Wednesday, July 25, 2007 11:45 AM
posted by Rolf B. Gainer, Ph.D. Sports, Concussion and Depression In a forthcoming study to appear in the Journal of the American College of Sports Medicine of 595 football players who experienced three or more concussions, 20.2% were found to have depression. The National Football League has refuted the survey results and attacked the methodology of the study. The facts speak louder than the attack in the form of professional football athletes who have shared their personal stories like former Patriots Linebacker, Ted Johnson who reported depression and cognitive problems. Certainly, the suicide death of former Philadelphia Eagles player, Andre Waters, also carries the story home. A neuropathologist who examined Mr. Waters brain concluded that repeated concussions caused the problems which resulted in Mr. Waters taking his own life.The debate between the NFL and the American College of Sports Medicine will carry on for some time as there is much at stake for the NFL and for the players.
For those of us who work in traumatic brain injury, we know that repeated concussion can result in cognitive and psychological changes. A concussion is a brain injury and multiple concussions are multiple brain injuries.Coaches, players and parents need to be mindful of the risks of repeated concussive injuries. They can result in significant problems which can be life changing. As schools gear up for fall training, let's remember to follow the guidelines for evaluation prior to returning players to the game if concussion is suspected.
link to this post  11:22 AM
posted by Rolf B. Gainer, Ph.D. Falling Between the Cracks in Healthcare: Reading and Wellness In 2003 the U.S. Department of Education identified that 14% of the nation or 30 million people cannot read or understand basic information presented in short, simple statements. In another study 12% of the adults could not read or understand information in simple documents, including basic maps. Recently the issue of literacy has entered into our examination of healthcare. David Williams at Harvard observed that economics and social status are directly linked to "wellness". He further noted that poor health practices related to cognitive abilities. Dr. Williams, in his 2006 study, found that obesity, hypertension, depression and diabetes occurred at higher rates in individuals with reduced health literacy.
For individuals with cognitive problems related to disability or other conditions, the issue of health literacy as the cause of healthcare disparities is alarming.Could a person remember to take medication as directed, find a physician's office and follow the requirements of a diet or medication regime to battle an illness or chronic condition? Many of the forms that are used in healthcare and directions for treatment are written at the 8th grade level. Will individuals with reading or cognitive problems eventually be shunned by physicians and clinics as reimbursement moves towards as "pay for performance" model? How will this impact individuals living with disabilities who may have the "double whammy" of reduced health literacy and social status. While the focus is on improving the health of our nation, we are missing a large segment of the population who, for clear reasons, will fall through the crack unless changes occur to address health literacy problems.
link to this post 10:55 AM
posted by Rolf B. Gainer, Ph.D. Albert Ellis, Pioneering Psychologist Dies at 93 Albert Ellis, a controversial psychotherapist who departed from Freud's classic psychoanalysis, died on July 25th at age 93 in New York. Dr. Ellis' theory became Rational Emotive Behavior Therapy in which he encouraged individuals to focus on what is happening in their lives at the moment and to take action. Dr. Ellis believed that people are born with a talent for what he termed "crooked thinking" or distortions of perception which sabotaged their attempts to be happy. He also felt that people could change through therapy by first accepting themselves and then retraining to avoid destructive thinking and emotions. Along with Dr. Aaron Beck, this approach became a foundation for today's Cognitive Behavior Therapy which is as effective as medication in treating depression, anxiety, obsessive-compulsive disorder and other conditions. Ellis long prided himself on his ability to confront people in positive and helpful ways. He used humor and frankness to address issues which were uncomfortable for many. His approach encouraged people to change and to take charge of their lives. Dr. Ellis' impact on modern psychotherapy is significant and he will be long remembered as a charismatic pioneer.
link to this post 9:30 AM
posted by Aric Thorpe 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." Click here to read the rest of the article
link to this post Tuesday, July 24, 2007 1:25 PM
posted by Michael Mason Depression Advice from the 17th Century In 1621, Robert Burton published a book called "The Anatomy of Melancholy," which may have been intended to be medical in nature, but wound up being more philosophical. Today, it can largely be read as a treatise on major depression--and it is only substantiated by Burton's own struggle with his melancholic temperament.
Here are some memorable lines:
Observe this short precept -- Be not solitary; be not idle.
I write of melancholy by being busy to avoid melancholy.
Melancholy... is the character of Mortality.
