Cannabis Use in Early Adolescence Especially Neurotoxic

Chronic cannabis use that starts before age 15 may have a more deleterious effect on cognitive functioning than chronic use that starts later, new research shows.

A study conducted by Brazilian investigators from the Federal University of Sao Paulo showed that early-onset (before age 15 years) chronic cannabis users had significantly poorer executive functioning than late-onset (after age 15 years) users.

“Our findings indicate that early-onset chronic cannabis users are cognitively impaired compared with controls, suggesting that early exposure to cannabis is associated with more adverse effects on the brain. These results are in line with previous studies examining cognitive effects associated with early cannabis exposure,” the authors, led by Maria Alice Fontes, PhD, write.

The study is published in the June issue of the British Journal of Psychiatry…….

By Caroline Cassels
Medscape Medical News

Jury Out on Early Intervention for Psychosis

There is “emerging, but as yet inconclusive” evidence that individuals in the prodromal phase of psychosis can benefit from early intervention, although whether this will prevent progression to full-blown schizophrenia remains to be seen, conclude the authors of a new Cochrane review.

There is also “some support for phase-specific treatment focused on employment and family therapy, but again, this needs replicating with larger and longer trials,” authors Max Marshall, MD, University of Manchester, and John Rathbone, MD, University of Sheffield, United Kingdom, write.

The review appears in the latest issue of the Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research.

Proponents of early intervention argue that schizophrenia outcomes may be improved if more efforts were focused on the early phase of psychosis. It’s estimated that about 10% to 20% of these individuals go on to develop full-blown schizophrenia. The aim of early intervention is to prevent this.

“The arguments in favor of early intervention have been so persuasive that early intervention teams are well-established in America, Europe and Australasia,” the authors note.

Early intervention in schizophrenia has 2 distinct goals. The first is the early identification of those likely to develop psychosis. These individuals display nonpsychotic prodromal symptoms but have never had a psychotic episode.

The second is phase-specific treatment that may include psychological, social, or physical treatment designed specifically for patients with early-stage illness. Early detection and phase-specific treatment may supplement standard care or may be provided through a specialized early intervention team.

However, clear-cut evidence of effectiveness of early intervention remains unclear, the authors note…….

By Megan Brooks
Medscape Medical News

Older Antipsychotics Trump Newer Agents for Schizophrenia

In a large population-based cohort study, conventional depot antipsychotics turned out to be superior to risperidone long-acting injection, Danish researchers reported here at the New Clinical Drug Evaluation Unit (NCDEU) 51st Annual Meeting, sponsored by the American Society of Clinical Psychopharmacology.

“Newer does not necessarily mean better,” Jimmi Nielsen, MD, PhD, from Aalborg Psychiatric Hospital, Aalborg, Denmark, told Medscape Medical News.

“People tend to think that new equals improved, but as we found, the conventional depot antipsychotic formulation was more effective and it also was much cheaper.”

Risperidone long-acting injection (RLAI), the first atypical depot antipsychotic, is widely used in Europe and the United States, and its superiority to placebo and oral antipsychotics has been shown in several randomized controlled trials, Dr. Nielsen said.

“Only a few studies have compared RLAI with the conventional depot formulation, so we decided to look at this issue in a large population using our Danish nationwide registers,” he said.

By Fran Lowry
Medscape News

Knowledge About Mental Illness Increases Likelihood Of Seeking Help

Increased knowledge about mental illness, attitudes of tolerance toward people with mental illness, and support for providing them with care in the community lead to an increased likelihood of individuals seeking help, according to research appearing in the June issue of the American Psychiatric Association’s journal Psychiatric Services…..

Source: American Psychiatric Association

ERs Frequented by Kids With Behavioral Problems: Report

WEDNESDAY, June 1 (HealthDay News) — Regular outpatient care has not kept children and teenagers with mental health issues and behavioral problems from making repeat visits to the emergency room (ER), according to a new study.
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Researchers from Johns Hopkins Children’s Center found that more often than not, children who repeatedly end up in the ER do not actually have life-threatening emergencies.

The study, published in the June 1 issue of Psychiatric Services, examined the medical records of more than 2,900 children, ranging in age from 3 to 17 years, who were treated at the center’s ER for mental health crises over the course of eight years. The analysis revealed that 12 percent of these children had a repeat trip to the ER within six months of their first visit.

The researchers also found that most of the children went to the ER seeking medical attention for behavioral problems or minor psychiatric problems, such as disruptive classroom behavior, verbal disputes and running away. Only 3 percent of the visits involved severe psychotic episodes and 10 percent were suicide attempts, the study authors noted…..

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