Various Mental Health Treatments To Help Those With A Mental Illness

Here is the good news - mental health is getting more attention from various governments around the world and as a result more mentally ill people have a better chance of a better lifestyle. As soon as someone around you begins to develop the symptoms of mental disorder, it is very important that you consult a mental health care provider and get help for the patient. Getting the right course of treatment helps to improve the condition of a person. In some cases, the patient might be able to recover from the illness which is a great achievement for all concerned.

When it comes to mental health treatment, community treatments are considered to be much more beneficial than hospital treatments. Obviously, psychological treatments are considered to be the most beneficial for people suffering from depression and anxiety disorders, whereas medications are considered to be more suitable for people suffering from mental illness.

The Initial Assessment

Getting the initial assessment done for anyone experiencing symptoms of mental problems is extremely important. A Carer can help the patient by taking him / her to a mental healthcare provider and explaining the symptoms to help the physician make the correct diagnosis. For example, symptoms like difficulty in sleeping, failure to concentrate or any work, a negative feeling towards life in general or feeling 'down' for very long periods of time can indicate that a person is suffering from depression.

After an accurate diagnosis is made, the doctor can then decide on the course of treatment that would be best suited for the concerned patient. A number of times, the diagnosis changes with a change in symptoms. Thus, it is extremely important for the Carer to understand the patient's symptoms to ensure that they can observe any change and if so the right treatment can be sourced.

Psychological Treatments for Mental Health Patients

Psychological treatments for treating patients suffering from mental problems are based on the belief that many problems occur due to the way different people perceive different things, the way they react and think about anything. Psychological treatment is a great way of reducing pressure and strain associated with symptoms of mental illness. However, keep in mind that it takes several weeks or sometimes even months, for the treatment to produce evident results.

Different kinds of psychological therapies which are used for treating mental health illnesses include:

Cognitive Behavior Therapy: This process of treatment involves examining the patient's feelings, behavior, and thoughts and establishing how they get caught up in unhelpful patterns. The therapist works with the patient to develop different ways of acting and thinking. This technique is extremely helpful for treating patients of depression, schizophrenia, and bipolar disorder.
Interpersonal Psychotherapy: This process involves examining the way in which the relationships and interactions of the patient with people around them, affects their own behavior and thinking.
Dialectic Behavior Therapy: This therapy is considered to be ideal for people suffering from borderline personality disorder, in which the patient is unable to handle their emotions. The therapy can help them to manage their responses and emotions in a better manner.

Other Mental Health Treatments Medications: Medications are more suited for patients who get seriously affected due to mental health problems. Antidepressants, mood stabilizing medications, and antipsychotic medications are often prescribed for mental patients.
Electroconvulsive Therapy: This is known to be quite effective for treating severe depression as well as for other mental illness. The process involves giving anesthetics and relaxants to the patients, after which the doctor passes an electric current through the patient's brain.
Community Support: This includes providing the required information, help in finding work, education in health and better management, training, and psychosocial rehabilitations, as well as mutual support groups.Chronic illnesses need medication but what is a problem is that many patients do not agree that there is anything wrong with them and do not want to continue treatment. This is where there becomes a problem as far as control and recovery from a mental illness is concerned.

Until a patient is in a fairly stable place they do not understand that they are actually ill and that they do need the help of medication in the recovery process.

Kaye Dennan is the author of an ebook 'Carer Coping Strategies'. Kaye has been a carer for 10 years and has been a Carers' Support group facilitator for 3 years. To read more about mental health carer's coping strategies or for more insight into mental health carer problems visit http://www.schizophrenia-carers.com/

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The Health Food Industry Is Wrong

Four years of college studying Exercise Science and all I learned about nutrition is that those books are making us fat. People are getting the wrong information when it comes to eating healthy from some pretty respectable sources. My favorite is when I see doctors walking around at least 30+ pounds overweight yet they can still suggest to their overweight patients that he/she needs to start eating better and getting in more exercise. More than likely your primary physician will suggest something along the lines of this:
Eat 500-600 calories a meal (not really being specific with the sources of those calories).Eat carbs at every meal since this is the source for all your bodies energy and recovery needs.Watch your fats. Eat as little fat as you can. (I suggest the zero calorie spray butter)Lots of Fruits and Veggies (good suggestion but then they say this). Drink juices like OJ and Apple Juice.Drink lots of Milk! You need your calcium! (the doctor probably doesn't know that there is even better quality of calcium found in leafy greens then there is in dairy.

