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.

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.

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.

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.

Bloomberg News (4/3, Ostrow) reports, “The 15 percent of US high school seniors who abuse alcohol and drugs first began using them at age 14 or 15,” according to a study published online April 2 in the Archives of General Psychiatry. Adolescents “whose substance abuse caused problems socially, in school or with the law, started drinking or doing drugs when they were 14 or 15 years old, the research found. By the time kids reach age 18, almost half consumed at least 12 drinks a year and 15 percent were abusers, according to the report.”

HealthDay (4/3, Preidt) points out that after analyzing “data from a US survey of more than 10,000 teens between the ages of 13 and 18,” researchers found that “more than 78 percent of the oldest teens had consumed alcohol, about 47 percent consumed at least 12 drinks a year, and about 15 percent met the criteria for alcohol abuse.” In addition, the study “found that 81.4 percent of the oldest teens reported the opportunity to use illicit drugs, 42.5 percent used drugs, and 16.4 percent were drug abusers.” Reuters (4/3, Seaman) also covers the story.

Related Links:

— “High School Substance Abusers Start Using at Age 14, Study Finds,”Nicole Ostrow, Bloomberg, April 2, 2012.

The Washington Post (4/1, A4, Brown) reported, “Numerous studies have shown that repeated deployment is a ‘risk factor’ for” post-traumatic stress disorder (PTSD). For example, a study published in the March issue of the American Journal of Public Health “examined the experience of 66,000 Marines who served in Iraq. Those with two deployments had almost twice the rate of PTSD as those deployed once.”

PTSD Susceptibility May Be Partially Determined By Gene Variants. BBC News (4/2) reports, “Susceptibility to post-traumatic stress disorder (PTSD) could be partially determined by gene variants,” according to a study published in the Journal of Affective Disorders. After examining “DNA from 200 members of 12 families who survived the 1988 Armenian earthquake,” researchers found that “those who carried two gene variants which affect the production of serotonin — which affects mood and behaviour — were more likely to display symptoms of PTSD.”

Related Links:

— “Link between PTSD and violent behavior is weak,”David Brown, The Washington Post, March 31, 2012.

MedPage Today (4/1, Smith) reported, “People said they would pay more to avoid some serious medical conditions than they would to avoid severe mental illnesses, such as schizophrenia and depression,” according to survey results published in the April issue of the journal Psychiatric Services. In the survey involving some 1,000 randomly chosen US adults, “respondents recognized that the two mental conditions had a health burden comparable to or higher than diabetes, below-the-knee amputation or partial blindness, according to Dylan Smith, PhD, of Stony Brook University in Stony Brook, NY, and colleagues.” Notably, “for a comparable benefit in terms of quality of life, participants in the study were willing to pay about 40% less to avoid the psychiatric illnesses,” the study authors reported.

Related Links:

— “Mental Illness Devalued in Survey,” Michael Smith, MedPage Today, March 31, 2012.

The Huffington Post (3/30, Chan) reports, “Soldiers, police, firemen and people who’ve suffered abuse aren’t the only ones with a high risk for post-traumatic stress disorder (PTSD) — a new study” published online March 29 in the Journal of Traumatic Stress “shows that 911 dispatchers may be at risk, too.” Investigators “from Northern Illinois University found that the 911 dispatchers still experienced the emotional distress associated with PTSD, even though they were not directly in the traumatic event.”

The Time (3/30, Sifferlin) “Healthland” blog reports that for the study, “researchers questioned 171 emergency dispatchers currently working in 24 US states. The dispatchers — predominately white women around age 38 with more than 11 years of dispatching experience — were asked about the types of calls they answer and their corresponding emotional distress.” Next, “participants…rated the types of calls that caused great distress and were asked to recall the worst call they ever received.”

“The unexpected injury or death of a child accounted for 16 percent of the calls dispatchers identified as their worst trauma,” HealthDay (3/30, Dallas). “The study authors noted that the dispatchers experienced a high level of distress following an average of 32 percent of potentially traumatic calls. In addition, 3.5 percent of the dispatchers reported symptoms severe enough to be classified as PTSD.”

Related Links:

— “911 Dispatchers At Risk For PTSD, Study Finds,”Amanda L. Chan, The Huffington Post, March 29, 2012.

A new report on autism rates in the US received heavy coverage in print and online, and was discussed for nearly ten minutes on last night’s national news broadcasts. ABC World News (3/29, story 2, 2:45, Sawyer) reported, “A new report from the Centers of Disease Control shows a big increase in the number of American children diagnosed with autism.”

The CBS Evening News (3/29, story 2, 3:00, Pelley) reports that Dr. Colleen Boyle of the CDC, who “oversaw the study,” said, “No matter what the number is, there’s one thing for certain, and that is that more children are being identified with autism.”

On NBC Nightly News (3/29, lead story, 2:45, Holt), Dr. Boyle, said, “Since 2002, the problems have increased 78%.”
In a second segment on NBC Nightly News (3/29, story 2, 1:10, Holt), Dr. Alanna Levine, of the American Academy of Pediatrics, said, “We need to allocate” research funds “towards finding out what is causing the autism spectrum disorders, and how we can help these children and it can also help communities allocate resources to make sure there are services available for children who need them.”

The AP (3/30, Stobbe) reports, “The CDC study is considered the most comprehensive US investigation of autism prevalence to date. Researchers gathered data from areas in 14 states — Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Maryland, Missouri, New Jersey, North Carolina, Pennsylvania, South Carolina, Utah and Wisconsin.” The report indicates that “one child out of 88 in the US” has “autism or a related disorder.”

USA Today (3/30, Weintraub) reports that the “figures…show a 23% increase in autism spectrum cases from 2006 to 2008, and 78% increase since 2002.” CDC Director Thomas Frieden, MD, said, “What we do know for certain is autism is common and needs to be effectively served.”

According to the Washington Post (3/30, Brown), the report found that “autism is five times as common in boys as girls (a lopsided ratio found in many other studies).” Researchers also found that “the fraction of autistic children with average or above-average intelligence has risen more than the fraction with ‘intellectual disability.'” Meanwhile, “autism prevalence in Hispanic children is two-thirds that of white children, but it is rising faster in them and in black children than in white ones.”

Related Links:

— “More autism reported, likely from better testing,”Mike Stobbe , AP Associated Press, March 29, 2012.