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"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."

Dealing with hopelessness can be really tough. Connect to the inner guidance through the Trivedi Effect and welcome a new life.

From the abstract: "the current study provides a n analysis of homeless and runaway youths' attitudes towards mental health servic es in order to identify possible factors t hat can assist service providers with understanding and increasing service engagement . V ariables examined included help seeking propensity, psychological openness , concern for mental health stigma, parental maltreat ment, street victimization and services n eeds assessment. The current study also examines the relationship between social support and attitudes toward mental health services. A comparison sample of housed youth was obtained in order to de termine if mental health attitudes are unique to homeless y outh. Fifty - six youth who identified as homeless were recruited through youth drop - in centers and a shelter in Northern California , and 97 housed youth were recruited from alternative community continuation schools in the same region . A nalys is of v ariance iii showed that homeless and housed groups did not differ significant ly on attitudes toward mental health services, help seeking propensity, psychological openness, and concern for mental health stigma . Additional f indings revealed that , for homeless youth, t he more perceived friend support , the more their concern for mental health stigma decreased and the more supportive individuals available , the more positive attitudes toward mental health services and help seeking propensity increased . Comparison of correl ations between homeless and housed groups revealed only one significant difference; the association between perceived family support and help seeking propensity was strongest for the housed group than for the homeless group . Results demonstrate d that home less youth and housed youth share similar attitudes toward mental health services , help seeking propensity, psychological openness, and c o ncern for mental health stigma. Mean scores obtained on these measures were comparable to the only existing study on

"The Child Mind Institute, dedicated to transforming mental health care for children everywhere, is waging war against the stigma, lack of awareness, and misinformation that cause so many children to miss out on treatments that can change their lives with its second annual national public education program, Speak Up for Kids. It will be held during National Children's Mental Health Awareness Week, May 6-12, 2012."

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

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."

Treatment is challenging both because interventions with clear empirical support have not been identified and because individuals affected by AN are typically reluctant to undergo weight restoration. Preliminary studies suggest that family-based treatment may be useful for younger patients with AN. Treatment development for adults with AN and pursuit of neurobiological correlates of AN remain high-priority research areas. (requires subscription or payment)

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"

The program significantly reduced overall readmission rates at participating hospitals. Patients involved in specific quality improvement initiatives that came out of the program also experienced significantly fewer readmissions, along with associated declines in inpatient days and costs.

In a year-long pilot test with 65 residents, the program reduced hospital admissions and readmissions, had no bounce backs to nursing homes, decreased falls, improved nutritional status, and increased levels of physical activity.

By establishing programs to help people recover emotionally after unexpected negative events, hospitals can achieve gains in patient satisfaction and in staff retention.

"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. "

The policies include mandatory screening for both disorders using validated tools, a learning collaborative and evaluations to promote quality improvement, and financial incentives to clinics achieving various service benchmarks. The department also offers training to help providers with various issues related to these policies.

"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."

Texas Youth Commission is discharging fewer teens for failure to make progress with mental health issues

a personal recollection of a sister struggling with bipolar affective disorder

Analysis of 2011 Behavioral Risk Factor Surveillance Survey (BRFSS) data

"Depression as a disorder is better explained as a spectrum rather than as a collection of discrete categories. Minor and subthreshold depression are common conditions and patients falling below the diagnostic threshold experience significant difficulties in functioning and a negative impact on their quality of life. Current diagnostic systems need to reexamine the thresholds for depressive disorders and distinguish them from ordinary feelings of sadness. "

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."