Regulating mobile mental health apps.

Mobile medical apps (MMAs) are a fast-growing category of software typically installed on personal smartphones and wearable devices. A subset of MMAs are aimed at helping consumers identify mental states and/or mental illnesses. Although this is a fledgling domain, there are already enough extant mental health MMAs both to suggest a typology and to detail some of the regulatory issues they pose.

Brain-themed self-help and the healthcare provider in the United States.

People commonly use the Internet to search for health information and tend to use the information they find without regard to source or credibility. Although regulation plays some role in minimizing false claims made by manufacturers of self-help products, effective communication with health professionals likely offers greater protection to the patient or consumer accessing self-help materials. In order to best serve patients (or healthcare consumers), providers should educate them about their healthcare needs, inquire about self-help product use, understand appropriate use, discuss the risks and benefits of use, monitor the patients' condition during use, and document these conversations.

Behavioral Genetics and the Forensic Mental Health Provider: An Overview.

The area of behavioral genetics has sufficiently entered the area of forensic mental health work that providers should have some working knowledge of the strengths and limitations of these exciting technical advances. Using MAOA as an example, this essay reviews some of the recurring themes in forensic behavioral genetics and suggests additional ways in which the technology might be used in legal matters.

The relationship of deiodinase 1 genotype and thyroid function to lifetime history of major depression in three independent populations.

Major depression (MD) is often associated with disturbances of the hypothalamic/pituitary/thyroid (HPT) axis. Unfortunately, whether this association is secondary to common underlying genetic variation or whether the MD-associated disturbances in HPT function are chronic or state-dependent is unknown. To examine these questions, we genotyped 12 single nucleotide polymorphisms identified in previous genome wide association analyses of thyroid function in DNA contributed by 1,555 subjects from three longitudinal ethnically diverse studies that are well-characterized for lifetime MD and thyroid function.

Methylation at 5HTT mediates the impact of child sex abuse on women's antisocial behavior: an examination of the Iowa adoptee sample.

Objective: To examine epigenetic processes linking childhood sex abuse to symptoms of antisocial personality disorder (ASPD) in adulthood and to investigate the possibility that the link between childhood sex abuse and deoxyribonucleic acid methylation at the 5HTT promoter might represent a pathway of long-term impact on symptoms of ASPD.

Method: Deoxyribonucleic acid was prepared from lymphoblast cell lines derived from 155 female participants in the latest wave of the Iowa Adoptee Study. Methylation at 71 CpG residues was determined by quantitative mass spectroscopy, and the resulting values were averaged to produce an average CpG ratio for each participant.

Behavioral genetics in antisocial spectrum disorders and psychopathy: a review of the recent literature.

Behavioral geneticists are increasingly using the tools of molecular genetics to extend upon discoveries from twin, family, and adoption studies concerning the heritability of antisocial spectrum disorders and psychopathy. While there is a substantial body of research concerning antisocial spectrum disorders in the behavioral genetics literature, only a few studies could be located using the phenotype of psychopathy. In this report we summarize some of the recent molecular genetics work concerning antisocial spectrum disorders and psychopathy, with a focus on genes involved in the serotonergic and dopaminergic pathways, while also mentioning some of the novel genetic factors being considered.

Child maltreatment moderates the association of MAOA with symptoms of depression and antisocial personality disorder.

There is a growing body of data indicating that Gene x Child Maltreatment interactions at monoamine oxidase A (MAOA) play a role in vulnerability to symptoms of antisocial personality disorder (ASPD) but not major depression (MD). Using a sample of 538 participants from the Iowa Adoption Studies, we introduce a conceptual model that highlights two distinct pathways from child maltreatment to symptoms of MD, suggesting that maltreatment has different effects depending on genotype and highlighting the importance of including the indirect pathway through ASPD. As predicted by the model, high activity alleles predispose to symptoms of MD in the context of child maltreatment whereas low activity alleles predispose to symptoms of ASPD.

The effect of smoking on MAOA promoter methylation in DNA prepared from lymphoblasts and whole blood.

Prior work using lymphoblast DNA prepared from 192 subjects from the Iowa Adoption Studies (IAS) demonstrated that decreased MAOA promoter methylation was associated with lifetime symptom count for nicotine dependence (ND) and provided suggestive evidence that the amount of methylation is genotype dependent. In the current investigation, we replicate and extend these prior findings in three ways using another 289 IAS subjects and the same methodologies. First, we show that methylation is dependent on current smoking status.

