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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 3.

The Ignorance Project
At the recent World Economic Forum, brain research was a hot topic; Dr. Insel reports on statistics presented at the conference that inspire optimism that progress can be made on difficult problems, including mental disorders. (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - December 29, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Funding Science
Relative to other countries, U.S. funding of science has declined in recent years; Dr. Insel talks about the need for research and development related to mental illness. (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - December 29, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

What Caused This to Happen?
Dr. Insel discusses the idea that chance may have as much to do with the development of mental illness as do genetic and environmental factors. (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - December 29, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Best of 2014
Dr. Insel offers an overview of his top ten mental health stories for 2014. (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - December 29, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Lost in Translation
Drug testing in mice has been a poor guide to effectiveness in humans; Dr. Insel talks about the need for research approaches that can more reliably guide medication development. (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - December 29, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Can We Prevent Psychosis?
In his blog, Dr. Insel talks about on new NIMH grants that will support research on services for people of all ages with autism. (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - December 29, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

P-Hacking
In his blog, Dr. Insel talks about on new NIMH grants that will support research on services for people of all ages with autism. (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - December 29, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Depression, Daughters, and Cellular Aging
An early sign of depression risk may provide not only a biomarker for depression but a clue to the relationship between depression and risk for medical illnesses; Dr. Insel blogs. (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - December 29, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Don’t poop where you eat: Mental health services for young physicians
Imagine you are an ambitious new worker at a powerhouse institution. Your job performance is soaring, but you frankly work like a dog. Your weeks top out at 80 hours, you get maybe a single 24-hour block of time off every 7 days, you work weekends, and you often work up to 30 hours straight in one stint, sleep at work, and eat exclusively from food options in the building. You rarely see the sun, your mother currently has to take care of your cat for you, and you are home so infrequently you cancelled your Internet and cable. You start doing too many drugs to stay awake, drinking too much alcohol to try to sleep afterwards...
Source: Kevin, M.D. - Medical Weblog - December 27, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

When “healing” loses its meaning: A cynical medical resident meets Patch Adams
The afternoon began like any other day in medical school.  Students arrived at the lecture hall and took their seats.  An individual with long blue-and-white hair and handlebar mustache entered the room wearing oversized fish-print pants, a loose-fitting clown shirt, and a single earing fashioned out of a bent fork.  He casually strolled up to the front, introduced himself as Dr. Patch Adams, and told us that the next several hours would be some of the most important in all of our medical training. We learned about the Gesundheit! Institute, a community that has provided care to thousands of patients without charge for ...
Source: Kevin, M.D. - Medical Weblog - December 27, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Residency Source Type: blogs

Miracle on 34th Street
We watched the 1947 version at a film night at church.  I had never seen it.  There Are many things of interest - 1940s New York, a scene in Dutch (involving a young girl who has come to New York from the Netherlands, I thought, because she had no English and I thought it was post war, for reasons related to the post war state of affairs there, but no reason is given), only one African American character (in the kitchen)...  And then there is the role of men and women - there is one very central female character, a divorcee and single parent, but the other women seem to be at home, with an allowance and havi...
Source: Browsing - December 26, 2015 Category: Databases & Libraries Tags: mental health Source Type: blogs

CMS Releases Draft 2017 Letter To Issuers In The Federally Facilitated Marketplaces
Implementing Health Reform. On December 23, 2017, the Centers for Medicare and Medicaid Services (CMS) released its draft 2017 Letter to Issuers in the Federally Facilitated Marketplaces (FFMs). CMS also released a draft bulletin on the timing of rate filing submissions and rate filings for January 1, 2017 non-grandfathered individual and small group plans and a table of key dates for qualified health plan (QHP) certification, rate review, risk adjustment, and reinsurance for 2017. The Draft Letter To Issuers CMS issues a draft letter to FFM insurers (the “draft letter”) late each year following the release of its pro...
Source: Health Affairs Blog - December 24, 2015 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Medicaid and CHIP Medicare Payment Policy cost-sharing reductions essential community providers Essential Health Benefits Federally Facilitated Marketplace Provider Participation Rate QHPs SHOP exchanges Source Type: blogs

