Risk of Death Increases in Nursing Home Residents After Exposure to Typical Antipsychotics

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Elderly Health/Long-Term Care

Antipsychotic medications are commonly used in nursing homes to help patients with dementia, schizophrenia, and other behavior problems. Older drugs, called typical antipsychotics, can cause a variety of central nervous system side effects. The newer, atypical agents are preferred by many due to their better side effect profiles. Typical antipsychotics can increase the risk for mortality in the elderly, concludes a new study.

–Agency for Healthcare Research and Policy

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The Intersection of Foster Care and Mental Health

In the United States, there are more than 400,000 children and teens in foster care.  Research reveals that children and teens in the foster care system have disproportionately high rates of psychiatric disability.

One study by the National Institute of Mental Health found that nearly half (47.9 percent) of youth in foster care were found to have clinically significant emotional or behavioral problems.  Likewise, researchers at the Casey Family Programs estimate that between one-half and three-fourths of children entering foster care exhibit behavioral or social competency problems that warrant mental health services.

Youth who have “aged out” of foster care also show high rates of psychiatric disability.  According to a study by the Casey Family Programs and Harvard Medical School, a high number of former foster children have psychiatric disabilities as adults.  Over half of foster care alumni had mental health diagnoses, compared to 22 percent of the comparison group.

The disproportionate level of mental health diagnoses is perhaps most evident with post-traumatic stress disorder (PTSD).  Thirty percent of foster alumni are diagnosed with PTSD, which is about twice the rate of U.S. combat veterans.

by Stephanie Orlando, Disability Blog

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Brain Patterns May Help Predict Relapse Risk for Alcoholism

Distinct patterns of brain activity are linked to greater rates of relapse among alcohol dependent patients in early recovery, a study has found. The research, supported by the National Institutes of Health, may give clues about which people in recovery from alcoholism are most likely to return to drinking.

“Reducing the high rate of relapse among people treated for alcohol dependence is a fundamental research issue,” said Kenneth R. Warren, Ph.D., acting director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of NIH. “Improving our understanding of the neural mechanisms that underlie relapse will help us identify susceptible individuals and could inform the development of other prevention strategies.”

Using brain scans, researchers found that people in recovery from alcoholism who showed hyperactivity in areas of the prefrontal cortex during a relaxing scenario were eight times as likely to relapse as those showing normal brain patterns or healthy controls.

The prefrontal brain plays a role in regulating emotion, the ability to suppress urges, and decision-making. Chronic drinking may damage regions involved in self-control, affecting the ability to regulate cravings and resist relapse.

–National Institutes of Health (NIH)

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Half of Pregnant Teen Admissions Used Drugs or Alcohol in the Month Prior to Entering Treatment

Report reveals special challenges of pregnant teens in substance abuse treatment

A new report shows that among the approximately 57,000 teenage female (ages 12 to 19) substance abuse treatment admissions each year, about 2,000 (4 percent) involve pregnant teens. The Substance Abuse and Mental Health Services Administration’s (SAMHSA) report finds that these pregnant teen admissions tend to face greater challenges than other female teen admissions in a number of key areas such as financial and educational status.

For example, pregnant teen admissions were three times more likely than other female teen admissions to receive public assistance as a primary source of income (15 percent versus 5.3 percent). Similarly in education, while 74 percent of non-pregnant female teen admissions who were not in the workforce were students, only 44.2 percent of pregnant teen admissions not in the workforce were students.

The report also indicates that about half (51 percent) of pregnant teen admissions reported some use of drugs or alcohol in the month prior to their treatment entry. This rate is substantially lower than that of other female teenage admissions (70.9 percent). However, nearly one fifth (19.3 percent) of pregnant teen admissions had used a drug or alcohol on a daily basis in the month before entering treatment – comparable to the rate among other female teen admissions (24.5 percent).

Marijuana was the most commonly used substance among both pregnant teen and other female teen treatment admission groups (72.9 percent and 70.2 percent respectively). However there were some notable differences in the substance use patterns between the two groups, particularly with regard to the use of methamphetamines and amphetamines. Pregnant teen admissions were twice as likely as other female treatment admissions to abuse these substances (16.9 percent for pregnant teen admissions versus 8.4 percent for other female teen admissions).

