Watch for signs of contemplating suicide

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September is Suicide Awareness Month. This month I have put together information about suicide prevention and awareness for educators and parents. The National Institutes of Health recently held an online videocast called “Suicide in the U.S.: Finding Pathways to Prevention.” Experts presented information and answered questions on the topic of suicide. I have summarized some of the highlights from the panel, along with recommendations from suicide prevention agencies.
There are myths surrounding suicide that should be dispelled. For example, sometimes it can be scary to talk about suicide because we fear that it will put the idea into someone’s head. Most experts agree, however, that this is not the case. If someone is showing warning signs of suicide, it is OK to ask something like, “Are you having thoughts of suicide?” This may let a child know that you are concerned and that you are a person with whom they can talk. Media coverage of suicide, however, is different. Deaths by suicide do need to be reported with care. If a suicide is covered extensively or if it is glamorized, it can increase risk of suicide for some people.
Another myth concerns the cause of suicide. The panelists agreed that suicide is very complicated and often is not caused by one event, such as the breakup of a relationship or a fight with a parent. It is much more complex than just being able to point to one reason. There may be a combination of stressful life events interacting with mental illness (e.g. chemical imbalance, depression). Substance abuse can also play a role.
Young kids can think about and die from suicide. This is rare younger than 10, but the occurrences do spike as kids get older. The following are warning signs of suicide that should be followed up on if a child is exhibiting them:
n Talking about wanting to die: Suicide notes and/or making threats such as, “I want to die” or “Everyone would be better off without me.”
n Previous suicide attempt or efforts to harm self: A child who has attempted suicide needs continued support and therapy. Also watch for signs of purposeful cutting or scratching on the child’s body.
n Depression: A child feeling helpless or hopeless. This can also be seen in risk-taking behaviors such as aggression or using drugs and alcohol.
n Any sudden changes: A child may suddenly withdraw from friends and activities that were once enjoyed. Changes in appetite or sleep patterns. Lack of interest in appearance.
n Difficulty concentrating and mood changes: Not being able to focus on school work or household chores. Trouble following and contributing to conversations.
n Planning and access: The more detailed the plans, the more at risk a child is. A plan in combination with access to weapons, pills, etc. can be very dangerous.
Steps that can be taken for suicide prevention include:
n Normalize talking about mental health. Be willing to talk about suicide. If you see signs, you can ask if the person is thinking about suicide. Asking does not hurt and can open the door for the person to seek help.
n Build relationships. Provide a welcoming environment that encourages children to seek help from an adult when needed. Talking through feelings with an adult can help. Having a trusted adult in a child’s life can make a valuable difference.
n Don’t wait for a tragedy. School systems should provide workshops or training sessions for staff that include learning warning signs for suicide. If you are an educator or parent and would like more information, the school psychologist should be a great resource.
The National Suicide Hotline number is (800) 273-TALK. They are able to provide information to people who are experiencing emotional distress and may be thinking about suicide. Information about suicide can also be obtained from www.sprc.org.

Sara Buhl, of Auburn, is a certified school psychologist. She can be reached at sarabuhl1@gmail.com

Read more: http://auburnpub.com/lifestyles/article_4ba4863a-e253-11e0-812c-001cc4c03286.html#ixzz1YtediN89

U.S. to develop chip that tests if a drug is toxic

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U.S. government researchers plan to design a chip that can check whether new drugs are toxic before they are tested in people, potentially speeding up the development of new therapies.

The chip would lump together human cells from the liver, heart, muscles and other organs, then diffuse a drug through them. Multiple readouts would then show how different proteins, genes and other compounds in the cells react to the medicine.

“If things are going to fail, you want them to fail early,” Dr. Francis Collins, the director of the National Institutes of Health (NIH), told Reuters on Friday. “Now you’ll be able to find out much quicker if something isn’t going to work.”

Collins said a drug’s toxicity is one of the most common reasons why promising compounds fail. But animal tests — the usual method of checking a drug before trying it on humans — can be misleading.

He said about half of drugs that work in animals may turn out to be toxic for people. And some drugs may in fact work in people even if they fail in animals, meaning potentially important medicines could be rejected.

The project aims to bring together new knowledge from engineering, biology and toxicology.

The cells in the chip will be grouped next to each other so they can interact, much as they would in a human body. The chip will be tested with drugs that are known to be safe, and those that are toxic, to look at how the readouts compare.

The Defense Advanced Research Projects Agency (DARPA) and the NIH will each spend up to $70 million over five years on their own separate programs to develop the chip.

