CDC: One in Five Kids Lives with a Mental Health Issue

From NAMI Top Story
by Stephanie Dinkmeyer, NAMI Communications Intern

Millions of American children are living with mental disorders. Reports and studies have shown that it’s nearly one in five. But a newly published six-year study from the Centers for Disease Control and Prevention (CDC) shed some light on the specifics behind the numbers.

Between 2005 and 2011, the CDC collected data from studies performed by theSubstance Abuse and Mental Health Services Administration (SAMHSA), theNational Institute of Mental Health (NIMH),  the Health Resources and Services Administration (HRSA), and others, concerning mental disorder diagnoses in children aged 3 to 17. The report also revealed a decrease in substance use disorders in children aged 12 to 17 from 2002 to 2011.

The study covers a breadth of disorders, including but not limited to ADHD,depressionanxiety, substance use disorders and Tourette’s syndrome. ADHD was the most common disorder to affect the children studied, at 6.8 percent. Tourette’s syndrome was the least common, at less than 0.5 percent. The study also revealed gender disparities. ADHD and conduct disorders such as oppositional defiant disorder (ODD) are more common in boys; over twice as common in the latter case. Autism spectrum disorders (ASD), too, are more prevalent in boys. Mood disorders, however, are shown to be more common in girls. While depression is just as prevalent in both genders, inequalities arise with age. Girls aged 14 to 16 are more likely to have been diagnosed or currently diagnosed with depression. This data is consistent with the fact that adult women are more prone to depression.

The report’s focus on mental health also included surveys about adolescent’s drug, alcohol and tobacco use. Although 1.7 million adolescents (classified as 12 to 17 year olds) are diagnosed with a substance use disorder every year, this number is almost a 2 percent decrease since 2002. The CDC’s source for this data, the National Survey on Drug Use and Health (NSDUH), differentiates between substance dependence and substance use disorder based on criteria such as tolerance, emotional and physical problems associated with the substance, withdrawal symptoms, and legal trouble.

As the first exhaustive report of childhood mental disorders of its kind, the CDC’s report has proven to be a critical first step in understanding the children affected. Although the new and controversial Diagnostic and Statistical Manual of Mental Disorders (DSM-5) may have an impact on the approach to these disorders in the years ahead, the groundwork for providing effective services to children and their families has been laid.

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New Analysis Compares 15 Antipsychotics

From APA Psychiatric News Alert: An analysis of 212 clinical trials of 15 antipsychotic medications found that all were significantly more effective than placebo, and the differences between them in efficacy were “small but robust.” The study, which was published online yesterday in Lancet, included data from randomized controlled trials involving more than 43,000 participants. In addition to assessing efficacy, the study also analyzed discontinuation of the medications and their side effects.

The researchers found that clozapine, amisulpride, and olanzapine showed, respectively, the greatest efficacy, while lurasidone and iloperidone showed the least. Assessment of all-cause discontinuation (when compared with placebo) showed that the best drug on this measure was amisulpride, and the worst was haloperidol. For extrapyramidal side effects, clozapine had the best odds ratio, and haloperidol the worst, while for sedation, amisulpride had the highest odds ratio, and clozapine the worst. Weight gain was also evaluated in comparison with placebo, and haloperidol was linked with the least weight gain, and olanzapine with the most. The researchers said as well that their findings “challenge the straightforward classification of antipsychotics into first-generation and second-generation groupings. Rather, hierarchies in the different domains should help clinicians to adapt the choice of antipsychotic drug to the needs of individual patients.”

To read about decision making in choosing a psychoactive medication, see the From the Experts column in Psychiatric News here.

Intra-Family Bullying Bad for Kids’ Mental Health

From Psychiatric News Alert
The Voice of the American Psychiatric Association
and the Psychiatric Community

Bullying by brothers or sisters against their siblings is as bad as that from outsiders and is associated with worse children’s and adolescents’ mental health. A national sample of 3599 youth and caregivers reported greater mental health distress in the prior year if they experienced psychological, property, or mild or severe physical assault by their siblings, wrote Corinna Jenkins Tucker, Ph.D., of the Department of Family Studies, University of New Hampshire in Durham.

Sibling physical aggression was nearly as harmful as that by non-family peers, and combined aggression from within and outside the family caused nearly double the level of distress.

“Sibling aggression is not benign for children and adolescents, regardless of how severe or frequent… An implication of our work is that parents, pediatricians, and the public should treat sibling aggression as potentially harmful and something not to be dismissed as normal, minor, or even beneficial. The mobilization to prevent and stop peer victimization and bullying should expand to encompass sibling aggression as well.”

Tucker et al., in the July issue of the journal Pediatrics.

