Markham's Behavioral Health

Children in U.S. 3xs more likely to be prescribed psychotropic medications than in Europe

Science Daily reported on September 25, 2008 on a study which will appear in an upcoming issue of the journal, Child and Adolescent Psychiatry and Mental Health, which found that children in the United States are three times more likely to be prescribed psychotropic medications than children in Western Europe. The authors speculate on the reasons for the difference in practice. If you would like to read more click here.

Antidepressant Scripts Up 16 Million Over 3-Year Period and most not prescribed by mental health professionals

Reuters HealthDay reported on July 24, 2008 on a report from the Agency for Healthcare Research and Quality which found that the prescription of antidepressant drugs has increased significantly over a 3 year period from 2002 - 2005 and less than a third of the antidepressant prescriptions are prescribed by psychiatrists with the great majority prescribed by primary care physicians.

It is interesting that most of the antidepressant medications are not precribed by mental health professionals which leads to the assumption that most depression is being treated without psychotherapy. Most outcome research seems to indicate that depression is better treated by psychotherapy or a combination of psychotherapy and antidepressant medication.

Here is a snippet from the HealthDay article:

Between 2002 and 2005, the number of prescriptions filled for antidepressant drugs increased from 154 million to 170 million, according to a report released Thursday by the U.S. government.

The analysis, by the Agency for Healthcare Research and Quality, of antidepressant prescriptions (not including refills) written after doctors talked with patients in-person or over the phone found that in 2005:

• 29 percent of prescriptions were written by psychiatrists -- medical doctors who specialize in the treatment of mental disorders.
• 23 percent came from general practitioners -- physicians who provide primary care but are specialty-trained.
• 21 percent came from family practitioners -- primary care physicians who complete a residency in family medicine.
• 10 percent came from internal medicine specialists -- physicians who complete a residency in internal medicine and who focus on the diagnosis and non-surgical treatment of adults with illnesses that are difficult to diagnose or manage.

The data used in the summary are from the Medical Expenditure Panel Survey of health services used by Americans.

 

MedlinePlus: Antidepressant Scripts Up 16 Million Over 3-Year Period.

Unproven therapies used on traumatized kids

Reuters reported on September 9, 2008 on a CDC report which will appear in the American Journal of Preventive Medicine that a lot of therapies provided to kids with PTSD are not proven. Here is a snippet from the article:

Many doctors and therapists use unproven approaches such as drugs, art or play therapy on children suffering trauma when old-fashioned talk therapy has been shown to work, a report released on Tuesday said.

A review of a dozen different studies showed no evidence that alternative therapies helped children traumatized by violence or abuse, even though more than 75 percent of U.S. mental health professionals who treat children and teens with post traumatic stress disorder may use them.

But cognitive therapy -- a type of talk therapy aimed at changing negative thoughts -- does work, the group at the U.S. Centers for Disease Control and Prevention said.

"The good news is there is substantial research showing the effectiveness of group or individual cognitive behavioral therapy in treating children and teens experiencing the psychological effects of trauma," the CDC's Robert Hahn, who led the study, said in a statement.

"We hope these findings will encourage clinicians to use the therapies that are shown to be effective."

Children can be traumatized by many things including physical or sexual abuse, witnessing domestic violence, community violence or natural disasters.

In my office, I use cognitive based therapy and, when relevant, include parents and/or caretakers in on the sessions. I find that children and adolescents usually do very well. I am chagrined to hear about the play therapies, sand tables, EMDR, and other things my colleagues are doing with kids which they usually learned at some workshop and now have become born again disciples of the technique. I have often wondered, as the research report above suggests, why they didn't take a workshop and learn how to do therapy that works instead of the latest fad? Like many things in life we are enamored with the new, the novel, the gimicky approach which promises quick and almost miraculous success.

I find it increasingly difficult to find good therapists to refer people to. The mananged care system and the atrophy of the community mental health centers have made it difficult for young therapists to find adequate training environments.

MedlinePlus: Unproven therapies used on traumatized kids -study.

Cheerleading causes majority of female athlete injuries

Reuters HealthDay reported on August 25, 2008 on this year's report from the National Center for Catastrophic Sports Injury Research at the University of North Carolina at Chapel Hill that the most female sports injuries are sustained in cheerleading. Almost 2/3rds of all female sports injuries to females occur in cheerleading. Often denigrated as even being a sport at all, most people greatly underestimated the physical demands of cheerleading. Here is a snippet from the HealthDay article:

Over the past 25 years, cheerleading accounted for two-thirds of all catastrophic sports injuries experienced by high school and college females in the United States, a much higher proportion than previously thought, a new report says.

Cheerleading accounted for 65.1 percent of female high school athlete injuries and for 66.7 percent of female college athlete injuries.

It was previously believed that cheerleading accounted for 55 percent of injuries among high school females and 59.4 percent of injuries among college females. But the percentages increased when new data was used for this year's report from the National Center for Catastrophic Sports Injury Research, based at the University of North Carolina at Chapel Hill.

