Blog Posts

Metabolic aspects of mental health & Dietitians

3/30/2024

Val's Take/Conjecture

I think as the "METABOLIC" aspects of Mental Health come more into focus there's going to be a need for Dieticians to provide specialized care.

One of the challenges of being "NEURO-DIVERSE" is sometimes what works for everyone else doesn't work for you.
This is also why BIOMARKERS are so important --- as opposed to subjective symptom clusters. Of course, most mental health professionals are not relying on subjective symptom clusters because they want to.

A Ketogenic Diet is being promoted by Metabolic Mind and the Researchers at Harvard and other places for Bipolar Disorder, etc.
- There are plenty of CAVEATS to that, even as people are experiencing a range of outcomes with current treatments.

Getting PERSONALIZED, INDIVIDUAL Dietary Advice and Monitoring is likely to be very important.

Mission

Provide resources and support which empower Behavioral Health Nutrition (BHN) Members to excel in the areas of addictions, eating disorders, intellectual and developmental disabilities, mental health.

Vision

Optimize the physical and cognitive health of those we serve through nutrition education and behavioral health counseling.

Ketosis and the ketogenic diet

FAT Metabolism and ATP Production

3/24/2024

Today Show
How Following the Keto Diet Improved this Man's Mental Health

SIGNIFICANTLY, no one is claiming a Keto Diet is a CURE-ALL.

But there are reasons to believe it could help address some of the METABOLIC ASPECTS of Mental Illness. Keto is lower carbs, high fat and moderate protein.

Fat can lead to greater ATP Production. Is it heart healthy, maybe not.

People with Mental Illness are often faced with various "CATCH-22s" when it comes to treatment.

Metabolic Mind --- Feb. 22, 2024
New Harvard Study Explores Brain Energy Metabolism in Bipolar Disorder

Fatty acid metabolism consists of various metabolic processes involving or closely related to fatty acids, a family of molecules classified within the lipid macronutrient category. These processes can mainly be divided into (1) catabolic processes that generate energy and (2) anabolic processes where they serve as building blocks for other compounds.

In catabolism, fatty acids are metabolized to produce energy, mainly in the form of adenosine triphosphate (ATP). When compared to other macronutrient classes (carbohydrates and protein), fatty acids yield the most ATP on an energy per gram basis, when they are completely oxidized to CO2 and water by beta oxidation and the citric acid cycle.[2] Fatty acids (mainly in the form of triglycerides) are therefore the foremost storage form of fuel in most animals, and to a lesser extent in plants.

In anabolism, intact fatty acids are important precursors to triglycerides, phospholipids, second messengers, hormones and ketone bodies. For example, phospholipids form the phospholipid bilayers out of which all the membranes of the cell are constructed from fatty acids. Phospholipids comprise the plasma membrane and other membranes that enclose all the organelles within the cells, such as the nucleus, the mitochondria, endoplasmic reticulum, and the Golgi apparatus. In another type of anabolism, fatty acids are modified to form other compounds such as second messengers and local hormones. The prostaglandins made from arachidonic acid stored in the cell membrane are probably the best-known of these local hormones.

------Wikipedia

ATP, Parkinson's and the neuro-developmental/Psychiatric continuum

3/15/2024

"The use of oxygen enables a net production of 38 molecules of ATP from one molecule of glucose. Without oxygen, net production is only 2 molecules of ATP.

Because oxygen-requiring reactions (aerobic metabolism) take place only in the mitochondria, it’s clearly advantageous in terms of energy production for cells to contain mitochondria."

Reference:
11.6: Aerobic Metabolism and the Mitochondria - Medicine ...

Parkinson's Disease in now being viewed as a failure to produce ATP.

"ATP is essential in human activities and health. We hypothesize that maintaining ATP levels may help to preserve vulnerable brain cells in neurodegenerative diseases like Parkinson's disease (PD). For this purpose, we developed and tested two types of chemical compounds, one for limiting ATP consumption and the other for enhancing ATP production."

