Why did mental health got attention at the World Economic Forum in Davos

29 01 2014

You can find three main answers for the question above at the latest post of NIMH director, Dr. Thomas Insel:

Mental Health in Davos

By Thomas Insel

Just returning from the World Economic Forum (WEF) in Davos, Switzerland. While media reports covered speeches from some of the 40 heads of state attending or skewered the over-the-top parties of the rich and famous associated with this annual meeting, they missed a remarkable story: this was the year that mental health became a hot topic at the WEF. There were over 20 sessions on health, many of them focused on mental illness, dementia, or mindfulness. Philip Campbell, editor-in-chief of Nature, moderated a session on the “Mental Health Imperative.” An unprecedented health summit began with the Prime Minister of Norway declaring that mental health was her leading health care priority. And celebrities from Goldie Hawn to Arianna Huffington argued for the need to focus on mental health. One Davos regular compared mental health in 2014 to AIDS in 1994, when the WEF declared the need for a global focus on an emerging, heavily stigmatized, frequently misunderstood disorder.

Why did mental health get so much attention at a global economic meeting, dedicated to “improving the state of the world”? I heard three answers to this question. First, the WEF focuses on the developing world, or in WEF-speak “emerging markets” as well as the developed world. Health problems have become a major speed bump to development, with chronic, non-communicable diseases (diabetes, heart disease, cancer, pulmonary diseases, mental disorders) the major economic and public health threat. In a study  commissioned by the WEF, mental disorders emerged as the single largest health cost with global projections increasing to $6 trillion annually by 2030, more than diabetes, cancer, and pulmonary diseases combined. Perhaps that should not be surprising since mental disorders, which usually start before adulthood, greatly increase the risk for other chronic, non-communicable diseases throughout the lifespan. Hence, the expression “no health without mental health.”

Second, for employers, mental illnesses, especially anxiety and mood disorders, are a threat to productivity. Research has shown that the high rates of absenteeism and presenteeism (at work despite illness) associated with depression cost, on average, $250,000 for every 1000 workers each year.1 An NIMH-funded study showed that even a low-intensity intervention, cognitive behavior therapy delivered by telephone, could offset these costs.2 While Davos extols compassionate leaders dedicated to the well-being of their employees, for many CEOs the business case for detecting and treating depression was also compelling.

Third, the Davos meeting is a place for identifying macroeconomic and social trends. This year we heard about big data, the “internet of things” (sensors for mobile devices and wearable computers), and robotics. But an even bigger trend was the recognition that the 21st century will belong to brain-based economies. This explains, in part, the brain initiatives that have been launched in the European Union and the United States (both featured at this meeting) and it explains the concern with policies for brain health, from promoting resources for child development to preventing dementia. In the same way that infectious diseases were understood and curtailed in the 20th century, WEF speakers stressed that research and better care must reduce the public health challenge of brain disorders in the 21st century for nations to succeed. Importantly, one of the recurrent comments in sessions at Davos was the importance of including social factors in both research and treatments for brain disorders. In addition to “no health without mental health,” we can add from Davos “no wealth without mental health.”

Like the rarefied atmosphere in Thomas Mann’s The Magic Mountain(thought to be set in Davos), the WEF is famous for big ideas that might not survive at sea level. But the emergence of mental health as a hot topic at this year’s meeting is just one example of the increasing recognition that the time has come to focus on this profound public health problem that has received too little attention. Recent articles in the New York Times (see for example “For the Mentally Ill, It’s Worse ,” by op-ed columnist Joe Nocera, January 24, 2014), new legislation  in Congress, and the White House meeting  last year all point to a trend: the time is now. It will be important to use this moment to focus on science as well as services, to aspire for outcomes measured by well-being and not just symptom reduction, and to put people with mental disorders at the center of our efforts.

References

1 Kessler RC, Merikangas DR, Wang PS. The prevalence and correlates of workplace depression in the national comorbidity survey replication. J Occup Environ Med. 2008 Apr;50(4):381-90. doi: 10.1097/JOM.0b013e31816ba9b8.

2 Wang PS et al. Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial.  JAMA. 2007 Sep 26;298(12):1401-11.





How the anatomical structure of the brain impacts its functional networks?

20 01 2014

Today I want to offer an interesting paper by Andreas et al (2013) that sought to  determine how the anatomical structure of the brain impacts its functional networks. I think that their interesting findings (see abstract below) may contribute to a better understanding of brain functioning in healthy people and people with neurodegenerative disorders such as Alzheimer’s disease and psychiatric disorders such as schizophrenia and bipolar disorder. Enjoy!

Andreas Horn, et al., “The structural–functional connectome and the default mode network of the human brain,” NeuroImage, 2013; DOI: 10.1016/j.neuroimage.2013.09.069

Abstract

An emerging field of human brain imaging deals with the characterization of the connectome, a comprehensive global description of structural and functional connectivity within the human brain. However, the question of how functional and structural connectivity are related has not been fully answered yet. Here, we used different methods to estimate the connectivity between each voxel of the cerebral cortex based on functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) data in order to obtain observer-independent functional–structural connectomes of the human brain. Probabilistic fiber-tracking and a novel global fiber-tracking technique were used to measure structural connectivity whereas for functional connectivity, full and partial correlations between each voxel pair’s fMRI-timecourses were calculated. For every voxel, two vectors consisting of functional and structural connectivity estimates to all other voxels in the cortex were correlated with each other. In this way, voxels structurally and functionally connected to similar regions within the rest of the brain could be identified. Areas forming parts of the ‘default mode network’ (DMN) showed the highest agreement of structure–function connectivity. Bilateral precuneal and inferior parietal regions were found using all applied techniques, whereas the global tracking algorithm additionally revealed bilateral medial prefrontal cortices and early visual areas. There were no significant differences between the results obtained from full and partial correlations. Our data suggests that the DMN is the functional brain network, which uses the most direct structural connections. Thus, the anatomical profile of the brain seems to shape its functional repertoire and the computation of the whole-brain functional–structural connectome appears to be a valuable method to characterize global brain connectivity within and between populations.





The Story of Maysoon Zayid

5 01 2014

“I have cerebral palsy. I shake all the time,” Maysoon Zayid announces at the beginning of this exhilarating, hilarious talk. (Really, it’s hilarious.) “I’m like Shakira meets Muhammad Ali.” With grace and wit, the Arab-American comedian takes us on a whistle-stop tour of her adventures as an actress, stand-up comic, philanthropist and advocate for the disabled.

Writer, actor, comedian, Maysoon Zayid is the co-founder of the New York Arab-American Comedy Festival. Do not miss this great lecture.

To see this lecture click HERE