July 25, 20077:46 am
posted by Aric Thorpe, MHR

Eating disorders: Reevaluating the disease

The onset of eating disorders “usually” comes in the late teens or early twenties; however, this does not mean that eating disorders automatically dissipate thereafter. According to patient stats from eating disorder clinics across the US, older women are increasingly seeking help with eating disorders as well. According to Park Nicollet Health Services, an eating disorder clinic in the suburbs of St. Louis, during the first six months of this year they saw nearly 500 patients 38 and older; in 2003, the same clinic saw 43 patients over the age of 38 for eating disorders. There are many speculations about why the typical age for treatment of eating disorder patients is rising. Baby boomers are getting older, an image conscious crowd bombarded by “perfect” body images in the media. Another possible reason is an increased awareness about eating disorders. One thing is certain; just because eating disorders develop in late teens and early twenties does not mean that they are no longer an issue after the age of thirty. For many women, struggling with an eating disorder is a life-time event. For others, eating disorders resurface due to mid-life crisis, marital issues, family death, etc. The good news is that there are a growing number of eating disorder clinics which are gearing their services toward accommodating more mature patients with eating disorders. The following is an excerpt from an CNN article that discusses this phenomenon:

MINNEAPOLIS, Minnesota (AP) — Kelli Smith was nervous as she walked into the treatment center, seeking help at last for her anorexia. Looking around at the other patients, she was struck by how young they seemed. “I just kind of looked around and I thought, ‘Oh, where is someone my age?”‘ recalls Smith. At age 31, she found herself face-to-face with teenagers and 20-somethings.

Eating disorders such as anorexia and bulimia have long been considered diseases of the young, but experts say in recent years more women have been seeking help in their 30s, 40s, 50s, and older. Some treatment centers are creating special programs for these more mature patients.

Most of the women in this age group who seek treatment have had the problem for years, said Dr. Donald McAlpine, director of an eating disorders clinic at Mayo Clinic in Rochester, Minnesota. “The epidemiology is pretty clear that anorexia and bulimia both peak in the late teens, early 20s,” yet “a lot of (patients) continue to be symptomatic right on through to middle life.”

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July 13, 200711:46 am
posted by Aric Thorpe, MHR

No link between antidepressants and suicide

According to a recent study published in the July issue of the American Journal of Psychiatry, suicide pattens of depressed people have nothing to do with antidepressant use. According to Gregory E. Simon, MD, and James Savarino, PhD, of the Group Health Cooperative, rates of suicide among depressed people were the same whether or not the patient was on antidepressants or engaged in psychotherapy or both. The study examined 130,000 cases of newly diagnosed patients with depression. The study, contrary to arguments that sight antidepressants as cause for suicide, found that rates of suicide were highest a month before treatment and second highest during the first month of treatment. Rates of suicide were actually lowest during the period after which therapy and or antidepressants had been utilized for over a month.

Studies like this are important in that they help to dispel myths about the effects of antidepressant drugs. Unfortunately, without an understanding of the effects of antidepressants and therapy, distortions of the truth can arise which can ultimately cause people struggling with depression not to get the help that they so desperately need. Below is an excerpt of an article from the Psychiatric Times that reviews the study:

Increases in suicide rates in the first month of treatment for depression appear to be unrelated to the use of antidepressants, reported investigators here.

The patterns of suicide attempts among patients treated for depression were similar whether they received antidepressants, psychotherapy, or both, reported Gregory E. Simon, M.D., M.P.H., and James Savarino, Ph.D., of the Group Health Cooperative, a Washington state health plan.

Data on more than 130,000 new episodes of depression showed that regardless of treatment type, the number of suicide attempts was highest in the month before therapy, next highest in the first of month of therapy, and lowest thereafter, the investigators reported in the July issue of the American Journal of Psychiatry.

“Our study indicates that there’s nothing specific to antidepressant medications that would either make large populations of people with depression start trying to kill themselves-or protect them from suicidal thoughts,” said Dr. Simon.

“Instead,” he said, “we think that, on average, starting any type of treatment-medication, psychotherapy, or both-helps most people of any age have fewer symptoms of depression, including thinking about suicide and attempting it.”

The investigators reviewed outpatient insurance claims, and identified 131,788 new episodes of treatment for depression — 70,368 beginning with a prescription for an antidepressant from a primary care physician, 7,297 with a prescription from a psychiatrist, and 54,123 with psychotherapy as the initial form of treatment.

The authors then looked at outpatient and inpatient claims to identify suicide attempts or possible attempts in a period ranging from 90 days before the start of treatment for depression to 180 days afterward.

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July 3, 200710:13 am
posted by Aric Thorpe, MHR

Alarmingly low numbers of people with alcohol dependency seek treatment

According to the 2001-2002 Epidemiologic Survey on Alcohol and Related Conditions published in this months issue of the Archives of General Psychiatry, alcohol disorders affect 3 out of 10 adults during their lifespan; specifically 17.8% of adults will abuse alcohol during their lifetime and 12.5% will become alcohol dependent. Alarmingly, however, only 24.1% of those that do become dependent will receive treatment. According to Deborah S. Hasin, PhD, of Columbia and the New York State Psychiatric Institute, surveys measuring the treatment rate for alcohol dependency ten years ago were only slightly lower, “a disappointing lack of progress.”

For those that have developed a physiological dependency on alcohol, talking about change is rarely enough; in most cases medically supervised detox is necessary. I personally feel that many more men and woman would be willing to seek treatment for alcohol dependency if they were encouraged to do so. Pastors, benevolence ministers and ministries, and Chaplains are in a unique position to gently guide people will alcohol dependency toward treatment.

Below is an excerpt of an article from Time that discusses the survey:

More than 30 percent of American adults have abused alcohol or suffered from alcoholism at some point in their lives, and few have received treatment, according to a new government study. Alcoholics who got treatment first received it, on average, at about age 30 — eight years after they developed dependence on drinking, researchers reported.

“That’s a big lag,” especially combined with the fact that only 24 percent of alcoholics reported receiving any treatment at all, said study co-author Bridget Grant of the National Institute on Alcohol Abuse and Alcoholism.

The treatment rate for alcoholics was slightly less than the rate found a decade earlier. The study did not look at reasons for the decline, but other research has revealed a belief among doctors and the public that treatment doesn’t work.

Click here to read the entire article from Time

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