The Wall Street Journal (8/26, A4, Winslow, Subscription Publication) reports that, according to a clinical guidance report by the American Academy of Pediatrics (AAP) and published in the September issue of Pediatrics, the majority of vaccines and medications appear to be safe for nursing mothers. Still, breastfeeding women are cautioned against taking certain psychiatric medications, as well as herbal medicines and some painkillers, including oxycodone, hydrocodone and codeine.

MedPage Today (8/26, Phend) reports that the AAP report urges caution “for the small proportion of drugs that are concentrated in human milk, have a long half-life, have known toxicity to mother or child, or expose the infant to relatively high doses or detectable serum concentrations.” Pediatrician Hari Cheryl Sachs, MD, of the Food and Drug Administration, and colleagues suggested that healthcare professionals “look up safety of specific medications on the National Library of Medicine’s peer-reviewed LactMed database online.” “The report also addressed common concerns about antidepressants, anxiolytics, and antipsychotics, many of which show up in low concentrations in breast milk.
Clinically significant levels of drug have been reported in breast milk for bupropion (Wellbutrin), diazepam (Valium), fluoxetine (Prozac), citalopram (Celexa), lithium (Eskalith), lamotrigine (Lamictal), and venlafaxine (Effexor).”

Related Links:

— “Many Drugs Found Safe for Breast-Feeding Mothers, “Ron Winslow, The Wall Street Journal, August 26, 2013.

HealthDay (8/24, Gordon) reported that most children “with autism will grow up to be adults with autism.” According to autism researcher Paul Shattuck, PhD, of the Washington University in St. Louis, an estimated “45,000 to 50,000 kids with autism turn 18 each year.” A number of experts have noted that “a shortage of necessary programs for adults with autism already exists and is likely to worsen” as more youngsters with autism become adults. Higher education and employment for these young adults with autism may be difficult or even impossible, and many young adults with autism are forced to continue living at home with their families.

Related Links:

— “Who Will Care for Children With Autism When They’re Adults?, “Serena Gordon, HealthDay, August 23, 2013.

In a segment on the NBC Nightly News, NBC News correspondent Mark Potter reported, “To prevent more violence in classrooms, teachers, counselors and other workers in the Miami-Dade County [FL] schools are now being trained to spot the warning signs of student mental illness.” Those warning signs “include talk of suicide, high risk or odd behavior, withdrawal, increased anger, bizarre thoughts and persistent sadness.” Potter added, “The program is paid for by the American Psychiatric Foundation and…is currently used in 21 states,” as well as in the District of Columbia.

The Fort Myers (FL) News-Press (8/18, Gluck) reported that electroconvulsive therapy (ECT) for the treatment of severe depression “has seen a resurgence at many US health centers in recent decades, experts say.” The procedure is not without controversy. Some patients who received the procedure in the past, as well as “anti-ECT groups, say it is little more than intentional brain damage.” Other patients cannot praise the treatment enough, and the procedure is endorsed by the US Surgeon General, the American Psychiatric Association and the American Medical Association. Researchers theorize that it works by enhancing certain beneficial brain chemicals or by “reducing ‘hyper-connectivity’ in the minds of severely depressed patients.” Most health insurers and Medicare cover ECT.

Related Links:

— “Despite controversial past, shock treatment sees resurgence, “Frank Gluck, The Fort Myers (FL) News-Press, August 18, 2013.

In a 2,700-word report, the Washington Post (8/18, McCrummen) profiles the workings of the mental health court that operates in Upper Marlboro in Maryland’s Prince George’s County, “one of a growing number of such courts.” The Post says the latest Federal data show more than half the inmates in jails and prisons suffer from signs of mental illness, and the court system is “adjusting to this reality” with about 300 specialized courts that try to match appropriate solutions from “a decentralized and often inadequate mental-health-care system” with people who often have “a tapestry of problems.” Partly because of the potential for violence, Judge Patrice E. Lewis often makes decisions that make “her pray she was right” in the Upper Marlboro court.

Related Links:

— “Pr. George’s mental health court aims to treat, rather than jail, defendants, “Stephanie McCrummen, The Washington Post, August 17, 2013.

