Effect of deployment on mental health of soldiers: common disorders and alcohol misuse more frequent than PTSD

This Lancet study examined the consequences of deployment to Iraq and Afghanistan on the mental health of UK armed forces from 2003 to 2009.

9990 (56%) participants completed the study questionnaire (roughly 8000 regulars, 1700 reservists).

The prevalence was:

- 19·7% for symptoms of common mental disorders

- 13% for alcohol misuse

- 4% for post-traumatic stress disorder (PTSD)

Deployment to Iraq or Afghanistan was significantly associated with alcohol misuse for regulars (odds ratio 1·22) and with post-traumatic stress disorder (PTSD) for reservists (2·83)

Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of post-traumatic stress disorder (PTSD) was low.

References:

What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study. The Lancet, Volume 375, Issue 9728, Pages 1783 - 1797, 22 May 2010.

What Happened to the Marlboro Marine?

Image source: The Los Angeles Times.

New schizophrenia drug lurasidone (Latuda) does not cause significant weight gain

Lurasidone (Latuda) was approved for the treatment of schizophrenia in adults in October 2010. Lurasidone acts as a D2, 5-HT2A, 5-HT7, and α2C-adrenergic receptor antagonist, and 5-HT1A receptor agonist.

Once-daily lurasidone did not cause significant weight gain, a common side effect of other schizophrenia drugs. Possible treatment side effects do include drowsiness, agitation, tremors, and nausea.

Lurasidone will carry a boxed warning - required of all atypical antipsychotics - about the increased risk for stroke and death when used off-label to treat dementia-related psychosis in older patients.

Other severe but rare side effects include neuroleptic malignant syndrome and tardive dyskinesia.

References:
New Schizophrenia Drug Approved. Journal Watch.

Image source: Lurasidone, Wikipedia, public domain.

Alternative to alcohol - BBC video

Psychologist and addiction expert Dr John Marsden takes part in a radical experiment as he trials an non-addictive drug alternative to alcohol:



A single injection reverses the 'drug' alternative to alcohol and Dr John Marsden is left to reflect on whether this is indeed be the way forward in reducing alcohol dependency in future generations:



Twitter comments:

@yayayarndiva (P. Mimi Poinsett MD): How about water? -- Searching for non-addictive alternative to alcohol - BBC video http://goo.gl/KYtss

Alcohol literally kills: Gary Moore had 380mg/dL in his blood, Winehouse 416mg/dL when she died surrounded by 3 empty vodka bottles. Telegraph UK, 2012. 

16% of motorists may be under the influence of drugs during weekends - one in six cars

Motorists under the influence of drugs are a growing threat on U.S. roads. If you think about driving on a Friday or Saturday evening about 16% of the vehicles - one in six of the cars - the driver will be under the influence of an illicit or licit drug.

"Drugged driving" hampers judgment, reaction time, driving skills and memory.

Video: "Fall down alcohol test".

References:

U.S. says drugged driving growing threat. Reuters.

Am I driving a car? Drunk motorist stuns police http://goo.gl/D9NOa
Drunk Driving, Distracted Driving, Moralism, and Public Health - NEJM
30% of U.S. adults have been arrested by age 23: study. Reuters, 2011.

"Talk to Frank" - British government website for drug abuse prevention and treatment

Talk to Frank" is a British government-funded website for drug abuse prevention and treatment tips for the general public available at http://www.talktofrank.com

The "A to Z" list of substances explains appearance and use, effects, chances of getting hooked, health risks and the UK law. It also includes information on peer pressure, etc.

R U OK? Day

Suicide is second to only accidental death as the leading cause of mortality in young men across the world. High-lethality methods of suicide are preferred by young men: hanging and firearms in high-income countries, pesticide poisoning in the Indian subcontinent, and charcoal-burning in east Asia (Lancet, 2012).

Hugh Jackman shows his support for R U OK?Day, a national day of action that aims to prevent suicide by encouraging people to connect with colleagues, friends and loved ones and ask: "Are you OK?". Suicide prevention in Australia: "A conversation could save a life", link via @dreamingspires.



References:
http://ruokday.com.au R U OK? Matt's Notes

Using the Internet for health purposes was associated with increased depression

The rapid expansion of the Internet has increased the ease with which the public can obtain medical information. Most research on the utility of the Internet for health purposes has evaluated the quality of the information or examined its impact on clinical populations. Little is known about the consequences of its use by the general population.

Health-related Internet use was associated with small but reliable increases in depression (i.e., increasing use of the Internet for health purposes from 3 to 5 days per week to once a day was associated with 0.11 standard deviations more symptoms of depression, P = 0.002).