The books are wrong. It's a joke. It's as if people were told one way to eating healthy and that's what everyone stuck too. Now that I think about it, the people who usually object to modern scientific approaches to eating are usually a bit older. Maybe it's old age setting in and they are getting more set in their ways. I don't know, but what I do know is that these modern approaches to eating are saving lives and allowing people to live longer and stronger than ever before.

It's just like different styles of weight training. I know a few people who are so stuck on traditional weight lifting that they don't even want to try anything new. Everything is a fad to them and it will all get washed way in the end. I hate to say it but we are only getting older. People are coming out with new things that are proving to make you faster and stronger.

Let's Think Outside of The Box Okay, back to what I was saying. You need to open your eyes, clean out your ears and start listening to some of these crazy people who are talking about changing the way you see food. We are taking you back to the basics. Back to a time where all you ate was what you could kill or pick from the land you lived on. The Primal Way of Life.

For the past couple of months I have really been looking at the way Americans eat now compared to how we ate back in the day (I'm talking climbing trees and hunting with sticks). It's no wonder that we are so fat. We are lazy. Our schedules are busy. I'm not blaming it 100% on you, but society as a whole is who is responsible. We need things to be faster. I call it the "Heat Lamp Generation" We don't have time to prepare and cook it the way we should. So we find a place where it has already been prepared and is patiently waiting under a heat lamp to be served. "Don't bother cooking that in front of me, do you have anything already pre-made?" There is a reason why our ancestors ate and prepared food the way they did (besides the fact that they were many years behind us a far as technology goes). It was what they had to do in order to support their lifestyles. they were the image of health.

We are bringing Primal back. We are eating plants and animals. This week I am going to go over the foundation to what a "Primal" eating style looks like. I am not going to confuse you or suggest you do things that are out of this world but I want you to see how easy it is to start changing a few of the things you do now to better your eating. This has been a slow and steady transition for me as well. I am not 100% primal but I have started to make small changes that have already started to prove there worth.

William

William Richards--Owner and writer of http://www.beyondgymwalls.com/ ---Twitter: Willfit---Facebook: Beyond Gym Walls

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Thinking globally to improve mental health

ScienceDaily (July 6, 2011) — Mental health experts are calling for a greater world focus on improving access to care and treatment for mental, neurological, and substance use (MNS) disorders, as well as increasing discoveries in research that will enable this goal to be met.

The Grand Challenges in Global Mental Health Initiative, led by the National Institutes of Health and the Global Alliance for Chronic Diseases, has identified the top 40 barriers to better mental health around the world. Similar to past grand challenges, which focused on infectious diseases and chronic, noncommunicable diseases, this initiative seeks to build a community of funders dedicated to supporting research that will significantly improve the lives of people living with MNS disorders within the next 10 years.

Twenty-five of the specific challenges and the process used to derive them are described in an article that will be published on July 7, 2011, in the journal Nature.

"Participating in global mental health research is an enormous opportunity, a means to accelerate advances in mental health care for the diverse U.S. population, as well as an extension of our vision of a world where mental illnesses are prevented and cured," said Thomas R. Insel, M.D., director of the National Institute of Mental Health (NIMH), the NIH institute heading this effort.

According to the paper's authors, the disorders targeted by the Grand Challenges in Global Mental Health -- for example, schizophrenia, depression, epilepsy, dementia, and alcohol dependence -- collectively account for more years of life lost to poor health, disability, or early death than either cardiovascular disease or cancer. Yet, compared to illnesses like cardiovascular disease and cancer, there are far fewer effective treatments or preventive methods. In addition, interventions are not widely available to those who need them most.

In recognizing the need to address this imbalance, Pamela Collins, M.D., M.P.H., of the NIMH Office for Research on Disparities and Global Mental Health, and colleagues assembled an international panel of experts to identify research priorities using the Delphi method, a widely accepted consensus-building tool. The panel consisted of 422 experts in fields such as neuroscience, basic behavioral science, mental health services, and epidemiology, and represented more than 60 countries.

