What Addicts Need (Newsweek Article)

While the roots of addiction remain a dark tangle of factors—most experts agree that addicts trying to quit will always need psychological support—the old white-knuckle wisdom that addicts simply lack resolve passed out of fashion decades ago. The American Medical Association recognized addiction as a disease back in 1956. But only now are we beginning to see treatments that target the underlying biochemistry of that disease.

What is the cost of the war in Iraq? (The Times of London Editorial)

The Bush Administration was wrong about the benefits of the war and it was wrong about the costs of the war. The president and his advisers expected a quick, inexpensive conflict. Instead, we have a war that is costing more than anyone could have imagined.
The cost of direct US military operations -- not even including long-term costs such as taking care of wounded veterans -- already exceeds the cost of the 12-year war in Vietnam and is more than double the cost of the Korean War.
And, even in the best case scenario, these costs are projected to be almost ten times the cost of the first Gulf War, almost a third more than the cost of the Vietnam War, and twice that of the First World War. The only war in our history which cost more was the Second World War, when 16.3 million U.S. troops fought in a campaign lasting four years, at a total cost (in 2007 dollars, after adjusting for inflation) of about $5 trillion. With virtually the entire armed forces committed to fighting the Germans and Japanese, the cost per troop (in today's dollars) was less than $100,000 in 2007 dollars. By contrast, the Iraq war is costing upward of $400,000 per troop.

Mentally ill unfairly portrayed as violent

[In] recent weeks, the news has been full of horrendous stories involving killers with known or suspected mental illness. As I write this, the nation is still reeling from the shootings at Northern Illinois University. Press reports now indicate that the shooter had a long history of mental illness and had recently stopped taking antidepressant medication.
To make matters worse, three psychotherapists have been assaulted or murdered in the past month. The most brutal attack involved a Manhattan psychologist murdered by a man who also gravely injured a psychiatrist. The New York Times reported that the accused man blamed the psychiatrist for having him institutionalized 17 years ago; apparently, the psychologist was not the intended victim. And only a few weeks ago, a social worker in Andover was killed, allegedly by her 19- year-old patient, during a visit to the man's home.
What do these attacks say about mental illness? Surely they create the impression that individuals with mental illness are a dangerous and violent lot. And as professor John Monahan and colleagues at the University of Virginia School of Law wrote recently, "the more a member of the general public believes that mental disorder and violence are associated, the less he or she wants to have an individual with a mental disorder as a neighbor, friend, colleague, or family member."
Yet the impression that we are awash in a sea of psychotic violence is clearly unfounded. Writing in the Nov. 16, 2006, New England Journal of Medicine, Dr. Richard A. Friedman of the Weill Cornell Medical College notes that only about 3 to 5 percent of violence in the general population is attributable to those with "serious mental illness," conventionally defined as schizophrenia, major depression, or bipolar disorder. The combined lifetime prevalence of these conditions in the US general population is estimated at 19 percent - far larger than their contribution to violence.

Glutamate and Schizophrenia

The trial results were a major breakthrough in neuroscience, says Dr. Thomas R. Insel, director of the National Institute of Mental Health. For 50 years, all medicines for the disease had worked the same way — until Dr. Schoepp and other scientists . . . . focused their attention on the way that glutamate, a powerful neurotransmitter, tied together the brain’s most complex circuits. Every other schizophrenia drug now on the market aims at a different neurotransmitter, dopamine.
The Lilly results have fueled a wave of pharmaceutical industry research into glutamate. Companies are searching for new treatments, not just for schizophrenia, but also for depression and Alzheimer’s disease and other unseen demons of the brain that torment tens of millions of people worldwide.

Antidepressant Discontinuation Syndrome

Steven Kazmierczak's bolt-from-the-blue shooting spree on Feb. 14 reignited a long-running debate over the benefits and risks of antidepressants -- taking them and discontinuing them."It's sad to watch this," says Ann Blake Tracy, executive director of the International Coalition for Drug Awareness and co-founder of a website, SSRI stories.com, that catalogs violent crimes like Kazmierczak's and links them to psychiatric drug use. "You find suicide, murder, rape, arson" -- all caused by drugs such as Prozac, she says. "How did they convince us that this is therapeutic?" Most in the psychiatric profession would counter that antidepressants overwhelmingly save lives, and salvage those hobbled by sadness and anxiety. They doubt that coming off these drugs -- especially Prozac, which Kazmierczak was reported to have taken -- led the Illinois gunman to kill. And they fret that depressed patients who believe the charges of critics like Tracy will turn their backs on medicine that can work wonders if taken -- and stopped -- correctly." When a story like this is brewing, people think, 'If this medication can possibly be related to a bad outcome, I'd better get off it now,' " says UCLA psychiatrist Andrew Leuchter. "We're talking about millions and millions of people who've been treated successfully with these drugs and stopped treatment without any kind of dramatic changes of behavior." At the center of the latest tempest over psychotropic drugs is a long-recognized phenomenon called Antidepressant Discontinuation Syndrome. First identified in psychiatric journals in the late 1990s, the condition is an assortment of symptoms that can plague patients for several weeks and, in a few cases on medical record, months after coming off a wide range of antidepressants. They include dizziness, headache, fatigue, changes in sleep patterns and appetite, vivid or disturbing dreams, agitation and anxiety. Some patients experience tingling or "electric zap" sensations passing through their extremities or head and, in rare cases, spasmodic jerking in the extremities, especially while sleeping.

A shortage of primary care doctors is predicted

The supply of primary care physicians is not keeping up with demand, which could be the start of a serious shortage, doctors and health advocates say. The gap is caused by retirements, better working hours and increased interest in specialty fields such as radiology and dermatology that offer higher salaries, health officials say. The Council on Graduate Medical Education projects an 85,000 physician shortfall in the United States by 2020.

Blue Cross halts letters amid furor

Facing a torrent of criticism Tuesday, Blue Cross of California abruptly halted its practice of asking physicians in a letter to look for medical conditions that could be used to cancel patients' insurance coverage.In a statement issued about 6 p.m., the state's largest for-profit insurer said, "Today we reached out to our provider partners and California regulators and determined this letter is no longer necessary and, in fact, was creating a misimpression and causing some members and providers undue concern.

Doctors balk at request for data

The state's largest for-profit health insurer is asking California physicians to look for conditions it can use to cancel their new patients' medical coverage. Blue Cross of California is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose "material medical history," including "pre-existing pregnancies."
"Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately," the letters say. The Times obtained a copy of a letter that was aimed at physicians in large medical groups.The letter wasn't going down well with physicians."We're outraged that they are asking doctors to violate the sacred trust of patients to rat them out for medical information that patients would expect their doctors to handle with the utmost secrecy and confidentiality," said Dr. Richard Frankenstein, president of the California Medical Assn. Patients "will stop telling their doctors anything they think might be a problem for their insurance and they don't think matters for their current health situation," he said.

Is Tobacco Money Tainted?

Here's a recipe for academic controversy: First, find dozens of hard-core teenage smokers as young as 14 and study their brains with high-tech scans. Second, feed vervet monkeys liquid nicotine and then kill at least six of them to examine their brains. Third, accept $6 million from tobacco giant Philip Morris to pay for it all. Fourth, cloak the project in unusual secrecy. At UCLA, a team of researchers is following this formula to produce what it hopes will be a groundbreaking study of addiction. So far, the scientists have proved that the issues of animal testing and tobacco-funded research are among the most contentious on university campuses.

ERs fail as the nation's safety net

The long waits that government inspectors say endanger emergency room patients at Harbor-UCLA Medical Center can also be found in backlogged hospitals across the country, according to emergency care experts who have been trying for years to draw attention to the nation's overloaded safety net."Overcrowding in our emergency departments is a national crisis," said Dr. Linda Lawrence, president of the American College of Emergency Physicians, an advocacy group based in Washington D.C. "We no longer have the capacity to serve as the safety net for society."The group surveyed 1,000 emergency care physicians in September and found that one in five knew of a patient who had died because of having to wait too long for care, Lawrence said.

