June 30, 20087:42 am
posted by Aric Thorpe, MHR

Substance Abuse Treatment in Pregnancy Reduces Complications

A recent study has revealed that mother’s who were treated successfully for substance abuse problems during routine obstetric visits almost entirely removed related risks posed to their child. According to the study the risks for preterm labor, stillbirth, and placental abruption were the same for both women who were successfully treated for substance abuse and for those that did not have substance abuse problems. Their children were still at risk for low birth weight; however, all other risks were drastically reduced after receiving treatment. Screening for substance abuse problems at routine obstetric appointments should be the gold standard, researchers explained. The following is an excerpt of an article from Medpage Today that reviews the findings:

These findings from a large observational study of women insured through Kaiser Permanente Northern California suggest that integration of substance abuse treatment into obstetric care should be the gold standard, the researchers said.

Before Kaiser Permanente started this program, women with substance abuse problems were counseled to stop and referred to outside programs but generally didn’t keep those appointments, the researchers noted.

Having someone in the clinic who specializes in both pregnancy and substance abuse treatment “affords women easy access to the program by removing both the physical and emotional barriers that can be overwhelming during pregnancy,” they wrote.

The American College of Obstetricians and Gynecologists recommends universal screening for substance abuse in pregnancy with a brief intervention and referral to treatment within the department for those who test positive.

At the 21 Kaiser Permanente obstetric clinics included in the study, all women were screened for drugs and alcohol with a questionnaire at the first prenatal visit along with urine toxicology testing for those who consented.

Click here to read the rest of this article from Medpage Today

Click here for information on the treatment of chemical dependency

Link to this post

June 27, 20087:38 am
posted by Aric Thorpe, MHR

The Pipeline: One Soldier’s Trip Through the Military’s Medical Megaride

This past Thursday area ministers, chaplains and other church professionals gathered to hear area author and former Brookhaven case manager Michael Mason present about systems of care for those who suffer traumatic brain injury through engagement in the Iraq war. The presentation, which Michael entitled “The Pipeline: One Soldier’s Trip Through the Military’s Medical Megaride,” gave participates a heart wrenching look into the lives of individuals injured in the Iraq war, which was intended to bring attention to issues surrounding the quality of systems of care for brain injured individuals both stateside and in Iraq’s national health care system. The seminar proved to be a success as Michael received numerous requests to bring his talk to venues at area churches.

Click here to view our sister site’s podcast archive wherein I interview Mike about his new book “Headcases: Stories of Brain Injury and Its Aftermath”

Link to this post

June 25, 200811:40 am
posted by Aric Thorpe, MHR

Discrimination: Mental health and chemical dependency overlooked in health care reforms

New data suggests that approximately one in four adult Americans that do not have health insurance have a mental illness, chemical dependency problem, or both. Although there are a variety of state funded health care initiatives that intend to aid individuals without private insurance many states are neglecting to cover mental health and chemical dependency problems. “Many states are trying to cover the uninsured but need to do more in these critical areas that affect one in four Americans,” said National Alliance on Mental Illness executive director Michael J. Fitzpatrick.

Mental illness and chemical dependency should not take the back seat to other health conditions; the fact is that mental illness is the leading cause of disability among adults and substance use the second. Commenting about the situation, Linda Rosenberg, President and CEO of the National Council for Community Behavioral Healthcare, said, “It is distressing that there are insurance plans and health care reform initiatives that continue to discriminate.” The following are some major findings of the report from http://healthcareforuninsured.org:

1. People with mental illness, substance use disorders, or both are prevalent among the uninsured. More than one in four adult Americans who lack insurance coverage have a mental illness, substance use disorder, or co-occurring disorder.
2. The scope of the benefit package for mental illness and substance use treatment varies greatly. Some state programs provide a variety of services designed to promote recovery from these disorders. Two state programs provide no coverage for either mental illness or substance use disorders.
3. Approximately 60 percent of the states evaluated had at least equal coverage for serious mental illness or mental illness compared with other health conditions in at least one of their programs for the uninsured.
4. Substance use disorders fare worse than mental illness in many state programs. Roughly 28 percent of the states evaluated have an equal benefit for substance use and other health conditions in at least one of their programs.

Click here to read the rest of the report’s major findings from http://healthcareforuninsured.org/

Link to this post

June 24, 20088:17 pm
posted by Aric Thorpe, MHR

Schizophrenia: Findings from recent studies

In some ways diagnosis and treatment of schizophrenia has traditionally been approached categorically and without much creativity. However, findings from recent studies have created new resolve in psychiatric researchers to look for answers about schizophrenia that are “out side of the box.” Several recent studies have indicated that schizophrenia is not just a singular problem with a standardized solution but rather a disease that encompasses a variety of mental health disorders that should be treated individualistically. One such study indicated that genetic mutations, which some have assumed would have been similar in nature among those with schizophrenia, are in fact unique, varying greatly from patient to patient. Findings from studies such as this one are causing a shift in thinking about schizophrenia and are already changing treatment plans to address the disorder. The following is an interesting article from the New York Times which discusses some new thinking about schizophrenia:

Yet there’s a restless energy among psychiatric researchers now, and it’s in part because of several recent studies that, paradoxically, reveal how insufficient current theories about schizophrenia are. Schizophrenia is not a single problem with a uniform solution, these results suggest. Rather, the disease most likely comprises a variety of related mental disorders, with an underlying biology and symptoms that can differ from person to person.

