Group items tagged

"As the U.S. population undergoes continuous shifts the population's health profile changes dynamically resulting in more or less expression of certain psychiatric disorders and utilization of health-care resources. In this paper, we analyze national data on the psychiatric morbidity of American patients and their summated cost in different age groups. Methods: The latest data (2009) on the number of hospital discharges and national bill (hospital charges) linked with psychiatric disorders were extracted from the Nationwide Inpatient Sample (NIS). Results: National data shows that mood disorders are the largest diagnostic category in terms of percentage of psychiatri-crelated discharges in the 1 - 17 years age group. The proportion decreases gradually as age progresses while delirium, dementia, amnestic and other cognitive disorders increase exponentially after 65 years of age. Schizophrenia and other psychotic disorders as well as alcohol and substance-related disorders peak in the working age groups (18 - 64 years). From an economic point of view, mood disorders in the 18 - 44 age group has the highest national bill ($5.477 billion) followed by schizophrenic and other psychotic disorders in the same age group ($4.337 billion) and mood disorders in the 45 - 64 age group ($4.310 billion). On the third place come schizophrenic and other psychotic disorders in the 45 - 64 age group ($3.931 billion). Conclusion: This paper illustrates the high cost of psychiatric care in the U.S., especially the large fraction of healthcare money spent on working-age patients suffering from mood disorders. This underlines psychiatric cost-efficiency as a vital topic in the current healthcare debate. "

"Major depressive disorder is a common global disease that causes a significant societal burden. Most interventional studies of depression provide a limited assessment of the interventions on mortality and suicide risks. This study utilizes data from an observational registry of patients with major depressive disorder to determine the impact of intervention (vagus nerve stimulation or standard pharmacological/non-pharmacological therapy) and a latent factor, patient trajectory toward response, on mortality, suicide and suicidal ideation. A total of 636 patients were available for an intent-to-treat analysis of all-cause mortality, suicide and suicidal ideation. Patients treated with vagus nerve stimulation in addition to standard therapies experienced lower, but not statistically significant, all-cause mortality (vagus nerve stimulation 4.93 per 1,000 person-years vs. 10.02 per 1,000 patient years for treatment as usual) and suicide rates (vagus nerve stimulation 0.88 per 1,000 person-years vs. 1.61 per 1,000 patient years for treatment as usual). Treatment with vagus nerve stimulation produced a statistically lower relative risk of suicidal ideation 0.80, 95% confidence interval (0.68,0.95). Further, patients that responded to either treatment saw a 51% reduction in relative risk of suicidal behavior; relative risk and 95% confidence interval of 0.49 (0.41,0.58). In summary, we find that treatment with adjunctive vagus nerve stimulation can potentially lower the risk of all-cause mortality, suicide and suicide attempts."

"includes mental health statistics at the national and State levels from 35 different data sources. The report is organized into three sections: * People: the mental health status of the U.S. population and prevalence of mental illness; * Providers: providers and settings for mental health services, types of mental health services, and rates of utilization; * Payers: expenditures and sources of funding for mental health services"

Among the research in collaborative care, the most comprehensive work has been done by Wayne Katon, MD, and Jürgen Unützer, MD, both of the University of Washington. Under the latter's collaborative care model, participants had fewer suicidal thoughts, higher recovery rates and improved function, and more depression-free days compared to typical primary care treatment. In addition, Unützer's research has shown potential overall health care savings of $3,300 per individual over a four-year period compared to individuals in usual primary care treatment.

" The American Psychiatric Association (APA) instituted a financial conflict of interest disclosure policy for the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The new disclosure policy has not been accompanied by a reduction in the financial conflicts of interest of DSM panel members. Transparency alone cannot mitigate the potential for bias and is an insufficient solution for protecting the integrity of the revision process. Gaps in APA's disclosure policy are identified and recommendations for more stringent safeguards are offered."

From the abstract: "We conducted systematic literature searches in PubMed, PsycINFO, and Embase up to November 2012, and identified additional studies through earlier meta-analyses and the references of included studies. We identified 198 studies, including 15,118 adult patients with depression, and coded moderator variables. Each of the seven psychotherapeutic interventions was superior to a waitlist control condition with moderate to large effects (range d = −0.62 to d = −0.92). Relative effects of different psychotherapeutic interventions on depressive symptoms were absent to small (range d = 0.01 to d = −0.30). Interpersonal therapy was significantly more effective than supportive therapy (d = −0.30, 95% credibility interval [CrI] [−0.54 to −0.05]). Moderator analysis showed that patient characteristics had no influence on treatment effects, but identified aspects of study quality and sample size as effect modifiers. Smaller effects were found in studies of at least moderate (Δd = 0.29 [−0.01 to 0.58]; p = 0.063) and large size (Δd = 0.33 [0.08 to 0.61]; p = 0.012) and those that had adequate outcome assessment (Δd = 0.38 [−0.06 to 0.87]; p = 0.100). Stepwise restriction of analyses by sample size showed robust effects for cognitive-behavioural therapy, interpersonal therapy, and problem-solving therapy (all d>0.46) compared to waitlist. Empirical evidence from large studies was unavailable or limited for other psychotherapeutic interventions."