ATP Maintenance via Two Types of ATP Regulators ... - ScienceDirect

Parkinson's is interesting because we think of it as a disorder of mobility, but it also has PSYCHIATRIC SYMPTOMS.

Psychiatric Symptoms Associated With Parkinson Disease

Many nonmotor aspects of PD, including depression, drug-induced psychosis and impulse control disorders, cognitive impairment, anxiety, and sleep disturbances, are common and are associated with a variety of poor outcomes. 2 These nonmotor symptoms complicate the clinical management of the disorder and are significant determinants of poor quality of life for patients and their caregivers. 3

Are hallucinations a symptom of Parkinson's disease?

Hallucinations and delusions are potential complications of Parkinson’s disease (PD). They may be severe enough to be classified as PD psychosis. Hallucinations are perceptions that aren’t really there. Delusions are beliefs that aren’t based in reality. One example is paranoia that persists even when a person is presented with contrary evidence.

Parkinson’s Hallucinations: Delusions and More - Healthline

Currently we estimate the "normal" Brain uses 20% of the oxygen of the body --- the brain uses more oxygen than any other organ of the body.

AUTISM

Autism Spectrum Disorders: The Mitochondria Connection

ourworldandautism.com ›
Why are Autistic People So Tired? Exploring Fatigue in Autism

Sep 21, 2023 · Fatigue in autism can be caused by sleep problems, such as difficulties falling asleep or staying asleep. Additionally, sensory overwhelm, which is common in autism, can lead to

ADHD

Response variability in Attention-Deficit/Hyperactivity ...

"The immediate effects of deficient ATP production and slow restoration of ionic gradients across membranes of rapidly firing neurons have implications for daily functioning: For individuals with ADHD, performance efficacy would be enhanced if repetitive and lengthy effortful tasks were segmented to reduce concurrent demands for speed and accuracy of response (introduction of breaks into lengthy/effortful activities such as examinations, motorway driving, assembly-line production)."

www.verywellhealth.com › adhd-fatigue-8407263ADHD Fatigue: Understanding the Connection - Verywell Health
Jan 4, 2024 · Fatigue is a common symptom in those with ADHD. Fatigue often brings tiredness and stress and can lead to burnout. Though the exact cause can be unknown and vary from person

MOOD DISORDERS

More recent studies showed that a decrease in the astrocytic release of ATP in the prefrontal cortex and hippocampus is a major cause of mood disorders. It is an attractive hypothesis that compensatory increases in P2X7Rs in these areas of the brain are the immediate actuators of MD and BD.
www.frontiersin.org › articles › 10Frontiers | Pathological ATPergic Signaling in Major ...

www.ncbi.nlm.nih.gov › pmc › articles
The relationship between fatigue and psychiatric disorders ... (2009)

Fatigue and psychiatric disorders frequently occur comorbidly and share similar phenomenological features. There has been debate as to whether chronic fatigue, or neurasthenia, should be

SCHIZOPHRENIA

www.ncbi.nlm.nih.gov › pmc › articles
Schizophrenia as metabolic disease. What are the causes?
Jan 19, 2023 · Purigenic signaling as a mechanism is Schizophrenia. ATP and adenosine work as neurotransmitters. ATP plays the role of the excitatory transmitter, while adenosine plays the

trialsjournal.biomedcentral.com › articles › 10Assessment of the efficacy of a fatigue management therapy in ...
Sep 17, 2020 · First, lack of energy, one of the main characteristics of fatigue, is frequently encountered in individuals with schizophrenia. Second, fatigue is a common and severe symptom

The Neuro-Developmental - Psychiatric Continuum and "Successful aging"

2/16/2024

Bodies of People With Mental Illness Are Biologically Older Than Their Actual Age

Neuroinflammation and Oxidative Stress in the Pathogenesis of Autism Spectrum Disorder (2023)

1 Department of Neuroscience and Cell Biology, Graduate School of Medicine, Osaka University, Japan
2 United Graduate School of Child Development, Osaka University, Japan
3 Global Center for Medical Engineering and Informatics, Osaka University, Japan
4 Addiction Research Unit, Osaka Psychiatric Research Center, Osaka Psychiatric Medical Center, Osaka, Japan
5 SANKEN (Institute of Scientific and Industrial Research), Osaka University, Japan

In this review, we discuss the inflammation and oxidative stress in the pathophysiology of ASD, particularly focusing on maternal immune activation (MIA).

