Mental Health Association of Nebraska

Adversities faced in childhood have effects on mental health far into the future

According to Ronald C. Kessler, PhD, of Harvard, "Mental illness in adulthood was increasingly likely the more traumas faced in childhood."  In Difficult Childhood Lingers in the Mind (MedPage Today, 2/4/2010), Crystal Phend reports that Kessler and other researchers found that "adversities relating to family dysfunction - substance abusing parents, sexual or physical abuse in the home, neglect, etc. - appeared to have the strongest link to onset and persistence of psychiatric disorders" and that "childhood adversities were projected to account for 44.6% of childhood-onset disorders, 32% of adolescent-onset disorders, and 28.6% of adult-onset disorders."

"Childhood trauma upsets the orderly psychological and biological cascades of development leaving the affected individual at increased risk of a wide range of adverse mental health outcomes."  To read more . . .

The debate over the effectiveness of antidepressants continues

In the February 8, 2010 issue of Newsweek,  Sharon Begley writes in The Depressing News about Antidepressants of a moral dilemma that arose when a friend shared his desire to "beat his chronic depression once and for all," and asked her if she knew of any research that might help him decide whether a new medication his doctor recommended might actually work.  The problem was that she knew of numerous studies, but their results tended to show little difference in the effectiveness of medications and placebos.

 Irving Kirsch (University of Connecticut) and other researchers have looked at published drug manufacturer conducted clinical trial reports (1998), and both published and unpublished clinical trial reports (2002), and found that patients on a placebo improved about 75 - 82 percent as much as those on drugs. A report published in the January 6, 2010, issue of The Journal of the American Medical Association found that "the magnitude of benefit of antidepressant medication compared with placebo increases with the severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms."

The question then becomes "How do the drugs work?"  Kirsch concluded that "the lion's share of the drugs' effect comes from the fact that patients expect to be helped by them, and not from any direct chemical action on the brain, especially for anything short of very severe depression."

Thus the moral dilemma: "In any given year, an estimated 13.1 million to 14.2 million American adults suffer from chronic depression. At least 32 million will have the disease at some point in their life.  Many of the 57 percent who receive treatment (the rest do not) are helped by medication.  For the benefit to continue, they need to believe in their pills."  To read more . . .

People living with mental illness v. Perception of violence and forced treatment

Ten years ago, Kendra Webdale was killed when she was pushed to in front of a moving train by a man who had been denied services for his mental illness.  As a result of these tragedies (Kendra’s death and the failure of a system that refused to give someone the help they need and want), New York State passed Kendra’s Law, which mandated outpatient or involuntary commitment to those deemed to sick to be in normal society.  Forty states  now have such laws, including Nebraska.  In New York, Kendra's Law is set to expire in June 2010.

Last November, Columbia University Law School hosted a forum to discuss the issue of involuntary commitment.  Steve Miccio, executive director of PEOPLe, Inc, stated that Kendra’s law was a “knee-jerk response” to a horrible tragedy and that was really systems failure.  To read more go . . .

In March 2008, the Association of Health Care Journalists hosted a panel presentation, on violence of the mentally ill and forced commitment.  Panel participants included Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services (NYAPRS) on one side and Dr. E. Fuller Torrey, president of the Treatment Advocacy Center on the other.  Thanks to MIWatch, you can hear Mr. Rosenthal and Dr. Torrey’s views on the subject.  Listen and decide for yourself. 

Then, if you like, watch Mentalhealthstigma.com's video, Will the Real Psycho please stand up!

It'll get you thinking.

Many Antipsychotic Users Not Getting Needed Tests

Megan Brooks of Reuters Health, citing a report recently released by Dr. Elaine H. Morrato of the University of Colorado-Denver, reports that "people who take newer drugs for schizophrenia and other psychotic conditions are supposed to have their blood sugar and cholesterol levels checked regularly but many don't."   So-called "second-generation" antipsychotic drugs, which include olanzapine (Zyprexa), risperidone (Risperdal) and aripiprazole (Abilify), were developed because older antipsychotics have significant side effects. However, the newer drugs are known to significantly increase blood sugar and cholesterol levels, raising the risk for diabetes and heart disease. Click on the link to read the entire article  Antipsychotic Users Not Getting Needed Tests

Psychiatric Polypharmacy Continues to Grow

Polypharmacy refers to the practice of prescribing two or more drugs to treat a single condition or disease, and its use by medical practitioners is growing according to a study recently released by Ramin Mojtabai, MD, PhD, MPH, of Johns Hopkins University, and Mark Olfson, MD, MPH, of Columbia University.  According to their report, "while some of these combinations are supported by clinical trials, many are of unproven efficacy," and  "these trends put patients at increased risk of drug-drug interactions with uncertain gains for quality of care and clinical outcomes."  To read more . . .