Wednesday, September 26, 2007 11:37 AM
posted by Rolf B. Gainer, Ph.D. Telephone Outreach Helps Depression For working individuals experiencing depression, help may literally be a phone call away. In a randomized controlled trial involving 604 workers with depression who were covered through the same insurance plan, a telephonic outreach and support program produced positive results in terms of increasing the worker participants' productivity and performance and in reducing lost time. The individuals also participated in clinical treatments, involving counseling and medication management. The control group received a counseling and medication management program without the telephonic supports.
In an article published in the Journal of the American Medical Association, Volume 298, No. 12, September 26, 2007, Telephone Screening, Outreach, and Care Management for Depressed Workers and Impact on Clinical and Work Productivity Outcomes , (Wang, et al), the authors describe this innovative study involving employed individuals with depression.The study demonstrated that the $100 to $400 cost per depressed worker produced an annualized gain of $1800 in higher worked hours per participant. While the study did not address the durability of the outcome attained, it provided a unique approach to bringing an effective support to the workplace to enable workers and their employers to benefit from increased job retention, enhanced productivity and reduced absenteeism.
Innovations in service delivery and supports can produce positive results. In this case the individuals and the employer experienced many positive benefits from a simple system of telephone outreach.
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posted by Rolf B. Gainer, Ph.D. Mindlessly Eating The newspapers and television news shows report daily on America's growing number of people with obesity.Media and print advertising is saturated with diet programs for weight loss, medical and surgical alternatives and fitness options. Brain Wansink of Cornell University's Food and Brand Lab and the author of Mindless Eating, has studied the eating habits of people. Wansink has observed that people eat more when in proximity to food such as family style dining and buffet restaurants. Similarly, being closer to available food items, eating from a package of food, away from the table, in front of TV or in a car also inspire people to consume more food. In an experiment using red colored potato chips, people would consume fewer chips when the number of colored vs. plain chips increased. People experienced the presence of the colored chips as a measurement and an inhibition to consumption.Wansink's experiments with eating behaviors clearly point to the contributing factors to obesity. Food has shifted from a necessary source of energy and nutrition to an activity which is far greater than our caloric and nutritional needs.
link to this post Friday, September 14, 2007 12:58 PM
posted by Aric Thorpe, MHR Suicide rates among teenagers and young adults rising Suicide rates among teenagers and young adults are increasing in the United States. A recent report from the CDC revealed that suicide rates among teenagers and young adults increased by 8% from 2003 to 2004. Interestingly, the increase coincided with a 22% decline in the use of SSRIs after a mandate to adhere warning labels that indicated a "risk of suicidal ideation." Groups that were identified as having the largest increase in suicide were boys 15 to 19, girls 10 to 14, and girls 15 to 19. There were no discernible differences in suicide rates among differing ethnic groups; researchers suggest that this may be due to limitations of the sample. The following is an excerpt of an article from Medpage today that discusses the findings in detail:
ATLANTA, Sept. 6 -- Suicide rates among adolescents and young adults in the United States increased by 8% from 2003 to 2004, the largest increase in 15 years, CDC investigators reported today.
"In surveillance-speak this is a dramatic and huge increase," said Ileana Arias, Ph.D., director of the CDC's National Center for Injury Prevention and Control, in a press briefing.
The increase followed a decline in combined suicide rates for 10- to 24-year-olds of 28.5% from 1990 through 2003, reported Keri M. Lubell, Ph.D., and CDC colleagues in the Sept. 7 issue of the Morbidity and Mortality Weekly Report.
All of the increase in the latest figures can be accounted for by a spike in suicides among three groups: girls 10 to 14, girls 15 to 19, and boys 15 to 19.
For young girls, there was a shift away from suicide by firearms or poisoning toward hanging or suffocation.
The rise in suicide rates coincides with a 22% decline in pediatric prescriptions for selective serotonin reuptake inhibitors (SSRIs) after the implementation of black box warnings about the risk of suicidality and suicidal ideation, which was reported in the September issue of the American Journal of Psychiatry.