On its “Federal Eye” blog, the Washington Post (8/17, Vogel) reported that, according to a study (pdf) conducted by the Naval Health Research Center and published in May in the journal BMC Psychiatry, “women who deploy to combat zones may be more susceptible to psychiatric disorders than men.” Researchers arrived at that conclusion after analyzing data from surveys completed by 1,113 Marines having returned from deployments to Iraq and Afghanistan during the years 2007 and 2008.

PTSD Diagnosis No Barrier To Army Redeployment. The Washington Post (8/18, Sieff) reported that “a diagnosis of post-traumatic stress disorder [PSTD] is not a barrier to being redeployed” by the US Army to Afghanistan. According to the Post, “the Army has knowingly redeployed soldiers with symptoms of PTSD” and “is now regularly embedding psychologists with units in the field.”

Related Links:

— “Do female combat vets face added mental health risks?, “Steve Vogel, The Washington Post, August 16, 2013.

USA Today (8/22, Zoroya) reports that, according to the results of a RAND study released yesterday, “researchers found no scientific proof supporting an Army idea to drop the word ‘disorder’ from the term post-traumatic stress disorder [PTSD] as a means of removing the stigma from the disease.” USA Today points out that “the Army asked the American Psychiatric Association to change the name in its official manual of mental illnesses,” claiming that soldiers would be more willing to seek treatment for PTSD if the word “disorder” were replaced instead by the words “stress” or “injury.” In 2011, the APA declined making that change.

Former Army Sergeant: PTSD Is Not A “Catchall” For All Behavior By Veterans. In an op-ed for the Washington Post (8/22, Van Reet), Brian Van Reet, a former Army sergeant who served in Baghdad from 2004 to 2005, writes that science is suggesting that “the link between war, post-traumatic stress disorder (PTSD) and self-harm is not what many expect.” According to a study in the Journal of the American Medical Association, “exposure to combat does not increase the likelihood that a service member will take his or her own life.” Reet argues that these findings “demonstrate the need for further examination of war’s effects on those who fight it.” Reet adds that PTSD “is a valuable concept but not if it is used as a catchall for the myriad ways that war, peace, genetics and institutions all shape the behavior of veterans.”

Related Links:

— “Dropping the D from PTSD won’t change stigma, study says, “Gregg Zoroya, USA Today, August 22, 2013.

USA Today (8/22, Jayson) reports in a related article that “even mental health professionals who specialize in gender identity say there is much about being transgender that is unclear,” therefore “classifying it for treatment purposes is challenging.” The piece quotes New York psychiatrist Jack Drescher, MD, who was a member of the American Psychiatric Association’s work group on gender identity working on revisions for the DSM-5. Dr. Drescher said, “This is the only mental disorder where the treatment is changing the body” to align a person’s physical characteristics so they match gender identity.

Related Links:

— “What ‘transgender’ means, and how society views it, “Sharon Jayson, USA Today, August 23, 2013.

The New York Times (8/23, A17, Huetteman, Stelter, Subscription Publication) reports that defense attorneys for Pvt. Bradley Manning brought up the fact that their client “is transgender during the sentencing phase of his court-martial, describing the emotional stress he endured while deployed in Iraq.” At the trial, “two psychiatrists testified about treating Private Manning for ‘gender identity disorder,’ a diagnosis for psychological discomfort with one’s sex that the American Psychiatric Association renamed ‘gender dysphoria’ last year.” Both “psychiatrists said that handling such a diagnosis in a combat zone, and at time when it was still against military law to be openly gay, would have put Private Manning under” enormous strain.

Related Links:

— “‘I Am a Female,’ Manning Announces, Asking Army for Hormone Therapy, “Emmarie Huetteman, The New York Times, August 22, 2013.

Medscape (8/21, Cassels) reports that, according to a study published online Aug. 17 in the Journal of the American Academy of Child and Adolescent Psychiatry, maternal consumption of “‘junk food’ during pregnancy and in early childhood is linked to a significantly increased risk for poor mental health, including anxiety and depression, in very young children.” Researchers arrived at this conclusion after having followed 23,020 mothers and their youngsters who were followed for five years. The study also found that “women who ate more unhealthy foods were significantly more likely to have children with more behavioral problems, such as tantrums and aggression.”