How Managerialists Turned Housestaff Training into a Zero-Sum Game: the Continuing Saga of the FIRST and iCompare Studies
Conclusion: the Problem is Managerialism    While the ongoing trials of housestaff sleep deprivation have been largely anechoic, the recent Washington Post commentary by Clark and Harari make questions about why in the world medical academics would have set up such trials and continue to defend them even more stark.But it seems that medical academics are boxed in, playing a zero-sum game.  They may know that there housestaff are overworked and sleep deprived, a situation that endangers the housestaff and their patients.  Yet every reasonable way one could imagined improving the situation would require s...
Source: Health Care Renewal - December 22, 2015 Category: Health Management Tags: academic medical centers amphetamines clinical trials generic managers managerialism medical ethics post-graduate medical education resident sleep deprivation Source Type: blogs

“Tyson Fabers, who has schizoaffective disorder, started...
"Tyson Fabers, who has schizoaffective disorder, started hearing voices when he learned that his girlfriend was cheating on him. The 41-year-old spent a total of 4 years between the Rikers Island jail complex and the Mid-Hudson Forensic Psychiatric Center in New Hampton, New York. Now, years later, he is taking medication. He works delivering packages for RDS Delivery Service, a company that makes a point of hiring people with disabilities. Tyson earns $8.75 an hour and works about 26 hours a week, using public transportation for his deliveries. Making ends meet is difficult, even with a monthly MetroCard provided by his e...
Source: Kidney Notes - December 21, 2015 Category: Urology & Nephrology Authors: Joshua Schwimmer Source Type: blogs

ACC Approves Transformational Changes to Its Governance Structure
By Kim Allan Williams Sr., MD, FACC, ACC President Leadership.  It’s not for the faint of heart. In a well-known Harvard Business Review article, author and psychiatrist Daniel Goleman wrote that the best leaders have five key traits: 1) self-awareness; … Continue reading → The post ACC Approves Transformational Changes to Its Governance Structure appeared first on ACC in Touch Blog. (Source: ACC in Touch Blog)
Source: ACC in Touch Blog - December 17, 2015 Category: Cardiology Authors: Kim Allan Williams Tags: Special Topics leadership Source Type: blogs

Saving Normal
By SAURABH JHA, MD The iconoclastic psychiatrist Thomas Szasz said that mental illness was metaphorical, not real, because mental diseases lacked biological substrates. The absence of a substrate predisposes psychiatry to overdiagnosis and avoiding overdiagnosis is psychiatry’s biggest challenge. This challenge has been taken up by Allen Frances in Saving Normal. Like Szasz, Frances writes in cultured, erudite prose. Unlike Szasz, Frances believes that psychiatric illnesses are real. To save the mentally ill, to save psychiatry from itself, Frances says we must save normal. Six years ago, Frances was enjoying retireme...
Source: The Health Care Blog - December 16, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB Saurabh Jha Source Type: blogs

The Pathologizing of Children
He’s suspended from school for defying his teacher and clashing with classmates. She’s a sullen, sometimes belligerent foster child.  He’s a toddler who cries frequently and doesn’t sleep through the night.  Their common denominator? All these children have been prescribed psychiatric medications. The likely overprescribing of psychotropic drugs for children is a serious issue. In the face of disturbing data and a lack of scientific evidence about safety and efficacy, some parents and professionals are speaking out. According to a report in The New York Times, about one in 54 children aged six through 17 covered ...
Source: Disruptive Women in Health Care - December 14, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Children Rx Source Type: blogs

Medical students are depressed, but they’re taking the wrong drugs
Studies have varied in their estimates of depression in medical school students, but they all show a similarly startling trend. Medical students have a higher depression rate than their non-medical counterparts. This culminates later in life with physicians with higher than average alcohol abuse problems and higher than average suicide rates, with male MDs 1.5 times as likely, and female MDs twice as likely to commit suicide than their non-medical counterparts. Depression in medical school reaches its peak around entry into the clinical years, with upwards of 1 in 4 medical students meeting the required criteria for depre...
Source: Kevin, M.D. - Medical Weblog - December 9, 2015 Category: Journals (General) Authors: Tags: Education Medical school Psychiatry Source Type: blogs

