Friday, May 09, 2008 8:57 AM
posted by Aric Thorpe, MHR "Going to Pot" According to a recent study conducted by David Gorelick, MD, Ph D., of the National Institute on Drug Abuse in Baltimore, and colleagues at a recent American Psychiatric Association meeting, withdraw from marijuana appears to be the real deal. According to the study, approximately one third of marijuana users who made real efforts to quit the drug failed because of withdraw symptoms. The study confirms several smaller studies on the subject. According to Dr. Gorelick, "I think the consensus now is that there is a cannabis withdrawal syndrome... this warrants attention during treatment of cannabis dependence." Dr. Gorelick also mentioned that while cannabis withdraw was not included in the DSM-IV the next version would be inclusive of it. The following is an excerpt of an article from Medpage Today that reviews the study:
The findings came from questionnaires administered to 469 self-reported marijuana users 18 to 64 years old from the Baltimore area, who were recruited by advertisements and word of mouth.
About 28% reported more than 10,000 lifetime uses of marijuana, the equivalent of once-daily use for 27 years. More than half the sample reported at least 2,000 lifetime uses.
"We get the picture that these were heavier users," Dr. Gorelick said.
Some 90.6% had at least three dependence criteria as defined in DSM-IV's section on general substance dependence.
Fewer than half -- 42.4% -- said they had experienced withdrawal symptoms when they tried to quit.
Among those that did, reported symptoms were both physical and psychological, Dr. Gorelick said.
Click here to read the rest of this story from Medpage Today
Click here for information on the treatment of chemical dependency
link to this post  Thursday, May 08, 2008 7:29 AM
posted by Aric Thorpe, MHR ADHD: a risk factor for developing an eating disorder during adolescence in girls A recent study published in the current issue of the Journal of Abnormal Psychology found that girls with attention deficit hyperactivity disorder (ADHD) have a much greater risk of developing an eating disorder during adolescence. According to psychologist Amori Yee Mikami of the University of Virginia, "Adolescent girls with ADHD frequently develop body-image dissatisfaction and may go through repeating cycles of binge eating and purging behaviors that are common in bulimia nervosa." The girls in the study found to have the highest risk were those that had a "combined type" of ADHD, which included both hyperactivity and inattention. However, all the girls in the study with ADHD were more likely to be overweight. The following is an excerpt of an article from Medical News Today that reviews the study's findings:
"Our finding suggests that girls may develop a broader range of problems in adolescence than their male counterparts," Mikami said. "They may be at risk for eating problems, which are a female-relevant domain of impairment. We know that eating disorders occur 10 times more often in girls than boys."
Additionally, Mikami noted that because ADHD is more common in boys, many girls with the disorder may go undiagnosed and untreated.
"Girls with ADHD may be more at risk of developing eating problems as adolescents because they already have impulsive behaviors that can set them apart from their peers," Mikami said. "As they get older, their impulsivity may make it difficult for them to maintain healthy eating and a healthy weight, resulting in self-consciousness about their body image and the binging and purging symptoms."
The study was conducted with an ethnically diverse sample of 228 girls in the San Francisco Bay area; 140 who had been diagnosed with ADHD and 88 matched comparison girls without ADHD. They were first assessed between the ages of 6 and 12 and again five years later.
Click here to read the rest of this article from Medical News Today
Click here to learn about treatment options for eating disorders
link to this post Wednesday, May 07, 2008 8:35 AM
posted by Aric Thorpe, MHR Angst in adolescents a precursor to schizophrenia? A recent birth cohort study found that agnst in adolescents may be a precursor to schizophrenia, especially if "many" symptoms are present. In the study, positive, negative and general signs of psychosis were common among the adolescent group; however, those who had more than one symptom in each category later developed mental illness. In particular, symptoms such as social withdrawal and problems connecting with others were significant predictors. According to Dr. Pirjo Maki, MD, of the University of Oulu in Finland, this finding is new. The following is an excerpt of an article from Medpage Today that reviews the study:
The researchers derived their conclusions from a study of 9,215 young Finns born between July 1, 1985 and June 30, 1986. They were asked to participate in a field study in 2001 and 2002, when they were either 15 or 16 years old, using a 21-item questionnaire.
