Structural differences in adolescent brains can predict alcohol misuse

Alcohol misuse during adolescence (AAM) has been associated with disruptive development of adolescent brains. In this longitudinal machine learning (ML) study, we could predict AAM significantly from brain structure (T1-weighted imaging and DTI) with accuracies of 73 -78% in the IMAGEN dataset (n∼1182). Our results not only show that structural differences in brain can predict AAM, but also suggests that such differences might precede AAM behavior in the data. We predicted 10 phenotypes of AAM at age 22 using brain MRI features at ages 14, 19, and 22. Binge drinking was found to be the most predictable phenotype. The most informative brain features were located in the ventricular CSF, and in white matter tracts of the corpus callosum, internal capsule, and brain stem. In the cortex, they were spread across the occipital, frontal, and temporal lobes and in the cingulate cortex. We also experimented with four different ML models and several confound control techniques. Support Vector Machine (SVM) with rbf kernel and Gradient Boosting consistently performed better than the linear models, linear SVM and Logistic Regression. Our study also demonstrates how the choice of the predicted phenotype, ML model, and confound correction technique are all crucial decisions in an explorative ML study analyzing psychiatric disorders with small effect sizes such as AAM.

Psychiatric genomics, mental health equity, and intersectionality: A framework for research and practice

The causal mechanisms and manifestations of psychiatric illness cannot be neatly narrowed down or quantified for diagnosis and treatment. Large-scale genome-wide association studies (GWAS) might renew hope for locating genetic predictors and producing precision medicines, however such hopes can also distract from appreciating social factors and structural injustices that demand more socially inclusive and equitable approaches to mental healthcare. A more comprehensive approach begins with recognizing that there is no one type of contributor to mental illness and its duration that should be prioritized over another. We argue that, if the search for biological specificity is to complement the need to alleviate the social distress that produces mental health inequities, psychiatric genomics must incorporate an intersectional dimension to models of mental illness across research priorities, scientific frameworks, and clinical applications. We outline an intersectional framework that will guide all professionals working in the expanding field of psychiatric genomics to better incorporate issues of social context, racial and cultural diversity, and downstream ethical considerations into their work.

Mental Illness, Mass Shootings, and the Future of Psychiatric Research into American Gun Violence

ABSTRACT

This article outlines a four-part strategy for future research in mental health and complementary disciplines that will broaden understanding of mass shootings and multi-victim gun homicides. First, researchers must abandon the starting assumption that acts of mass violence are driven primarily by diagnosable psychopathology in isolated "lone wolf" individuals. The destructive motivations must be situated, instead, within larger social structures and cultural scripts. Second, mental health professionals and scholars must carefully scrutinize any apparent correlation of violence with mental illness for evidence of racial bias in the official systems that define, measure, and record psychiatric diagnoses, as well as those that enforce laws and impose criminal justice sanctions. Third, to better understand the role of firearm access in the occurrence and lethality of mass shootings, research should be guided by an overarching framework that incorporates social, cultural, legal, and political, but also psychological, aspects of private gun ownership in the United States. Fourth, effective policies and interventions to reduce the incidence of mass shootings over time-and to prevent serious acts of violence more generally-will require an expanded body of well-funded interdisciplinary research that is informed and implemented through the sustained engagement of researchers with affected communities and other stakeholders in gun violence prevention. Emerging evidence that the coronavirus pandemic has produced a sharp increase both in civilian gun sales and in the social and psychological determinants of injurious behavior adds special urgency to this agenda.

The development of mental hospitals in West Bengal: A brief history and changing trends

The communication between G. S Bose and Sigmund Freud is a well-documented fact, and philosophical blend of rich cultural experiences is unique to modification of traditional psychoanalysis in the context of development of psychiatry in West Bengal. The Calcutta lunatic asylum was established at Bhowanipore, and first general hospital psychiatric unit was formed at R. G. Kar Medical College, Calcutta. Prof. Ajita Chakraborty was a pioneer to describe her struggling days in the early career and shared her views with experiences in her autobiography. The volume and quality of research work, especially in the field of epidemiology led by Dr. D. N. Nandi is worth mentioning. A jail had been converted to mental hospital which is the largest in terms of bed strength (n = 350) at Berhampore, Murshidabad district where Kazi Nazrul Islam and Netaji Subhas Chandra Bose had spent some period as prisoner during British rules. Bankura was the first district in West Bengal to start District Mental Health program. The various nongovernmental organizations are working together in public-private partnership model or indigenous ways in tandem over years for the betterment of mental health services both at institutional and community level.

