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Psychiatry Newsletter - Our Variety's Showing: A Sampler of New Work
Hopkins BrainWise Fall 2009
Our Variety's Showing: A Sampler of New Work
Date: November 2, 2009
When Anxiety’s Apple Falls Close to the Tree
Children of clinically anxious parents are up to seven times more likely to suffer anxiety illness themselves.
Yet no adequate studies have tackled the problem with at-risk children.
Psychologist Golda Ginsburg designed the Childhood Anxiety Prevention Study to see if the cognitive behavioral techniques that help children with existing anxiety disorders might head off problems in healthy kids.Forty children age 7 to 12 and their parents participated in a program to increase resilience, instill hope and raise awareness of anxiety’s known risk factors and how to whittle them. Half got the program immediately; the other half waited a year.
At year’s end, 30 percent of untreated youngsters developed an anxiety disorder. None in the CAPS program did.It’s no surprise their parents were delighted.For information: 443-287-4349 or e-mail CAPS@jhmi.edu
The More You Eat, the More You Want
Doughnuts. Peanut butter cups. Not only are they unhealthful foods, but eating them in a less-than-circumspect way may be a form of self-sabotage, a new study suggests.Work by Nicholas Bello and colleagues in Hopkins’ Eating Disorders Program showed that either chronic overconsumption or binge eating of a mixture of Crisco and sugar causes a scaling-back of mu-opioid receptors in the hindbrains of standard lab rats. That’s probably a response to the outpouring of natural opioids—molecules of encouragement.“The results are interesting,” Bello says, “because we see changes in a brain area that controls how much you eat at a meal.”
The idea is that overconsuming fatty sugarplums by rats or humans may prompt further binge-eating behavior.For information: 410-955-2996.
A Panic Personality?
A tie exists, studies say, between panic disorder and the habit of coping with life by becoming overly dependent on other people or by avoiding certain things.But what sort of tie? Do the traits themselves predict or somehow encourage the psychiatric illness? Or is the opposite true, that early inklings of panic symptoms mold an avoidant/dependant personality?
To sort it out, psychiatrists Joseph Bienvenu, Gerald Nestadt and colleagues sifted data from a longstanding epidemiologic survey, finding adults who admitted excessive timidity, hypervigilance or the like but who had no overt mental illness. Then they checked follow-up data gathered some 13 years later.
Did the suspect traits predict—not necessarily cause—panic disorder and/or agoraphobia? “Yes,” says Bienvenu.“And knowing that is indispensable to understand these disorders in all their complexity.” For information 410-614-9063.
Cocaine: When Abuse Turns to Addiction
Of the major illicit drugs, cocaine is most likely to lead takers from regular use to dependence.What “flips the switch” is an amalgam of genes, environment and developmental and social factors. Little’s known, however, about the specifics.
A recent study by Hopkins’ Behavioral Pharmacology Research Unit sheds some light. The researchers compared cocaine abusers to a matched group frankly dependent on the drug.It’s no surprise that the dependent group desired and valued cocaine more highly. Less expected, though, was the number of similarities: Both groups reported equal impulsivity. Most physiological and other responses to test doses of cocaine were also the same.The exception? Abusers reported more suspiciousness and showed more irritability and other unpleasant effects that cocaine brings.
Perhaps greater sensitivity marks those who don’t slip into dependence, says psychiatrist George Bigelow. For information: 410-550-0035.
Postpartum Gene Search Yields a Bright Spot
In one of the first studies to comb the human genome for genetic ties to mood disorders in new mothers, Pamela Belmonte Mahon and Jennifer Payne found a gene that’s a prime target for future study.Turning to two large existing databases, their team analyzed DNA sequences of 1,000 blood samples—all from women in an NIMH study of bipolar disorder or one on those with recurring depression.
After an initial pass linked suspect DNA variations to chromosomes 1 and 9, the researchers fine-mapped the chromosomal areas of interest.One gene, HMCN1, stood out. That it’s expressed in the brain and codes for estrogen receptor-binding sites makes it an attractive candidate. For information: 410-502-2586.
Schizophrenia: Skin Gives You the Skinny
It’s a schizophrenia researcher’s fantasy: to create cultures of neurons from living patients—cells touched by flaws that underlie the disease.“You can’t study function in cells in tissue from autopsies,” says Russell Margolis, who heads Hopkins’ Schizophrenia Program. And grave concerns limit use of patient reproductive or embryonic tissues.So Margolis and colleague Christopher Ross have seized on the newly found ability to sample skin fibroblast cells from consenting patients—it’s but a pinprick—and convert them into induced pluripotent stem (iPS) cells. Those in turn are transformed into true neurons.
A pilot study to derive neurons has begun. If they indeed model patient cells, they’re one mighty tool to clarify schizophrenia pathology and test new drugs. For information: 410-614-4262.
The Anxiety of Parkinson’s
Clinical-level anxiety dogs too many Parkinson’s disease (PD) patients. But documenting its nature and scope—a start to seeing that the most patients get the most help—hasn’t happened.
To that end, geriatric psychiatrist Gregory Pontone and a Hopkins psychiatric team surveyed 127 PD patients in great depth.Almost half reported an anxiety disorder at some time in their lives, with 43 percent in the midst of one.Their most frequent diagnosis—the DSM’s anxiety disorder not otherwise specified—includes PD-specific fears such as being unable to move in a public place or panic attacks when drugs’ benefits wear off. Panic disorder, generalized anxiety disorder and phobias weren’t uncommon.A surprise: The most anxious patients had intensified physical (motor) problems—a characteristic that could be used to help predict PD’s impact, Pontone says.For information: 410-614-0308.
GOSPEL Waylays the Downhill Path
Having complicated labor raises the risk of schizophrenia. A stroke or heart attack ups the immediate likelihood of depression.What these events hold in common is an unfortunate cut in the brain’s oxygen supply, tripping a “stress cascade” in cells. Certain diseases with a psychiatric turn—like Parkinson’s and Alzheimer’s—also turn on oxidative stress pathways.
Recently Akira Sawa uncovered key steps in what comes next, showing that ultimately, oxidative stress can alter gene expression.The gene changes—they’re epigenetic—at worst bring about cell death or, Sawa speculates, they hobble the brain in ways typical of psychiatric disease.
Most exciting is Sawa’s discovery of GOSPEL, a natural protective molecule that interrupts this downhill path in lab animals, and the likelihood that, deprenyl, a prescription drug already on the market for another condition can mimic it. For information: 410-955-4726.