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    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
    • Anti-Social Personality Disorder >
      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
      • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
    • Executive Functioning & "Prison Brain" >
      • Job Accommodation Network on Executive Functioning Deficits
    • Medicaid & Medicare Network Adequacy >
      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
      • OIG: ACCESS TO CARE: PROVIDER AVAILABILITY IN MEDICAID MANAGED CARE (Dec. 2014)
      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
      • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
    • Medicaid Mental Health & Substance Use Disorder Parity >
      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
      • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
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      • Comprehensive Olmstead Planning
      • the Logical Long Term Consequences of our failure to provide Intensive Community MH Treatment
      • Olmstead Nation ---State Pages: How Far to Comply with Olmstead?
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  • " 'Defund the Police" Means 'Invest in the Resources Our Communities Need' " or Don't Cost Shift to the Police
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  • Inflammation, the Immune System, Neuro-Developmental Disorders, Psychiatric Disorders, Substance Use Issues & Chronic Disease
  • Microglia and the Brain's Immune System
  • Substance Issues & the Immune System



Translational Medicine Friday

Executive Functioning in--Neuro-Developmental and Psychiatric Disorders

11/22/2021

 

Conjecture


I think that some of the BIG TALENTS one sees in NEURO-DIVERSITY may be the result of:
  • ​Differences in Information and Sensory Processing AS WELL AS
  • The need to OVERCOME EXECUTIVE FUNCTIONING DIFFERENCES, CHALLENGES or DEFICITS.
 
Further, this is on a CONTINUUM and most people probably are dealing with SOME LEVEL of EXECUTIVE DISFUNCTION --- Professor Graham Rook from King's College London estimates the level of LOW GRADE INFLAMMATION in the US POPULATION is--- 95%.I think that may be why there is not a lot of SYMPATHY for bad behavior tied to neurodevelopmental or psychiatric disorders and associated poor executive functioning --- on some level most people are dealing with some of these executive functioning issues.
 
  • Further, there are MILLIONS of PEOPLE with some category of NEURO-DEVELOPMENTAL and/or PSYCHIATRIC DISORDER that are not homeless or justice involved.
 
  • WHAT's the DIFFERENCE?  Generally 2 big issues:
    • People who are Justice-Involved or Homeless can be a lot further along on that CONTINUUM, and/or
    • Accessing Support may be more difficult if :
      • you are poor and marginalized, and
      • it is certainly more difficult if one has greater needs.
 
  • Addressing EXECUTIVE FUNCTIONING is the BIG NEED in Mental Health.
    • ​Partly, that is rehabilitative attempts, BUT
    • A much BIGGER PART is finding WORK-AROUNDS that even High IQ patients may be struggling with due to DEVELOPMENTAL EXECUTIVE FUNCTIONING DIFFERENCES.  ​​
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Neurocognitive insight and executive functioning in schizophrenia (2015)
​Affiliation
1a "Psychologie, Santé et Qualité de vie" , Univ Bordeaux ,Bordeaux , France.
Conclusion:

These results provide support for the hypothesis that executive dysfunctioning is a limiting factor for NI (neuro-cognitive insight), independently from depressive and anxiety symptoms.
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​Executive functioning but not IQ or illness severity predicts occupational status in bipolar disorder (2020)
​Affiliations
1Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Blå Stråket 15, 413 45, Gothenburg, Sweden.
2Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Blå Stråket 15, 413 45, Gothenburg, Sweden. 
3Department of Psychology, University of Pennsylvania, 3720 Walnut Street, Philadelphia, PA, 19104, USA.
4Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
5Center for Autism Research, The Children's Hospital of Philadelphia, 2716 South St, Philadelphia, PA, 19104, USA.
Conclusions:

Executive functioning was a more powerful predictor of occupational status in bipolar disorder patients than IQ and other clinical factors, including illness severity.
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Executive function deficits and neurodevelopmental disorders in childhood and adolescence (2019)
Affiliations
1Universidad Pública de Navarra, Pamplona, España.
2Hospital San Juan de Dios, Pamplona, España.
3Hospital Universitario Marqués de Valdecilla, Santander, España.
​Neurodevelopmental disorders are diverse, and even though they are independent diagnostic entities they share common manifestations in people with brain damage or dysfunction of the prefrontal cortex; that is, neurodevelopmental disorders present different alterations in executive functions.
Conclusions:

The dimensions of executive functioning are affected to a variable degree in different neurodevelopmental disorders.

