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Archive for the ‘mental health and substance abuse’ Category

What does the Research Tell us about Services for Children in Therapeutic/Treatment Foster Care with Behavioral Health Issues?

July 18, 2014 Comments off

What does the Research Tell us about Services for Children in Therapeutic/Treatment Foster Care with Behavioral Health Issues?
Source: Substance Abuse and Mental Health Services Administration

Reports on a technical expert panel convened to assess the research about services for foster care children in therapeutic or treatment care. Reviews the scientific evidence and expert panel input to identify actions to be taken and further research needs.

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Psychiatric Aspects of Infectious Diseases

July 16, 2014 Comments off

Psychiatric Aspects of Infectious Diseases
Source: Open Journal of Psychiatry

Psychiatric symptoms can be associated with several systemic and central nervous system infections and they can be the initial presenting symptoms, occurring in the absence of neurological symptoms in some disorders as in some cases of viral encephalitis. They could also be part of the clinical picture in other cases such as psychosis or mood symptoms secondary to brucellosis or toxoplasmosis. Late-onset neuropsychiatric complications may also occur several years following the infection such as in the case of subacute sclerosing panencephalitis due to measles. Some Infectious diseases may have possible etiological role for major psychiatric disorders, based on yet unconfirmed reports for viral infectious diseases (e.g. Influenza virus and HSV-1) which are thought to have risk for developing schizophrenia and psychosis. Neuropsychiatric adverse effects can occur due to drugs (e.g. mefloquine, interferon-alpha) that are used for treatment of infectious diseases. Psychiatric symptoms can also be reactivated resulting from chronic, complicated and serious infections such as HIV that can lead to depression, anxiety or adjustment disorders, although CNS involvement can also be a possible etiological factor. Patients suffering from primary and severe psychiatric disorders are at increased risk of contracting infection; that is mainly related to high risk behaviors in patients with mania or schizophrenia. It is also important to consider that the co-occurrence of psychiatric symptoms and infection can be incidental (i.e. infectious diseases can occur in psychiatric patients regardless of the above mentioned factors). Early identification of the underlying etiology for organic/secondary psychiatric symptoms is essential for appropriate intervention and early treatment of the primary condition that could be the etiology of psychiatric symptoms so as to avoid unnecessary long-term psychiatric treatment and to avoid complications of possible misdiagnosis or delayed diagnosis of the primary condition.

Hysteria around the World

July 16, 2014 Comments off

Hysteria around the World (PDF)
Source: Frontiers of neurology and neuroscience

In the 20th century the term hysteria declined and the interest in the hysteria-related diseases decreased in comparison to the florid period of studies that was inspired by Charcot’s legacy in the second half of the 19th century. Scientific interest has once again increased in the 21st century, and dissociative and somatoform disorders (previously indicated as hysteria or hysterical neurosis) have come to be regarded as conditions that are known to be much more prevalent than formerly estimated. Available current epidemiological data from several countries on different continents (adopting DSM criteria for diagnosis) suggest not only that the prevalence is probably similar, but also that there is a consistency in their clinical manifestation around the world and across different cultures, social classes, and institutional settings. In line with this uniformity, and also with Charcot’s concept of hysteria as a functional disorder, neuroimaging studies suggest that for some of these disorders, there might be some changes of neural connectivity in specific pathways at the origin of the behavioral aspects. Only large-scale multidisciplinary transcultural studies can improve the research and the development of therapeutic interventions for these disorders.

Decline in Drug Overdose Deaths After State Policy Changes — Florida, 2010–2012

July 15, 2014 Comments off

Decline in Drug Overdose Deaths After State Policy Changes — Florida, 2010–2012
Source: Morbidity and Mortality Weekly Report (CDC)

