Medscape (5/6, Brooks) reported, “Determining when it is time for a patient to stop driving and hand over the keys is a growing issue for psychiatrists.” A poster presentation “at the American Psychiatric Association’s 2012 Annual Meeting highlights the fact that psychiatrists are ‘increasingly’ faced with patients whose driving ability may be impaired by excessive daytime sleepiness due to primary sleep disorders or to sleep disturbance associated with medical and psychiatric illness, such as dementia, epilepsy, or substance abuse.” What’s more, “patients with dementia are three to five times more likely to be involved in a motor vehicle accident than age-matched control individuals, and epilepsy is one of the most frequently implicated medical causes for motor vehicle accidents.”

Related Links:

— “Patients’ Fitness to Drive a Growing Issue for Psychiatrists,”Megan Brooks, Medscape Today, May 5, 2012.

HealthDay (5/5, Preidt) reported, “Patients with mental health emergencies wait an average of 11.5 hours — nearly half a day — in hospital emergency departments, and those who are older, uninsured or intoxicated wait even longer,” according to a study published online in the Annals of Emergency Medicine. Investigators found that “overall, patients with psychiatric emergencies wait about 42 percent longer in the emergency department than other patients.”

MedPage Today (5/6, Bankhead) reported, “Several recent studies have shown that patients who go to emergency departments for psychiatric care have substantially longer waits compared with patients seeking other types of care.” For instance, “In a survey by the American College of Emergency Physicians, 40% of emergency department medical directors said psychiatric patients waited more than eight hours from disposition decision to discharge from the ED. In contrast, 7% of the directors said medical patients had to wait that long.”

Related Links:

— “Psychiatric Patients Often Wait Nearly 12 Hours in ER,”Robert Preidt, HealthDay, May 2, 2012.

USA Today (5/5, Stoller) reported that suicides committed by Americans in foreign countries are “the fourth-leading cause of death abroad from non-natural causes after road accidents, homicides and drowning, according to the Centers for Disease Control and Prevention.” A USA Today “analysis of State Department statistics — which show only the date and city where a suicide occurred — found that a suicide abroad is reported an average of every 2½ to three days.” But, “in reality, American suicides abroad are probably much more frequent. The State Department says many American deaths abroad — regardless of cause — are not reported to it.” The most number of American suicides occur in Mexico.

Related Links:

— “Suicide: The fourth-leading cause of American deaths abroad,” Gary Stoller, USA Today, May 5, 2012.

In his opinion column in the Detroit Free Press (5/6), Jeff Garrett wrote that in Michigan as well as across the rest of the US, “with the closing of most state psychiatric hospitals and cuts in community mental health programs, jails will continue to hold thousands of mentally ill prisoners. Easing the problem will require sheriffs to work closely with local Community Mental Health authorities, assess mentally ill prisoners immediately, maintain medications, and divert more nonviolent offenders from costly jail time to treatment.” Garrett urged “federal and state lawmakers” to “enact legislation requiring insurance and Medicaid benefits to continue in jail.”

Related Links:

— “Jeff Gerritt: When jails must be mental clinics,”Jeff Garrett, Detroit Free Press, May 6, 2012.

The Washington Post (5/6, Jaffe) reported that debate is under way about whether to change the name of post-traumatic stress disorder (PTSD) to “post-traumatic stress injury” to “reduce the stigma that stops troops from seeking treatment.” The debate moves to a public hearing Monday in Philadelphia by a psychiatric working group and also “is coming to a head because the American Psychiatric Association is updating its bible of mental illnesses, the Diagnostic and Statistical Manual of Mental Disorders, for the first time since 2000.” The request comes from the US Army and “has raised new questions over the causes of PTSD, the best way to treat the condition,” insurance coverage, and federal disability designations.

Army Surgeon General’s Office Has New Policy Discounting Use Of Psychological Tests For PTSD. The Fayetteville (NC) Observer (5/5, Barnes) reported that Army’s Office of the Surgeon General has a new policy that “discounts the use of psychological tests” in diagnosing PTSD among service members. The Army surgeon general’s policy also addresses a complaint by Fort Bragg soldiers that “they are being overmedicated for their PTSD symptoms” and “encourages the use of intensive counseling and other alternatives, including yoga, acupuncture and massage therapies.”

Psychiatrist Praises APA Meeting’s Focus On Military Matters. In the Time (5/5) “Battleland” blog, psychiatrist Elspeth Cameron Ritchie, MD, MPH, wrote that the APA’s meeting this week in Philadelphia is “exciting because of the prominence military matters are going to get.” She pointed out, “As you might expect, there will be a lot of focus on diagnosing and treating PTSD. But there are also sessions on what it is like to work as a civilian at a military base, personal reflections of psychiatrists who have worked in war zones, research on the long-term effects of combat exposure from the experts at the Rand Corp., and a symposium on complementary and alternative treatments.” In addition, “The APA is also heavily involved in the White House Joining Forces initiative and the Give an Hour program (links). Their efforts make me proud to be a member.”