We can hypothesis that the dimensions that are affected in the different neurodevelopmental disorders can be characterized in terms of the existence of a continuum, and occasionally those dimensions are too complex to establish categorical limits when comparing different neurodevelopmental disorders.
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The structure of adult ADHD (2017)
​Affiliations
1Department of Psychiatry and Child and Adolescent Psychiatry, New York University Langone School of Medicine and Psychiatry Service, New York, NY, USA.
2Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA.
3Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
4Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
5Hofstra Northwell School of Medicine, Hofstra University, Hempstead, NY, USA.
6Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
​Although DSM-5 stipulates that symptoms of attention-deficit hyperactivity disorder (ADHD) are the same for adults as children, clinical observations suggest that adults have more diverse deficits than children in higher-level executive functioning and emotional control. 

These results show that executive dysfunction is as central as DSM-5 symptoms to adult ADHD, while emotional dyscontrol is more distinct but nonetheless part of the combined presentation of adult ADHD.

Autoimmunity in Neurodiversity and Psychiatric Disorders and Maternal Immune Activation

11/14/2021

 
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Maternal Immune Activation as a Risk Factor for Schizophrenia: Evidence From Preclinical and Clinical Studies

  • Maternal immune activation and neuroinflammation in human neurodevelopmental disorders  (Nature Reviews Neurology -- Aug. 2021)
​
  • The Future of Psychiatry and Neurodevelopmental Disorders: A Paradigm Shift (2018) 
    • Abstract
      "A paradigm shift is now taking place in psychiatry with the emphasis on neurodevelopmental disorders with a neurobiologic emphasis and early onset including autism, ADHD, learning disability, schizophrenia and bipolar disorder.
​
                    "This paradigm superseded the attachment paradigm of the second             half of the twentieth century with so many misguided theories such as, “blaming the  mother”—the so-called refrigerated mother  and the schizophrenogenic  mother.

"The new paradigm allows more focused treatment interventions."
​
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RIFFING
  1.  If you want to know why we are not on top of the Mental Health Crisis --- just read the abstract above.   
  2. I'll be 60 in 2023 -- and I've lived the bad paradigms of the late 20th Century and early 21st Century --- only now it's ----COPING SKILLS and RESILIENCE.   
    1. When I say "I've lived the bad paradigms" --- what do I mean?
      1. A movement disorder that is not really Tourette's but did come on at childhood and family members and co-workers (especially at The Legal Center --- now Disability Law Colorado -- were aware of --- "TOUCHDOWN" --- that's me with my arms in the air as I'm thinking)
      2. Two or Three Trips to the Psychologist in 4th Grade --- ultimate verdict -- my mom should chill out about my wardrobe choices and let me be me.
      3. Saw a therapist three or four times for depression when I was about 37 while pregnant.
      4. A psychotic episode when I was 43 that was potentially extremely dangerous.
      5. At 50, a diagnosis of ADHD.
             
​                [With the current paradigms--- it's pretty hard to do much with that. 

                  But with the NEW PARADIGMS, we're bringing in:
  • Maternal Immune Activation
  • BLURRED DIAGNOSTIC CATEGORIES
  • DEVELOPMENTAL INFLAMMATION
  • The ENDOCRINE SYSTEM is involved
  • Etc.

                   -----With the NEW PARADIGMS --- we have a much better handle on what's going on --- even though it's not perfect.

