Research round-up

Abstract

Suicide in young peopleThe increasing gap between suicide in young people in rural and urban areas is highlighted in a US longitudinal study. Authors studied the incidence of suicide in individuals aged 10–24 years from 1996 through to 2010 across the USA, during which there were 66 595 deaths attributed to suicide; notably, over half of the suicides were completed by use of a firearm. Suicide rates in male individuals in urban areas declined over time (p<0·001), although no such decrease was found in rural areas. In 2008–2010, the rate of suicides in male individuals in the most rural areas was 19·93 per 100 000 versus 10·31 per 100 000 in urban areas (adjusted incident rate ratio 1·19, 95% CI 1·07–1·32). In female individuals, suicide rates over time increased in young people from the most urban and most rural counties (p=0·04 for both).Air pollution and cognitive developmentResearchers for the BREATHE project have investigated the association between traffic-related air pollutants and cognitive development in a prospective cohort study. In their study including 39 schools exposed to either low or high traffic-related air pollution, cognitive development of 2715 primary school children was assessed every 3 months between January 2012 and March 2013. Air pollution was assessed through 2012. Overall, cognitive development improved over time for both groups. However, a smaller improvement was measured in the development of children from higher polluted areas: the group difference in working memory widened from 5·3 points at baseline to 9·9 points at the end of the study period (difference between the groups: 4·1%, 95% CI 1·5–6·8%; p=0·0024). Although adjustments for confounders were made, the authors noted that some outstanding confounding due to sociodemographic variables was a possibility.Mortality risk with antipsychotics in dementiaAuthors of a retrospective study have assessed the risk of death in people with dementia treated with an antipsychotic or an antidepressant. The study population comprised 46 008 participants with dementia who received one of the drugs under study plus 45 393 matched controls. The rate of 180-day mortality was highest in haloperidol users at 20·7%, with a risk difference of 3·8% (95% CI 1·0–6·6%) compared with controls and 12·3% (95% CI 8·6–16·0%) compared with users of antidepressants (number needed to harm: 26, 95% CI 15–99 and 8, 6–12, respectively). In users of antipsychotics, quetiapine had the lowest mortality (11·8%), with a risk difference of 2·0% (0·7–3·3%) compared with controls.ABCB1 and antidepressant outcomesCan variation at the ABCB1 locus affect outcomes for people treated with antidepressants? Researchers for the iSPOT-D trial have attempted to address this question by assessing if ABCB1 single-nucleotide polymorphisms (SNP) affect remission in people (n=683) treated for a minimum of 2 weeks with sertraline, extended-release venlafaxine, or escitalopram, for major depressive disorder. Remission was more likely in carriers of the rs10245483 SNP (p<0·001). Response to sertraline (p=0·020) and escitalopram (p=0·032) was significant in individuals who were homozygous for common alleles, with remission rates of 45% for both drugs, compared with 18% and 24% in minor allele homozygotes, respectively. Individuals who were homozygous for minor alleles had a significant response to venlafaxine (p=0·018).Risk taking in bipolar disorderInsight into the processes underlying risky decision-making in people with bipolar disorder is provided by a new study. By using EEG event-related potentials, Mason and colleagues measured the different stages of response to winning and losing money in a Roulette task. N1 (predominantly showing early-attentional processing) and P300 (predominantly showing lateral cognitive processing) were greater for gains than losses (p=0·03 and p=0·01). FRN (predominantly showing motivational salience processing) was greater for losses compared with gains (p=0·04). Compared with matched controls (n=20), participants with euthymic bipolar disorder (n=20) exhibited greater N1 (p=0·03), and decreased FRN (p=0·001).Drivers of youth access to mental health servicesThe challenges of engaging youth with mental health services are highlighted in a 12-month study from Australia. Authors assessed drivers of help-seeking behaviour for young people (aged 12–25 years) with use of specialised mental health services across 55 specialised primary care centres or through an online service. In 2013, the online service was used by 7155 individuals, and 30 839 used the specialised centres. A higher proportion of young people aged 21–25 reported themselves (“me”) as being the main influence for seeking help from the in-person services compared with young people aged 12–14 years (male individuals 32% vs 6%; female individuals 41% vs 8%); family was the main help-seeking influence in this younger group compared with the 21–25 years group (male individuals 69% vs 22%; female individuals 57% vs 16%). Individuals reported