During 2003–2009, the number of deaths caused by drug overdose in Florida increased 61.0%, from 1,804 to 2,905, with especially large increases in deaths caused by the opioid pain reliever oxycodone and the benzodiazepine alprazolam (1). In response, Florida implemented various laws and enforcement actions as part of a comprehensive effort to reverse the trend. This report describes changes in overdose deaths for prescription and illicit drugs and changes in the prescribing of drugs frequently associated with these deaths in Florida after these policy changes. During 2010–2012, the number of drug overdose deaths decreased 16.7%, from 3,201 to 2,666, and the deaths per 100,000 persons decreased 17.7%, from 17.0 to 14.0. Death rates for prescription drugs overall decreased 23.2%, from 14.5 to 11.1 per 100,000 persons. The decline in the overdose deaths from oxycodone (52.1%) exceeded the decline for other opioid pain relievers, and the decline in deaths for alprazolam (35.6%) exceeded the decline for other benzodiazepines. Similar declines occurred in prescribing rates for these drugs during this period. The temporal association between the legislative and enforcement actions and the substantial declines in prescribing and overdose deaths, especially for drugs favored by pain clinics, suggests that the initiatives in Florida reduced prescription drug overdose fatalities.

The association between internet addiction and psychiatric co-morbidity: a meta-analysis

July 14, 2014 Comments off

The association between internet addiction and psychiatric co-morbidity: a meta-analysis
Source: BMC Psychiatry

Background
This study evaluates the association between Internal Addiction (IA) and psychiatric co-morbidity in the literature.

Methods
Meta-analyses were conducted on cross-sectional, case-control and cohort studies which examined the relationship between IA and psychiatric co-morbidity. Selected studies were extracted from major online databases. The inclusion criteria are as follows: 1) studies conducted on human subjects; 2) IA and psychiatric co-morbidity were assessed by standardised questionnaires; and 3) availability of adequate information to calculate the effect size. Random-effects models were used to calculate the aggregate prevalence and the pooled odds ratios (OR).

Results
Eight studies comprising 1641 patients suffering from IA and 11210 controls were included. Our analyses demonstrated a significant and positive association between IA and alcohol abuse (OR = 3.05, 95% CI = 2.14-4.37, z = 6.12, P < 0.001), attention deficit and hyperactivity (OR = 2.85, 95% CI = 2.15-3.77, z = 7.27, P < 0.001), depression (OR = 2.77, 95% CI = 2.04-3.75, z = 6.55, P < 0.001) and anxiety (OR = 2.70, 95% CI = 1.46-4.97, z = 3.18, P = 0.001).

Conclusions
IA is significantly associated with alcohol abuse, attention deficit and hyperactivity, depression and anxiety.

No Time to Waste: Evidence-Based Treatment for Drug Dependence at the United States Veterans Administration Department of Veterans Affairs

July 13, 2014 Comments off

No Time to Waste: Evidence-Based Treatment for Drug Dependence at the United States Veterans Administration Department of Veterans Affairs
Source: Human Rights Watch

The 39-page report states that more than one million US veterans take prescription opioids for pain, and nearly half of them use the drugs “chronically,” or beyond 90 days. Alcohol and drug dependence is strongly associated with homelessness and mental health conditions including post-traumatic stress syndrome and depression, psychological conditions that affect 40 percent of Iraq and Afghanistan veterans in VA care. Drugs or alcohol are involved in 1 of 3 Army suicides, and the VA estimates that 22 veterans commit suicide each day.

Measuring Post Traumatic Stress Disorder in Twitter

July 11, 2014 Comments off

Measuring Post Traumatic Stress Disorder in Twitter
Source: AAAI Publications, Eighth International AAAI Conference on Weblogs and Social Media

Traditional mental health studies rely on information primarily collected through personal contact with a health care professional. Recent work has shown the utility of social media data for studying depression, but there have been limited evaluations of other mental health conditions. We consider post traumatic stress disorder (PTSD), a serious condition that affects millions worldwide, with especially high rates in military veterans. We also present a novel method to obtain a PTSD classifier for social media using simple searches of available Twitter data, a significant reduction in training data cost compared to previous work. We demonstrate its utility by examining differences in language use between PTSD and random individuals, building classifiers to separate these two groups and by detecting elevated rates of PTSD at and around U.S. military bases using our classifiers.

Approach to hoarding in family medicine

July 10, 2014 Comments off

Approach to hoarding in family medicine
Source: Canadian Family Physician (CFP-MFC)

Objective
To review the presentation of hoarding and provide basic management approaches and resources for family physicians.

