Psychiatry

Women With Schizophrenia are at Higher Risk for Breast Cancer

Schizophrenia and the incidence of breast cancer may be linked together.

Some Antihypertensives May Be Linked to Mood Disorders

  • Patients taking beta blockers and calcium channel antagonists had 2x the risk of being hospitalized with a mood disorder.
  • Patients taking angiotensin converting enzymes for hypertension had a lower risk of developing a severe mood disorder.
  • Patients taking a diuretic had a similar mood disorder risk as did control participants.

Web-Based Intervention Found to Improve Eating Disorders

  • In a randomized, controlled trial, the Featback intervention was found to reduce rates of eating disorders among a Dutch population.
  • Web-based intervention also helped to reduce rates of eating-disorder comorbid psychopathologies.
  • Featback helped participants reduce rates of symptoms of anorexia nervosa, bulimia nervosa, and binge eating disorder in a statistically significant manner.
  • Therapist support did not further improve the efficacy of the Featback intervention but it did improve patient satisfaction.

People in These Occupations Have Dramatically Higher Suicide Rates

  • Higher suicide rates ranged from >90/100,00 to >50/100,000 vs.13 to 16/100,000 among the general population.
  • People who work as farmers, fishers, foresters, and in the construction and extraction industries are at greatest risk of suicide.
  • Among women, the highest rate was seen in those working in protective services, such as policing and firefighting.
  • Early physician intervention would be of greatest benefit with these patient groups.

Lithium Found Significantly Superior to Newer Bipolar Drugs

  • Patients taking lithium had lower rates of self-harm and unintentional injury versus those taking valproate, olanzapine, or quetiapine.
  • Patients diagnosed with bipolar disorder are 15x more likely to die by suicide and 6x more likely to die by accidental injury than people in the general population.
  • People taking valproate, olanzapine, or quetiapine were 40% more likely to harm themselves compared to patients taking lithium.
  • People taking valproate or quetiapine were 32% to 34% more likely to suffer an unintentional injury.

Depression, Anxiety Interventions Pay Enormous Dividends

  • Increased investment treatment of people with anxiety or depressive symptoms would significantly increase productivity in the 36 largest nations on earth.
  • An investment of US$147 billion over 14 years would result in a return of $230 billion for depression treatment and $169 billion for improvement in people with anxiety in terms of improved productivity and reduced absenteeism and presenteeism.
  • The benefit-to-cost ratios of increased investment in treatment of anxiety and depression range from 2.3 to 3.0:1 when economic benefits only are considered, and 3.3 to 5.7:1 when the value of health returns are also included.
  • Few health interventions are as cost effective.
  • For malaria, the estimated benefit-to-cost ratios are calculated to be in the range of 28:1 to 40:1.

Exercise Programs Feasible, Beneficial for Patients with Bipolar Disorder

  • Exercise and improvements in health-related lifestyle can significantly benefit people with bipolar disorder (BD).
  • Lifestyle changes targeting nutrition, exercise, wellbeing beliefs, coping strategies, and attitudes towards health reduced the risk of comorbid ailments in patients with bipolar disorder.
  • These targeted changes also were associated with and improved health measures, decreased depressive symptoms, and improved function and quality of life among these patients.
  • Two recent systematic reviews came to similar conclusions regarding health-related lifestyle changes and improved outcomes among patients with BD.

Multimedia Patient Reminders Significantly Improve Clinical Outcomes

  • Numerous studies report that reminders via telephone, internet, and short message service (SMS), and other methods are associated with improved outcomes for patients with a variety of disorders.
  • Multimedia patient reminders are highly cost effective for control of a number of medical and psychiatric disorders.
  • Reminders were found to improve bipolar disorder medication adherence, appointment attendance, vaccination coverage, and substance misuse and abuse outcomes.

Depression, Now The Sixth Vital Sign

  • U.S. Preventive Services Task Force has recommended that clinicians routinely screen all adults for depression.
  • Depression is among the leading causes of disability in the U.S. among people aged 15 years and older, affecting individuals, families, businesses, and society as a whole.
  • It is among common among patients in the primary care setting.
  • The Task Force has specifically recommended screening women who are pregnant and those who have recently given birth.
  • Screening should be implemented in a routine manner; adequate systems should be in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up, the Task Force recommended.

Behavior Modification Significantly More Cost Effective vs. Pharmacotherapy for ADHD

  • Beginning treatment of attention deficit hyperactivity disorder (ADHD) with a low-dose/intensity regimen of behavior modification was found to be less costly for a school year of treatment than beginning treatment with a low dose of stimulant medication.
  • Behavior modification therapy (large-group parent training) cost $961 per school year in 2013 U.S. dollars compared with $1,669 for pharmacologic therapy.
  • Outcome data found equivalent or superior outcomes for treatments beginning with low-intensity behavior modification compared to intervention beginning with medication.

Cut Readmission Rates with Patient-Centered Discharge Plan: Cochrane Analysis

  • The analysis included 30 randomized clinical trials (RCTs) and 11,964 patients.
  • Patient-centric discharge plans were associated with reduced readmission rates and improved satisfaction among patients and providers.
  • Individualized plans were also associated with reduced length of hospital stay.
  • Patients included in the trials included medical patients, surgical patients, patients with a combination of medical and surgical conditions, patients who had been injured in a fall, and patients treated in a psychiatric hospital.
  • Evidence that patient-centric discharge plans reduced overall cost of care was inconclusive.

If Heart Failure Doesn’t Kill Patient, Subsequent Depression May Well Do So


  • Moderate to severe depression increased risk of death by five times.
  • Twenty to 40% of heart failure patients suffer with depression post-op.
  • Increased risk of death associated with moderate to severe depression was independent both of other health problems and of the severity of heart failure.
  • “Depression is strongly associated with death during the year following discharge from hospital after an admission for the exacerbation of heart failure; we expect that the link persists beyond one year."

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