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Free Borderline Disorder Call In Series

Via Scoop.itHealthcare Continuing Education

Free BPD Call In Series

Thanks to the generosity of the professional borderline personality disorder community, the National Education Alliance for Borderline Personality Disorder will be hosting lectures on the phone providing the larger community the opportunity to hear the latest information and research on the disorder.

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Posted by on September 26, 2011 in General

 

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No Health Without Mental Health

By Thomas R. Insel, MD (NIMH Director)

Mental Health in US

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Five years ago, Colton and Mandersheid surveyed mortality data from eight states and concluded that, on average, Americans with major mental illness die 14 to 32 years earlier than the general population. The average life expectancy for people with major mental illness ranged from 49 to 60 years of age in the states they examined — a life span on par with many sub-Saharan African countries, including Sudan (58.6 years) and Ethiopia (52.9 years). Average life expectancy in the United States is 77.9 years. It would appear that the increase in longevity enjoyed by the general U. S. population over the past half century has been lost on those with serious mental illness (SMI). In fact, this drop in life expectancy due to mental illness would surpass the health disparities reported for most racial or ethnic groups. Yet this population is rarely identified as an underserved or at-risk group in surveys of the social determinants of health.

Why is there such a profound disparity in life expectancy for those with SMI? Disorders such as schizophrenia, major depression, and bipolar disorder are risk factors for suicide, but most people with SMI do not die by suicide. Rather, the 5 percent of Americans who have SMI die of the same things that the rest of the population experiences — cancer, heart disease, stroke, pulmonary disease, and diabetes. They are more likely to suffer chronic diseases associated with addiction (especially nicotine), obesity (sometimes associated with antipsychotic medication), and poverty (with its attendant poor nutrition and health care) and they may suffer the adverse health consequences earlier.

The risks are striking. People with a mental illness are more than twice as likely to smoke cigarettes and more than 50 percent more likely to be obese compared to the rest of the population. But this only partly explains the premature mortality. Recently, when Druss and colleagues analyzed the early mortality data derived from a nationally representative survey, they found three drivers: clinical risk factors, socioeconomic factors, and health system factors.

The clinical risk factors include the frequent co-occurrence of mental illness with heart disease, diabetes or other medical conditions, generally referred to as “comorbidity.” For example, people with major depressive disorder are at higher risk for cardiovascular disease and stroke. Conversely, for those who have had a heart attack, experiencing depression increases their risk for cardiac-related death three-fold, more than any cardiovascular variable except congestive heart failure. And people with diabetes have double the risk for depression. We do not fully understand the relationship between diabetes or heart disease and depression, but current thinking attributes the increased risk to both depressive behaviors (e.g., poor diet, low activity, low adherence to treatment) as well as some common biology such as elevated inflammatory factors.

While we are still trying to understand the cause of comorbidity between mental disorders and other health problems, the health system factors may offer a better short-term target for change. Few people in the public mental health care system are receiving high quality health care.

The Patient Protection and Affordable Care Act outlines a specific model of integrated care, the patient-centered medical home (PCMH), which could improve access and quality of health care to those with multiple chronic disorders. The PCMH model includes comprehensiveness, holistic patient-centered care, and, emphasis on care in the community. The Centers for Medicare and Medicaid Services has been tasked with piloting a series of PCMHs and studying their impact over the coming years with the goal of wider dissemination in the future. Knowing that people with SMI are a high risk group for multiple chronic disorders and targeting the PCMH for their specific needs could be an effective approach to improving health outcomes for the entire population.

Short of a new health care system, there are models for improving health outcomes for people with mental illness. Collaborative care, in which primary care and mental health providers work closely together to deliver effective treatments within the primary care setting, represents a fundamental change toward addressing mental disorders in conjunction with other physical conditions. Over the past two decades more than 40 research trials have demonstrated the effectiveness of the collaborative care model. In the case of major depression, for example, studies have shown collaborative care programs to be an effective approach for treating depression alongside other conditions, and to be more cost-effective than standard treatment. A recent study indicates that implementing this approach for depression in the Medicare system would result in cost savings of approximately $15 billion annually.

Collaborative care for depression and diabetes or depression and heart disease is the proverbial low hanging fruit. What about schizophrenia and bipolar disorder, which are usually treated in specialty mental health clinics rather than primary care? Is it better to add primary care capacity to the behavioral health center or to integrate patients with SMI into primary care? Can our current system, which separates behavioral health from health care, ever be “equal” in quality or outcomes? These remain research questions of urgent importance.

The unavoidable fact is that we will not improve overall longevity or contain health care costs in this nation without addressing the needs of the nearly 5 percent of Americans with serious mental illness. This is a population that not only dies early; they have multiple chronic diseases requiring expensive care, often in emergency rooms and intensive care units. We need better strategies for dealing with this urgent public health issue and we need to ensure that whether these strategies are collaborative care for depression or an innovative medical home for those with serious mental illness, we implement these interventions where the need is greatest.

