Thursday, September 25, 2014

The Delusions We Deserve by By GARY GREENBERG - Thursday September 25th, 2014 at 5:52 PM - NYT > Mental Health And Disorders: A psychiatrist and his philosopher brother discuss how mental illness reflects culture.

The Delusions We Deserve by By GARY GREENBERG
Thursday September 25th, 2014 at 5:52 PM

NYT > Mental Health And Disorders
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A psychiatrist and his philosopher brother discuss how mental illness reflects culture. 

Impact of Early Intervention on Psychopathology, Crime, and Well-Being at Age 25.by Conduct Problems Prevention Research Group
Thursday September 25th, 2014 at 5:57 PM

Pubmed: "Am J Psychiatry"[Jo...
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Impact of Early Intervention on Psychopathology, Crime, and Well-Being at Age 25.
Am J Psychiatry. 2014 Sep 15;
Authors: Conduct Problems Prevention Research Group
Abstract
Objective: This randomized controlled trial tested the efficacy of early intervention to prevent adult psychopathology and improve well-being in early-starting conduct-problem children.
Method: Kindergarteners (N=9,594) in three cohorts (1991-1993) at 55 schools in four communities were screened for conduct problems, yielding 979 early starters. A total of 891 (91%) consented (51% African American, 47% European American; 69% boys). Children were randomly assigned by school cluster to a 10-year intervention or control. The intervention goal was to develop social competencies in children that would carry them throughout life, through social skills training, parent behavior-management training with home visiting, peer coaching, reading tutoring, and classroom social-emotional curricula. Manualization and supervision ensured program fidelity. Ninety-eight percent participated during grade 1, and 80% continued through grade 10. At age 25, arrest records were reviewed (N=817, 92%), and condition-blinded adults psychiatrically interviewed participants (N=702; 81% of living participants) and a peer (N=535) knowledgeable about the participant.
Results: Intent-to-treat logistic regression analyses indicated that 69% of participants in the control arm displayed at least one externalizing, internalizing, or substance abuse psychiatric problem (based on self- or peer interview) at age 25, in contrast with 59% of those assigned to intervention (odds ratio=0.59, CI=0.43-0.81; number needed to treat=8). This pattern also held for self-interviews, peer interviews, scores using an "and" rule for self- and peer reports, and separate tests for externalizing problems, internalizing problems, and substance abuse problems, as well as for each of three cohorts, four sites, male participants, female participants, African Americans, European Americans, moderate-risk, and high-risk subgroups. Intervention participants also received lower severity-weighted violent (standardized estimate=-0.37) and drug (standardized estimate=-0.43) crime conviction scores, lower risky sexual behavior scores (standardized estimate=-0.24), and higher well-being scores (standardized estimate=0.19).
Conclusions: This study provides evidence for the efficacy of early intervention in preventing adult psychopathology among high-risk early-starting conduct-problem children.
PMID: 25219348 [PubMed - as supplied by publisher]
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Genomic Analysis Yields Eight Distinct Types of Schizophrenia
Thursday September 25th, 2014 at 5:57 PM

PsychiatryOnline | Psychiatric News | Home
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Psychiatry Is Involved In The Biggest Con This Planet Has Ever Seen by unknown
Thursday September 25th, 2014 at 5:55 PM

Psychiatry - Google Blog Search
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The “disorders” in the diagnostic manual are mostly invented by psychiatrists and placed in the DSM for the sole purpose of increasing the numbers of diagnosis that can be made, thereby putting more cash in their pockets.

Critical psychiatry: Untitled by Duncan Double
Thursday September 25th, 2014 at 5:55 PM

Psychiatry - Google Blog Search
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A Lancet Psychiatry editorial argues for compromise in debates about mental health issues. I do agree that "the opportunities for global discussion on blogs and social media [shouldn't be] ... squandered". However, it is ...

Leiter Reports: A Philosophy Blog: Philosophy and Psychiatryby Brian Leiter
Thursday September 25th, 2014 at 5:55 PM

Psychiatry - Google Blog Search
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Philosophy and Psychiatry. The blog. Posted by Brian Leiter on September 25, 2014 at 08:18 AM in Philosophy in the News | Permalink. Paid Advertisements: Why Tolerate Religion? Advertise on LR. Recent Comments. Anonymous Two on ...