  1. Of course, knowing what the hell you're talking about is right up there, too.
    1. ​This may seem IRONIC to say for someone who engages in as much CONJECTURE as I do  
  2.  But we haven't known about DEVELOPMENTAL  INFLAMMATION.
  3. In 2021 many of our researchers do know --- BUT that hasn't been effectively transmitted to CLINICIANS, FAMILY MEMBERS, INDIVIDUALS and the SOCIETY at large,   ​​ ​
​​​
  • Immunological Dysfunction in Tourette Syndrome and
    Related Disorders
  • ​Parental Autoimmune Diseases Associated With Autism Spectrum Disorders in Offspring 
  • Autoimmune Diseases and Psychotic Disorders​

Mental Health Patients have been written off for a long time as having "SOMATIC COMPLAINTS" in which the mental health professional often couldn't find a physical source.

At least in a significant number of cases, Maternal Immune Activation is not only often contributing to related IMMUNE DYSREGULATION such as THYROID DISORDERS and other IMMUNE DISORDERS, but that Maternal Immune Activation is a PRIMARY SOURCE of the NEURO-DIVERSITY and/or PSYCHIATRIC DISORDER .

This isn't saying that PSYCHIATRIC DISORDERS are not a brain disease, but many researchers are conceptualizing PSYCHIATRIC DISORDERS as MULTI-SYSTEM DYSREGULATIONS --- and certainly as well as the Central Nervous System --- the IMMUNE SYSTEM,  MICROBIOME and the ENDOCRINE SYSTEM are prime systems associated with these DYSREGULATIONS.

I think it is going to take the NAMIs and Mental Health Americas to make bringing this research to clinicians a PRIORITY --- because it certainly doesn't seem to be a PRIORITY.

A few years ago, NAMI Montana did take on mental health's beleaguered diagnostic system.    ​
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These new understandings can fuel policy reform even as they are INCOMPLETE.   Knowledge is always incomplete.

The On-Going and Unfinished Pursuit of Knowledge is why a robust PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE is needed:
  • Psychiatric PARADIGMS are changing and we don't have the systems to incorporate those new understandings and consider the implications  in a timely manner, AND
  • Those new understandings are going to keep coming and at a faster and faster pace --- we need something both more nimble and sophisticated than what we currently have to keep up. ​

Wrong Jungle --- But Can We Get Out Without the Knockout Treatment?

11/10/2021

 
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​
  • Researchers are yelling "Wrong Jungle" when it comes to psychiatric disorders
  • Namely, in 2021 it is hard to understand psychiatric disorders without understanding the role of the IMMUNE SYSTEM --- BUT CLINICIANS are not up to speed on that.
  • One of the reasons for that is that Researchers don't understand how important these new conceptualizations are for policymaking --- even without the knockout treatment.
  • For a lot of people in the Criminal Justice System and Homeless who essentially have an IMMUNE DISORDER that affects the BRAIN ---
    • ​These new conceptualizations are a GAME-CHANGER.
New theory suggests blood immune and clotting components could contribute to psychosis
A scientific review has found evidence that a disruption in blood clotting and the first line immune system could be contributing factors in the development of psychosis.
Immune dysregulation in depression: Evidence from genome-wide association -- 2020
​Abstract

A strong body of evidence supports a role for immune dysregulation across many psychiatric disorders including depression, the leading cause of global disability.

Recent progress in the search for genetic variants associated with depression provides the opportunity to strengthen our current understanding of etiological factors contributing to depression and generate novel hypotheses.

Here, we provide an overview of the literature demonstrating a role for immune dysregulation in depression, followed by a detailed discussion of the immune-related genes identified by the most recent genome-wide meta-analysis of depression.

​These genes represent strong evidence-based targets for future basic and translational research which aims to understand the role of the immune system in depression pathology and identify novel points for therapeutic intervention.
Immune dysregulation in depression: Evidence from genome-wide association -- 2020
Conclusions: The link between immune dysregulation, autoimmunity, and bipolar disorder may be closer than previously thought.

