Monday, August 02, 2004

Lauded healthcare plan for kids takes a hit
Christian Science Monitor story - "After years of little impact, budget woes are now taking a toll on kids' healthcare. The State Children's Health Insurance Program, known as SCHIP, which provides coverage for children of working parents with lower incomes, has seen the first decrease in enrollment since it was enacted in 1997. Popular with both parties, SCHIP was one of the few state priorities to emerge unscathed in the face of multimillion-dollar, in some cases billion-dollar, deficits in state budgets, at least until now. A new study by the Kaiser Family Foundation found that the number of children enrolled in SCHIP dropped for the first time during the second half of 2003. Texas, New York, and Maryland were responsible for 99 percent of the decrease..." See also the item posted here July 27 about the Kaiser Commission reports.  
  

Depressed Patients Demonstrate Emotional Blunting on Functional MRI
Medscape Medical News story - "Functional magnetic resonance imaging (fMRI) of a series of patients with unipolar depression indicate that compared with nondepressed control subjects, depressed patients demonstrate no neuronal response to emotional stimuli, which suggests that a treatment strategy that focuses on the processing of emotions may be clinically useful, according to data presented here at the American Psychological Association annual meeting..." [Viewing Medscape resources requires registration, which is free].  
  

Metabolic Disorders in Schizophrenia: Relationship to Atypical Antipsychotic Treatment
Medscape Psychiatry & Mental Health article - "Even prior to the introduction of neuroleptic medications in the 1950s, there was evidence that individuals with schizophrenia suffered from a variety of medical and metabolic disorders at rates higher than the general population. Investigators in the early 1900s observed that patients with dementia praecox had increased rates of abnormal glucose tolerance tests, and more recent studies have found an increased rate of type 2 diabetes in schizophrenic patients compared with the general population. Studies have shown that first-episode, never-medicated schizophrenia patients have increased visceral adiposity, impaired fasting glucose tolerance, and are more insulin resistant than healthy comparison controls. Other factors such as increased smoking, sedentary lifestyle, and lack of self care increase the risk even further. Therefore, due to a confluence of health and lifestyle factors, individuals with schizophrenia are at high risk for a variety of untoward health consequences..." [Viewing Medscape resources requires registration, which is free].  
  

Promotional Talks for the Pharmaceutical Industry
Medscape Psychopharmacology Today article - " Medical education in the United States has begun to embrace a new paradigm -- core competencies. The idea behind this paradigm is that it is no longer sufficient to provide education to students and physicians, but that the education system must also somehow ascertain individual competency. As a point of departure for the adoption of the competency model, the Accreditation Council for Graduate Medical Education (the institution responsible for residency training) and the American Board of Medical Specialties (the institution responsible for Board certification) have agreed on 6 general categories of competency. A discussion of all 6 of these is beyond the scope of this column, so I will focus on one of them: 'practice-based learning.' Practice-based learning is defined as the ability of physicians to remain knowledgeable and current in their field throughout their career..." [Viewing Medscape resources requires registration, which is free].  
  

Landmark Survey Reports on the Prevalence of Personality Disorders in the United States
Press release at the National Institutes of Health web site - " An estimated 30.8 million American adults (14.8 percent) meet standard diagnostic criteria for at least one personality disorder as defined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV), according to the results of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) reported in the current issue of the Journal of Clinical Psychiatry [Volume 65:948-958]. Conducted by the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, the NESARC is a representative survey of the U.S. civilian noninstitutionalized population aged 18 years and older. More than 43,000 American adults participated in the survey. Designed to assess prevalence and comorbidity, or co-occurrence, of multiple mental health disorders, the NESARC is the first national survey conducted in the United States to estimate the prevalence of selected personality disorders — stable patterns of inner experience and behavior that are inflexible and maladaptive that begin in early adulthood and are displayed in a variety of contexts — that often co-occur with other mental health disorders such as substance use disorders and anxiety and mood disorders."  
  

Study reports prevalence and co-occurrence of alcohol, drug, mood and anxiety disorders
National Institute on Alcohol Abuse and Alcoholism press release at EurekAlert - "An estimated 17.6 million American adults (8.5 percent) meet standard diagnostic criteria for an alcohol use disorder and approximately 4.2 million (2 percent) meet criteria for a drug use disorder. Overall, about one-tenth (9.4 percent) of American adults, or 19.4 million persons, meet clinical criteria for a substance use disorder--either an alcohol or drug use disorder or both--according to results from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) reported in the current Archives of General Psychiatry [Volume 61, August 2004: 807-816]. Conducted by the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, the NESARC is a representative survey of the U.S. civilian noninstitutionalized population aged 18 years and older. With more than 43,000 adult Americans participating, the NESARC is the largest study ever conducted of the co-occurrence of psychiatric disorders among U.S. adults." See also the related resources available at the NIAAA web site.  
  

Proportion of Tennessee children using antipsychotic medications up significantly
Press release from the JAMA and Archives web site, reprinted at EurekAlert - "The proportion of children and adolescents in Tennessee taking antipsychotic medications nearly doubled between 1996 and 2001, with the largest increase in the use of antipsychotics to treat attention-deficit/hyperactivity disorder, conduct disorder, and affective disorders, according to an article in the August issue of The Archives of Pediatrics & Adolescent Medicine, a theme issue on pediatric mental health and one of the JAMA/Archives journals. According to the article, the use of antipsychotic medications in children and adolescents for illnesses other than Tourette syndrome or psychosis is controversial, although some studies indicate that antipsychotics may help treat symptoms associated with behavior disorders including attention deficit/hyperactivity disorder (ADHD), and conduct disorders..." See also the online table of contents for the August issue of The Archives of Pediatrics & Adolescent Medicine - linked abstracts are available at no cost, while full text of the articles requires payment. A number of other articles in that issue are covered in EurekAlert press releases as well - see Adolescents hospitalized for psychiatric disorders experience more emotional distress in adulthood, Family meals appear to be associated with adolescent's well-being and Involvement in bullying linked with poor psychosocial adjustment.  
  

Substance Abuse, Mental Woes Strike 1 in 10
Health News story - "A new study finds that substance abuse and depression aren't as intertwined as conventional wisdom would have it, but are stand-alone illnesses that each affect roughly one in 10 Americans. Although a substantial minority of people with one of these disorders have another, most people suffer from just one, says a report in the August issue of the Archives of General Psychiatry. But in those commingling cases, doctors shouldn't assume they can kill two birds with one stone and should instead treat the problems separately, the researchers said.."  
  

Mental health millions bypass Bucks (Pennsylvania)
Story in The Intelligencer - "People with mental illness in Bucks County have been shortchanged millions of dollars that could have been spent on innovative treatment plans, according to advocates. Bucks gets the least amount per person in state funding for mental health programs of the five suburban Philadelphia counties, according to budget figures from the state. It is in the bottom quarter of funding when compared to all other counties. Even when other funding programs are added to the mix, Bucks remains second to last in terms of total mental health spending per capita...."  
  

Schools developing mental health plans (Illinois)
Story in the Pantagraph - "School districts across Illinois are working on new policies to address the emotional well-being of children, an area of treatment long neglected, say children's mental health advocates. ... The groundwork for the new approach was laid two years ago with the formation of the state Task Force on Children's Mental Health. The group's report, Children's Mental Health: An Urgent Priority for Illinois, was the basis for a new law signed by Gov. Rod Blagojevich last year..." For related stories and a link to the task force's report, see the related posting here from July 22.