from the introduction: "his progress report outlines advances made to date to expand the quality and availability of mental health care services for active military service members, veterans, and their families. Highlights of the report include: Increasing the capacity of the Veterans Crisis Line Building partnerships between the VA and community-based mental health providers Increasing the number of VA mental health providers and peer specialists Implementing a national suicide prevention campaign."

Andrew Lipsitt and parents "Marcie and Eric Lipsitt of Franklin -- are featured in an HBO documentary scheduled to air Wednesday (1/6/10) that sheds light on how families cope with a diagnosis of pediatric bipolar disorder"

A husband tells the story of his spouse's sudden onset of severe mental illness, how he supported her through it and about his own coping mechanisms, as well as perspective gained upon reflection

Literature review of twenty years worth of studies revealing some disadvantages for people with behavioral health issues

From the Chronicle of Higher Education

Excellent article - intense academic study in any field can place a strain on students' mental health. Yet the added stress of needing to be "creative on demand" is worth considering.

Thanks for your insightful comment, Sarah. I agree. There seem to be more and more reports of students struggling with mental health issues. I did a double take when I read about the six hour art classes at some IHEs. The therapist's dilemma of treating the patient while not wanting to stifle creativity also seems problematic. Thanks again for posting.

Discusses benefits and drawbacks of online therapy or telepsychiatry using online applications such as Skype. Considerations include disconnect because of lack of eye contact, insurance issues, ability to evaluate pathologies that can be observed in person but not so much online,

Self-compassion is essential from the beginning of the recovery process. Once you admit that you have a problem, you likely start to see all of the problems you caused in a different light. Find out how self-compassion can be the best tool in Rehab for Teens' latest blog.

" Parenting teenagers can often trigger your own memories of growing up and the roller coaster ride of emotions, drama, unpredictability, and the need to fit in. You may be realizing that being a teenager today is more complicated than ever due to the steady stream of social media in all its various forms. Now as the parent of a teen who was adopted, your role has become even more challenging as you need to keep in mind the extra layers of teen emotions and identity issues that come with being adopted. You may be wondering what is considered typical teenage behavior and what requires more immediate attention. This tipsheet focuses on whether your teen may be going through a temporary phase, or instead, may be suffering from teen depression. "

Abstract"Objective To evaluate whether a new computerised cognitive behavioural therapy intervention (SPARX, Smart, Positive, Active, Realistic, X-factor thoughts) could reduce depressive symptoms in help seeking adolescents as much or more than treatment as usual.Design Multicentre randomised controlled non-inferiority trial.Setting 24 primary healthcare sites in New Zealand (youth clinics, general practices, and school based counselling services).Participants 187 adolescents aged 12-19, seeking help for depressive symptoms, with no major risk of self harm and deemed in need of treatment by their primary healthcare clinicians: 94 were allocated to SPARX and 93 to treatment as usual.Interventions Computerised cognitive behavioural therapy (SPARX) comprising seven modules delivered over a period of between four and seven weeks, versus treatment as usual comprising primarily face to face counselling delivered by trained counsellors and clinical psychologists.Outcomes The primary outcome was the change in score on the children's depression rating scale-revised."

"Combined data for the years 2008 to 2010 show that 8.4 percent of full-time college students aged 18 to 22 and 8.2 percent of other young adults (part-time college students and those not currently enrolled in college) aged 18 to 22 experienced a major depressive episode (MDE) in the past year "

This weekly newspaper brings updates on what's happening in psychology, in particular sharing resources designed to increase our knowledge of the field.Read and subscribe free of charge at: http://paper.li/NattyStewart24/1327249950

"unless states carefully regulate the plans that compete in the exchanges and the benefits that they offer, people with mental illness, who typically have higher health care costs, are at risk of receiving poorer quality care."

University of Pennsylvania research findings published in JAMA: "Antidepressants were more effective than a placebo only for patients with very severe depression, who made up 40% of trial participants but, according to a recent survey cited in DeRubeis' paper, represent fewer than 30% of depressed people who seek treatment in the real world."

Report of a study involving four therapists, eight sessions of CBT, thirty clients, evaluating therapists' resistance to clients.