Do Free Pens and Lunches Influence Doctors' Prescribing Behavior?

A new UPMC conflicts-of-interest policy will take effect that day aimed at making doctors' decisions free from influence created by gifts or improper relationships with the drug or medical device industries. Among other provisions, the policy bans gifts such as pens, note pads and food provided by industry representatives as they work to present information about their products at doctors' offices. . . . The policy directly applies to about 50,000 faculty, staff and students of the university's Schools of the Health Sciences and other professionals and staff employed or contracted by UPMC's U.S. operations.

From Bush, Foe of Earmarks, Similar Items

President Bush often denounces the propensity of Congress to earmark money for pet projects. But in his new budget, Mr. Bush has requested money for thousands of similar projects. He asked for money to build fish hatcheries, eradicate agricultural pests, conduct research, pave highways, dredge harbors and perform many other specific local tasks. The details are buried deep in the president’s budget, just as most Congressional earmarks are buried in obscure committee reports that accompany spending bills. . . . The White House defines “earmarks” in a way that applies only to projects designated by Congress, not to those requested by the administration.

Planned Parenthood Blog

Missouri voters, like you, understand that votes matter and have already told us that you strongly support state funds for family planning (69%), that you believe pharmacies should dispense birth control without discrimination or delay (65%), that you believe sex education should be comprehensive (76%), and that the government should not step between a patient and her doctor (63%). Not what Governor Blunt wants to hear. But, together, we say "enough is enough to failed policies and failed politicians."

Very Premature Babies Don't Get Follow-Up Care

A groundbreaking study reports that most very low birth-weight babies born to low-income women failed to get critical follow-up care within their first two years of life. The study illustrates how these premature infants, who are vulnerable to vision, hearing and speech impairments, are falling through the cracks of the U.S. health-care system, the researchers said.
Only 20 percent of the babies with hearing problems returned for specialized care within their first six months of life, while fewer than one in four underwent recommended vision tests between 1 and 2 years of age.

In Health Debate, Clinton Remains Vague on Penalties

Senator Hillary Rodham Clinton inched closer Sunday to explaining how she would enforce her proposal that everyone have health insurance, but declined to specify — as she has throughout the campaign — how she would penalize those who refuse. Mrs. Clinton, who did not answer Senator Barack Obama’s question on the topic in a debate last Thursday, was pressed repeatedly to do so Sunday by George Stephanopoulos on the ABC program “This Week.” When Mr. Stephanopoulos asked a third time whether she would garnish people’s wages, Mrs. Clinton responded, “George, we will have an enforcement mechanism, whether it’s that or it’s some other mechanism through the tax system or automatic enrollments.” She then added that the focus on enforcement clouded a more important point, that her proposal to cover the uninsured was superior to Mr. Obama’s because she would mandate coverage for all, while he would require it only for children.
What might seem a mundane debate over health policy has taken on outsized importance in the approach to Tuesday’s voting because it is one of the few substantive differences between the two leading Democratic presidential candidates. . . . Polling has found that health care is a top concern of Democratic voters, and that they rank covering the uninsured as more important than reducing health costs or improving quality.

Online house calls click with doctors

Consulting your family physician is finally moving into the 21st century and out of the doctor's office. Since the dawn of e-mail, patients have been pleading for more doctors to offer medical advice online. No traffic jams, no long waits, no germ-infested offices with outdated magazines and bad elevator music. There was always one major roadblock: Most health insurers wouldn't pay for it. Until now.

Keeping Your Brain Fit

Just within the past few months, several groups of researchers have added support for the growing consensus that plenty can be done to slow the age-related declines in memory, mental speed, and decision making that affect most people. In November, a team from the Mayo Clinic and the University of Southern California announced that one computer-based mental training program appeared to improve older people's cognitive performance by as much as 10 years. That same month, a Harvard researcher found that long-term use of beta carotene supplements delayed cognitive decline by up to a year and a half.

Wal-Mart Expands In-Store Health Clinics

Wal-Mart Stores Inc. will open its first in-store medical clinics under its own brand name after leasing space in dozens of stores to outside companies that operate the quick-service health stops.
Bentonville, Ark.-based Wal-Mart is among several U.S. supermarket and drug store chains that in the past couple of years have begun opening store-based health clinics, which are staffed mostly by nurse practitioners or physician assistants and offer quick service for routine conditions from colds and bladder infections to sunburn.
About 7 percent of Americans have tried a clinic at least once, according to an estimate by the Convenient Care Association, an industry trade group formed in 2006.
That number is expected to increase dramatically, as chains like Wal-Mart, CVS Corp., Target Corp. and Walgreen Co. partner with mini-clinic providers like RediClinic and MinuteClinic to expand operations. The trade group estimates there will be more than 1,500 by year-end, up from about 800 in November.

Major Problem Often Overlooked When Linking Violence, Illness

Public and professional attention in recent years has tended to focus on whether people with mental illness are more likely than others to commit acts of violence, but a new study suggests that violent victimization of these individuals may be the greater public health problem.
A literature review of studies published since 1990 on the perpetration of violence by, and violent victimization of, mentally ill individuals indicates that victimization is considerably more common than perpetration. The study was published in the February Psychiatric Services as part of a special issue on violence and mental illness.
Among outpatients, 2 percent to 13 percent had perpetrated violence in the prior six months to three years, compared with 20 percent to 34 percent who had been violently victimized. Studies combining outpatients and inpatients reported that 12 percent to 22 percent had perpetrated violence in the prior six to 18 months, compared with 35 percent who had been a victim in the preceding year. "Although society may regard persons with mental illness as dangerous criminals, our review of the literature shows that violent victimization of persons with severe mental illness is a greater public health concern than perpetration of violence," wrote lead author Linda Teplin, Ph.D., and colleagues in their report.

People With Mental Illness Target of New Gun Law

Supporters of a new gun-control law claim it might have prevented the deaths of 32 people last year in a massacre at Virginia Tech carried out by a student who was mentally ill. Some psychiatrists, however, say the law falls short as a meaningful way to reduce gun violence.
The debate stems from President George W. Bush's signing of a measure in January intended to prevent people with serious mental illness from buying guns.
The legislation (HR 2640), sponsored by Rep. Carolyn McCarthy (D-N.Y.), authorizes up to $1.3 billion in state grants to improve the tracking and reporting of individuals who are legally barred from gun purchases, including those involuntarily confined to a psychiatric hospital. (McCarthy's husband was killed by a mentally ill gunman who went on a rampage on a suburban commuter train 14 years ago.)
Paul Appelbaum, M.D., a professor of psychiatry at Columbia University and chair of APA's Council on Psychiatry and Law, said that a fully funded Virginia background check that looked for involuntary psychiatric care before the gun sales to the Tech shooter and the reporting of his outpatient care by state officials might have kept him from buying his weapons. "But he could have easily gotten them through other means," such as private sales and gun-show sales, which are unregulated by the background-check system, said Appelbaum, a former APA president.

Study backs value of U.S. state anti-smoking plans

U.S. state tobacco control programs are effective at cutting the number of smokers, and states that spend more get the best results, federal health officials said on Tuesday.
Declines in adult smoking rates in individual states are directly related to increases in state per-capita investments in tobacco control and smoking cessation programs, according to a study published in the American Journal of Public Health.

Flawed embryos seen as source for stem cells

From what is now considered medical waste might be fashioned bio-treasure: stem cells able to form into any of the body's 220 cell types, including blood, nerves, bone, and skin tissue, new research suggests. The poor quality embryos are "an ethically acceptable source" for the creation of stem cell lines. Scientists at Children's Hospital Boston have forged stem cells from the "flawed" and "poor quality" early-stage embryos that in vitro fertilization clinics discard by the hundreds of thousands every year, according to research published yesterday in the journal Nature Biotechnology.