MIA is a one of the common environmental risk factors for the onset of ASD during pregnancy.

It induces an immune reaction in the pregnant mother’s body, resulting in further inflammation and oxidative stress in the placenta and fetal brain.

These negative factors cause neurodevelopmental impairments in the developing fetal brain and subsequently cause behavioral symptoms in the offspring.

3 Big Takeaways from the Research

Neuroscience News

Protein Key to Neuroprotection and Aging Discovered (Dec. 2023)

The study emphasizes the potential of this discovery for developing new therapies for age-related diseases and promoting successful nervous system aging.

Source: LSU

Scientists at LSU Health New Orleans’ Neuroscience Center of Excellence, led by Nicolas Bazan, MD, PhD, Boyd Professor and Director, have identified a new mechanism that regulates a protein key for cell survival.

It appears to protect against the excessive oxidative stress that precedes the development of neurodegenerative diseases of the brain and eye.

Results are published in the Nature journal, Cell Death & Disease.

Elovanoid-N34 modulates TXNRD1 key in protection against oxidative stress-related diseases (2023)

Lipid mediators in the regulation of innate and adaptive immunity (2023)

Emerging roles of innate and adaptive immunity in Alzheimer’s Disease (2022)

Lipids and cancer: emerging roles in pathogenesis, diagnosis and therapeutic intervention (2020)

More Hard Issues: Homicidality, SUICIDALITY and the Imperfect world of psychiatric medications

1/24/2024

Val's Take

Sometimes we think serious, potentially catastrophic mental illness is not in the middle and upper middle class suburbs --- but it is.
That was seemingly proven once again by the killing of a father by his thirty-something son with "schizophrenia" in Highlands Ranch.
One of the ideas that the parents seemingly had and that clinicians have historically had and even advocates had in the beginnings of the MENTAL HEALTH MOVEMENT ----- "JUST TAKE THE DAMN MEDICATION."
So if people find the medication helpful --- they generally are taking it, and they are generally lobbying to ensure access to the medication at a reasonable price.
One of the places you see this is for people where the GENERIC is NOT going to be an ADEQUATE SUBSTITUTE.
In some ways, the current Activist Mental Health Movement is made up of a significant percentage of people in which the medication didn't work that well or made things worse.
In addition to that, sometimes Executive Functioning may be so impaired that adhering to a medication regime is not realistic.
While I think it was idiosyncratic mental health patients that have pushed this issue, Clinicians are more and more sophisticated about this issue as well --- and will do genetic testing if it is available for that particular medication and are on the lookout for side effects that would indicate the discontinuation of that particular medication.

TedTalk --- David Anderson of Cal-Tech
Most Psychiatric Medications work on the Brain -- Globally --- NOT SPECIFIC NEURAL CIRCUITS -- that can do more harm than good.

Pharmacogenetic Information & News
How Does Genetic Testing for Psychiatric Medication Work? (2017)

BUT what if --- you don't have a current medication or treatment that will bring the person into a RANGE in which the person can function without being a danger to others, themselves or "gravely disabled"?

TWO THINGS:

We need some place safe for that person to live
- For some people that is a Secure Placement.
- It is not for most people
Even if it is a Secure Placement, it needs to be comfortable and the person needs to have the ability to work with Clinicians and Peers to develop their "STRENGTHS" which often are IDIOSYNCRATIC -- and accommodations and workarounds for Executive Functioning Issues.

Not acknowledging the complexity of psychiatric medication in 2024 and failure to provide "contingency planning" if the medication:

Doesn't work for the person or well enough
Makes things worse
The person can't manage the administration
It's not clear what treatment would work
Etc.

IS MAKING US LESS SAFE.

