People With Mental Health Issues More Likely to Be Uninsured

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Americans with frequent bouts of mental distress are more likely to lack health insurance than those with frequent physical distress, a new study says.

Researchers examined national data collected from 1993 through 2009 and found that 22.6 percent of people with frequent mental distress (indicative of mental illness) were uninsured, compared with 17.7 percent of those with frequent physical distress (indicative of chronic disease). About 16.6 percent of people with neither mental or physical distress were uninsured.

People with only frequent mental distress and those with both frequent mental and physical distress were equally likely to not have insurance, which suggests that mental distress was the main factor, according to the researchers.

The study appears in the October issue of the journal Psychiatric Services.

Compared to adults with insurance, those who are uninsured have less access to recommended care, receive poorer quality care, and have worse health outcomes, the researchers noted in an American Psychiatric Association news release.

The purpose of their study was to establish baseline data that can be used to assess the impact of the Affordable Care Act, which is scheduled to be fully implemented in January 2014 and will provide insurance coverage to millions of previously uninsured Americans.

U.S. News & World Report

Drugs Used for Psychotics Go to Youths in Foster Care

Foster children are being prescribed cocktails of powerful antipsychosis drugs just as frequently as some of the most mentally disabled youngsters on Medicaid, a new study suggests.

The report, published Monday in the journal Pediatrics, is the first to investigate how often youngsters in foster care are given two antipsychotic drugs at once, the authors said. The drugs include Risperdal, Seroquel and Zyprexa — among other so-called major tranquilizers — which were developed for schizophrenia but are now used as all-purpose drugs for almost any psychiatric symptoms.

“The kids in foster care may come from bad homes, but they do not have the sort of complex medical issues that those in the disabled population do,” said Susan dosReis, an associate professor in the University of Maryland School of Pharmacy and the lead author.

The implication, Dr. dosReis and other experts said: Doctors are treating foster children’s behavioral problems with the same powerful drugs given to people with schizophrenia and severe bipolar disorder. “We simply don’t have evidence to support this kind of use, especially in young children,” Dr. dosReis said….

By

The New York Times

http://www.nytimes.com/2011/11/21/health/research/study-finds-foster-children-often-given-antipsychosis-drugs.html

 

Suicide Risk Increased for All Psychiatric Disorders

Clinical Context

All mental disorders are associated with an increased risk for death from suicide. This risk is often expressed as the odds ratio for suicide in those who have contact with mental health services. No studies have actually conducted lifetime follow-up after psychiatric contact, but lifetime risk is mentioned in many reports. Estimates range from 4% for schizophrenia to 15% for unipolar disorder.

This is a population-based cohort study of the Danish population to examine the lifetime risk for death from suicide among men and women with psychiatric contact and the general population.

Study Synopsis and Perspective

Patients with any major psychiatric disorder are at significant risk for suicide after their first hospital visit, according to new research.

In a Danish registry study of more than 175,000 individuals who were followed-up for up to 36 years, investigators found that among men, those with bipolar disorder or unipolar affective disorder had the highest absolute risk for suicide. Schizophrenia, followed closely by bipolar disorder, represented the highest risks for women.

Comorbidities were also significant risk factors for both sexes, and the cooccurrence of deliberate self-harm increased the risk by 2-fold.

“The steepest increase in suicide incidence occurs during the first years after first contact,” write lead author Merete Nordentoft, MD, from the Psychiatric Center Copenhagen and Copenhagen University in Denmark, and colleagues.

The investigators note that the absolute risk for suicide varied between 2% and 8% for the different psychiatric disorders studied.

“Our estimates are lower than those most often cited, but they are still substantial and indicate the continuous need for prevention of suicide among people with mental disorders,” the authors write.

The study appears in the October issue of the Archives of General Psychiatry….

By Deborah Brauser and Désirée Lie, MD, MSEd

Medscape

http://www.medscape.org/viewarticle/751701