SSRI Use Around Time Of Surgery Linked To Increased Risks.

HealthDay (4/30, Mann) reports that the use of selective serotonin reuptake inhibitors (SSRIs) “around the time of surgery may increase risks associated with the procedure, including bleeding, the need for a blood transfusion, hospital readmission and even death,” according to research published in JAMA Internal Medicine. Investigators looked at data on “more than half a million people who had surgery at 375 U.S. hospitals between 2006 and 2008.”

MedPage Today (4/30, Phend) reports that individuals “on SSRIs in the perioperative period had 20% higher odds of dying in the hospital after elective major surgery (95% CI 1.07 to 1.36) compared with all other patients.” The researchers also found that “bleeds and early readmission to the hospital also occurred more often among those patients.” However, these results did not “prove causality.”

Related Links:

— “Some Antidepressants Linked to Bleeding Risk With Surgery, “Denise Mann, HealthDay, April 29, 2013.

Childhood Emotional Abuse Associated With BD.

Medscape (4/30, Lowry) reports, “Emotional abuse experienced in childhood, especially in children aged five years and younger, confers an increased risk for bipolar disorder [BD],” according to research presented April 24 at the 14th International Congress on Schizophrenia Research. The study involved more than 700 patients and controls. “Regression analysis showed that children who were emotionally abused were more than twice as likely to develop bipolar disorder (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.51 – 3.02).”

Mediterranean Diet Adherence Tied To Lower Risk Of Cognitive Impairment.

Alabama Live (4/30, Oliver) reports that people who follow a Mediterranean diet “were 19 percent less likely to develop problems with their thinking and memory skills,” according to a studypublished April 29 in the journal Neurology.

HealthDay (4/30, Reinberg) reports, “Using data from participants enrolled in a nationwide study on stroke, the researchers gleaned diet information from more than 17,000 white and black men and women whose average age was 64.” Study “participants also took tests that measured their memory and thinking (cognitive) skills.”

Related Links:

— “Mediterranean Diet Might Help Stave Off Dementia, “Steven Reinberg, HealthDay, April 29, 2013.

NYT Urges Country To Look At Substance Abuse As A Public Health Issue.

In an editorial, the New York Times (4/27, Subscription Publication) said that the US “is beginning to realize that it cannot enforce or imprison its way out of the addiction problem,” but in order to “create broadly accessible and effective treatment strategies for the millions of people who need them, it must abandon the ‘drug war’ approach to addiction that has dominated the national discourse in favor of a policy that treats addiction as a public health issue.” The Affordable Care Act “sets the stage for such a transformation by barring insurers from denying coverage to people with pre-existing conditions, including substance dependency.”

Related Links:

— “The Next Step in Drug Treatment, “The Editorial Board, The New York Times, April 26, 2013.

NYT Magazine Examines Treatment Of Bipolar Disorder.

In the New York Times (4/28, Subscription Publication) Magazine, Linda Logan wrote about her own experience with bipolar disorder and how treatment is gradually shifting to address the lost sense of self that plagues patients. “For many people with mental disorders, the transformation of the self is one of the most disturbing things about being ill. And their despair is heightened when doctors don’t engage with the issue, don’t ask about what parts of the self have vanished and don’t help figure out strategies to deal with that loss.” She writes that too much of treatment is now medicine-based, “and a patient’s crisis of self is not very likely to come up in a 15-minute session with a psychopharmacologist.”

Related Links:

— “The Problem With How We Treat Bipolar Disorder, “Linda Logan, The New York Times, April 26, 2013.

Boston Bombing First Responders Willing To Seek Mental-Health Counseling.

The Wall Street Journal (4/26, A6, Kesling, Levitz, Subscription Publication) reports on how first responders to the Boston Marathon Bombing are receiving mental-health therapy in order to ward off psychological inflections, such as post-traumatic stress disorder. Boston Police Commissioner Ed Davis has notably called for large-scale counseling efforts. He said, “We are extremely concerned” about the well-being of the first responders, adding he would also see a therapist.