They will also work with the Food and Drug Administration, the U.S. drugs regulator, which could potentially use the chip to test drugs during the approval process.

It takes an average of 15 years and more than $1 billion to get approval to sell a drug in the United States, according to the drug industry group PhRMA.
“We know the development pipeline has bottlenecks in it, and everyone would benefit from fixing them,” Collins said.

Reported by by Anna Yukhananov
Reuters

Bidirectional Relationship Between Schizophrenia and Epilepsy, Study Finds

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Researchers from Taiwan have confirmed a bidirectional relation between schizophrenia and epilepsy. The study published in Epilepsia, a journal of the International League Against Epilepsy (ILAE), reports that patients with epilepsy were nearly 8 times more likely to develop schizophrenia and those with schizophrenia were close to 6 times more likely to develop epilepsy….

ScienceDaily staff
ScienceDaily
http://www.sciencedaily.com/releases/2011/09/110919074244.htm

Tribe turns to tradition to combat suicide

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It began inside a jail cell, where a young man hanged himself.

What followed was a cascade of death that threatened to engulf the Wind River Indian Reservation.

During August and September of 1985, nine young people killed themselves. Most were Northern Arapahos.

Four of the victims were between the ages of 14 and 19, and five between 23 and 26.

Three additional victims, between the ages of 18 and 23, had ties to the reservation and to some of the other victims.

Eighty-eight verified suicide attempts or threats also were recorded, the majority by young people 13 to 19 years old.

Mental health experts from around the nation tried to intervene.

“But it wasn’t doing any good,” Nelson White Sr., an Arapaho elder, recalled.

National media descended on the scene, an intrusion many people resented as insensitive and bent on sensationalism. One television crew tried to crash a victim’s funeral. Eventually, tribal leaders barred the press from Indian land.

Almost as quickly as it spread, the contagion ended.

Alcohol was a direct factor in four of the deaths. But in the absence of concrete answers, larger causes remained matters of conjecture.

At the height of the episode, an Arapaho elder remembered that certain ceremonies had been performed during an epidemic many years earlier.

Prayers were said, and offerings made to the four directions and to the Creator, to purify and restore harmony in a manner consistent with traditional beliefs.

Elders Nelson White Sr. and Crawford White said that’s when the deaths stopped.

Their account is corroborated by a scientific review of the incident.

In a journal article, Margene Tower of the Indian Health Service referred to a “traditional medicine” ceremony that happened at the height of the epidemic.

“This ceremony was held following the ninth suicide,” she wrote. “It was an important cultural and spiritual event that aided in the resolution of grief and increased cohesiveness in the community. No further deaths occurred after this ceremony was held.”

She noted that while suicide attempts remained abnormally high for two months after the ninth death these soon subsided.

It was the power of community and a people’s prayer that broke the deadly cycle, Nelson White Sr. said: “We belong to the Creator.”

What happened among the Northern Arapahos in 1985 has not been forgotten. Efforts to forestall suicides today incorporate ceremonies conducted in the Arapaho language, talking circles, sweat lodges and involvement of elders, all woven together in a kind of community safety net.

Trained suicide interveners watch for early signs of trouble. Both the Northern Arapaho and the Eastern Shoshone with whom they share the Wind River reservation have suicide prevention programs.

Read more: http://trib.com/special-section/suicide/article_9c00e087-6904-54b4-a097-090e8afed8d1.html#ixzz1YylxLaaC

By TOM MAST
Star-Tribune
http://trib.com/special-section/suicide/article_9c00e087-6904-54b4-a097-090e8afed8d1.html

Growing pains hit mental health in China

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When an ax-wielding man attacked people on the street in Henan Province on Wednesday, the terse media reports created headlines and public panic. Wang Hongbin, 30, killed six people, including two children, and is said to be mentally ill.

Is this yet another sign of a worsening mental illness in China?

We recall last year’s alarming stories of five major attacks in Chinese schools, leaving 17 people, including 15 pupils, dead.

In March, a local resident in Fujian stabbed students, killing eight and injuring five. The suspected attacker, a former community doctor, was suffering from mental illness, the Xinhua report said.
In May, Wu Huanming, 48, stabbed students in a private kindergarten in Shanxi province, killing nine people, including seven pupils. According to Xinhua, local police said Wu slumped into depression after suffering several illnesses.

Following those grisly attacks, Premier Wen Jiabao pledged that government authorities will beef up security in schools and will address the social issues related to the attacks.

These incidents have triggered heated discussions in the Chinese media whether mental illness should be considered mitigating factors in criminal trials.