For more in Psychiatric News about bullying, click here.

New Federal Website and SAMHSA’s Toolkit for Community Conversations About Mental Health

U.S. Department of Health and Human Services Secretary Kathleen Sebelius has announced the launch of MentalHealth.gov as an online resource for people looking for information about mental health. This website provides information about the signs of mental illness, how individuals can seek help, and how communities can host conversations about mental health. The website also features videos from a number of individuals sharing their stories about mental illness, recovery, and hope.

SAMHSA will release a Toolkit for Community Conversations About Mental Health to support communities interested in holding discussions about mental health using consistent information and approaches. The Toolkit has three parts: an “Information Brief,” a “Discussion Guide” and an “Organizing Guide.” These components will help communities and individuals start a conversation about mental health and help identify innovative and creative actions to meet the mental health needs of our Nation.

Through MentalHealth.gov and SAMHSA’s Toolkit for Community Conversations About Mental Health, we can all work together to provide youth and adults accurate information about the prevention and treatment of mental health conditions, coupled with open spaces to tell their stories, ask for help, share their successes, and support one another. These conversations will also give us a venue to highlight the importance of recovery, support those in recovery, and offer opportunities for everyone to see that recovery is possible.

The entire SAMHSA Toolkit for Community Conversations About Mental Health will be available soon via the SAMHSA website, the SAMHSA Store, and MentalHealth.gov. The Information Brief section of the Toolkit is available for print and electronic download on the SAMHSA Store and at www.mentalhealth.gov/talk/community-conversation/index.html.

From: Substance Abuse & Mental Health Services Administration
1 Choke Cherry Road
Rockville, MD 20857
1-877-SAMHSA-7 (1-877-726-4727)
http://www.samhsa.gov

 

I have Bipolar Disorder, I am not Bipolar

by Ellen Krantz, NAMI San Francisco

Nobody is cancer, or is a heart attack. That’s not to say when my symptoms are bad, my thoughts, feelings and actions are not drastically affected, because they are. But my illness is not my whole identity. I define recovery not by lack of symptoms but by continuing to live life more fully. What I call more fully now is very different than what it meant to me before. I had expected to continue working at a high-pressure, high-paying job. I just thought I’d buy another new car and continue to go on expensive vacations. Now, when I’ve been able to work, I have no need to make a lot of money. When I can’t work, I gain enormous satisfaction from volunteering. And I appreciate people more. I’m kinder and more giving. And sometimes that’s just in a small way—for example, I fully see and thank the man bagging my groceries—while most people don’t even acknowledge that he’s there.

It’s difficult for many people to understand the pain of having a mental illness since it’s not physical pain. Diseases like breast cancer aren’t any less devastating, but everywhere you look there are pink ribbons and fundraisers. At least when we see someone who has lost their hair, we know they have had chemo. How many people know the horrible side effects of psychotropic meds? My father had tardive dyskinesia, causing his tongue to protrude. What did people think?

We know society stigmatizes people with mental illness, and many of us have internalized that stigma to some degree. After 40 years of suffering from bipolar disorder and having had to get ECT numerous times, my father would only admit to “having some problems.” Denial can cost people who live with a mental illness their lives—it might have done that for me. And it took me years to really reduce my self-stigma. I remember the first time I went to my local pharmacy to get meds that are only prescribed for people with bipolar disorder. I was mortified and completely embarrassed because now the pharmacist would know. Now I really like my pharmacist and we are on a first-name basis!

And what about when people call us crazy? One night I was sitting in the ER waiting room with my friend who has bipolar disorder, as does her daughter. We were there because she had to have her daughter hospitalized. Since the hospital had to search for an open bed we knew it would be many hours before that would happen. My friend can’t skip her meds for even one night without getting horrendous withdrawal symptoms, so she took her pills and fell asleep. I stayed awake so she wouldn’t be alone in the waiting room and every so often I’d check on her daughter. The last thing any of us were was crazy.  Her daughter was scared and in enormous pain. My friend was brave and saving her daughter’s life. And I was being there for them.

Obviously our society should feel compassion for everyone who has a mental illness and it’s sad but if those of us who don’t fit the stereotype go public it will be more likely to reduce stigma. It makes it difficult for people to say it’s only “those” people and distance themselves. As it happens, neither my father nor I fit the stereotype. For one thing our symptoms started after we had already gotten an education, and in my case, had been working. He was in his first year of med school I had gotten a degree in engineering from Columbia and had worked for 15 years as a computer programmer. Becoming more and more public about my illness and helping to reduce stigma is my goal to live life even more fully in the future.

This story originally appeared in the fall 2012 edition of The Voice, NAMI’s quarterly newsletter directly mailed to past and present donors.