The results of the field study were correlated with the Finnish Hospital Discharge Register from 2002 to the end of 2005, Dr. Maki said.
All told, there were 17 cases of psychosis among the cohort, including three cases of schizophrenia, three of bipolar disease, two of psychotic depression, and nine of other psychoses.
The study found that 45% of boys and 27% of girls reported no positive symptoms -- such as difficulty thinking clearly and feeling peculiar -- but most reported one or more, with girls saying they had more of the 11 symptoms.
The study found that 13 of the 17 youths who had psychosis had three or more positive features, compared with less than a third of those who had no disorders -- a difference that was significant at P<0.001.
In the same way, youths with three or more general features -- such as depression and apathy or anxiety -- were significantly more likely to be diagnosed with a psychosis, also at P<0.001, Dr. Maki reported.
Click here to read the rest of this article
link to this post Tuesday, May 06, 2008 8:34 AM
posted by Aric Thorpe, MHR Grim statistics Statistics surrounding the mental health of the 1.6 million U.S. vets returning from the Middle East have some serious implications for both individuals and insurance companies. Thomas Insel, M.D., director of the National Institute of Mental Health, commenting on the situation said, “…a gathering storm" looms over civilian psychiatric care. The risks for us are significant if one just does the math." Truly Dr. Insel's math should be harkened to as one out of five returning vets will suffer from depression and or post-traumatic stress disorder. Additionally, up to 70% of soldiers returning home with PTSD or depression will not seek help from the Veterans Administration. The following is an excerpt of an article from Medpage Today that discusses these grim realities:
Dr. Insel said PTSD -- which he defined as a "failure to cope" -- emerges months and in some cases years after a traumatic event. "About 10% of people simply don't recover," he said.
He likened the Mid-East wars to Hurricane Katrina, in which thousands of people underwent a traumatic event and then were dispersed around the country, making it hard for them to get access to mental health services.
There are still "significant questions" about what treatments for PTSD, depression, or the combination are best, he said, and how returning vets should get treatment.
Since many vets will go back to small-town America, it's also important to figure out how treatment is to be "disseminated," he said.
A key issue is to "de-stigmatize" the need for mental health care, said Nada Stotland, M.D., of Rush Medical Center in Chicago and incoming president of the APA.
"We need to make it OK for members of the military to get the care they need," Dr. Stotland said.
The RAND Corporation report, released April 17, said that a survey revealed that only about half of the returned vets with possible PTSD or depression had sought help.
Click here to read the rest of the Medpage Today article
Click here for information on the treatment of depression
Click here for information on the treatment of PTSD
link to this post Monday, May 05, 2008 8:01 AM
posted by Aric Thorpe, MHR Digital Therapist? A recent study from Yale University found that patients who received computer-assisted training in addition to counseling were more successful in addressing their substance abuse problem(s) than those that received counseling alone. Seventy-seven people seeking treatment for drug and alcohol abuse participated in the study and those who received the supplementary computer-based training had significantly fewer positive drug tests at the end of the study. The study, which was reported in the May 1st edition of the American Journal of Psychiatry, utilized a software program developed by Kathleen M. Carroll, professor of psychiatry at Yale, and colleagues. The software program utilized various types of media to interact with participants, including text, video and audio. In reference to the software Carroll said, "We think this is a very exciting way of reaching more people who may have substance use problems and providing a means of helping them learn effective ways to change their behavior."
Applications for this type of software may be useful in instances where patients lack funding sources, therapists lack time, or even in instances where therapists lack training specifically in cognitive behavioral therapy. Obliviously, there are "potential" ethical issues surrounding such computer-based training and counselor sensitivity and adaptability to the client/patient must not be overlooked; Nonetheless, the study is quite interesting. The following is an excerpt from Medical News Today that reviews the study:
"I am immensely proud of Dr. Carroll and her colleagues' work,'' said William Sledge, MD, interim chair and George D and Esther S Gross professor of psychiatry. "At first glance one might conclude that this computer-based training in some way threatens the conventionally perceived value of the relationship between the therapist and the patient, however, I do not see it as so. Rather, they have demonstrated how a low cost but carefully conceived procedure can enhance conventional treatment and add additional element of richness and effectiveness to its power."