​Psychiatrists should be vigilant for autoimmunity in presentations of bipolar disorder due to its high morbidity and therapeutic implications.

​Advances in neuroimaging and biomarker identification related to immune dysregulation and neuroinflammation will contribute to our knowledge of the pathophysiology of bipolar disorder.
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Neuroinflammation in Mood Disorders: Role of Regulatory Immune Cells ---2021
Abstract
​
Mood disorders are associated with chronic low-grade systemic (sterile) inflammation, with increased plasma levels of pro-inflammatory mediators targeting all tissues including the brain. Importantly, pro-inflammatory cytokines (ex., tumor-necrosis factor alpha [TNF-α], interleukin [IL]-6) regulate mood behavior and cognition by influencing neurotransmitter levels, activating stress-responsive endocrine axes, among other effects.

However, the mechanisms underlying this enhanced inflammation are not well understood.

There is increasing evidence indicating that impaired immunoregulatory mechanisms may play a role in this context.

Patients with mood disorders (major depression [MDD] and bipolar disorder [BD]) have reduced numbers of major regulatory cells of both innate (natural killer regulatory cells and myeloid-derived suppressor cells [MDSCs]) and adaptive immune responses (CD4+CD25+FoxP3+, B regulatory cells).

Dysfunctional regulatory immune cells might contribute to systemic and neuroinflammation observed in mood disorders via different mechanisms, such as:
(i) failure to develop adequate stress-related responses,
(ii) indirectly through microglial activation,
(iii) lack of trophic support and pro-cognitive functions of T cells in the brain, and
(iv) dysbiosis.

In conclusion, maladaptive immunoregulatory mechanisms seem to be involved with both onset and progression of mood disorders.

A deeper understanding of these mechanisms may lead to the development of new therapeutic strategies
The immune system and psychiatric disease: a basic science perspective -- 2019
Summary

Mental illness exerts a major burden on human health, yet evidence-based treatments are rudimentary due to a limited understanding of the underlying pathologies.

Clinical studies point to roles for the immune system in psychiatric diseases, while basic science has revealed that the brain has an active and multi-cellular resident immune system that interacts with peripheral immunity and impacts behavior.

In this perspective, we highlight evidence of immune involvement in human psychiatric disease and review data from animal models that link immune signaling to neuronal function and behavior.

We propose a conceptual framework for linking advances in basic neuroimmunology to their potential relevance for psychiatric diseases, based on the subtypes of immune responses defined in peripheral tissues.

​Our goal is to identify novel areas of focus for future basic and translational studies that may reveal the potential of the immune system for diagnosing and treating mental illnesses​

Migraines, Sensory Processing, Neuro-Diversity and Psychiatric Disorders

11/9/2021

 
​Two BIG LINKS:
  • Migraines are more and more associated with psychiatric disorders;
    • ​What is the link between migraine and psychiatric disorders? From epidemiology to therapeutics
  • Sensory / Information Processing Differences and Disorders are associated with NEURO-DIVERSITY
    • Sensory processing related to attention in children with ASD, ADHD, or typical development: results from the ELENA cohort
    • ​Sensory hypersensitivity in Tourette syndrome: A review

A BIG PART OF BETTER TREATMENT IS BETTER PREVENTION & DIAGNOSTICS.
A BIG PART OF BETTER TREATMENT IS BETTER PREVENTION & DIAGNOSTICS.

People who are NEURO-DIVERSE and/or have MIGRAINES are at high risk for PSYCHIATRIC DISORDERS.

On the other hand, because of their SENSORY PROCESSING DIFFERENCES, NEURO-DIVERSE people often have BIG STRENGTHS in ACADEMIC, ATHLETIC and/or CREATIVE pursuits.