Over the course of two months, NIMH staff pared the panel's initial list of 1,565 challenges down to 154, with input from a scientific advisory board. From this list, the expert panel selected the top 40, of which the top five challenges identified after the third and final round of ranking are:

Integrate screening and core packages of services into routine primary health careReduce the cost and improve the supply of effective medicationsImprove children's access to evidence-based care by trained health providers in low- and middle-income countriesProvide effective and affordable community-based care and rehabilitationStrengthen the mental health component in the training of all health care personnel.

These top five challenges were ranked according to the ability to reduce the burden of disease, ability to reduce inequalities in health and health care, length of time until results can be observed, and the ability for the topic to be researched effectively.

"Addressing these challenges could have far-reaching effects, including increasing access to services and ultimately, reducing the treatment gap associated with these disorders," said Dr. Collins.

The Grand Challenges in Global Mental Health Initiative is led by NIMH and the Global Alliance for Chronic Diseases, in partnership with the Wellcome Trust, the McLaughlin-Rotman Centre for Global Health, and the London School of Hygiene and Tropical Medicine. Other NIH components participating in the Grand Challenges in Global Mental Health include the Fogarty International Center; the National Heart, Lung, and Blood Institute; and the National Institute of Neurological Disorders and Stroke.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by NIH/National Institute of Mental Health.

Journal Reference:

Pamela Y. Collins, Vikram Patel, Sarah S. Joestl, Dana March, Thomas R. Insel, Abdallah S. Daar, Isabel A. Bordin, E. Jane Costello, Maureen Durkin, Christopher Fairburn, Roger I. Glass, Wayne Hall, Yueqin Huang, Steven E. Hyman, Kay Jamison, Sylvia Kaaya, Shitij Kapur, Arthur Kleinman, Adesola Ogunniyi, Angel Otero-Ojeda, Mu-Ming Poo, Vijayalakshmi Ravindranath, Barbara J. Sahakian, Shekhar Saxena, Peter A. Singer, Dan J. Stein, Warwick Anderson, Muhammad A. Dhansay, Wendy Ewart, Anthony Phillips, Susan Shurin, Mark Walport. Grand challenges in global mental health. Nature, 2011; 475 (7354): 27 DOI: 10.1038/475027a

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Length of parental military deployment associated with children's mental health diagnoses, study finds

ScienceDaily (July 4, 2011) — Children with a parent who was deployed in the U.S. military efforts Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) for longer periods were more likely than children whose parents did not deploy to receive a diagnosis of a mental health problem, according to a report published Online First by Archives of Pediatrics and Adolescent Medicine, one of the JAMA/Archives journals.

According to background information in the article, previous research has attributed children's depression and negative affect to parental military deployments. However, there has not been much research into this topic with regards to the United States' present conflicts, OIF and OEF. "As troops face dynamic and evolving threats (e.g., an increasingly sophisticated array of roadside explosive devices)," write the authors, "the need to anticipate the psychological consequences for their children and to offer timely intervention becomes increasingly important."

Alyssa J. Mansfield, Ph.D., M.P.H., then of the University of North Carolina at Chapel Hill, now of the National Center for Posttraumatic Stress Disorder in Honolulu, and colleagues examined electronic medical record data for outpatient care received at military facilities or through military health insurance between 2003 and 2006. The study included children ages 5 years through 17 years who had at least one parent serving on active duty in the U.S. Army. (Children of Reserve and National Guard personnel were excluded.) Researchers used the International Classification of Disease, Ninth Revision, to identify mental health diagnoses.

The study included 307,520 children, of whom 16.7 percent had a mental health diagnosis (most often for stress disorders, depression, behavioral problems, anxiety, and sleep disorders) during the study. More than 62 percent of parents were deployed at least once during the period, for an average of 11 months. The researchers found that mental health diagnoses were more common among children who had a parent who was deployed at least once for military operations in Iraq or Afghanistan. After adjusting the data for age, sex and mental health history, they showed that the likelihood of a mental health diagnosis increased with increases in parental deployment length; other factors included older age groups and male sex. The strongest associations were for acute stress reaction and adjustment disorders, depressive disorders, and behavioral disorders, among the total of 6,579 mental health diagnoses observed in children of deployed parents.

"We observed a clear dose-response pattern such that children of parents who spent more time deployed between 2003 and 2006 fared worse than children whose parents were deployed for a shorter duration," write the authors. "Similar to findings among military spouses, prolonged deployment appears to be taking a mental health toll on children." They urge further research of this issue among other branches of the military as well as the National Guard and Reserves.