Click here to read "The Anatomy of Melancholy" for free.
link to this post Wednesday, July 11, 2007 2:49 PM
posted by Rolf B. Gainer, Ph.D. Long Term Impact of Childhood Trauma Trauma poses lifelong effects for individuals exposed as children.The negative effects can extend for years post trauma exposure specifically in terms of risk for mood and anxiety disorders. Studies of adult psychiatric patients have long told us of the psychobiologic effects of exposure to long term adversity. Studies of PTSD further support the evidence of brain changes created by trauma. In a recent study, (Pole N. et al, Associations between Childhood Trauma and Emotion-Modulated Psychophysiological Responses to Startling Sounds: A Study of Police Cadets, Journal of Abnormal Psychology 2007 May; 116: 352-61) individuals without current psychopathology who had childhood trauma demonstrated greater reactivity and self-reported psychological effects to differing levels of potential threat via a finger shock. The childhood trauma group had fewer positive emotions, more negative emotions, greater eyeblink response and greater skin conductance than the group without trauma histories.
What becomes important for clinicians is to consider the importance of a childhood history of trauma in the identification of Axis I disorders in individuals without prior psychiatric histories.If we understand that trauma can produce changes in the brain, we can apply that understanding to the responses of adults exposed to stress and anxiety. These individuals may have a greater likelihood of developing psychiatric problems later in life due to a more sensitized response mode.
link to this post Thursday, July 05, 2007 1:36 PM
posted by Rolf B. Gainer, Ph.D. Epilepsy Diagnosis Creates Risk for Suicide Individuals with newly diagnosed epilepsy were found to be at a three-fold increase in risk for suicide. The risk for newly diagnosed individuals with previous psychiatric diagnoses jumped to a 29-fold increase in the first six months of the epilepsy diagnosis according to an article in Lancet Neurology (July 3, 2007). The findings are based on a Danish study involving nearly 450,000 individuals of which over 21,000 committed suicide. Of the group who died by suicide, 492 had been diagnosed with epilepsy in the six month period prior to their death. In a review of the study by Michael Sperling, M.D. of the Jefferson Comprehensive Epilepsy Center in Philadelphia, he referred to the study as "frankly confirmatory" and noted that "persons with epilepsy are also more likely to experience depression and, particularly when seizures are uncontrolled, suicides are significantly higher." Dr. Christiansen who was involved in the study reported that the risk of suicide declined with the duration of epilepsy.
This study highlights the need to inform individuals with a new diagnosis of epilepsy of the risks of depression and to consistently monitor their mental health status and risk factors during the critical first six month post-diagnosis period. Certainly for individuals with a prior psychiatric diagnosis, the risk factors need to be carefully followed and evaluated on an ongoing basis.
link to this post Monday, July 02, 2007 7:47 AM
posted by Michael Mason Not Even Once: Montana's Meth Commercials Mean It Thomas Siebel, a Montana businessman and philanthropist, founded the Montana Meth project and plunked down ten million dollars to ensure it sends a message to state teens. Not even once, the commercials say--but it's the gripping and terrifying images that speak louder than the slogan.
One commercial portrays a girl turned to prostitution as a result of meth, another shows an angry young man beating on the door of his parent's house. The commercials are shocking for their realism and emotionality--it's a gut level assault on addiction. While the commercials are difficult to watch, the results have been impressive:
"Data collected in 2006 indicates that programs recently initiated in Montana have begun to have a significant impact on the state's Methamphetamine problem... While the data are preliminary, the evidence available clearly demonstrates that the prevention campaign started in 2005 by the Montana Meth Project has had a positive impact on the state of Montana." (Montanta State Attorney McGrath)
To see the commercials for yourself, click here.
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Rolf B. Gainer, Ph.D., Diplomate ABDA, is the Chief Executive Office at Brookhaven Hospital and the Vice President of Rehabilitation Institutes of America. Dr. Gainer has been involved in the design and operation of treatment programs since 1977.
Stephen Harnish, MD is the Medical Director of Brookhaven Hospital. Dr. Harnish is a member of the American Psychiatric Association and is well known in Oklahoma for his informative radio and television appearances.
Aric Thorpe, MHR, is Brookhaven Hospital's Pastoral Liaison Representative. He conducts the quarterly Minister's Lifeline series and provides mental health information to pastors and clergy.
Sarah McGee serves as the Community Education Provider for Brookhaven Hospital. She provides information on mental health and drug and alcohol treatment to healthcare professionals in Oklahoma and surrounding states. |