Center director Frederick O. Mueller, a professor of exercise and sports science who's authored the annual report since it began in 1982, said catastrophic injuries to female athletes have increased over the years.

Managing your anger can save your life

The British Health Service has a good video on anger management. It lasts 5:14.

Abstinence based sex ed programs don't work - Bush Administration gets it wrong

  Reuters HealthDay reported on August 21, 2008 on a study which appears in the journal Perspectives on Sexual and Reproductive Health which found that abstinence based programs don't work.

In 2007 alone the Bush administration spent 176 million dollars on abstinence only sex education for our young people and nothing for comprehensive sex education. Here is a snippet from the HealthDay article:

"Interventions that have been created to encourage abstinence have treated abstinence and sexual activity as opposites. However, teenagers say they don't think of them as opposites," lead author Tatiana Masters, a doctoral student in social work, said in a university news release.

"These (abstinence-only) interventions are less likely to work than more comprehensive sex-education programs, because they are not meeting adolescents where they are, and they are speaking a different language," Masters said.

The study included 365 adolescents (230 girls, 135 boys) in Seattle who took part in an intervention to reduce HIV risk behavior. The participants filled out questionnaires asking them about their attitudes and intentions about abstinence and sex, and about their sexual activity in the previous six months.

At the start of the study, 11 percent of the boys and 4 percent of the girls had had sexual intercourse. That increased to 12 percent of the boys and 8 percent of the girls six months later, and to 22 percent of the boys and 12 percent of the girls one year later.

"This paper demonstrates that increasing abstinence intention does not lead to less sex. In fact, when abstinence intention and sex intention interact with each other a teenager is more likely to have sex," Masters said.

The study was published in the journal Perspectives on Sexual and Reproductive Health.

In 2007, the U.S. government provided $176 million for abstinence-only programs, but there is no federal funding for comprehensive sex education programs. This study's findings "raise serious concerns about the abstinence-only approach as a risk-reduction method for adolescent sexual behavior," Masters and colleagues concluded.

Government steps in again, bails out AIG with $85B of taxpayers money

The big lie of Reaganomics exposed. The little guy and the middle class gets screwed again as our plutocracy marches on manipulating our economy for the benefit of the rich and powerful and the politicians they are in bed with. So much for Friedman and his idiot disciples who preach a free market and a smaller role for government. I can't see how the Repbulicans have any credibility left with any Americans who have the brains to understand what is going on.

Under the Repbulican administration of the last 8 years capitalism has gotten way out of control. Now we have to pay for misguided policies and the foolishness of the American voters who put these idiots in power.

Government steps in again, bails out AIG with $85B - Yahoo! News.

Fed pumps $50B into nation's financial system - The big lie of free markets

Milton Friedman and his disciples are a bunch of charlatans when it comes to their preaching about free markets. They are only free when the plutocrats are making money. When they loose money the markets quickly become socialized by the government and the taxpayers pay. When will the voters catch on to the nonsense that comes out of Washington?

Fed pumps $50B into nation's financial system - Yahoo! News.

Big lie exposed - No such thing as free markets

I woke up this morning to the headline on Yahoo news that the U.S. government is going to take over two of the largest mortgage companies in the United States. So much for free markets.

Of course, the government took over Bear Sterns a couple of months ago trying to prop up the investment companies.

The Republican nonsense about free markets is peddled to the working class and poor but the upper middle class and rich know that there is no such thing as free markets. Markets are manipulated by the rich, monied class and they are in bed with the government officials to line their pockets. When their schemes don't work, the government steps in to bail them out. This is another example of capitalism out of control. Here is a snippet from the Yahoo web site:

By ALAN ZIBEL, AP Business Writer 45 minutes ago

WASHINGTON - The government is expected to take over Fannie Mae and Freddie Mac as soon as this weekend in a monumental move designed to protect the mortgage market from the failure of the two companies, which together hold or guarantee half of the nation's mortgage debt, a person briefed on the matter said Friday night.

Some of the details of the intervention, which could cost taxpayers billions, were not yet available, but are expected to include the departure of Fannie Mae CEO Daniel Mudd and Freddie Mac CEO Richard Syron, according to the source, who asked not to be named because the plan was yet to be announced.

Federal Reserve Chairman Ben Bernanke, Treasury Secretary Henry Paulson and James Lockhart, the companies' chief regulator, met Friday afternoon with the top executives from the mortgage companies and informed them of the government's plan to put the troubled companies into a conservatorship.

Brooklyn Follies, the book

I never before read any of Paul Auster's novels and I have fallen in love. The first book of Mr. Auster's I have read is Brooklyn Follies which is the story about Nathan Glass, a retired life insurance salesman, who is divorced and has been through cancer and is in remission and who has returned to Brooklyn the place of his growing up to die.

As Nathan gets settled into Brooklyn he meets all kinds of characters and creates quite an interesting life for himself which I enjoyed learning about.

The moral of the story is that life doesn't have to be over after retirement and after a cancer diagnosis. There still are many interesting adventures awaiting for us. All it requires is a willingness to participate and be open to life's infinite variety of people and experiences.

I enjoyed this book very much and highly recommend it.