Hunger Pains: Binge-eating disorder linked to lifelong impairments in 12-country study

Binge-eating disorder linked to lifelong impairments in 12-country study Binge-eating disorder, designated only months ago by the American Psychiatric Association as a diagnosis in its Diagnostic and Statistical Manual of Mental Disorders, is associated with substantial lifelong impairments comparable to those of bulimia nervosa, according to a World Health Organization study based on community epidemiological surveys conducted in 12 nations worldwide. The publication of the results online today in Epidemiology and Psychiatric Sciences is timed to coincide with the beginning of Weight Stigma Awareness Week (September 23-27). Although both binge-eating disorder and bulimia involve recurrent episodes of excessive food consumption with experienced loss of control, it had been generally assumed that bulimia carried a greater functional burden of illness owing to its more complex symptom profile. A defining symptom of bulimia, lacking in binge-eating disorder, is inappropriate compensatory behavior such as purging or laxative use to offset the weight gain associated with bingeing. However, compared to matched populations of people with no history of eating disorders, a lifetime history of binge-eating disorder or bulimia each predicted between two- and nearly four-fold increases in current days unable to work or carry out usual activities. Despite the significant challenges that people with these disorders face, both are generally undetected by medical professionals and therefore left untreated. "Binge-eating disorder has been largely ignored by health care providers, but it has a tremendous cost to the physical and psychological well-being of people with the disorder," said Ronald Kessler, McNeil Family Professor of Health Care Policy at Harvard Medical School and senior author of the paper. "When all of the cases of the disorder are taken together, the elevated levels of depression, suicide and lost days at work represent substantial costs to society." The study found that binge-eating disorder and bulimia nervosa both typically arose during adolescence and were associated with a range of later-onset mental disorders (including depression and anxiety disorders) and physical disorders (such as musculoskeletal disorders and diabetes). Early-onset binge-eating disorder was associated with subsequent low rates of employment among men, low rates of marriage among women and high rates of work disability among both men and women. The researchers concluded that the adverse effects of binge-eating disorder and bulimia on subsequent functioning were largely the result of these later-onset comorbidities. This finding, the researchers said, raises the possibility that expanded efforts at early detection and treatment of eating disorders during the vulnerable school years might help prevent the onset of subsequent mental and physical disorders and impairments associated with these disorders. In independent commentaries published in the same journal, international experts on eating disorders Janet Treasure and Cynthia Bulik wrote that the evidence in the report argues strongly for proceeding with clinical effectiveness trials to evaluate the long-term effects on adult health and well-being of early detection and treatment of binge-eating disorder and bulimia among students. The study was based on community surveys in 12 countries. Researchers interviewed a total of 22,635 adult respondents. Binge-eating disorder was roughly twice as common as bulimia across the countries studied, which included the U.S., several countries in Latin America (Brazil, Colombia, Mexico), a number in Europe (Belgium, Italy, Netherlands, Northern Ireland, Portugal, Romania, Spain) and New Zealand Professional Counselor Continuing Education ### The analysis for this paper was carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative. These activities were supported by the U.S. National Institute of Mental Health (R01MH070884) and the Mental Health Burden Study (Contract number HHSN271200700030C) and by a number of government agencies in the other participating countries, as well as by foundations and industry sponsors. This study received supplemental support from Shire Pharmaceuticals. Complete funding information is presented in the published paper. ADDITIONAL CONTACT INFORMATION/ INDEPENDENT INTERNATIONAL EXPERTS Janet Treasure King's College London, Institute of Psychiatry Psychological Medicine, Section of Eating Disorders, UK Email: janet.treasure@kcl.ac.uk Cynthia M. Bulik Distinguished Professor of Eating Disorders Department of Psychiatry University of North Carolina at Chapel Hill, USA Email: cbulik@med.unc.edu Harvard Medical School has more than 7,500 full-time faculty working in 11 academic departments located at the School's Boston campus or in one of 47 hospital-based clinical departments at 16 Harvard-affiliated teaching hospitals and research institutes. Those affiliates include Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Cambridge Health Alliance, Boston Children's Hospital, Dana-Farber Cancer Institute, Harvard Pilgrim Health Care, Hebrew Senior Life, Joslin Diabetes Center, Judge Baker Children's Center, Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, McLean Hospital, Mount Auburn Hospital, Schepens Eye Research Institute, Spaulding Rehabilitation Hospital and VA Boston Healthcare System.

