A Blood Test for Depression?


The possibility of using a blood test to detect depression has been demonstrated by researchers at MedUni in Vienna where they have now used functional resonance imaging of the brain and pharmacological investigations to demonstrate that there is a close relationship between the speed of serotonin uptake in blood platelets and the function of a depression network in the brain.

While blood tests for mental illness have until recently been regarded as impossible, the recent study clearly indicates that, in principle, depression can be in fact diagnosed in this way.

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38-Year Study Assesses Violence and Premature Mortality in People With Schizophrenia

People with schizophrenia and related disorders have increased rates of suicide, premature mortality, and convictions for violent offenses, according to a report from British and Swedish researchers published in Lancet.

English: Image showing brain areas more active...

English: Image showing brain areas more active in controls than in schizophrenia patients during a working memory task during a fMRI study. Two brain slices are shown. (Photo credit: Wikipedia)

The study compared 24,297 Swedish patients with their unaffected siblings and matched controls from the general population, assessing outcomes from 1972 through 2009. Within five years of diagnosis, 13.9% of male patients and 4.7% of female patients recorded one of those three adverse outcomes. Overall, those adverse outcomes were 7.5 times more likely compared with men in the general population and 11.1 times more likely for women, wrote Seena Fazel, M.D., an honorary consultant forensic psychiatrist in the University of Oxford’s Department of Psychiatry, and colleagues.

The authors assessed adverse outcomes in all three study groups and found that three risk factors present in all three cohorts predicted the adverse outcomes: drug use disorders, criminality, and self-harm. “Schizophrenia and related disorders are associated with substantially increased rates of violent crime, suicide, and premature mortality,” they concluded. “Risk factors for these three outcomes included both those specific to individuals with schizophrenia and related disorders, and those shared with the general population. Therefore, a combination of population-based and targeted strategies might be necessary to reduce the substantial rates of adverse outcomes in patients with schizophrenia and related disorders.”

“[T]he authors suggest that to best manage violence and suicide risk, we should perhaps now turn our attention to those factors evident across populations,” added Eric Elbogen, Ph.D., an associate professor, and Sally Johnson, M.D., a professor of psychiatry at the University of North Carolina, in a related commentary. “In this way, we might not only reduce actual risk in people with schizophrenia, but appropriately place this in the context of violence reduction for society as a whole. The potential to achieve practical, evidence-based, and potentially less stigmatising interventions is one of the most exciting implications of this study.”

To read more research on violence risk in those with schizophrenia, see the Psychiatric News articles, “Antisocial Behavior Raises Violence Risk in Some Psychosis Patients” and “Untreated Schizophrenia Increases Risk for Violence By Inmates.” Also see “Systematic Suicide Risk Assessment for Patients With Schizophrenia: A National Population-Based Study” in Psychiatric Services.

Study on Vets With Schizophrenia, Comorbid Anxiety

FROM Psychiatric News Alert: Veterans with schizophrenia and a comorbid anxiety disorder have increased rates of other disorders, higher psychiatric and medical hospitalization, and increased utilization of outpatient mental health services, according to the study, “Service Utilization Among Veterans With Schizophrenia and a Comorbid Anxiety Disorder,” published in the APA journal Psychiatric Services in Advance.

Researchers from the Department of Veterans Affairs’ Serious Mental Illness Treatment Resource and Evaluation Center in Ann Arbor, Mich., examined diagnostic, utilization, and medication records included in the Veterans Health Administration (VHA) National Psychosis Registry. Relationships between schizophrenia and anxiety disorders were evaluated along demographic and service utilization dimensions.

During Fiscal 2011, 23.8% of 87,006 VHA patients with schizophrenia were diagnosed with a comorbid anxiety disorder; 15.2% of the sample had a posttraumatic stress disorder (PTSD) diagnosis and 8.6% a non-PTSD anxiety disorder. The researchers found that patients without a comorbid anxiety disorder had significantly lower rates of other comorbid mental disorders than did patients with comorbid anxiety disorders. Specifically, 20.6% of patients with no anxiety disorder had depression, compared with 47.7% of those with PTSD and 46.8% of those with non-PTSD anxiety disorders. Only 3.7% of patients with no anxiety disorder had a personality disorder, compared with 11.2% of those with PTSD and 10.8% of those with non-PTSD anxiety.

