The Los Angeles Times (4/8, Murphy) reported that “in a small but growing number of cases across the nation, lawyers are blaming the US military’s heavy use of psychotropic drugs for their clients’ aberrant behavior and related health problems.” According to the Times, “more than 110,000 active-duty Army troops last year were taking prescribed antidepressants, narcotics, sedatives, antipsychotics and anti-anxiety drugs. … Nearly 8% of the active-duty Army is now on sedatives and more than 6% is on antidepressants — an eightfold increase since 2005.”

VA Part Of Effort To Reduce Painkiller Usage. On its front page, the New York Times (4/9, A1, Meier, Subscription Publication) reports, “Data suggests that hundreds of thousands of patients nationwide may be on potentially dangerous dosages” of powerful painkillers like oxycodone. The “Departments of Defense and Veterans Affairs are trying new programs to reduce use among active-duty troops and veterans. Various states are experimenting with restrictions.”

Related Links:

— “A fog of drugs and war,”Kim Murphy, Los Angeles Times, April 7, 2012.

In a special analysis piece, the New York Times (4/9, SR3, Harmon, Subscription Publication) reports, “The report by the Centers for Disease Control and Prevention that one in 88 American children have an autism spectrum disorder has stoked a debate about why the condition’s prevalence continues to rise,” conceding that the increase could possibly be attributed to better methods of detection or perhaps to some unknown factor in the environment. However, last month’s report also “appears to be serving as a lightning rod for those who question the legitimacy of a diagnosis whose estimated prevalence has nearly doubled since 2007.” Meanwhile, an American Psychiatric Association workgroup “in charge of autism criteria for the new version of the Diagnostic and Statistical Manual of Mental Disorders has proposed changes that would exclude some who currently qualify, reducing the combination of behavioral traits through which the diagnosis can be reached from a mind-boggling 2,027 to 11, according to one estimate.”

Related Links:

— “The Autism Wars,”Amy Harmon, The New York Times, April 7, 2012.

The Boston Globe (4/7, Lazar) reported, “Violence is uncommon among people suffering from dementia, and acts of extreme violence are rarer still,” according to experts “stunned by allegations that a Shrewsbury [MA] man stricken with the condition had brutally slain his wife.” The piece pointed out, however, that “statistics on the frequency of violence by dementia patients are hard to find. One small 1992 study by University of Illinois researchers found that roughly 16 percent of Alzheimer’s patients had been violent toward a family member who cared for them in the year since their diagnosis. The violence was defined as hitting, kicking, biting, punching, or threats with a weapon.”

Studies Underscore Stress Of Caregiving For Patients With Dementia. In a lengthy article, the Knoxville (TN) News Sentinel (4/8, Nelson) reported, “More than 400,000 Tennesseans are caregivers for patients with Alzheimer’s or another type of dementia.” The caregiving comes with a steep cost. “Study after study highlights the stress of caregiving for someone with Alzheimer’s. In one report, more than 60 percent of dementia caregivers rate the emotional stress of caregiving as ‘high’ or ‘very high.’ A third of caregivers said they had experienced symptoms of depression.” One study, conducted by the University of Pittsburgh on behalf of the National Caregivers Alliance, found an association between a person’s Alzheimer’s progression with a decline in health of the caregiver.

Related Links:

— “Extreme violence by dementia patients is rare,”Kay Lazar, Boston.com, April 7, 2012.

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.

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.

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.

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.

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.

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.”

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.