“It is critical that pregnant women of all ages have access to prevention, support, and recovery services that meet their specialized needs,” said SAMHSA Administrator Pamela S. Hyde. “These specialized needs are even more acute for our pregnant teens. Community programs that can address the needs of pregnant teens by providing them both access to substance abuse support services and specialized pregnant and post partum services can help ensure that these future mothers and their children live healthier, happier and more productive lives.”

–SAMHSA

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Sharp Rise in Emergency Department Visits Involving the Sleep Medication Ambien

Zolpidem is the active ingredient in Ambien, Ambien CR, Edluar and Zolpimist

A new report shows that the number of emergency department visits involving adverse reactions to the sleep medication zolpidem rose nearly 220 percent from 6,111 visits in 2005 to 19,487 visits in 2010.   The Substance Abuse and Mental Health Services Administration (SAMHSA) report also finds that in 2010 patients aged 45 or older represented about three-quarters (74 percent) of all emergency department visits involving adverse reactions to zolpidem.

In 2010 there were a total of 4,916,328  drug-related visits to emergency departments throughout the nation.

From 2005 to 2010 there was a 274 percent increase in the number of female visits to emergency department involving zolpidem (from 3,527 visits in 2005 to 13,130 in 2010)  — in comparison to a 144 percent increase among males during the same period (2,584 visits in 2005 to 6,306 in 2010). In 2010 females accounted for more than two-thirds (68 percent) of all emergency department visits related to zolpidem.

Zolpidem is an FDA-approved medication used for the short-term treatment of insomnia and is the active ingredient in drugs such as Ambien, Ambien CR, Edluar and Zolpimist. These drugs have been used safely and effectively by millions of Americans, however, in January 2013, FDA responded to increasing numbers of reports of adverse reactions by requiring manufacturers of drugs containing Zolpidem to halve the recommended dose for females. FDA also suggested that manufacturers reduce the recommended dose for men as well.

Adverse reactions associated with the medication include daytime drowsiness, dizziness, hallucinations, agitation, sleep-walking and drowsiness while driving. When zolpidem is combined with other substances, the sedative effects of the drug can be dangerously enhanced. This is especially true when zolpidem is combined with certain anti-anxiety medications and narcotic pain relievers which depress the central nervous system. The report finds that in 2010 half of all emergency department visits related to zolpidem involved its use with other drugs. In 37 percent of all emergency department visits involving zolpidem it was used in combination with drugs that depress the central nervous system.

“Although short-term sleeping medications can help patients, it is exceedingly important that they be carefully used and monitored,” said SAMHSA Administrator Pamela S. Hyde. “Physicians and patients need to be aware of the potential adverse reactions associated with any medication, and work closely together to prevent or quickly address any problems that may arise.”

–SAMHSA

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Photos: SARDAA Booth at MHA Conference

Linda Stalters and Wayne Lindstrom, Ph.D.

Linda Stalters and Wayne Lindstrom, Ph.D.
Linda Stalters and Wayne Lindstrom, Ph.D.

CDC Finds Suicide Rates Among Middle-Aged Adults Increased From 1999-2010

Suicide deaths have surpassed deaths from motor vehicle crashes in recent years in the United States. In 2010 there were 33,687 deaths from motor vehicle crashes and 38,364 suicides. Suicide rates among middle-aged Americans have risen substantially since 1999, according to a report in today’s CDC journal, Morbidity and Mortality Weekly Report.

Annual suicide rates for this age group increased 28 percent over this period (from 13.7 suicides per 100,000 people in 1999 to 17.6 per 100,000 in 2010), with particularly high increases among non-Hispanic whites and American Indians and /Alaska Natives.

Most suicide research and prevention efforts have focused historically on youth and the elderly. This report’s findings suggest that efforts should also address the needs of middle-aged persons.

Suicide prevention strategies involve enhancing social support and community connectedness, improving access to mental health and preventive services, and reducing the stigma and barriers associated with seeking help. Other prevention strategies include programs to help those at increased risk of suicide, such as those struggling with financial challenges, job loss, intimate partner problems or violence, stress of caregiving for children and aging parents, substance abuse, and serious or chronic health problems.