Commentary: A Closer Look at the Effect Military Deployment Has on Children

In a commentary, Stephen J. Cozza, M.D., from the Uniformed Services University School of Medicine in Bethesda, Md., provides perspective on the scope of U.S. military deployment and the population it touches. As of 2009, he notes, 44 percent of active duty military members have children (for a total of 1.2 million children), as well as 43 percent of Reserve and National Guard members. Furthermore, since combat operations began in 2001, roughly 2 million U.S. military personnel have deployed at least once.

The article by Mansfield and colleagues, writes Cozza, provides "an important contribution to our understanding of a child's health and its relationship to parental combat deployment." The study, he adds, appears to confirm earlier research into this topic. But it also raises questions, such as what long-term consequences, if any, deployments have on children's health and development.

Cozza recommends that these findings be used to raise national awareness of the problem, both within the military community and without. Since affected children are likely to at some point receive care outside the military health system, he urges civilian clinicians to pay special attention to these patients. "Brief screening for anxiety, depression, behavioral problems, academic difficulties, peer relational problems, or high-risk behaviors (such as substance misuse or unsafe sexual practices) is warranted and will help identify treatment needs," Cozza concludes.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal References:

Alyssa J. Mansfield; Jay S. Kaufman; Charles C. Engel; Bradley N. Gaynes. Deployment and Mental Health Diagnoses Among Children of US Army Personnel. Archives of Pediatrics and Adolescent Medicine, 2011; DOI: 10.1001/archpediatrics.2011.123Stephen J. Cozza. Children of Military Service Members: Raising National Awareness of the Family Health Consequences of Combat Deployment. Archives of Pediatrics and Adolescent Medicine, 2011; DOI: 10.1001/archpediatrics.2011.117

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Length of parental military deployment associated with children's mental health diagnoses, study finds

ScienceDaily (July 4, 2011) — Children with a parent who was deployed in the U.S. military efforts Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) for longer periods were more likely than children whose parents did not deploy to receive a diagnosis of a mental health problem, according to a report published Online First by Archives of Pediatrics and Adolescent Medicine, one of the JAMA/Archives journals.

According to background information in the article, previous research has attributed children's depression and negative affect to parental military deployments. However, there has not been much research into this topic with regards to the United States' present conflicts, OIF and OEF. "As troops face dynamic and evolving threats (e.g., an increasingly sophisticated array of roadside explosive devices)," write the authors, "the need to anticipate the psychological consequences for their children and to offer timely intervention becomes increasingly important."

Alyssa J. Mansfield, Ph.D., M.P.H., then of the University of North Carolina at Chapel Hill, now of the National Center for Posttraumatic Stress Disorder in Honolulu, and colleagues examined electronic medical record data for outpatient care received at military facilities or through military health insurance between 2003 and 2006. The study included children ages 5 years through 17 years who had at least one parent serving on active duty in the U.S. Army. (Children of Reserve and National Guard personnel were excluded.) Researchers used the International Classification of Disease, Ninth Revision, to identify mental health diagnoses.

The study included 307,520 children, of whom 16.7 percent had a mental health diagnosis (most often for stress disorders, depression, behavioral problems, anxiety, and sleep disorders) during the study. More than 62 percent of parents were deployed at least once during the period, for an average of 11 months. The researchers found that mental health diagnoses were more common among children who had a parent who was deployed at least once for military operations in Iraq or Afghanistan. After adjusting the data for age, sex and mental health history, they showed that the likelihood of a mental health diagnosis increased with increases in parental deployment length; other factors included older age groups and male sex. The strongest associations were for acute stress reaction and adjustment disorders, depressive disorders, and behavioral disorders, among the total of 6,579 mental health diagnoses observed in children of deployed parents.

"We observed a clear dose-response pattern such that children of parents who spent more time deployed between 2003 and 2006 fared worse than children whose parents were deployed for a shorter duration," write the authors. "Similar to findings among military spouses, prolonged deployment appears to be taking a mental health toll on children." They urge further research of this issue among other branches of the military as well as the National Guard and Reserves.

Commentary: A Closer Look at the Effect Military Deployment Has on Children

In a commentary, Stephen J. Cozza, M.D., from the Uniformed Services University School of Medicine in Bethesda, Md., provides perspective on the scope of U.S. military deployment and the population it touches. As of 2009, he notes, 44 percent of active duty military members have children (for a total of 1.2 million children), as well as 43 percent of Reserve and National Guard members. Furthermore, since combat operations began in 2001, roughly 2 million U.S. military personnel have deployed at least once.