NEURO-DIVERSE people who can look like such OPPOSITES -- often have in common SENSORY PROCESSING DIFFERNCES that DIVERGE FROM THE NORM.  
​
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​Pathophysiology of Migraine: A Disorder of Sensory Processing
​
 (2017)
Affiliations
  1. Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom;
  2. Department of Neurology, University of California, San Francisco, San Francisco, California;
  3. Department of Neurology, University of Hamburg-Eppendorf, Hamburg, Germany; and
  4. ​Department of Neurology, University Hospital Bern-Inselspital, University of Bern, Bern, Switzerland.
Abstract
​
Plaguing humans for more than two millennia, manifest on every continent studied, and with more than one billion patients having an attack in any year, migraine stands as the sixth most common cause of disability on the planet.

The pathophysiology of migraine has emerged from a historical consideration of the "humors" through mid-20th century distraction of the now defunct Vascular Theory to a clear place as a neurological disorder.

It could be said there are three questions: why, how, and when?

Why:
migraine is largely accepted to be an inherited tendency for the brain to lose control of its inputs.


How:
the now classical trigeminal durovascular afferent pathway has been explored in laboratory and clinic; interrogated with immunohistochemistry to functional brain imaging to offer a roadmap of the attack.

When:
migraine attacks emerge due to a disorder of brain sensory processing that itself likely cycles, influenced by genetics and the environment.


In the first, premonitory, phase that precedes headache, brain stem and diencephalic systems modulating afferent signals, light-photophobia or sound-phonophobia, begin to dysfunction and eventually to evolve to the pain phase and with time the resolution or postdromal phase.

Understanding the biology of migraine through careful bench-based research has led to major classes of therapeutics being identified: triptans, serotonin 5-HT1B/1D receptor agonists; gepants, calcitonin gene-related peptide (CGRP) receptor antagonists; ditans, 5-HT1F receptor agonists, CGRP mechanisms monoclonal antibodies; and glurants, mGlu5 modulators; with the promise of more to come.

Investment in understanding migraine has been very successful and leaves us at a new dawn, able to transform its impact on a global scale, as well as understand fundamental aspects of human biology.

NeuroDiversity & Mental Health

10/22/2021

 
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Neurodiversity and Mental Health?


​"There is growing evidence that neurodiverse conditions are accompanied by mental health challenges." 

​                                                                                --------Aug. 2021 

           For a lot of people like myself, that Developmental Diagnosis came LAST, rather tragically.

              When we talk about TRANSLATIONAL MEDICINE and understanding that ---- NEURO-DIVERSE people are at particular risk if not the primary population for psychiatric disorders --- WHAT DOES THAT MEAN?

              Well, it tends to mean a helluva lot.

              While NEURO-DIVERSITY is all over the map, one of the things it often has in common is EXECUTIVE FUNCTIONING DEFICITS or DIFFERENCES and at least often --- Special Abilities in one or more areas.

                So from a Translational Medicine Perspective, we need to be:
  • Providing early identification and support to kids with ADHD, Autism, Dyslexia, "Giftedness," etc.
  • That Support includes development of STRENGTHS, and workarounds and accommodations for EXECUTIVE FUNCTIONING DIFFERENCES.
  • Continuation of appropriate level of SUPPORT throughout the lifespan.

        The SUPPORT NEEDED is related to how WIDESPREAD the UNDERSTANDING and KNOWLEDGE is in the Society regarding Executive Functioning Deficits or Differences.

        If that knowledge isn't SOLID in the Mental Health Profession, much less the rest of the COMMUNITY ---- there is going to be an IMMENSE NEED for SUPPORT.  
Highlights from the 2019 UK national multidisciplinary conference on Neurodiversity and Mental Health.
​[Next Friday:  Developmental Inflammation & Neuro-Immune Dysregulations in Neuro-Diversity]

Neuro-Inflammation and re-defining the "BIG PICTURE"

10/16/2021

 
"Neuroinflammation" is DOMINATING much of the RESEARCH regarding "PSYCHIATRIC DISORDERS" --- but it largely hasn't gotten to CLINICIANS.

Monday --- we're getting back to our letter to the American Bar Association. 

In some ways, I do think LAWYERS tend to be MORE FLEXIBLE THINKERS and INTEGRATERS OF KNOWLEDGE.