Role of GABRA2 on risk for alcohol, nicotine, and cannabis dependence in the Iowa Adoption Studies.

Aim: A number of studies have shown that genetic variation at GABRA2 alters vulnerability to alcohol dependence. The exact identity of the causal variant(s), and the relationship of these variants to other forms of substance use and behavioral illness is, however, uncertain.

Objective: Therefore, we genotyped 516 individuals from the Iowa Adoption Studies, a large longitudinal case and control adoption study of substance use, at 39 single nucleotide polymorphisms encompassing the GABRA2 locus and analyzed them with respect to their lifetime history of three common forms of substance use dependence [alcohol dependence (AD), nicotine dependence (ND), and cannabis dependence (CD)] in the Iowa Adoption Studies and relevant exposure variables.

MAOA methylation is associated with nicotine and alcohol dependence in women.

In recent years, the role of epigenetic phenomenon, such as methylation, in mediating vulnerability to behavioral illness has become increasingly appreciated. One prominent locus at which epigenetic phenomena are thought to be in play is the monoamine oxidase A (MAOA) locus. In order to examine the role of methylation at this locus, we performed quantitative methylation analysis across the promoter region of this gene in lymphoblast lines derived from 191 subjects participating in the Iowa Adoption Studies (IAS).

Frequency of mental and addictive disorders among 320 men and women entering the Iowa prison system: use of the MINI-Plus.

The Mini-International Neuropsychiatric Interview-Plus (MINI-Plus) was used to assess the frequency of mental and addictive disorders among 320 randomly selected men and women newly committed to the general population of the Iowa prison system. More than 90 percent of offenders met criteria for a current or lifetime psychiatric disorder. The most frequent were substance use disorders (90%), mood disorders (54%), psychotic disorders (35%), antisocial personality disorder (35%), and attention deficit hyperactivity disorder (22%).

Control of methamphetamine misuse.

Policy should target substance misuse as a whole, rather than single substances

Shared psychotic disorder and criminal responsibility: a review and case report of folie à trois.

We present a case of shared psychotic disorder involving three sisters who were successful in establishing an insanity defense on numerous felony charges in the South Carolina criminal court system. Two of the authors of this article were court-appointed examiners in this case. We then present a history of shared psychotic disorder, an overview of the use of this diagnosis in the defense of insanity, and a discussion of the disposition of individuals with "temporary insanity.

Adult outcomes of attention deficit hyperactivity disorder and conduct disorder: are the risks independent or additive?

Methods: Data were obtained from a longitudinal study sample of 754 adoptees and categorized based on review of the available adoption agency, medical, and psychiatric records of the biological parents. Categorical data were analyzed using chi2 or Fisher's exact tests, as appropriate. Logistic regression analyses were used to assess the relative contribution of variables.

Characteristics of admissions for primary stimulant dependence during 2001.

The production and consumption of synthetic stimulants has been increasing in recent years accompanied by an increase in the number of individuals seeking treatment for synthetic stimulant "abuse."1 The misuse of stimulants is occurring at younger ages and primarily in the context of polysubstance use. This article examines the characteristics of admissions entering treatment centers that received some form of public funding in 2001 as compiled in the Treatment Episodes Data Set produced by the Substance Abuse Mental Health Services Administration, Office of Applied Studies.

Older admissions to substance abuse treatment in 2001.

Objective: The number of older people with substance abuse problems is expected to increase over the next decade. Given the expected growth in the number of elderly clients needing substance abuse treatment, the authors provide a description of admissions of patients age 55 years and over to facilities receiving some public funds.

Methods: The Treatment Episode Data Set (TEDS), a public-use data-set, contained information on 58,073 admissions to substance treatment (age 55+) and 1,043,910 admissions age 30-54 years.

The emergence of national electronic health record architectures in the United States and Australia: models, costs, and questions.

Emerging electronic health record models present numerous challenges to health care systems, physicians, and regulators. This article provides explanation of some of the reasons driving the development of the electronic health record, describes two national electronic health record models (currently developing in the United States and Australia) and one distributed, personal model. The US and Australian models are contrasted in their different architectures ("pull" versus "push") and their different approaches to patient autonomy, privacy, and confidentiality.