–Centers for Disease Control and Prevention (CDC)

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Flu in Pregnancy May Quadruple Child’s Risk for Bipolar Disorder, Schizophrenia

Pregnant mothers’ exposure to the flu was associated with a nearly fourfold increased risk that their child would develop bipolar disorder in adulthood, in a study funded by the National Institutes of Health. The findings add to mounting evidence of possible shared underlying causes and illness processes with schizophrenia, which some studies have also linked to prenatal exposure to influenza.

“Prospective mothers should take common sense preventive measures, such as getting flu shots prior to and in the early stages of pregnancy and avoiding contact with people who are symptomatic,” said Alan Brown, M.D., M.P.H, of Columbia University and New York State Psychiatric Institute, a grantee of the NIH’s National Institute of Mental Health (NIMH).  “In spite of public health recommendations, only a relatively small fraction of such women get immunized. The weight of evidence now suggests that benefits of the vaccine likely outweigh any possible risk to the mother or newborn.”

Brown and colleagues reported their findings online May 8, 2013 in JAMA Psychiatry.

Although there have been hints of a maternal influenza/bipolar disorder connection, the new study is the first to prospectively follow families in the same HMO, using physician-based diagnoses and structured standardized psychiatric measures. Access to unique Kaiser-Permanente, county and Child Health and Development Study databases made it possible to include more cases with detailed maternal flu exposure information than in previous studies.

Among nearly a third of all children born in a northern California county during 1959-1966, researchers followed 92 who developed bipolar disorder, comparing rates of maternal flu diagnoses during pregnancy with 722 matched controls.

The nearly fourfold increased risk implicated influenza infection at any time during pregnancy, but there was evidence suggesting slightly higher risk if the flu occurred during the second or third trimesters. Moreover, the researchers linked flu exposure to a nearly sixfold increase in a subtype of bipolar disorder with psychotic features.

A previous study, by Brown and colleagues, in a related northern California sample, found a threefold increased risk for schizophrenia associated with maternal influenza during the first half of pregnancy. Autism has similarly been linked to first trimester maternal viral infections and to possibly related increases in inflammatory molecules.

“Future research might investigate whether this same environmental risk factor might give rise to different disorders, depending on how the timing of the prenatal insult affects the developing fetal brain,” suggested Brown.

Bipolar disorder shares with schizophrenia a number of other suspected causes and illness features, the researchers note. For example, both share onset of symptoms in early adulthood, susceptibility genes, run in the same families, affect nearly one percent of the population, show psychotic behaviors and respond to antipsychotic medications.

Increasing evidence of such overlap between traditional diagnostic categories has led to the NIMH Research Domain Criteria (RDoC) project, which is laying the foundation for a new mental disorders classification system based on brain circuits and dimensional mechanisms that cut across traditional diagnostic categories.

National Institute of Mental Health (NIMH)

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Film Synopsis: Hidden Pictures

Filmmaker and physician Delaney Ruston grew up under the shadow of her dad’s illness, schizophrenia. While reconnecting with him after years of estrangement, (as seen in the award winning PBS documentary Unlisted: A Story of Schizophrenia) Ruston became interested in the experiences of other families around the globe. How are people accepted or rejected? What is mental health care like? Given that the WHO estimates that 450 million people worldwide have a mental illness, why do we rarely hear about their lives?

Ruston takes us on her journey to answer these questions, uncovering personal stories in India, China, South Africa, France, and the US. What emerges are scenes of profound frustration, moments of true compassion, and haunting insights. The journey ends by exploring the force of change that individuals are bringing about, including actress Glenn Close’s movement to fight stigma.

HIDDEN PICTURES is the first feature documentary on global mental health. Artistically crafted, with unforgettable characters, this powerful film will bring needed dialogue to a vastly neglected field.

