Friday, January 21, 2005

Bipolar Patients Say Depression More Disabling Than Mania  Psychiatric News story - " When treating bipolar patients, clinicians may focus more on manic than depressive symptoms, but a new study suggests that it is time for that focus to shift. In bipolar patients both manic and depressive episodes take their toll, of course, but a large new population-based study finds that the depressive phases are far more disabling on several key dimensions than are the manic phases. Among bipolar illness patients, depressive symptoms caused more serious disruptions in occupational, family, and social functioning—findings, researchers emphasized, that point to a need for strategies that will lead to enhanced recognition and treatment of bipolar disorder."  
  

Mental Health Screening Will Save LivesPage at the NAMI web site - "Our nation simply cannot afford to continue to fail our youth with mental disorders who need treatment. The tragic consequences of our failure to identify youth through early assessment and to intervene with appropriate mental health treatment and services are well documented..." See also NAMI's recently adopted position paper on mental health screening.  
  

Medicaid Managed Care: Access and Quality Requirements Specific to Low-Income and Other Special Needs EnrolleesGeneral Accounting Office report (in Adobe Acrobat format) - "The use of managed care within Medicaid, a joint federal-state program that finances health insurance for certain low-income families with children and individuals who are aged or disabled, increased significantly during the 1990s. By 2003, 59 percent of Medicaid beneficiaries were enrolled in managed care, compared with less than 10 percent in 1991.1 Medicaid managed care, under which states make prospective payments to managed care plans to provide or arrange for all services for enrollees,2 attempts to ensure the provision of appropriate health care services in a cost-efficient manner. However, because plans are paid a fixed amount regardless of the number of services they provide, managed care programs require safeguards against the incentive for some plans to underserve enrollees, such as by limiting enrollees’ access to care. Access is also affected by other factors, such as physician location and willingness to participate in managed care plans..."  
  

FDA Safety Labeling Changes: Altace, Wellbutrin XL, Levaquin, Pepcid Medscape Medical News story - "The U.S. Food and Drug Administration (FDA) approved last October revisions to safety labeling to advise healthcare professionals of the following changes: ramipril may be linked to risk of intestinal angioedema; the extended-release formulation of bupropion HCl may be linked to a dose-related risk of seizures; levofloxacin has been associated with a risk of arthropathy in animal studies; and over-the-counter products containing famotidine should not be used if signs of a more serious condition exist." [Viewing Medscape resources requires registration, which is free].  
  

An Empowerment Model of Recovery From Severe Mental Illness An "Expert Interview" in Medscape Psychiatry & Mental Health with Daniel B. Fisher, Executive Director of the National Empowerment Center - "Our description of mental illness is a combination of severe emotional distress and an interruption of a person's place in the community and social role -- being a worker, parent, student, a participant in overall community life -- which is not dissimilar from what is considered a mental disorder in DSM-IV. The most important finding in our research is that people who have shown significant or complete recovery from severe mental illness -- by that I mean schizophrenia, bipolar disorder, or schizoaffective disorder -- have cited hope as an extraordinarily important component in their recovery. Part of the recovery was being around people who saw their condition as not permanent, a condition from which they could take increasing control of their life and reestablish a place in society." [Viewing Medscape resources requires registration, which is free].  
  

Study: Kids' mental health care mixed (California)  Sacramento Bee story - "A first-ever look at the quality of publicly funded mental health care for tens of thousands of California's neediest children has exposed serious gaps. The study, commissioned by the state and conducted by researchers at four University of California campuses, found, for example, that less than a third of children who were prescribed a psychiatric drug were being monitored for changes in weight, pulse, blood pressure and liver function. The research paper, appearing in the February issue of the Journal of the American Academy of Child and Adolescent Psychiatry, also documented some good news. The vast majority of mental health providers, for example, followed guidelines to evaluate patients and assess suicide risk."