Lilly Considers $1 Billion Fine to Settle Case

Eli Lilly and federal prosecutors are discussing a settlement of a civil and criminal investigation into the company’s marketing of the antipsychotic drug Zyprexa that could result in Lilly’s paying more than $1 billion to federal and state governments. If a deal is reached, the fine would be the largest ever paid by a drug company for breaking the federal laws that govern how drug makers can promote their medicines. . . . Zyprexa has serious side effects and is approved only to treat people with schizophrenia and severe bipolar disorder. But documents from Eli Lilly show that from 2000 to 2003 the company encouraged doctors to prescribe Zyprexa to people with age-related dementia, as well as people with mild bipolar disorder who had previously had a diagnosis of depression. Although doctors can prescribe drugs for any use once they are on the market, it is illegal for drug makers to promote their medicines for any uses not formally approved by the Food and Drug Administration.

State Response to Virginia Tech Shootings

A bill passed by the [Virginia] House Courts of Justice Committee would ensure that those who have been ordered to seek treatment are monitored by mental health workers. Seung Hui Cho, the gunman who shot and killed 32 students and teachers at Virginia Tech in April before killing himself, was ordered into treatment in 2005, but the local mental health agency never followed up. . . . Currently, people must be deemed an "imminent danger" to be hospitalized against their will. Under Howell's bill and a similar one advanced by a House committee last week, there must be a "substantial likelihood" that a person would cause "serious physical harm to himself" in the near future or could "suffer serious harm due to substantial deterioration."

Happiness is being young or old, but middle age is misery

People are most likely to become depressed in middle age, according to a worldwide study of happiness. The team of economists leading the work found that we are happiest towards the beginning and end of our lives, leaving us most miserable in middle years between 40 and 50.
The results, published in the journal Social Science & Medicine, showed that people's levels of happiness followed a U-shaped curve, a pattern that was remarkably consistent in the vast majority of countries the researchers looked at, from Azerbaijan to Zimbabwe. For both men and women in the UK, the probability of depression peaked at around the age of 44. In the US, men were most likely to be unhappiest at 50, while for women the age was 40.

Soldier Suicides at Record Level

Suicides among active-duty soldiers in 2007 reached their highest level since the Army began keeping such records in 1980, according to a draft internal study obtained by The Washington Post. Last year, 121 soldiers took their own lives, nearly 20 percent more than in 2006.
At the same time, the number of attempted suicides or self-inflicted injuries in the Army has jumped sixfold since the Iraq war began. Last year, about 2,100 soldiers injured themselves or attempted suicide, compared with about 350 in 2002, according to the U.S. Army Medical Command Suicide Prevention Action Plan.
The Army was unprepared for the high number of suicides and cases of post-traumatic stress disorder among its troops, as the wars in Iraq and Afghanistan have continued far longer than anticipated. Many Army posts still do not offer enough individual counseling and some soldiers suffering psychological problems complain that they are stigmatized by commanders. Over the past year, four high-level commissions have recommended reforms and Congress has given the military hundreds of millions of dollars to improve its mental health care, but critics charge that significant progress has not been made.

A wave of change in medical schools puts emphasis on care of seniors

At Brown University medical school in Providence, students discuss why the organs of their cadavers look different from their own. They spend hours studying how the brain ages. They practice physical examinations on residents of an assisted living complex. And even in obstetrics and gynecology, they learn about problems affecting seniors.
The new emphasis on aging is part of a wave of change sweeping medical schools nationwide as they focus - many for the first time - on preparing all newly minted doctors to treat the growing population of older Americans. Although students have traditionally trained in hospitals filled with older patients, many graduated with little knowledge of how elderly patients' bodies and minds differ from younger ones.

California Health Plan Defeated

In handing Gov. Arnold Schwarzenegger his biggest legislative setback, members of a Senate panel expressed concerns Monday that his plan to cover most Californians without health insurance was inadequately funded and would worsen the state budget crisis.
But the legislation negotiated by the Republican governor and Assembly Speaker Fabian Núñez, D-Los Angeles, was unable to surmount several political hurdles beyond the annual tab, now estimated at $14.9 billion. A proposed tobacco tax drew high-powered opposition. The fact that raising taxes takes a two-thirds vote in the Legislature made finding financing a complicated exercise. Republicans never supported the measure. Democrats weren't on the same page.

Lax oversight favors doctors over patients

PART 1: [Wisconsin's] lax system of oversight favors doctors over patients. A Journal Sentinel review of five years' worth of disciplinary action found that the board is slow to look into complaints, keeps many of its investigations secret and rarely imposes serious discipline, even when patients die.

PART 2: The patient, a man who had been injured on the job, was feeling out of it and dizzy and his vision was blurred. Huffman checked the patient's IV, according to court records. The next thing the man knew, he said, he felt Huffman performing oral sex on him. Three months after the February 1991 incident, a second patient at St. Mary's Hospital in Milwaukee said he awoke to Huffman indecently touching him. In June 1991 Huffman was charged with two felonies. He pleaded guilty to reduced charges of misdemeanor sexual assault in January 1992. The doctor went to jail. But he didn't lose his medical license. State officials say they took progressively harsher action against Huffman over the next decade - action they thought would protect patients. They were wrong.
Despite his record, Huffman managed to get hired at three other facilities. Patients at two of them accused him of sexual misconduct. His license was revoked effective Feb. 28, 2002 - 11 years after his first documented sexual assault of a patient.

Medicaid Managed Care Plans Place More Burden On Patients And Families With Severe Mental Illness, AJP Study Shows

Managed care health plans for Medicaid patients with schizophrenia and other severe mental illnesses may result in lower costs to the Medicaid system, but lead to greater personal expenditures and higher caregiver burden for patients and their families, new research indicates. . . . The managed care strategies employed by plans led to savings within the Medicaid budget, but these savings were offset by personal expenditures and the contributions of family and friends of the enrollees in the managed care plans. Managed care was not associated with increased overall costs to non-Medicaid government programs. Despite the Medicaid-specific savings, society's total costs were not reduced by managed care. This wider public health perspective is especially important when considering patients with long-term disabling illnesses, who have multiple needs that cross different types of services and payers. Although an earlier report by the same authors indicated similar clinical outcomes for the patients in the three plans studied, the outcomes may have depended in part on substantial contributions from families and friends. Cost substitution may further impoverish already destitute individuals and result in inefficient treatment.

States lead in rush to reform health care

An estimated 47 million Americans gamble daily that they won't suffer a major illness or injury and often go without needed medicine. With rapidly-rising health care costs, the number of uninsured has grown from 43 million in 2006. U.S. lawmakers have argued over reform plans for years, and the spiraling problem is a hot topic in the 2008 presidential campaign with leading Democrats and Republicans alike acknowledging changes are needed. But state leaders say they are tired of waiting for answers from Washington and at least a dozen states are trying to pass far-ranging health reforms this year.

Lackluster Legacy On Health Care

President Bush didn't dally on the matter of health care during last night's State of the Union address, but he did flick at some tired themes: tax breaks for individual health insurance buyers (as opposed to employers); pooled insurance policies that help small businesses save money by spreading risk; and the expansion of Health Savings Accounts, which allow consumers to sock away pretax dollars to cover medical expenses. Yet the one issue that didn't merit mention--the State Children's Health Insurance Program (SCHIP)--may likely be the linchpin of Bush's legacy on health care, both for small businesses and the Republican party. Twice last fall, Bush vetoed bills to double funding for SCHIP, a 10-year-old program that offers free or low-cost health insurance to children of low-income families. Last week, the House again failed to override the president's veto.

Job Stress and Heart Disease

Work really can kill you, according to a study on Wednesday providing the strongest evidence yet of how on-the-job stress raises the risk of heart disease by disrupting the body's internal systems. The findings from a long-running study involving more than 10,000 British civil servants also suggest stress-induced biological changes may play a more direct role than previously thought, said Tarani Chandola, an epidemiologist at University College London.
"This is the first large-scale population study looking at the effects of stress measured from everyday working life on heart disease," said Chandola, who led the study. "One of the problems is people have been skeptical whether work stress really affects a person biologically."

