MFPBlog

Researchers say risk of completed suicide among individuals with a previous failed attempt highest in first year of follow-up

MedWire (11/21, Czyzewski) reports, "The risk for completed suicide among individuals with a previous failed attempt is especially high in the year after the initial bid," according to a study published in the BMJ.

]]> Dag Tidemalm, of the Karolinska Institute in Stockholm, and colleagues, "analyzed data on 39,685 individual (53 percent female) who were admitted to hospital for attempted suicide between 1973 and 1982."

The researchers "found that over half of all completed suicides took place within the first year of follow-up," and that "the strongest predictor for completed suicide throughout the entire follow-up was a diagnosis of schizophrenia, with a hazard ratio (HR) of 4.1 in men, and 3.5 in women, compared with individuals with no major psychiatric disorder." Notably, "a diagnosis of bipolar or unipolar depressive disorder carried an HR for completed suicide of 3.5 in men, and 2.5 in women relative to individuals with no major psychiatric disorder."

Related Links:

- "Risk for completed suicide high in year after initial failed attempt," Andrew Czyzewski, MwedWire, November 21, 2008.

Study suggests happier people watch less television

The New York Times (11/20, Rabin) reports, "Happy people spend a lot of time socializing, going to church, and reading newspapers -- but they don't spend a lot of time watching television," according to a study published in the journal Social Indicators Research. John Robinson, Ph.D., a professor of sociology at the University of Maryland, and colleagues, analyzed "the responses of 45,000 Americans collected over 35 years by the University of Chicago's General Social Survey," as well as "published 'time diary' studies recording the daily activities of participants." The researchers focused on "eight to 10 activities that hap py people engage in, and for each one, the people who did the activities more -- visiting others, going to church, all those things -- were" happier. Still, the authors "could not tell whether unhappy people watch more television, or whether being glued to the set is what makes people unhappy."
Columnist criticizes study. In the San Francisco Chronicle (11/19) Notes & Errata column, Mark Morford criticized the study, saying that the authors did not say "what everyone already knows: that there's an entire universe of unhappy things that unhappy people also indulge in besides

]]> John Robinson, Ph.D., a professor of sociology at the University of Maryland, and colleagues, analyzed "the responses of 45,000 Americans collected over 35 years by the University of Chicago's General Social Survey," as well as "published 'time diary' studies recording the daily activities of participants." The researchers focused on "eight to 10 activities that hap py people engage in, and for each one, the people who did the activities more -- visiting others, going to church, all those things -- were" happier. Still, the authors "could not tell whether unhappy people watch more television, or whether being glued to the set is what makes people unhappy."

In the San Francisco Chronicle (11/19) Notes & Errata column, Mark Morford criticized the study, saying that the authors did not say "what everyone already knows: that there's an entire universe of unhappy things that unhappy people also indulge in besides."

Related Links:

- "What Happy People Don’t Do," Roni Caryn rabin, New York Times, November 19, 2008.
- "Misery loves TV," Mark Morford, San Francisco Chronicle, November 19, 2008.

Report finds several states lack adequate care for children with serious mental disorders

USA Today (11/20, Elias) reports, "Publicly funded mental-healthcare for children has improved in the past 25 years, but top officials in more than one out of five states say no child with serious mental disorders receives good care in their states," according to a new report.

]]> Investigators at the National Center for Children in Poverty at Columbia University "surveyed state and county mental-health officials and others involved with children's care." They "collected the information, updating a similar survey 25 years ago."

The data showed that "only seven states reported consistent funding for children of all ages." Notably, "some federal and state policies block Medicaid reimbursement for preventive or early care, such as with troubled preschoolers or those who don't have a major mental illness."

The report also indicted that "many states now help support school-based mental-health programs, which can stop trouble early, and a growing number promote or require treatment that's supported by evidence."

Related Links:

- "States lacking in children's mental health care," Marilyn Elias, USA Today, November 20, 2008.

Study indicates delays in reimbursement may discourage physicians from seeing new Medicaid patients

In the Wall Street Journal (11/18) Health Blog, Vanessa Fuhrmans wrote, "Fewer doctors are accepting Medicaid patients not just because fees are so low, but because it often takes months to get paid."

