The Los Angeles Times (8/27, Koseff) reports that Medal of Honor winner Army Staff Sgt. Ty Carter “has spoken openly of his struggle with post-traumatic stress disorder [PTSD], which many veterans bring home after violent experiences in combat.” Carter “has said he wants to eliminate the stigma and shame that discourages soldiers from getting help,” urging “the American public to learn more about PTSD” and its effects on combat soldiers.

The Washington Post (8/27, Vogel) “Federal Eye” blog reports that in remarks during the medal presentation ceremony, President “Obama said it was ‘absolutely critical…to put an end to any stigma’ that prevents troops from getting treatment for PTSD.”

Related Links:

— “Medal of Honor recipient urges support for PTSD, “Alexei Koseff, Los Angeles Times, August 26, 2013.

The Wall Street Journal (8/27, A6, Lagnado, Subscription Publication) reports that a two-year effort by nursing homes and Medicare to reduce use of antipsychotic medications has been unsuccessful. Centers for Medicare and Medicaid officials witnessed a 9% decrease in antipsychotic usage from 2011 to 2013, far from the goal of a 15% decrease by the end of 2012. Officials now hope to reach the 15% rate decrease by the end of the year. According to nursing home officials, instead of addressing the issue of hiring more staff, many nursing homes instead resort to antipsychotics to pacify their residents.

Related Links:

— “Nursing Homes’ Drug Use Falls,The Wall Street Journal, August 26, 2013.

Medscape (8/27, Cassels) reports that, according to a study published online Aug. 21 in the BMJ, “antidepressant use by pregnant women around the time of delivery is linked to an increased risk for postpartum hemorrhage.” The study of 106,000 pregnant women of childbearing age diagnosed with either anxiety or a mood disorder revealed “a 1.5-fold increased risk for postpartum hemorrhage associated with all classes of antidepressants and not just selective serotonin reuptake inhibitors.” An accompanying editorial called the increased risk a “cause for concern.”

Related Links:

— “Antidepressants and postpartum haemorrhage,BMJ, August 21, 2013.

The Wall Street Journal (8/26, A4, Winslow, Subscription Publication) reports that, according to a clinical guidance report by the American Academy of Pediatrics (AAP) and published in the September issue of Pediatrics, the majority of vaccines and medications appear to be safe for nursing mothers. Still, breastfeeding women are cautioned against taking certain psychiatric medications, as well as herbal medicines and some painkillers, including oxycodone, hydrocodone and codeine.

MedPage Today (8/26, Phend) reports that the AAP report urges caution “for the small proportion of drugs that are concentrated in human milk, have a long half-life, have known toxicity to mother or child, or expose the infant to relatively high doses or detectable serum concentrations.” Pediatrician Hari Cheryl Sachs, MD, of the Food and Drug Administration, and colleagues suggested that healthcare professionals “look up safety of specific medications on the National Library of Medicine’s peer-reviewed LactMed database online.” “The report also addressed common concerns about antidepressants, anxiolytics, and antipsychotics, many of which show up in low concentrations in breast milk.
Clinically significant levels of drug have been reported in breast milk for bupropion (Wellbutrin), diazepam (Valium), fluoxetine (Prozac), citalopram (Celexa), lithium (Eskalith), lamotrigine (Lamictal), and venlafaxine (Effexor).”

Related Links:

— “Many Drugs Found Safe for Breast-Feeding Mothers, “Ron Winslow, The Wall Street Journal, August 26, 2013.

HealthDay (8/24, Gordon) reported that most children “with autism will grow up to be adults with autism.” According to autism researcher Paul Shattuck, PhD, of the Washington University in St. Louis, an estimated “45,000 to 50,000 kids with autism turn 18 each year.” A number of experts have noted that “a shortage of necessary programs for adults with autism already exists and is likely to worsen” as more youngsters with autism become adults. Higher education and employment for these young adults with autism may be difficult or even impossible, and many young adults with autism are forced to continue living at home with their families.

Related Links:

— “Who Will Care for Children With Autism When They’re Adults?, “Serena Gordon, HealthDay, August 23, 2013.

