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Clinical and Research News
 DOI: 10.1176/appi.pn.2014.4b5
Journal Digest
Psychiatric News
Volume 49 Number 8 page 1
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Researchers from Indiana University and Karolinska Institute in Stockholm analyzed medical records from everyone born in Sweden from 1973 to 2001 and found a significant association between advancing paternal age and increased risk for psychiatric disorders in offspring.

The findings showed that a child born to a 45-year-old father, when compared with one born to a 24-year-old father, is 3.5 times more likely to have autism spectrum disorder, 13 times more likely to have attention-deficit/hyperactivity disorder, 25 times more likely to have bipolar disorder, and two times more likely to have a psychotic disorder. The outcomes were consistent after adjusting for parental education level and income.

The researchers hypothesized that unlike women, who are born with all their eggs, men continue to produce sperm throughout life. However, each time sperm replicates, as molecular studies have shown, there is an increased risk for genetic mutations to occur, which may be the reason for the increased incidence of psychiatric disorders in those born to older fathers.

D’Onofrio B, Rickert M, Frans E, et al. “Paternal Age at Childbearing and Offspring Psychiatric and Academic Morbidity.” 2014. JAMA Psychiatry. Feb 26. [Epub ahead of print].
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Previous studies have found a link between hearing impairment and depression in children, but data are lacking on whether this holds true for adults as well, according to a study published in JAMA Otolaryngology-Head and Neck Surgery.

Chuan-Ming Li, M.D., Ph.D., a health and medical researcher at the National Institute on Deafness and Other Communication Disorders, and colleagues conducted a study in more than 18,000 individuals aged 18 and older to assess the impact of hearing loss on depression rates in adult populations. The study found that the rate of moderate to severe depression was 11.4 percent in adults who self-reported hearing impairment, compared with 7.1 percent in those with “good” hearing and 4.9 percent for individuals with “excellent” hearing. Women were more likely than men to have an association between moderate hearing impairment and depression. There was no association found between self-reported hearing impairment and depression among people aged 70 and older.

After adjusting for health conditions and others factors associated with depression, the data showed that self-reported hearing impairment was in fact independently associated with depression, particularly in women. The authors urged health care professionals to be alert to an increased risk for depression in adult patients who have hearing loss.

Li C, Zhang X, Hoffman H, et al. “Hearing Impairment Associated With Depression in U.S. Adults, National Health and Nutrition Examination Survey 2005-2010.” 2014. JAMA Otolaryngol Head Neck Surg. Mar 6. [Epub ahead of print].
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Ronald Kessler, Ph.D., a professor of health care policy at Harvard Medical School, and colleagues evaluated 3,689 children from families receiving public-housing assistance to determine if housing mobility intervention programs might serve as a mechanism for reducing mental health risk in youth living in areas of high poverty. The youth were divided into three groups: a low-poverty voucher group (those given vouchers to move to an area with a low poverty rate), a traditional voucher group (those given geographically unrestricted vouchers), and a control group (no intervention).

After assessing the rate of mental disorders 10 to 15 years later, the researchers found that compared with the control group, boys in the low-poverty voucher cohort were twice as likely to be diagnosed with major depression and three times as likely to have posttraumatic stress disorder (PTSD) or conduct disorder. Boys in the traditional voucher cohort were also three times as likely to suffer from PTSD, while girls in the same group had a reduced risk for major depression and conduct disorder. Girls who moved from high to low areas of poverty had no increased risk for psychiatric disorders.

The authors noted that “it is. . .difficult to draw policy implications from these results, because the findings suggest that the interventions might have had harmful effects on boys but protective effects on girls.” Though the findings demonstrate that the effects of housing mobility interventions are more complicated than expected, the researchers concluded that a better understanding of mental health risks concerning neighborhood characteristics is needed before future changes in public-housing policy are made.

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A new biomarker may be on the horizon to more accurately identify psychiatric patients who may later develop acute psychosis, according to a study published in Biological Psychiatry.

Daniel Mathalon, M.D., Ph.D., a professor of psychiatry at the University of California, San Francisco, led a study evaluating the amount of mismatch negativity (MMN)—an auditory signaling process that travels to the frontal lobe regions in response to sound—in 101 individuals with schizophrenia, at high clinical risk for psychosis, or with no history of mental illness.

The results showed that MMN was significantly reduced in subjects with schizophrenia and in those who were at high clinical risk for psychosis, compared with controls. There was no difference in MMN between schizophrenia patients and those with elevated risk for psychotic disorder. In addition, MMN was significantly reduced in high-risk patients who later developed acute psychosis, compared with those who remained in the high-risk category.

“Our study results show that mismatch negativity deficits precede the onset of psychosis in clinical high-risk individuals and further show that the larger the deficit, the more imminent the risk for conversion to a psychotic disorder,” commented Mathalon. “This remarkable convergence of findings points to the mismatch negativity as a promising electroencephalography-based biomarker of psychosis risk that, with further development, could enhance our ability to identify which individuals are at greatest risk for psychosis and in greatest need of early treatment, particularly if the treatment is associated with potential adverse effects (such as antipsychotic medication).”

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Though more people are surviving critical illness due to advances in medicine, severely ill patients are often exposed to respiratory distress and delirium, which may negatively impact mental health.

Researchers from Columbia University assessed the prevalence of psychiatric diagnoses and medication prescriptions given—before and after critical illness—to patients who were connected to a mechanical ventilation device while in the intensive care unit (ICU).

The analysis showed that among the 24,179 critically ill patients, 6.2 percent had one or more psychiatric diagnosis within the five years prior to the severe illness, compared with 2.4 percent of people in the general population. Critically ill patients were also more likely to have prescriptions for a psychoactive medication than were the general population (48.7 percent versus 33.2 percent). Previous ICU patients with no history of psychiatric disorders were 25 times more likely to receive a psychiatric diagnosis after hospitalization than the general population and 18 times more likely to be given a prescription for psychoactive drugs three months after ICU release. The differences in psychoactive prescriptions between former ICU admittees and the general population decreased after one year.

“Our data suggest both a possible role of psychiatric disease in predisposing patients to critical illness and an increased but transient risk of new psychiatric diagnoses and treatment after critical illness,” said the authors. They concluded that prompt evaluation of patients’ psychiatric history and management of psychiatric symptoms post-ICU may be an important focus for interventions concerning mental health among critically ill patients. ■

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