National Institute of Mental Health (NIMH) Grantees To Receive 2013 Lasker Award

A current and a former National Institute of Mental Health (NIMH) grantee recently collected the prestigious 2013 Albert Lasker Basic Medical Research Award for their meticulous mapping of the molecular mechanisms involved in neurotransmitter release, the process by which the brain sends and receives chemical messages. Richard H. Scheller, Ph.D. Richard H. Scheller, Ph.D Genentech Thomas C. Südhof, M.D., at Stanford University School of Medicine, and Richard H. Scheller, Ph.D., at Genentech, parsed the proteins that enable one neuron to speak to another. This communication occurs across the synapse, a gap that separates the two neurons. Collectively called the “SNARE complex,” these proteins include vesicle-associated membrane protein (VAMP/synaptobrevin), synaptogamin, syntaxin, and SNAP-25. The complex allows for the preparation and release of the neurotransmitters into the synapse. Defects in this process contribute to mental disorders such as schizophrenia, depression, bipolar disorder, epilepsy, and many other pathological conditions. Thomas C. Südhof, M.D. Thomas C. Südhof, M.D. Stanford University School of Medicine Dr. Südhof is a current NIMH grantee and has served on several study sections at the NIH Center for Scientific Review, in addition to the Molecular, Cellular, and Developmental Neuroscience study section at NIMH. Dr. Scheller received research support from NIMH, and served on both the NIMH Molecular, Cellular, and Developmental Neuroscience study section, and the National Advisory Mental Health Council. Both have received the NIMH MERIT Award. Known as “America’s Nobels” because many recipients go on to win the Nobel Prize, the Lasker Awards are among the most respected science prizes in the world. Congratulations, Drs. Südof and Scheller Aspira Continuing Education Online Courses

Professional Counselor Continuing Education

Aspira Continuing Education offers online CE courses for Professional Counselors in most states. View our state board approved list to see if Aspira’s CE courses are approved in your state. All of Aspira’s CE courses are NBCC approved and are available for online CEUs for Licensed Professional Counselors (LPC), Licensed Professional Clinical Counselors (LPCC) and Mental Health Counselors (MHC). Check with your State Board’s Website for more information. View our Board Approvals and Accreditations page for provider numbers. California Legislature passed Senate Bill 788 establishing a new license category for Licensed Professional Clinical Counselors (LPCC) to be regulated by the California Board of Behavioral Sciences (BBS). View the CA BBS Licensed Professional Clinical Counselors Information page. View Aspira’s CE courses to see the variety options you have to satisfy your CE requirements. Aspira Continuing Education is a board approved and accredited online CEU provider. Aspira is committed to excellence in the fields of Social Work, Marriage and Family Therapy and Professional Counseling providing board approved CEUs online. We offer MFT continuing education, Social Worker continuing education and Professional Counselor continuing education. Our online CE courses are the best you'll find. We offer a broad range of CE course subjects that are board approved for many professions and states. The process is as simple as selecting an online CE course, completing and passing the online exam, and receiving/printing your certificate. Your certificate is available to view/print once payment has been processed. With Aspira, you can: Satisfy your CE requirements conveniently anywhere you have online access. View all CE course materials in PDF format for FREE. View and take any exam at any time for FREE. Take as much time as needed to complete the exam. Take the exam as many times necessary to receive a 70% passing score. Pay after you have passed your exam. Purchase a subscription for unlimited units that could reduce your cost per unit to under $4. (This will vary depending on the number of units used during the 12 month subscription period.) Print your certificate at any time after passing your exam and purchasing your units. Earn CE hours for passing exams based on books you may have already read. (These CEU courses require purchasing a book separately, if not already owned.) Listen to selected audio CE courses directly from your computer or MP3 player. Keep track of CEUs earned from other sources on your own personalized myCourses page.

The More Hemispheric Lateralization, the Better Thinking Performance

By examining activity of the living human brain at rest via fMRI, NIMH intramural scientists have discovered a secret to how it enhances thinking ability. It turns out that left brain regions are biased to talk more to each other, while right brain regions talk more evenly with both hemispheres. These biases are most pronounced in brain regions associated with the specialized functions of the two hemispheres – e.g., language and motor control on the left and visual/spatial attention on the right. Such lateralization is associated with enhanced cognition, say Drs. Stephen Gotts, Hang Joon Jo, Alex Martin, and colleagues of the NIMH Cognitive Neuropsychology Section, Laboratory of Brain and Cognition. The more such lateral specialization subjects showed at rest, the better they performed on verbal and spatial tasks later. For more information, see PNAS Blog: Brain Halves Interact Differently with Each Other CBT - How to Implement Trauma-Focused Cognitive Behavioral Therapy Two types of lateralization

