Journal Digest

Serious Mental Illness Linked to Neighborhood Characteristics

Neighborhoods in which adults with serious mental illness reside are more apt to have higher levels of physical and structural inadequacy, drug-related activity, and crime than comparison neighborhoods, said Philadelphia-based researchers. They evaluated the characteristics of the neighborhoods of residence of a sample of 15,246 adults who were treated for serious mental illness in Philadelphia from 1997 to 2000 and compared them with an equally sized group of neighborhoods created by randomly generated addresses representative of the city’s general population.

“Although this study was unable to directly test the relationship between neighborhood environmental context and the functioning of persons with serious mental illness, its findings are nonetheless concerning in light of emerging evidence that worse neighborhood characteristics impede the community integration of persons with serious mental illness,” said the researchers, who also noted that their findings establish the importance of further exploration of the degree to which environmental factors may act as either barriers or facilitators to the functioning and participation of persons with serious mental illness.

Exposure to Suicide Predicts Increased Suicidality In Adolescents

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Being exposed to suicide can lead to suicidal ideation and suicide attempts among adolescents, researchers at the Harvard School of Public Health reported. Their finding was based on responses from 8,766 adolescents aged 12 to 17 who were part of the National Longitudinal Survey of Children and Youth, carried out from 1998 to 2007. Study participants were asked whether anyone in their school had died by suicide and whether they personally knew anyone who had died by suicide. Social support for the youth and stressful life events were also assessed.

The prevalence of exposure to a schoolmate’s suicide and personally knowing someone who died by suicide increased with age, and such exposure was consistently associated with suicide attempts and, to a lesser degree, with suicidal ideation. “Our results support schoolwide interventions over current targeted interventions, particularly over strategies that target interventions toward children closest to the decedent,” the researchers concluded.

No Serologic Tie Found Between Autism and Lyme Disease

Despite reports of a link between Lyme disease and autism, controlled studies to assess serological evidence of infection with Borrelia burgdorferi (the causative agent of Lyme disease) in patients with autism are lacking. Researchers based at Weill Cornell Medical College and New York Medical College obtained serum samples from 120 children aged 2 through 18 (70 with autism and 50 unaffected controls) acquired from the Autism Genetic Resource Exchange and the Weill Cornell Autism Research Program and then tested them for antibodies to B. burgdorferi. None of the children with autism or the unaffected controls had serological evidence of Lyme disease by two-tier testing. “The data do not address whether Lyme disease may cause autism-like behavioral deficits in some cases,” said the researchers. “However, the study’s sample size is large enough to effectively rule out the suggested high rates of Lyme disease or associated seroprevalence among affected children.”

Case Report: Tachycardia Treatment Thought to Resolve Suicidal Depression

Researchers at the UCLA Mattel Children’s Hospital in Los Angeles reported a case of a 14-year-old girl whose suicidal depression resolved after treatment for ectopic atrial tachycardia (EAT). The patient had no other significant medical history until she began experiencing several life stressors that gradually escalated prior to her suicide attempt with lorazepam and alcohol. She suffered depression, anxiety, panic attacks, insomnia, and anhedonia and eventually sought psychiatric evaluation when she experienced suicidal ideations and began cutting her wrists. Her EAT was subsequently diagnosed when she was hospitalized after her suicide attempt. She was transferred to an inpatient psychiatric ward, where her symptoms improved but did not resolve completely. Once stable, she underwent catheter ablation, after which her feelings of anxiety and depression dramatically improved; the patient had been asymptomatic without recurrence for over a year since her procedure. Follow-up echocardiography revealed normalization of ventricular function. “This case underscores the need to screen patients for arrhythmia when being evaluated by their general pediatrician or psychiatrist for psychiatric illness,” concluded the researchers. ■