Social Work Today E-Zine

Some kids with autism may have a genetic defect that affects the muscles, according to research that will be presented at the American Academy of Neurology annual meeting in Chicago.

The study looked at 37 children with autism spectrum disorders who were evaluated for mitochondrial disease, which causes muscle weakness and prevents a child from being able to participate in physical activities and sports. Mitochondrial disease occurs when genetic mutations affect the mitochondria, or the part of the cell that releases energy.

A total of 24 of the children, or 65%, had defects in the process by which cells produce and synthesize energy in the muscles, or oxidative phosphorylation defects in the skeletal muscles.

“Most children with autism spectrum disorders do not have recognizable abnormalities when you look at genetic tests, imaging, and metabolic tests,” said study author John Shoffner, MD, owner of Medical Neurogenetics, LLC in Atlanta, GA, and member of the American Academy of Neurology. “But a subset of these children does have significant defects in this area. Identifying this defect is important for understanding how genes that produce autism spectrum disorders impact the function of the mitochondria.”

— Source: American Academy of Neurology

Parents of children with autism were roughly twice as likely to have been hospitalized for a mental disorder, such as schizophrenia, than parents of other children, according to an analysis of Swedish birth and hospital records by a University of North Carolina (UNC) at Chapel Hill researcher and colleagues in the United States and Europe. The study appeared in a recent issue of the journal Pediatrics.

“We are trying to determine whether autism is more common among families with other psychiatric disorders. Establishing an association between autism and other psychiatric disorders might enable future investigators to better focus on genetic and environmental factors that might be shared among these disorders,” says study author Julie Daniels, PhD, an assistant professor in the UNC School of Public Health’s epidemiology and maternal and child health departments.

“Earlier studies have shown a higher rate of psychiatric disorders in families of autistic children than in the general population,” she says. “We wanted to see if the parents of autistic children were more likely to be diagnosed with mental disorders. Our research shows that mothers and fathers diagnosed with schizophrenia were about twice as likely to have a child diagnosed with autism. We also saw higher rates of depression and personality disorders among mothers, but not fathers.”

The study examined 1,237 children born between 1977 and 2003 who were diagnosed with autism before age 10, and compared them with 30,925 control subjects matched for gender, year of birth and hospital. The large sample size enabled researchers to distinguish between psychiatric histories of mothers versus fathers in relation to autism. The association was present regardless of the timing of the parent’s diagnosis relative to the child’s diagnosis.

— Source: University of North Carolina at Chapel Hill

Older adults with low blood levels of vitamin D and high blood levels of a hormone secreted by the parathyroid glands may have a higher risk of depression, according to a report in a recent issue of Archives of General Psychiatry.

Witte J. G. Hoogendijk, MD, PhD, and colleagues at Vrije Universiteit Amsterdam Medical Center in the Netherlands measured blood levels of vitamin D and parathyroid hormone and assessed symptoms of depression among 1,282 community residents aged 65 to 95. Of those individuals, 26 had a diagnosis of major depressive disorder, 169 had minor depression and 1,087 were not depressed. The average blood vitamin D level was 21 nanograms per milliliter and the average parathyroid hormone level was 3.6 picograms per milliliter.

Blood vitamin D levels were 14% lower in individuals with major and minor depression (averaging 19 nanograms per milliliter) compared with non-depressed participants (averaging 22 nanograms per milliliter). In addition, parathyroid hormone thyroid levels were an average of 5% higher in those with minor depression (averaging 3.72 picograms per milliliter) and 33% higher in those with major depressive disorder (averaging 4.69 picograms per milliliter) than in those who were not depressed (averaging 3.53 picograms per milliliter).

The findings may be important to patients because both low blood vitamin D levels and high parathyroid hormone levels can be treated with higher dietary intake of vitamin D or calcium and increased sunlight exposure. “Moreover, the clinical relevance of the present study is underscored by our finding that 38.8% of men and 56.9% of women in our community-based cohort had an insufficient vitamin D status,” they conclude. Additional studies are needed to determine whether changes in levels of vitamin D and parathyroid hormone precede depression or follow it.

— Source: American Medical Association

Major mental disorders cost the nation at least $193 billion annually in lost earnings alone, according to a new study funded by the National Institutes of Health's National Institute of Mental Health (NIMH). The study was published in a recent issue of the American Journal of Psychiatry.

In the study, Ronald C. Kessler, PhD, of Harvard University, and colleagues analyzed data from the 2002 National Comorbidity Survey Replication (NCS-R), a nationally representative study of Americans aged 18 to 64. Using data from 4,982 respondents, the researchers calculated the amount of earnings lost in the year prior to the survey among people with serious mental illness (SMI).

Eighty-six percent of respondents reported earning income in the previous year. But those with SMI reported earning significantly less—around $22,545—than respondents without SMI, who averaged $38,852. Although men with SMI took a greater hit in earnings than women with SMI, men still earned more overall than women with and without SMI.