A Theoretical Framework for Evaluating Psychiatric Research Strategies

One of the major goals of basic studies in psychiatry is to find etiological mechanisms or biomarkers of mental disorders. A standard research strategy to pursue this goal is to compare observations of potential factors from patients with those from healthy controls. Classifications of individuals into patient and control groups are generally based on a diagnostic system, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD). Several flaws in these conventional diagnostic-based approaches have been recognized. The flaws are primarily due to the complexity in the relation between the pathogenetic factors (causes) and disorders: The current diagnostic categories may not reflect the underlying etiological mechanisms. To overcome this difficulty, the National Institute of Mental Health initiated a novel research strategy called Research Domain Criteria (RDoC), which encourages studies to focus on the neurobiological mechanisms and core aspects of behavior rather than to rely on traditional diagnostic categories. However, how RDoC can improve research in psychiatry remains a matter of debate. In this article, we propose a theoretical framework for evaluating psychiatric research strategies, including the conventional diagnostic category-based approaches and the RDoC approach. The proposed framework is based on the statistical modeling of the processes of how the disorder arises from pathogenetic factors. This framework provides the statistical power to quantify how likely relevant pathogenetic factors are to be detected under various research strategies. On the basis of the proposed framework, we can discuss which approach performs better in different types of situations. We present several theoretical and numerical results that highlight the advantages and disadvantages of the strategies. We also demonstrate how a computational model is incorporated into the proposed framework as a generative model of behavioral observations. This demonstration highlights how the computational models contribute to designing psychiatric studies.

The Infernal Alternatives of Corporate Pharmaceutical Research: Abandoning Psychiatry

What happens when health research is measured by market size? How does this change the dynamics of medical research, and how is its growth envisioned and managed? In this article, I build on my arguments in Drugs for Life: How Pharmaceutical Companies Define our Health, which focused primarily on the development and marketing of mass medications for heart disease and I examine the market dynamics that are used to drive research into and out of psychiatric and other neuromedicines, such as the closing of mental health research at most major pharmaceutical companies. Industry compares entire sectors of medical research to evaluate their relative chances of profits and growth; it is willing to sacrifice a whole region of effective and profitable medicine if it can grow profits more in other regions. Baudrillard, Pignarre, and Stengers are used to consider whether this situation can best be described as one of infernal alternatives, and how to analyze the responses of psychiatric leaders.

The 5/95 gap in the indexation of psychiatric journals of low- and middle-income countries

OBJECTIVE

To investigate the relationship between science production and the indexation level of low- and middle-income countries (LAMIC) journals in international databases.

METHOD

Indicators of productivity in research were based on the number of articles produced over the 1994-2004 period. A survey in both Medline and ISI/Thomson was conducted to identify journals according to their country of origin. A WPA Task Force designed a collaborative process to assess distribution and quality of non-indexed LAMIC journals.

RESULTS

Twenty LAMIC were found to present more than 100 publications and a total of 222 indexed psychiatric journals were found, but only nine were from LAMIC. The Task Force received 26 questionnaires from editors of non-indexed journals, and concluded that five journals would meet criteria for indexation.

CONCLUSION

Barriers to indexation of journals contribute to the difficulties in achieving fair representation in the main literature databases for the scientific production in these countries.

