Tuesday, September 25, 2007

Treating Depression is a Good Business Move

[Associated Press]

CHICAGO (AP) - A new study suggests that by quickly getting employees treatment and even offering telephone psychotherapy companies can cut absenteeism and improve workers' health.
A researcher with the National Institute of Mental Health, which funded the study, says it shows that spending money on depression is a smart business move.

Employees who got the aggressive intervention worked on average about two weeks more during the yearlong study than those who got the usual care. Also, researchers say more of them were still employed by year's end, thus saving employers additional hiring and training costs.
In addition, those in the intervention group were almost 40% more likely to recover from depression during the study, which is reported in Wednesday's Journal of the American Medical Association.

Monday, September 10, 2007

American Girls' Suicide Rates Rise

[By Greg Bluestein, www.Time.com]

The suicide rate among preteen and teenage girls rose to its highest level in 15 years, and hanging surpassed guns as the preferred method, federal health officials reported...


Saturday, September 08, 2007

Depression May Be World's Most Disabling Disease

FRIDAY, Sept. 7 (HealthDay News) -- When compared with other chronic diseases, depression may well be the most disabling disease in the world, a new global study finds.

People with chronic physical diseases such as angina, arthritis, asthma and diabetes also fare far worse if they also suffer from depression, the team of international researchers found.

"Being sad is bad for your health," according to lead researcher Dr. Somnath Chatterji, from the World Health Organization (WHO) in Geneva, Switzerland.

But all too often, he said, depression doesn't get the serious attention paid to physical ailments.
"Treatment of mental health conditions such as depression are a necessity, not a luxury. Mental health conditions such as depression must be treated on a par with physical health conditions," Chatterji said.

In the study, published in the Sept. 8 issue of The Lancet, Chatterji's team perused data on more than 245,000 people from 60 countries participating in WHO's World Health Survey.
They found that 3.2 percent of people had experienced a depressive episode in the past year. For people with angina, the rate was 4.5 percent; for people with arthritis, it was 4.1 percent; for those with asthma, it was 3.3 percent; and for people with diabetes, it was 2 percent.

Moreover, between 9 percent and 23 percent of people had depression in addition to suffering from one or more of these conditions. That's significantly higher than the likelihood of having depression without having a chronic disease, Chatterji's group noted.

After the researchers had accounted for socioeconomic factors and health conditions, they confirmed that depression had the biggest effect on worsening health compared with the other four major chronic illnesses. In different countries, people with depression plus one or more chronic diseases were in the worst health of all the disease states studied, Chatterji's team reported.

"Compared to the chronic physical illnesses of angina, arthritis, asthma and diabetes, depression produces the most decline in health," Chatterji said. "Having depression over and above a physical illness significantly worsens health even further," he said.

Depression needs to be recognized and treated as an urgent public health priority, Chatterji said. "Persons with physical illnesses should also be examined for depression and treated appropriately. Primary care providers must learn to recognize and manage concurrent physical illnesses and depression to reduce disease burden and improve population health," he added.
One expert hailed the findings.

"It is encouraging to see that results that we have been seeing from our country, from studies in the United States about the devastating effects of comorbid depression with other chronic illnesses, are replicable internationally," said David L. Shern, the president and CEO of the nonprofit advocacy group Mental Health America.

Depression is a huge public health issue, Shern said. "Continuing to have these inane debates about whether we should have insurance coverage for mental health care, in the light of data like these, is just silly," he said.

The study also highlights the need for integrated care and screening for depression, Shern said. "Practitioners need to be educated to look for depression, and consumers need to push their doctors to be aware of their depression," he said.

Depression is treatable, Shern noted. "That's one of the big stories of the last 20 years -- the development of pharmacological treatments that have broad scale effectiveness," he said. "There are psychosocial treatments, for people who don't want to take medication, that are just as effective," he said. "Combining the two is the preferred regimen."

For more on depression, visit the U.S. National Institute of Mental Health.

Thursday, September 06, 2007

Suicide Rises in Youth

[By BENEDICT CAREY - Published: September 7, 2007]

In a finding that is likely to revive a debate of many years about the safety of drugs prescribed for depression, health officials reported yesterday that the rate of suicide in Americans ages 10 to 24 increased 8 percent from 2003 to 2004, the largest jump in more than 15 years.

Some psychiatrists argue that the reason for the increase is the decline in prescriptions of antidepressant drugs like Prozac to young people since 2003, leaving more cases of serious depression untreated. Others say that it is impossible to know if the increase is linked to patterns of antidepressant prescriptions. The one-year spike in suicides could be a statistical fluctuation, they say, and not the start of a trend.