]]> In fact, "only half of US doctors don't restrict or cap the number of Medicaid patients they see, while more than 70 percent of doctors accept all new Medicare or privately insured patients," according to some studies. One study, by the Center for Studying Health System Change, published online Nov. 18 in Health Affairs, showed that "the problems with Medicaid aren't limited to just the low payments," but they also include "bureaucracies [that] can delay payments for months."

For the study, researchers analyzed "how 4,900 physicians in 21 states responded to not only how much they were paid by their state's Medicaid program, but also by how quickly they were paid," Modern Healthcare (11/18, Robeznieks) added.

Comparing Medicaid participation among the study's participants, the researchers found that 64 percent of physicians "in states with higher and faster reimbursement" were accepting new Medicaid patients. Meanwhile, of those in "states with high fees but slow reimbursement," 50.9 percent "were taking new Medicaid patients." Notably, physicians were reimbursed "the fastest in Kansas, averaging 36.9 days, and slowest in Pennsylvania, averaging 114.6 days."

Related Links:

- "Payment Hassles, Not Just Stinginess, Turn Doctors Off Medicaid," Vanessa Fuhrmans, Wall Street Journal,/i>, November 18, 2008.

Experts discuss raising an autistic child

The Washington Post (11/18) published a transcript of an online discussion regarding children with autism with Jayne Lytel, author of Act Early Against Autism: Give Your Child a Fighting Chance from the Start, and Fred R. Volkmar, M.D., an autism expert and the director of the Child Study Center at the Yale School of Medicine.
]]> When asked whether nutritional supplements may serve as an effective treatment, Dr. Volkmar said that "the actual data relative to vitamins and diet treatment are not as strong as we'd hope -- most of what is out there is anecdotal reports, and the science has not been as supportive."

Lytel noted that, because "difficulties with social communication" are "the hallmark deficit of autism spectrum disorder," top therapies include applied verbal behavior and floortime, speech therapy, occupational therapy, social skills group, and an inclusion school.

Related Links:

- "Raising an Autistic Child," Jayne Lytel and Dr. Fred R. Volkmar, Washington Post, November 18, 2008.

Article discusses symptoms of OCD

On its website, BBC News (11/18, Liddell) reported that people with obsessive-compulsive disorder (OCD) constantly "worry about leaving the gas on, or arrive at work and worry that" they "have not locked the front door."
]]> These compulsions are "motivated by a genuine and deep-rooted fear that the person or their loved ones will be in grave danger if they don't check. It's an emotion that everyone can relate to, the idea of the house burning down is probably enough to get anyone out of bed just to check 'one more time.'" Yet, "checking and rituals can quickly come to dominate a person's life. Hours every day are taken up with compulsions which have a major impact on work and relationships."

BBC News noted that "distinguishing between reactions that are generally considered healthy and those that are signs of a full-blown mental disorder has always been a challenge for psychiatry."

Related Links:

- "How mad are you?," Rob Liddell, BBC News, November 18, 2008.

Psychiatric Comorbidity and self-medication

MedWire (11/18, Davenport) reports, "Although it is common for individuals with mood disorders to self-medicate with alcohol and drugs in order to relieve symptoms, it is associated with significant psychiatric comorbidity," according to a study published in the Journal of Affective Disorders.
]]> James Bolton, of the University of Manitoba in Winnipeg, and colleagues, "examined data from the nationally representative National Epidemiologic Survey on Alcohol and Related Conditions, involving 43,093 community dwelling adults." The data showed that "2,184 individuals had dysthymia, 7,822 had major depressive disorder, 1,546 had bipolar I disorder, 538 bipolar II disorder, and 8,420 any mood disorder."

The researchers found that "overall, 24.1 percent of individuals with any mood disorder self-medicated with alcohol or drugs. Specifically, 22.9 percent of dysthymia patients, 23.2 percent of major depressive disorder patients, 41.0 percent of bipolar I disorder patients, and 34.7 percent of bipolar II disorder patients self medicated with these substances."