In Synch – Growing Older with the Rhythms of Life
Dr. Donald L. McEachron, Teaching Professor, School of Biomedical Engineering, Science and Health Systems, Drexel University Dr. Eugenia V. Ellis, Associate Professor, Architectural and Interior Design, Drexel University Human beings are the result of biological evolution rather than engineering design. One result of this reality is that humans are dependent on a variety of internal biological rhythms to control and coordinate both physiological and behavioral activities. Organisms, exposed to powerful geophysical cycles for countless millennia, have evolved specific mechanisms to adapt both internally and externally to da...
Source: Disruptive Women in Health Care - December 9, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Aging Source Type: blogs

Create an animated Cochrane Video: get schooled on presenting Cochrane evidence on Youtube
Alex Weaver is a medical student at University of Nottingham’s School of Medicine in the Division of Psychiatry and Applied Psychology. She recently created an animated video on Chlorpromazine using evidence from two Cochrane Reviews. Read more about the trial-and-error in creating the video as Alex shares tips for those wanting to make their own videos for their Cochrane group. read more (Source: Cochrane Collaboration - Official Blog)
Source: Cochrane Collaboration - Official Blog - December 7, 2015 Category: Internal Medicine Authors: Muriah Umoquit Tags: Issue 51 Authors Current news Cochrane contributors Cochrane Reviews Training Websites & Events Source Type: blogs

There is no oversight for prior authorizations. There should be.
The letter from the insurance company was addressed to my patient. The two pages of information boiled down to one simple sentence: “After a thorough review, our decision to not cover the medication Provigil (modafinil) is unchanged.” The letter went on to explain that there was no further recourse, and that the medication would not be approved because it was not Food and Drug Administration–approved for the condition my patient had: major depression. If she chose to take it, there would be no reimbursement. In many psychiatric conditions, the FDA-approved options are very limited; for some disorders, there simply ar...
Source: Kevin, M.D. - Medical Weblog - December 6, 2015 Category: Journals (General) Authors: Tags: Meds Medications Psychiatry Source Type: blogs

Dealing with my patients’ losses. And the losses in my own life.
My patient sat in front of me, silent.  She was a beautiful, elderly woman, always well dressed in bright, matching outfits, and not a single hair out of place.  Her lipstick was perfectly applied.  She normally had a quick wit, joking about how she might drop a few knickknacks from my office into her handbag on her way out. Not today.  Today her tears flowed.  Today was the day she grieved the loss of her husband of fifty-six years.  Today was the day she questioned whether she had done enough for him at the end.  Today she wondered whether she had said everything she wanted to say.  Today she wished for just a li...
Source: Kevin, M.D. - Medical Weblog - December 3, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

Do psychiatrists have value? Yes, they do.
While slogging through a crappy first draft of a document about the value of psychiatrists in mental health and substance use disorder services, I did a literature search for supporting evidence. I found nothing. (1) “So how exactly are we helpful?” I mused out loud. Maybe we aren’t: There are groups out there who do not believe that psychiatrists can or do help anyone. I am an N of 1. Therefore, this post is an anecdote, not evidence. Nonetheless: Psychiatrists provide psychiatric services. These are increasingly limited to only medication management, which is unfortunate. Psychiatrists need psychotherapy skills &#...
Source: Kevin, M.D. - Medical Weblog - December 2, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

NLM Tool, RxMix, Provides New Insights into Questionable Use of Psychiatric Drugs
RxMix, a digital tool developed by the Lister Hill National Center for Biomedical Communications at NLM, was one of the keys used in an investigative report to unlock concerns about the use of psychiatric drugs in juvenile correctional facilities in Pennsylvania. A multi-part story by PublicSource, a Pennsylvania-based news organization, found that young adults sent… (Source: NLM In Focus)
Source: NLM In Focus - November 30, 2015 Category: Databases & Libraries Authors: Posted by NLM in Focus Tags: Products Source Type: blogs

When will we start taking mental health seriously?
As a fourth-year medical student in a sub-internship in internal medicine, I have something that no doctor in America has. I have as much time as I want to spend with my patients. Don’t get me wrong, I am still a student. I’m still paying hospitals to let me be there, and I only have a maximum of four patients per day, but I inevitably end up spending more time with each patient than the average resident. Today, I spent my time with one patient in particular. She was a Caucasian woman who was a previous intravenous drug abuser who has been sober for fifteen years. She is on methadone and takes Xanax for anxiety. She pr...
Source: Kevin, M.D. - Medical Weblog - November 25, 2015 Category: Journals (General) Authors: Tags: Conditions Hospital Psychiatry Source Type: blogs