Sources of information
PubMed was searched from 2001 to May 2011. The MeSH term hoarding was used to identify research and review articles related to the neuropsychological aspects of hoarding and its diagnosis and treatment.

Main message
Hoarding is often a hidden issue in family medicine. Patients with hoarding problems often present with a sentinel event such as a fall or residential fire. Although hoarding is traditionally associated with obsessive-compulsive disorder, patients more commonly have secondary organic disease associated with hoarding behaviour or have hoarding in absence of substantial compulsive traits. Hoarding disorder is expected to be included in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Management is best provided by a multidisciplinary approach when possible, and an increasing number of centres provide programs to improve symptoms or to reduce harm. Pharmacologic management has been shown to be of some help for treating secondary causes. In the elderly, conditions such as dementia, depression, and substance abuse are commonly associated with hoarding behaviour. Attempts should be made to keep patients in their homes whenever possible, but an assessment of capacity should guide the approach taken.

Conclusion
Hoarding is more common than family physicians realize. If hoarding is identified, local resources should be sought to assist in management. Assessment and treatment of underlying causes should be initiated when secondary causes are found. It is expected that primary hoarding will be a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition.

Intellectual Disability, Australia, 2012

July 9, 2014 Comments off

Intellectual Disability, Australia, 2012
Source: Australian Bureau of Statistics

Intellectual disability is a term used to describe a reduced ability to understand new or complex information and to learn and apply new skills (Endnote 1). The Survey of Disability, Ageing and Carers (SDAC) defines intellectual disability as “difficulty learning or understanding things.”

The Burden of Stress in America

July 8, 2014 Comments off

The Burden of Stress in America (PDF)
Source: NPR/Robert Wood Johnson Foundation/Harvard School of Public Health

The NPR/Robert Wood Johnson Foundation/Harvard School of Public Health Burden of Stress in America Survey was conducted from March 5 to April 8, 2014 with a sample of 2,505 respondents. The survey examines the role stress plays in different aspects of Americans’ lives, including the public’s personal experiences of stress in the past month and year, the perceived effects of their stress and causes of that stress, their methods of stress management and their general attitudes about effects of stress in people’s lives.

In U.S., Veterans Report Less Stress, Worry Than Civilians

July 4, 2014 Comments off

In U.S., Veterans Report Less Stress, Worry Than Civilians
Source: Gallup

Americans may understandably believe that the nation’s veterans are suffering emotionally given news reports of high levels of post-traumatic stress disorder and other mood or anxiety disorders among those who have served in the military. However, Gallup finds that among employed Americans, active-duty and veteran populations are more emotionally resilient than their civilian counterparts.

Dating Violence Among Male and Female Youth Seeking Emergency Department Care

July 3, 2014 Comments off

Dating Violence Among Male and Female Youth Seeking Emergency Department Care
Source: Annals of Emergency Medicine

Study objective
We determine prevalence and correlates of dating violence, dating victimization, and dating aggression among male and female patients aged 14 to 20 years seeking emergency department (ED) care.

Methods
This was a systematic sampling of subjects aged 14 to 20 years seeking care at a single large academic ED between September 2010 and March 2013. Participants completed a computerized, self-administered, cross-sectional survey of demographics, dating violence from physical abuse measures of the Conflict in Adolescent Dating Relationships Inventory, associated behaviors, and ED health service use. Separate analyses were conducted for male and female patients.

Results
Four thousand three hundred eighty-nine youths (86.1% participation rate) were screened, and 4,089 (mean age 17.5 years; 58% female patients) were eligible for analysis. Almost 1 in 5 female patients (n=215; 18.4%) and 1 in 8 male patients (n=212; 12.5%) reported past-year dating violence. Of female patients, 10.6% reported dating victimization and 14.6% dating aggression, whereas of male patients, 11.7% reported dating victimization and 4.9% reported dating aggression. Multivariate analyses showed that variables associated with any male dating violence were black race (adjusted odds ratio [AOR] 2.26; 95% CI 1.54 to 3.32), alcohol misuse (AOR 1.03; 95% CI 1.00 to 1.06), illicit drug use (AOR 2.38; 95% CI 1.68 to 3.38), and depression (AOR 2.13; 95% CI 1.46 to 3.10); any female dating violence was associated with black race (AOR 1.68; 95% CI 1.25 to 2.25), public assistance (AOR 1.64; 95% CI 1.28 to 2.09), grades D and below (AOR 1.62; 95% CI 1.07 to 2.43), alcohol misuse (AOR 1.04; 95% CI 1.02 to 1.07), illicit drug use (AOR 2.85; 95% CI 2.22 to 3.66), depression (AOR 1.86; 95% CI 1.42 to 2.44), and any past year ED visit for intentional injury (AOR 2.64; 95% CI 1.30 to 5.40).

