May 24, 2005
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Disorder: A Cycle of Highs and Lows Part Two
Bipolar disorder harder on youngsters
suicide ‘out of the darkness'
Depression is Widespread Among Heart Attack Patients
Managing maternal depression during pregnancy presents
significant challenge to clinicians
*DID YOU KNOW?
CMS Wants to Develop Database of Medicare Prescriptions
Centers for Medicare & Medicaid Services Administrator Mark McClellan wants to partner with pharmaceutical benefit management companies to create a database that contains all Medicare beneficiaries’ prescription histories. Timed to launch with the new Medicare drug benefit in January, the purpose of the database would be to allow health providers access to a centralized clearinghouse of patient drug histories. Questions of who would have access to the database and other privacy issues still need to be worked out. (WSJ.com, 5/20/05)
Psychiatrists Approve Statement in Support of Gay Marriage
The American Psychiatric Association approved a statement Sunday at its annual conference in Atlanta in support of gay marriage, noting that it is in the “interest of maintaining and supporting mental health.” Marriage promotes a “positive influence of a stable, adult partnership on the health of all family members,” according to the resolution. If approved by the association’s board in July, this organization will become the first major medical association to take such a stance. (The New York Times, 5/23/05)
Governors’ Official Decries Funding Arrangement for Dually-Eligible Older Adults
The federal government should take over all the costs of providing healthcare to older adults who are eligible for both the Medicare and Medicaid programs, according to National Governors’ Association Executive Director Ray Scheppach. Older adults should be the responsibility of the federal government while those younger than 65 should be the responsibility of state governments, said Scheppach, who spoke at the annual Princeton Conference in New Jersey. Although the federal government will assume the prescription drug costs of dually-eligible older adults in January 2006, Scheppach noted that states will have to return much of their savings to the federal government to, in effect, reimburse the federal government for these costs. (Reuters Health, 5/23/05)
Medical Device May Help Physicians Determine Whether Antidepressants Are Working
Boston Scientific will provide Aspect Medical Systems with funding to further develop a device that can give physicians an indication of whether antidepressant drugs that they prescribe are working for their patients. Because antidepressants affect people differently, a drug that might be effective in one person may not help someone else. The device is a type of electroencephalogram, which measures brain waves. If a drug is working in a patient, that person’s brain waves will change. If it isn’t working, the waves will remain the same and the physician can prescribe a different drug. (The Wall Street Journal, 5/23/05)
Senate Committee Investigates FDA Tentative Approval of Vagus Nerve Stimulator
The Senate Finance Committee is examining the FDA’s handling of an application from Cyberonics to market the company’s implantable vagus nerve stimulator as a treatment for depression. In a letter to the company, the committee wrote that it’s examining why earlier this year the FDA reversed it’s recent rejection of the company’s application despite “strong objections from FDA scientists” regarding the device’s safety and efficacy. The committee also wrote that it “alleges no wrong-doing on Cyberonics’ part,” and the company said it plans to cooperate. (The Wall Street Journal, 5/19/05)
Little Evidence Seen to Support Vagus Nerve Stimulator Effectiveness, Though Some Are Helped
The FDA may soon give final approval to Cyberonic’s vagus nerve stimulator as a treatment for depression despite little evidence that the device is effective, say experts. In the only “rigorously” controlled study of the device in people who have depression, the device was no more effective in treating the disorder than was the surgery through which the device was implanted. Proponents of the device say, however, that the device is intended for people whose depression is not responsive to other therapies and are desperate for any help, which the device does provide, at least to some people. (The New York Times, 5/21/05
Newspaper Editor Writes of Novelist’s Views on Art and Mental Illness
In a tribute to his mentor, novelist Frank Conroy, who died of cancer last month, an editor wrote about Conroy’s writings on his family’s struggle with mental illness, including his first novel, “Stop-Time.” At an early 1990s meeting in Iowa for the Alliance for the Mentally Ill, whose members were concerned that society often “romanticizes” mental disorders, especially with regard to artists, the editor quoted Conroy as saying that “[t]he artist creates despite these conditions, not because of them.” The editor wrote, “Yes, the gifted mind is often plagued with doubts, insecurities and emotional frailties. But chronic depression, mania and schizophrenia are another thing altogether. Imagine the poetry [Sylvia] Plath would have produced if she had lived as long as [Walt] Whitman.” (The Wall Street Journal, 5/18/05)