That shift in thinking has already led to expanded treatment options for some patients, and it is likely to guide research on the disorder for years to come.

Perhaps the most striking demonstration of how biologically diverse schizophrenia may be came in a gene study published in March. An analysis of blood samples revealed that rare and previously undetectable genetic mutations were strongly associated with the development of the disorder.

Click here to read the rest of this article from the New York Times

Link to this post

June 18, 20087:08 am
posted by Aric Thorpe, MHR

Connection between type 2 diabetes and depression

A recent study published in the Journal of the American Medical Association found a connection between type 2 diabetes and depression. The connection, according to Sherita Hill Golden, M.D., of John’s Hopkins, was found to be a “bidirectional association;” those that had diabetes were likely to develop depression and those that had depression were at risk of developing diabetes. The researchers believe that “… psychological stress associated with diabetes management may lead to elevated depressive symptoms.” Conversely, lifestyle choices associated with depression may account for increased risk of the development of diabetes. The following is an excerpt of an article from Medpage Today that reviews findings from the study:

At the same time, the investigators found a nonsignificant trend for depressed patients to develop type 2 diabetes, primarily because of lifestyle changes engendered by depression.

They concluded that the studies support a “bidirectional association” between depression and type 2 diabetes, in which each contributes to or exacerbates the other.

Patients with type 2 diabetes had an odds ratio of 1.54 (95% CI 1.13 to 2.09) of developing depressive symptoms during three to four years of follow-up, compared with participants with normal glucose, the researchers found.

Click here to read the rest of this article from Medpage Today

Click here for information on the treatment of depression

Link to this post

June 17, 20087:45 am
posted by Aric Thorpe, MHR

Severe sleep disturbance in returning vets

Preliminary findings from a study focusing on the sleep disturbances of vets returning from the middle east conflict have yielded some intriguing results. According to Anne Germain, Ph.D., of the University of Pittsburg, returning vets can have sleep disturbance just as severe as persons with insomnia. Vets who served in combat and are having difficulty with adjustment upon returning home “do not get good sleep like good sleepers,” said Dr. Germain. During her talk at the Professional Sleep Societies meeting Dr. Germain presented both subjective patient reports of sleep disturbance and objective findings from measures used in the study. The current findings are a part of a study that intends to gather data from 90 participants by the time of its close. The following is an excerpt of an article from Medpage today that discusses the findings:

In the sleep lab, Dr. Germain said, she tested 11 medication-free veterans, of whom nine met full criteria for current moderate-to-severe posttraumatic stress disorder (PTSD).

She also tested 11 medication-free and healthy volunteers who were good sleepers, using Cohen’s d-values to assess group differences with small, medium, and large effect sizes indicated by d-values of 0.20, 0.50, and 0.80, respectively.

* Had lower sleep efficiency (d=0.81), related to moderate increases in sleep latency (d=0.35), duration and number of nocturnal awakenings (d=0.49 and d=0.62, respectively), and reduced total sleep time (d=0.34).
Sleep efficiency was significantly and negatively correlated with PTSD severity, at P<0.001.

Click here to read the rest of this article from Medpage Today

Click here for information on the treatment of PTSD

Pastoral Action Point: Adjustment is a major issue for most combat vets returning from war. One of the things that can help bring normal life back into perspective for returning vets is community. Obviously, church is a wonderful place to find compassionate, supportive community. As such, it is important to embrace returning vets, welcoming them back, letting them know that the church community embraces them. Perhaps a house visit, some home baked goods, or simply a phone call would be appropriate to reestablish connection with these heroes.

Link to this post

June 13, 20083:35 pm
posted by Aric Thorpe, MHR

Sleepy Cell Phone Users

Could cell phone usage contribute to poor sleep? Findings from a small pilot study suggest that it does. According to Gaby Badre. M.D., Ph.D., of the University in Gothenberg Sweden, healthy young adults and teens who make more than 15 calls a day are more likely to have poor sleep compared to those who use cell phones less often. In his presentation at the meeting of the Associated Professional Sleep Societies, Dr. Badre said that heavy cell phone users in the study had more difficulty sleeping, waking up, and generally felt more tired during the day. However, Dr. Badre and colleagues found no differences in depression or anxiety among the participants using the Beck Youth Scale. The following is an excerpt of an article from Medpage Today that reviews the study:

Dr. Badre said that as a sleep specialist whose patients include young people working in London’s financial district, he has seen many heavy cell phone users who suffered from anxiety and whose sleep was disrupted.