In a segment on the NBC Nightly News, NBC News correspondent Mark Potter reported, “To prevent more violence in classrooms, teachers, counselors and other workers in the Miami-Dade County [FL] schools are now being trained to spot the warning signs of student mental illness.” Those warning signs “include talk of suicide, high risk or odd behavior, withdrawal, increased anger, bizarre thoughts and persistent sadness.” Potter added, “The program is paid for by the American Psychiatric Foundation and…is currently used in 21 states,” as well as in the District of Columbia.

The Fort Myers (FL) News-Press (8/18, Gluck) reported that electroconvulsive therapy (ECT) for the treatment of severe depression “has seen a resurgence at many US health centers in recent decades, experts say.” The procedure is not without controversy. Some patients who received the procedure in the past, as well as “anti-ECT groups, say it is little more than intentional brain damage.” Other patients cannot praise the treatment enough, and the procedure is endorsed by the US Surgeon General, the American Psychiatric Association and the American Medical Association. Researchers theorize that it works by enhancing certain beneficial brain chemicals or by “reducing ‘hyper-connectivity’ in the minds of severely depressed patients.” Most health insurers and Medicare cover ECT.

Related Links:

— “Despite controversial past, shock treatment sees resurgence, “Frank Gluck, The Fort Myers (FL) News-Press, August 18, 2013.

In a 2,700-word report, the Washington Post (8/18, McCrummen) profiles the workings of the mental health court that operates in Upper Marlboro in Maryland’s Prince George’s County, “one of a growing number of such courts.” The Post says the latest Federal data show more than half the inmates in jails and prisons suffer from signs of mental illness, and the court system is “adjusting to this reality” with about 300 specialized courts that try to match appropriate solutions from “a decentralized and often inadequate mental-health-care system” with people who often have “a tapestry of problems.” Partly because of the potential for violence, Judge Patrice E. Lewis often makes decisions that make “her pray she was right” in the Upper Marlboro court.

Related Links:

— “Pr. George’s mental health court aims to treat, rather than jail, defendants, “Stephanie McCrummen, The Washington Post, August 17, 2013.

On its “Federal Eye” blog, the Washington Post (8/17, Vogel) reported that, according to a study (pdf) conducted by the Naval Health Research Center and published in May in the journal BMC Psychiatry, “women who deploy to combat zones may be more susceptible to psychiatric disorders than men.” Researchers arrived at that conclusion after analyzing data from surveys completed by 1,113 Marines having returned from deployments to Iraq and Afghanistan during the years 2007 and 2008.

PTSD Diagnosis No Barrier To Army Redeployment. The Washington Post (8/18, Sieff) reported that “a diagnosis of post-traumatic stress disorder [PSTD] is not a barrier to being redeployed” by the US Army to Afghanistan. According to the Post, “the Army has knowingly redeployed soldiers with symptoms of PTSD” and “is now regularly embedding psychologists with units in the field.”

Related Links:

— “Do female combat vets face added mental health risks?, “Steve Vogel, The Washington Post, August 16, 2013.

USA Today (8/22, Zoroya) reports that, according to the results of a RAND study released yesterday, “researchers found no scientific proof supporting an Army idea to drop the word ‘disorder’ from the term post-traumatic stress disorder [PTSD] as a means of removing the stigma from the disease.” USA Today points out that “the Army asked the American Psychiatric Association to change the name in its official manual of mental illnesses,” claiming that soldiers would be more willing to seek treatment for PTSD if the word “disorder” were replaced instead by the words “stress” or “injury.” In 2011, the APA declined making that change.

Former Army Sergeant: PTSD Is Not A “Catchall” For All Behavior By Veterans. In an op-ed for the Washington Post (8/22, Van Reet), Brian Van Reet, a former Army sergeant who served in Baghdad from 2004 to 2005, writes that science is suggesting that “the link between war, post-traumatic stress disorder (PTSD) and self-harm is not what many expect.” According to a study in the Journal of the American Medical Association, “exposure to combat does not increase the likelihood that a service member will take his or her own life.” Reet argues that these findings “demonstrate the need for further examination of war’s effects on those who fight it.” Reet adds that PTSD “is a valuable concept but not if it is used as a catchall for the myriad ways that war, peace, genetics and institutions all shape the behavior of veterans.”

Related Links:

— “Dropping the D from PTSD won’t change stigma, study says, “Gregg Zoroya, USA Today, August 22, 2013.