Related Links:

- "Significant comorbidity linked to self-medication in mood disorders," Liam Davenport, Medwire, November 18, 2008.

Economic stress can have negative impact on health

NBC Nightly News (11/14, story 7, 2:00, Williams) reported, "Even if your financial situation is stable at home, the bad news, the uncertain atmosphere, can affect all of our health and well-being."
]]> Correspondent Robert Bazell explained, "Hard work is not dangerous stress, experts say. Loss of work, or the fear of it, so pervasive these days, is the big danger." According to Bruce McEwen, M.D., of Rockefeller University, "Stress does cause genuine effects on the human body. I think we're pretty clear about that as far as cardiovascular disease."

Dr. McEwen added, "Depression is widely recognized to be result in part from stressful events." Overeating, "insofar as it's linked to consumption of comfort foods, may actually contribute to the diabetes and obesity epidemic."

Related Links:

- Video: "Stressed Out," Robert Bazell, MSNBC News, November 14, 2008.

Maryland county's healthcare program suspends enrollment sessions amid flood of applicants

The Baltimore Sun (11/13) reported, "After just a few enrollment sessions," Howard County, Maryland's "new health access program for the uninsured attracted so many applicants that sign-up sessions were suspended so staff members could catch up."
]]> Healthy Howard is aimed at offering "access to affordable, comprehensive healthcare to the roughly 20,000 limited-income county residents who are uninsured." In the first year, officials anticipated "to enroll about 2,200 people."

According to county health officer Dr. Peter L. Beilenson, enrollment sessions "were so well attended that the sign-ups were suspended," and "enrollment efforts will be redirected." To date, "fewer than half the applications received have been fully processed." The program will now rely on "community-based enrollment, meaning residents can apply at locations throughout the county."

Next month, advertising for Healthy Howard "will be targeted at small-business owners who can't afford to provide health insurance for their workers," Beilenson added.

Related Links:

- "A health care 'deluge'," Larry carson, Baltimore Sun, November 13, 2008.

Chinese government outlines guidelines defining Internet Addiction Disorder

In the Wall Street Journal (11/10) China Journal blog, Juliet Ye noted that a "panel of Chinese medical experts over the weekend approved the country's first diagnostic definition of 'Internet addiction,' according to the official Xinhua news agency.
]]> Symptoms of Internet Addiction Disorder, or IAD as the new standard calls it, include being irritated and anxious if not able to get online, fear of social contact, and difficulty concentrating and sleeping." Now, China's Ministry of Health "will consider treatment approaches under the standard set by the panel.

Under the method being considered, hospitals will designate special psychiatric units to treat Internet addiction as a clinical disease." One Chinese study estimated that almost 10 percent of the "40 million young web users in China" may "suffer from Internet addiction."

According to PsychCentral (11/10, Grohol), the new guidelines "suggest that Internet users who spend six hours or more per day online could be diagnosed with the disorder." Patients would "also have to exhibit at least one additional symptom, such as difficulty sleeping or concentrating, a yearning to be online, irritation, and mental or physical distress."

Related Links:

- "hina Sets Internet Addiction Standard," Juliet Ye, Wall Street Journal, November 10, 2008.
- "China Declares Internet Addiction Real," John M. Grohol, PsychCentral, November 10, 2008.

Family caregivers seen as large part of nation's health services

In the Personal Health column in the New York Times (11/11, D9), Jane E. Brody writes that with the increase in the "number of people with severe disabilities, debilitating chronic diseases, and terminal illnesses...concern about their care has focused primarily on" medical facilities.
]]> Yet, "relatively little official attention has been paid to" family caregivers, "who provide the overwhelming bulk of services for people...who are unable to care for themselves." Experts claim that "family caregivers provide an estimated $237 billion in unpaid services" each year, supplying nearly "80 percent of the care for ill or disabled relatives."

According to a study of 1,149 caregivers in the Jan. 2007 issue of the Archives of Internal Medicine, family caregivers "often have what amounts to a full-time job and then some, providing more than 40 hours a week of demanding work."