The article by Mansfield and colleagues, writes Cozza, provides "an important contribution to our understanding of a child's health and its relationship to parental combat deployment." The study, he adds, appears to confirm earlier research into this topic. But it also raises questions, such as what long-term consequences, if any, deployments have on children's health and development.

Cozza recommends that these findings be used to raise national awareness of the problem, both within the military community and without. Since affected children are likely to at some point receive care outside the military health system, he urges civilian clinicians to pay special attention to these patients. "Brief screening for anxiety, depression, behavioral problems, academic difficulties, peer relational problems, or high-risk behaviors (such as substance misuse or unsafe sexual practices) is warranted and will help identify treatment needs," Cozza concludes.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal References:

Alyssa J. Mansfield; Jay S. Kaufman; Charles C. Engel; Bradley N. Gaynes. Deployment and Mental Health Diagnoses Among Children of US Army Personnel. Archives of Pediatrics and Adolescent Medicine, 2011; DOI: 10.1001/archpediatrics.2011.123Stephen J. Cozza. Children of Military Service Members: Raising National Awareness of the Family Health Consequences of Combat Deployment. Archives of Pediatrics and Adolescent Medicine, 2011; DOI: 10.1001/archpediatrics.2011.117

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

'One-stop' clinic ups mental health, social work visits for veterans

ScienceDaily (June 10, 2011) — Iraq and Afghanistan veterans who visited a U.S. Veterans Administration (VA) integrated care clinic were much more likely to undergo initial mental health and social work evaluations than veterans who visited a standard VA primary care clinic, according to a study led by a San Francisco VA Medical Center researcher.

The increase was especially significant for women veterans, younger veterans, veterans with mental health diagnoses, and veterans who screened positive for traumatic brain injury.

The study was published on June 7, 2011 in the electronic Online First section of the Journal of General Internal Medicine.

The decisive factor was the integrated care model, itself, said the lead author of the study, Karen Seal, MD, MPH, co-founder and co-director of the Integrated Care Clinic at the San Francisco VA Medical Center, which was the site of the study.

Under the conventional VA model, patients are seen by a primary care physician and, if they screen positive for mental illness according to the VA's standard protocol, are referred to a mental health provider. That referral appointment would not necessarily be available the same day, nor in the same clinic.

Under the integrated care model, all patients are referred immediately by their primary care physician to a mental health provider, called the "Post-Deployment Stress Specialist," and a social worker, called the "Combat Case Manager." All visits take place during the same appointment, in the same clinic, with no waiting.

"This demonstrates the value of the integrated care clinic model for our veterans, especially those who may be more vulnerable," said Seal, who is also an associate professor in residence of medicine and psychiatry at the University of California, San Francisco.

The study also showed, however, that the rate of follow-up mental health care -- the number of subsequent visits with mental health providers that took place after initial evaluation -- was not any higher under the integrated care model than under standard care.

"We are really good at initial engagement, but unfortunately, we are not as successful at helping veterans stay with and complete a course of mental health treatment," said Seal. "We need to learn how to help veterans stick with the more difficult first few sessions of PTSD treatment, so they can get through to the other side when they really start to feel better." Seal explained that successful PTSD treatment usually takes nine to 12 sessions.

The study examined the medical records of 526 Iraq and Afghanistan veterans who came to SFVAMC between 2005 and 2009 for their first primary care visit after returning from combat deployment. Veterans who visited after April 1, 2007 -- the date that the Integrated Care Clinic was founded -- were given an appointment at either the Integrated Care Clinic or a conventional care clinic.

The 30-day mental health evaluation rate was 92 percent for the integrated care patients versus 59 percent for standard care patients. The rate for social work evaluation was 77 percent versus 56 percent.

For women veterans, the rate of initial mental health evaluations in integrated care was three times the conventional care rate. "This is good news, because women veterans have a high burden of mental health problems, and, at the same time, a disproportionate number of barriers to care, such as child care issues and other logistical constraints," said Seal.

Seal noted that the overall rate of initial mental health evaluations was higher in the integrated care model even after allowing for an overall VA systemwide improvement in first-time mental health evaluations that occurred after 2007.

