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RESEARCH WEEKLY: September Research Roundup

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

*

One in four individuals with serious mental illness live in poverty

Twenty-four percent [[link removed]]of the 11.3 million individuals with serious mental illness
lived below the federal poverty line in 2018, according to results from the 2018
National Survey on Drug Use and Health, a survey conducted annually by the Substance
Abuse and Mental Health Services Administration, released last month. There was
a significant increase in the number of individuals with serious mental illness
living in poverty from the previous year, when 22% or 2.5 million individuals lived
on less than $12,140 a year.
RESEARCH of the month

* Improving metabolic risk screening for individuals taking antipsychotic medications.
Despite the importance of antipsychotic medications in reducing adverse symptoms
for people with severe mental illness, they sometimes come with side effects. One
of the most serious side effects of these effective medications is cardiometabolic
disease, such as high blood pressure or diabetes, both of which contribute to the
lower life-expectancy experienced by individuals with severe mental illness compared
to the general population. Therefore, screening for these illnesses in individuals
taking antipsychotic medications is crucial.

A recently published systematic review of all studied interventions for metabolic
risk screening in people taking antipsychotic medications found that although most
of the interventions showed improvements in metabolic risk screening, many lacked
the scientific rigor necessary to bridge the gap between research and incorporation
into clinical practice. Even in the research settings, up to one-third of individuals
taking antipsychotic medications were never screened for cardiometabolic risk. The
authors write that strategies that focused on shifting provider culture to encourage
screening were among the most promising approaches.

Melamed, O. C., et al. (2019). Interventions to improve metabolic risk screening among adult patients
taking antipsychotic medication: A systematic review [[link removed]]. Psychiatric Services.

*
Using real-world functioning to assess treatments for schizophrenia.
Schizophrenia can be extremely disabling to many individuals with the illness. Yet,
much research into treatments for schizophrenia does not measure how the treatment
affects real-world functioning in individuals. In addition, current assessments
often depend on self-reporting, which is known to be unreliable due to the time
between when the event occurred and when the individual is asked to recall it.

New research published this month in Schizophrenia Bulletin provides an alternative
to such methods, utilizing a type of tool referred to as ecological momentary assessment
(EMA). EMA is a data collection technique delivered through a smart phone that allows
for real-time assessment of behaviors. The smart phone can signal an individual
several times a day to respond to a brief questionnaire about their daily life and
has already shown to be feasible and reliable for research into a variety of different
factors in schizophrenia such as severity of hallucination symptoms or substance
abuse.

The current study utilized the EMA technique to examine how this tool can be used
to assess functioning in individuals with schizophrenia. The authors found that
the brief surveys delivered to participants via their smart phone were accurate
and reliable in measuring different types of real-world functioning, including social
interactions, self-care, home-care, leisure, work, and educational functioning behaviors.
The authors suggest that the results support the inclusion of EMA of real-world
functioning as an outcome measure for future research in schizophrenia.

Granholm, E., et al. (2019). What do people with schizophrenia do all day? Ecological momentary assessment
of real-world functioning in schizophrenia. [[link removed]]Schizophrenia Bulletin.

*
Research neglect of suicide prevention.
Ethical considerations around research into vulnerable populations is extremely
important, justifying the risk versus the potential benefits and protecting the
individual participant and society. However, a recently published JAMA Psychiatry
viewpoint article argues that ethical considerations have negatively shaped attitudes
on suicide research, limiting innovative research and resulting in major scientific
neglect into this important issue.
There is a need for research into suicide prevention, as suicide rates have been
steadily increasing in the United States over the past 20 years, according to the
authors. Yet, research has shown that currently, there are no known risk factors
for suicidal ideation that predict suicide with any accuracy. The authors argue
that novel investigative approaches are necessary to reverse the societal injustice
of the scientific neglect of suicide.
Roberts, L. W., et al. (2019). Ethical considerations in research on suicide prediction: Necessity
as the mother of invention [[link removed]]. JAMA Psychiatry.
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Elizabeth Sinclair
Director of Research
Treatment Advocacy Center
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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.
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The Treatment Advocacy Center does not solicit or accept funds from pharmaceutical
companies.
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