Telehealth under alternative payment models
The post below originally ran on Milliman, Inc. on November 23. Telehealth, as a modality of delivering healthcare services, is growing in terms of acceptance and adoption. There are a few key drivers for this dynamic: (1) consumer demand for convenient access to care; (2) availability of lower-cost telehealth technologies; (3) clinician comfort and willingness to provide certain services remotely; and (4) evolving payment models that seek to incentivize value and better population health. Evolving payment models reflect the need to mitigate perverse incentives for the unnecessary healthcare utilization, waste, and ineffic...
Source: Disruptive Women in Health Care - November 25, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Innovation Technology Source Type: blogs

The question about education that this doctor asks every new patient
“How far did you go in school?” This is a question that I ask every new patient as a matter of course. Granted, I have gotten some very odd answers, including hearing from a very successful businessman who only finished the seventh grade, or a very psychotic person who has a double master’s degree. Not implausible, but certainly not expected or the mainstream answer from the majority of my patients. Now, leaving the children aside, most of whom are of course still actively engaged in academic pursuits, what is one of the most common answers to that question that I hear day in and day out? Continue reading ... Your p...
Source: Kevin, M.D. - Medical Weblog - November 24, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

DSM-V is psychiatry’s maladaptation in the grey zone masquerading as science
The iconoclastic psychiatrist Thomas Szasz said that mental illness was metaphorical, not real, because mental diseases lacked biological substrates. The absence of a substrate predisposes psychiatry to overdiagnosis and avoiding overdiagnosis is psychiatry’s biggest challenge. This challenge has been taken up by Allen Frances in Saving Normal. Like Szasz, Frances writes in cultured, erudite prose. Unlike Szasz, Frances believes that psychiatric illnesses are real. To save the mentally ill, to save psychiatry from itself, Frances says we must save normal. Six years ago, Frances was enjoying retirement after a distingu...
Source: Kevin, M.D. - Medical Weblog - November 21, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

DSM-5 is psychiatry’s maladaptation in the grey zone masquerading as science
The iconoclastic psychiatrist Thomas Szasz said that mental illness was metaphorical, not real, because mental diseases lacked biological substrates. The absence of a substrate predisposes psychiatry to overdiagnosis and avoiding overdiagnosis is psychiatry’s biggest challenge. This challenge has been taken up by Allen Frances in Saving Normal. Like Szasz, Frances writes in cultured, erudite prose. Unlike Szasz, Frances believes that psychiatric illnesses are real. To save the mentally ill, to save psychiatry from itself, Frances says we must save normal. Six years ago, Frances was enjoying retirement after a distingu...
Source: Kevin, M.D. - Medical Weblog - November 21, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

A physician at TEDMED 2015: Here’s the topic that stood out
The one question every medical school admissions committee will ultimately ask: “Why do you want to be a doctor?” As if the many overqualified and seemingly undervalued applicants rejected each year do not have a sufficient answer. My answer was stereotypical, but I meant it. “I want to help people.” Four years later, I am a University of California, San Diego emergency medicine resident. And I am also fortunate to be a TEDMED attendee. In 1984, the synergy of technology, entertainment, and design was realized in the form of an event called TED. The organization’s motto is, “Ideas worth spreading.” Ov...
Source: Kevin, M.D. - Medical Weblog - November 19, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

Embrace adversity, and you will be stronger after
I’ve been intrigued by the recent presidential debates and interviews and analyses and pundit commentary. One of the issues that has come up has been how the candidates handle adversity, even at this very early time in the 2016 race. They say that Donald Trump is in it for the thrill and the fun and sheer ego-boosting ride that is pre-caucus and pre-primary politics, when the love of the American people can be, all at once, embracing, supportive, petty and fickle. When it is no longer fun, the story goes, he will be gone too. Continue reading ... Your patients are rating you online: How to respond. Manage your online re...
Source: Kevin, M.D. - Medical Weblog - November 18, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

