Drug discovery still entails a matter of luck. The average length of time from discovery of a possible compound to its approval is more than 13 years, and the failure rate exceeds 95 percent. And yet these are the odds for the compounds that enter the drug pipeline. For each compound that enters the drug discovery path--a costly venture averaging more than $1 billion per successful drug--there are of thousands of compounds that remain partially developed. Hoping to increase the chances of success for these underdeveloped compounds, the National Institutes of Health has funded $12.7 million to match nine academic research groups with a selection of pharmaceutical industry compounds to explore new treatments for patients in eight disease areas including Alzheimer’s disease, alcohol and nicotine dependence, and schizophrenia. The collaborative pilot initiative, called Discovering New Therapeutic Uses for Existing Molecules, is led by the National Center for Advancing Translational Sciences (NCATS) and funded by the NIH Common Fund.

Wild mood swings. Impulsive behavior. Unstable relationships. These are just a few of the symptoms that are linked to the disorder known in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as “borderline personality disorder” or in the International Statistical Classification of Diseases and Related Health Problems (ICD) as “emotionally unstable personality disorder, borderline type.” Many mental health professionals find it challenging to diagnose the disorder and even find fault with its names.

To learn more about this disorder and the controversies that surround it, please join us Friday, May 31, from 1 to 2 pm ET for a Twitter chat in recognition of Borderline Personality Disorder Awareness Month. The National Institute of Mental Health (NIMH) will team up with Perry D. Hoffman, Ph.D., President and co-founder of the National Education Alliance for Borderline Personality Disorder (NEA-BPD). Dr. Hoffman has several grants from the NIMH that focus on families who have a relative with BPD. She conducted a landmark study documenting the importance of family emotional involvement in a patient’s recovery. Along with co-editing several books on the topic, Dr. Hoffman is also a co-principal investigator of the five-part video series on BPD “If Only We Had Known.”

You can find this discussion under #NIMHchats. An archive of the chat will be posted shortly after the event.

Most children encounter and surmount streptococcal bacteria (strep) infection—pediatricians can test for it either within minutes via a quick throat swab or days with a throat culture. But sometimes these infections take a turn for the worse and the diagnosis can take longer to determine. Such is the case for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and its related syndrome Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). In these disorders, children experience dramatic, “overnight” symptoms, including motor or vocal tics and obsessive-compulsive disorder (OCD). With PANS, children can also experience eating disorders, such as anorexia.

Source: Sue Swedo, M.D., NIMH

To learn more about these disorders that lead to childhood rapid-onset of OCD, please join us Wednesday, May 8, from 11 am to noon ET for a Twitter chat. Sue Swedo, M.D., and her colleague, Paul Grant, M.D., both at the Pediatrics and Developmental Neuroscience Branch at NIMH,  will be online to answer questions. Dr. Swedo and her team were the first to identify PANDAS, and more recently PANS, as a subset of childhood OCD. The chat is part of an ongoing campaign to acknowledge National Children’s Mental Health Awareness DayExternal Link: Please review our disclaimer. and National Mental Health Awareness Month.External Link: Please review our disclaimer.

You can find this discussion under #NIMHchats. An archive of the chat will be posted shortly after the event.

National Children’s Mental Health Awareness Day is a national campaign coordinated by the Substance Abuse and Mental Health Services Administration to increase public awareness of children’s mental health. Positive mental health is essential for a child’s development. Local, state and federal partners include advocacy groups, government agencies, service organizations, professional groups and affiliates. This year SAMHSA hopes to increase community involvement by engaging local groups in a national conversation about the importance of children's social and emotional well-being. Local groups are also encouraged to offer individuals attending Awareness Day events an opportunity to become a "hero of hope" by making a pledge to take action to help a child or youth.

President Barack Obama proclaimed May as National Mental Health Awareness Month. He called upon citizens, government agencies, organizations, health care providers and research institutions to “redouble our efforts to address mental health problems in America.” Tens of millions of Americans are living with a mental health problem yet only half receive available treatment.

Join us Friday, May 3, from 11 am to noon EST, for a discussion of attention deficit hyperactivity disorder (ADHD) to help commemorate National Children’s Mental Health Awareness DayExternal Link: Please review our disclaimer. on May 9. NIMH’s own Ben Vitiello, M.D, from the Child and Adolescent Treatment and Preventive Intervention Research Branch, will field questions regarding ADHD in children and teens.