To study the issue, he and colleagues enrolled 21 healthy volunteers, ages 14 through 20 and divided them into two groups according to cell phone use. The 11 in the experimental group used the phone a minimum of 15 times a day, although four reached more than 30 and one young woman continually hit 200 calls or messages a day, he said.

Click here to read the rest of this study from Medpage Today

Link to this post

June 11, 20087:11 am
posted by Aric Thorpe, MHR

Too much alcohol is bad for the heart

There are many studies that relay the heart health benefits of moderate consumption of red wine; however, consuming large amounts of alcohol could actually be bad for your heart. According to findings presented at a recent American Society of Hypertension meeting, too much alcohol is bad for the heart. Azra Mahmud, M.D., Ph.D. of St. James Hospital in Dublin, explained that the effects of too much drinking are different based on gender. Men who have on average more than three stout drinks per day are likely to suffer from stiff ventricles and arteries. Women, on the other hand, who consume more than two stout drinks per day are likely to develop large hearts. The following is an excerpt of an article from Medpage Today that reviews the findings:

Dr. Mahmud and colleagues studied 200 consecutive patients seen at her hypertension clinic for initial assessment of elevated blood pressure. On the basis of self reports, patients were classified as nondrinkers, moderate drinkers (one to 21 units of alcohol per week for men and one to 14 for women), or excessive drinkers (more than 21 units for men and more than 14 for women).

Approximately 10% of the women in the study and 35% of the men were excessive drinkers and about 20% of men and women were nondrinkers, she said.

The patients were assessed with echocardiography with tissue Doppler imaging, and arterial stiffness was measured with pulse-wave velocity and augmentation index.

Blood pressure was measured with a digital oscillometric monitor after a supine rest of 15 minutes and also by 24-hour ambulatory blood pressure monitoring.

Click here to read the rest of this article from Medpage Today

Link to this post

June 9, 20083:32 pm
posted by Aric Thorpe, MHR

“A little hard work never hurt anyone…”

Work is sometimes labeled as being stressful or depressing; however, a recent study published in the journal Occupational Medicine found that returning to work can help in the recovery of depressed patients. The study examined the lives of 500 individuals with depression from a variety of industries that were unable to work over a year’s time. In this population, returning to work was found to be a significant factor in recovery from depression. One vital dynamic was the flexibility and attentiveness of employers during the recovery process. The following is an excerpt of an article from Medical News Today that reviews the study:

The study echoes the findings of Dame Carol Black’s Review ‘Working for a healthier tomorrow’ which recognized that for most people work is good both for their long-term health and for their family’s well-being. The review found that ill health was costing the country £100 billion a year - £40 billion of which was related to mental health.

“Better access to occupational health services and psychological support are essential if employees with depression and anxiety are to get back to work quickly” said Dr Gordon Parker, President of the Society of Occupational Medicine. “‘Employers are often frightened of contacting an employee whose sick note says ‘depression’ for fear of being accused of harassment, but sympathetic contact with the employee and early help through occupational health can identify the most appropriate support. Occupational health services are ideally placed to advise managers and employees on the best return to work plan and should be involved early in the management of the employee’s absence.”

Click here to read the rest of this article from Medical News Today

Link to this post

June 6, 20087:41 am
posted by Aric Thorpe, MHR

Exposure Therapy Tops Cognitive Restructuring in Preventing PTSD

A recent study published in the June issue of the Archives of General Psychiatry found that prolonged-exposure therapy is more successful in treating individuals who have suffered a traumatic event than cognitive restructuring. According to the study, six months after the traumatic event only 37% of patients who received prolonged-exposure therapy developed PTSD. Conversely, 63% of those that were treated with cognitive restructuring developed PTSD. This is the first study that has compared the two types of therapies. Prolonged-exposure therapy helps the individual to confront the traumatic event and as such some feel that it elicits a certain amount of distress. However, Dr. Richard A. Bryant and colleagues conducting the study said, “Despite some concerns that patients may not be able to manage the distress elicited by [prolonged-exposure therapy], there was no difference in dropout rates.” The following is an excerpt of a article from Medpage Today that reviews the study:

In prolonged-exposure therapy, patients are encouraged to relive the traumatic event over and over. They may describe it verbally in detail in sessions with a therapist and do daily homework assignments that force patients to go over the event in their minds.

Dr. Bryant and colleagues said many clinicians have resisted using exposure therapy because they worry the distress it creates may drive patients away from therapy altogether.

Cognitive restructuring involves identifying unhealthy thoughts and emotional responses to the trauma and tries to modify them by having patients apply rational analysis. The unhealthy thoughts typically revolve around guilt about behavior during the trauma and excessive worry about future harm and their reactions to the stress.

The researchers recruited 90 patients who had been involved in motor vehicle accidents or non-sexual assaults and who met criteria for acute stress disorder — 30 patients were assigned to prolonged-exposure therapy, 30 to cognitive restructuring, and 30 were assigned to a wait list. Patients on the wait list were reassessed six weeks later and then offered unspecified active treatment.

Click here to read the rest of this article from Medpage Today

Click here for information on the treatment of PTSD

Link to this post