“Anxiety disorders are common among individuals with schizophrenia within the VHA and appeared in this study to convey additional disability in terms of psychiatric comorbidity and the need for increased psychiatric care,” the researchers pointed out. “Future research should investigate ways to improve detection and enhance treatment provided to this population.”

For more on care of veterans with psychiatric disorders, see the Psychiatric Newsarticles, “APA Calls for Better Training to Treat Chronic Pain, Addiction Among Vets” and “Knowledge of Military Life Facilitates Vets’ MH Care.”

Meeting Tonight – Local Psychiatric Mobile Response Teams

At tonight’s meeting, Linda Boyd, RN, BSN, MN, LAC Department of Mental Health Program Head for the Law Enforcement Psychiatric Mobile Response Teams, will speak on the various psychiatric mobile response teams in the South Bay. This will be an opportunity to learn about the various psychiatric emergency teams in our area, how families should connect and interact with the teams. Ms. Boyd has extensive experience with these type of emergency response teams that are often called by family members in time of crisis. You won’t want to miss this important presentation on a service many of us have used and may use in the future.

The meeting begins at 7:30 PM, Monday, July 21 in the Fellowship Hall at First Lutheran Church, 2900 Carson Street in Torrance.

Linda Boyd was the co-creator and co-founder of four collaborative teams, which combines a law enforcement officer and a mental health clinician responding to 911 calls involving the mentally ill or persons in an emotional crisis:

  • LA County Sheriff, Mental Evaluation Team (MET)
  • LAPD, Systemwide Mental Assessment Response Team (SMART)
  • Long Beach PD, Long Beach Mental Evaluation Team (LBMET)
  • Pasadena PD, Homeless Outreach and Psychiatric Evaluation Team (HOPE)

Ms. Boyd is also Program Manager for the PEl School Threat Assessment Response Team (START). She holds a Master in Nursing Degree from UCLA with an emphasis on Community Mental Health. Ms. Boyd has conducted numerous presentations, training sessions and workshops on Critical Incident and Disaster Stress, Suicide Intervention, Mental Health 101 for Law Enforcement, as well as the Development of Collaborative Law Enforcement Mental Health Teams.

The Caring and Sharing Support Group meeting will be 6:00 p.m. to 7:15 p.m. in the Fireside Room at First Lutheran Church immediately before the general meeting. Caring and Sharing is a support group for family members of persons with a severe mental illness. We look forward to seeing you.

Two Pending Congressional Bills On Mental Illness

English: An American Lady butterfly against a ...

English: An American Lady butterfly against a cloud-filled sky. (Photo credit: Wikipedia)

Which of the two Bills do you endorse?

The Murphy Bill Empowers Parents and Caregivers:

  • Clarifies the Health Information Portability and Accountability (HIPPA) privacy rule and the Family Educational Rights and Privacy Act. It would allow physicians and mental health professionals can provide crucial information to parents and caregivers about a loved one in an Acute mental health crisis to protect their health, safety, and wellbeing.
  • Unlike private health insurance or Medicare, Medicaid will not reimburse for inpatient medical care at a psychiatric facility with more than 16 beds (IMD Institute for Mental Disease).  The bill will increase access to inpatient psychiatric care for the most critically ill patients by making narrowly tailored exceptions to the IMD.
  • Promotes alternatives to long-term inpatient care, such as court-ordered “Assisted Outpatient Treatment.” AOT allows the court to direct treatment in the community for the hardest to treat patients-fewer than 1 percent of the people with SMI (severe mental illness) who have a history of arrest, repeat hospitalizations, and violence, because of their illness. AOT has reduced rates of imprisonment, homelessness, substance abuse, and costly emergency room visits for chronically mentally ill participants of upward to 70 percent. It has reduced Medicaid costs by 46 percent for participants.
  • Modeled on a successful state project in Massachusetts, the bill advances tele-psychiatry to link pediatricians and primary care physicians with psychologists.
  • Creates an Assistant Secretary for Mental Health and Substance Use Disorders position within the Department of Health and Human Services to coordinate federal government programs and ensure recipients of the community mental health service block grant use evidence-based models of care.
  • Emphasizes evidence-based treatments, reforms and unauthorized programs, and strengthens congressional oversight of all behavioral health grants. Applies rigorous quality standards for a new class of Federally Qualified Behavioral Health Clinics.
  • Protects patients who are treated in the healthcare system from being warehoused in the criminal justice system. Mental health courts are provided cost-effective and responsible alternatives to incarcerating the MI.
  • Protects certain classes of drugs, commonly used to treat mental illness, so physicians are able to prescribe the right medication for those on Medicare and Medicaid.
  • The Department of Education will undertake a national campaign aimed at reducing the stigma of Severe Mental Illness in schools. Reauthorizes the Garrett Lee Smith suicide prevention program.
  •  Extends the Health Information Technology Incentive program to mental health providers.
  • Eliminates federal legal barriers under the Federal Tort Claims Act that prevent physician volunteerism at community mental health clinics and federally qualified health centers.