Boston Bombing Victims Begin Long, Painful Recovery. In a front-page story, The New York Times (4/26, A1, Goodnough, Bidgood, Subscription Publication) reports in the wake of the Boston Marathon bombing, many of the survivors have suffered “complex wounds that are causing intense pain and that will require several more operations.” Some will require surgery “to repair bones, veins and nerves,” while more will need physical therapy. Besides the physical ailments, many victims are experiencing “phantom pain” of lost limbs and post-traumatic stress disorder “that may continue indefinitely.” At Spaulding Rehabilitation Hospital in Boston, “a team of doctors, nurses, psychologists and physical therapists will focus exclusively on the bombing victims, many of whom will be fitted with prosthetic legs while they are there. Inpatient rehabilitation usually lasts a few weeks, said Dr. Ross Zafonte, Spaulding’s chief medical officer, although some of these patients will be there longer.”

Related Links:

— “First Responders Seek Out Counseling as Attitudes Shift, “Ben Kesling, The Wall Street Journal, April 25, 2013.

Small Study Examines Factors Delaying Remission After Psychosis Treatment.

Medwire (4/26, McDermid) reports, “The longer patients with first-episode psychosis go untreated, the less likely they are to achieve remission within a year of starting treatment,” according to a study published April 30 in the journal Psychiatry Research. The 153-patient study revealed that “the average duration of untreated psychosis was 8.8 months in patients who achieved remission versus 15.6 months in those who did not.” The investigators found that “just three factors predicted remission: longer duration of untreated psychosis; worse negative symptoms (higher Scale for the Assessment of Negative Symptoms [SANS] scores); and having completed only primary education.”

Related Links:

— “Delayed psychosis treatment harms chance of success, “Eleanor McDermid, Medwire News, April 26, 2013.

Anthem Agrees To Reprocess 28,000 Behavioral Health Claims.

In continuing coverage, the Connecticut Mirror (4/25, Merritt) reports, “Anthem Health Plans has agreed to reprocess 28,000 claims amounting to $400,000 in additional payments to mental health providers following an investigation by the [Connecticut] Department of Insurance, the department announced Wednesday.” Nevertheless, “it is unlikely that the agreement will prompt physicians’ groups to withdraw a discrimination lawsuit against Anthem on the same issue any time soon.” The piece explains, “Anthem had adjusted its billing codes and fees as of Jan. 1 when a new set of codes established by the American Medical Association took effect.”

Hartford Business (4/25) reports, “Anthem will begin notifying affected providers May 1 and will also explain the change in the billing code reimbursement procedure to its members.” Connecticut Insurance Commissioner Thomas “Leonardi said that Anthem has cooperated fully with the department throughout the oversight process, which began in early March after the department received a formal complaint from” clinicians.

Related Links:

— “Anthem agrees to reprocess 28,000 claims to mental health providers, “Grace Merritt, The Connecticut Mirror, April 24, 2013.

Stressful Home Event In Preschoolers May Increase Risk For Psychosis.

Medscape (4/25, Lowry) reports, “Results from the first phase of the North American Prodrome Longitudinal Study (NAPLS) showed that preschoolers who underwent a stressful home event had a 30% increased risk of developing psychosis.” What’s more, “the type of stressful events that predicted psychosis in preschool-aged children were those that concerned the home or family, independent of other types of stressors.” The research, which “was supported by the National Institute of Mental Health,” was presented at the 14th International Congress on Schizophrenia Research.

Childhood Bullying Tied To Psychiatric Disorders In Young Adulthood.

Medwire (4/24) reports that according to a study published in JAMA Psychiatry, “young adolescents who have been bullied have an increased risk for developing a psychiatric disorder as young adults, with the worst effects seen for individuals who are both victims and bullies.” After following “420 young adolescents who had been bullied, were bullies only, or were both bullies and victims (bullies/victims) annually between the ages of 9 and 16 years” and then adjusting for confounding factors, researchers found that “victims of bullying in childhood had a 4.3-, 3.1-, and 4.6-fold increased risk for developing anxiety disorders, panic disorders, or agoraphobia, respectively.”

Related Links:

— “Psychiatric disorders in young adulthood linked to bullying in childhood, “Ingrid Grasmo, Medwire News, April 23, 2013.