January 16th, 2011 by Dinah Miller, M.D. in Better Health Network, Opinion
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I’ve followed in bits and pieces — sometimes for Shrink Rap, sometimes because the issues fill my email inbox, sometimes because there’s no escape. Oh, and lots of the players have familiar names.
In the December 27th issue of Wired magazine, Gary Greenberg writes a comprehensive article on the debates around the revision of the American Psychiatric Association’s (APA) upcoming revision of the Diagnostic and Statistical Manual (DSM) entitled “Inside the Battle to Define Mental Illness.” Do read it. Here’s an excerpt:
I recently asked a former president of the APA how he used the DSM in his daily work. He told me his secretary had just asked him for a diagnosis on a patient he’d been seeing for a couple of months so that she could bill the insurance company. “I hadn’t really formulated it,” he told me. He consulted the DSM-IV and concluded that the patient had obsessive-compulsive disorder.
“Did it change the way you treated her?” I asked, noting that he’d worked with her for quite a while without naming what she had.
“No.”
“So what would you say was the value of the diagnosis?”
“I got paid.” Read more »
*This blog post was originally published at Shrink Rap*
January 13th, 2011 by Michael Craig Miller, M.D. in Health Policy, News
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When reports arrived that accused gunman Jared Lee Loughner had opened fire in Tucson, Arizona on January 7, journalistic first responders linked the incident to the fierceness of political rhetoric in the United States. Upon reflection, some of the discussion has turned to questions about mental illness, guns, and violence.
And plenty of reflection is required, because the connections are not at all simple. To get a sense of just how complicated they are, we invite you to read the lead article in this month’s Harvard Mental Health Letter entitled, “Mental Illness and Violence.” Strangely (for us) it was prepared for publication a month before the tragedy in Tucson. In light of the shooting, we are making the article available to non-subscribers.
I am not surprised at the outrage expressed in the news or at the impulse to blame. A quick scan of the news, however, shows there is not much agreement about whom to blame. In addition to the alleged perpetrator, one can find explicit and implicit criticisms of politicians for playing to our baser instincts; of media figures, various men and women of zeal, for their disingenuous or manipulative partisanship; of the various community bystanders (police, teachers, doctors, family members, neighbors, friends), whom we imagine could have intervened to prevent tragedy.
The political debate flowing from this incident will continue, as will the endless cycle of blame and defensiveness. But I caution all of us — and especially mental health professionals — not to make clinical judgments about Mr. Loughner. Very few people will or should have access to the kind of information that would allow such judgments. From a public health perspective, however, we should make careful judgments about policies that could reduce risk. Read more »
*This blog post was originally published at Harvard Health Blog*
January 8th, 2011 by admin in Better Health Network, Health Tips
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This is a guest post from Dr. Jennifer Wider.
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Winterize Your Mind And Body
During the winter months, certain health issues may arise that women should have on their radar. From mental health issues like stress, depression and seasonal affective disorder (SAD), to physical concerns like skin care, the winter can certainly pack an extra punch.
Depression peaks during the holiday season, affecting more than 17 million Americans, according to the National Mental Health Association. On average, women are more vulnerable to stress-related illnesses like depression and anxiety than men. One study, conducted by Pacific Health Laboratories, revealed that 44 percent of American women report feeling sad through the holidays compared to 34 percent of American men.
“Depression of any kind is more common in females than males,” explains Greg Murray, M.D., lecturer and clinical psychologist at Swinburne University of Technology in Australia. “A pattern of elevated depression in the winter months is more marked in women than in men.”
There are a host of different reasons why women may be more susceptible to stress during the winter than men. Women tend to be the primary caretakers of the family and often take on the extra burden of the holidays with gift buying, entertaining, and coordinating visits with extended family. For working women, the added responsibilities can be difficult to balance, especially if they are already balancing a family, job, childcare and eldercare duties. Read more »
January 5th, 2011 by AnneHansonMD in Better Health Network, Humor, News, Research
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I was surfing around the Net one day and I found this article about scientists who are creating a machine that will detect acetone in someone’s breath. Acetone can be a sign that someone suffers from diabetes, so in theory this machine could use scent to diagnose this disease.
That story brought to mind other stories I’ve heard about people using dogs to sniff out cancer in people. According to this article:
“The results of the study showed that dogs can detect breast and lung cancer with sensitivity and specificity between 88% and 97%. The high accuracy persisted even after results were adjusted to take into account whether the lung cancer patients were currently smokers. Moreover, the study also confirmed that the trained dogs could even detect the early stages of lung cancer, as well as early breast cancer.”
People have even tried “smelling” schizophrenia. Read more »
*This blog post was originally published at Shrink Rap*
December 28th, 2010 by Dinah Miller, M.D. in Better Health Network, Opinion
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Meg sent me a link to Happiness in The World (what an upbeat name for a medical blog!) and The Danger of Early Closure. She wanted to know how it pertains to psychiatry. The author writes:
Sometimes doctors gather all the clues correctly, think all the right things based on those clues, and still get it wrong. But in this case, another significant thought error contributed to the misdiagnosis: My tendency to come to early closure.
Early closure, it turns out, is a danger that lies in wait mostly for seasoned clinicians (far more commonly, at least, than for medical students and residents). Because seasoned clinicians rely more on pattern recognition to make diagnoses and often come to their conclusions rapidly, they’re at far greater risk for leaping toward those conclusions without examining all other should present (luckily for us all, this is the exception and not the rule).
At other times, however, these mistakes are made because the physician was simply in a hurry, or tired, or didn’t care enough to think through the evidence in ways he should have, saw a pattern he thought he recognized, and stopped asking the most important question a physician can ever ask: What else could this be? Read more »
*This blog post was originally published at Shrink Rap*