The Age of Ambition

With the American presidential campaign in full swing, the obvious way to change the world might seem to be through politics. But growing numbers of young people are leaping into the fray and doing the job themselves. These are the social entrepreneurs, the 21st-century answer to the student protesters of the 1960s, and they are some of the most interesting people here at the World Economic Forum (not only because they’re half the age of everyone else).

Employers put health coverage in workers' hands

Nick Trikolas plans to drop health insurance for his employees and give them money to buy their own coverage. He says doing so will put him in the vanguard of a movement by employers searching for answers to rising health costs. "This may be the future of health insurance," says Trikolas, CEO of Ilios Partners in Chicago, which plans to switch its 100 employees from group to individual coverage this year. As health insurance costs continue to rise, some employers are adopting a controversial new approach: ending group coverage and giving employees $50 to $200 or so a month to help them buy their own.

Puberty is arriving ever younger in American females

At 8 or 9 years old, the typical American schoolgirl is perfecting her cursive handwriting style. She's picking out nouns, verbs, adjectives and adverbs in sentences, memorizing multiplication tables and learning to read a thermometer.She's a little girl with a lot to learn. And yet, in increasing numbers, when girls this age run across the playground in T-shirts, there is undeniable evidence that their bodies are blossoming. The first visible sign of puberty, breast budding, is arriving ever earlier in American girls.Some parents and activists suspect environmental chemicals. Most pediatricians and endocrinologists say that, though they have suspicions about the environment, the only scientific evidence points to the obesity epidemic. What's clear, however, is that the elements of female maturity increasingly are spacing themselves out over months, even years -- and no one quite knows why.

Health Effects of Marriage

Decades of data collection have shown that marriage--for all its challenges--is like a health-insurance policy. A 2006 paper that tracked mortality over an eight-year period found that people who never married were 58% likelier to die during that time than married folks were.

Crying Out For Help

Latinas ages 12 to 17 are the largest minority group of girls in the country, and growing. They are more likely to try to take their lives than any other racial or ethnic group their age. Twenty-five percent say they've thought about suicide, according to the Centers for Disease Control and Prevention, and about 15 percent attempt it, compared with approximately 10 percent of white and black teen girls. Other studies put the proportion of attempters at 20 percent -- slightly less than the fraction who smoke cigarettes.
In most cases, a girl swallows pills at home, according to Luis Zayas, a psychologist and professor of social work at Washington University in St. Louis. Zayas is in the middle of a five-year study of more than 150 young Latina girls who have attempted suicide. He says cutting is also finding a following among Latinas.

List of problem prescription drugs is growing

An increasing number of prescription drugs - some that have been widely promoted through seductive advertising - are turning out to have problems long after they've reached the market. With more than 40 percent of the U.S. population taking at least one prescription medication, the ever-growing list of medication concerns is drawing public attention and a sharp eye from consumer watchdogs. Research within the past week has raised questions about Vytorin, a popular cholesterol-lowering drug, and an analysis published in the New England Journal of Medicine suggested doctors and patients may have been misled about the effectiveness of many antidepressants.

psychiatric side effects of experimental medicines

After decades of inattention to the possible psychiatric side effects of experimental medicines, the Food and Drug Administration is now requiring drug makers to study closely whether patients become suicidal during clinical trials. The new rules represent one of the most profound changes of the past 16 years to regulations governing drug development.

Texans find gaps in candidates' health coverage plans

While health coverage is shaping up as one of the major issues of this presidential campaign, no candidate, Democrat or Republican, has proposed a plan that would address all of Texas' concerns. Democrats' stump speeches talk of covering all Americans but so far have avoided the politically explosive issue of whether to treat the 12 million illegal immigrants living in the U.S.
Along with such immigrants, Texas also has the second-highest number of uninsured residents – and some of the nation's highest rates of pre-existing chronic illnesses. Those illnesses could create problems if Republican candidates' plans to encourage more reliance on individual insurance policies are enacted because those people couldn't find insurance.

Veto Stands on Measure to Expand Health Plan

Democrats cited the nation’s economic problems as a reason to expand a popular health insurance program for children on Wednesday, but their effort failed as the House sustained President Bush’s veto of a bill to provide coverage to nearly four million uninsured children.
The vote for the bill was 260 to 152. Supporters were 15 votes short of the two-thirds majority needed to pass the measure over the president’s objections.

Blunt won’t seek re-election

JEFFERSON CITY Gov. Matt Blunt, facing a tough re-election fight and a slowing economy, bowed out of the race Tuesday, declaring that he had accomplished all he set out to do.
In a video posted on the YouTube Internet site, Blunt said he decided not to seek re-election because he had little left to achieve. . . . “You could have knocked me over with a feather,” said Rep. Margaret Donnelly, a St. Louis County Democrat who is running for attorney general.
The announcement came just a week after Blunt’s campaign filed a quarterly fundraising report showing he had raised $9.88 million for his re-election bid.

Please Review the Candidates Positions on Mental Health Policy

The National Alliance on Mental Illness (NAMI) has sent a questionnaire to all presidential candidates in each party. We also encouraged candidates to provide us with other relevant materials or explanations of their positions if they did not have time to respond to our questionnaire.
NAMI does not endorse specific candidates and any materials posted are intended for educational purposes only. They should not be used by any affiliate to endorse a candidate. Non-profit charitable organizations, including NAMI affiliates, are prohibited by law from endorsing specific candidates.

35 years after Roe: A legacy of law and morality

The January 22, 1973, Supreme Court decision legalizing abortion remains the law of the land, and passions remain high on both sides of the issue, with annual protests on the anniversary. Access to abortion, then and now, is more than just about simple legalities. Social, religious and family values, as well as finances and politics, still play a role in shaping the abortion issue, but many legal and medical experts say the debate has become predictable.

Could comparative-effectiveness studies rein in health-care costs?

MOST industries have grasped the idea that new products should be measured against rival offerings. From laptops to double-glazed windows, consumers have ready access to comparative studies from consumer magazines, independent testing bodies and the like.
When it comes to health care, however, comparative-effectiveness studies for new drugs, devices and procedures are rare. Drugs trials often compare new treatments with placebos, not rival pills. Device makers rush to get new gizmos into action before cost-benefit analyses can be done. In America the federal government's health programmes eschew comparative-effectiveness tests as a matter of policy. Now moves are afoot in America's Congress to promote the use of such techniques to rein in rampant cost inflation.

What are your views on ECT?

Electroconvulsive therapy, discredited in a previous incarnation as "shock therapy," has gained acceptance from patients and doctors alike in recent years. As the means of administering the electric current have grown more sophisticated and less harmful, the benefits of the treatment have become more apparent, especially for people suffering depression.
The Mayo Clinic estimates that 100,000 people a year undergo the treatment in the United States -- a number that has roughly tripled in the last 25 years.

Out from the shadow of teen suicide

It was fall 2005. Three Needham students had already committed suicide, and there would soon be a fourth. And as Haas, just 16, flirted with suicidal thoughts of his own, his parents, Chris and Ronnie Haas, were busy planning Michael's college education, not seeing signs of his deepening depression. It is the classic parent-child disconnect, mental health specialists said yesterday at a State House forum about teenage depression. Specialists say that depression often goes unnoticed by parents, which can lead to more serious problems, like the suicides in Needham or more recently Nantucket, where three teenagers - ages 15, 16, and 17 - have killed themselves in the last 11 months. The problem with teenage depression, specialists said yesterday, is that many people do not want to or do not know how to talk about it and often retreat into silence for fear of what others might think or say.

Change the environment to treat obesity

Several recent studies, papers and a popular weight-loss book argue that eating is an automatic behavior triggered by environmental cues that most people are unaware of -- or simply can't ignore. Think of the buttery smell of movie theater popcorn, the sight of glazed doughnuts glistening in the office conference room or the simple habit of picking up a whipped-cream-laden latte on the way to work.Accepting this "don't blame me" notion may not only ease the guilt and self-loathing that often accompanies obesity, say the researchers behind the theory, but also help people achieve a healthier weight.