THE CRIMINAL JUSTICE SYSTEM and POLICYMAKERS need FLEXIBILITY OF THOUGHT and and ability to INTEGRATE VAST AMOUNTS OF KNOWLEDGE.

By and large, Flexibility of Thought and Integration of Knowledge involve IDENTIFYING ANOMALIES and RE-WORKING that BIG PICTURE.
Neuroinflammation in psychiatric disorders: PET imaging and promising new targets (2020) 
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​Affiliations

1Campbell Family Mental Health Research Institute, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
2Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden.
3Molecular Imaging Branch, National Institute of Mental Health, Bethesda, MD, USA.
4Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.
5Molecular Imaging Branch, National Institute of Mental Health, Bethesda, MD, USA.
Brain-Derived Neurotrophic Factor in Brain Disorders:  Focus on Neuroinflammation (2019)
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​University of Groningen Medical Center --- The Netherlands
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Pontifical Catholic University of ​Rio Grande do Sul in Brazil ​
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​Abstract

Brain-derived neurotrophic factor (BDNF) is one of the most studied neurotrophins in the healthy and diseased brain.

As a result, there is a large body of evidence that associates BDNF with neuronal maintenance, neuronal survival, plasticity, and neurotransmitter regulation.

Patients with psychiatric and neurodegenerative disorders often have reduced BDNF concentrations in their blood and brain.

A current hypothesis suggests that these abnormal BDNF levels might be due to the chronic inflammatory state of the brain in certain disorders, as neuroinflammation is known to affect several BDNF-related signaling pathways.

Activation of glia cells can induce an increase in the levels of pro- and antiinflammatory cytokines and reactive oxygen species, which can lead to the modulation of neuronal function and neurotoxicity observed in several brain pathologies.

Understanding how neuroinflammation is involved in disorders of the brain, especially in the disease onset and progression, can be crucial for the development of new strategies of treatment.

Despite the increasing evidence for the involvement of BDNF and neuroinflammation in brain disorders, there is scarce evidence that addresses the interaction between the neurotrophin and neuroinflammation in psychiatric and neurodegenerative diseases.

This review focuses on the effect of acute and chronic inflammation on BDNF levels in the most common psychiatric and neurodegenerative disorders and aims to shed some light on the possible biological mechanisms that may influence this effect.

In addition, this review will address the effect of behavior and pharmacological interventions on BDNF levels in these disorders.
​Affiliations
​

1Neurobiology and Developmental Biology Laboratory, Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Ipiranga Av. 6681, Porto Alegre, 90619-900, Brazil.
2Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 31.001, 9713 GZ, Groningen, The Netherlands.
3Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 31.001, 9713 GZ, Groningen, The Netherlands.

What "Mental Health" Has Been Missing?   ​DEVELOPMENTAL DIFFERENCE & ITS RAMIFICATIONS

10/9/2021

 
​
  • This has been DIFFICULT for BOTH INDIVIDUALS and PROFESSIONALS --- because most people with PSYCHIATRIC DISORDERS have:
    • ​An IQ above 70
    • Have AVERAGE or ABOVE-AVERAGE INTELLIGENCE
    • OFTEN have special ATHLETIC, CREATIVE and/or INTELLECTUAL ABILITIES
 
  • So that didn't seem to describe our CLASSIC UNDERSTANDING of a person with an INTELLECTUAL DEVELOPMENTAL DISABILITY.
    • ​So the IDEA that the Mental Health Profession was going to help people "CHANGE" --- didn't seem out of place.
 
  • This IDEA of "CHANGING PEOPLE" not only seems out of place --- it seems DANGEROUS in 2021
    • ​Most people with PSYCHIATRIC DISORDERS have "HYPER-CONNECTED BRAINS" 
    • According to the National Institute of Mental Health, PSYCHIATRIC DISORDERS are NOT DISTINCT --- BUT BLURRED.
    • It is not just the BRAIN, but also the IMMUNE SYSTEM, the MICROBIOME and the ENDOCRINE SYSTEM that are involved in "PSYCHIATRIC DISORDERS."
 