It’s normal for children to be inattentive, hyperactive or impulsive sometimes, but these behaviors are more severe and frequent in children with ADHD. This common mental disorder in children and adolescents continues through adulthood. Although treatments relieve many of the disorder’s symptoms, there is no cure. With treatment, most people with ADHD can be successful in school and lead productive lives. Researchers are developing more effective treatments and interventions, and using new tools such as brain imaging, to better understand the disorder and to find more effective ways to treat and prevent it.

National Children’s Mental Health Awareness Day is a national campaign coordinated by the Substance Abuse and Mental Health Services Administration to increase public awareness that positive mental health is essential for a child’s development. Local, state and federal partners include advocacy groups, government agencies, service organizations, professional groups and affiliates. This year SAMHSA hopes to increase community involvement by engaging local groups in a national conversation about the importance of children's social and emotional well-being. Local groups are also encouraged to offer individuals attending Awareness Day events an opportunity to become a "hero of hope" by making a pledge to take action to help a child or youth.

You can find this discussion under #NIMHchats. An archive of the chat will be posted shortly after the event.

Read more about ADHD.

People with serious mental illnesses such as schizophrenia, bipolar disorder and major depression can lose weight and keep it off through a modified lifestyle intervention program, a National Institute of Mental Health (NIMH)-funded study reported online today in The New England Journal of Medicine.

Over 80 percent of people with serious mental illnesses are overweight or obese, which contributes to them dying at three times the rate of the overall population. They succumb mostly to the same things the rest of the population experiences—cardiovascular disease, diabetes and cancer. Although antipsychotic medications increase appetite and cause weight gain in these patients, it is not the only culprit. Like the general population, sedentary lifestyle and poor diet also play a part. Lifestyle modifications such as diet and exercise should work for these patients, yet they are often left out of weight loss studies.

“People with serious mental illnesses are commonly excluded from studies to help them help themselves about their weight,” said Gail L. Daumit, M.D., of Johns Hopkins University, Baltimore, and the study’s lead author. “We’re showing that serious mentally ill patients can make successful, sustained changes with proper interventions.”

This study could usher in new forms of weight loss treatment for people with serious mental illness.

“Until now, obesity among those with serious mental illnesses has not received adequate attention,” said NIMH Director Thomas R. Insel, M.D. “People with serious mental illnesses need more attention to their physical health. This study provides convincing evidence these individuals can make substantial lifestyle changes and therefore should suffer fewer medical complications as they age.”

Other factors that preclude people with serious mental illnesses from losing weight include memory impairments or residual psychiatric symptoms that impede learning and adopting new behaviors such as counting calories. Socioeconomics are also a factor as many can’t afford or can’t get to physical activity programs like fitness gyms. Some patients additionally suffer from social phobia or have poor social interactions, and are simply afraid to work out in a public area.

Daumit’s group attempted to solve these issues by bringing the gyms and nutritionists to places most of these patients frequent—psychiatric rehabilitation outpatient programs. Under the trial name ACHIEVE, the researchers randomized 291 participants in 10 rehab centers around Maryland to receive the usual care, consisting of nutrition and physical activity information, or six months of intensive intervention consisting of exercise classes three times a week along with individual or group weight loss classes once a week. Both groups were followed for an additional year, during which the weight loss classes of the intervention arm tapered down but the exercise classes remained constant. The intervention arm included goals such as reducing caloric intake by avoiding sugar-sweetened beverages and junk food; eating five servings of fruits and vegetables daily; choosing smaller portions and healthy snacks; and moderate intensity aerobic exercise.

Participants in the specially tailored weight loss program lost seven pounds more than the controls—and continued to lose weight and did not regain, despite the reduced frequency of classes and counseling sessions. In contrast, the general population tends to experience peak weight loss in the first six months and then rebound and gain part or all of their weight back.

On average, each participant was on three psychotropic medications, with half on lithium or mood stabilizers, all known to cause weight gain. But no matter what they were on, they lost the weight.

“We’re showing behavioral interventions work regardless of what they’re taking,” Daumit said. Her group is now looking for ways to spread the program.

VIDEO

Project Achieve is the first weight loss clinical trial to include people with serious mental illnesses.

