MedPage Today (7/13, George) reports, “Delirium was linked to long-term cognitive decline in both” hospitalized “surgical and nonsurgical patients,” investigators concluded. The 23-study meta-analysis revealed that “patients who experienced an episode of delirium were more than twice as likely to show long-term cognitive decline than patients without delirium.” The findings were published online July 13 in JAMA Neurology.

Psychiatric News (7/13) reports, “The circumstances of the delirium (following anesthesia, trauma, infection, and so on) did not affect the odds of future cognitive decline,” thereby suggesting that “the underlying mechanisms of delirium may be similar and possibly associated with inflammatory processes common to both surgical and nonsurgical contexts, the investigators noted.”

Related Links:

— MedPage Today (requires login and subscription)

Medscape (7/13, Davenport, Subscription Publication) reports, “Although patients with bipolar disorder commonly experience depressive symptoms, clinicians should be very cautious about treating them with antidepressants, especially as monotherapy, experts asserted in a recent debate on the topic” that took place during the virtual European Psychiatric Association 2020 Congress. During the Congress, “psychiatric experts said that clinicians should also screen patients for mixed symptoms that are better treated with mood stabilizers.” In addition, “these same experts…raised concerns over long-term antidepressant use, recommending continued use only in patients who relapse after stopping antidepressants.”

Related Links:

— “Caution Urged for Antidepressant Use in Bipolar Depression, “Liam Davenport, Medscape, July 13, 2020

Healio (7/10, Schaffer) reported, “A cohort of French women currently taking any antidepressant medication were more likely to develop type 2 diabetes [T2D] during six years of follow-up compared with nonusers, independent of severe depressive symptoms,” investigators found after analyzing “data from 63,999 women without type 2 diabetes at baseline.” The findings were published online June 16 in the journal Diabetic Medicine.

Related Links:

— “Antidepressants elevate risk for type 2 diabetes, “Regina Schaffer, Healio, July 10, 2020

The Washington Post (7/10, Kornfield, Wan) reports the success of a safe injection site in the US “has prompted calls for policymakers to start considering solutions that focus on reducing harm and deaths rather than traditional law enforcement and punishment.” Experts are saying “they fear that if the country doesn’t intervene, this year will bring a wave of fatalities driven by pandemic-related isolation, unemployment and changes to the drug supply.” The piece mentions that “Nora Volkow, director of the National Institute on Drug Abuse…said it is also important to understand the effect the pandemic is having on those who use drugs.”

Related Links:

— “America needs to reduce soaring overdoses. A secret supervised injection site may show us how., “Meryl Kornfield and William Wan, The Washington Post, July 10, 2020

Newsweek (7/9, Gander) reports that research suggests “the stress of living through the COVID-19 pandemic may be associated with a rise in” stress cardiomyopathy.
NBC News (7/9, Sandoval) reports that investigators “looked at the medical records of 1,914 patients at two hospitals in the Cleveland Clinic health system from five eight-week periods, four of which occurred before the pandemic and the other since then.” Prior to “the pandemic, there were, on average, five to 12 cases in an eight-week period, but in the cohort observed during the pandemic, the number rose to 20.” The researchwas published in JAMA Open Network.

Related Links:

— “Stress Caused by COVID-19 May Have Triggered Rise in Broken Heart Syndrome, “Kashmira Gander, Newsweek, July 9, 2020

Modern Healthcare (7/8, Livingston, Subscription Publication) reports some states that have expanded access to telehealth during the pandemic have taken steps “to make those changes permanent.” For example, “Colorado Gov. Jared Polis signed a bill on Monday that expands telehealth access by barring insurers from requiring that patients have a pre-established relationship with a virtual care [professional] or imposing additional location, certification or licensure requirements on [professionals] as a condition for telehealth reimbursement.”

Related Links:

— “Some states cement COVID-19 telehealth expansions, “Shelby Livingston, Modern Healthcare, July 8, 2020

Psychiatric News (7/9) reports, “COVID-19–associated discrimination disproportionately impacted members of racial and ethnic minorities in the United States in March and April, and those individuals experienced increased mental distress,” investigators concluded in a 3,665-participant survey that revealed that “the overall percentage who said they had experienced COVID-19–associated discrimination doubled from 4% in March to 10% in April.” Researchers also found that “Asian Americans were at higher risk of COVID-19–associated discrimination in March, and the risk of COVID-19 discrimination among Black individuals increased from March to April.” The findings were published online July 6 in the American Journal of Preventive Medicine.

Related Links:

— “Racial, Ethnic Minorities in United States More Likely to Experience COVID-19 Discrimination, Psychiatric News, July 9, 2020

Healio (7/7, Laday) reports, “Patients with fibromyalgia, osteoarthritis [OA] or rheumatoid arthritis [RA] are at an increased risk for self-harm, compared with those without these diseases,” investigators concluded after identifying “10,484 adults with ankylosing spondylitis, 17,546 with fibromyalgia, 410,384 with OA and 23,205 with RA,” then matching these cases “to an unexposed cohort of the same size for each condition.” The findings were published online in Arthritis Care & Research.

Related Links:

— “Patients with fibromyalgia, OA, RA at increased risk for self-harm, “Jason Laday, Healio, July 7, 2020

Cancer Network (7/8, Slater) reports, “An article published in Cancer discussed the risk factors for posttraumatic stress disorder (PTSD) in patients with breast cancer, as well as the role of inflammation and endocrine function.” In the “meta-analysis of 38 studies evaluating breast cancer diagnoses and treatment, it was determined that 10% of women develop PTSD after a diagnosis of breast cancer.” Furthermore, “a cancer diagnosis increases the lifetime risk of PTSD by a factor of 1.66 compared with those who have never been diagnosed with cancer.”

Related Links:

— “Recognizing Factors Contributing to PTSD May Improve Clinical Care in Patients with Breast Cancer, “Hannah Slater, Cancer Network, July 8, 2020

In a piece discussing pandemic-related mental health, The Atlantic (7/7, Stern) says that “one thing that is certain about the current pandemic is that we are not doing enough to address its mental-health effects. Usually, says Joshua Morganstein, the chair of the American Psychiatric Association’s Committee on the Psychiatric Dimensions of Disaster, the damage a disaster does to mental health ends up costing more than the damage it does to physical health.” But “in any case, the full extent of the fallout will not come into focus for some time. Psychological disorders can be slow to develop, and as a result, the Textbook of Disaster Psychiatry, which Morganstein helped write, warns that demand for mental-health care may spike even as a pandemic subsides.” Of COVID-19, Morganstein says, “If history is any indicator, we should expect a significant tail of mental-health effects, and those could be extraordinary.”

Related Links:

— “This Is Not a Normal Mental-Health Disaster , “Jacob Stern, The Atlantic, July 7, 2020