The increase was particularly sharp among adolescents, especially girls, according to the Centers for Disease Control and Prevention, which released the figures yesterday. The timing of the increase coincided with a public debate in the United States and overseas over whether the antidepressants increased the risk of suicide in a small percentage of young people who took them. In late 2004, after public hearings, the Food and Drug Administration called for drug makers to put a prominent “blackbox” warning on the drugs’ labels, cautioning about the possibility of increased suicide risk in minors.

Since then, experts have been arguing over whether the controversy about the drugs and the drug agency’s warnings had saved lives or scared away patients who could have benefited from antidepressant treatment, leading to more suicides. In a study first presented at a scientific meeting last December and published Wednesday in The American Journal of Psychiatry, an international team of researchers found that a decrease in antidepressant prescriptions to minors of just a few percentage points coincided with a 14 percent spike in suicides in the United States; in the Netherlands, the suicide rate went up almost 50 percent in young people when prescription rates began to drop, the study found.

Ileana Arias, director of the C.D.C.’s National Center for Injury Prevention and Control, which produced the new report, said it was impossible to say what caused the increase.
“The issue is that there is a wide range of factors that may be accounting for the increase, and we’re not aware of anyone who has done an analysis to account for those,” Dr. Arias said.
In addition to changes in prescribing habits, she said, other changes might include increased rates of mental health disorders or increased rates of alcohol or drug use.

Dr. Thomas Laughren, director of the division of psychiatry products at the F.D.A., said in a conference call with reporters that the agency would need to see more data over time, linking declines in prescriptions to suicide risk before revisiting any of its decisions. In January, after a lengthy review of drug trial data, an F.D.A. panel voted to extend the “blackbox” warning to include adults up to age 24 — and also to include cautions on the labels that untreated depression was a risk factor for suicide.

“You simply cannot reach causal conclusions” from the new C.D.C. data, Dr. Laughren said.
The disease control agency’s analysis found that in 2004 there were 4,599 suicides in Americans ages 10 to 24, up from 4,232 in 2003, for a rate of 7.32 per 100,000 people that age. In the years before that, the rate had dropped to 6.78 per 100,000 in 2003 from 9.48 per 100,000 in 1990.

Over the last year, several studies have suggested that antidepressant drugs are more likely to reduce suicide risk than increase it.

“We’re starting to get a very cohesive story, that the highest risk period for suicide is right before treatment is started, and the risk actually comes down once pharmacotherapy or psychotherapy is started,” said Robert Gibbons, a professor of biostatistics and psychiatry at the University of Illinois in Chicago and the lead author of the study in the psychiatry journal.
But Andrew C. Leon, a psychiatric researcher at Weill Cornell Medical College in New York, said it was still far too early to tell what the link was, if any, between antidepressant use and suicide. “These are rare events, suicides, and it’s very difficult to disentangle random fluctuations in the numbers from the start of a real trend,” Dr. Leon said.

Monday, September 03, 2007

Mental Health neglected Worldwide

New research published in the medical journal, The Lancet, has highlighted the extent to which the mentally ill are neglected in the developing world.

Scientists say mental illness makes up about 14% of global disease, more than cancer or heart disease.

Up to 800,000 people commit suicide each year, mostly in poorer countries.

Despite this, the authors say, 90% of sufferers in developing countries receive no care. In some cases they are chained to trees or kept in cages.

Health officials called for new strategies and more money for treatment of the mentally ill in the developing world in a special series published by The Lancet.

They warned that as more people suffer from mental problems as a result of war, poverty and disease, unless widespread treatment becomes available, poor countries will be further handicapped in the future.

Nirmala Srinivasan, head of Action For Mental Illness, a lobby group based in Bangalore, India, told the Associated Press news agency that only 7% - 8% of an estimated 40 million to 50 million people in India who are victims of some form of mental illness - schizophrenia, depression, obsessive compulsive disorder, anxiety - get proper treatment.

Mentally ill adults in the major Brazilian cities are frequently seen begging on street corners and sleeping under highway overpasses.

In poor rural communities, families living in poverty cope the best they can with mentally ill relatives, but are often unable to afford medication or specialized care.

In Zambia, where it is believed to be a sign of witchcraft or being possessed by the devil, people who are sick are reluctant to seek help.

Mental illness is indeed life-threatening. About 800,000 a year commit suicide.

More than four out of five are in low or middle income countries.

But the report is also keen to stress the impact of mental health on other health conditions.
Poor mental health makes people more prone to other health problems - and then they are also less likely to get the medical help, social support and treatment they need.

Their dependents may suffer too. There is evidence from India and Pakistan, for example, that mothers who are depressed are more likely to have a malnourished child.

Many poorer countries are often presented with a stark choice when it comes to the treatment of mental patients given the scarcity of resources.

But many of the experts say basic mental health services can be provided cheaply and simply, especially if they are made part of general healthcare.