  • In 2021, "EXECUTIVE FUNCTIONING DIFFERENCES"  are certainly recognized in the RESEARCH COMMUNITY as an often COMMON CHALLENGE across "PSYCHIATRIC DISORDERS."

  • Rather than trying to CHANGE these DEVELOPMENTAL DIFFERENCES, it would be much more helpful if MENTAL HEALTH [or SOMEBODY] would:
    • ​Focus on WORKAROUNDS for Executive Functioning Differences
    • Develop Strengths, AND
    • ​and STOP WASTING OUR TIME AND MONEY.
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Temple Grandin
​Boccamazzo adds that he "can't think of a single soul who has a diagnosis of autism, ADHD or learning disability, who only has a diagnosis of autism, ADHD or learning disability."  

"All of us are anxious as hell, pretty much all of us struggle with chronic depression as well, largely due to the fact that we've been told we're a broken version of normal our entire lives," he continues.

------Understanding and supporting neurodiversity in the workplace
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Maternal Immune Activation alters Adult Behavior

10/3/2021

 
​
  • Some "EXPERTS" raised SIGNIFICANT ISSUES regarding PSYCHIATRIC DISORDERS---
    • ​It wasn't always clear whether they UNDERSTOOD THE IMPLICATIONS of the ISSUES they were raising --- OR
    • They did UNDERSTAND those IMPLICATIONS -- BUT they were TOO PRO SOCIALLY COMPETENT to say them OUT LOUD.
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Dr. Thomas Insel
​
  • In 2013, the National Institute of Mental Health and its then Director Dr. Thomas Insel started to say some things OUT LOUD.​
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  • The DSM 5 is NOT SCIENTIFICALLY VALID because it only describes CLUSTERS of SYMPTOMS and NOT THE UNDERLYING BIOLOGY.
  • Psychiatric Disorders are much more BLURRED than previously thought --- there are COMMON MECHANISMS.
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What has become CLEARER in the INTERIM --- is that MATERNAL IMMUNE ACTIVATION is one of those COMMON MECHANISMS.​
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Maternal immune activation
alters---

Adult Behavior, Intestinal Integrity, Gut Microbiota and the Gut Inflammation (April 2021)
​Affiliations
  • Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
  • Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang, China.
  • International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, China.
  • Henan Province People's Hospital, Zhengzhou, China.
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​
Maternal Immune Activation
and 
​

​
Neuropsychiatric Illness:

A Translational Research Perspective
​Affiliation
  • From the New York State Psychiatric Institute, Columbia University Medical Center, New York; the Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich; and the Neuroscience Center Zurich, University of Zurich and ETH Zurich.

Inflammation, Positive "EMODIVERSITY" and CAUSE & EFFECT

9/24/2021

 
​
  • Cause & Effect are complicated in Psychiatric Disorders
  • Major Psychiatric Disorders are being linked to MATERNAL IMMUNE ACTIVATION and DEVELOPMENTAL INFLAMMATION
  • "Positive Emodiversity" is interesting but is it a CAUSE or an EFFECT of LOWER INFLAMMATION​
​
  • Understanding CAUSE & EFFECT is a PROBLEM in our discussions of psychiatric disorders and it is definitely a problem in the Criminal Justice System.
  • Now one of the reasons CAUSE and EFFECT are such a problem is because PSYCHIATRIC DISORDERS are not just GENETICS but the interplay of GENETICS, MATERNAL IMMUNE ACTIVATION, EPIGENETICS and ENVIRONMENT.
​
  • I would submit that people who were born with greater DEVELOPMENTAL INFLAMMATION probably are going to have a significantly harder time achieving the LOWER INFLAMMATION associated with "POSITIVE EMODIVERSITY."
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Affiliations
​

1Department of Human Development, Cornell University.
2Department of Human Development and Family Studies, The Pennsylvania State University.
3Department of Psychology, Arizona State University.
Epigenetics in Critical Illness:
A New Frontier
 (2013)
Emodiversity and biomarkers of inflammation (2018)
​Abstract

There is growing evidence that inflammatory responses may help to explain how emotions get “under the skin” to influence disease susceptibility.