Neuro-Diversity, Metabolism, Diet and the Need for Precision Medicine

1/20/2024

So to me the important thing about "Maternal Immune Activation" is "DYSREGULATION" of MULTIPLE SYSTEMS OF THE BODY.

And one of the BIG KEYS to that is "MITOCHONDRIA."

Down Syndrome based on research from the University of Colorado School of Medicine is now being conceptualized as an IMMUNE DISORDER. See also Mayo Clinic on general Down Syndrome information.

Nobody is expecting Down Syndrome to be REVERSED by "DIET" alone.

High IQ Developmental Difference/Disorder --- the reality of that is not something we're really willing to accept. I'm not saying we should "ACCEPT IT and DO NOTHING" ---

But there can be much more of looking for a "QUICK FIX" --- that may in fact help --- may even be LIFE SAVING
Even as the Developmental Aspects are shrugged off, ignored or never appreciated in the first place.

October 25, 2023

Metabolomic Biomarker Signatures for Bipolar and Unipolar Depression

Maternal Inflammation During Pregnancy and Offspring Brain Development:

The Role of Mitochondria

"The association between maternal immune activation (MIA) during pregnancy and risk for offspring neuropsychiatric disorders has been increasingly recognized over the past several years. "

Critical role of dysfunctional mitochondria and defective mitophagy in autism spectrum disorders (2021)

Affiliations

Hengyang Key Laboratory of Neurodegeneration and Cognitive Impairment & Institute of Neuroscience, Hengyang Medical College, University of South China, Hengyang, Hunan, 421001, People's Republic of China; Lhasa Guangsheng Hospital, Lhasa, People's Republic of China.

Translational Neuroscience:
Toward New Therapies

Chapter 3
Psychotic Disorders and the Neurodevelopmental Continuum

Michael J. Owen

"EMBO" stands for Excellence in the Life Sciences in Europe and Around the World

Metabolic Mind: Interview with Dr. Chris Palmer at Harvard.

One of the current big ideas in PSYCHIATRIC DISORDERS is around METABOLISM and a KETOGENIC DIET.

This is being promoted by a number of academics and organizations including METABOLIC MIND.

Above is an interview with Dr. Chris Palmer at Harvard. I find SOME of Dr. Palmer's ideas very interesting --- I am concerned that there is not an appreciation of some of the DEVELOPMENTAL ASPECTS of this.

Mental Illness & Metabolism

What are the basic rules for keto?

Keto basics

"The ketogenic diet is a very low carb, high fat diet that shares many similarities with the Atkins and low carb diets.

"It involves drastically reducing carbohydrate intake and replacing it with fat. This reduction in carbs puts your body into a metabolic state called ketosis.

"When this happens, your body becomes incredibly efficient at burning fat for energy. It also turns fat into ketones in the liver, which can supply energy for the brain (6Trusted Source).

"Ketogenic diets can cause significant reductions in blood sugar and insulin levels. This, along with the increased ketones, has some health benefits."

A DSM 5 Classification System that Isn't Good Enough

1/16/2024

Our current classification system contained in the DSM 5 is not supported by the research.

What is supported by the research is something much more DEVELOPMENTAL in which diagnostic categories are not fixed..
That has clinical, legal and policy ramifications.

Neurodevelopmental disorders (NDD) without boundaries: research and interventions beyond classifications (2023)

"Both genetic and environmental factors, along with clinical and imaging features, argue toward a continnum between NDD (Neuro-Developmental Disorders) but also with adult psychiatric presentations.

"This new paradigm could modify the therapeutic strategy, with the development of large-spectrum treatments or new psychotherapies addressing co-occuring symptoms."

December 12, 2023

The Ups and Downs of Bipolar Disorder

National Institute of Mental Health feature story on Josh Santana who was academically gifted, had ADHD and Bipolar Disorder.

King's College London
Thinking Twice About ADHD and Autism Spectrum Disorder (2019)

Autism and Beyond: Unveiling Overlapping Neurotypes

January 24, 2024

Key Facts:

The study found a substantial overlap in neurodivergence, with 76.2% of autistic children displaying traits of other neurotypes, including ADHD.

