Friday, May 09, 2008 8:57 AM
posted by Aric Thorpe

"Going to Pot"

The findings came from questionnaires administered to 469 self-reported marijuana users 18 to 64 years old from the Baltimore area, who were recruited by advertisements and word of mouth.

About 28% reported more than 10,000 lifetime uses of marijuana, the equivalent of once-daily use for 27 years. More than half the sample reported at least 2,000 lifetime uses.

"We get the picture that these were heavier users," Dr. Gorelick said.

Some 90.6% had at least three dependence criteria as defined in DSM-IV's section on general substance dependence.

Fewer than half -- 42.4% -- said they had experienced withdrawal symptoms when they tried to quit.

Among those that did, reported symptoms were both physical and psychological, Dr. Gorelick said.

Click here to read the rest of this story from Medpage Today

7:29 AM
posted by Aric Thorpe

ADHD: a risk factor for developing an eating disorder during adolescence in girls

A recent study published in the current issue of the Journal of Abnormal Psychology found that girls with attention deficit hyperactivity disorder (ADHD) have a much greater risk of developing an eating disorder during adolescence. According to psychologist Amori Yee Mikami of the University of Virginia, "Adolescent girls with ADHD frequently develop body-image dissatisfaction and may go through repeating cycles of binge eating and purging behaviors that are common in bulimia nervosa." The girls in the study found to have the highest risk were those that had a "combined type" of ADHD, which included both hyperactivity and inattention. However, all the girls in the study with ADHD were more likely to be overweight. The following is an excerpt of an article from Medical News Today that reviews the study's findings:

"Our finding suggests that girls may develop a broader range of problems in adolescence than their male counterparts," Mikami said. "They may be at risk for eating problems, which are a female-relevant domain of impairment. We know that eating disorders occur 10 times more often in girls than boys."

Additionally, Mikami noted that because ADHD is more common in boys, many girls with the disorder may go undiagnosed and untreated.

"Girls with ADHD may be more at risk of developing eating problems as adolescents because they already have impulsive behaviors that can set them apart from their peers," Mikami said. "As they get older, their impulsivity may make it difficult for them to maintain healthy eating and a healthy weight, resulting in self-consciousness about their body image and the binging and purging symptoms."

The study was conducted with an ethnically diverse sample of 228 girls in the San Francisco Bay area; 140 who had been diagnosed with ADHD and 88 matched comparison girls without ADHD. They were first assessed between the ages of 6 and 12 and again five years later.

Click here to read the rest of this article from Medical News Today

Click here to learn about treatment options for eating disorders

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Wednesday, May 07, 2008 8:36 AM
posted by Aric Thorpe

Angst in adolescents a precursor to schizophrenia?

A recent birth cohort study found that agnst in adolescents may be a precursor to schizophrenia, especially if "many" symptoms are present. In the study, positive, negative and general signs of psychosis were common among the adolescent group; however, those who had more than one symptom in each category later developed mental illness. In particular, symptoms such as social withdrawal and problems connecting with others were significant predictors. According to Dr. Pirjo Maki, MD, of the University of Oulu in Finland, this finding is new. The following is an excerpt of an article from Medpage Today that reviews the study:

The researchers derived their conclusions from a study of 9,215 young Finns born between July 1, 1985 and June 30, 1986. They were asked to participate in a field study in 2001 and 2002, when they were either 15 or 16 years old, using a 21-item questionnaire.

The results of the field study were correlated with the Finnish Hospital Discharge Register from 2002 to the end of 2005, Dr. Maki said.

All told, there were 17 cases of psychosis among the cohort, including three cases of schizophrenia, three of bipolar disease, two of psychotic depression, and nine of other psychoses.

The study found that 45% of boys and 27% of girls reported no positive symptoms -- such as difficulty thinking clearly and feeling peculiar -- but most reported one or more, with girls saying they had more of the 11 symptoms.

The study found that 13 of the 17 youths who had psychosis had three or more positive features, compared with less than a third of those who had no disorders -- a difference that was significant at P<0.001.

In the same way, youths with three or more general features -- such as depression and apathy or anxiety -- were significantly more likely to be diagnosed with a psychosis, also at P<0.001, Dr. Maki reported.

Click here to read the rest of this article

Pastoral Action Point: The interesting thing about mental illness in general is that, while much of its origins may be genetic and attributed to heredity, therapy along with prescribed medications can and does yield significant results. For this cause, it is immensely important to connect individuals with professional help at the earliest sign of the onset of mental illness. Early detection is key.