themselves as the main influence for accessing online services across all age groups. Suicide in young peopleThe increasing gap between suicide in young people in rural and urban areas is highlighted in a US longitudinal study. Authors studied the incidence of suicide in individuals aged 10–24 years from 1996 through to 2010 across the USA, during which there were 66 595 deaths attributed to suicide; notably, over half of the suicides were completed by use of a firearm. Suicide rates in male individuals in urban areas declined over time (p<0·001), although no such decrease was found in rural areas. In 2008–2010, the rate of suicides in male individuals in the most rural areas was 19·93 per 100 000 versus 10·31 per 100 000 in urban areas (adjusted incident rate ratio 1·19, 95% CI 1·07–1·32). In female individuals, suicide rates over time increased in young people from the most urban and most rural counties (p=0·04 for both). The increasing gap between suicide in young people in rural and urban areas is highlighted in a US longitudinal study. Authors studied the incidence of suicide in individuals aged 10–24 years from 1996 through to 2010 across the USA, during which there were 66 595 deaths attributed to suicide; notably, over half of the suicides were completed by use of a firearm. Suicide rates in male individuals in urban areas declined over time (p<0·001), although no such decrease was found in rural areas. In 2008–2010, the rate of suicides in male individuals in the most rural areas was 19·93 per 100 000 versus 10·31 per 100 000 in urban areas (adjusted incident rate ratio 1·19, 95% CI 1·07–1·32). In female individuals, suicide rates over time increased in young people from the most urban and most rural counties (p=0·04 for both). Air pollution and cognitive developmentResearchers for the BREATHE project have investigated the association between traffic-related air pollutants and cognitive development in a prospective cohort study. In their study including 39 schools exposed to either low or high traffic-related air pollution, cognitive development of 2715 primary school children was assessed every 3 months between January 2012 and March 2013. Air pollution was assessed through 2012. Overall, cognitive development improved over time for both groups. However, a smaller improvement was measured in the development of children from higher polluted areas: the group difference in working memory widened from 5·3 points at baseline to 9·9 points at the end of the study period (difference between the groups: 4·1%, 95% CI 1·5–6·8%; p=0·0024). Although adjustments for confounders were made, the authors noted that some outstanding confounding due to sociodemographic variables was a possibility. Researchers for the BREATHE project have investigated the association between traffic-related air pollutants and cognitive development in a prospective cohort study. In their study including 39 schools exposed to either low or high traffic-related air pollution, cognitive development of 2715 primary school children was assessed every 3 months between January 2012 and March 2013. Air pollution was assessed through 2012. Overall, cognitive development improved over time for both groups. However, a smaller improvement was measured in the development of children from higher polluted areas: the group difference in working memory widened from 5·3 points at baseline to 9·9 points at the end of the study period (difference between the groups: 4·1%, 95% CI 1·5–6·8%; p=0·0024). Although adjustments for confounders were made, the authors noted that some outstanding confounding due to sociodemographic variables was a possibility. Mortality risk with antipsychotics in dementiaAuthors of a retrospective study have assessed the risk of death in people with dementia treated with an antipsychotic or an antidepressant. The study population comprised 46 008 participants with dementia who received one of the drugs under study plus 45 393 matched controls. The rate of 180-day mortality was highest in haloperidol users at 20·7%, with a risk difference of 3·8% (95% CI 1·0–6·6%) compared with controls and 12·3% (95% CI 8·6–16·0%) compared with users of antidepressants (number needed to harm: 26, 95% CI 15–99 and 8, 6–12, respectively). In users of antipsychotics, quetiapine had the lowest mortality (11·8%), with a risk difference of 2·0% (0·7–3·3%) compared with controls. Authors of a retrospective study have assessed the risk of death in people with dementia treated with an antipsychotic or an antidepressant. The study population comprised 46 008 participants with dementia who received one of the drugs under study plus 45 393 matched controls. The rate of 180-day mortality was highest in haloperidol users at 20·7%, with a risk difference of 3·8% (95% CI 1·0–6·6%) compared with controls and 12·3% (95% CI 8·6–16·0%) compared with users of antidepressants (number needed to harm: 26, 95% CI 15–99 and 8, 6–12, respectively). In users of antipsychotics, quetiapine had the lowest mortality (11·8%), with a risk