Conclusion
Nearly 1 of 6 male and female patients aged 14 to 20 years and seeking ED care report recent dating violence, and health disparities remain among this population. Dating violence was strongly associated with alcohol, illicit drug use, and depression and correlated with previous ED service use among female youths. ED interventions should consider addressing these associated health conditions, as well as improving screening protocols to address dating violence among male and female youths.

The State of Learning Disabilities — Third Edition, 2014

July 3, 2014 Comments off

The State of Learning Disabilities — Third Edition, 2014 (PDF)
Source: National Center for Learning Disabilities

This revised and expanded 2014 edition of The State of Learning Disabilities reflects NCLD’s commitment to ensuring that everyone who is concerned about the well-being of individuals — with or without identified learning disabilities — has access to the most relevant and updated information.

This new report is much more than a collection of facts. It provides an overview of what learning disabilities are, of the impact they have on the lives of children during the school-age years and of the ways that they shape the rocky transition that teens and young adults all too frequently have when moving from school to postsecondary educational settings and the workplace.

This report has been reformatted to tell a story about the realities of LD in society today: where we’ve been, where we are now and where we seem to be heading. It also points to areas of interest and concern where data specific to individuals with learning disabilities are either outdated, limited or missing. These areas encompass such topics as Response to Intervention, charter schools, vouchers, online and blended learning and juvenile justice.

Also worthy of mention in this new report is a section devoted to public perceptions of learning and attention issues. Recent work has yielded results from national surveys and interviews that offer insights into how learning challenges are understood and misunderstood. These data tell a critical story about the realities of having LD in today’s world.

Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012

July 3, 2014 Comments off

Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012
Source: Morbidity and Mortality Weekly Report (CDC)

Background:
Overprescribing of opioid pain relievers (OPR) can result in multiple adverse health outcomes, including fatal overdoses. Interstate variation in rates of prescribing OPR and other prescription drugs prone to abuse, such as benzodiazepines, might indicate areas where prescribing patterns need further evaluation.

Methods:
CDC analyzed a commercial database (IMS Health) to assess the potential for improved prescribing of OPR and other drugs. CDC calculated state rates and measures of variation for OPR, long-acting/extended-release (LA/ER) OPR, high-dose OPR, and benzodiazepines.
Results: In 2012, prescribers wrote 82.5 OPR and 37.6 benzodiazepine prescriptions per 100 persons in the United States. State rates varied 2.7-fold for OPR and 3.7-fold for benzodiazepines. For both OPR and benzodiazepines, rates were higher in the South census region, and three Southern states were two or more standard deviations above the mean. Rates for LA/ER and high-dose OPR were highest in the Northeast. Rates varied 22-fold for one type of OPR, oxymorphone.

Conclusions:
Factors accounting for the regional variation are unknown. Such wide variations are unlikely to be attributable to underlying differences in the health status of the population. High rates indicate the need to identify prescribing practices that might not appropriately balance pain relief and patient safety.

Implications for Public Health:
State policy makers might reduce the harms associated with abuse of prescription drugs by implementing changes that will make the prescribing of these drugs more cautious and more consistent with clinical recommendations.

UN World Drug Report 2014

July 2, 2014 Comments off

World Drug Report 2014
Source: United Nations
From press release (PDF):

Drug use prevalence is stable around the world, according to the 2014 World Drug Report of the United Nations Office on Drugs and Crime (UNODC), with around 243 million individuals, or 5 per cent of the world’s population aged 15- 64 having used an illicit drug in 2012. Problem drug users meanwhile numbered about 27 million, roughly 0.6 per cent of the world’s adult population, or 1 in every 200 people.