Antidepressant Studies Unpublished

The makers of antidepressants like Prozac and Paxil never published the results of about a third of the drug trials that they conducted to win government approval, misleading doctors and consumers about the drugs’ true effectiveness, a new analysis has found.
In published trials, about 60 percent of people taking the drugs report significant relief from depression, compared with roughly 40 percent of those on placebo pills. But when the less positive, unpublished trials are included, the advantage shrinks: the drugs outperform placebos, but by a modest margin, concludes the new report, which appears Thursday in The New England Journal of Medicine.

Shelters can't help all fleeing abuse

Domestic violence shelters across the state are becoming overwhelmed and are increasingly turning victims away, driving some of those seeking help back to abusive partners or to the streets, according to advocates and shelter program directors. The number of victims turned away from shelters more than quadrupled, from 1,374 in fiscal 2003 to 5,520 in fiscal 2005, according to Jane Doe Inc., a statewide coalition against sexual assault and domestic violence that also tracks trends. On many days, only one bed will be available in the state for 100 people who call domestic violence hotlines seeking shelter. Sometimes, none can be found.

Do you support mandatory random drug-testing for student-athletes?

The Illinois High School Association on Monday joined a small but growing number of states to implement mandatory random drug-testing for student-athletes. Its Board of Directors voted 10-0 to begin testing with the 2008-09 school year. The timing was coincidental with two highly publicized incidents regarding drugs and sports. Last month the Mitchell report on the use of performance-enhancing substances in baseball included allegations Clemens, the seven-time Cy Young Award-winning pitcher, had taken steroids and human growth hormone.Last week a U.S. District Court judge sentenced former Olympic track champion Jones to six months in prison in part for lying about her use of performance-enhancing drugs.

Psychologists in state ask for authority to prescribe

Missouri psychologists and their patients are asking lawmakers for the authority to write certain prescriptions for mental health disorders, saying it will improve access to badly needed care.
It's a question of service and need, say advocates with Missouri Families for Access to Comprehensive Treatment.
The state has fewer than 400 licensed psychiatrists, the only mental-health professionals in Missouri allowed to prescribe drugs, advocates say. And, they add, waiting times to see a psychiatrist ranges from two weeks to eight months, especially in underserved rural and inner-city communities.

Bush signs new gun bill

President Bush signed legislation on Tuesday aimed at preventing the severely mentally ill from buying guns, in a rare bipartisan agreement with the Democratic-led Congress after the bloody Virginia Tech shooting.
The bill authorizes up to $1.3 billion in grant money for states to improve their ability to track and report individuals who shouldn't qualify to buy a gun legally, including those involuntarily confined by a mental institution. Much of the money, to be spent over five years, would be used to increase state feeds to a national system used to run background checks on gun purchases.

The Anti-Drug Drugs

Researchers are developing a range of vaccines—which are normally used to combat infectious diseases—against such highly addictive substances as cocaine, nicotine, heroin and methamphetamine. If these new drugs come to market, experts hope they can overcome one big hurdle that previous anti-addiction medications have failed to clear. "The idea of vaccines is not anywhere near as stigmatized as giving medication to the addicted," says Thomas Kosten, the Baylor Medical School psychiatrist who is leading research on the cocaine vaccine. "Vaccine sounds more wholesome than drug." Addiction is often seen as a personal weakness, not a medical condition to be treated or cured. Some experts say that stigmatization has stymied research into potential treatments for the estimated 20 million Americans who struggle with drug addiction.

Help your heart with exercise - and booze

Moderate drinkers are at 30% lower risk of heart disease than teetotallers, according to a study of nearly 12,000 people. And those who combine a mild tipple with regular exercise are even less likely to die of the disease. Their risk is between 44% and 50% lower than couch potatoes who abstain from alcohol.
The team behind the 20-year study said that previous research has shown that moderate drinking and exercise both lower the risk of heart disease. But this is the first time scientists have quantified the benefits of both together.

New smoking restriction ignites debate

Never before has California banned smoking on private property used exclusively by members of the owner's family – until now.
Beginning this month, motorists can be fined $100 for lighting up a cigarette, cigar or pipe in their own car, even in their driveway, if one passenger is a child.
The law marks a new frontier in more than two decades of state smoking restrictions that focused on workplaces, public buildings, restaurants, airplanes, tot lots and gathering spots.
It also comes as cigar-smoking Republican Gov. Arnold Schwarzenegger is teaming with Democrats to push a proposed ballot measure that would increase cigarette taxes by $1.75 per pack to expand health insurance.

Nation's Hospital Bill

A handful of high-cost and high-volume conditions helped drive the national hospital bill up 7% in 2005, to $873 billion, a record high and nearly double 1997 spending adjusted for inflation, a federal agency reported. The report, from the federal Agency for Health Care Research and Quality, analyzed figures from the most recent year available and found in part that triple-digit percentage growth in the amount charged for blood infections, nonspecific chest pain, respiratory failure, back pain and arthritis over the past decade contributed to the increase.
The 20 costliest conditions accounted for 52% of hospital charges, and the five costliest accounted for a fifth of all charges. Medicare and Medicaid, the government health plans for the elderly, disabled and poor, accounted for nearly two-thirds of total charges. The five costliest categories were coronary-artery disease, pregnancy and delivery, newborn-infant care, heart attack and congestive heart failure, followed by pneumonia and arthritis.

Point Counterpoint Essays on HR 2640 (Gun Control Law)

About 3%-5% of all violence in the United States is perpetrated by individuals with mental illness. But the risk of violence is much higher with “rampage killers,” those who go into schools, malls, and other public places and shoot. About 50% have a history of mental illness and 8% have been committed. Legislation recently passed in the House of Representatives is a good idea if even one life is saved. The bill, H.R. 2640 (the National Instant Criminal Background Check System Improvement Amendments Act of 2007), would require the states to update the NICS with the names and other identifying information of people committed to mental institutions so that they could not buy firearms.

BUT

We still have no data to show that this approach would be effective. Guns are widely available from legal and illegal sources in the United States. Federal purchase restrictions only apply to purchases from a dealer. They do not affect those who already own guns, obtain a gun from another person, or buy one at a gun show. If even a single life could be saved by stopping gun purchase by mentally ill patients, why not do it? Because the costs would vastly outweigh a small likelihood of benefit. The financial impact will be enormous. The federal bill offers states $1 billion to participate in a national database. Think of what else we could do with that money to combat gun violence.

Health care challenges fire up U.S. students

One measure of the troubled state of U.S. health care is the hordes of idealistic young people lining up to fix it. . . . students are pouring into health policy classes in economics, political science, history, and public health departments. Many plan on making health policy their career.
"I tell some of my friends that are a few years younger then me, if they are interested in politics and what is going on -- take policy courses. Health policy is something that affects us and it's going to affect us in the long run," said Chang, who hopes to attend law school.

World 'must do more' for children

More must be done more quickly to make the world fit for children by 2015, the UN children's agency, UNICEF, has said. In a report it noted considerable strides had been made to meet pledges in education and areas of health care. But it stressed that "much more must be done" in order to meet the 2015 Millennium Development Goals deadline.

Marketing hype or a miracle cure?

A costly drug cocktail touted as the first pharmacological treatment for cocaine and methamphetamine addiction is at the center of a raging national debate.The treatment, called Prometa, is not approved by the Food and Drug Administration as an addiction therapy, nor has it undergone extensive scientific testing. But officials at Los Angeles-based Hythiam Inc., the company that sells the treatment protocol, say it can work miracles for people struggling to break their addiction.

