Mental Health Recap: 4 Must-Read Studies From August 2021

Certain telepsychiatry interventions could significantly benefit people with PTSD and/or bipolar disorder living in underserved communities, one study shows.

Medically Reviewed

Esketamine, an FDA-approved nasal spray for adults with treatment-resistant depression, does not appear to have negative effects on cognition, new research suggests.

The U.S. Food and Drug Administration (FDA) has cleared a noninvasive, brain-stimulating magnetic system for the management of anxiety in depression, and telepsychiatry proves successful for post-traumatic stress disorder (PTSD) and bipolar disorder — read on for more mental health news from August 2021.

FDA Clears Deep Transcranial Magnetic Stimulation System for Anxious Depression

What’s New On August 18, the FDA cleared the BrainsWay deep transcranial magnetic stimulation system (TMS) for the management of co-occurring symptoms of anxiety in adults with major depressive disorder (MDD).

Research Details The FDA’s decision is based on results of 11 studies in which 573 people received the nondrug, noninvasive treatment, which uses magnetic fields to stimulate brain cells. The studies found that this treatment was “clinically meaningful” in reducing anxiety symptoms when compared with medication or placebo.

Why It Matters Although the device was studied in a relatively small number of people, its clearance by the FDA is a step in the right direction. More research is still needed on the effects of different types of TMS, such as repetitive TMS and deep TMS, in people with anxious depression.

But as Aron Tender, MD, chief medical officer of BrainsWay, stated in a press release, the device’s clearance by the FDA is confirmation that this “unique form of therapy [could] address comorbid anxiety symptoms using the same depression treatment protocol.”

The FDA had previously approved TMS for the treatment of MDD alone, as well as obsessive-compulsive disorder.

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One-Third of Young Adults With ADHD Have an Alcohol Use Disorder, Too

What’s New A Canadian study published on August 3 in the journal Alcohol and Alcoholism suggests that one in three adults with attention-deficit hyperactivity disorder (ADHD) between the ages of 20 and 39 have had a co-occurring alcohol use disorder.

Research Details Researchers who administered a mental-health-related survey received responses from nearly 6,900 people, of whom 270 had ADHD. The results indicated that one in three, or 36 percent of respondents with ADHD, had an alcohol use disorder at some point in their lives. People with ADHD also were more likely to develop a cannabis use disorder or other drug disorder compared with people who didn’t have ADHD.

The findings also showed that factors like history of depression, anxiety, or childhood adversity played a key role in the relationship between ADHD and substance use disorders.

“We found that 27 percent of young adults with ADHD had a history of major depression and 23 percent had a history of anxiety disorders. These rates are almost triple that of their peers without ADHD,” says study author Esme Fuller-Thomson, PhD, a professor and director of the Institute for Life Course and Aging at the University of Toronto's Factor-Inwentash Faculty of Social Work in Ontario.

The prevalence of substance use disorders was much higher among young adults with ADHD who had these mental health problems, she adds.

Why It Matters “It may be that [young adults with ADHD] with depression or anxiety issues are abusing substances as a way to self-medicate,” explains Fuller-Thomson. “Since these problems are so intertwined, health professionals who target this toxic trio of addictions, depression, and anxiety may have better results than those who focus on only one of these issues at a time.”

RELATED: Under Pressure: Young and Surrounded by Substances

Telepsychiatry Effective for PTSD and Bipolar Disorder

What’s New People with PTSD and/or bipolar disorder — especially those living in underserved communities — could benefit significantly from receiving telepsychiatry services to help manage their mental health conditions, according to new findings published on August 25 in JAMA Psychiatry.

Research Details More than 1,000 people who screened positive for PTSD and/or bipolar disorder were included in a trial comparing telepsychiatry- and telepsychology-enhanced referral — in which psychiatrists and psychologists provided remote online treatment — with collaborative care, in which psychiatrists consulted online with the patients’ primary care providers.

Overall, the study participants were considered underserved — many lived in rural areas, did not graduate high school, weren’t married, didn’t have full-time employment, and lived below the 2016 federal poverty level.

The results of the one-year trial showed that people who received either form of treatment experienced “large and clinically meaningful improvements” in their conditions.

Why It Matters “The trial clearly demonstrated that telepsychiatry increased patients’ perceived access to needed mental healthcare and that a large proportion of patients received treatment,” says lead study author John Fortney, PhD, a professor of psychiatry and behavioral sciences at the University of Washington School of Medicine in Seattle.

“To make a widespread and sustained impact, policies will need to be implemented that encourage telepsychiatrists and telepsychologists to practice in underserved communities,” Fortney adds.

RELATED: Your Everyday Guide to Telemedicine

Treatment-Resistant Depression: Ketamine and Esketamine Likely Don’t Affect Cognitive Function

What’s New Ketamine and esketamine don’t appear to have negative effects on cognitive function among people with treatment-resistant depression, or depression that doesn’t improve with standard antidepressants, according to a review article published on August 5 in Harvard Review of Psychiatry.

And in some cases, ketamine treatment may be tied to improved cognitive function, the authors of the review said.

Research Details An examination of data from 14 studies linked ketamine treatment with improvements in processing speed, visual memory, and other cognitive factors.

One study found that ketamine was associated with cognitive impairment related to processing speed and verbal memory. However, according to a press release, these symptoms dissipated within seven days following treatment.

Esketamine was not found to be associated with any changes in cognitive performance.

Why It Matters “Ketamine and esketamine do not seem to exert significant deleterious neurocognitive effects in the short or long term in individuals with treatment-resistant depression,” the authors of the study wrote. Interestingly, some of the studies in the review showed that those with certain cognitive characteristics before treatment — such as slower processing speed, poor attention, or better memory — had better responses. Future research on this topic could help determine who is a better candidate for treatment with ketamine.

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