(March 26, 2019) Research Roundup is a monthly public service of the Office of Research and Public Affairs. Each edition describes a striking new data point about serious mental illness and summarizes recently published research reports or developments.
DATAPOINT of the Month
- 2.3 million individuals incarcerated in the United States. The United States incarcerates more people per capita than any other nation, with 698 individuals confined per 100,000 residents, according to the Prison Policy Initiative's report, Mass Incarceration: The Whole Pie 2019. The report highlights where these 2.3 million individuals are incarcerated and why, and shows how individuals are distributed across various correctional settings and what charges that landed them there. Among their findings, 76% of individuals in jail have not been convicted of a crime. This includes 9,000 individuals who have a severe mental illness and are awaiting competency evaluation or restoration.
RESEARCH of the Month
- Cariprazine found to be effective for treating depression in bipolar disorder.
Cariprazine is a second-generation antipsychotic that is approved by the Federal Drug Administration for treating mania in individuals with bipolar I disorder, the most severe form of bipolar disorder that affects approximately 2.2% of the population. Results from a clinical trial of the drug on 488 patients in the United States and Europe indicate that cariprazine may also be effective in treating depression among individuals with bipolar disorder. Depressive episodes are predominant during the long-term course of the illness, and conventional antidepressants have limited effectiveness in treating their symptoms, the study authors write. Therefore, the results of the trial are promising for an evidence-based treatment option for severe bipolar depression in the future.
Earley, W., et al. (2019). Cariprazine Treatment of Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Phase 3 Study.The American Journal of Psychiatry.
- Preventing suicide among individuals with psychotic disorders.
Death by suicide and suicidal behaviors are common among individuals with psychotic disorders, especially with the onset of psychotic symptoms or after a psychiatric hospitalization. And assessing suicide risk among individuals with psychotic disorders may be more challenging than would be for the general population due to differences in risk factors, such as the hallucinations and delusions that are common symptoms of the illness. Individuals with psychotic disorders also display a stronger association between suicide ideation, or thinking about suicide, and death by suicide, suggesting that measuring suicidal thoughts among individuals with psychotic disorders is vital for prevention.
Research published this month in Psychiatric Services indicates that suicidal risk among individuals with psychotic disorders can be measured utilizing the standard suicide risk assessment questionnaire, the PHQ-9. Study authors found that individuals with psychotic disorders provide clinically useful responses to the self-report questionnaire about thoughts of self-harm. Although a negative response does not guarantee that an individual is not at risk, an endorsement of suicidal thoughts indicates an increased risk for self-harm and a need for appropriate care planning, the authors write. Based on the results, generated from 33,000 outpatient visits across nine states, the authors argue that self-report measures used by clinicians can be useful for addressing high-risk behavior among individuals with psychotic disorders, and should be incorporated into outpatient mental health and primary care practices throughout the United States.
Simon, G. E., et al. (2019). Self-reported suicidal ideation as a predictor of suicide behavior outpatients with diagnoses of psychotic disorders.Psychiatric Services.
- Telemedicine for improving medication adherence for individuals with severe mental illness.
Telephone monitoring for individuals with severe mental illness may improve adherence to their prescribed psychotropic medication, according to new research published this month in Psychiatric Services. Individuals with severe mental illness are at high risk for discontinuing psychotropic medication, a major contributor for relapse and re-hospitalization. A randomized control trial of 120 outpatients with schizophrenia or bipolar disorder found that personalized telephone calls and text messages may provide support that reduces medication non-adherence after hospital discharge. The authors suggest this relatively low-cost intervention can partially compensate for the care gaps faced by individuals with severe mental illness and is encouraging for improving adherence and reducing re-hospitalization among this high-risk population.
Schulze, L., N. et al. (2019). Improving medication adherence with telemedicine for adults with severe mental illness.Psychiatric Services.
Elizabeth Sinclair
Director of Research
Treatment Advocacy Center
Research Weekly is a summary published as a public service of the Treatment Advocacy Center and does not necessarily reflect the findings or positions of the organization or its staff. Full access to research summarized may require a fee or paid subscription to the publications.