They have also put the spotlight on the state of mental health in China.

Are things are getting worse?

Dr. Michael Phillips, director of Suicide Research and Prevention Center at Shanghai Jiao Tong University School of Medicine, does not think so.

“I expect the recent spate of violence by persons with mental illness is more a reflection of increased press interest than the result of greater frequency of such events,” he tells me. “Given the size of the country, these events are going to happen.”

Phillips has resided and worked in China for more than 20 years. He has co-authored research papers on mental health issues in China, including one on the alarmingly high suicide rate in China.

The Canadian psychiatrist says “there is no clear evidence that the prevalence of mental disorders has changed dramatically in the last decade or so” — with the exception of alcohol abuse.

“It’s impossible to characterize the mental health of a nation, particularly on the size and diversity of China. My large study with 60,000+ subjects in four provinces found rates of mental illnesses similar to that reported in Europe and North America,” he said.

Shortage of counselors

Still, the China numbers are staggering.

By Jaime FlorCruz
CNN

Study reveals genetic secrets behind schizophrenia and bipolar disorder

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One of the world’s largest schizophrenia studies ever has pinpointed five new genetic blips linked to the condition, paving the way for new drugs and management strategies, researchers said.

Schizophrenia affects 1 in 100 people, commonly causing delusions, hallucinations and an increased risk of suicide.

Scientists knew that a family history of schizophrenia could predispose subsequent generations to the condition but it was not clear exactly which parts of the human genome were linked to an increased risk.

To find out, the Schizophrenia Psychiatric Genome-Wide Association Study Consortium, which included 190 researchers from 135 institutions worldwide, analysed genetic data from 21,856 individuals and checked their conclusions by studying an additional 29,839 people.

In a paper titled “Genome-wide association study identifies five new schizophrenia loci” published today in the journal Nature Genetics, the researchers said their study found five new genetic variations associated with schizophrenia. They also confirmed several other genetic blips that previous studies had suggested could contribute to the disorder.

By Sunanda Creagh
The Conversation
http://theconversation.edu.au/study-reveals-genetic-secrets-behind-schizophrenia-and-bipolar-disorder-3435

Medical Breakthrough: The Viral Link to Mental Illness

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Flu, AIDS, meningitis, Ebola, polio, herpes, measles, rabies—the list of diseases caused by viruses is a litany of woe ranging from the merely annoying to the deadly. Every year almost two million people are killed by the human immunodeficiency virus (HIV), and around half that many people succumb to viral hepatitis infections. The economic toll of viral illnesses is nearly as staggering as the human one; flu costs the United States an estimated $25 billion a year, and HIV costs $36 billion. To make matters worse, new viruses continue to appear (see “Virus Hunter” below), often after hiding in animal populations for centuries before moving into humans—as did HIV, avian flu, and severe acute respiratory syndrome (SARS). But while public health officials and physicians focus on the threat of emerging viruses, little-noticed research is implicating these primitive microbes in diseases long thought to have nothing to do with them: mental illnesses.

The notion that “insanity is infectious,” as virologist Ian Lipkin of Columbia University’s Mailman School of Public Health bluntly puts it, goes back to antiquity. As late as the 1800s, the mentally ill were locked away because, among other reasons, they were thought to be contagious. The notion wasn’t completely misguided. Until the discovery of penicillin ushered in the age of antibiotics, a major cause of mental illness was syphilis. But biomedicine is subject to fads and fashion no less than skirts are, and over the last 40 years disease detectives seeking the cause of mental conditions such as schizophrenia, bipolar disorder, autism, and obsessive-compulsive disorder have turned from microbes to genes as the cause. And now, a parade of discoveries suggests that viruses may be the culprit rather than your family tree. The new research indicates that viral infection can affect the developing brain and contribute to mental illnesses even before birth….

by Sharon Begley
The Saturday Evening Post
http://www.saturdayeveningpost.com/2011/09/12/lifestyle/living-well/viral-link-mental-illness.html

Psychopharmacology of Aggression in Schizophrenia

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Abstract

The management of aggression in patients with schizophrenia is a complex and challenging clinical dilemma. It also is greatly influenced by prevailing societal and medicolegal considerations regarding the perceived associations between violence and mental illness. This article provides a succinct account of a complex area and offers evidence for available treatments to reduce the occurrence of violent behavior among patients with schizophrenia.
Introduction

