RESEARCH WEEKLY: January Research Roundup
By Molly Vencel
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
Nine to 13 times higher risk of death in the first five years after diagnosis with a schizophrenia spectrum psychotic disorder.
In a large study of more than 11,000 outpatient clinic and inpatient hospital patients published in the Schizophrenia Bulletin, researchers from the University of Toronto and Western University found that death rates were much higher than expected for individuals diagnosed with a psychotic or schizophrenia-spectrum illness compared to the general population of similar age groups. This data adds to the evidence of a large mortality gap for people with severe mental illness compared to the general population. The top causes of deaths among individuals with psychosis within the first five years of diagnosis were suicide and accidents. The study authors emphasize that many patients did not see a psychiatrist within the first year of diagnosis, and that fast and timely mental health care may be able to prevent many of these deaths.
RESEARCH of the month
Racial Minorities Less Likely to Receive Early Intervention Services
Researchers at the University of Southern California followed 3,017 individuals diagnosed with first-episode psychosis, examining access to early intervention services, and published their findings in JAMA Psychiatry late last year. Of the individuals, Black and Hispanic people with first episode psychosis were less likely to receive behavioral health and outpatient services, and less likely to fill antipsychotic and antidepressant prescriptions, according to the results. The researchers utilized statistical methods to ensure these differences were not due to socioeconomic status or insurance enrollment. Noting the connection between the duration of untreated psychosis and long-term recovery, researchers emphasize the need for Black and Hispanic young adults to receive timely care.
Substance Use Patterns in Individuals with Schizophrenia
More than 75% of individuals used at least one substance at the time of admission to the hospital, according to a review of individuals receiving treatment for schizophrenia in an inpatient hospital setting. Researchers at a teaching hospital in Central Brooklyn, N.Y. reviewed medical records of 365 patients to extract both schizophrenia and substance use disorder diagnoses. The most common substances used were tobacco, marijuana and alcohol. It was also common for patients to be using multiple substances. The authors of the study point out that substance use often warrants modifications to the treatment plan for individuals. This high prevalence supports previous research and highlights the need to address substance use in those with severe mental illness.
Mental Health and Substance Use Disorders the Most Common Telehealth Appointment
The Office of Research and Public Affairs continues to monitor the impact of COVID-19 on individuals with severe mental illness. As previously reported in November’s Research Roundup, there are telehealth platforms and services that can work for people with serious mental illness. Nearly a year after the start of the pandemic, research about telehealth during this time is beginning to emerge. A recent study conducted by RAND Corporation, a research organization, has revealed that in the early months of the pandemic (March-May 2020), people with mental health conditions and substance use disorders were more likely to use telehealth than those with other chronic health conditions. More than half (53.6%) of people with a mental health disorder or substance use disorder interacted with a provider via telehealth while only 43% of individuals with chronic physical conditions utilized telehealth services.
As the nation considers what life after the COVID-19 pandemic looks like, research evaluating the impact of telehealth and other changes will be important to ensure access to services and quality are maintained. In addition, it is important that people with severe mental illness are included in research about the pandemic to address the pandemic’s effect on quality and availability of mental health services.
Suicides in Vulnerable Populations During the COVID-19 Pandemic
In a recent video, Dr. Paul Nestadt, a professor of psychiatry at Johns Hopkins University, discusses recent data out from Maryland about deaths due to suicide during the COVID-19 pandemic. While he notes that in previous pandemics, such as the flu pandemics in 1889 and 1918, suicides increased, Maryland so far has shown a decrease overall in the rate of death by suicide. Importantly, he noted that the decrease isn’t consistent in all groups. Specifically, suicide in Black individuals increased. He called attention to the possibility that other vulnerable groups, such as people with serious mental illness, may still be more vulnerable to suicide during these difficult times.