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Tuesday, May 06, 2008 8:34 AM
posted by Aric Thorpe

Grim statistics

Statistics surrounding the mental health of the 1.6 million U.S. vets returning from the Middle East have some serious implications for both individuals and insurance companies. Thomas Insel, M.D., director of the National Institute of Mental Health, commenting on the situation said, “…a gathering storm" looms over civilian psychiatric care. The risks for us are significant if one just does the math." Truly Dr. Insel's math should be harkened to as one out of five returning vets will suffer from depression and or post-traumatic stress disorder. Additionally, up to 70% of soldiers returning home with PTSD or depression will not seek help from the Veterans Administration. The following is an excerpt of an article from Medpage Today that discusses these grim realities:

Dr. Insel said PTSD -- which he defined as a "failure to cope" -- emerges months and in some cases years after a traumatic event. "About 10% of people simply don't recover," he said.

He likened the Mid-East wars to Hurricane Katrina, in which thousands of people underwent a traumatic event and then were dispersed around the country, making it hard for them to get access to mental health services.

There are still "significant questions" about what treatments for PTSD, depression, or the combination are best, he said, and how returning vets should get treatment.

Since many vets will go back to small-town America, it's also important to figure out how treatment is to be "disseminated," he said.

A key issue is to "de-stigmatize" the need for mental health care, said Nada Stotland, M.D., of Rush Medical Center in Chicago and incoming president of the APA.

"We need to make it OK for members of the military to get the care they need," Dr. Stotland said.

The RAND Corporation report, released April 17, said that a survey revealed that only about half of the returned vets with possible PTSD or depression had sought help.

Click here to read the rest of the Medpage Today article

Click here for information on the treatment of depression

Click here for information on the treatment of PTSD

Pastoral Action Point: With numbers like these (“one out of five returning vets”) it is important for Pastors, church counselors, and benevolence ministers to be aware of the possibility of underlying issues confronting veterans. Keeping in mind that PTSD and depression, in particular, are statistically significant in returning soldiers helps to establish a probable direction for treatment referral in cases where ministers are sought out for advice.

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Monday, May 05, 2008 8:01 AM
posted by Aric Thorpe

Digital Therapist?

A recent study from Yale University found that patients who received computer-assisted training in addition to counseling were more successful in addressing their substance abuse problem(s) than those that received counseling alone. Seventy-seven people seeking treatment for drug and alcohol abuse participated in the study and those who received the supplementary computer-based training had significantly fewer positive drug tests at the end of the study. The study, which was reported in the May 1st edition of the American Journal of Psychiatry, utilized a software program developed by Kathleen M. Carroll, professor of psychiatry at Yale, and colleagues. The software program utilized various types of media to interact with participants, including text, video and audio. In reference to the software Carroll said, "We think this is a very exciting way of reaching more people who may have substance use problems and providing a means of helping them learn effective ways to change their behavior."

Applications for this type of software may be useful in instances where patients lack funding sources, therapists lack time, or even in instances where therapists lack training specifically in cognitive behavioral therapy. Obliviously, there are "potential" ethical issues surrounding such computer-based training and counselor sensitivity and adaptability to the client/patient must not be overlooked; Nonetheless, the study is quite interesting. The following is an excerpt from Medical News Today that reviews the study:

"I am immensely proud of Dr. Carroll and her colleagues' work,'' said William Sledge, MD, interim chair and George D and Esther S Gross professor of psychiatry. "At first glance one might conclude that this computer-based training in some way threatens the conventionally perceived value of the relationship between the therapist and the patient, however, I do not see it as so. Rather, they have demonstrated how a low cost but carefully conceived procedure can enhance conventional treatment and add additional element of richness and effectiveness to its power."

Carroll is one of 20 Yale School of Medicine faculty members who have been designated ISI HighlyCited researcher, a listing of the most highly influential scientists in the world. The Yale drug and alcohol program received top ranking among graduate programs in 2008 from the US News and World Report.