Hidden Pictures Website

Photos of Cocktails and Couture — SARDAA’s 5th Anniversary Celebration and Schizophrenia Awareness Recognition

C. Patrick McIlvain, Roxane Pyle, K. David Quackenbush, Mike Alsup, Aymeric Martinoia

C. Patrick McIlvain, Roxane Pyle, K. David Quackenbush, Mike Alsup, Aymeric Martinoia

May 2013–We celebrated SARDAA’s 5th anniversary at a private club, The Marque, in Houston, TX while recognizing Schizophrenia Awareness Week with informative and fun experiences for all attendees. Highlights of the evening:

  • Patrick McIlvain of The Houston Walk gave an extemporaneous talk about how we work together to help our brothers and sisters. It was well received by all in attendance. Attendees new and established learned more about schizophrenia related disorders and about the upcoming October 26th conference.
  • J.J. Essen delighted guests with his original and cover music.
  • The elegance of The Marque was heightened by the delicious served hors d’oeuvres.
  • Delighted guests got a peak at some truly exciting supercars.
  • Dr. Harris Hauser was surprised and excited to discover that SARDAA exists and welcomes the opportunity to help us succeed.
  • Dr. & Mrs. Hauser had a great time dancing to the wonderful sounds of J.J. and his turntable.
  • We thank Sameera Faridi, of Poshak, for her generous contribution of gorgeous jewelry and the design of Linda Stalters’ beautiful gown.
  • The most enchanting aspect of the evening was the continued friendships and relationships and the continued support of many volunteers: Carmen Hedley, Catalina van Meerbeke, Alex van Meerbeke, Audrey Hosie, Lisa Hosie, Katie Hosie, and Amy Larsen.  We enjoyed the fantastic international alliance and friendships.
We also thank our photographer, Brittany Taylor.
Auction Item – Houston Motor Club Dream Drive

Auction Item – Houston Motor Club Dream Drive

Auction Items

Auction Items – Alongside of Poster presentation of Children diagnosed with schizophrenia – The Marque Dinner for 2, Wine and Petron Basket, Painting “Sun Falls”

K. David & Mary Kay Quackenbush, Cynthia Wood

K. David & Mary Kay Quackenbush, Cynthia Wood

Russ Stalters, Orlando Cardenas, Jason Jimenez

Russ Stalters, Orlando Cardenas, Jason Jimenez

K. David & Mary Kay Quackenbush

K. David & Mary Kay Quackenbush

Jason Jimenez, Orlando Cardenas, Aymeric Martinoia

Jason Jimenez, Orlando Cardenas, Aymeric Martinoia

Jennifer Smith & Linda Stalters

Jennifer Smith & Linda Stalters

Lisa & Katie Hosie

Lisa & Katie Hosie

Patrick and Griselda Combe with daughter Karine and friend Daniel

Patrick and Griselda Combe with daughter Karine and friend Daniel

Dr. & Mrs. Hauser

Dr. & Mrs. Hauser

Jason Jimenez & Orlando Cardenas

Jason Jimenez & Orlando Cardenas

Aymeric & Susana Martinoia, Jason & Jessica Jimenez

Aymeric & Susana Martinoia, Jason & Jessica Jimenez

Katie, Lisa & Audrey Hosie

Katie, Lisa & Audrey Hosie

C. Patrick McIlvain, Dr. & Mrs. Hauser

C. Patrick McIlvain, Dr. & Mrs. Hauser

Linda Stalters & Mike Alsup

Linda Stalters & Mike Alsup

Mike Alsup & Cynthia Wood

Mike Alsup & Cynthia Wood

Jennifer Smith, Linda Stalters

Jennifer Smith, Linda Stalters

Dr. & Mrs. Hauser dancing to JJ Essen

Dr. & Mrs. Hauser dancing to JJ Essen

Dr. & Mrs. Hauser dancing to JJ Essen

Dr. & Mrs. Hauser dancing to JJ Essen

  • C. Patrick McIlvain, Carmen Hedley, Darren Hedley, Marvin Joiner

    C. Patrick McIlvain, Carmen Hedley, Darren Hedley, Marvin Joiner

    Jason Jimenez, Aymeric Martinoia and Linda Stalters
    Jason Jimenez, Aymeric Martinoia and Linda Stalters

Cynthia Wood & Mary Kay Quackenbush

Cynthia Wood & Mary Kay Quackenbush