Maryland: Gov. Robert Ehrlich vetoed a bill last week that would have required any corporation operating in the state with more than 10,000 employees – a qualification that only Wal-Mart would meet – to spend at least 8 percent of its payroll in the state on employee health benefits or pay the state’s Medicaid program the equivalent in cash. The governor said that the bill is a “bad piece of public policy.” Because employees of many large corporations don’t have access to health benefits, according to bill proponents, many of the employees have to rely on Medicaid for health coverage. (Dow Jones Newswires, 5/19)
Oregon: The state’s House of Representatives held a hearing last week on mental health parity legislation, which would require private health insurers to provide the same coverage for mental health as they do for physical health. Testifying at the hearing were dozens of supporters of the bill, which has already passed the state Senate, a first for parity legislation. The National Federation of Independent Businesses and other business groups oppose the bill, claiming that the legislation would make insurance so expensive that thousands of Oregonians will lose all their health coverage. Legislation proponents, including the Oregon Business Association, dispute this assertion, saying that cost increases will be negligible and that businesses will benefit through increased worker productivity. (The Oregonian, 5/22/05)
Researchers Link Autism With Difficult Birth, Parental Psychosis: Having a difficult birth or a parent with a history of psychosis may place an infant at greater risk for the development of autism, a new Centers for Disease Control and Prevention study indicates. The study was published in the American Journal of Epidemiology. About one out of every 250 Americans are born with autism, which usually develops within the first three years of life, according to the Autism Society of America. (Dow Jones Newswires, 5/17/05)
Intensity, Not Frequency, of Exercise Helps Depression: To help relieve symptoms of depression through exercise, a person doesn’t need to exercise each day, a health columnist wrote in response to a letter. The intensity of exercise in a given week is more important than the frequency. Optimal depression-relieving benefits can be achieved through exercise that burns 17.5 calories per kilogram of body weight during the course of a week. The letter was in response to a previous column that described a recent study demonstrating that exercise may be an effective help in relieving symptoms of depression. (The Wall Street Journal, 5/17/05)
Expectant Mothers’ Late-Pregnancy Antidepressant Use May Cause Temporary, Sometimes Serious, Conditions in Infants: Babies who are born to women who took antidepressant medications late in their pregnancy are more likely to have short-term jitteriness, irritability and, though rare, serious respiratory problems, a study published in the Journal of the American Medical Association indicates. The study’s lead researcher noted that “this isn’t a cause for alarm” and that women should talk to their physicians about the possible effects. The researchers also noted that while little research has been done on the long-term effects of these drugs on infants, one study showed that these children were developmentally normal at eight months. (The Associated Press/Dow Jones Newswires, 5/18/05)
Childhood Obesity Risk Factors Include Television Watching and Lack of Sleep: Three-year-olds who spend more than eight hours each week watching television or get less than 10.5 hours of sleep each night are at a greater risk of becoming obese later in life, Scottish researchers reported in the British Medical Journal. Television viewership and the amount of time sleeping are two of eight risk factors the researchers identified for later weight problems. The others include high birth weight; early size; rapid weight gain; quick growth in years one and two; early body fat; and having obese parents. (Reuters Health, 5/20/05)
Chief of Gulfport, Miss., mental health center offers non-frilly advice.
The Sun Herald (Biloxi, Mississippi) (via Knight-Ridder/Tribune Business News); 5/19/2005
Byline: Jean Prescott
May 19--Jeff Bennett subscribes to the old-fangled notion that what you don't know won't hurt you, at least where your mental health is concerned, and mental health is his business.
He's director of the Gulf Coast Mental Health Center in Gulfport, and he offers some sound, non-frilly advice about minding our mental health during national Mental Health Month -- this month, May -- with the theme, not coincidentally, of "MIND Your Health."
"We have too much information," he says, getting back to the overload topic. "We have security concerns, security codes. Every morning one of the news shows has a story about some new health disorder. If you eat, drink or smoke this, you'll die."
He isn't suggesting we bury our heads in the sand, but he makes a good case for setting aside anything we can't control.
"I try to tell people, 'Let's get things in perspective here.' As human beings, we tend to turn everything into a catastrophe," Bennett said. Some things are, indeed, catastrophic, but not everything, and while circumstances may not be good, they're rarely catastrophic. Human beings tend to let such things spin out of control.