Reference Two distinct forms of functional lateralization in the human brain. Gotts SJ, Jo HJ, Wallace GL, Saad ZS, Cox RW, Martin A. Proc Natl Acad Sci U S A. 2013 Aug 19. [Epub ahead of print] PMID: 23959883

DSM-5 and RDoC: Shared Interests

Thomas R. Insel, M.D., Director, NIMH Jeffrey A. Lieberman, M.D., President-elect, APA NIMH and APA have a shared interest in ensuring that patients and health providers have the best available tools and information today to identify and treat mental health issues, while we continue to invest in improving and advancing mental disorder diagnostics for the future. Today, the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM), along with the International Classification of Diseases (ICD) represents the best information currently available for clinical diagnosis of mental disorders. Patients, families, and insurers can be confident that effective treatments are available and that the DSM is the key resource for delivering the best available care. The National Institute of Mental Health (NIMH) has not changed its position on DSM-5. As NIMH's Research Domain Criteria (RDoC) project website states, "The diagnostic categories represented in the DSM-IV and the International Classification of Diseases-10 (ICD-10, containing virtually identical disorder codes) remain the contemporary consensus standard for how mental disorders are diagnosed and treated." Yet, what may be realistically feasible today for practitioners is no longer sufficient for researchers. Looking forward, laying the groundwork for a future diagnostic system that more directly reflects modern brain science will require openness to rethinking traditional categories. It is increasingly evident that mental illness will be best understood as disorders of brain structure and function that implicate specific domains of cognition, emotion, and behavior. This is the focus of the NIMH’s Research Domain Criteria (RDoC) project. RDoC is an attempt to create a new kind of taxonomy for mental disorders by bringing the power of modern research approaches in genetics, neuroscience, and behavioral science to the problem of mental illness ceus for social workers The evolution of diagnosis does not mean that mental disorders are any less real and serious than other illnesses. Indeed, the science of diagnosis has been evolving throughout medicine. For example, subtypes of cancers once defined by where they occurred in the body are now classified on the basis of their underlying genetic and molecular causes. All medical disciplines advance through research progress in characterizing diseases and disorders. DSM-5 and RDoC represent complementary, not competing, frameworks for this goal. DSM-5, which will be released May 18, reflects the scientific progress seen since the manual's last edition was published in 1994. RDoC is a new, comprehensive effort to redefine the research agenda for mental illness. As research findings begin to emerge from the RDoC effort, these findings may be incorporated into future DSM revisions and clinical practice guidelines. But this is a long-term undertaking. It will take years to fulfill the promise that this research effort represents for transforming the diagnosis and treatment of mental disorders. By continuing to work together, our two organizations are committed to improving outcomes for people with some of the most disabling disorders in all of medicine.

New Data Reveal Extent of Genetic Overlap Between Major Mental Disorders

Schizophrenia, Bipolar Disorder Share the Most Common Genetic Variation Press Release • August 12, 2013 The largest genome-wide study of its kind has determined how much five major mental illnesses are traceable to the same common inherited genetic variations. Researchers funded in part by the National Institutes of Health found that the overlap was highest between schizophrenia and bipolar disorder; moderate for bipolar disorder and depression and for ADHD and depression; and low between schizophrenia and autism. Overall, common genetic variation accounted for 17-28 percent of risk for the illnesses. “Since our study only looked at common gene variants, the total genetic overlap between the disorders is likely higher,” explained Naomi Wray, Ph.D., University of Queensland, Brisbane, Australia, who co-led the multi-site study by the Cross Disorders Group of the Psychiatric Genomics Consortium (PGC), which is supported by the NIH’s National Institute of Mental Health (NIMH). “Shared variants with smaller effects, rare variants, mutations, duplications, deletions, and gene-environment interactions also contribute to these illnesses.” Dr. Wray, Kenneth Kendler, M.D., of Virginia Commonwealth University, Richmond, Jordan Smoller, M.D., of Massachusetts General Hospital, Boston, and other members of the PGC group report on their findings August 11, 2013, in the journal Nature Genetics. “Such evidence quantifying shared genetic risk factors among traditional psychiatric diagnoses will help us move toward classification that will be more faithful to nature,” said Bruce Cuthbert, Ph.D., director of the NIMH Division of Adult Translational Research and Treatment Development and coordinator of the Institute’s Research Domain Criteria (RDoC) project, which is developing a mental disorders classification system for research based more on underlying causes. Earlier this year, PGC researchers – more than 300 scientists at 80 research centers in 20 countries – reported the first evidence of overlap between all five disorders. People with the disorders were more likely to have suspect variation at the same four chromosomal sites. But the extent of the overlap remained unclear. In the new study, they used the same genome-wide information and the largest data sets currently available to estimate the risk for the illnesses attributable to any of hundreds of thousands of sites of common variability in the genetic code across chromosomes. They looked for similarities in such genetic variation among several thousand people with each illness and compared them to controls – calculating the extent to which pairs of disorders are linked to the same genetic variants. The overlap in heritability attributable to common genetic variation was about 15 percent between schizophrenia and bipolar disorder, about 10 percent between bipolar disorder and depression, about 9 percent between schizophrenia and depression, and about 3 percent between schizophrenia and autism. The newfound molecular genetic evidence linking schizophrenia and depression, if replicated, could have important implications for diagnostics and research, say the researchers. They expected to see more overlap between ADHD and autism, but the modest schizophrenia-autism connection is consistent with other emerging evidence. The study results also attach numbers to molecular evidence documenting the importance of heritability traceable to common genetic variation in causing these five major mental illnesses. Yet this still leaves much of the likely inherited genetic contribution to the disorders unexplained – not to mention non-inherited genetic factors. For example, common genetic variation accounted for 23 percent of schizophrenia, but evidence from twin and family studies estimate its total heritability at 81 percent. Similarly, the gaps are 25 percent vs. 75 percent for bipolar disorder, 28 percent vs. 75 percent for ADHD, 14 percent vs. 80 percent for autism, and 21 percent vs. 37 percent for depression. Among other types of genetic inheritance known to affect risk and not detected in this study are contributions from rare variants not associated with common sites of genetic variation. However, the researchers say that their results show clearly that more illness-linked common variants with small effects will be discovered with the greater statistical power that comes with larger sample sizes. “It is encouraging that the estimates of genetic contributions to mental disorders trace those from more traditional family and twin studies. The study points to a future of active gene discovery for mental disorders” said Thomas Lehner, Ph.D., chief of the NIMH Genomics Research Branch, which funds the project.