By extrapolating these results to the general population, the researchers calculated that SMI costs society $193.2 billion annually in lost earnings. The researchers attributed about 75% of this total to the reduced income that people with SMI likely earn, while 25% is attributed to the increased likelihood that people with SMI would have no earnings.

"The results of this study confirm the belief that mental disorders contribute to enormous losses of human productivity," says Kessler. "Yet this estimate is probably conservative because the NCS-R did not assess people in hospitals or prisons, and included very few participants with autism, schizophrenia or other chronic illnesses that are known to greatly affect a person's ability to work. The actual costs are probably higher that what we have estimated."

— Source: The National Institutes of Health

Today, one out of very 12 people aged 65 and older will experience a decline in their ability to remember, think clearly, reason, and make daily decisions. The decline in memory and mental abilities may be subtle, but it limits quality of life and oftentimes leads to depression.

James Siberski, MS, an assistant professor, geriatric-care manager certificate program director, and coordinator of the Gerontology Education Center for Professional Development at Misericordia University, and colleague Margie Eckroth-Bucher, RN, an associate professor of nursing at Bloomsburg University; are leading the research with Misericordia students in a six-month study to better understand how to treat people with memory problems and who have a decreased ability to think clearly. The study will also determine what effects the activities might have on any symptoms of depression.

Researchers divided volunteers into two sections, a treatment group and control group. The treatment group is involved in the specific research activities, while the control group volunteers participate in the examinations, but maintain their normal schedule of activities.

The treatment group’s results from the mental status and cognitive ability examinations are entered into a computer that records the scores for each participant and exercise. The information will also be used to determine if the program’s activities had an effect on any individuals.

“This study is an important first step in understanding how routine daily activities might have a positive effect on the aging mind," says Siberski. “With our aging population and baby boomers nearing retirement, it is vitally important for health care providers to find proven tools that slow down the deterioration of an older person’s cognitive abilities."

— Source: Misericordia University

For children of divorce, what happens after their parents split up may be just as important to their long-term well being as the divorce itself. A new study found that children who lived in unstable family situations after their parents divorced fared much worse as adults on various measures compared with children who had stable post-divorce family situations.

“For many children with divorced parents, particularly young ones, the divorce does not mark the end of family structure changes—it marks the beginning,” says Yongmin Sun, coauthor of the study and an associate professor of sociology at Ohio State University’s Mansfield campus. “A stable family situation after divorce does not erase the negative effects of a divorce, but children in this situation fare much better than do those who experience chronic instability”

The study appears in a recent issue of the Journal of Marriage and Family. Data for this study came from the National Education Longitudinal Study, which surveyed thousands of students across the country beginning in 8th grade in 1988, when they were about 14 years old. They were surveyed again in 1990, 1992 and then again in 2000 when they were about 26 years old.

In the two divorced family groups, children may have lived in single-parent families or ones with a stepparent. The key for this research was whether that arrangement—whichever it was—changed between the ages of 14 and 18. The researchers compared how children in these groups fared on measures of education, income, and poverty in 2000 when they were 26.

Results showed that young adults who grew up in stable post-divorce families had similar chances of attending college and living in poverty compared with those from always married families. But they fared less well on measures of the highest degree obtained, occupational prestige, and income. However, the young adults who lived in unstable family situations after their parents divorced did worse on all measures. In fact, they fared more than twice as poorly on most measures compared with their peers who had stable family situations.

— Source: Ohio State University

For years, the only concept of drug abuse counseling was for patients to meet face-to-face with a therapist. Scientists are now convinced we can add a computer to that picture. The first randomized controlled trial that combined a computer-learning program with traditional counseling showed a longer period of abstinence from drugs than for those patients who had counseling alone. The study, conducted by researchers from the Yale University School of Medicine, was recently published in the American Journal of Psychiatry.

All participants received standard treatment at the clinic, which consisted of weekly individual and group drug counseling sessions. They were all English-speaking adults who met the diagnostic criteria for substance dependence, including alcohol, cocaine, opioids, or marijuana. Those who were randomized to the computer program were led through six modules in a range of formats, including movies of actors demonstrating coping skills in realistic situations and opportunities for patients to review and practice the new skills. The modules covered several core concepts, including understanding and changing patterns of substance abuse, coping with craving, refusing offers of drugs and alcohol, problem-solving skills, identifying and changing thoughts about drugs and alcohol, and improving decision-making skills.

During the study period, participants’ self-reports of illegal drug use were verified through urine toxicology screens that were obtained at every assessment visit. Those who used the computer-based program submitted significantly fewer drug-positive urine specimens and tended to have longer periods of abstinence during treatment compared to patients who only met with a counselor.

With this computerized approach, treatment can be tailored to the needs of the individual, selecting specific topics, modifying speed of presentation and repetition of modules as necessary. The research team plans to use the program for more refined studies of the individual CBT components as well as to determine whether or not it could be effective when delivered alone, rather than as an adjunct to standard treatment.

— Source: The National Institute on Drug Abuse