RESEARCH WEEKLY: June Research Roundup
By Elizabeth Sinclair Hancq
Research Roundup is a monthly public service of the Office of Research and Public Affairs. Each edition describes a striking new data point about severe mental illness and summarizes recently published research reports or developments.
DATAPOINT of the month
536,000 people with serious mental illness identify as Lesbian or Gay
June represents Pride Month, a time to recognize the impact that lesbian, gay, bisexual, transgender and queer individuals have had on history. The first Pride parade occurred on June 28, 1970 in New York City in honor of the one-year anniversary of the Stonewall Uprising, considered a major turning point against LGBTQ discrimination.
According to data from the Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health, there are more than 500,000 people with serious mental illness who identify as Lesbian or Gay. An additional two million identify as bisexual, according to the same data.
Research on LGBTQ+ and severe mental illness is scarce. A review published in Psychiatric Services in 2016 concludes “there is a pressing need for research into interventions for LGBT populations with severe mental illness as well as descriptive studies to inform efforts to reduce illness morbidity linked to discrimination.”
RESEARCH of the month
Isolation in caregivers of individuals with mental illness
Half of family caregivers of individuals with mental illness report feeling isolated, according to research published earlier this month in the journal Social Work. Researchers from the University of Pittsburgh analyzed survey data from 1,505 family members who provide unpaid caregiving to loved ones with mental illness. The results indicate that although caring for a loved one with serious mental illness can be rewarding, it can also carry a high burden when the care required is more than an individual can reasonably provide.
Female caregivers were more likely to experience isolation than males, according to the results. Perceived isolation was especially high if the care recipient had a serious mental illness, as caregivers experienced more stigma and had less personal time for themselves which limited their ability to participate in social activities and led to loneliness. These findings highlight the need for more support for caregivers as well as more accessible and intensive social care programs for the individual with serious mental illness to reduce the care burdens on their families.
Autoimmune disease association with severe mental illness
Previous research, including from Treatment Advocacy Center founder Dr. E. Fuller Torrey, indicates there is an association of immune system functioning and severe mental illness. In a new article published this month from researchers from India, the study authors examine the degree to which 30 different autoimmune disorders are potential risk factors for bipolar disorder, schizophrenia and non-affective psychosis.
The study authors utilize data from 2,031 individuals with schizophrenia, 907 individuals with non-affective psychosis and 992 individuals with bipolar disorder and analyzed if an autoimmune disorder was also present, a method only possible due to the case register of individuals in India where this study took place. The researchers found that autoimmune disorders are more associated with schizophrenia, including psoriasis, autoimmune hepatitis and type 1 diabetes. Conversely, pernicious anemia in the family, previous Crohn’s disease and Guillain-Barre’ syndrome are associated with bipolar disorder, although to a lesser extent. The authors indicate these findings further support the role of infection, inflammation and autoimmune processes in the development of mental illness and that further research on immune markers before the onset of psychosis is needed.
Metabolic monitoring for individuals taking antipsychotic medications
Individuals with serious mental illness have high rates of co-morbid physical health conditions, including cardiovascular disease and diabetes. Metabolic monitoring, lab blood tests for hemoglobin A1C, lipids and fasting blood glucose, is vital to prevent adverse cardiovascular events in people with serious mental illness. Despite the clear clinical guidelines for patient care for these individuals, metabolic monitoring is poorly implemented in outpatient settings.
In an article published this month in Psychiatric Services, researchers from University of North Carolina Chapel Hill analyze the effects of a quality improvement initiative designed to improve metabolic monitoring for individuals taking antipsychotic medications at an outpatient clinic. They found that a simple, low burden intervention of providing reminders and a flier with directions to the phlebotomy lab were effective in improving metabolic monitoring. After one year of implementing the program, the rate of metabolic monitoring increased from 33% to 49%, according to the results.
