Congressional Quarterly (1/16, Bettelheim, Subscription Publication) reports that starting this month, many physicians “who were likely to expand basic medical care offered to low-income Americans — a goal of the 2010 health care law — could see Medicaid fees drop an average of almost 43 percent.” The pay cut comes after Congress declined to renew a temporary fee bump in the ACA designed to shrink the “historic gap” between what Medicaid and Medicare pay physicians. According to CQ, the drop in reimbursements puts access to care for millions of patients at stake. Physician lobbies “will try to persuade Congress this spring to retroactively restore the bonuses, but their best hope may be pressing states to step forward and pay the difference with their own money.”

Related Links:

— Congressional Quarterly (requires login and subscription)

The Los Angeles Times (1/15, Zarembo) reports that an analysis to appear in the February issue of the Annals of Epidemiology indicates that “recent veterans have committed suicide at a much higher rate than people who never served in the military.” The data indicated that “the rate was slightly higher among veterans who never deployed to Afghanistan or Iraq, suggesting that the causes extend beyond the trauma of war.” The analysis also found that “recent female veterans commit suicide at a rate more than twice as high as other women.”

Epidemiologist Michael Schoenbaum, PhD, of the National Institute of Mental Health, commented on the study’s findings, saying, “People’s natural instinct is to explain military suicide by the war-is-hell theory of the world.” He added, “But it’s more complicated.” Schoenbaum, an expert in military suicides, had no involvement with the study.

Related Links:

— “Detailed study confirms high suicide rate among recent veterans,” Alan Zerembo, Los Angeles Times, January 14, 2015.

The New York Daily News (1/15, Engel) reports that a study published online Jan. 14 in the journal Neurology suggests that individuals with Alzheimer’s “may experience depression and other behavioral changes before their memory starts to fade.” The study’s lead author explained, “While earlier studies have shown that an estimated 90% of people with Alzheimer’s experience behavioral or psychological symptoms such as depression, anxiety and agitation, this study suggests that these changes begin before people even have diagnosable dementia.” For the study, researchers tracked “2,416 people who had visited an Alzheimer’s center.” All of the people were at least 50 years old and did not display any difficulties with cognition at the start of the study.

TIME (1/15, Sifferlin) reports that the participants were followed for seven years, during which time 1,218 people were diagnosed with dementia. The researchers found that participants “with dementia had twice the risk of developing depression earlier – far before their dementia symptoms started – than people without the disease,” and had a 12 times higher likelihood of delusions. What’s more, “the symptoms appeared in consistent phases: first, irritability, depression, and nighttime behavior changes; followed by anxiety, appetite changes, agitation and apathy.” In the final phase, patients displayed “elation, motor disturbances, hallucinations, delusions and disinhibition.”

Related Links:

— “Alzheimer’s first may show itself as depression, mood changes: study,” Meredith Engel, New York Daily News, January 14, 2015.

In continuing coverage, Medscape (1/14, Melville) reports that a report from Mental Health America called “Parity or Disparity, the State of Mental Health in America 2015” reveals a “significant shortage of psychiatrists” in the US, particularly for youngsters, a need that will only increase under the Affordable Care Act. Renee Binder, MD, president-elect of the American Psychiatric Association, said, “The country will need an additional 30,000 child psychiatrists to meet the needs generated by the expanded coverage under the ACA, and we currently only have 8000, so we need to triple the number of child psychiatrists.”

Meanwhile, “the APA has been promoting new systems of collaborative care, with psychiatrists working together with other specialties, including primary care [clinicians] and pediatricians,” she added.

Related Links:

— Medscape (requires login and subscription)

The Los Angeles Times (1/14, Kaplan) “Science Now” blog reports that research published in BMJ indicated that people who “worked at least 49 hours a week were up to 13% more likely to engage in ‘risky alcohol use’ compared with those who were on the job for only 35 to 40 hours a week.” Investigators came to this conclusion after analyzing “data on more than 430,000 people.”

Bloomberg News (1/14, Cortez) reports on the BMJ study, and also points out that “in a 2012 survey by the” CDC, “71 percent of Americans said they’d had a drink in the past year, while about 56 percent had done so in the past month.” Bloomberg News adds that “there are a small and growing number of people who drink excessively at one sitting, and it’s not clear why, said George Koob, director of the National Institute on Alcohol Abuse and Alcoholism.” Koob said, “We’re seeing a higher number of drinks per individual.” He added, “What’s growing is the intensity of drinking in a single bout. We are concerned about that. We haven’t figured out how to address it.”

Related Links:

— “Workaholics are more likely to drink too much alcohol, study says,” Karen Kaplan, Los Angeles Times, January 13, 2015.