Asking patients about suicide sometimes feels out of place
We have all seen patients whose distress is off the charts, or off the Distress Thermometer (NCCN). They sit in our offices, dazed and seemingly so depressed that we ask the mandatory question: “Are you thinking of hurting yourself?” Some patients just shake their head, not making eye contact, and even though they say they aren’t going to hurt themselves, we persist in our questioning because we have to and we want to make sure, as much as we can, that they are not going to harm themselves on leaving the institution. This past week I saw a woman with an increasingly common cancer that has some more rare features. Her...
Source: Kevin, M.D. - Medical Weblog - November 16, 2015 Category: Journals (General) Authors: Tags: Conditions Cancer Psychiatry Source Type: blogs

Why doctors won’t use the new end-of-life Medicare counseling codes
Poor bored government. So much time on their hands; so little real work that needs to get done, all they can do is micromanage poor physicians like me to death. Well, they can try. For its first forty-five years, Medicare was (in)famous for the very narrow limits on things it covered. It would pay for medical care when you were sick or injured, and that was basically it. No preventive care. No shots. Counseling, coming under the rubric of psychiatric care, was paid at 65 percent of the “medical” rate. On the flip side, all you had to do to get paid was bill for it. Somehow way back then, physicians were considered prof...
Source: Kevin, M.D. - Medical Weblog - November 14, 2015 Category: Journals (General) Authors: Tags: Physician Palliative care Primary care Source Type: blogs

An open letter to Dr. Richard Horton and The Lancet
Dr. Richard Horton The Lancet 125 London Wall London, EC2Y 5AS, UK Dear Dr. Horton: In February, 2011, The Lancet published an article called “Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomized trial.” The article reported that two “rehabilitative” approaches, cognitive behavior therapy and graded exercise therapy, were effective in treating chronic fatigue syndrome, also known as myalgic encephalomyelitis, ME/CFS and CFS/ME. The study received international attention and has had widespread infl...
Source: virology blog - November 13, 2015 Category: Virology Authors: Vincent Racaniello Tags: Commentary Information adaptive pacing therapy CFS chronic fatigue syndrome clinical trial cognitive behaviour therapy graded exercise therapy mecfs PACE specialist medical care The Lancet Source Type: blogs

An open letter to MPs of Malaysia
13 November 2015 An open letter to the Members of Parliament of Malaysia  We, the undersigned medical professional bodies and non-governmental organisations, would like to register our concern regarding the increasing presence of electronic cigarettes and vaping in our society. We note with dismay the Cabinet’s rejection of the Ministry of Health’s proposal to ban the sales and use of electronic cigarettes.  1. Malaysia proudly signed and ratified the World Health Organisation’s Framework Convention on Tobacco Control (FCTC). This is a reflection of the nation’s commitment to protect present and futu...
Source: Malaysian Medical Resources - November 13, 2015 Category: Global & Universal Authors: palmdoc Tags: Miscellaneous Source Type: blogs

Maybe medical school applications should come with a warning label
I did some pretty crazy things to get into medical school (don’t worry Mom, nothing illegal). For several years before applying I became a medicine groupie. I read books about being a doctor, watched documentaries about medicine, shadowed physicians for hours on end so I could imagine what it might be like. I watched many a friend go off to med school and graduate … and I waited, I hoped. I did research (which involved a little too much rat killing for my liking), I worked in a peach orchard to demonstrate my dedication to migrant farm worker health. I became an EMT; I got three master’s degrees. I got as close to me...
Source: Kevin, M.D. - Medical Weblog - November 13, 2015 Category: Journals (General) Authors: Tags: Education Medical school Psychiatry Source Type: blogs

Who’s to blame for this psychiatric failure?
Jerry once killed a man, his best friend.  He told me about it, unemotionally, but as if it had just happened. He wandered the street like a refugee in a war-torn country, except he was in mid-America: Louisville, Kentucky, as it were.  He was homeless.  I’ve known him for five years, anyway.  He’s approaching fifty, a rough-looking man, large, with thick gray hair, which is quite long now.  He has lost a lot of weight recently, and I’m not sure why.  He is slightly mentally retarded and very mentally ill.  Schizophrenia is his diagnosis, I believe, along with several other classifications, includi...
Source: Kevin, M.D. - Medical Weblog - November 12, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