She speculated that one promising approach to helping veterans complete their course of PTSD treatment might be the VA Patient Aligned Care Team (PACT) model, a new team-based method of providing primary care in the VA system. "One member of the patient care team could be assigned to make reminder phone calls for example, to encourage veterans to stick with and complete their mental health treatment," Seal said.

Co-authors of the study are Greg Cohen, MSW, and Daniel Bertenthal, MPH, of SFVAMC; Beth E. Cohen, MD, MAS, and Shira Maguen, PhD, of SFVAMC and UCSF; and Aaron Daley, MA, of SFVAMC.

The study was supported by funds from the US Department of Defense that were administered by the Northern California Institute for Research and Education.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of California - San Francisco.

Journal Reference:

Karen H. Seal, Greg Cohen, Daniel Bertenthal, Beth E. Cohen, Shira Maguen, Aaron Daley. Reducing Barriers to Mental Health and Social Services for Iraq and Afghanistan Veterans: Outcomes of an Integrated Primary Care Clinic. Journal of General Internal Medicine, 2011; DOI: 10.1007/s11606-011-1746-1

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Childhood trauma linked to higher rates of mental health problems

ScienceDaily (June 12, 2011) — New research has shown that children's risk for learning and behavior problems and obesity rises in correlation to their level of trauma exposure, says the psychiatrist at the Stanford University School of Medicine and Lucile Packard Children's Hospital who oversaw the study. The findings could encourage physicians to consider diagnosing post-traumatic stress disorder rather than attention deficit/hyperactivity disorder, which has similar symptoms to PTSD but very different treatment.

The study examined children living in a violent, low-income neighborhood and documented an unexpectedly strong link between abuse, trauma and neglect and the children's mental and physical health: It reported, for instance, that children experiencing four types of trauma were 30 times more likely to have behavior and learning problems than those not exposed to trauma.

"In communities where there is violence, where children are exposed to events such as shootings in their neighborhoods, kids experience a constant environmental threat," said senior author Victor Carrion, MD, associate professor of psychiatry and behavioral sciences at Stanford. "Contrary to some people's belief, these children don't get used to trauma. These events remain stressful and impact children's physiology."

The new study is being published online June 8 in the journal Child Abuse & Neglect. Carrion collaborated on the research with scientists at the University of New Orleans and the Bayview Child Health Center, part of San Francisco's California Pacific Medical Center.

The findings provide compelling evidence that pediatricians should routinely screen children for trauma exposures, said Carrion, who is also a child psychiatrist at Packard Children's.

"As simple as it may seem, physicians do not ask about trauma," he said. "And kids get the wrong diagnoses."

The study builds on earlier work that linked worsening health in adults with their dose of exposure to nine types of adverse childhood events, including being subject to various kinds of abuse or neglect; having a household member who abused alcohol or drugs, was incarcerated or was mentally ill; having a mother who was treated violently; and not living in a two-parent household. Middle-class men exposed to more of these events had more chronic diseases in adulthood, the prior research found. The results of the current study highlight the need for early identification of such adversity-associated health problems, and early intervention. Obesity, for example, may act as a mediator to other health problems such as diabetes, cardiac risk and inflammatory illness.

To perform the study, the researchers evaluated medical records from 701 children treated at a primary-care clinic in Bayview-Hunter's Point, a San Francisco neighborhood with high rates of poverty and violence. About half the children were African-American; the rest came from other ethnic backgrounds. Each child's exposure to adverse events was scored on a scale from 0 to 9, with one point given for each type of adversity. The researchers also evaluated the medical records for evidence of obesity and learning or behavior problems.

Two-thirds of the children in the study had experienced at least one category of adversity, and 12 percent experienced four or more categories. An adversity score of 4 or higher left kids 30 times as likely to show learning and behavior problems and twice as likely to be obese as those with a score of 0. Children with an adversity score of 1 were 10 times as likely to have learning and behavior problems as those not exposed to trauma.

Prior research has shown that about 30 percent of children in violent communities have symptoms of post-traumatic stress disorder, which can include the learning and behavior problems detected in the current study, Carrion noted. However, a physician unaware of the fact that a child experienced trauma, and noting the child's physiological hyperarousability and cognitive difficulties, may diagnose ADHD instead of PTSD. That's a problem because the two disorders have opposite treatments, he said. Kids with PTSD need psychotherapy, not the stimulant medications given for ADHD.

