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Antidepressant Plus Antipsychotic May Cause Cardiometabolic Complications

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A new study from the 81st Scientific Sessions of the American Diabetes Association (ADA) shows that concomitant treatment with selective serotonin reuptake inhibitors (SSRIs) and second generation antipsychotics (SGAs) for mental disorders in children can have adverse effects on cardiometabolic health .

The researchers found that although treatment with either drug has been linked to cardiometabolic complications and an increased risk of type 2 diabetes, little is actually known about using both drugs at the same time.

To evaluate the cardiometabolic effects of a combination of treatments, a team led by Rupinder Thandi, BS, and colleagues from the University of British Columbia conducted a cross-sectional study of children at their facility’s Child and Adolescent Psychiatry Department.

The study

All examined patients (n = 569) were 5-18 years old; presented with a mental health diagnosis; had no endocrine, genetic, or eating disorders; and had not taken any medication that affected her metabolism.

Rupinder and team then divided the patients into 4 cohorts: SSRI and SGA treatment-naive (n = 242), only SSRI (n = 123), only SGA (n = 112) and SSRI + SGA (n = 92). Patients who received either or both drugs were given them for 7 days in the analysis analysis.

The team collected anthropometric and fasting blood samples from patients and assessed systolic / diastolic blood pressure, glucose homeostasis, and plasma lipids. Fitted linear and logistic regression models were used to determine any relationship between treatment groups and cardiometabolic risk factors.

The mean age was 13.04 for the naive population, 13.61 for the SSRI population, 11.63 for the SGA population, and 12.31 for the SSRI + SGA population.

In addition, the most common primary mental health diagnosis in all groups was anxiety disorder. Other primary diagnoses in the population were depressive disorder and ADHD.

The results

Patients who received SSRIs only received medication for an average of 5.38 months and patients who received combination therapy received an average of 8.00 months.

Overall, the researchers found that children treated with SSRI + SGA had higher z-scores on waist circumference (0.91) than children treated with SSRI only (0.48; P <0.05).

In addition, compared to SSRI-treated patients, children in the combined cohort had a higher probability of waist circumference in ≥90. Percentile (odds ratio [OR], 2.63, 95% CI; 1.34-5.18; P <0.05).

They also had higher plasma total cholesterol compared to SGA only (4.63 vs. 4.34 mmol / L; P <0.05, adjusted for age, gender, and BMI-Z scores) and a higher chance of having plasma -Total cholesterol ≥ 5.18 mmol / l (OR 2.36, 95% CI 1.05-5.30, P <0.05.

No differences in fasting plasma glucose, insulin, or insulin resistance (as measured by homeostasis model assessment of insulin resistance) were observed [HOMA-IR]) between treatment groups.

“Our results suggest major cardiometabolic complications in children treated with SSRIs and SGAs concurrently,” the researchers concluded.

The study “Effects of Concomitant Use of Selective Serotonin Reuptake Inhibitors and Second Generation Antipsychotic Drugs on Cardiometabolic Health in Children” was presented at ADA 2021.

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Health experts warn of increase in PTSD as pandemic eases – The Oakland Press

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One of the consequences of the COVID-19 pandemic is the appearance of various mental disorders. Due to the traumatic nature of the pandemic, there has been an increasing surge of people seeking treatment for post-traumatic stress disorder.

When people hear the term PTSD, they often associate the condition with veterans and survivors of sexual assault. However, the disorder can occur after a variety of overwhelming, terrifying, traumatic events. PTSD is in the classification of trauma and stress-related disorders that develop when a person is at risk of death or injury, learns from someone who has had the experience, or when exposed to vivid details of a traumatic event.

PTSD symptoms can include:

• Burglaries: Unwanted annoying memories, nightmares, and flashbacks.

• Avoidance: Avoidance of thoughts, feelings, places and people that recall the traumatic event.

• Negative changes in thinking and mood: Excessively negative thoughts and feelings about yourself or the world, feelings of shame, and difficulty remembering parts of the event.

• Changes in physical and emotional responses: difficulty concentrating, trouble sleeping, irritability or aggression, and feeling that you or the world around you are not real.