Some studies also indicate that "the stress of caregiving can increase a person's risk of depression and anxiety disorders, slow the rate of wound healing, diminish immune responses, and result in a greater incidence of hospitalizations."

Related Links:

- "When Families Take Care of Their Own," Jane Brody, New York Times, Novmber 10, 2008.

APA, other organizations pledge support to veterans' mental health charity

AFP (11/11) reported that "major US mental-health organizations," including the American Psychiatric Association (APA) and three other groups, "pledged to offer volunteer help on Monday for a non-profit group that provides free counseling to US soldiers suffering from the psychological wounds of war."
]]> The organizations are supporting the Give an Hour charity, a non-profit "which seeks to enlist an army of volunteers to provide free mental-health services to US troops and their families." Give an Hour aims "to expand its current list of around 3,000 volunteers to 40,000."

It is estimated that the "cost of treating soldiers diagno sed with PTSD or depression in the first two years following their return from war" adds "up to $6.2 billion, while the cost of one year of treatment for just 2,700 cases of traumatic brain injury identified to date" is "up to $910 million."

Related Links:

- "Major Mental Health Associations Join to Support Give an Hour," wall Street Journal, November 10, 2008.
- Give an Hour

PTSD services, domestic violence intervention programs should be combined, researchers say

UPI (11/11) reported, "Research in the Veterans Administration shows that male veterans with" post-traumatic stress disorder (PTSD) "are two to three times more likely than veterans without PTSD to engage in intimate partner violence, and more likely to be involved in the legal system."
]]> Because of this, researchers from Washington University are advocating combining "mental health services and treatments for PTSD...with the specialized domestic violence intervention programs offered by community agencies for those veterans engaging in battering behavior against intimate partners and families."

Related Links:

- "PTSD ups veterans' domestic violence risk," United Press International, November 11, 2008.

FDA unveils medication-safety website

AMNews (11/17, Landers) reports that the "Food and Drug Administration (FDA) has a new webpage intended to provide one-stop shopping for postmarket" medication-safety "information.
]]> Many physicians say the agency has, to a large extent, succeeded in its mission." The website "provides links to an array of data," including labeling information; "medications that have risk evaluation and mitigation strategies; postmarket studies; information from MedWatch; and quarterly reports on" medications "being evaluated for safety issues."

The site is a result of the Food and Drug Administration Amendments Act of 2007, a measure "enacted last fall to help correct numerous" medication-safety "problems that have plagued the agency over the past few years."

Related Links:

- "FDA launches drug safety information Web site," Susan J. Landers, American Medical News, November 17, 2008.
- FDA: Postmarket Drug Safety Information for Patients and Providers

Study indicates one-on-one counseling may reduce risk of youth violence

HealthDay (11/6, Preidt) reported, "For children and teens who suffer violence at the hands of peers, immediate one-on-one mentoring on how to safely avoid conflict and diffuse threats reduces their risk of becoming victims again," according to a study published in the Nov. issue of the journal Pediatrics.
]]> Dr. Tina Cheng, of Johns Hopkins Children's Center, and colleagues, recruited "10- to 15-year-olds treated for assault injuries -- including gunshot, knife and fist-fight wounds -- at emergency" departments (ED) "between 2001 and 2004." Fifty percent "of the 113 victims were treated and then referred by an" ED physician "for at least six sessions of one-on-one counseling and three parent-home visits."

The remaining "victims were referred to community resources, and received two follow-up phone calls." The researchers found that "participants who received personalized counseling and formed a mentoring relationship with their counselors reported 25 percent fewer fights, and 42 percent fewer fight injuries six months later, compared to those who received referrals only."

Related Links:

- "Counseling Can Combat Youth Violence," Robert Preidt, Healthday, November 6, 2008.
- "ABSTRACT: Effectiveness of a Mentor-Implemented, Violence Prevention Intervention for Assault-Injured Youths Presenting to the Emergency Department: Results of a Randomized Trial," Tina L. Cheng, MD,et. al., Pediatrics, Vol. 122 No. 5 November 2008, pp. 938-946.