Ranking America's Mental Health: An Analysis of Depression Across the States (Missouri Ranks #45)

Depression is a chronic illness that exacts a significant toll on America's health and productivity. It affects more than 21 million American children and adults annually and is the leading cause of disability in the United States for individuals ages 15 to 44.
Lost productive time among U.S. workers due to depression is estimated to be in excess of $31 billion per year. Depression frequently co-occurs with a variety of medical illnesses such as heart disease, cancer, and chronic pain and is associated with poorer health status and prognosis. It is also the principal cause of the 30,000 suicides in the U.S. each year. In 2004, suicide was the 11th leading cause of death in the United States, third among individuals 15-24.
Despite significant gains in the availability of effective depression treatment over the past decade, the level of unmet need for treatment remains high. On average, people living with depression go for nearly a decade before receiving treatment, and less than one-third of people who seek help receive minimally adequate care.
"Ranking the States: An Analysis of Depression Across the States" was researched and written by Mental Health America and Thomson Healthcare. It looks at data from 2002-2006 and was conducted from July to November 2007. The report compares depression levels and suicide rates in all 50 states and the District of Columbia and uses the information to highlight solutions to improve states' mental health status.

Doctors don't report colleagues, errors

Nearly half of doctors surveyed say they have failed to report an impaired or incompetent colleague or a serious medical error, and more than one-third say they would order an unneeded MRI scan for an insistent patient - though these actions conflict with what the physicians consider the heart of their professional obligations.

The survey is the first broad attempt to measure the success of a new movement called "medical professionalism." Arguing that government regulation, financial incentives, and public reporting alone will not improve the quality and efficiency of medical care, physicians groups in the past several years have been promoting a new code of professional values, meant to modernize the ancient Hippocratic Oath.

Exercise pill hope for depression?

Yale University experts say that experiments on mice could show why regular exercise can help people suffering from depression. Writing in the journal Nature Medicine, they say it could lead to more effective drugs. Mental Health charities in the UK already back exercise programmes as a way of lifting depression. While the link between exercise and improved mood is well known, the reasons behind it are not fully understood. The latest research focuses on an area of the brain called the hippocampus, which is already established as a target for antidepressant drugs.

Schizophrenia Risk May Start in Womb

Over the past several decades, a steady stream of studies has documented that people born in winter and spring have an increased risk for schizophrenia, a serious mental illness characterized by disordered thinking, hallucinations and other psychotic symptoms.
Explanations for the increased risk have ranged from the astrological -- different signs of the zodiac have been associated with various mental problems -- to accounts that suggested the risk came from seasonal variations in sunlight.
In recent months and years, scientists have developed a different explanation: Studies show the increased risk of schizophrenia appears linked to maternal infections during the first and second trimesters of pregnancy -- especially flu infections. Since the flu peaks in the fall, this might explain why babies born in the winter and spring have the higher risk.

A warning on safe sex at any age

KANSAS CITY, Mo. — Jane Fowler thinks it's about time college students had "the talk" with their grandparents.She doesn't mean grandmothers and grandfathers explaining the facts of life. She wants kids to explain safe sex to their elders.It's part of a broader message the 72-year-old has advocated for more than a decade. Ever since she contracted HIV when she was in her 50s, Fowler has made it her mission to help aging baby boomers and members of her generation avoid her mistakes."Once people get past their own embarrassment and understand grandparents today are still sexually active, they realize I'm right," said Fowler, who is scheduled to speak at a safe-sex event on the Kansas State University campus today. "Their grandparents face the same risks of sexually transmitted diseases as they do."

Costs of Hospice Care Rising

Hundreds of hospice providers across the country are facing the catastrophic financial consequence of what would otherwise seem a positive development: their patients are living longer than expected.
Over the last eight years, the refusal of patients to die according to actuarial schedules has led the federal government to demand that hospices exceeding reimbursement limits repay hundreds of millions of dollars to Medicare.

Older white women join Kenya's sex tourists

[T]he health risks are stark in a country with an AIDS prevalence of 6.9 percent. Although condom use can only be guessed at, Julia Davidson, an academic at Nottingham University who writes on sex tourism, said that in the course of her research she had met women who shunned condoms -- finding them too "businesslike" for their exotic fantasies.

Hard choices on healthcare (LA Times)

By most accounts, the SCHIP program has been a 10-year success story. The number of uninsured children dropped steadily from 11.1 million in 1998, the year after the program began, to its lowest level of 7.9 million in 2004, according to U.S. Census Bureau figures. But the number of kids without insurance grew by about 1 million from the beginning of 2004 through 2005, and according to the Kaiser Family Foundation, half of the newly uninsured children came from families earning from about $40,000 to about $80,000 a year (based on a family of four). "It increased in the last year, probably because both adults and kids are losing job-based coverage," says E. Richard Brown, director of the UCLA Center for Health Policy Research.Some of those newly uninsured children qualify for SCHIP but their families are unaware of the program. In some cases, states with budget shortfalls have stopped enrolling children. And when a family loses employer coverage, their children must go through a waiting period of a year, extended in August by the Department of Health and Human Services from three months, before being eligible.What's certain is that SCHIP-insured kids get their checkups. Children in the program are more likely to receive preventive healthcare, specialty care and dental care than uninsured children, and their parents report fewer financial burdens, unmet medical needs and less worry about their children, according to a report in the August 2007 journal Health Services Research. "It has provided access to kids who wouldn't have had coverage," says Brown. "It's cheap, and it'll help produce healthy and productive adults. I don't know what more we could ask for."

Health Care: Solutions Without Borders

At a time when most Americans favor an overhaul of the health care system, it's important to look closely at what other countries are getting right. A growing number of health care stakeholders, including policymakers and insurance industry officials, are recommending that we look across the Atlantic to explore the health systems in countries that cover all of their citizens.
The Commonwealth Fund's 2007 International Health Policy Survey released in October—our 10th annual international survey—reveals that, while no one health system provides an ideal model, we have much to learn from the other countries.
Rather than caricature the health systems in other nations, we should evaluate their strengths and shortcomings—and use that knowledge to create a high-performing health system in the United States.

Study Debunks Theory On Teen Sex, Delinquency

Researchers at Ohio State University garnered little attention in February when they found that youngsters who lose their virginity earlier than their peers are more likely to become juvenile delinquents. So obvious and well established was the contribution of early sex to later delinquency that the idea was already part of the required curriculum for federal "abstinence only" programs.
There was just one problem: It is probably not true. Other things being equal, a more probing study has found, youngsters who have consensual sex in their early-teen or even preteen years are, if anything, less likely to engage in delinquent behavior later on.

Veterans Without Health Care

Although many Americans believe that the nation’s veterans have ready access to health care, that is far from the case. A new study by researchers at the Harvard Medical School has found that millions of veterans and their dependents have no access to care in veterans’ hospitals and clinics and no health insurance to pay for care elsewhere. Their plight represents yet another failure of our disjointed health care system to provide coverage for all Americans.

Advocates tout rising support for child health plan

Democrats and healthcare advocates are expressing increasing confidence that their emphasis on expanding children's health insurance - a measure already vetoed once by President Bush - has succeeded in putting healthcare on the national agenda. They point to a new round of polls that found wide public support for the child health program. Proponents say the difference between the Republican and Democratic positions is stark, giving voters a clear choice on what many call the most important domestic issue in next year's presidential election.

Autism epidemic may be all in the label

A few decades ago, people probably would have said kids like Ryan Massey and Eddie Scheuplein were just odd. Or difficult.
Both boys are bright. But Ryan, 11, is hyper and prone to angry outbursts, sometimes trying to strangle another kid in his class who annoys him. Eddie, 7, has a strange habit of sticking his shirt in his mouth and sucking on it.
Both were diagnosed with a form of autism. And it's partly because of children like them that autism appears to be skyrocketing: In the latest estimate, as many as one in 150 children have some form of this disorder. Groups advocating more research money call autism "the fastest-growing developmental disability in the United States."

Suicide Tourism

People are traveling to New York City with the aim of killing themselves in a phenomenon researchers call "suicide tourism," a Manhattan public health expert reported Monday. Research reported in Washington at the annual meeting of the American Public Health Assn. suggests that one in 10 suicides committed in Manhattan since 1990 have involved nonresidents.