Using the Internet for health purposes was associated with increased depression. The increase may be due to increased rumination, unnecessary alarm, or over-attention to health problems.

In contrast, using the Internet to communicate with friends and family was associated with declines in depression.

References:

Effects of Internet Use on Health and Depression: A Longitudinal Study. J Med Internet Res 2010;12(1):e6.

Negative consequences from the use of internet for health information - CDC (PDF) http://goo.gl/Fgcq via http://goo.gl/947F

Image source: Wikipedia, public domain.

Updated: 08/12/2010

Evaluation of driving risk in dementia - practice parameter update

For patients with dementia, the following characteristics are useful for identifying
patients at increased risk for unsafe driving:

- Clinical Dementia Rating scale (Level A)
- caregiver’s rating of a patient’s driving ability as marginal or unsafe (Level B)
- history of crashes or traffic citations (Level C)
- reduced driving mileage or self-reported situational avoidance (Level C)
- Mini-Mental State Examination scores of 24 or less (Level C)
- aggressive or impulsive personality characteristics (Level C)


Evaluation of driving risk in dementia (click to enlarge the image).

The following characteristics are not useful for identifying patients at increased risk for unsafe driving:

- patient’s self-rating of safe driving ability (Level A)
- lack of situational avoidance (Level C)

References:

Practice Parameter update: Evaluation and management of driving risk in dementia. Neurology 2010;74:1316–1324 (PDF)

Q&A from CCJM: When should I discuss driving with my older patients? http://buff.ly/1xeoBTw

Cognitive behavioural treatment may work for low-back pain

Low-back pain is a common and costly problem. This study estimated the effectiveness of a group cognitive behavioural intervention in addition to best practice advice in people with low-back pain in primary care.

Over 1 year, the cognitive behavioural intervention had a sustained effect on troublesome subacute and chronic low-back pain at a low cost to the health-care provider.

References:

Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis. The Lancet, Volume 375, Issue 9718, Pages 916 - 923, 13 March 2010.

Image source: Different regions (curvatures) of the vertebral column, Wikipedia, public domain.

Couple addicted to the internet let their baby starve to death while raising a virtual daughter online

From BBC:

A South Korean couple who were addicted to the internet let their three-month-old baby starve to death while raising a virtual daughter online, police said.

An autopsy showed her death was caused by a long period of malnutrition.

The couple had become obsessed with nurturing a virtual girl called Anima in the popular role-playing game Prius Online.

Some psychiatrists still have doubts if Internet addiction exists but it looks pretty much for real in this video:



References:

S Korea child 'starves as parents raise virtual baby'. BBC.

High-risk profession: Suicide rate of U.S. doctors is one per day

More than a quarter of primary care doctors reported being "burnt out," in part due to worsening time pressures and a chaotic work pace, which were "strongly associated with low physician satisfaction."

The United States loses the equivalent of at least one entire medical school class (approximately 400 physicians) each year to suicide.

In other words, 300-400 doctors in the United States kill themselves every year, or roughly 1 per day. Male doctors have suicide rates 1.4 times that of the general population, while female doctors have twice the rate of depression and 2.3 times the suicide rate when compared with women who are not physicians.

References:

Help for Today's Tense, Frustrated Doctors. Medscape, 2009.
http://www.medscape.com/viewarticle/710904

Doctors have higher rates of suicide than the general population: 40% higher for male doctors, 130% for female doctors http://goo.gl/ckTm

Doctors are quietly opting out of medicine http://goo.gl/emmTA

Image source: Vincent van Gogh's 1890 painting At Eternity's Gate. Wikipedia, public domain.

Hysteria: Historical Perspective

"Women under hysteria" from Wikipedia. D.M. Bourneville and P. Régnard, public domain.

From The Lancet:

The changing meanings of hysteria have mirrored the preoccupations of the societies that used the term:

Ancient Egyptians, and subsequently Greeks, blamed a displaced hystera, or womb, for many women's afflictions, including choking, mutism, and paralysis, although the term hysteria was not applied until later.

Hippocratic writings speak of a dry womb rising towards the throat in search of moisture, thereby impeding breathing.

As anatomical knowledge increased, such notions became untenable and Galen instead blamed blocked menstrual flow and sexual abstinence.

Galen suggested that retained sperm could contribute to male hysteria, igniting a debate which was to run for centuries over whether men could indeed suffer hysteria.

Psychiatrists have gradually replaced the term "hysteria" with "somatization disorder". In 1980 the American Psychiatric Association officially changed the diagnosis of "hysterical neurosis, conversion type" to "conversion disorder".