Over 55% of children assessed for autism might also meet the diagnostic threshold for ADHD, highlighting the necessity of holistic neurotype assessments.

Despite the clinical overlap, only 26% of children with additional traits were investigated for an underlying diagnosis, stressing the need for more comprehensive evaluation methods.

Source: University of Glasgow

Affiliations

1 GHU-Paris Psychiatrie et Neurosciences, Paris, France.
2 Excellence Centre for Autism and Neuro-Developmental Disorders, Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris Cité University, Paris, France.
3 Immunology, Immunopathology, Immunotherapy, INSERM U959, Sorbonne University, Paris, France.
4 Université de Paris, INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France.
5 Child and Adolescent Psychiatry Department, Saint-Etienne University Hospital and CNRS UMR 5229, Institute of Cognitive Neuroscience Marc Jeannerod, University Lyon 1, Bron, France.
6 Child Mind Institute, New York, USA.
7 Univ. Bordeaux, INRAE, Bordeaux INP, NutriNeuro, UMR 1286, Bordeaux, France.
8 CHU Montpellier-Saint Eloi Hospital, University of Montpellier, Unit of Child and Adolescent Psychiatry (MPEA1), Montpellier, France.
9 Center for Research in Epidemiology and Population Health (CESP), INSERM U 1018, Paris-Saclay University, Villejuif, France.
10 Department of Pediatrics, Sainte Justine Hospital Research Center, University of Montreal, Montreal, QC, H4A3J1, Canada.
11 INSERM-UMR1163, Université Paris Cité, Institut Imagine, Paris, France.
12 Faculty of Medicine, University of Tours, Tours, France.
13 Autism and NDD GIS (GIS Autisme et Troubles du Neurodéveloppement), Paris, France.
14 Autism and NDD GIS (GIS Autisme et Troubles du Neurodéveloppement), Paris, France. paul.olivier2@inserm.fr.
15 Department of Psychiatry, McGill University, Montreal, Canada.

Science Up

Shared Genes & Psychiatric Disorders

Mirror Neurons innately tuned to aggression

1/5/2024

med.stanford.edu ›

mirror-neurons-aggression

Scientists discover mirror neurons in mice and find they’re ...

Feb 15, 2023 · The researchers found also that these mirror neurons seemed innately tuned to aggression, even in mice that had never witnessed or engaged in aggressive behavior. They did

BUT . . .

Unlocking Anger’s Potential:

A Surprising Key to Goal Achievement

Alice Merton -- No Roots
"A thousand times I've seen this road. A thousand times."

Dec. 5, 2023
Cerebellar Glia Influence Aggression Level

Mirror Neurons & Aggression

Does a Mirror-Trap reactivate aggression-mirroring neurons?

We used a genetically encoded mirror-TRAP strategy to functionally interrogate these aggression-mirroring neurons. We find that their activity is essential for fighting and that forced activation of these cells triggers aggressive displays by mice, even toward their mirror image.

Hypothalamic neurons that mirror aggression - PubMed

Cortical Thickness & the Neurobiology of 6 Psychiatric

12/10/2023

Virtual Histology of Cortical Thickness and Shared Neurobiology in 6 Psychiatric Disorders (2021)

JAMA (Journal of the American Medical Assn.) Psychiatry

Conclusions and relevance: In this study, shared neurobiologic processes were associated with differences in cortical thickness across multiple psychiatric disorders. These processes implicate a common role of prenatal development and postnatal functioning of the cerebral cortex in these disorders.