Click here to read the rest of this article

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Friday, May 02, 2008 7:12 AM
posted by Aric Thorpe

Depression and Faith

Some of the theorist Carl Jung's statements have spurred a few academic events within the last couple of months in Boston about faith and its place in emotional wellness. At one such event, an MIT conference, psychoanalyst Kathryn Madden relayed how that Jung believed that many psychological issues of adults during treatment were essentially problems of meaning. To quote Jung, ''Among all my patients in the second half of life -- that is to say, over 35 -- there has not been one whose problem in the last resort was not that of finding a religious outlook in life." These ideas resonated at other area conferences as well. Rev. Suzanne Guthrie, Cornell University Episcopal Chaplain, told of the connection between her once depressed state and a desire for faith exploration to an audience at Weston Jesuit School of Theology. Rev. William Rich, Trinity's associate for adult Christian formation and teacher at New York's Blanton-Peale Institute, remarked, ''Sometimes, people get depressed when they do not have any kind of grounding, centering place in their lives; If they don't have some kind of spiritual base -- belief in God or transcendent power -- then they have very little place to go." The following is an excerpt of an article from The Boston Globe that discusses these ideas:

That doesn't mean that atheists are doomed to depression, but it does mean that they and the devout must double-check their psychic insurance, Rich says. ''Everyone has a center that grounds them. Is your family your grounding place? OK, what happens if there's trouble in the family? Is your work your grounding place? OK, what happens if there's stress [there]?"

Religious faith is a place for believers to find that grounding, but it is no guarantee against mental illness. ''We're all susceptible to depression," he says.

Madden, the dean and chief executive officer of Blanton-Peale, cited one study in her MIT talk asserting that religious faith can speed recovery from mild or moderate bouts of depression. But she said that spiritual exploration can be full of harrowing uncertainty and suggested that depression might be, for the depressed, a step toward a better, more spiritual life.

Click here to read the rest of this article from the Boston Globe

On a side note, it is important to mention that individuals with strong faith can experience clinical depression. An understanding of this alleviates the guilt for people of faith experiencing severe depression, freeing them from the fear of breaking societal norms, which could result in an individual seeking out the help that they need. The general idea I pull from the afore mentioned article is that complete treatment addresses the whole person, spirit, mind and body.

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Thursday, May 01, 2008 7:10 AM
posted by Aric Thorpe

Brain Pace-Maker?

Deep-brain stimulation has provided yearlong relief of symptoms of severe depression for patients who had been refractory to a variety of other therapies. Ali R. Rezai, MD, of the Cleveland Clinic reported that eight of 16 patients enrolled in the study showed at least 50% improvement in depression scores at an interview before his presentation at the American Association of Neurological Surgeons. According to Dr. Rezai, "[Responders] had significant improvement in quality of life, returning back to work, getting engaged, dating." The study's focus was on patients that had disabling severe major depression for over five years and had not had any response to at least three different classes of antidepressants at the highest dosage levels. The following is an excerpt of an article from Medpage Today that reviews the study’s findings:

The study enrolled 17 patients overall, with one patient not yet completing a year of treatment when the data were analyzed.

Patients had severe and disabling major depression lasting at least five years without response to at least three classes of antidepressants titrated to the highest tolerated doses. All patients also failed combined therapy with at least two augmentation agents and multiple electroconvulsive therapy trials.

Those considered to be at imminent risk of suicide were excluded, as were patients with current or past psychotic disorders, associated neurological disorder, any significant brain imaging abnormality, substance abuse, history of severe personality disorder, coagulopathy, or other medical problems that could increase the risk of surgery.

Treatment involved placement of a Medtronic Soletra implantable pulse generator, a pacemaker-like device used in deep brain stimulation for Parkinson's disease. Bilateral leads were placed in the ventral portion of the anterior limb of the internal capsule and ventral striatum with high-resolution MRI targeting.

Each electrode contact was 3 mm long with 4 mm of spacing or insulation between contacts. The diameter and other physical properties were the same as the common electrodes used in deep brain stimulation for movement disorders, Dr. Rezai said.

Click here to read the rest of this article from Medpage Today

Click here for information on the treatment of clinical depression

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Stephen Harnish, MD is the Medical Director of Brookhaven Hospital. He is board certified in psychiatry, and is a graduate of Dartmouth Medical School. Dr. Harnish is a member of the American Psychiatric Association and is well known in Oklahoma for his informative radio and television appearances.

Rev Robert Wester, MDIV MA is Senior Chaplain at Brookhaven Hospital and the RENEWAL programs. Chaplain Wester conducts daily devotional services and offers pastoral counseling to clients in the RENEWAL program.

Aric Thorpe, MHR, is Brookhaven Hospital's Pastoral Liaison Representative. He conducts the quarterly Minister's Lifeline series and provides mental health information to pastors and clergy.

Sarah McGee serves as the Community Education Provider for Brookhaven Hospital. She provides information on mental health and drug and alcohol treatment to healthcare professionals in Oklahoma and surrounding states.