Related Links:

— “New name for PTSD could mean less stigma,”Greg Jaffe, The Washington Post, May 5, 2012.

In a letter to the editor of the Washington Post (5/4), John Oldham, MD, president of the American Psychiatric Association, writes in regard to the “April 29 Outlook article titled ‘When a diagnosis does more harm than good.'” Dr. Oldham observes, “Paula J. Caplan contended that many people are ‘arbitrarily slapped with a psychiatric label,’ which can ‘cost anyone their health insurance, job, custody,’ etc. I find this argument troubling, since overwhelming evidence demonstrates that stigma and misinformation about psychiatric illness prevent people from getting appropriate treatment.” Dr. Oldham points out, “Brain disorders are just as real as disorders of other organs in the body. The process of diagnosis is not an exact science, but a scientifically informed one, and scientific understanding of brain disorders is advancing rapidly.”

Related Links:

— “A psychiatric ‘label’ can save a life,”Edward Gogek, The Washington Post, May 3, 2012.

The Washington Post (5/4, Vogel) reports, “Seeking new ways to treat post-traumatic stress, the Department of Veterans Affairs is studying the use of transcendental meditation to help” veterans. The department “has a ‘huge investment’ in mental-health care but is seeking alternatives to conventional psychiatric treatment, said” VA Deputy Secretary W. Scott Gould, who spoke at a “summit Thursday in Washington on the use of TM to treat post-traumatic stress suffered by veterans and active-duty service members.” According to the Post, VA’s “$5.9 billion system for mental-health care is under sharp criticism, particularly after” the recent release of an inspector general’s report on how long it takes vets to get such care from VA.

In its “Federal Eye” blog, the Washington Post (5/4, Vogel) notes that VA is “spending about $5 million on a dozen trials involving several hundred veterans from a range of conflicts, including Iraq and Afghanistan. Results from the trials will not be available for another 12 to 18 months.” Gould, however, “said he was ‘encouraged’ by the results of trials which were presented at the summit.”

Related Links:

— “VA testing whether meditation can help treat PTSD,”Steve Vogel, The Washington Post, May 3, 2012.

MedPage Today (5/3, Gever) reports, “Draft revisions to the American Psychiatric Association’s (APA) influential diagnostic manual are again open for public comment, the group announced Wednesday” in a press release (pdf). “This is the last opportunity for the general public to provide input on the fifth edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, before it is put into essentially final form at the end of this year. The formal release is slated for May 2013.” The APA is seeking public comment through June 15. The latest draft of the document and further information about it can be seen here.

Related Links:

— “Input Sought Again on DSM-5,”John Gever, Medpage Today, May 2, 2012.

The Washington Times (5/3, Hill) reports, “Gov. Martin O’Malley signed bills into law on Wednesday, including legislation that will limit use of septic systems and double the state’s so-called ‘flush tax,'” which “were among several notable pieces of environmental legislation.” In addition, he “signed a bill allowing the state to set up a health benefits exchange where residents and small businesses can buy benefits from private insurers in accordance with the US Patient Protection and Affordable Care Act.”

Related Links:

— “Environmental, health insurance bills become Md. law,”David Hill , The Washington Times, May 2, 2012.

Reuters (5/2, Pittman) reports that an analysis published May 2 in the Journal of the American Medical Association indicates that many clinical trials testing medications and devices are small and the quality is not consistent.

MedPage Today (5/2, Smith) reports that investigators analyzed “the more than 95,000 studies registered since 2004” in the ClinicalTrials.gov database. The researchers found “that the database is dominated by small studies, many conducted at a single center, with significant differences that would make them hard to compare.” The investigators, “for much of the analysis…concentrated on interventional trials in three areas — oncology, cardiology, and mental illness — that included a total of 79,413 studies.”

HealthDay (5/2, Dotinga) reports that altogether, “seven percent of the studies didn’t bother to mention their purpose, while others failed to provide other important details.” The researchers found that “62 percent of the trials from 2007-2010 were small, with 100 or fewer participants.” Just “four percent had more than 1,000 participants.”

Medscape (5/2, Brown) reports, “Mental health trials were more likely than cardiovascular and oncology trials to report use of” data monitoring committees. The researchers found that “oncology trials were least likely to use randomization (64.7% didn’t use randomization, vs 26.2% for cardiovascular trials and 20.8% for mental health trials), and 87.6% of oncology trials were not blinded.”

Related Links:

— “Drug and device trials vary in size, quality: study,”Genevra Pittman , Reuters, May 01, 2012.