Often the headlines are more telling than the actual stories. Some of the headlines seem to blindly accept misleading conclusions of the type about which I blog frequently – although the publications do use the word “may” a lot so as not to imply that any conclusion is actually proven. Other stories clearly contradict these same very conclusions.
10/2/12. Study: Screening For BD May Reveal Undiagnosed Anxiety Disorder. MedWire (10/2, Grasmo) reports, "Patients who receive a false-positive diagnosis during screening tests for bipolar disorder [BD] are likely to have an undiagnosed anxiety disorder," according to a study published in Dec. 1 issue of the Journal of Affective Disorders. For the study, "1534 patients attending the Black Dog Institute Depression Clinic completed the Mood Swings Questionnaire (MSQ)-46 and 852 also completed the Mood Disorders Questionnaire (MDQ)." Notably, "46% of MSQ-assigned false positives and 63% of MDQ-assigned false positives in the unipolar non-melancholic group had comorbid anxiety conditions."
2/15/2013. Mania Symptoms Appear Similar For Kids, Teens. Medwire (2/15, Piper) reports, "The nature of mania symptoms appears to be similar in young people with bipolar disorder, irrespective of whether they occur in childhood or adolescence," according to a study published in the March issue of the Journal of Affective Disorders. The study authors did find, however, that "the only exception was the emergence of psychotic symptoms, including hallucinations and delusions, in adolescents with adolescent-onset of symptoms, but not in children with child-onset symptoms." The study also found that "mania symptomatology that was similar across 163 children with child-onset of symptoms (before 12 years of age), 94 adolescents with child-onset of symptoms, and 90 adolescents with adolescent-onset of symptoms (after 12 years of age) was characterized by 'activated/pleasure seeking' and 'labile and disorganized' behaviors."
The findings highlighted in red are indeed disturbing. If your psychiatrist fails to do some or all of them, please run away as fast as you can, and find another psychiatrist immediately.
Cuts in Mental Health Services
It’s amazing how some people keep wondering why there are so many more mentally ill people homeless on the street, and/or why they are crowding our jails.
12/27/12. Report: $4.35B Cut From State Mental Health Services Since 2009. The Huffington Post (12/27, Horowitz) reports, "In the past three years, $4.35 billion for services has been cut from state budgets across the country, according to a report by the National Association of State Mental Health Program Directors Research Institute." At the same time that "states are slashing funding for treatment, private care is getting harder to obtain. Mental health advocates say that the number of [practitioners] nationwide has decreased in recent years."
1/23/13. More Psychiatric Patients Forced To Wait In EDs Due To Cutbacks In Inpatient Beds. The Washington Post (1/23, Khazan) reports on an "increasingly common" problem for psychiatric patients nationwide, where mental health patients are "boarded" in hospital emergency departments "in part because of cutbacks in inpatient hospital beds." The Post explains, "As states trimmed their budgets in the economic downturn, resources for mental health patients were among the casualties." The piece notes, "For many patients suffering from psychiatric crises, this translates to longer waits in emergency departments, where they receive no treatment for days - and sometimes weeks - while social workers try to chase down open spots in psychiatric wards, doctors said."
Here’s a bunch of evidence for the "safety" of amphetamine use - if they are legal, that is. If they are illegal, they are very dangerous. Interesting, since they all do exactly the same thing.
1/10/12. Psychotic Symptoms More Likely Among Meth Addicts. MedPage Today (1/10, Phend) reports, "Methamphetamine use makes hallucinations and other psychotic symptoms substantially more likely among addicts, particularly for those abusing other substances," according to a 278-patient study published online Jan. 9 in JAMA Psychiatry. "The odds of psychotic symptoms were 5.3-fold higher during periods of meth use (P<0.001)," researchers reported. "That risk was dose-dependent and further doubled by frequent marijuana or alcohol use," the study found.
2/4/13. Addictive Potential Of AD/HD Medicines Examined. On its front page, the New York Times (2/3, A1, Schwarz, Subscription Publication) reported that medications like Adderall (amphetamine, dextroamphetamine mixed salts) "can markedly improve the lives of children and others with" attention-deficit/hyperactivity "disorder [AD/HD]. But the tunnel-like focus the medicines provide has led growing numbers of teenagers and young adults to fake symptoms to obtain steady prescriptions for highly addictive medications that carry serious psychological dangers." Some doctors "skip established diagnostic procedures, renew prescriptions reflexively and spend too little time with patients to accurately monitor side effects." While "very few people who misuse stimulants devolve into psychotic or suicidal addicts...AD/HD practices can fail patients, particularly young adults."
1/10/13. Among Meth Addicts, MedPage Today (1/10, Phend) reports, "Methamphetamine use makes hallucinations and other psychotic symptoms substantially more likely among addicts, particularly for those abusing other substances," according to a 278-patient study published online Jan. 9 in JAMA Psychiatry. "The odds of psychotic symptoms were 5.3-fold higher during periods of meth use (P<0.001)," researchers reported. "That risk was dose-dependent and further doubled by frequent marijuana or alcohol use," the study found.