The Delusions We Deserve by By GARY GREENBERG
Thursday September 25th, 2014 at 5:52 PM

NYT > Mental Health And Disorders
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A psychiatrist and his philosopher brother discuss how mental illness reflects culture.
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Selling Prozac as the Life-Enhancing Cure for Mental Woesby By CLYDE HABERMAN
Thursday September 25th, 2014 at 5:51 PM

NYT > Mental Health And Disorders
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In the late 1980s and the ’90s, Prozac was seen as a life preserver for those drowning in anguish. It was also a marvel of commercial branding.

F.B.I. Confirms a Sharp Rise in Mass Shootings Since 2000by By MICHAEL S. SCHMIDT
Thursday September 25th, 2014 at 5:51 PM

NYT > James Holmes (Batman Shootings, Aurora, Colo.)
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A report confirmed what many Americans had feared but that law enforcement officials had never documented: mass shootings have risen dramatically.




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Saturday, August 16, 2014

To Know Suicide: Depression Can Be Treated, but It Takes Competence - By KAY REDFIELD JAMISON - AUG. 15, 2014 - NYT

» Depression is a disease of loneliness
16/08/14 03:00 from Comment is free | theguardian.com
A lack of friends can suck someone into solitude sharing the language of affection could help to ease the pain Continue reading...

 » To Know Suicide
16/08/14 01:00 from NYT > Contributors
Depression may be a deadly illness, but we can help people back to life.

BALTIMORE — WHEN the American artist Ralph Barton killed himself in 1931 he left behind a suicide note explaining why, in the midst of a seemingly good and full life, he had chosen to die.
“Everyone who has known me and who hears of this,” he wrote, “will have a different hypothesis to offer to explain why I did it.”
Most of the explanations, about problems in his life, would be completely wrong, he predicted. “I have had few real difficulties,” he said, and “more than my share of affection and appreciation.” Yet his work had become torture, and he had become, he felt, a cause of unhappiness to others. “I have run from wife to wife, from house to house, and from country to country, in a ridiculous effort to escape from myself,” he wrote. The reason he gave for his suicide was a lifelong “melancholia” worsening into “definite symptoms of manic-depressive insanity.”
Barton was correct about the reactions of others. It is often easier to account for a suicide by external causes like marital or work problems, physical illness, financial stress or trouble with the law than it is to attribute it to mental illness.
Certainly, stress is important and often interacts dangerously withdepression. But the most important risk factor for suicide is mental illness, especially depression or bipolar disorder (also known as manic-depressive illness). When depression is accompanied by alcohol or drug abuse, which it commonly is, the risk of suicide increases perilously.
Suicidal depression involves a kind of pain and hopelessness that is impossible to describe — and I have tried. I teach in psychiatry and have written about my bipolar illness, but words struggle to do justice to it. How can you say what it feels like to go from being someone who loves life to wishing only to die?
Suicidal depression is a state of cold, agitated horror and relentless despair. The things that you most love in life leach away. Everything is an effort, all day and throughout the night. There is no hope, no point, no nothing.
The burden you know yourself to be to others is intolerable. So, too, is theagitation from the mania that may simmer within a depression. There is no way out and an endless road ahead. When someone is in this state, suicide can seem a bad choice but the only one.
It has been a long time since I have known suicidal depression. I am one of millions who have been treated for depression and gotten well; I was lucky enough to have a psychiatrist well versed in using lithium and knowledgeable about my illness, and who was also an excellent psychotherapist.
This is not, unfortunately, everyone’s experience. Many different professionals treat depression, including family practitioners, internists and gynecologists, as well as psychiatrists, psychologists, nurses and social workers. This results in wildly different levels of competence. Many who treat depression are not well trained in the distinction among types of depression. There is no common standard for education about diagnosis.
Distinguishing between bipolar depression and major depressive disorder, for example, can be difficult, and mistakes are common. Misdiagnosis can be lethal. Medications that work well for some forms of depression induce agitation in others. We expect well-informed treatment for cancer or heart disease; it matters no less for depression.



We know, for instance, that lithium greatly decreases the risk of suicide in patients with mood disorders like bipolar illness, yet it is too often a drug of last resort. We know, too, that medication combined with psychotherapy is generally more effective for moderate to severe depression than either treatment alone. Yet many clinicians continue to pitch their tents exclusively in either the psychopharmacology or the psychotherapy camp. And we know that many people who have suicidal depression will respond well toelectroconvulsive therapy (ECT), yet prejudice against the treatment, rather than science, holds sway in many hospitals and clinical practices.
Severely depressed patients, and their family members when possible, should be involved in discussions about suicide. Depression usually dulls the ability to think and remember, so patients should be given written information about their illness and treatment, and about symptoms of particular concern for suicide risk — like agitation, sleeplessness and impulsiveness. Once a suicidally depressed patient has recovered, it is valuable for the doctor, patient and family members to discuss what was helpful in the treatment and what should be done if the person becomes suicidal again.