Carroll is one of 20 Yale School of Medicine faculty members who have been designated ISI HighlyCited researcher, a listing of the most highly influential scientists in the world. The Yale drug and alcohol program received top ranking among graduate programs in 2008 from the US News and World Report.
Click here to read the rest of this article
link to this post Thursday, May 01, 2008 7:10 AM
posted by Aric Thorpe, MHR Brain Pace-Maker? Deep-brain stimulation has provided yearlong relief of symptoms of severe depression for patients who had been refractory to a variety of other therapies. Ali R. Rezai, MD, of the Cleveland Clinic reported that eight of 16 patients enrolled in the study showed at least 50% improvement in depression scores at an interview before his presentation at the American Association of Neurological Surgeons. According to Dr. Rezai, "[Responders] had significant improvement in quality of life, returning back to work, getting engaged, dating." The study's focus was on patients that had disabling severe major depression for over five years and had not had any response to at least three different classes of antidepressants at the highest dosage levels. The following is an excerpt of an article from Medpage Today that reviews the study’s findings:
The study enrolled 17 patients overall, with one patient not yet completing a year of treatment when the data were analyzed.
Patients had severe and disabling major depression lasting at least five years without response to at least three classes of antidepressants titrated to the highest tolerated doses. All patients also failed combined therapy with at least two augmentation agents and multiple electroconvulsive therapy trials.
Those considered to be at imminent risk of suicide were excluded, as were patients with current or past psychotic disorders, associated neurological disorder, any significant brain imaging abnormality, substance abuse, history of severe personality disorder, coagulopathy, or other medical problems that could increase the risk of surgery.
Treatment involved placement of a Medtronic Soletra implantable pulse generator, a pacemaker-like device used in deep brain stimulation for Parkinson's disease. Bilateral leads were placed in the ventral portion of the anterior limb of the internal capsule and ventral striatum with high-resolution MRI targeting.
Each electrode contact was 3 mm long with 4 mm of spacing or insulation between contacts. The diameter and other physical properties were the same as the common electrodes used in deep brain stimulation for movement disorders, Dr. Rezai said.
Click here to read the rest of this article from Medpage Today
Click here for information on the treatment of clinical depression
link to this post Wednesday, April 30, 2008 7:29 AM
posted by Aric Thorpe, MHR Sufferers of chronic pain turn to art to depict their struggle Recently, an art exhibit on pain attempted to convey a glimpse of the sometimes little understood world of those who are chronic pain sufferers. It is no surprise that an exhibit such as this one would surface in the media as pain is so difficult to describe. Many that have chronic pain turn to art to depict their struggle. According to Allan I. Basbaum, editor-in-chief of Pain, the medical journal of The International Association for the Study of Pain, "It’s often much more difficult to put pain into words, which is one of the big problems with pain... You can’t articulate it, and you can’t see it. There is no question people often try to illustrate their pain." Mark Collen, age 47 and a former insurance salesman, struggled after losing his regular doctor to retirement to communicate his pain to his new physician. As a result, and with no art training, Mr. Collen created a piece of art to depict his pain to his physician. According to Mr. Collen, "It was only when I started doing art about pain, and physicians saw the art, that they understood what I was going through." The following is an interesting article from the New York Times that discusses the subject:
Finding ways to communicate pain is essential to patients who are suffering, many of whom don’t receive adequate treatment from doctors. In January, Virtual Mentor, the American Medical Association Journal of Ethics, reported that certain groups are less likely to receive adequate pain care. Hispanics are half as likely as whites to receive pain medications in emergency rooms for the same injuries; older women of color have the highest likelihood of being undertreated for cancer pain; and being uneducated is a risk factor for poor pain care in AIDS patients, the journal reported.
Some of the images from the Pain Exhibit, like "Broken People" by Robert S. Beal of Tulsa, Okla., depict the physical side of pain. Others, such as "Against the Barrier to Life," convey the emotional challenges of chronic pain. "I feel like I am constantly fighting against a tidal wave of pain in order to achieve some quality of life,'’ wrote the work’s creator, Judith Ann Seabrook of Happy Valley in South Australia. “I am in danger of losing the fight and giving up."
Click here to read the rest of this article from the New York Times
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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. |
