Psychiatric News (4/14) reports that in a viewpoint published online April 10 in JAMA Internal Medicine, Sandro Galea, MD, of Boston University School of Medicine; Raina M. Merchant, MD, of Perelman School of Medicine; and Nicole Lurie, MD, of the Coalition for Epidemic Preparedness Innovations in Norway, “recommended three steps they believe can help…address the likely rise of mental disorders and related challenges from the” COVID-19 pandemic. The three steps include making “plans to address loneliness and its aftereffects as populations physically isolate and to develop ways to intervene,” having “mechanisms in place for surveillance, reporting, and intervention, particularly when it comes to domestic violence and child abuse,” and bolstering “the mental health system.”

Related Links:

— “Take Steps Now to Mitigate Mental Health Effects of COVID-19, Psychiatric News, April 14, 2020

According to HealthDay (4/13, Norton), “people who carry a gene called APOE4 face an increased risk of Alzheimer’s,” an effect that “may be lessened if they” carry another gene called “klotho.” Investigators arrived at that conclusion after “collecting data on more than 20,000 people age 60 and up – some with Alzheimer’s, some with milder impairment, and some with intact thinking and memory skills.” The study revealed that “among APOE4 carriers, those who also had one copy of the protective klotho variant were 30% less likely to develop Alzheimer’s by age 80.” It does not appear, however, “that the klotho variant protected people who did not carry the APOE4 variant.” The findings were published online April 13 in JAMA Neurology. MedPage Today (4/13, George) also covers the study.

Related Links:

— “Certain Gene Might Help Shield At-Risk People From Alzheimer’s, “Amy Norton, HealthDay, April 13, 2020

Psychiatric News (4/13) reports, “The rapid spread of the novel coronavirus (COVID-19) has led to dramatic public health actions at a national level to reduce human contact in hopes of slowing virus transmission,” but in a viewpoint published online April 10 in JAMA Psychiatry, “mental health experts discuss the potential of this long-term isolation to increase suicide risk.” In order to help mitigate “these risks, psychiatrists and mental health professionals should determine ways to incorporate mental health screening into COVID-19 screening and prevention efforts.” In addition, they should “consider ways to reach patients who are using tele-mental health services or receiving care in alternative treatment settings (such as a private space outside).”

Related Links:

— “Experts Warn of Potential of COVID-19 to Increase Suicide Risk, Psychiatric News, April 13, 2020

MedPage Today (4/13, Hlavinka) reports that even though “personal protection is often cited as a motive for firearm ownership, self-defense homicides accounted for far fewer firearm-related deaths than accidental deaths and suicides in Washington state’s King County,” research indicated. The study revealed that “for each case of self-defense homicide to occur in the home from 2011 to 2018, there were 44.1 suicides…7.3 criminal homicides,” and “0.9 unintentional deaths.” What’s more, “across the seven-year period, the incidence rate of firearm deaths was 3.9 per 100,000 person-years,” investigators learned. The findings were published online April 13 in a research letter published in JAMA Internal Medicine.

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— MedPage Today (requires login and subscription)

HealthDay (4/10) reported that a Chinese study published in JAMA Neurology “finds that strokes, altered consciousness and other neurological issues are relatively common in more serious cases of COVID-19.” After looking at 214 cases of severe coronavirus illness treated “during the early phase of the global pandemic, doctors reported that 36.4% of patients displayed neurological symptoms.” Researchers says that “sometimes these symptoms appeared in the relative absence of ‘typical’ symptoms of COVID-19.” The team said that “in such cases, doctors should consider coronavirus infection as a potential cause of the problem ‘to avoid delayed diagnosis or misdiagnosis.’”

Related Links:

— “Brain, Nervous System Affected in 1 in 3 Cases of Severe COVID-19, “E.J. Mundell, HealthDay, April 10, 2020

TIME (4/10) reported that “a study published March 23 in the medical journal JAMA found that, among 1,257 healthcare workers working with COVID-19 patients in China, 50.4% reported symptoms of depression, 44.6% symptoms of anxiety, 34% insomnia, and 71.5% reported distress.” Meanwhile, in interviews with TIME, many doctors and nurses said they’re “afraid of spreading the disease to their families, frustrated about a lack of adequate protective gear and a sense they can’t do enough for their patients, exhausted as hours have stretched longer without a clear end in sight, and, most of all, deeply sad for their dying patients, many of whom are slipping away without their loved ones at their side.” Dr. Albert Wu, of the Johns Hopkins Bloomberg School of Public Health, “says that evidence from the 2003 SARS outbreak suggests that failing to support healthcare workers in a crisis…can erode their ‘wellbeing and resilience,’ ultimately leading to chronic burnout.”