[See Cleveland Clinic: Cerebral Cortex]

Affiliations

1 Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
2 Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.
3 The Hospital for Sick Children, Toronto, Ontario, Canada.
4 Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
5 Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles.
6 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.
7 Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
8 Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
9 Department of Psychiatry, Yale University, New Haven, Connecticut.
10 Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
11 University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, Groningen, the Netherlands.
12 Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Spain.
13 FIDMAG Germanes Hospitalàries Research Foundation, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Catalonia, Spain.
14 The Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, University of Toronto, Toronto, Ontario, Canada.
15 Department of Pediatrics University of Toronto, Ontario, Canada.
16 Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland.
17 Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM.
18 The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
19 Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology and Neuroscience; King's College London, London, England.
20 Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy.
21 INT UMR 7289, Aix-Marseille Université, CNRS, Aix-en-Provence, France.
22 Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria; Centro de Investigación Biomédica en Red de Salud Mental, Santander, Spain.
23 Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, the Netherlands.
24 Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
25 Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
26 The Research Institute of Pediatrics and Child Health of the Central Clinical Hospital of the Russian Academy of Sciences of the Ministry of Science and Higher Education of the Russian Federation, Moscow, Russia.
27 Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
28 University of Münster, Department of Psychiatry, Münster, Germany.
29 Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.
30 Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy.
31 Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy.
32 Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neuroscience, Amsterdam Neuroscience, Amsterdam, the Netherlands.
33 Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Department of Psychiatry, Utrecht, the Netherlands.
34 Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, Barcelona, Spain.
35 Department of Psychiatry, University of Basel, Basel, Switzerland.
36 McLean Hospital, Harvard Medical School, Belmont, Massachusetts.
37 School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
38 Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany.
39 Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
40 Department of Developmental Neuroscience - IRCCS Fondazione Stella Maris, Pisa, Italy.
41 Department of Clinical and Experimental Medicine, University of Pisa.
42 Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Georgia.
43 Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain.
44 Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); University of Barcelona, Spain.
45 Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland.
46 School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia.
47 Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland.
48 Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, England.
49 Centre for Integrative Neuroscience and Neurodynamics, School of Psychology and Clinical Language Sciences, University of Reading, Reading, England.
50 Departments of Paediatrics and Psychiatry, University of Melbourne, Melbourne, Australia.
51 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany.
52 Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain; Departamento de Psiquiatria, Universidad de Sevilla, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain.
53 Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London UK; Zurich Center for Neuroeconomics, University of Zurich, Zurich, Switzerland.
54 Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota.
55 Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, Sackler Institute for Translational Neurodevelopment, London, London, England.
56 Orygen, Melbourne, Australia.
57 Department of Psychiatry, Amsterdam UMC, Amsterdam, the Netherlands.
58 IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
59 Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
60 Department of Psychology, School of Arts and Social Sciences, City, University of London, Northampton Square, Clerkenwell, London, England.
61 Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany.
62 Department of Psychiatry and Biological Sciences, Albert Einstein College of Medicine, the Bronx, New York.
63 University Medical Center Goettingen, Department of Psychiatry and Psychotherapy, Systems Neuroscience and Imaging in Psychiatry, Göettingen, Germany.
64 Department of Psychiatry, University of Tuebingen, Tuebingen, Germany.
65 Behavioral Neuroscience Department, Oregon Health & Science University, Portland.
66 Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York.
67 Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
68 Child OCD and Anxiety Disorders Program, Department of Psychiatry, University of Michigan Medical School, Ann Arbor.
69 San Francisco VA Medical Center, San Francisco, California.
70 Department of Psychiatry, Trinity College Dublin, Dublin, Ireland.
71 University of East London, School of Psychology, London, England.
72 Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
73 Department of Neuroscience, Brighton and Sussex Medical School, Brighton, England.
74 Tommy Fuss Center for Neuropsychiatric Disease Research, Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
75 Central Clinical Hospital of the Russian Academy Sciences, Moscow, Russia.
76 Department of Psychology, Stanford University, Stanford, California.
77 Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
78 Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
79 Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
80 Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany.
81 FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.
82 Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
83 Department of Bioengineering, Imperial College London, London, England.
84 Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
85 Department of Biomedicine, University of Bergen, Bergen, Norway.
86 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia.
87 University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands.
88 Department of Experimental Psychology, Vrije Universiteit, Amsterdam, Netherlands.
89 Genentech Inc, South San Francisco, California.
90 Department of Psychology, University of Oslo, Oslo, Norway.
91 Research Center for Child Mental Development, Chiba University, Chiba, Japan.
92 Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco.
93 University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, the Netherlands.
94 Radboud University Medical Center, Karakter University Center of Child And Adolescent Psychiatry, Nijmegen, the Netherlands.
95 Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland.
96 National Institute of Mental Health, Klecany, Czech Republic.
97 Department of Clinical Medicine, University of Bergen, Bergen, Norway.
98 Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
99 Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany.
100 University of Oxford, Oxford, England.

