Psychiatric Disorders, Chronic Pain Common Among Patients Frequently Admitted To Hospital.

MedPage Today (4/6, Walsh) reports, “Patients with psychiatric disorders and those with chronic pain used a disproportionally high amount of healthcare resources because of frequent hospital readmission, a researcher said” at the Society of Hospital Medicine meeting. “In a chart review of 29 patients who had an index admission during 2011 and six or more readmissions,” researchers found that “55% had psychiatric conditions and 52% had chronic pain.” The investigators reported that “other common diagnoses included pneumonia, chronic obstructive pulmonary disease, end-stage renal disease, and persistent vomiting.”

Related Links:

— “Study IDs Hospital Frequent Flyers,”Nancy Walsh, MedPage Today, April 5, 2012.

Expert Points Out Similarities Between Overeating, Drug Addiction.

The Time (4/6, Szalavitz) “Healthland” blog reports that Nora Volkow, MD, director of the National Institute on Drug Abuse, has argued that there are similarities between overeating and drug addiction, and that examining those similarities could help to better understand all types of compulsive behavior. Although not all health professionals agree that food is an addictive substance in the way that a drug is, some experts, such as Volkow, contend that there are “common dysfunctions in the areas of the brain involved in pleasure and self-control that are seen in both food and drug addictions. These systems rely on the neurotransmitter dopamine; in both drug addictions and obesity, reductions in the number of dopamine D2 receptors are common.”

Related Links:

— “Can Food Really Be Addictive? Yes, Says National Drug Expert,”Maia Szalavitz , TIME Healthland, April 5 , 2012.

Depression, Anxiety Associated With Physical Disabilities In Seniors.

HealthDay (4/6, Preidt) reports, “Seniors with psychological distress such as depression or anxiety are more likely to have physical disabilities,” according to a study published April 5 in the Journal of the American Geriatrics Society. After examining “data from nearly 100,000 Australian men and women, aged 65 and older,” researchers found that, “the risk of physical disability was more than four times higher among those with any level of psychological distress and nearly seven times higher among those with moderate levels.” Notably, those seniors who displayed greater levels of regular physical activity were not as likely to be physically disabled.

Related Links:

— “Depression, Anxiety Tied to Physical Disabilities in Seniors,”Robert Preidt, Healthday, April 5, 2012.

Studies: Intellectual Activities May Slow Mental Decline.

HealthDay (4/5, Dotinga) reports that two studies published online April 4 in the journal Neurology offer “insights into the mysterious phenomenon of rapid cognitive decline in the two or three years before death, and [confirm] that intellectually challenging activities can help keep your mind sharp.” The first study “suggests that while Alzheimer’s disease may nudge the mental decline early on, other causes seem to be at play when the decline speeds up in the years just before death.” HealthDay adds, “Can people do anything to prevent the mind from declining in old age? A second study suggests that’s a possibility — through activities such as reading, playing board games, and doing crossword puzzles.”

An accompanying editorial observed, “The research on declining mental abilities represents an important advance in the science of aging,” MedPage Today (4/5, Smith) reports. The editorial argued that “the controversial issue of de-differentiation’ may hold clues to the biology of aging and is thus ‘an important research topic whose study deepens our understanding of both disease-based and normal biological aging.’

Related Links:

— “Brain Falters Near End of Life, but Games, Puzzles Might Slow Decline,”Randy Dotinga , HealthDay, April 4, 2012.

Risk Of Suicide, CV Death May Increase Immediately After Cancer Diagnosis.

The Los Angeles Times (4/5, Khan) reports that research “involving more than six million Swedes reveals that the risk of suicide and cardiovascular death increases immediately after a cancer diagnosis.”

HealthDay (4/5, Esposito) reports, “Using nationwide census and death registry data that covered more than six million people over a 15-year period ending in 2006, Swedish researchers tabulated the suicides and cardiovascular fatalities among people with new cancer diagnoses and compared them to similar deaths in those without cancer.”

MedPage Today (4/5, Neale) reports, “In the first week after receiving the diagnosis, patients had a greater risk of committing suicide (RR 12.6, 95% CI 8.6 to 17.8) and of dying from a cardiovascular cause (RR 5.6, 95% CI 5.2 to 5.9) compared with cancer-free people.” The researchers found that “the elevated risk extended up to one year and beyond for suicide, and up to about six months for cardiovascular death.” The study was published April 5 in the New England Journal of Medicine.

Related Links:

— “Cancer diagnosis raises risk of heart attack and suicide, study says,”Amina Khan, Los Angeles Times, April 4, 2012.