difference of 2·0% (0·7–3·3%) compared with controls. ABCB1 and antidepressant outcomesCan variation at the ABCB1 locus affect outcomes for people treated with antidepressants? Researchers for the iSPOT-D trial have attempted to address this question by assessing if ABCB1 single-nucleotide polymorphisms (SNP) affect remission in people (n=683) treated for a minimum of 2 weeks with sertraline, extended-release venlafaxine, or escitalopram, for major depressive disorder. Remission was more likely in carriers of the rs10245483 SNP (p<0·001). Response to sertraline (p=0·020) and escitalopram (p=0·032) was significant in individuals who were homozygous for common alleles, with remission rates of 45% for both drugs, compared with 18% and 24% in minor allele homozygotes, respectively. Individuals who were homozygous for minor alleles had a significant response to venlafaxine (p=0·018). Can variation at the ABCB1 locus affect outcomes for people treated with antidepressants? Researchers for the iSPOT-D trial have attempted to address this question by assessing if ABCB1 single-nucleotide polymorphisms (SNP) affect remission in people (n=683) treated for a minimum of 2 weeks with sertraline, extended-release venlafaxine, or escitalopram, for major depressive disorder. Remission was more likely in carriers of the rs10245483 SNP (p<0·001). Response to sertraline (p=0·020) and escitalopram (p=0·032) was significant in individuals who were homozygous for common alleles, with remission rates of 45% for both drugs, compared with 18% and 24% in minor allele homozygotes, respectively. Individuals who were homozygous for minor alleles had a significant response to venlafaxine (p=0·018). Risk taking in bipolar disorderInsight into the processes underlying risky decision-making in people with bipolar disorder is provided by a new study. By using EEG event-related potentials, Mason and colleagues measured the different stages of response to winning and losing money in a Roulette task. N1 (predominantly showing early-attentional processing) and P300 (predominantly showing lateral cognitive processing) were greater for gains than losses (p=0·03 and p=0·01). FRN (predominantly showing motivational salience processing) was greater for losses compared with gains (p=0·04). Compared with matched controls (n=20), participants with euthymic bipolar disorder (n=20) exhibited greater N1 (p=0·03), and decreased FRN (p=0·001). Insight into the processes underlying risky decision-making in people with bipolar disorder is provided by a new study. By using EEG event-related potentials, Mason and colleagues measured the different stages of response to winning and losing money in a Roulette task. N1 (predominantly showing early-attentional processing) and P300 (predominantly showing lateral cognitive processing) were greater for gains than losses (p=0·03 and p=0·01). FRN (predominantly showing motivational salience processing) was greater for losses compared with gains (p=0·04). Compared with matched controls (n=20), participants with euthymic bipolar disorder (n=20) exhibited greater N1 (p=0·03), and decreased FRN (p=0·001). Drivers of youth access to mental health servicesThe challenges of engaging youth with mental health services are highlighted in a 12-month study from Australia. Authors assessed drivers of help-seeking behaviour for young people (aged 12–25 years) with use of specialised mental health services across 55 specialised primary care centres or through an online service. In 2013, the online service was used by 7155 individuals, and 30 839 used the specialised centres. A higher proportion of young people aged 21–25 reported themselves (“me”) as being the main influence for seeking help from the in-person services compared with young people aged 12–14 years (male individuals 32% vs 6%; female individuals 41% vs 8%); family was the main help-seeking influence in this younger group compared with the 21–25 years group (male individuals 69% vs 22%; female individuals 57% vs 16%). Individuals reported themselves as the main influence for accessing online services across all age groups. The challenges of engaging youth with mental health services are highlighted in a 12-month study from Australia. Authors assessed drivers of help-seeking behaviour for young people (aged 12–25 years) with use of specialised mental health services across 55 specialised primary care centres or through an online service. In 2013, the online service was used by 7155 individuals, and 30 839 used the specialised centres. A higher proportion of young people aged 21–25 reported themselves (“me”) as being the main influence for seeking help from the in-person services compared with young people aged 12–14 years (male individuals 32% vs 6%; female individuals 41% vs 8%); family was the main help-seeking influence in this younger group compared with the 21–25 years group (male individuals 69% vs 22%; female individuals 57% vs 16%). Individuals reported themselves as the main influence for accessing online services across all age groups.