Trial By Error, Continued: Why has the PACE Study’s “Sister Trial” been “Disappeared” and Forgotten?
By David Tuller, DrPH David Tuller is academic coordinator of the concurrent masters degree program in public health and journalism at the University of California, Berkeley. In 2010, the BMJ published the results of the Fatigue Intervention by Nurses Evaluation, or FINE. The investigators for this companion trial to PACE, also funded by the Medical Research Council, reported no benefits to ME/CFS patients from the interventions tested.  In medical research, null findings often get ignored in favor or more exciting “positive” results. In this vein, the FINE trial seems to have vanished from the public discussion over ...
Source: virology blog - November 9, 2015 Category: Virology Authors: Vincent Racaniello Tags: Commentary Information adaptive pacing therapy CFS chronic fatigue syndrome clinical trial cognitive behavior therapy Dave Tuller exercise Fatigue Intervention by Nurses Evaluation FINE graded exercise therapy mecfs myalgic encep Source Type: blogs

It’s dangerous. It can kill. But physicians don’t want to talk about it.
“You need to come to the ED ASAP.” A new patient was admitted at 2 a.m. and requested for a crisis counselor. Unlike with cases of sexual assault, survivors of domestic violence had to specifically request for the presence of an advocate when I was volunteering in NYC back in 2009. This woman, I’ll call her Sadie, had already taken the first courageous step to seek help. I briskly walked past distressed family members looking anxiously around for a glimpse of a messenger bearing good news. After knocking on the door asking for permission to enter, I walked in to find Sadie struggling to rest her left leg cove...
Source: Kevin, M.D. - Medical Weblog - November 8, 2015 Category: Journals (General) Authors: Tags: Conditions Emergency Psychiatry Source Type: blogs

Mental health in America requires a collaborative solution
Getting mental health right for all Americans is a huge undertaking. For the last 150 years, our “solutions” to mental illness can, at best, be characterized as a series of good intentions that were poorly, if not disastrously, implemented. But while there may be a conversation that needs to happen about how we got here, what’s important right now is how we go about shoring up a system that is on the verge of collapse. This year, one in five adults in the United States will suffer from a diagnosable mental disorder. Some will be mild, some severe and some chronic, and more than 68 percent of these patients will also ...
Source: Kevin, M.D. - Medical Weblog - November 7, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

Can Clinicians Maim Healthy Organs? The Case of Jewel Shuping
by Matthew Dias This October, reports surfaced that a psychologist deliberately blinded a North Carolina woman named Jewel Shuping, per her request. Thirty-year-old Shuping suffers from Body Integrity Identity Disorder (“BIID”), a psychiatric condition in which individuals experience an overwhelming, lifelong desire to develop a disability—most often by amputating a limb but sometimes by maiming an organ. Even if they are completely healthy, classic BIID sufferers feel that their natural body state is incomplete and that only through amputation or maiming can they achieve their “true identity.” The blinding of Sh...
Source: blog.bioethics.net - November 5, 2015 Category: Medical Ethics Authors: Matthew Dias Tags: Featured Posts Health Care BIID blinding Medical care Shuping Source Type: blogs

Meet Disruptive Woman to Watch: Linda Rosenberg
In June of this year, the American Foundation for Suicide Prevention (AFSP), the nation’s largest suicide prevention organization, publicly recognized Linda Rosenberg, the president of the National Council for Behavioral Health (NCBH), for her work in increasing access to mental health care services and in preventing suicide. In his speech explaining why Rosenberg was selected for the Allies in Action Nonprofit Partner Award, the AFSP Vice President for Public Policy said, “With contributions like Ms. Rosenberg’s and her organization, we are much closer to achieving our goal of reducing the suicide rate 20 percent by...
Source: Disruptive Women in Health Care - November 4, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Advocacy Mental Health Source Type: blogs

The Case for Expanding Physician-Assisted Death to Psychiatric Conditions
Bonnie Steinbock (Source: blog.bioethics.net)
Source: blog.bioethics.net - November 4, 2015 Category: Medical Ethics Authors: Susan Gilbert Tags: Health Care syndicated Source Type: blogs