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Click here for more information on depression and suicide
link to this post Friday, September 07, 2007 9:38 AM
posted by Aric Thorpe, MHR Can supplements treat depression and anxiety? The use of herbal and dietary supplements is on the rise. According to a recent article from the American Academy of Family Physicians, the use of herbal remedies and dietary supplements jumped from 34% in 1990 to 42% in 1997; this trend undoubtedly is increasing and with some justification. Data supports the idea that some herbal remedies and dietary supplements may be effective in alleviating symptoms of depression and anxiety.
While physicians should not encourage the use of certain supplements, negativity towards them could hinder patient disclosure about what herbal remedies and or dietary supplements he or she is taking. Conversely, recognizing the possible validity of using supplements opens up dialog between patient and doctor in which collaboration that minimizes risk can occur. The following is an article from the American Academy of Family Physicians that discusses this issue:
Use of complementary and alternative medicine has increased over the past decade. A variety of studies have suggested that this use is greater in persons with symptoms or diagnoses of anxiety and depression. Data support the effectiveness of some popular herbal remedies and dietary supplements; in some of these products, particularly kava, the potential for benefit seems greater than that for harm with short-term use in patients with mild to moderate anxiety. Inositol has been found to have modest effects in patients with panic disorder or obsessive-compulsive disorder. Physicians should not encourage the use of St. John's wort, valerian, Sympathyl, or passionflower for the treatment of anxiety based on small or inconsistent effects in small studies. Although the evidence varies depending on the supplement and the anxiety disorder, physicians can collaborate with patients in developing dietary supplement strategies that minimize risks and maximize benefits. (Am Fam Physician 2007;76:549-56. Copyright © 2007 American Academy of Family Physicians.)
Use of complementary and alternative medicine in all of its varieties, such as herbal remedies and dietary supplements, increased from 34 percent of the overall U.S. population in 1990 to 42 percent in 1997.1 Use appears to be twice as great in persons reporting anxiety and depression than in those reporting any other problem, except for back and neck pain.1 Based on results of two large-scale community surveys,2,3 investigators have noted an association between both panic disorder and major depression and the use of complementary and alternative medicine.
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link to this post 9:13 AM
posted by Aric Thorpe, MHR Patients with epilepsy have an increased risk of suicide The connection between epilepsy and suicide has been validated by many studies. However, many of these studies have left readers with uncertainly about findings due to their power limitations and design. Christensen and colleagues, however, have recently published a nicely powered study that confirms the findings of many of these previous smaller studies.
According to Christensen, patients with epilepsy have three times the risk for suicide than controls. Even more alarming, patients with both epilepsy and affective disorder or schizophrenia have 20 times more risk for suicide than controls. The risk for suicide is even greater during the first 6-months after diagnosis of epilepsy and or mental illness, according to the study. The following is an excerpt of an article from Journal Watch that reviews the study:
Numerous studies have shown an increased rate of suicide among patients with epilepsy, yet the design and power limitations of those studies have led to uncertainty as to the magnitude and nature of this risk. Christensen and colleagues used the Danish Cause of Death Registry and several other databases to determine the relative risk for suicide among people with epilepsy. They examined approximately 21,000 suicide cases and more than 400,000 age- and sex-matched controls in the general population.
The relative risk for suicide was three times higher among people with epilepsy than among controls, and it remained significantly (two times) higher even after controlling for demographic and socioeconomic factors and history of psychiatric disease. Notably, the risk for suicide was greatest during the first 6 months after epilepsy was diagnosed and among those with epilepsy and comorbid psychiatric illness (affective disorder, schizophrenia, anxiety disorder, chronic alcohol use, and others). The risk for suicide among those with epilepsy and either affective disorder or schizophrenia was more than 20 times the risk among controls; after controlling for demographic and socioeconomic factors, the risk among those with epilepsy and schizophrenia was 13 times higher than the risk in controls. Compared with controls, the increase in suicide risk after age 60 was less pronounced in people with epilepsy.
Click here to read the entire article
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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. |