1/28/13. Report: AD/HD Medication-Related Emergency Room Visits Up Sharply. The Los Angeles Times (1/25, Healy) reported in its "Booster Shots" health blog that a study found that between 2005 and 2010, "ADHD medication-related emergency room visits have more than doubled - from 13,379 in 2005 to 31,244 in 2010," with the increase being "particularly pronounced in those over 18." The data was "reported Thursday in an issue of the DAWN (Drug Abuse Warning Network) Report, published by the Substance Abuse and Mental Health Services Administration, an office of the National Institutes of Health." About half of the "stimulant-related emergency department visits --15,585 in 2010 - were for 'non-medical' use of ADHD medication: They were to treat stimulant-related effects in patients who either had not been diagnosed with ADHD and prescribed the drugs or in patients who were not taking the medication as prescribed." HealthDay (1/26, Preidt) adds SAMHSA administrator Pamela Hyde said in an agency news release, "ADHD medications, when properly prescribed and used, can be of enormous benefit to those suffering from ADHD, but like any other medication they can pose serious risks - particularly when they are misused." Cases for adults "rose from about 2,100 to 8,100 among those aged 18 to 25, from about 1,750 to 6,100 among those aged 26 to 34 and from roughly 2,500 to nearly 8,000 among those over 35, during the time period." The study found that the gap between males and females in the number of ER visits related to nonmedical use of ADHD drugs was narrowing. "In 2005, the numbers were about 3,800 for males and about 1,400 for females. In 2011, numbers reached 8,650 for males and about 6,900 for females." Medscape (1/26, Brauser) also covered the story.
2/8/13. Maternal Depression, Domestic Violence May Raise Kids' Risk For AD/HD. HealthDay (2/8, Mann) reports, "Preschoolers whose parents report depression and intimate partner violence may be more likely to develop attention-deficit/hyperactivity disorder (AD/HD) by the age of six." Furthermore, "young children with depressed moms may be more likely to receive prescription drugs to treat behavioral and mental health issues down the road," according to a study published online Feb. 4 in the journal JAMA Pediatrics. The study "included more than 2,400 children who were three years old" and their parents who answered questionnaires regarding domestic violence and personal depression history.
2/12/13. Violent Video Game Proliferation Has Not Coincided With Spikes In Youth Violent Crime. On the front of its Science Times section, the New York Times (2/12, D1, Carey, Subscription Publication) reports, "In surveys about 80 percent of high school-age boys say they play video games, most of which are thought to be violent, and perhaps a third to a half of those players have had a habit of 10 hours a week or more." The Times notes, however, that "the proliferation of violent video games has not coincided with spikes in youth violent crime." In fact, "the number of violent youth offenders fell by more than half between 1994 and 2010, to 224 per 100,000 population, according to government statistics, while video game sales have more than doubled since 1996." The article describes contradictory research into how media violence and video games may affect behavior.
1/31/12. Non-Drug Treatments May Not Reduce Key Symptoms Of AD/HD. MedPage Today (1/31, Bankhead) reports that "nondrug treatments for attention deficit/hyperactivity disorder have limited evidence of efficacy and their use for core symptoms is not supported, a European guideline committee concluded." While "uncontrolled clinical evaluations produced positive results for a variety of dietary and psychological interventions," these "significant benefits disappeared in 'probably blinded' assessments, except for free fatty acid (FFA) supplementation and avoidance of artificial food color, according to" an article from the European ADHD Guideline Group published online January 30 in the American Journal of Psychiatry. MedPage Today adds, "Meta-analyses and systematic reviews have supported the efficacy of nonpharmacologic interventions in ADHD, but inclusion of nonrandomized trials and non-ADHD patients and outcome measures has complicated attempts to evaluate the interventions' effects on ADHD core symptoms, the committee members wrote." HealthDay (1/31, Gray) reports that the "multinational team of experts" involved in the study "identified no positive effects from psychological treatments including mind exercises (cognitive training), neurofeedback and behavioral training (positive reinforcement). And the researchers discovered only small benefits associated with dietary treatments: supplementation with omega-3 and omega-6 free fatty acids, and elimination of artificial food coloring." HealthDay notes that "according to the American Psychiatric Association, between 3 percent and 7 percent of U.S. children have" ADHD. Medscape (1/31, Cassels) also covers the story.
Notice how exactly no non-drug treatments that involve intervention with dysfunctional families, or even talk therapies, were included in this study. The psychological treatments they do mention are of course totally inadequate and off the mark, yet the authors broadly conclude that no non-drug treatments are likely to be effective.
This is what we refer to in logic circles as a Straw Man Argument. It is probably also true that if the authors did a similar studies on drug therapy, and the drug used was penicillin, that "drugs" would be shown to be ineffective as well.
And finally, of course as we all know there is no evidence of a push by big Pharma to increase the number of ADHD diagnoses dramatically.
9/10/12. Can a new eye test detect schizophrenia? A mathematical model that assesses eye movements known to be abnormal in individuals with schizophrenia appears to discriminate schizophrenia cases from controls with near-perfect accuracy. The lead scientist was philip benson, ph.d., of the university of aberdeen in scotland, and study findings were published in biological psychiatry. "this is a very interesting study," l. Elliot hong, m.d., a professor of psychiatry at the university of maryland and a schizophrenia expert, commented to psychiatric news. "[however] the important next steps are [determining] whether these measures are specific only to schizophrenia or whether they can also separate different psychiatric diagnoses...." benson agreed. "we already know that the model can distinguish cases diagnosed with bipolar disorder [from those diagnosed with schizophrenia] with around 95 percent accuracy. We have preliminary data suggesting that major depressive disorder can also be distinguished [from schizophrenia], which is a tremendously exciting finding."