101 Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
102 Department of Internal Medicine, First Affiliated Hospital of Kunming Medical University, Kunming. China.
103 Research Institute of Pediatrics and child health of the Central clinical hospital of the Ministry of Science and Education, Moscow, Russia.
104 Department of Psychiatry, Philipps-University Marburg, Marburg, Germany.
105 Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
106 Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
107 Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany.
108 Child Neuropsychology Section, University Hospital RWTH Aachen, German; JARA-Brain Institute II Molecular Neuroscience and Neuroimaging, Research Centre Juelich, Juelich, Germany.
109 Department of Psychiatry and Psychotherapy, University of Bonn, Germany.
110 Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.

111 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
112 Mental Health Research Center, Moscow, Russia.
113 Division of Molecular Psychiatry, Center of Mental Health, University of Würzburg, Würzburg, Germany.
114 SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa.
115 Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil.
116 Department of Biological and Medical psychology, University of Bergen, Bergen, Norway.
117 Departments of Psychiatry and Pediatrics, University of Calgary, Calgary, Alberta, Canada.
118 University Centre for Information Technology, University of Oslo, Oslo, Norway.
119 Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia.
120 Group of Research in Mental Health, Institut d'Investigació Biomèdica Sant Pau, IIBSant Pau; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.

121 Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
122 Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
123 Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
124 McMaster University, Mood Disorders Program, SJH Hamilton, Hamilton, Ontario, Canada.
125 Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
126 Department of Forensic and Neurodevelopmental Science, King's College London, London, England.
127 Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry Psychology and Neuroscience, King's College, London, England.
128 Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston.
129 OCD clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.

130 Department of Pediatrics, University of California, Irvine.
131 Center for MR Research, University Children's Hospital, Zürich, Switzerland.
132 Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
133 Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, department of Pediatrics, Amsterdam Reproduction and Development, Amsterdam, the Netherlands.
134 Center for Neurobehavioral Genetics, University of California Los Angeles.
135 Department of Psychiatry, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
136 Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain.
137 Neuroscience Research Australia, Sydney, Australia.
138 Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, England.
139 Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia.

140 Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), and Center of Mental Health, University of Würzburg, Würzburg, Germany.
141 Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Denmark.
142 Department of Psychiatry and Human Behavior, University of California, Irvine.
143 Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute, Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
144 Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain.
145 Priority Centre for Brain & Mental Health Research, The University of Newcastle, Callaghan, New South Wales, Australia.
146 Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany.
147 Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
148 National Institute for Nuclear Physics, Pisa Division, Pisa, Italy.
149 Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England.

150 Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
151 Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard Medical School, Belmont, Massachusetts.
152 Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Facultad de Psicologia, Universidad Autónoma de Madrid.
153 Neuroscience Research Australia, Sydney, New South Wales, Australia.
154 Department of Child and Adolescent Psychiatry, RWTH Aachen University Hospital, Aachen, Germany.
155 National Human Genome Research Institute and National Institute of Mental Health, Bethesda, Maryland.
156 School of Psychology, Deakin University, Geelong, Melbourne, Australia.
157 West Region, Institute of Mental Health, Singapore.
158 Columbia University Irving Medical Center, New York, New York.
159 Center for Child and Adolescent Mental Health, Institute of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.
160 Pediatric OCD Consultation Clinic, Anxiety Treatment and Research Center, SJH Hamilton, Ontario, Canada.
161 Department of Psychiatry, New York University School of Medicine, Nathan Kline Institute, New York.
162 Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.
163 Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut.
164 Laboratory of Medical Physics and Magnetic Resonance - IRCCS Fondazione Stella Maris, Pisa, Italy.
165 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands.
166 Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands.
167 Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands.
168 Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands.
169 Academic Child Psychiatry Unit, Department of Pediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia.