Related Links:

— “‘We Carry That Burden.’ Medical Workers Fighting COVID-19 Are Facing a Mental Health Crisis, “Tara Law, TIME, April 10, 2020

The Wall Street Journal (4/12, Petersen, Subscription Publication) reports that the coronavirus pandemic has been especially difficult for individuals suffering from depression and anxiety because of additional stress and isolation. According to a survey released by the American Psychiatric Association, over one-third of Americans say the pandemic is having a serious impact on their mental well-being.

Related Links:

— “The Struggle to Cope With Depression Amid Coronavirus, “Andrea Petersen, The Wall Street Journal, April 12, 2020

MD Magazine (4/9, Walter) reports, “Antidepressants could be beneficial in managing the symptoms of depression, while changing the behaviors of people who” also have overweight or obesity, researchers concluded after examining “electronic health records to identify adults who were either overweight or obese with incident depression, but no prior depression diagnosis in their records,” then following up with “each patient…between 2000-2019.” The findings of the 519,513-patient study were published online April 7 in the journal Obesity.

Related Links:

— “Antidepressants Could Address Depression and Obesity Behaviors, “Kenny Walter, MD Magazine, April 9, 2020

Healio (4/9, Gramigna) reports, “Cannabis withdrawal syndrome appeared common among regular cannabis users,” investigators concluded in “a systematic review and meta-analysis” encompassing “47 studies that included 23,518 participants.” The findings were published online April 9 in JAMA Network Open. MD Magazine (4/9, Rosenfeld) also covers the study.

Related Links:

— “Cannabis withdrawal syndrome may affect nearly 50% of regular users, “Joe Gramigna, Healio, April 9, 2020

NPR (4/9, Noguchi) reports many psychiatrists are using teletherapy to reach patients affected by the coronavirus pandemic. For example, Dr. Philip Muskin in New York City says he is reaching patients using the phone and many of them feel trapped having lost their livelihood or sense of safety to the pandemic. The pandemic has led “to a spike in anxiety, depression and addiction – not just among Muskin’s patients, but across the U.S.” and in response, psychiatrists are using the phone and newer technologies to reach out to patients and conduct teletherapy.

HealthDay (4/9, Gordon) reports that while the coronavirus pandemic has created additional barriers to receiving psychiatric treatment, some insurers are increasingly covering telehealth behavioral services and some related regulations have been relaxed. Dr. Shabana Khan, a member of the APA’s committee on telepsychiatry, says that telemedicine “can literally save lives,” and some psychiatrists “are surprised at how much patients are embracing the new technology.” However, the APA is also “concerned that not everyone who wants services can get them,” including those without “access to a computer or fast internet service,” so the APA has asked CMS “to ease requirements and allow telephone appointments.”

Coronavirus Pandemic Reportedly Poses Challenges For People Recovering From Addiction,.USA Today (4/9, Rodriguez) reports the coronavirus pandemic poses challenges for people recovering from addiction. For example, a 41-year-old man from Milwaukee who “has been clean from heroin for six months and completely sober for three months,” said, “It’s difficult to get yourself out of this mindset of thinking the world is going to hell, and I might as well use to make myself feel good.” USA Today describes how the pandemic and the restrictions aimed at stopping it can make it difficult for people recovering from addiction to start or continue treatment, including group therapy.

Expert Discusses Impact Of Coronavirus Pandemic On People With Severe Mental Illnesses And How To Address It. Medscape (4/9, Anderson, Subscription Publication) reports Benjamin Druss, MD, MPH, of Emory University’s Rollins School of Public Health, warns in a viewpoint article published in JAMA Pscyhiatry that the impact of the coronavirus pandemic on patients with severe mental illnesses (SMI) needs to be addressed. Dr. Druss wrote that “disasters disproportionately affect poor and vulnerable populations, and patients with serious mental illness may be among the hardest hit,” but Dr. Druss also “says there are strategies that can help minimize the risk of exposure and transmission of the virus in” patients with SMI.

Related Links:

— “Psychiatrists Lean Hard On Teletherapy To Reach Isolated Patients In Emotional Pain, “Yuki Noguchi, NPR, April 9, 2020