,000 deaths from suicide are reported in the United States annually. Those who plan to attempt suicide have been found to be more likely to inform their friends and family of their intentions than their physicians. Social media postings might help provide a clearer, objective picture of a patient’s history leading up to a suicide attempt when compared with subjective physician interactions alone.
Data Breakdown: A 27-year-old man gave investigators consent to review his Facebook postings in order for them to reconstruct a picture of his suicide attempt and establish a clear timeline of events. The patient had wished friends well and offered to give away household items through his Facebook posts. The researchers found that reviewing these posts helped them better understand the patient’s state of mind and also helped the patient understand the seriousness of his attempt. Reviewing the posts also helped investigators to get the patient to finally accept medication and psychiatric therapy.
Take Home Pearls: Reviewing Facebook and other social media may provide additional, objective information in assessing a patient’s suicide attempt. Reviewing social media postings with patients may help them understand the seriousness of their situation and agree to treatment.
Readings & Resources (click to view)
For more information on these studies and others that were presented at the American Psychiatric Association’s 165th Annual Meeting, go to www.psychiatry.org/learn/2012-annual-meeting.