"Children can recover from PTSD with the appropriate treatment, which is one of approach and not avoidance," Carrion said. "By not asking about trauma, we're utilizing avoidance. We're perpetuating PTSD."

As part of their efforts to address the long-term health problems that stem from childhood trauma, Carrion, his collaborators and several San Francisco community partners are working to launch the Center for Youth Wellness, a one-stop health and wellness center for urban children and families in San Francisco. The Center for Youth Wellness will combine pediatrics with mental health services, educational support, family support, research and best practices in child-abuse response under one roof. With both public and private support, the center will coordinate the services of multiple agencies to give children a safe and accessible place to increase their resilience to adverse life experiences and improve their well-being.

The center, which aims to begin operation by mid-2012, is a partnership between California Pacific Medical Center's Bayview Child Health Center, San Francisco Child Abuse Prevention Center, San Francisco District Attorney's Office, Stanford's Early Life Stress Research Program at Lucile Packard Children's Hospital and Tipping Point Community. Nadine Burke, MD, director of the Bayview center, is also a co-author of the study.

"We need to create trauma-informed systems," Carrion concluded, adding that the Center for Youth Wellness hopes to function as a model for such systems across the nation. People working for the welfare of children need to be on the lookout for trauma and know how to intervene, and how to work with the family and with schools, he said. "If trauma goes untreated, it's very costly for the individuals involved and for society in general."

The research was funded by the Lennar Urban Corp. and awards to Carrion from the National Institute of Mental Health and the Evans Foundation.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Stanford University Medical Center.

Journal Reference:

Nadine J. Burke, Julia L. Hellman, Brandon G. Scott, Carl F. Weems, Victor G. Carrion. The impact of adverse childhood experiences on an urban pediatric population. Child Abuse & Neglect, 2011; DOI: 10.1016/j.chiabu.2011.02.006

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Workplace mental health disability leave recurs sooner than physical health leave, CAMH study shows

ScienceDaily (June 29, 2011) — The recurrence of an employee's medical leave of absence from work tends to happen much sooner with a mental health leave than a physical one, a Centre for Addiction and Mental Health (CAMH) study shows.

Most workers who take a mental health leave from their jobs do not have another disability leave for at least two years, according to a new study from CAMH. In contrast, most who have had a physical health disability leave have almost four years before a second episode.

Mental health disability leaves cost approximately $51 billion a year in Canada in health care and work disruption costs, and those with a previous episode are at higher risk of having another one.

"If we understand the timing of a repeated episode, as well as who is at risk of having a recurrence, we can develop more effective prevention programs to help people stay at work," says Dr. Carolyn Dewa, study lead and head of CAMH's Centre for Research on Employment and Workplace Health. The study was published in the June issue of the Journal of Occupational and Environmental Medicine.

For their study, Dr. Dewa and colleagues looked at the records of a Canadian company with 13,000 employees from 2003 to 2006. Among this group, 3,593 employees had one or more disability leaves during this period. An episode was at least five continuous days off work related to a medical diagnosis.

Among all workers, 72 per cent who had a disability leave were still at work after a year. Those who were more likely to have a second episode sooner included women, maintenance workers and those with disrupted marriages.

"It's important to be aware that although workers who have had one mental health disability leave are at risk of having a recurrence, it doesn't happen immediately," added Dr. Dewa. "These workers want to be back at work, but unfortunately, sometimes supports to help maintain their health are not available." It is important to do return-to-work planning to help employees transition back after a leave. Workplace resources can be very valuable in sustaining worker well-being and help them remain on the job longer.

It is a complex task to untangle the reasons why mental health disability leave recurs sooner than those for physical health. It is possible the workers in the study had not fully recovered when they returned, because some aspects of their illness were overlooked, the researchers point out.

"The workers' major symptoms may have subsided, but their ability to work may still be impaired due to memory loss or inability to focus," says Dr. Dewa. "The return-to-work forms that physicians fill out don't always ask about a person's functional abilities at work, just about medical symptoms. And workers may attribute symptoms such as memory loss or lack of focus to aging."

If a workers' ability to do their job is impaired, it could create resentment among their colleagues -- and there is growing evidence to suggest social support, both within and outside the workplace, is important to prevent psychiatric disorders. This may explain, for example, why those with disrupted marriages relapsed sooner. Past research also shows a link between low social support and depression in women.