Common inherited genetic variation (single nucleotide polymorphisms, or SNPs) accounted for up to about 28 percent of the risk for some disorders, such as ADHD (dark green). Among pairs of disorders (light green), schizophrenia and bipolar disorder (SCZ-BPD) shared about 16 percent of the same common genetic variation (coheritabilities). Source: Cross-Disorder Group of the Psychiatric Genomics Consortium Professional Counselor Continuing Education Reference Cross-Disorder Group of the Psychiatric Genomics Consortium. Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs. Nature Genetics, August 11, 2013 Grants R01MH065562, R01MH43518, R01MH065554, R01MH65707, R01MH065571, R01MH65588, R01MH65578, R01MH65558 ### The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. For more information, visit the NIMH website. About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit the NIH website. Press Contact(s) Jules Asher NIMH Press Office 301-443-4536 NIMHPress@nih.gov More Science News about: Attention Deficit Hyperactivity Disorder (ADHD) Autism Bipolar Disorder Depression Schizophrenia Contact the Press Office Phone: 301-443-4536 Email: NIMHpress@mail.nih.gov Press Resources Mental Health Information Statistics on Mental Disorders Summaries of Scientific Meetings Information about NIMH RePORTER: Research Portfolio Online Reporting Tool Expenditures and Results PubMed Central: An Archive of Life Sciences Journals Recommendations for Reporting on Suicide News from the Field News from the Field NIMH-Funded Science on EurekAlert Teen Eating Disorders Increase Suicide Risk The Love Hormone is 2-Faced Fear Factor: Missing Brain Enzyme Leads to Abnormal Levels of Fear in Mice, Reveals New Research More news from the field... Bookmark & Share Newsletters RSS Feeds Facebook

Community-based Treatments Offset Depression Disparities

Depression can affect anyone, but it hits ethnic groups more heavily partly because of reduced access to quality mental health care. To offset this imbalance, researchers from the RAND Corporation and UCLA, and community partners from more than two dozen community agencies, compared whether evidence-based quality improvement programs, which include psychotherapies such as cognitive behavioral therapy and antidepressant medications, are better implemented through involvement of the entire community or through clinic-based programs. The researchers polled 1,018 depressed patients in 90 randomized community- and clinic-based programs. The community-based approaches--in such places as churches, senior centers, and barber shops--worked best at improving mental-health quality of life, increasing physical activity, reducing homelessness risk factors, and getting more people to seek hospital and primary physician care. Project officer and Associate Director of Dissemination and Implementation Research David Chambers, Ph.D., discusses in a video the significance of these findings. For further details, see RAND Corporation’s press release, “Incorporating Community Groups Into Depression Care Can Improve Coping Among Low-Income Patients, Study Finds.” Aspira Continuing Education Online Courses