Moving beyond examination of individuals’ average level of emotion, this study examined how the breadth and relative abundance of emotions that individuals experience— emodiversity—is related to systemic inflammation.

Using diary data from 175 adults aged 40 to 65 who provided end-of-day reports of their positive and negative emotions over 30 days, we found that greater diversity in day-to-day positive emotions was associated with lower circulating levels of inflammation (indicated by IL-6, CRP, fibrinogen), independent of mean levels of positive and negative emotions, body mass index, anti-inflammatory medications, medical conditions, personality, and demographics.

No significant associations were observed between global or negative emodiversity and inflammation.

These findings highlight the unique role daily positive emotions play in biological health.
IL-6 -- Interleukin-6 (CUSABIO)

Cytokine (Oxford Languages):  
  1. any of a number of substances, such as interferon, interleukin, and growth factors, which are secreted by certain cells of the immune system and have an effect on other cells.

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​Interleukin-6, also known as IL-6, is a cytokine that belongs to the class of interleukins.

​
It is produced by fibroblasts, monocytes/macrophages, T lymphocytes, B lymphocytes, epithelial cells, keratinocytes, and various tumor cells.

The production of interleukin-6 can be induced in normal cells by various factors, involving IL-1, TNF-a, PDGF, viral infection, double-stranded RNA and so on.

For this reason, IL-6 plays a critical role in acute inflammatory response.
​
​Mayo Clinic

The level of C-reactive protein (CRP) increases when there's inflammation in your body.

​ A simple blood test can be done to check your C-reactive protein level.
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​Fibrinogen (Fg) is a biomarker of inflammation (1-5) which, when elevated, indicates the presence of inflammation and identifies individuals with a high risk for cardiovascular disorders.

Inflammatory Markers: Serum Amyloid A, Fibrinogen and C ...

More on Inflammation, Fetal brain Development & Psychiatric Disorders

9/20/2021

 
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3 Related Insights from the Research:
  • The Blurring of Traditional Psychiatric Categories, AND
  • The Relationship of MATERNAL IMMUNE INFLAMMATION to those CATEGORIES
  • ADHD and AUTISM  (Traditional Developmental Differences a part of those BLURRED CATEGORIES and part of what we're traditionally thinking of as NEURO-DIVERSITY ​
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​Central South University, Hunan, China
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​SUNY Upstate Medical Center
​Inflammation-related biomarkers in major psychiatric disorders: a cross-disorder assessment of reproducibility and specificity in 43 meta-analyses
​Affiliations
  • 1Department of Psychiatry, The Second Xiangya Hospital; Mental health Institute of the Second Xiangya Hospital; National Clinical Research Center on Mental Disorders; National Technology Institute on Mental Disorders, Central South University, Changsha, Hunan, China.
  • 2Department of Psychiatry, Hunan Provincial Brain Hospital; Clinical Research Center for Mental Behavioral Disorder in Hunan Province, Clinical Medical School of Hunan University of Chinese Medicine, Changsha, Hunan, China.
  • 3Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China.
  • 4Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA.
  • 5Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China. 
  • 6Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA. [email protected].
  • 7School of Psychology, Shaanxi Normal University, Xi'an, Shaanxi, China
Prevalence and correlates of low-grade systemic inflammation in adult psychiatric inpatients (2018)
​"A notable proportion of acutely unwell psychiatric patients from all ICD-10 major diagnostic groups show evidence of low-grade inflammation, suggesting inflammation may be relevant for all psychiatric disorders."
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​Cambridge Biomedical Campus -- UK
​aDepartment of Psychiatry, University of Cambridge, Cambridge, England, UK
bCambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England, UK
*Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus
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