Finding the right balance of providing social support without intruding too much or violating a person's privacy is challenging, but possible, says Dr. Dewa. "Occupational health staff can provide support or just check in with workers who have had a previous disability leave. People like it when you genuinely care about the answer to, 'How are you?'"

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Centre for Addiction and Mental Health, via EurekAlert!, a service of AAAS.

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Length of parental military deployment associated with children's mental health diagnoses, study finds

ScienceDaily (July 4, 2011) — Children with a parent who was deployed in the U.S. military efforts Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) for longer periods were more likely than children whose parents did not deploy to receive a diagnosis of a mental health problem, according to a report published Online First by Archives of Pediatrics and Adolescent Medicine, one of the JAMA/Archives journals.

According to background information in the article, previous research has attributed children's depression and negative affect to parental military deployments. However, there has not been much research into this topic with regards to the United States' present conflicts, OIF and OEF. "As troops face dynamic and evolving threats (e.g., an increasingly sophisticated array of roadside explosive devices)," write the authors, "the need to anticipate the psychological consequences for their children and to offer timely intervention becomes increasingly important."

Alyssa J. Mansfield, Ph.D., M.P.H., then of the University of North Carolina at Chapel Hill, now of the National Center for Posttraumatic Stress Disorder in Honolulu, and colleagues examined electronic medical record data for outpatient care received at military facilities or through military health insurance between 2003 and 2006. The study included children ages 5 years through 17 years who had at least one parent serving on active duty in the U.S. Army. (Children of Reserve and National Guard personnel were excluded.) Researchers used the International Classification of Disease, Ninth Revision, to identify mental health diagnoses.

The study included 307,520 children, of whom 16.7 percent had a mental health diagnosis (most often for stress disorders, depression, behavioral problems, anxiety, and sleep disorders) during the study. More than 62 percent of parents were deployed at least once during the period, for an average of 11 months. The researchers found that mental health diagnoses were more common among children who had a parent who was deployed at least once for military operations in Iraq or Afghanistan. After adjusting the data for age, sex and mental health history, they showed that the likelihood of a mental health diagnosis increased with increases in parental deployment length; other factors included older age groups and male sex. The strongest associations were for acute stress reaction and adjustment disorders, depressive disorders, and behavioral disorders, among the total of 6,579 mental health diagnoses observed in children of deployed parents.

"We observed a clear dose-response pattern such that children of parents who spent more time deployed between 2003 and 2006 fared worse than children whose parents were deployed for a shorter duration," write the authors. "Similar to findings among military spouses, prolonged deployment appears to be taking a mental health toll on children." They urge further research of this issue among other branches of the military as well as the National Guard and Reserves.

Commentary: A Closer Look at the Effect Military Deployment Has on Children

In a commentary, Stephen J. Cozza, M.D., from the Uniformed Services University School of Medicine in Bethesda, Md., provides perspective on the scope of U.S. military deployment and the population it touches. As of 2009, he notes, 44 percent of active duty military members have children (for a total of 1.2 million children), as well as 43 percent of Reserve and National Guard members. Furthermore, since combat operations began in 2001, roughly 2 million U.S. military personnel have deployed at least once.

The article by Mansfield and colleagues, writes Cozza, provides "an important contribution to our understanding of a child's health and its relationship to parental combat deployment." The study, he adds, appears to confirm earlier research into this topic. But it also raises questions, such as what long-term consequences, if any, deployments have on children's health and development.

Cozza recommends that these findings be used to raise national awareness of the problem, both within the military community and without. Since affected children are likely to at some point receive care outside the military health system, he urges civilian clinicians to pay special attention to these patients. "Brief screening for anxiety, depression, behavioral problems, academic difficulties, peer relational problems, or high-risk behaviors (such as substance misuse or unsafe sexual practices) is warranted and will help identify treatment needs," Cozza concludes.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal References:

Alyssa J. Mansfield; Jay S. Kaufman; Charles C. Engel; Bradley N. Gaynes. Deployment and Mental Health Diagnoses Among Children of US Army Personnel. Archives of Pediatrics and Adolescent Medicine, 2011; DOI: 10.1001/archpediatrics.2011.123Stephen J. Cozza. Children of Military Service Members: Raising National Awareness of the Family Health Consequences of Combat Deployment. Archives of Pediatrics and Adolescent Medicine, 2011; DOI: 10.1001/archpediatrics.2011.117

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here