Wednesday, May 18, 2005

Investigating the appropriateness of current alcohol-use disorder criteria for adolescents University of Pittsburgh School of Medicine press release - "North American clinicians generally use alcohol-use disorder (AUD) criteria as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Concerns exist, however, about the appropriateness of these criteria for adolescents. For the first time, a study in the May issue of Alcoholism: Clinical & Experimental Research uses a single representative sample of the U.S. population to examine the effects of age, gender, race/ethnicity, and drinking status on the prevalence of DSM-IV diagnostic criteria among both adolescents and adults."  
  

Introduction to New Research: Understanding the Issues in Child and Adolescent Bipolar Disorder  A new CME unit at Medscape - "Debate still exists in the psychiatric field over whether pediatric bipolar disorder is a valid diagnosis. Many clinical features of this disorder distinguish it from the well-established criteria that define adult-onset bipolar disorder. Perhaps the most salient of these is the high prevalence of irritability as the major presenting symptom as opposed to the euphoria more often seen with the adult disorder. In addition to irritability, pediatric bipolar disorder tends to present with a mixed or continuous presentation of mania in contrast to the discrete manic episodes classically described for bipolar disorder. Research in adults has revealed that bipolar disorder causes high morbidity, with patients symptomatically ill for 47% of the weeks in their life following diagnosis. Depressive symptoms and subsyndromal depression predominate a patient's life with this disorder..." [Viewing Medscape resources requires registration, which is free].  
  

Addressing the Root Causes of the So-Called Access Problem Drug Benefit Trends article at Medscape - "A national telephone survey of 7197 primary care physicians (PCPs) found that access to high-quality specialty services for their patients was available 81% of the time for specialty medical services, compared with 28% of the time for outpatient specialty mental health services. With some 35,000 psychiatrist members of the American Psychiatric Association, 150,000 members of the American Psychological Association, 153,000 members of the National Association of Social Workers, and a rapidly increasing number of nurse practitioners and psychiatric clinical nurse specialists, why is there a problem? (These quoted numbers are only an approximation of clinical resource availability. Professional membership does not equate with actual availability, because not all professionals work full-time to deliver care in mental health settings or choose to belong to their professional associations.)That we have a sluggish and unresponsive specialty behavioral health system does not make sense, especially with primary care providers doing most of the prescribing for the majority of patients with anxiety and/or depression..." [Viewing Medscape resources requires registration, which is free].  
  

NAMI Connection The first issue of a new e-newsletter from NAMI - "The NAMI Connection will bring periodic, lively news and stories of interest to NAMI supporters, supplementing The Advocate, NAMI's magazine for dues-paying members that arrives four times a year by regular mail. It will provide a broader view of NAMI than our more specialized electronic newsletters..."  
  

Helping the Hospital (Vermont) WCAX-TV story - "Workers at the Vermont State Hospital in Waterbury could be getting a pay hike, if they stay on board. The Governor and mental health advocates are working on a plan that would boost the salaries of hospital workers. It's part of an effort to retain employees while the state moves to close the mental health facility. Workers have been leaving their jobs because the hospital has a series of troubles. This plan hopes to address short term issues. The century old facility is aging and is scheduled to close in the coming years. Just about all the players agree a new facility is needed to treat the mentally ill, but some are worried patients will suffer in the short term."  
  

Gaps in Mental Health Care System Remain Following Central State Closure (Indiana) WISH-TV story - "It's been a little over ten years since then-Governor Evan Bayh announced he was closing Central State Hospital. The reasoning behind the closure was – and remains today – that many patients no longer need a hospital setting. Did that decision create a critical gap in the mental health system? ... Dr. Eric Wright and Dr. John McGrew have been following the last 389 patients discharged from Central State in 1994. They found of that group of patients, many have integrated into the community and report being satisfied with their living conditions. There is an interesting twist to the study. Every month someone was checking with a professional on the whereabouts and well being of each of those particular clients. That kept everyone, the patients and the professionals, on their toes..."  
  

Mental Health chief ends stormy 4-year term (South Carolina) Story at The State - "The man at the eye of South Carolina’s swirling mental health care crisis for the past four years resigned Tuesday. George Gintoli, director of the state Department of Mental Health, leaves behind shriveled state budgets that led to layoffs, sparked a surge of mental patients into area emergency rooms and prompted legal action over the state’s handling of the mentally ill..."