Psychiatrist: Financial Pressures Causing Retreat From Mission Of Mental Healthcare.

In a video commentary for Medscape (4/5), psychiatrist Jeffrey A. Lieberman, MD, of Columbia University, asserts, “What we are seeing in the context of this great recession that we are experiencing, the deficits that are occurring at the state level, and the changes in healthcare delivery that financial pressures are occasioning is a retreat from the mission of mental healthcare.” He adds, “This creates a vicious cycle where the state cuts back, putting more pressure on the nonpublic healthcare” clinicians who are “also under financial pressure. They are also looking for ways to reduce their financial vulnerability, and so they cut services. All of this leaves psychiatry and patients who need psychiatric services in the lurch and out in the cold.”

VA Facing Psychiatrist Shortfall.

USA Today (4/5, Zoroya) reports, “As thousands of additional veterans seek mental health care every month, the Department of Veterans Affairs is short of psychiatrists, with 20% vacancy rates in much of the country served by VA hospitals, according to department data.” What’s more, “the vacancies occur at a time when the number of veterans with post-traumatic stress disorder is increasing by about 10,000 every three months, what experts say is the cumulative effect of a decade of war, VA data show.” According to internal data, “the VA has about a 20% shortfall in psychiatrists at hospitals throughout the Northwest, Deep South, and Southern California,” particularly in rural areas with smaller populations.

Sen. Murray Raises Question Whether Cost Factors Into PTSD Diagnosis Decision. In continuing coverage, the AP (4/5) reports that US Sen. Patty Murray (D-WA) “is questioning military and Veterans’ Affairs officials over concerns that cost has been a factor in reversing diagnoses of soldiers found to suffer” from post-traumatic stress disorder (PTSD). Murray’s “questioning came Wednesday at a Tacoma field hearing of the Senate Veterans’ Affairs Committee, which she chairs.” While the AP did not mention what VA officials had to say in response to the questioning, it did report that “military officials pointed out that it is not US policy to deny soldiers and veterans necessary medical care or benefits for financial reasons.” However, some soldiers who have PTSD challenged that claim at Wednesday’s hearing.

Related Links:

— “VA sees shortfall of mental health specialists,”Gregg Zoroya, USA Today, April 5, 2012.

Medicare Coverage For Depression Screening Said To Encourage Landscape Change.

The Washington Post (4/3, Andrews) reports that “depression often goes undiagnosed in the elderly, who feel the stigma of mental illness more acutely than younger people and are often less likely to seek help,” but “the situation may be changing,” because “in October, Medicare began to cover annual depression screening in primary-care settings with no cost sharing for beneficiaries.” The piece notes that “the landscape should change as policymakers and insurers increasingly offer incentives to primary care physicians to transform their practices into medical homes for their patients and reward [clinicians] for better disease control rather than simply running tests and doing procedures.”

Related Links:

— “Depression often goes undiagnosed, but new Medicare benefit may change that,”Michelle Andrews, The Washington Post, April 2, 2012.

Special Structured Therapy Program May Help Traumatized Children.

The New York Times (4/3, Brody) “Well” blog points out that according to a “report being released Tuesday by Safe Horizon, a victim assistance group that operates child advocacy centers in New York City, and the Childhood Violent Trauma Center at Yale University, children who are abused or neglected are 59 percent more likely than those who were not victimized to be arrested as juveniles, 28 percent more likely to be arrested as adults, and 30 percent more likely to commit a violent crime.” What’s more, these youngsters “face much higher rates of teenage pregnancy and are likelier to abuse or neglect their own children,” the report concludes. However, a special program involving “just four to six structured sessions with trained clinicians” involving both the traumatized children and their caregivers may help ameliorate the children’s symptoms.

Related Links:

— “A Brief Therapy Heals Trauma in Children,”Jane E. Brody, The New York Times, April 2, 2012.

Disordered Sleep Breathing Associated With Depression.

In “Vital Signs,” the New York Times (4/3, D6, Bakalar, Subscription Publication) reports, “Snorting and stopping breathing during sleep are associated with depression, even in people whose symptoms do not meet the criteria for a diagnosis of obstructive sleep apnea,” according to a study published in the April issue of the journal Sleep. After studying “9,714 men and women participating in an ongoing national health survey by the Centers for Disease Control and Prevention,” researchers found that “among those with a diagnosis of obstructive sleep apnea, depression was more than twice as common among men and more than five times as common among women, compared with those who did not have the condition.”

Related Links:

— “Hazards: Mild Sleep Disorders Tied to Depression,”Nicholas Bakalar, The New York Times, April 2, 2012.