170 Hospital Clinic, University of Barcelona, Spain.
171 Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Cerdanyola del Vallès, Barcelona, Spain.
172 Instituto ITACA, Universitat Politècnica de València, Valencia, Spain.
173 Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
174 Department for Child and Adolescent Psychiatry, University Hospital RWTH Aachen, Aachen, Germany.
175 Department of Psychology, University of Bath, Bath, England.
176 Clinical Translational Neuroscience Laboratory, University of California Irvine, Irvine, CA; Center for the Neurobiology of Learning and Memory, University of California, Irvine.
177 German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany.
178 University of California San Francisco, Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco, Weill Institute for Neurosciences.
179 Department of Child and Adolescent Psychiatry, New York University Child Study Center, Hassenfeld Children's Hospital at NYU Langone, New York.

180 Seoul National University Hospital, Seoul, Republic of Korea.
181 Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China.
182 Departments of Human Genetics and Psychiatry, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
183 Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
184 Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud UMC, Nijmegen, the Netherlands.
185 Donders Centre for Cognitive Neuroimaging, Radboud University Medical Centre, Nijmegen, the Netherlands.
186 Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
187 Department of Psychiatry, Amsterdam UMC, location VUMC, Amsterdam, the Netherlands.
188 Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
189 SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
190 Psychology Department and Neuroscience Institute, Georgia State University, Atlanta, Georgia.
191 Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada.

Significant correlation between Altitude and Suicide Mortality among US Veterans

12/9/2023

Conjecture

Colorado Medicaid Providers might want to partner in a more STRUCTURED & SYSTEMIC Way to address issues of ALTITUDE and Mental Health with---

National Jewish Hospital in Denver
- They are a national leader in respiratory work & have a SLEEP LAB.
My take has been if the COPING MECHANISM you need is OXYGEN ---- THERE REALLY is no SUBSTITUTE.
People should be screened for:
- Deviated Septum
- Allergies
- Asthma
- Sleep Apnea --- sleep apnea can be due to a lot of things ---
  - Obstructive sleep apnea
  - Substance-Induced sleep apnea, and
  - Altitude induce sleep apnea
    - Sleep apnea has been associated with bipolar disorder according to Taiwan University.
- Etc.

I re-iterate I don't think the ONLY issue in Mental Health is ALTITUDE, SLEEP APNEA, etc. --- but I think this is an issue that helps explain why Mountainous Regions have significantly above Average Suicide Rates.If we want to say there are other SOCIAL FACTORS --- that's fine --

BUT STOP IGNORING ALTITUDE and other Complicated Factors to getting OXYGEN to the BRAIN.
There should be a SYSTEM OF COORDINATED CARE to have people evaluated for oxygen issues and screened for mental health issues.

I think people can sometimes feel EMBARRASSED by these really MUNDANE ISSUES that could potentially lead to something more SERIOUS or Bizarre Behavior that's even MORE EMBARRASSING or WORSE.

High Altitude & Sky High Suicide Rates

The Need for a New Integrated DSM

An examination of the association between altitude and suicide deaths, suicide attempts, and suicidal ideation among veterans at both the patient and geospatial level (Sept. 2022)

Highlights

•There is a significant correlation between altitude and suicide mortality rate for U.S. veterans.

•The association between altitude and suicide deaths is higher than the association with suicide attempts or ideation.

•Controlling for relevant factors improves the correlation.

Our work suggested that geospatial factors such as altitude may be significant and should be included in suicide prediction models.

Future studies should incorporate altitude and other hypoxia-related variables into the suicide prediction models in order to further investigate how altitude and associated variables are related to suicide.

Affiliations

1 Applied Mathematics and Computational Research Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
2 Applied Mathematics and Computational Research Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
3 Departments of Mathematics and Statistics, University of California, Los Angeles, CA, USA.
4 Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM, USA.
5 Departments of Computer Science, Hood College, Frederick, MD, USA.
6 VISN 4 Mental Illness Research, Education, and Clinical Center, Center of Excellence, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, PA, USA.
7 Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
8 Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA.
9 Million Veteran Program, Department of Veterans Affairs, USA.

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