Tuesday, September 30, 2003

Long-term Management of Bipolar Disorder
A new CME from Medscape. From the introduction - " Bipolar disorder is a chronic, recurrent illness associated with tremendous societal costs -- increased healthcare costs, loss of productivity, lower quality of life, and suicide.The illness is also characterized by increased risk of recurrence with age. However, maintenance treatment, in general, has been short-term and episode-focused. Maintenance treatment, in bipolar disorder, is achieved by using medications that, alone or in combinations, prevent the occurrence of new episodes, optimize socio-occupational functioning by keeping the severity of interepisode symptoms to a minimal level, and are tolerable to facilitate long-term compliance with the medication regimen. Remission and "functional recovery," the primary goals of treatment, are possible despite the complex nature of bipolar disorder..." [Viewing Medscape resources requires registration, which is free].  
  

Stanford Research Finds Gene Variations That Alter Antidepressant Side Effects
Stanford University Medical Center press release at PsycPORT - "Researchers at Stanford University Medical Center have identified a genetic marker that can explain why some people experience side effects to common antidepressants while others do not. They also found that a key liver enzyme involved in breaking down these antidepressants surprisingly played no role in the development of side effects nor in how well the drugs worked. The findings may lead to fewer side effects for patients undergoing antidepressant drug therapy." See also the abstract of "Pharmacogenetics of Antidepressant Medication Intolerance" at the American Journal of Psychiatry (full text is available for a fee),  
  

Numbers of Americans With and Without Health Insurance Rise, Census Bureau Reports
Census Bureau press release - "The number of people with health insurance rose by 1.5 million between 2001 and 2002, to 242.4 million, and the number of uninsured rose by 2.4 million, to 43.6 million, the U.S. Census Bureau reported today. An estimated 15.2 percent of the population had no health insurance coverage during all of 2002, up from 14.6 percent in 2001..." The full report, Health Insurance Coverage in the United States: 2002, is available in Adobe Acrobat format. See also the overview of the report and reaction to it at the Kaiser Daily Health Policy Report. Related news stories include Census Finds Many More Lack Health Insurance (Washington Post), Big Increase Seen in People Lacking Health Insurance (New York Times, registration required),  and Number of nation's uninsured up sharply (Philadelphia Inquirer).  
  

Journals toughen disclosure rules
Baltimore Sun story - "...As commercial backing for researchers grows, Nature and other top scientific and medical journals are redoubling efforts to safeguard the credibility that makes them some of the most influential magazines in the world. Nature has broadened disclosure rules for authors beyond original research papers to include reviews... of earlier discoveries. Science is contemplating refinements of its rules, while it becomes more assertive about pursuing conflict disclosures from authors. The Journal of the American Medical Association continues to take great care with commercially sponsored research. JAMA, for example, is asking authors of one potentially important paper to have their data reviewed and verified by at least one expert with no connection to the company that funded the research..."  
  

Race and the Blues
Psychology Today article by Hara Estroff Marano - "Depression is often ignored in the African-American community. Depression is as prevalent a problem as it is for the population as a whole, affecting 6% in any year. Within the black community there are groups whose experience or environment makes them especially vulnerable to depression and other mental health disorders. Yet depression carries such a stigma in the black community that the word is not easily uttered. Nor is the condition readily talked about. One major consequence is that depression is often misunderstood by those who have it, undetected and untreated, perpetuating unnecessary suffering at a time when helpful treatments are available and capable of preventing the long-term damage now thought to result from recurring bouts of depression."