Britain’s Prince Harry recently spoke about his own therapeutic journey with trauma in an interview with Oprah. He stressed the fact that “it’s not what’s wrong with you, it’s what happened to you.” Fortunately, our brains are adept at dealing with negative events. However, some events are too many for our systems to handle without assistance and this is where therapy should be sought.

Eye Movement Desensitization Reprocessing (EMDR) therapy is one of the main forms of treatment for PTSD. EMDR is recognized as the primary treatment for trauma by institutions such as the World Health Organization and the US Department of Defense. Prince Harry said it helped him come to terms with his mother’s tragic death.

EMDR is performed by recalling the traumatic memory, and while the client is focusing on the painful memory, the doctor uses bilateral stimulation – a type of movement back and forth across the midline of the body – to the client’s brain help to process the material a more adaptable method. These movements may include following the doctor’s hand with eyes, watching a light, or hearing a sound in changing ears. Prince Harry’s method was to pat his shoulders with your hands.

During a session, a client focuses on the traumatic event – what was seen, felt, heard, thought, and any beliefs and body sensations about the event. Then the therapist involves the client in the bilateral stimulation. A client’s role in this process is to leave whatever comes to mind without controlling or judging it. The goal of EMDR is to reduce the intrusive nature and emotional intensity of traumatic memories and to develop more positive thoughts and beliefs about yourself in relation to the trauma.

A lot of people ask what EMDR feels like. The therapy is similar to REM sleep (Rapid Eye Movement). Have you ever gone to bed upset, got a full night’s sleep, and woke up feeling better from the bad experience from the previous day? This is what the treatment essentially feels like. Once processed, the memory no longer causes distressing symptoms.

EMDR is suitable for children, adolescents and adults. For information on EMDR and a great introduction to this therapy, visit the EMDR International Association website: emdria.org/about-emdr-therapy.

Christine Muska is an EMDR Certified Therapist and Consultant with the Birmingham Maple Clinic.

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sexual predators online are targeting teens wanting to lose weight. Platforms are looking the other way

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There is no shortage of people on the internet trying to exploit and manipulate the weak among us. One such group are anorexia coaches or “anacoaches”.

They are typically middle-aged male sex offenders who go online to find impressionable young people to exploit under the guise of “weight loss coaching.”

I did some research on how anacoaches work. I have found that they are made easier by flaws in social media algorithms, as well as large numbers of young people seeking weight loss help online.

Anacoach message on Tumblr.
Author stated

My ongoing research, along with other media reports, shows that the opportunities for anacoaches have increased in recent years. My analysis has shown that on Twitter alone there are around 300 one-time requests for anacoaches around the world every day.

Anacoaches operate on numerous channels, including established social platforms such as Twitter, TikTok, Tumblr, and Kik. Even so, these platforms did not address the problem.

Address young people

An estimated 4% of Australians, or around a million people, have eating disorders. And almost two thirds (63%) of these people are female.

Screenshot from TikTok.
Author stated

Teenagers with eating disorders are more likely to experience poor mental health and impaired social function – making them more susceptible to the influence of anacoaches.

Research has also shown that social media use can increase the extent to which teenagers and young adults chase a “thin” ideal.

A study of anacoaches’ predatory behavior published by a Dutch human rights group found that victims who report themselves were sexually abused and even raped.

And with anacoaching comes the potential for other forms of criminal abuse, such as pedophilia, forced prostitution, and even human trafficking.

Read more: The virtual door to online childcare is wide open

The platform offers social media

With the advent of online platforms, communities have emerged that pursue a thin ideal. These networks tend to share content advocating extreme thinness.

Group identity is formed through interactions and hashtag sharing, with a focus on terms that are regularly used in connection with eating disorders. Common hashtags are #proana (pro-anorexia), #bonespo (bone inspiration), #edtw (eating disorder warning), #promia (pro bulimia), #bulimie, #thighgap, #uw (ultimate weight), #cw (current weight), #gw (target weight) and #tw (trigger warning).

As highlighted in my previous research, communication in these communities includes sharing tips on weight loss, diet plans, extreme exercise plans, pictures of thin bodies, and emotional “support”.