The treatment of patients with schizophrenia who are aggressive is particularly challenging. Our capacity for accurate prediction of violent behavior—itself a daunting task—juxtaposes our responsibilities for societal risk alongside our responsibility to provide and safe care to the psychotic patient who is/could become violent. Moreover, the choice of the treatment methods varies depending on the possible cause of aggression: is the aggression stemming directly from psychosis or due to some other comorbidity, eg, traumatic brain injury or mental retardation or due to the personality disorder? For a long time, the clinicians had available only the typical (first generation) antipsychotics to reduce aggression, and often “megadoses” were used and/or potentially coercive use when noncompliance involved long-acting injectable.[1]

Complicating medication choice is the multifactorial etiology for the agitated behavior. This requires the assessment of the patient for possible comorbidities, such as somatic conditions or other psychiatric conditions, or adverse effects of medications, such as akathisia. In particular, special consideration needs to be made for patients who may be in acute alcohol or sedative withdrawal where reduction of the seizure threshold with the use of antipsychotics can be problematic. In these instances, medications that are cross-tolerant with alcohol, such as lorazepam (well absorbed intramuscularly), are preferred because they will treat the potential withdrawal state as well as exert a calming effect. However, these agents do not address the underlying core psychotic illness, and long-term use of a benzodiazepine can also result in physiological tolerance, leading to potential rebound anxiety or agitation in between doses or when doses are missed. Moreover, the underlying causes for the propensity toward aggression are themselves complex.[1,2] Herein, we briefly illuminate core principles—both legal and clinical—and practices that currently guide our management of this complicated clinical scenario….

by Peter Buckley; Leslie Citrome; Carmen Nichita; Michael Vitacco
Medcape
http://www.medscape.com/viewarticle/749195

Humane Housing for the Mentally Ill

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Gov. Andrew Cuomo brought an end to a shameful chapter in New York’s history last week when he agreed to settle a suit over the mistreatment of mentally ill people who have been unnecessarily confined in nursing homes.

During the 1990s the state began shunting people who left state psychiatric hospitals into prison-style nursing homes, where they were barred from going outside, had little contact with others and had almost no ability to object to confinement. Under the settlement, New York will move as many of them as possible into community housing, where they will receive the services they need to live independently.

Federal disability law forbids warehousing of the disabled and requires the states to house and care for them in the least restrictive setting. The aim is to integrate the mentally ill into the communities where they live.

Advocates for people with mental illness, led by Disability Advocates, filed suit in 2006. They charged that the state’s practice violated federal law and did little to give people the psychiatric treatment or life skills training they needed to live independently.

Under the settlement, the state will adopt a new discharge policy under which only those who cannot be cared for in the community will be sent to nursing homes. Over the next three years, more than a thousand nursing home residents will be evaluated to determine whether they are suited for independent living. New York also agreed to develop 200 units of housing that would be appropriate for this population. It is long past time to move these people into more humane, integrated settings.

Editorial
New York Times

New hope for treating mental illness

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There may be encouraging news for the millions of Americans who now suffer from some form of mental illness. A recent report shows that a record 301 medicines are currently being developed in the U.S. to help ease the devastating impact that mental illnesses have on patients, their families and society. According to the National Institute of Mental Health (NIMH), nearly 60 million Americans are affected by some form of mental illness. Nearly one American in seven suffers from a serious mental illness.

For too long, such misunderstood conditions as depression and bipolar disorders have stigmatized patients, needlessly causing shame and fear. In addition to the human toll, diagnosing and treating mental illnesses exacts a heavy economic burden. In fact, according to NIMH, the total direct and indirect cost of treating mental illness in the United States is $205 billion per year. Fortunately, many mental illnesses are highly treatable as the new medicines being developed hold the promise of providing patients and doctors with more and better treatment options. Among the medicines now in the research pipeline: 70 new treatments for depression, which affects nearly 22 million Americans; 30 medicines to treat addictive disorders, including dependence on alcohol, tobacco or illicit drugs; 56 therapies for anxiety disorders, which affect more than 40 million adults; 90 for dementias-including Alzheimer’s disease, which affects more than 5 million Americans; and 45 promising remedies for schizophrenia, which strikes some 2.5 million adults each year. In addition to developing new medicines, American pharmaceutical research companies say they’ve made strides in helping uninsured and underinsured patients gain access to the medicines they need. The companies have sponsored the Partnership for Prescription Assistance (PPA), which has helped connect more than 5 million uninsured and financially struggling Americans to more than 475 patient assistance programs that provide free or nearly free medicines. Over 200 of the participating patient assistance programs are directly sponsored by an American pharmaceutical research company.

We applaud those involved in improving the lives of the mentally ill.

Cherokee Chronicle Times