Psychology — Gifted Children and Adults—Neglected Areas of Practice

July 2, 2014 Comments off

Gifted Children and Adults—Neglected Areas of Practice
Source: National Register of Health System Psychologists

Working with gifted and talented children and their families and with gifted adults is a neglected area of practice for psychologists. Two widespread myths among educators, pediatricians, and psychologists, is that gifted children and adults are quite rare, and that bright minds have few issues and seldom need special help. In fact, gifted children and adults are defined as those in the upper three to ten percent of the population in any of several intellectual domains (NAGC, 2010). Clinical and educational practice usually focuses on disadvantaged persons and obvious psychopathology. Many are unaware that talented and gifted children are at risk for underachievement, peer relationship issues, power struggles, perfectionism, existential depression, and other problems, and that bright adults often have job difficulties, problems with peers, spouses or children, and existential depression that stem from giftedness. In addition, few psychologists understand that special issues can arise when a child or adult is twice-exceptional—that is, gifted as well as having diagnosable condition such as a learning disability, vision difficulties, auditory issues, ADHD, etc. As a result, many gifted children and adults are being overlooked, misdiagnosed, and receiving treatment that may be inappropriate.

Contribution of Excessive Alcohol Consumption to Deaths and Years of Potential Life Lost in the United States

June 30, 2014 Comments off

Contribution of Excessive Alcohol Consumption to Deaths and Years of Potential Life Lost in the United States
Source: Preventing Chronic Disease (CDC)

Introduction
Excessive alcohol consumption is a leading cause of premature mortality in the United States. The objectives of this study were to update national estimates of alcohol-attributable deaths (AAD) and years of potential life lost (YPLL) in the United States, calculate age-adjusted rates of AAD and YPLL in states, assess the contribution of AAD and YPLL to total deaths and YPLL among working-age adults, and estimate the number of deaths and YPLL among those younger than 21 years.

Methods
We used the Centers for Disease Control and Prevention’s Alcohol-Related Disease Impact application for 2006–2010 to estimate total AAD and YPLL across 54 conditions for the United States, by sex and age. AAD and YPLL rates and the proportion of total deaths that were attributable to excessive alcohol consumption among working-age adults (20-64 y) were calculated for the United States and for individual states.

Results
From 2006 through 2010, an annual average of 87,798 (27.9/100,000 population) AAD and 2.5 million (831.6/100,000) YPLL occurred in the United States. Age-adjusted state AAD rates ranged from 51.2/100,000 in New Mexico to 19.1/100,000 in New Jersey. Among working-age adults, 9.8% of all deaths in the United States during this period were attributable to excessive drinking, and 69% of all AAD involved working-age adults.

Conclusions
Excessive drinking accounted for 1 in 10 deaths among working-age adults in the United States. AAD rates vary across states, but excessive drinking remains a leading cause of premature mortality nationwide. Strategies recommended by the Community Preventive Services Task Force can help reduce excessive drinking and harms related to it.

Tobacco Product Use Among Adults — United States, 2012–2013

June 30, 2014 Comments off

Tobacco Product Use Among Adults — United States, 2012–2013
Source: Morbidity and Mortality Weekly Report (CDC)

Despite significant declines in cigarette smoking among U.S. adults over the past five decades, progress has slowed in recent years, and the prevalence of use of other tobacco products such as cigars and smokeless tobacco has not changed (1,2). Additionally, the prevalence of use of emerging products, including electronic cigarettes (e-cigarettes), has rapidly increased (3). This report provides the most recent national estimates of tobacco use among adults aged ≥18 years, using data from the 2012–2013 National Adult Tobacco Survey (NATS). The findings indicate that 21.3% of U.S. adults used a tobacco product every day or some days, and 25.2% used a tobacco product every day, some days, or rarely. Population-level interventions focused on the diversity of tobacco product use, including tobacco price increases, high-impact antitobacco mass media campaigns, comprehensive smoke-free laws, and enhanced access to help quitting, in conjunction with Food and Drug Administration (FDA) regulation of tobacco products, are critical to reducing tobacco-related diseases and deaths in the United States (4).