 Contact: Congressman Tim Murphy ~ http://murphy.house.gov

The Ron Barber Bill – “Strengthening Mental Health in our Communities.” Bill would increase mental health funding for veterans and active-duty service members.

  • Create “Mental Health First Aid” programs in schools and communities.
  • Create a White House Office of Mental Health Policy.
  • Make hospital care more accessible to seniors with mental illness.
  • Require Medicare to cover and treat mental health hospitalizations. Currently Medicare sets a 190-day lifetime cap on inpatient psychiatric care.
  • Create a new Assistant Secretary of Mental Health and Substance Abuse Disorders.
  • Requires that states that get federal mental health grants to change their standards for involuntary psychiatric commitment, allowing people to be hospitalized against their will, when they need treatment.
  • Provide families with more information about their loved one’s care.
  • Allow hospitals to be reimbursed for short term care including IMD’s.

Contact: Congressman Ron Barber ~ http://barber.house.gov

DMHC Provider Complaint Commitment

The Department of Managed Health Care (DMHC) has increased staffing for and reorganized its Provider Complaint Division, including an all new web interface for this purpose.

DMHC has vowed to demonstrate a renewed commitment to be more provider and consumer friendly and more aggressive in following up on complaints that you may have with plans.

http://www.dmhc.ca.gov/fileacomplaint/providercomplaint/submitaprovidercomplaint.aspx

Take them up on their commitment if you need assistance.

Also, the DMHC Help Center is designed for patients to use with their complaints. That telephone number is 1-888-466-2219.

Regulators can’t regulate unless you complain, give them something to work with!!

What is Laura’s Law?

The standard California state route marker con...

In 2002 the California Legislature passed Laura’s Law as a treatment option for those individuals with chronic and severe mental illness with repeated and recent hospitalizations, incarceration, and or documented acts or threats of serious violent behavior. The law provides for court ordered community based “assisted outpatient treatment” (AOT) to a small population of individuals who meet strict legal criteria and who do not seek voluntary mental health care as a result of their mental illness. Services under the law operate through a team.

Background

Marin County line on the Golden Gate Bridge

Marin County line on the Golden Gate Bridge (Photo credit: Wikipedia)

The California law was named for Laura Wilcox, a victim of a Grass Valley, Nevada County, rampage shooting by a man with untreated schizophrenia. The law was modeled on the New York state Kendra’s Law, passed in 1999. Under Laura’s Law each county must formally opt into the law through county supervisors’ resolution and the appropriation of a support program. The law does not come with appropriated state financial support. The statute can only be utilized in counties that choose to enact outpatient commitment programs based on the measure. In 2004, Los Angeles County implemented Laura’s Law on a limited basis. Since the passage of the MHSA, Nevada County fully implemented Laura’s Law in May 2008 and several other counties are discussing it, notably San Francisco CountySan Mateo CountySan Diego CountyMarin County and others.

Who Qualifies for Laura’s Law?

The law applies strictly only to those who meet the criteria below:

  • An individual must be at least 18 years of age
  • An individual must have serious mental illness; AND
  • A recent history of hospitalization, incarceration, and acts, threats, or attempts of
  • serious violent behavior
  • Individual must have been hospitalized at least twice in the past 36 months or harmed themselves or another individual in the past 48 months

Keep in Mind:

  • AOT does not physically restrain an individual or force “feed” medication. An individual may
  • walk away, refusing to participate, but such non-compliance could result in a person being
  • hospitalized.
  • Laura’s Law has been voted down by counties for reasons related to start-up costs and effort
  • in light of the precarious health of county governments and/or civil liberties issues.