Credulity and skepticism exist in a dynamic balance
As we grow into adulthood, each of us develops a personal comfort zone located on the continuum between paranoia and gullibility.  A few of us are highly suspicious by nature, a few are unwitting dupes; most of us are in between.  Mental health professionals are no exception, and it shows in our work.  Is a request for tranquilizers or stimulants legitimate, or are we abetting a substance abuser? When told of horrific past abuse, do we believe every word, or do we allow for possible exaggeration or distortion?  Credulity and skepticism exist in dynamic balance: Too much of either impairs clinical work. Our ...
Source: Kevin, M.D. - Medical Weblog - November 3, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

New Codes for End-of-Life Counseling; Heaven Help Us
Poor bored Government. So much time on their hands; so little real work that needs to get done, all they can do is micromanage poor physicians like me to death. Well, they can try. For its first forty-five years, Medicare was (in)famous for the very narrow limits on things it covered. It would pay for medical care when you were sick or injured, and that was basically it. No preventive care. No shots. Counseling, coming under the rubric of Psychiatric care, was paid at 65% of the “medical” rate. On the flip side, all you had to do to get paid was bill for it. Somehow way back then, physicians were considered pro...
Source: Musings of a Dinosaur - November 1, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs

Could the Doula Model Work for Women Seeking Mental Health Care and Support through the Veteran’s Administration, Especially After Rape or Sexual Trauma?
Elayne Clift, M.A. Her first experience with childbirth was traumatic. Repeated “checks” to determine how near she was to giving birth seemed like unnecessary invasions. When she questioned their frequency she was silenced, as she was when she asked why she had to remain in bed attached to an IV. Labeled a “failure to progress” after only seven hours in labor she was given a C-section “to ensure a healthy baby.”  During her second pregnancy she chose a medical practice that included nurse-midwives and allowed for vaginal birth after Caesarean. Then she “hired” a volunteer doula to support her through labor...
Source: Disruptive Women in Health Care - November 1, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Childbirth Women Veterans Source Type: blogs

David Tuller responds to the PACE investigators
David Tuller’s three-installment investigation of the PACE trial for chronic fatigue syndrome, “Trial By Error,” has received enormous attention. Although the PACE investigators declined David’s efforts to interview them, they have now requested the right to reply. Today, virology blog posts their response to David’s story, and below, his response to their response.  According to the communications department of Queen Mary University, the PACE investigators have been receiving abuse on social media as a result of David Tuller’s posts. When I published Mr. Tuller’s articles, my intent was to provide a...
Source: virology blog - October 30, 2015 Category: Virology Authors: Vincent Racaniello Tags: Commentary Information adaptive pacing therapy CFS chronic fatigue syndrome clinical trial cognitive behavior therapy Dave Tuller exercise graded exercise therapy mecfs myalgic encephalomyelitis outcome PACE trial recovery Source Type: blogs

Beyond the death count: The psychological casualties of mass violence
On October 9th , while President Obama was attempting to console the victims of the October 1st mass shooting at Umpqua Community College (UCC) in Oregon, two more students were killed, and five people were wounded at colleges in Arizona and Texas. In Flagstaff, Arizona, a gunman opened fire at Northern Arizona University. Hours later, Texas Southern University (TSU) classes were canceled at the Houston school as the campus was locked down in the fourth shooting near TSU since August. Counseling services were offered to students and faculty at both schools. On October 1, Christopher Harper-Mercer opened fire on a classroo...
Source: Kevin, M.D. - Medical Weblog - October 30, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

PACE trial investigators respond to David Tuller
Professors Peter White, Trudie Chalder and Michael Sharpe (co-principal investigators of the PACE trial) respond to the three blog posts by David Tuller, published here on 21st, 22nd and 23rd October 2015, about the PACE trial. Overview The PACE trial was a randomized controlled trial of four non-pharmacological treatments for 641 patients with chronic fatigue syndrome (CFS) attending secondary care clinics in the United Kingdom (UK) (http://www.wolfson.qmul.ac.uk/current-projects/pace-trial) The trial found that individually delivered cognitive behaviour therapy (CBT) and graded exercise therapy (GET) were more effecti...
Source: virology blog - October 30, 2015 Category: Virology Authors: Vincent Racaniello Tags: Commentary Information adaptive pacing therapy CFS chronic fatigue syndrome clinical trial cognitive behavior therapy Dave Tuller exercise graded exercise therapy mecfs myalgic encephalomyelitis outcome PACE trial recovery Source Type: blogs