Shy? Or Something More Serious?

Bashfulness, once prized as a virtue, became a sign for medical concern. According to the 1994 National Comorbidity Survey, as much as 12.1 percent of the U.S. population might have social anxiety disorder and a staggering 28.8 percent suffer from some kind of anxiety disorder.
As a result of statistics like these and the disease criteria listed in the updated Diagnostic and Statistical Manual of Mental Disorders, or DSM, large numbers of people swallow daily doses of Paxil, Prozac and Zoloft for conditions that many experts now consider medical problems stemming from a chemical imbalance. After examining prescription rates for these three antidepressants alone, David Healy and Graham Aldred of the North Wales Department of Psychological Medicine at Britain's Cardiff University reported in the International Review of Psychiatry that just over 67.5 million Americans had taken at least one of them in the 15-year period ended in 2002. More than 18.5 million of those had received a prescription for Paxil, the first antidepressant to receive FDA approval for social anxiety disorder.

WHO aims to balance drug companies, poor

GENEVA - The U.N. health chief urged countries on Monday to come up with new ways to make medicine for HIV/AIDS and other diseases more affordable in the world's poorest countries, without stifling innovation among pharmaceutical companies.
The World Health Organization's 193 member states are hoping to forge a global strategy on the highly divisive issues of drug development, patenting and pricing by the end of the week.
"People should not be denied access to lifesaving and health-promoting interventions for unfair reasons," said Dr. Margaret Chan, WHO's director-general, in opening the agency's first meeting devoted to the subject since May, when the United States walked out of a negotiating session and dissociated itself from a WHO resolution.
Under rules agreed by the World Trade Organization, countries can issue so-called "compulsory licenses" to disregard patent rights, but only after negotiating with the patent owners and paying them adequate compensation. If they declare a public health emergency, governments can skip the negotiating.
Brazil and Thailand have invoked the procedure to import cheap generic versions of American AIDS drugs, among other medicines, to treat patients who developed resistance to older anti-retrovirals and needed more expensive, second-line drugs.
The moves by Brazil and Thailand were praised by health campaigners but criticized by industry groups. The United States later placed Thailand on a copyright watch list of nations where American companies face problems protecting intellectual property rights. Countries on the list are under extra scrutiny and can face trade sanctions if alleged violations worsen.
The international aid group Oxfam says compulsory licensing almost never occurs because developing countries face pressure from rich governments acting on behalf of their drug companies. Its report last year on drug access cited WHO statistics that 74 percent of AIDS medicines are still under monopoly, and that 77 percent of Africans still lack any access to AIDS treatment.

Are we too quick to medicate children?

In 2005, the latest year for which statistics are available, at least 2.2 million American children over the age of 4 were being treated for serious difficulties with emotion, concentration, behavior or ability to get along with others. It's a figure mental-health professionals say has exploded in the last decade and a half, along with sales of a wide range of psychiatric medications for use by children.A welter of studies has shown that kids are being diagnosed at younger ages, with a wider range of disorders and with more severe disorders than ever before. And in growing numbers, they are being medicated with drugs whose safety, effectiveness and long-range effects on children have not been demonstrated by extensive research.

Depressed male veterans have highest suicide risk

Among depressed U.S. military veterans, young white men have the highest risk of suicide, the results of a large VA study suggest. Using government data for more than 800,000 veterans who were treated for depression between 1999 and 2004, the investigators found that the overall suicide risk was 7 to 8 times higher compared with that in the general population.
Male veterans had roughly three times the rate of suicide as female veterans did, while younger veterans -- those ages 18 to 44 -- had a higher suicide rate than their older counterparts. Men who were 65 years or older had the second highest risk, while the lowest risk was seen among men between the ages of 45 and 64 years old.

New Film Stirs Up ’Ex-Gay’ Debate

In spite of a near-unanimous consensus from the psychological community that homosexuality is a normal, natural, and fixed orientation, ex-gay ministries and reparative therapy groups have only grown larger over the years. Salzer decided to make the film after attending an annual American Psychological Association (APA) meeting, in which participants were becoming more and more concerned about the overwhelming efforts of ministries and organizations like Exodus and Love Won Out to target and conduct public outreach in the gay community.

1.8 Million Veterans Lack Health Coverage

Of the 47 million uninsured Americans, one in every eight (12.2 percent) is a veteran or member of a veteran’s household, according to a study by Harvard Medical School researchers published in the December, 2007 issue of the American Journal of Public Health (galley version available here). 1.8 million Veterans (12.7 percent of non-elderly veterans) were uninsured in 2004, up 290,000 since 2000, the study found. An addition 3.8 million members of their households were also uninsured and ineligible for VA care.

In China, Brain Surgery Is Pushed on the Mentally Ill

The irreversible brain surgeries performed at No. 454 Hospital, which are all but blacklisted for mental illness in the developed world, are being done across China. They are a symptom of the problems plaguing the nation's health-care system, which has left hospitals with scant public funding and hungry for profit.

Scientists Denounce Global Warming Report 'Edits'

Environmental and public health experts overwhelmingly denounced editing by the White House of a federal health agency head's testimony to Congress Tuesday. Significant deletions were made from the testimony, concerning global warming and the potential impact on human health. The original, unedited testimony presented to Congress by Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention (CDC) and obtained by ABC News was 14 pages long, but the White House Office of Management and Budget edited the final version down to a mere six pages.
Scientists and public health organizations called the move "frustrating," "terrible" and "appalling." The edits essentially deleted all sections that referred to climate change as a public health concern -- including the risks of increased food-borne and waterborne diseases, worsening extreme weather events, worsening air pollution and the effect of heat stress on humans. "Dr. Gerberding is the lead of the premiere public health agency in the U.S.," said Kim Knowlton, a science fellow on global warming and health at the National Resources Defense Council in New York. "It's shocking that she was not allowed to say in a public discussion some of these vital details.
"One has to wonder why was this is so threatening to the White House."

Suicide by Soldiers in Iraq

More service members killed themselves while serving in the Iraq war last year than in any year since the war began, and the suicide count for 2007 is on track to surpass that. The dead are generally junior enlisted soldiers who are single, white and male.

SCHIP Redux

Sensing a political advantage, Democrats rushed Wednesday to move a health care bill for children back to the House floor, having made minor changes to win over more Republicans.
Speaker Nancy Pelosi said the House would vote Thursday on the new bill. Like the original, which President Bush vetoed three weeks ago, it would cover 10 million children through the State Children’s Health Insurance Program and increase spending on the program by $35 billion, for a total of $60 billion, in the next five years.
But the new bill would tighten eligibility for the program, generally barring the use of federal money to cover illegal immigrants, childless adults and children of families with incomes exceeding three times the poverty level: $61,950 for a family of four. . . .
Under the new bill, as under the previous one, the federal excise tax on cigarettes would be increased by 61 cents a pack, to a total of $1, and Mr. Leavitt said the administration still opposed that provision.

Should Middle School Students Have Access to Birth Control?

Two days after the school committee voted 7 to 2 in favor of adding prescription contraceptives to the services offered at the health clinic, the issue continues to draw fervent support and ardent opposition in this city of 64,000, the largest in Maine.
“I think it’s a great idea,” said Cathleen Allen, whose son is enrolled at King. “Someone is finally advocating for these students to take care of themselves.”
Ms. Allen added, “It’s an eye-opener for all of us, but when you look at the facts, why not?”
Bishop Richard J. Malone of the Roman Catholic Diocese of Portland is calling on the school committee to rescind its decision, as have the state and city Republican Parties. The city party is also pushing a recall for members who voted in favor.
Nick McGee, the city’s Republican Party chairman, said of the policy, “It is an attack on the moral fabric of our community, and a black eye for our state.”
On Friday, John Coyne, chairman of the school committee and one of the two members who voted against the plan, said he wanted the panel to reconsider the program. Mr. Coyne said that parents should have the option to enroll their children in all aspects of the clinic except reproductive health treatment, and that parents should be made more aware of the state’s confidentiality laws.
“I still don’t feel comfortable with this,” Mr. Coyne said. “There’s no talk about the health issues and the possible long-term ill effects on these young ladies.”
The school’s clinic functions much like a physician’s office and has been offering condoms and testing for pregnancy and sexually transmitted diseases since 2000. It also offers dental, mental health and basic care.
The clinics at Portland high schools have offered oral contraceptives for years, said Douglas S. Gardner, the city’s director of health and human services. Health officials decided to extend the policy to middle school after learning that 17 middle school students had become pregnant in the last four years, seven of them in the 2006-7 school year.

