Director’s Blog Released today, the World Health Organization (WHO)'s report, ” Preventing Suicide: A global imperative ,” provides the first global view of how often suicide attempts and deaths occur, and how suicide-related behaviors affect all ages, nationalities, economic levels, and cultures. Every year around the world more than 800,000 people die by suicide. Globally, suicide is the second leading cause of death in 15- to 20-year-olds.

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Abstract: Objective: Previous epidemiologic studies have documented a link between anxiety disorders and ulcer among adults. Few studies have examined these associations over time and little is understood about the pathways underlying these relationships.Method: Data were drawn from n=2101 adult participants in the Midlife Development in the United States I and II. Data on ulcer diagnoses were collected through self-report: among participants in the current sample, 38 reported ulcer at Waves 1 and 2 (prevalent ulcer), and 18 reported ulcer at Wave 2 but not at Wave 1 (incident ulcer)

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Importance The DSM-5 classifies mood and anxiety disorders as separate conditions. However, some studies in adults find a unidimensional internalizing factor that underpins anxiety and depression, while others support a bidimensional model where symptoms segregate into distress (depression and generalized anxiety) and fear factors (phobia subscales). However, little is known about the phenotypic and genetic structure of internalizing psychopathology in children and adolescents.

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Importance Tractography studies investigating white matter (WM) abnormalities in patients with bipolar disorder have yielded heterogeneous results owing to small sample sizes. The small size limits their generalizability, a critical issue for neuroimaging studies of biomarkers of bipolar I disorder (BPI). Objectives To study WM abnormalities using whole-brain tractography in a large international multicenter sample of BPI patients and to compare these alterations between patients with or without a history of psychotic features during mood episodes.

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Opioid abuse is reaching epidemic proportions in the United States. The consequences of opioid abuse and dependence include emergency department visits, premature death, HIV, hepatitis, criminal activity, lost workdays, and economic costs that in the United States exceed $56 billion annually. Agonist maintenance is the most efficacious treatment for opioid dependence and dramatically reduces morbidity, mortality, and spread of infectious disease

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Abstract: Objective: A growing number of health information technologies (HIT) are being developed and tested to address mental health conditions. HIT includes Internet and smartphone programs or apps, text messaging protocols and telepsychiatry. We reviewed the promise and evidence that HIT can expand access to mental health care and reduce disparities in use of services across groups in need.Conclusions: Limited reach of mental health services is a pervasive problem in the United States, and solving it will require innovations that enable us to extend our clinical reach into underserved populations without significantly expanding our workforce.

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Abstract: Introduction: One thousand five hundred suicides take place on inpatient psychiatry units in the United States each year, over 70% by hanging. Understanding the methods and the environmental components of inpatient suicide may help to reduce its incidence.Methods: All Root Cause Analysis reports of suicide or suicide attempts in inpatient mental health units in Veterans Affairs (VA) hospitals between December 1999 and December 2011 were reviewed. We coded the method of suicide, anchor point and lanyard for cases of hanging, and implement for cutting, and brought together all other reports of inpatient hazards from VA staff for review.Results: There were 243 reports of suicide attempts and completions: 43.6% (106) were hanging, 22.6% (55) were cutting, 15.6% (38) were strangulation, and 7.8% (19) were overdoses.

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Director’s Blog When Secretary of State Hillary Clinton visited NIH last November , she spoke of an “AIDS-free generation” and the promise of research to achieve this goal. AIDS is an infectious disease, and not surprisingly, most NIH AIDS research is supported by NIAID. But the AIDS epidemic is driven by behavior, so NIMH has been an important part of the NIH fight against HIV/AIDS for over two decades.

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Director’s Blog About a decade ago NIH held a series of workshops to develop a Roadmap for Biomedical Research. We brought experts to Bethesda to suggest new directions for technology development, training, and a range of other areas. In one such meeting, on re-engineering clinical research, many of the nation’s leading clinical scientists debated how to improve our approach to research on diseases.

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Abstract: Objective: Physician suicide is an important public health problem as the rate of suicide is higher among physicians than the general population. Unfortunately, few studies have evaluated information about mental health comorbidities and psychosocial stressors which may contribute to physician suicide.

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