Partnerships for promoting dissemination of mental health research globally

Low-and middle-income countries (LAMIC), with more than 80% of the global population, bear the greatest burden of mental disorders. Yet these countries are very under-represented in published psychiatric research. There are barriers to publication of mental health research from LAMIC and to the representation of research from these countries in the main literature databases worldwide. The World Psychiatric Association (WPA) aimed to help investigate the reasons for the under-representation of LAMIC in published psychiatric research and consider how to support improved research dissemination, relevant for better mental health and mental health care in all countries. As part of its work plan for the years 2008 to 2011, WPA developed a project to encourage efforts to offer support to psychiatric journals in LAMIC. A WPA publications taskforce was appointed in 2008 to promote the dissemination of research from LAMIC. The taskforce began work together with journal editors to strengthen their chances of being indexed in international databases. Among the first journals participating in the project was the IJP, which is now an inspiration and source of support for other journals.

Shared challenges in psychiatric research in India and Sri Lanka

The need for good research in psychiatry has never been more important than in this era of 'Evidence-based medicine' (EBM).[1] The countries in south Asia have to rise to the challenge and abandon the emphasis placed on 'Experiencebased medicine', as was popular in the traditional systems of medicine - the art was handed down from father to son or guru to shishya (student).Evidence-based medicine does not abandon clinician experience, skills, and judgment, but rather complements it with the best available evidence and patient choice.[2] This article explores the challenges in obtaining the best available evidence in the south Asian context.

The Maudsley Hospital and the Rockefeller Foundation: the impact of philanthropy on research and training

Opened in February 1923 to raise the status of academic psychiatry in the UK, the Maudsley Hospital struggled to secure grant income. Without a track record of published research and lacking internationally recognized clinicians, it failed to impress the British Medical Research Council. To challenge leading U.S. and German departments of neuropsychiatry, Edward Mapother, the medical superintendent, looked overseas for investment in an "institute of psychiatry." Intense lobbying and a modified strategy for research and training designed to meet the Rockefeller Foundation's prioritization of psychiatry and medical specialization ultimately led to a significant endowment. Alan Gregg and Daniel O'Brien at the Foundation played a pivotal role in re-defining the Maudsley's programs of research and teaching. Pressure on Mapother to attract funding was matched by that on administrators required to show that their philanthropy had yielded tangible gains in public health. While wealthy charities, like the Rockefeller, often had a vision of the direction that they wished to pull medical science, and they provided much needed income, the impact of their policy agenda was not without drawbacks. Institutions unwilling to embrace a charity's philosophy were unlikely to secure grants, while those that did might find themselves drawn into less optimal areas.

Indexation of psychiatric journals from low- and middle-income countries: a survey and a case study

The objective of this cross-sectional study was to determine the prevalence of migraine headache among depressed Latino adolescents of Mexican American origin. This is, to the best of our knowledge, the first study of the prevalence of migraine among depressed adolescents of any ethnic/racial background. In a mental health clinic for the indigent, 132 consecutive Latino adolescents fulfilling the DSM-IV criteria for major depressive episode were compared with a sample of adolescents with other mental disorders. Logistic regression was used to test for associations and control for confounding effects. The prevalence of migraine headache among depressed adolescents was 6 times greater than that of the comparison patients (OR = 5.98, z = 2.35, p = 0.019). This finding is consistent with previously published reports involving adult samples, in which the prevalence of migraine was found to exceed that in the general population. However, contrary to what we previously found in Latino adults, the prevalence of migraine was not higher in bipolar than in unipolar adolescents.

Reporting ethical aspects in published research articles in the Indian Journal of Psychiatry

BACKGROUND

Reporting of informed consent and ethical approval are important aspects of published papers which indicate the knowledge and sensitivity about ethical aspects of research by the researchers.

MATERIALS AND METHODS

This study reports description of informed consent and ethical approval in the published psychiatric research in the main journal of psychiatry in India. All original research articles (n=157) published in the Indian Journal of Psychiatry in the years 2000, 2003 to 2007 were included.

RESULTS

Informed consent was mentioned in 51% of studies in 2000, which gradually rose to 82% by the year 2007. Ethics committee approvals were mentioned in 2% of studies in 2000, and 25% of reports in 2007. Consent was reported to be written in only 40%, content of the consent forms was mentioned in 17%, and the language of consent form was reported in 3% of the studies where consent was reported.

CONCLUSIONS

Regulation of ethical principles and formulation of necessary guidelines or rules for research as well as for publications are necessary and desirable to ensure the safety of participants and good quality of research.