Sexual misconduct plagues US schools

The young teacher hung his head, avoiding eye contact. Yes, he had touched a fifth-grader's breast during recess. "I guess it was just lust of the flesh," he told his boss.
That got Gary C. Lindsey fired from his first teaching job in Oelwein, Iowa. But it didn't end his career. He taught for decades in Illinois and Iowa, fending off at least a half-dozen more abuse accusations.
When he finally surrendered his teaching license in 2004 — 40 years after that first little girl came forward — it wasn't a principal or a state agency that ended his career. It was one persistent victim and her parents. . . .
One report mandated by Congress estimated that as many as 4.5 million students, out of roughly 50 million in American schools, are subject to sexual misconduct by an employee of a school sometime between kindergarten and 12th grade. That figure includes verbal harassment that's sexual in nature.

Biden unveils health care plan

Democratic presidential candidate Joe Biden on Tuesday released a plan that would expand access to health coverage for all children and adults, but stops short of mandating universal coverage. . . .
The plan would cost an estimated $110 billion each year. It would be paid for by rolling back tax cuts for the top 1 percent of Americans, eliminating tax breaks on capital gains and ending tax loopholes for hedge fund managers and private equity partners, the campaign said.
To provide health coverage for uninsured children, Biden proposes expanding the State Children's Health Insurance Program, or SCHIP, to at least 300 percent of the poverty level — or about $61,950 for a family of four, and raising the coverage age to at least 21. Families that don't meet the poverty criteria would be able to purchase coverage under the program.

Voters favor Democratic ideas to mend healthcare

Healthcare is widely seen as the top domestic issue in next year's presidential race. Two of the main proposals advanced by Democrats received majority support in the poll. Sixty-two percent said they supported requiring large employers to help pay for coverage whereas 31% opposed it. And 51% said they favored a mandate that individuals purchase health insurance, much as drivers are required to carry auto coverage; 39% disagreed. Tax breaks to make insurance more affordable -- a leading Republican idea -- more closely divided the public, with 44% backing that approach and 45% opposing it. In one of the most politically significant results, the poll finds that independents and moderates were generally lining up with Democrats in the healthcare debate.

Holiday-Suicide Link Newspapers Continue to Perpetuate the Myth

Despite no basis in fact, newspapers continue to report on the increased risk of suicide around the Thanksgiving, Christmas and New Year holidays. An analysis of newspaper reporting over the past seven years released today by the Annenberg Public Policy Center shows that this story represents about half of all holiday-relevant suicide reporting. . . .
As noted in previous studies, the rate of suicide in the U.S. is lowest in December, and peaks in the spring and fall. Data collected by the National Center for Health Statistics show that this pattern has not changed through 2003, the most recent year for which national data are available.

House Failure To Override Veto Good News For Tobacco

The U.S. House's failure Thursday to override President George W. Bush's veto of tobacco tax hike legislation is another break for the industry. The bill would have increased federal tobacco excise taxes the equivalent of 61 cents per pack of cigarettes. . . .
The $35 billion raised by the tobacco tax increase over five years would have offset the cost of expanding the State Children's Health Insurance Program. The bill's supporters said that by 2012, the expansion would have allowed the program to cover nearly 10 million children.
House Speaker Nancy Pelosi, D-Calif., already has promised to have the same bill back on Bush's desk within two weeks. Asked whether the bill might include an alternative funding source, Pelosi said simply, "no."
Bush vetoed the bill on Oct. 3, arguing that it would encourage families to drop private insurance. He has offered $5 billion that would temporarily increase the number of children enrolled in the program, but would reduce enrollment over the next five years.

Meth Stories

Some of these first-person accounts may be of interest.

Should Cities Offer Safe Sites for Injection Drug Users?

City health officials and addiction experts took the first steps Thursday toward opening the nation's only government-sponsored injection room that would give drug addicts a safe, clean place to shoot up. Hoping to reduce San Francisco's high rate of fatal drug overdoses, the local public health department co-sponsored a symposium on the only such facility in North America, a 4-year-old Vancouver site where an estimated 700 users a day self-administer narcotics under the supervision of nurses.

Optimal treatment for depression (LA Times article)

Nearly 20 million Americans suffer from some form of depression, according to the National Institute of Mental Health. About 14% of adults now take antidepressants -- triple the percentage during the late 1980s -- and most stay on them for at least six months. A study published in this month's issue of the Archives of General Psychiatry estimated that mental disorders, largely depression, cost Americans 1.3 billion days of normal activity each year. Many people with such illnesses say they feel hopeless, helpless, unable to face life, unable to find solutions to their problems, and at times think of killing themselves. Some of them do.

Medicare Audits Show Problems in Private Plans

Tens of thousands of Medicare recipients have been victims of deceptive sales tactics and had claims improperly denied by private insurers that run the system’s huge new drug benefit program and offer other private insurance options encouraged by the Bush administration, a review of scores of federal audits has found. . . . The audits show the growing pains that Medicare has experienced as it introduced the popular new drug benefit and shifted more responsibility to private health plans. For years, Democrats have complained about efforts to “privatize Medicare,” and they are likely to cite the findings as evidence that private insurers cannot be trusted to care for the sickest, most vulnerable Medicare recipients.

Kids get inadequate health care

As Washington debates children's health insurance, a startling study finds that kids who regularly see doctors get the right care less than half the time — whether it's preschool shots or chlamydia tests for teen girls. The findings, from the first comprehensive look at children's health care quality, are particularly troubling because nearly all the 1,536 children in the nationwide study had insurance. Eight-two percent were covered by private insurance. Three-quarters were white, and all lived in or near large or midsized cities. Two experts called the findings "shocking." Others said minority children, those with more-restrictive government insurance, and the millions with no insurance at all certainly fare even worse.

Boom Times for Dentists, but Not for Teeth

Previously unreleased figures from the Centers for Disease Control and Prevention show that in 2003 and 2004, the most recent years with data available, 27 percent of children and 29 percent of adults had cavities going untreated. The level of untreated decay was the highest since the late 1980s and significantly higher than that found in a survey from 1999 to 2002.

Despite the rise in dental problems, state boards of dentists and the American Dental Association, the main lobbying group for dentists, have fought efforts to use dental hygienists and other non-dentists to provide basic care to people who do not have access to dentists.

Fifth Of State Prison Inmates Mentally Ill

A legislative report shows more than 20 percent of Connecticut's approximately 19,000 prison inmates have moderate to severe mental illness.That fact is prompting some state lawmakers to point out an apparent shortage of trained psychiatric nurses and a need for more training for correction officers. Also, there's talk of creating a separate facility for inmates with mental illness to ease the space crunch" . . . . "If you want to free up prison beds [to keep violent offenders behind bars longer], then get these mentally ill people out of there," Lawlor said.

Suicide prevention team: Victim's dad, former tormentor

After a 17-year-old fellow student took his own life, Kirk Zajac was devastated. Not because he and the other teen were friends; but because they so clearly were not.
Kirk didn't even know the name of the quiet boy whom he and others tormented regularly on the crowded bus to Notre Dame-Cathedral Latin School. They called him "Polar Bear" because of his size and refused to make room for him in a seat. They made fun of him behind his back and to his face.
Last September, when the principal somberly announced that Andy Lehman had died in a car crash, it took awhile for Kirk to even figure out who Andy was. Then he discovered that the crash was no accident.