References:
Hysteria, Perspectives. The Lancet, Volume 374, Issue 9702, Page 1669, 14 November 2009.
Hysteria. Wikipedia.
Somatoform Disorder: Conversion. eMedicine Specialties > Pediatrics: Developmental and Behavioral > Medical Topics.

CNN Video: Psychostimulants popular on college campuses, easy to get

CNN Video: Psychostimulants popular on college campuses, easy to get.

School bullies and their victims are at higher risk of psychiatric disorders later in life

Schoolyard bullies and their victims face higher risks of anxiety, depression, other psychological disorders later in life http://bit.ly/3Yr4rB
6% of boys in Finland routinely bullied other kids, while 3% were both bullies and victims.
Less than 1% of girls were either bullies or "bully-victims."

30% of boys who had been both bullies and victims ended up taking a psychiatric medication, 17% were admitted to a hospital.
Among girls, 32% of those who had been bullied were eventually prescribed a psychiatric medication (16% if not bullied).

Related reading:

DNA of children who experienced violence and bullying shows wear and tear that is associated with rapid aging http://goo.gl/FzY2i

Image source: Bullying. Wikipedia, GNU Free Documentation License.

TED Talks: "Success is a continuous journey"

Richard St. John: "Success is a continuous journey"

" In his typically candid style, Richard St. John reminds us that success is not a one-way street, but a constant journey. He uses the story of his business' rise and fall to illustrate a valuable lesson -- when we stop trying, we fail."

RICHARD ST. JOHN’S BLOG: The 8-Traits that Lead to Great Success.

Desperate Japanese head to 'suicide forest' with stunning views of Mount Fuji, also known as place to die

Suicide is second to only accidental death as the leading cause of mortality in young men across the world. High-lethality methods of suicide are preferred by young men: hanging and firearms in high-income countries, pesticide poisoning in the Indian subcontinent, and charcoal-burning in east Asia (Lancet, 2012).

From CNN:

Suicides in Japan were 15 percent higher in January 2009 than a year earlier. Japan's suicide rate, already one of the world's highest, has increased with the recent economic downturn.

The Danger of Being a Doctor on Social Networks

Berci OMG, just got a message at the Ann Myers Medical Center in Second Life: "i have depression and need medical help, i am suicidal..." about 2 hours ago from TweetDeck

What would you do? What should you do?

If you are included in this post but would like to have your tweet removed for any reason, please email me and will comply with your request the same day.

NBC: Teenager Commits Suicide Over "Sexting"

"Sexting" (from "sex" and "texting") is the act of sending sexually explicit photos electronically, primarily between cell phones. It is practiced primarily by young adults, though it is known to occur amongst children as young as middle-school age. In January 2009, a survey of 1200 teenagers reported that one in five had sent explicit photos of themselves. Sexting has been linked to severe embarrassment when photos are passed to people other than the intended recipient, even contributing to the suicide of the sexting initiator.

Visit msnbc.com for Breaking News, World News, and News about the Economy

NBC The Today Show, March 6, 2009: 18-year-old Jesse Logan took her own life after a nude picture of her was passed around by e-mail. TODAY?019s Matt Lauer talks to her mom, Cynthia Logan, and Internet safety expert Parry Aftab about the dangers of sexting.

References:
Sexting, from Wikipedia, the free encyclopedia.

CNN Video: Millions of Americans take performance-enhancing drugs for the brain

CNN Video: Steroids for the mind, 2:10 minutes.

Before you recommend wine for CV risk reduction, consider this: 1 in 5 men at risk of drinking problem

Compared with non-drinkers, men who consumed wine, beer, or spirits had a 36% lower risk of all-cause mortality and a 34% lower risk of cardiovascular mortality.

Before you recommend wine for CV risk reduction, consider this:

• One in five men at risk of drinking problem during their lifetimes
  
  
• Women have an 8 to 10 percent chance of becoming dependent on alcohol during their lifetimes
  
  
• Men have 15% lifetime risk for alcohol abuse, 10% risk for alcohol dependence. "Each cuts your life short by 10-15 years."
  
  
• Heavy drinking increases risk of depression by 40%, and 80% of people dependent on alcohol are smokers
  
  

References:
One in five men at risk of drinking problem. Reuters, 10/2009.
Drinking Alcohol Daily Seems to Cut the Risk for Coronary Artery Disease the Most
Taking Up Moderate Drinking in Middle Age Decreases Cardiovascular Risk
Medical News: Exercise and Alcohol Effect on Health
A glass of wine daily may prolong life. How you can you predict which patient will have a bottle daily though?
Image source: OpenClipArt.org, public domain.