Anacoaches lurk in chat forums that focus on thin ideals. Each coach is usually present in numerous chat rooms and attracts teenagers with stories about their previous “successes” from coaching.

They market themselves with dubious claims. Some will assign themselves labels like “strict coach” or “common coach”. The following screenshots show messages published in the Kik app.

Screenshot by Kik.
Author stated

Screenshot by Kik.
Author stated

The coaching mainly involves sharing pictures and videos for nude body checks (or in underwear), weekly weighing, and enforcing strict rules on what foods to eat and avoid.

Screenshot by Kik.
Author stated

While there is currently no way of knowing how long a coaching will take on average, the damage is far-reaching. Because of the way its content algorithms work, TikTok, which has a huge young following, will begin recommending user accounts focused on eating disorders as soon as such content is sought.

Screenshot from TikTok.
Author stated

What is being done?

There are currently insufficient regulations from platforms to prevent anacoaches from operating, despite a number of reports highlighting the problem.

So far, Instagram, TikTok and Pinterest have tried to filter out selected words such as “proana” or “thinspo” and to prohibit searches for content that promotes extreme thinness.

A TikTok spokesperson told The Conversation that the platform does not allow content that depicts, promotes, or glorifies eating disorders.

“When a user searches for terms related to eating disorders, we don’t return any results, but instead forward them to the Butterfly Foundation for helpful and appropriate advice. We have also introduced permanent public notices (PSAs) on related hashtags to support our community, ”the spokesman said.

Screenshot from TikTok.
Author stated

The spokesman said accounts found to have been sexually harassed could be blocked. Platforms will block users if they violate user guidelines, but anacoaches often reappear under a new account name.

According to Twitter, bypassing account locks is against the rules. Earlier this year, Twitter announced that it would enable a security mode that would allow users to enable proactive checking of spam and abusive content. It remains to be seen what role this will play in containing targeted attacks by anacoaches.

A research-based report published this month by the 5Rights Foundation details how minors are being attacked with sexual and suicidal content online. It refers to platforms like Twitter, TikTok, Instagram, Snapchat, Facebook, Discord, Twitch, Yubo, YouTube and Omegle.

The study showed that children under the age of 13 are directly attacked with malicious content on the Internet within 24 hours of creating an online account.

Screenshot from TikTok.
Author stated

You may receive unwanted messages from adults who offer pornography, as well as recommendations about content related to eating disorders, extreme diets, self harm, suicide, and sexualized or distorted body images.

Australia’s platform guidelines need to be revised to ensure platforms adhere to community guidelines and are held accountable for violations.

The government, informed by the eSafety office, should impose firm rules on how vulnerable young people should be helped on the Internet.

A differentiated approach to intervention would produce better results for users with eating disorders because each user would have different circumstances and mental health status.

Anacoaches on social media should be viewed and treated like criminals. And platforms that fail to do so should be fined for failing to provide a safe user environment for the weak.

In the past, the European Union fined platforms for allowing terrorist content. Social media giants have also hired contract workers to review content for examples of terrorism, pedophilia and abuse. These efforts should be extended to anacoaches.

Screenshot by Kik.
Author stated

The Conversation reached out to Tumblr for comment but received no responses within the deadline. The popular messaging app Kik was acquired by MediaLab in 2019. The Conversation reached out to MediaLab for comment but received no response within the allotted time frame.

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UMass Medical School drama therapy mental illness patients

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WORCESTER – In the piece “Lost & Found” there is a king, a queen, a princess and a wise man. The characters read the lines in their scripts.

But these “actors” are not real actors from a drama series.

You are a group of people struggling with mental illness who are either stuck in the dark or in the recovery process and undergoing a novel and innovative treatment – drama therapy.

Traditional methods of treating patients with mental illness include treatments such as medication and psychotherapy. These may work for some of the patients, but not for another group of people who have limitations on certain medications and are reluctant to share their trauma through talk therapy.