People who are depressed are not always easy to be with, or to communicate with — depression, irritability and hopelessness can be contagious — so making plans when a patient is well is best. An advance directive that specifies wishes for future treatment and legal arrangements can be helpful. I have one, which specifies, for instance, that I consent to ECT if my doctor and my husband, who is also a physician, think that is the best course of treatment.
Because I teach and write about depression and bipolar illness, I am often asked what is the most important factor in treating bipolar disorder. My answer is competence. Empathy is important, but competence is essential.
I was fortunate that my psychiatrist had both. It was a long trip back to life after nearly dying from a suicide attempt, but he was with me, indeed ahead of me, every slow step of the way.


Kay Redfield Jamison, a professor of psychiatry at the Johns Hopkins School of Medicine, is the author of “An Unquiet Mind: A Memoir of Moods and Madness” and “Night Falls Fast: Understanding Suicide.”
A version of this op-ed appears in print on August 16, 2014, on page A19 of the New York edition with the headline: To Know Suicide. Order Reprints|Today's Paper|Subscribe 


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Saturday, April 26, 2014

The Pentagon released a report Friday that provided final data for 2012 suicides and some preliminary numbers for 2013: Suicides among Army National Guard and Reserve members increased last year, even as the number of active-duty troops across the military who took their own lives dropped by more than 15 percent, according to new data - AP




Military Suicides Dropped 15 Percent Last Year; Army National Guard Deaths Rose

 | by  LOLITA C. BALDOR
Posted: Updated: 
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WASHINGTON (AP) — Suicides among Army National Guard and Reserve members increased last year, even as the number of active-duty troops across the military who took their own lives dropped by more than 15 percent, according to new data.
The overall totals provided by the Army, Navy, Air Force and Marine Corps give some hope that prevention programs and increased efforts to identify troops at risk may be taking hold after several years of escalating suicide rates. But the increase among Army National Guard and Reserve members raises questions about whether those programs are getting to the citizen soldiers who may not have the same access to support networks and help that their active duty comrades receive.
Not only did suicides among Army National Guard and Reserve members increase from 140 in 2012 to 152 last year, but the 2013 total exceeded the number of active-duty soldiers who took their own lives, according to the Army. There were 151 active duty soldier suicides last year, compared with 185 in 2012, Army officials said.
The Pentagon released a report Friday that provided final data for 2012 suicides and some preliminary numbers for 2013. But the department data differs a bit from the totals provided by the services because of complicated accounting changes in how the department counts suicides by reservists. Some of the Pentagon numbers were finalized a year ago, while the services have more recently updated totals that reflect the results of some death investigations.
According to the four military services, there were 289 suicides among active duty troops in 2013, down from 343 in 2012. The vast majority were in the Army, the nation's largest military service. The Navy saw a 25 percent decline, from 59 in 2012 to 44 in 2013. The Marines went from 48 to 45, while the Air Force went from 51 to 49.
Due to the accounting changes and other updates, the Pentagon numbers are generally a bit lower and reflect a larger decline in overall active-duty suicides of about 18 percent from 2012 to 2013. In some cases, the services are counting Guard and Reserve members who have been called to active duty as part of the active duty total, while the Pentagon did not.
Both sets of numbers, however, show the same trends: fewer active duty suicides across all four services and slightly more deaths among the Army National Guard and Reserve.
The Pentagon also released detailed demographic data on the 2012 suicides, showing that more often they involve young, white men using a non-military issued gun. They also frequently had reported family or relationship stress.
Military leaders say it's too soon to declare success in the battle against suicides, but they say that some programs appear to be working.
"I think we've changed the cultural mindset — that it's OK for a sailor or a soldier or an airman or Marine to come forward and ask for help," said Rear Adm. Sean Buck, the Navy's officer in charge of suicide prevention and resilience programs. "We're trying to reduce the stigma that used to exist."
Buck said the Navy has focused on doing more programs designed to reduce stress, including teaching sailors coping mechanisms and stress management tools.
For example, he said, Navy leaders noticed a spike in suicides by medical specialists, including doctors and nurses, reaching a total of 22 for 2011 and 2012 combined. The Navy surgeon general started a program that found that there seemed to be a lot of transitions during that time involving the sailors' jobs or base locations.
Buck said that due to the frequent moves, sailors could sometimes find themselves unconnected to their families or units or higher command. "In many instances, if you find yourself in time of need and you're not in a permanent command, you may not know who to turn to," he said.
In response, Navy leaders were told to reach out to communicate with their medical specialists on a daily basis, checking with them to see how they were doing and if there were any problems.
Last year, Buck said, there was a sharp decline in suicides among the medical community, with six in 2013.
Lack of consistent contact with leaders or units could also be a factor for reservists.
Scattered across the United States, often in small or remote rural communities, many members of the Army National Guard and Reserve report for training about one weekend a month and two weeks in the summer. And they often don't have quick access to military medical or mental health services that may be on bases far from their homes. That means the outreach effort by the armed services to address the increase in suicides may not always get to reservists in need — particularly those who don't actively seek help.
According to the Army data, more than half of the reservists who committed suicide in 2012 and 2013 had served in Iraq and Afghanistan. Officials, however, have not been able to establish a strong link between military service on the warfront and suicide.
Army spokeswoman Lt. Col. Sunset Belinsky said the Army set up several programs to deal with the problem, including a 24-hour suicide prevention phone line. The Army Reserve set up six Army Strong Community Centers in New York, North Carolina, Pennsylvania, Oregon, Connecticut and Michigan.
___
For help: http://www.veteranscrisisline.net/ActiveDuty.aspx
Crisis phone line: 1-800-273-8255


Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.
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Suicides down for active-duty troops. What about veterans?

By Josh Hicks Updated: April 25 at 3:49 pm

A new Pentagon report shows that suicides among active-duty troops declined by 15 percent last year, offering hope that the military’s suicide-prevention programs may be working.
But at least one veterans group, the Iraq and Afghanistan Veterans of America, says a similar focus on prevention is needed to lower the rate among former service members. An estimated 22 veterans killed themselves each day in 2010, compared with 18 per day in 2007, according to the latest figures available from the Department of Veterans Affairs.
The IAVA said troops can struggle more as they transition into the civilian world and away from the military’s suicide-prevention programs. The group is advocating for a more robust network of care to assist service members throughout their lives.
“The Department of Defense, the Department of Veterans Affairs, the White House and the entire nation need to strengthen our efforts to support our military community in this effort,” IAVA chief executive Paul Rieckhoff said in a statement. “Our service members and veterans fought for our nation, and now is the time for us to fight for them.”
The VA has taken steps in recent years to address the suicide epidemic among veterans, including setting up a toll-free crisis hotline, placing suicide-prevention specialists in all of the agency’s 151 medical centers and integrating mental health services with primary care. The suicide rate among veterans who use the VA health system has not risen like it has for veterans overall, according to the agency’s numbers. VA officials take that as a sign that the department’s suicide-prevention programs are making an impact.
“We have made strong progress, but we must do more,” the VA said in a statement on Friday. “Every veteran suicide is a tragic outcome, and regardless of numbers or rates, even one veteran suicide is too many.”
The Pentagon report Friday also showed that suicides among reservists and National Guard troops actually increased by 8 percent last year. Overall, 289 active-duty troops committed suicide last year, compared with 343 in 2012. Among reservists and National Guard personnel, the number rose from 140 to 152 over the same period.
The American Legion said Friday that the Defense Department and VA need more proactive programs to address suicide risks before current and former troops reach the crisis stage. The group called for better risk-recognition and intervention strategies, such as targeted outreach for high-risk veterans and education to help families identify the signs of a suicidal service member.
“It’s not the ones calling the military crisis line, who are currently being treated or flagged for suicide ideation, that we are worried about, but the ones who fall through the cracks,” said Legion official John Stovall. “We as friends and neighbors have to do a better job identifying those in distress.”
Follow Josh Hicks on Twitter, Facebook or Google+. Connect by e-mail at  josh.hicks(at)washpost.com. Visit The Federal Eye, and The Fed Page for more federal news. Submit news tips and suggestions to federalworker@washpost.com.
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Military Suicide Studies Review


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Friday, April 25, 2014

New figures show nearly half of the most hardened criminals, with at least 11 previous convictions, commit another crime within 12 months.

» 70,000 with at least 11 previous convictions reoffend in one year 
25/04/14 14:30 from the Mail online | News
New figures show nearly half of the most hardened criminals, with at least 11 previous convictions, commit another crime within 12 months.
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