Effects of a behavioral weight loss intervention in persons with serious mental illness. Daumit GL, Dickerson FB, Wang N-Y, Dalcin A, Jerome GJ, Anderson CAM, Young DR, Frick KD, Yu A, Gennusa III JV, Oefinger M, Crum RM, Charleston J, Casagrande SS, Guallar E, Goldberg RW, Campbell LM, Appel LJ. NEJM, March 21, 2013.

Grant number: MH080964

###

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.

The U.S. Centers for Disease Control and Prevention (CDC) and Health Resources and Services Administration released a report titled "Changes in Prevalence of Parent-reported Autism Spectrum Disorder in School-aged U.S. Children: 2007 to 2011–2012External Link: Please review our disclaimer.". The report presents data on the prevalence of diagnosed autism spectrum disorder (ASD) as reported by parents of school-aged children ages 6–17 years in 2011–2012. Data was drawn from the 2007 and 2011–2012 National Survey of Children’s Health, which comprises independent, nationally representative telephone surveys of households with children.

Last year, the CDC’s Autism and Developmental Disabilities Monitoring Network estimated that 1 in 88 children had been identified with ASD. The CDC now estimates that in 2011–2012, about 1 in 50 school-aged children, or 2 percent of children ages 6–17 years have some form of the disorder. Since the average school bus holds 50–55 children, that means, statistically speaking, on average there is one child with parent-reported ASD on every school bus in America.

The agencies conclude that the increase in prevalence of parent-reported ASD was largely due to improved diagnosis of ASD by doctors or other health professional in recent years, especially when the symptoms were mild.

Learn more about autism spectrum disorders.

On March 14, 2013, NIMH hosted a Twitter chat on the teen brain with Dr. Jay Giedd in recognition of Brain Awareness Week. NIMH’s own Jay Giedd, M.D., answered questions from the audience regarding the teen brain and other Brain Awareness Week activities.

Dr. Giedd is chief of the Unit on Brain Imaging in the Child Psychiatry Branch of the Division of Intramural Research Program

Brain Awareness Week is a week-long global campaign coordinated by The Dana Alliance for Brain Initiatives that occurs every March to increase public awareness of the progress and benefits of brain research. Partners include universities, hospitals, K-12 schools, advocacy groups, government agencies, service organizations, professional groups, and affiliates.

Read the Twitter chat transcriptExternal Link: Please review our disclaimer..

Read more about the teen brain.

NIMH grantee Subimal Datta, Ph.D., of Boston University, has pinpointed brainwave activity, deep in the brainstem of sleeping rodents, that signals successful consolidation of safety memories that override fear memories. Aleksandra Vicentic, Ph.D., Acting Chief, NIMH Behavioral Science and Integrative Neuroscience Research Branch, which funded the study, comments on the significance of the results.

See news release: BUSM study reveals potential target to better treat, cure anxiety disordersExternal Link: Please review our disclaimer.

Learn more about anxiety disorder and post-traumatic stress disorder.

From Autism to Depression: Largest Genetic Study Shows Mental Disorders Share Genetic KinksExternal Link: Please review our disclaimer.
--Associated Press

Mental Illnesses Share Common DNA Roots, Study FindsExternal Link: Please review our disclaimer.
--nbcnews.com

An NIMH-funded study published online today in LancetExternal Link: Please review our disclaimer. reveals that five major mental disorders—autism, attention deficit hyperactivity disorder, bipolar disease, schizophrenia, and major depression—all share similar genetic components.

“These disorders that we thought of as quite different may not have such sharp boundaries,” said Dr. Jordan W. Smoller of Massachusetts General Hospital, one of the lead study authors.

The results suggest that a rethink in how these disorders are defined might be in order. Rather than focusing on symptoms, which can be attributed to one or more disorder, physicians could one day start to rely on specific gene mutations or biologic pathways to make a formal diagnosis.

And it also could lead to better treatments, said Dr. Bruce Cuthbert, director of the NIMH’s Division of Adult Translational Research and Treatment Development. “We are finally starting to make inroads where we have actual physiological mechanisms that we can target,” he said. “We can really start to understand the biology instead of having to guess at it.”

Cross-Disorder Group of the Psychiatric Genomics Consortium. Identification of Risk Loci with Shared Effects on Five Major Psychiatric Disorders: A Genome-wide Analysis. LancetExternal Link: Please review our disclaimer., published online February 28, 2013.