Source: http://www.nimh.nih.gov/about/director/2011/no-health-without-mental-health.shtml

 

 

 

 

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Posted by on September 24, 2011 in General

 

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Mental Health Medications – Free Guide

Free resource from the National Institute of Mental Health.

This guide describes the types of medications used to treat mental disorders, side effects of medications, directions for taking medications, and includes any FDA warnings.

http://www.nimh.nih.gov/health/publications/mental-health-medications/nimh-mental-health-medications.pdf

Guide to Mental Health Medications

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Posted by on September 20, 2011 in General

 

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Attention Deficit Hyperactivity Disorder

Frequently asked questions about ADHD and teenagers.

Frequently asked questions about ADHD and teenagers

Click to view continuing education courses addressing ADHD

Q: What is ADHD?

A: Attention Deficit Hyperactivity Disorder (ADHD) is a term used to describe a group of behaviors that most often appear in young, school-aged children.

Q: What are the symptoms of ADHD?

A: ADHD has a wide range of symptoms and it can be confusing and stressful for the child or teen. Young people mature at different rates and have different personalities, temperaments, and energy levels. Most of us get distracted, act impulsively, and struggle to pay attention at one time or another. It is when symptoms such as these, or acting in impulsive or reckless ways, daydreaming, becoming easily confused, or trouble sitting still for any length of time are hurting school work or impairing social activities that ADHD should be looked into.

Q: How is ADHD diagnosed?

A: Most ADHD symptoms usually appear early in life, often between the ages of 3 and 6. No single test can diagnose ADHD, but a licensed health professional such as a pediatrician or mental health specialist with experience in childhood mental disorders can first try to rule out other reasons for the symptoms.

Q: What causes ADHD?

A: Scientists are not sure what causes ADHD, although many studies suggest that genes (the “blueprints” for who we are) play a large role. Like many other illnesses, ADHD probably results from a combination of genetic and environmental factors such as nutrition, brain injuries, or social environment.

Q: Can a teenager have ADHD?

A: Most children with ADHD continue to have symptoms as they enter adolescence. Some may not be diagnosed until then. It’s not easy being a teenager, but for a teenager with ADHD, it can be especially hard. Staying with the recommended treatments, prescribed medications, psychosocial interventions, or a combination of the two, is also a challenge. Since inattention can be a problem, driving is another major concern for those with ADHD. Working cooperatively with parents, schools, and health care professionals is key.

Q: How is ADHD treated?

A: Available treatments focus on reducing the symptoms of ADHD and improving functioning. A one-size-fits-all treatment does not exist and sometimes several different medications or dosages must be tried before finding one that works for a specific person. Anyone taking medications must be closely watched by their doctors. Parents and doctors need to work together to decide which medication is best, if the young person needs medication only for school hours or also for evenings and weekends, and also what psychosocial interventions are best for that individual.

Q: What can be done if you or your friend has ADHD?

A: First you need to help reduce the stress caused by the frustration that is experienced with these conditions. It is best for you or your friend to work with your family and a team of health professionals to find the best treatments.

Q: Once diagnosed, what is there to do about it?

A: With the right kind of help, most children and teens with ADHD can usually improve dramatically.

Q: Where can I get more information?

A: Knowledge in genetics, brain imaging, and behavioral research is leading to a better understanding of the causes of the disorder, how to prevent it, and how to develop more effective treatments for all age groups. NIMH has studied ADHD treatments for pre-school and school-aged children in a large –scale, long term studies. NIMH-sponsored scientists are continuing to look for the biological basis of ADHD and how differences in genes and brain structures may combine with life experiences to produce the disorder.

Source: National Institute of Mental Health: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-teens-fact-sheet/attention-deficit-hyperactivity-disorder.shtml

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Posted by on August 26, 2011 in General

 

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Bipolar Disorder – Overview

Bipolar Disorder - Overview

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Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives.

More than 2 million American adults, or about 1 percent of the population age 18 and older in any given year, have bipolar disorder. Bipolar disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop them late in life. It is often not recognized as an illness, and people may suffer for years before it is properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person’s life.

“Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide.”

“I am fortunate that I have not died from my illness, fortunate in having received the best medical care available, and fortunate in having the friends, colleagues, and family that I do.”

Kay Redfield Jamison, Ph.D., An Unquiet Mind, 1995, p. 6.
(Reprinted with permission from Alfred A. Knopf, a division of Random House, Inc.)

Bipolar disorder causes dramatic mood swings—from overly “high” and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.

Learn more about Bipolar disorder and earn 1-hour of continuing education credit with this introductory course. Currently on sale for $6! (regular $12)

This publication, written by Melissa Spearing of NIMH, is a revision and update of an earlier version by Mary Lynn Hendrix. Scientific information and review were provided by NIMH Director Steven E. Hyman, M.D., and NIMH staff members Matthew V. Rudorfer, M.D., and Jane L. Pearson, Ph.D. Editorial assistance was provided by Clarissa K. Wittenberg, Margaret Strock, and Lisa D. Alberts of NIMH. All material in this publication is in the public domain and may be copied or reproduced without permission of the Institute. Citation of the source is appreciated.

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Posted by on April 28, 2011 in General

 

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