"Karl Menninger (with his brother William, at the forefront of modern psychiatry) said the first thing you need to do is talk to your friends. Not a doctor, but your friends." That well may be all you need to do.
Adds Bennett, "Each of us has to develop our own expectations based on our own capacity.
"Sometimes we want to do things because other people expect it of us," a quiet person, for example, letting an acquaintance convince him or her that he must be more gregarious. The behavior doesn't fit, and the capacity is exceeded.
"Once you say you should do something and don't, you think that makes you a terrible person," Bennett says. "Learn to be a little gentler with yourself.
"I don't beat people over the head with their shortcomings. Instead, I try to look for the positive in everybody -- help them accurately assess a situation."
According to Bennett, the No. 1 mental health concern he sees is clinical depression, which includes bipolar disorder, what used to be called manic-depression, "but I guess the word 'manic' looked or sounded too much like maniac, so they changed the term," he says.
Signs of clinical depression follow, and if you experience five or more of these symptoms for two weeks or longer, you could be clinically depressed and should see a doctor or other qualified mental health professional for help right away:
--Persistent sad, anxious or "empty" mood
--Change in sleep patterns (sleeping less or more than usual)
--Reduced appetite and weight loss or increased appetite and weight gain
--Loss of pleasure and interest in once-enjoyable activities, including sex
--Persistent physical symptoms that do not respond to treatment, such as chronic pain or digestive disorders
--Difficulty concentrating at work or at school, or difficulty remembering things or making decisions
--Fatigue or loss of energy
--Feeling guilty, hopeless or worthless
--Thoughts of suicide or death
"The sad thing is that people think they are somehow deficient (when any of these feelings occur), and they don't reveal it to anyone. They get into a hole, and a lot of bad things can come of that. Suicide is one."
Bennett says the Department of Mental Health estimates that at some time in their lives, one in four people will have a problem that should be addressed by some kind of intervention, problems that run the gamut from simple life-stress situations to conditions that call for confinement.
To learn more about mental health, call the Coast center, 863-1132, or the National Mental Health Association toll-free line, 1-800-969-6642, or go to www.nmha.org.
Copyright (c) 2005, The Sun Herald, Biloxi, Miss.
Research and Markets: Pfizer and Eli Lilly Have Both Implemented Large Compliance Programs in Psychiatry, Which Have Been Well Received By Medical Community.
PR Newswire; 5/19/2005
DUBLIN, Ireland, May 19 /PRNewswire/ -- Research and Markets (http://www.researchandmarkets.com/reports/c17775 ) has announced the addition of Stakeholder Insight: Patient Compliance in Psychiatry - From Patient Acquisition to Patient Retention to their offering.
Generic saturation coupled with a poor R&D pipeline is forcing pharmaceutical companies to seek alternative ways of maintaining revenue growth in the ever-competitive psychiatry sector. Surprisingly, despite being long recognized as a costly problem, interest in patient compliance is only just gaining momentum and effective patient compliance programs have yet to become standard practice. Players in the schizophrenia, bipolar disorder, and depression markets lose millions of dollars in drug sales annually due to noncompliance. Capturing this lost revenue is becoming ever important as the return on investment of traditional lifecycle management strategies is dwindling.
Pfizer and Eli Lilly have both implemented large compliance programs in psychiatry, which have been well received by the medical community. The popularity of these programs can be attributed to a patient-focused design, which, among other benefits, has served the companies profile among end-users.
Ultimately, education to patients is a free service provided by companies. If shown to improve treatment outcomes in controlled studies, companies would be in a stronger position to convince payers and regulatory bodies to advocate their brands over generics.
This report provides analysis of the prevalence of noncompliance in schizophrenia, bipolar disorder and depression with an overview of compliance improving strategies. For these three disorders, a discussion of general and side-effect specific reasons for noncompliance is provided. This report provides insight into the actions taken by care managers of noncompliant patients, and also includes an in-depth analysis of the perceived usefulness of approaches to tackle noncompliance and the influence of education sources.
For more information visit http://www.researchandmarkets.com/reports/c17775
CONTACT: Laura Wood, Senior Manager of Research and Markets, firstname.lastname@example.org , or fax, +353-1-4100-980
Web site: http://www.researchandmarkets.com/reports/c17775
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