USA Today (3/13, Painter) reports that according to a new position paper published online March 13 in the journal Neurology, physicians “should not give in to pressure to prescribe medications that might boost mental performance in healthy children and teens.” The position paper “focuses mostly on inappropriate use of Ritalin [methylphenidate], Adderall [amphetamine, dextroamphetamine mixed salts] and other stimulant medications commonly used to treat attention-deficit/hyperactivity disorder (AD/HD).” These medicines “are sought out by some parents, teens and college students as grade-boosting ‘study drugs.'”

The Hartford (CT) Courant (3/13, Weir) reports that the authors of the position paper contend that the overprescription of stimulant medications “poses both health risks and ethical concerns: the long-term effects of the medications are unknown, the practice creates the potential for over-medication and dependency, and it jeopardizes the integrity of the doctor-patient relationship.” The Courant quotes the paper’s lead author, Dr. William Graf, of the Yale School of Medicine, who said, “You have ethics and professional integrity to consider.”

On its website, CBS News (3/14, Jaslow) reports, “In recent years, a growing number of students have used the medications as ‘study drugs’ to take before tests, and in turn, more parents are requesting AD/HD drugs for kids who don’t meet the criteria for the disorder.” A study published last June in the journal “Pediatrics found the number of AD/HD drug prescriptions for children under 17 climbed 46 percent from 2002 to 2012. Methylphenidate – a psychostimulant drug for AD/HD sold generically or as Ritalin and Concerta – was the top prescription dispensed to adolescents between the ages of 12 and 17.”

The NBC News (3/13, Rettner) “Vitals” blog runs a MyHealthNewsDaily story that reports, “Over the last two decades, there’s been a 20 percent increase in AD/HD diagnoses, and a tenfold increase in the production and consumption of AD/HD medications.” Still, “whether doctors are intentionally prescribing AD/HD drugs to healthy kids, or whether they mistakenly diagnose the children with AD/HD based on children’s reports of their own symptoms, is not clear.” Adolescents “may fake symptoms of the behavioral disorder, or parents may lie to doctors for their children to get the drugs.”

CNN (3/13, Christensen) reports that AD/HD medications may “have serious side effects like cardiac risks, and taking them can be addictive.” Yet, despite the potential for physical side effects and abuse, Dr. Mark Wolraich, chairman of the American Academy of Pediatrics clinical practice guideline subcommittee on AD/HD, is concerned that some parents “may be too nervous to seek treatment for their children with AD/HD, for whom the drugs would actually be beneficial.”

Also covering the story are Reuters (3/14, Pittman), the Connecticut Post (3/14, Cuda), HealthDay (3/14, Gray), and Medscape (3/14, Anderson).

Related Links:

— “Don’t give kids ADHD drugs as study aid, doctors warn, “Kim Painter, USA Today, March 13, 2013.

The Chicago Tribune (3/12, Mann) reports, “Adults with mental illnesses are more likely to smoke cigarettes and less likely to quit than people without mental illnesses, said a recent report from the US Centers for Disease Control and Prevention.” The report found that “thirty-six percent of the mentally ill smoke, compared with 21 percent of those without mental illnesses.” The report data were derived from responses to “the Substance Abuse and Mental Health Services Administration’s 2009-11 survey of 138,000 people 18 and older.”

Thomson Reuters News & Insight (3/12, Humer) reports that UnitedHealth Group Inc., the biggest health insurer in the US, has been sued by the New York State Psychiatric Association (NYSPA), which is part of the American Psychiatric Association, and some UnitedHealth policyholders. The suit alleges that UnitedHealth has not provided mental health treatments called for under the Affordable Care Act, the Federal Parity Act, ERISA, and the laws of New York State. The suit, which is seeking class action status for NYSPA members as well as other customers with health insurance, seeks to force UnitedHealth to comply with applicable laws. The lawsuit is in Re: New York State Psychiatric Assn. Inc., Michael A. Kamins, Jonathan Denbo and Brad Smith vs. UnitedHealth Group, Southern District of New York, No. 13-cv-01599.

Bloomberg News (3/12, Smythe) reports, “The company denied or limited access to psychotherapy and other mental-health treatments for patients suffering from conditions including psychosis, chronic depression, and anxiety disorders, according to the 102-page complaint, which seeks to represent all customers of the company facing similar situations.” Bloomberg News adds, “So-called parity laws of the US, New York and California prohibit insurers from imposing more restrictive limits on care for mental health than for other health-care conditions, according to the complaint.” In addition, UnitedHealth “violated the federal Affordable Care Act by failing to continue to pay for mental-health treatment until final internal appeals were resolved, according to the complaint.”

Related Links:

— “NY State Pyschiatric Assn files suit against UnitedHealth, “Caroline Humer, Thomson Reuters, March 11, 2013.

The Atlantic (3/11, Graham) reported that “implementation of the Mental Health Parity and Addiction Equity Act of 2008 has been hobbled by a lack of clear guidance from the government, and final rules governing the statute have yet to be published.” In addition, according to the article, “insurers are not clarifying the process they use to evaluate the medical necessity of mental health services, and how this compares to processes used in relation to medical services, said Sam Muszynski, director of the office of healthcare systems and financing for the American Psychiatric Association. ‘When providers ask for this kind of information, they just don’t get it,’ he said.”

Related Links:

— “Since 2008, Insurers Have Been Required by Law to Cover Mental Health—Why Many Still Don’t, “Judith Graham, The Atlantic, March 11, 2013.

In print and in its “Well” blog, the New York Times (3/11, D4, Bakalar) reports that “a new study finds that anger, coupled with psychotic delusions, may be the most significant factor in violence committed by people with mental illness.”

Medwire (3/12, Piper) reports, “Anger due to delusions appears to be a key factor explaining violent behavior in patients with acute psychosis,” according to the results of the 458-patient East London First Episode Psychosis Study published online March 6 in JAMA Psychiatry. “The population-attributable risk percentage of anger related to delusions was 30.8% for minor violence and 55.9% for serious violence, after taking into account gender, ethnicity, age, comorbid antisocial personality disorder, drug use, mania symptoms, and trait anger,” the study found.

Related Links:

— “Delusions, Anger and Violence, “Nicholas Bakalar, The New York Times, March 11, 2013.