School mental health services: signpost for out-of-school service utilization in adolescents with mental disorders? A nationally representative United States cohort

June 25, 2014 Comments off

School mental health services: signpost for out-of-school service utilization in adolescents with mental disorders? A nationally representative United States cohort
Source: PLoS ONE

Background
School mental health services are important contact points for children and adolescents with mental disorders, but their ability to provide comprehensive treatment is limited. The main objective was to estimate in mentally disordered adolescents of a nationally representative United States cohort the role of school mental health services as guide to mental health care in different out-of-school service sectors.

Methods
Analyses are based on weighted data (N = 6483) from the United States National Comorbidity Survey Replication Adolescent Supplement (participants’ age: 13–18 years). Lifetime DSM-IV mental disorders were assessed using the fully structured WHO CIDI interview, complemented by parent report. Adolescents and parents provided information on mental health service use across multiple sectors, based on the Service Assessment for Children and Adolescents.

Results
School mental health service use predicted subsequent out-of-school service utilization for mental disorders i) in the medical specialty sector, in adolescents with affective (hazard ratio (HR) = 3.01, confidence interval (CI) = 1.77–5.12), anxiety (HR = 3.87, CI = 1.97–7.64), behavior (HR = 2.49, CI = 1.62–3.82), substance use (HR = 4.12, CI = 1.87–9.04), and eating (HR = 10.72, CI = 2.31–49.70) disorders, and any mental disorder (HR = 2.97, CI = 1.94–4.54), and ii) in other service sectors, in adolescents with anxiety (HR = 3.15, CI = 2.17–4.56), behavior (HR = 1.99, CI = 1.29–3.06), and substance use (HR = 2.48, CI = 1.57–3.94) disorders, and any mental disorder (HR = 2.33, CI = 1.54–3.53), but iii) not in the mental health specialty sector.

Conclusions
Our findings indicate that in the United States, school mental health services may serve as guide to out-of-school service utilization for mental disorders especially in the medical specialty sector across various mental disorders, thereby highlighting the relevance of school mental health services in the trajectory of mental care. In light of the missing link between school mental health services and mental health specialty services, the promotion of a stronger collaboration between these sectors should be considered regarding the potential to improve and guarantee adequate mental care at early life stages.

New From the GAO

June 25, 2014 Comments off

New From the GAO
Source: Government Accountability Office

Reports

1. Information Security: Additional Oversight Needed to Improve Programs at Small Agencies. GAO-14-344, June 25.
http://www.gao.gov/products/GAO-14-344
Highlights - http://www.gao.gov/assets/670/664420.pdf

2. Aviation Safety: Additional Oversight Planning by FAA Could Enhance Safety Risk Management. GAO-14-516, June 25.
http://www.gao.gov/products/GAO-14-516
Highlights - http://www.gao.gov/assets/670/664401.pdf

3. Traffic Safety: Alcohol Ignition Interlocks Are Effective While Installed; Less Is Known about How to Increase Installation Rates. GAO-14-559, June 20.
http://www.gao.gov/products/GAO-14-559
Highlights - http://www.gao.gov/assets/670/664282.pdf

4. Diplomatic Security: Overseas Facilities May Face Greater Risks Due to Gaps in Security-Related Activities, Standards, and Policies. GAO-14-655, June 25.
http://www.gao.gov/products/GAO-14-655
Highlights - http://www.gao.gov/assets/670/664423.pdf
Podcast - http://www.gao.gov/multimedia/podcasts/664325

Testimonies

1. Export-Import Bank: Status of GAO Recommendations on Risk Management, Exposure Forecasting, and Workload Issues, by Mathew J. Scirè, director, financial markets and community investment, before the House Committee on Financial Services. GAO-14-708T, June 25.
http://www.gao.gov/products/GAO-14-708T
Highlights - http://www.gao.gov/assets/670/664379.pdf

2. Medicare Fraud: Further Actions Needed to Address Fraud, Waste, and Abuse, by Kathleen M. King, director, health care, before the Subcommittee on Oversight and Investigations, House Committee on Energy and Commerce. GAO-14-712T, June 25.
http://www.gao.gov/products/GAO-14-712T
Highlights - http://www.gao.gov/assets/670/664382.pdf

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