“A lot of patients just didn’t want to talk about it. As painful as the scar, the wound is so deep, ”said Dr. Xiaoduo Fan, psychiatrist of UMass MIND program, the community outreach program of the Psychotic Disorders Program at UMass Medical School Scar, how can you recover? ”

Virtual co-active therapeutic theater production

In May of this year, UMass MIND organized a piece “Lost & Found: A Message of Hope” in cooperation with Lesley University for a virtual co-active therapeutic theater production.

The script for the play was developed by participants to symbolize their personal mental health challenges and recovery journeys, and to tell an intimate story of hope, family, and recovery that goes beyond those who are biologically related to them. It was performed after eight weeks of rehearsals and preparations.

Viewers were also invited to share their own message of hope, which was later turned into a poem.

This was the second pilot program that paved the way for a true three year drama therapy degree.

Powerful results

In 2019 UMass MIND carried out its first personal pilot test. Fan said they weren’t sure the tech would work as no one had ever done it before.

Still, the result was impressive, Fan said. Patients who would rather be treated with non-verbal therapy are more open to sharing their experiences through the program, he said.

As a result, the result gave them confidence to continue the novel therapy and later apply for a National Endowment for the Arts scholarship of $ 95,000.

Project starts this fall

The three-year NEA-funded project starts this fall.

The project will enroll six participants for 12-week sessions in a randomized and controlled research study with multiple drama therapy groups using the Co-Active Therapeutic Theater Manualized Model developed by Laura Wood, Associate Professor of Theater Therapy at Lesley University . The sessions will culminate in a public personal performance, which is expected to take place in early to mid-November.

Participants suffer from various types of mental health problems, including cognitive repair, experiencing extreme trauma, or dealing with feelings of shame and stigma.

Community partner

In addition to Lesley University, the project also works with mental health organizations in the Worcester area, including Open Sky Community Services, Genesis Club and Community Healthlink.

These community mental health organizations help raise awareness of the program, train their members, and encourage people to participate in therapy.

“I think the program itself is such an opportunity for people with severe mental illness to share their voice and experience and rediscover, or perhaps for the first time, discover their own creative abilities,” said Lisa Brennan, Executive Director of the Genesis clubs. “In many ways, I think this was the last time this program was done and listening to our members who attended, they talked about how they felt very empowered.”

Together with Fan, Kalea Barger, soon to be a senior at Clark University with a focus on psychology, and Victor Agwu, a sophomore medical student at UMass Medical School, lead the drama therapy program.

Although Barger was not an acting major, Barger had acted in high school, which fueled her interest in participating in a drama-based community program. He worked for Agwu in mental health prior to medical school, which easily led him to the program, he said.

Dr.  Xiaoduo fan

Sometimes it is difficult for people with mental illness to express their feelings verbally. So if they use other forms of expression like masks, costumes, poetry, or a character from a movie or TV show, they’ll be better able to express their feelings non-verbally, explained the program directors.

In a drama therapy session, participants willing to work with staff and drama therapists can create a play that resonates with their personal life or experiences.

“For example, if a patient really loves a particular TV show that helps them deal with their symptoms and express themselves, they can choose a role, any role on that TV show, and play that role. This way of expressing yourself is therapeutic, ”said Agwu.

The program is flexible, he said. The staff lead them, but it’s more about letting them choose what character they want to be or how they want to express themselves.

“We can’t tell them how to express themselves. We don’t know how to feel. We want them to express themselves comfortably,” said Agwu.

Past trauma could emerge during sessions where participants are acting, he said. The staff is there to help them find healthy ways to cope with them, he said.

“(It’s) a deeper sense of yourself and a part of yourself that you can cherish and relate to your journey to mental health well-being, so it’s like a deeper (a) connection to recovery,” said Barger about the hopeful outcome after each therapy session.

“It’s also a sense of self-worth, a sense of (belonging) to the community,” added Agwu.

For some patients, Fan said, drama therapy is more effective than conventional therapy methods, as it serves as an additional option or preferred way to express their emotions or to connect socially with people.

After three years, Fan hopes that the mainstream healthcare system will eventually embrace the novel treatment, learn from it, educate itself, become more aware of the novel treatment and understand how powerful it can be.

“It is a process of getting health system approval to change the way (we) intervene. It is not easy. It’s always a process. Nothing will happen overnight, ”said Fan.

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