Medicare covers screening and counseling for alcohol misuse and screening for depression

The Centers for Medicare & Medicaid Services (CMS) today announced two new national coverage determinations that cover alcohol misuse screening and behavioral counseling for Medicare beneficiaries as well as screening for depression. These new coverage policies add to the existing portfolio of covered preventive services, most of which are now available to people with Medicare at no additional cost.

The coverage decision on alcohol misuse screening is online at and the decision on depression screening is online at

This release may be viewed in its entirety at:

Brain Memory Finding May Help Schizophrenia Research

A variation in a part of the brain may explain why some people have a better memory of reality than others and could advance understanding of brain disorders like schizophrenia, scientists said.

In a study published in the Journal of Neuroscience, researchers from Cambridge University tested 53 volunteers and found differences in their ability to distinguish between real or imagined memories.

The scientists then found a direct link between these results and the size of a specific area of the brain called the paracingulate sulcus, or PCS.

The PCS is one of the last regions of the brain to develop before birth, and the study found that people with a larger PCS were better at discerning real experiences from imagined ones.

“The memory differences we observed were quite striking. It is exciting to think that these individual differences in ability might have a basis in a simple brain folding variation,” said Cambridge’s Jon Simons, who led the research.

The findings may also help scientists understand more about schizophrenia, he said, because an inability to recognize what is real and what isn’t is a hallmark of the disease.

“Hallucinations are often reported whereby, for example, someone hears a voice when nobody’s there. Difficulty distinguishing real from imagined information might be an explanation for such hallucinations,” Simons said. “The person might imagine the voice but misattribute it as coming from the outside world.”
Schizophrenia is a severe mental disorder which affects 24 million people worldwide, according to World Health Organization data, yet relatively little is known of its causes.

“We’ve found evidence that suggests this particular (brain)region might be reduced in people with schizophrenia, and that this could be the beginning of an explanation for why these people experience hallucinations,” Simons said in a telephone interview.

The 53 volunteers in the study first had brain scans which showed whether they had either a clear presence or absence of PCS in the left or right brain.

The researchers then showed them well-known word pairs — such as “Laurel and Hardy” for example — which were sometimes complete and sometimes had the second word blanked out.

The volunteers were then asked to remember whether they had seen a completed pair, or whether they had completed the pair in their own mind.

“What we’re interested in linking next. is whether individuals with schizophrenia who also have that reduction in the PCS are definitely more likely to experience hallucinations,” Simons said, adding that his team is planning further research in the coming months.


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Government report finds major gaps in mental health care in Indian Country

BILLINGS, Mont. (AP) — A new U.S. government report highlights serious gaps in mental health care for many American Indians and Alaska Natives, groups that suffer from problems including a teenage suicide rate more than twice the national average.

One in five hospitals and clinics in Indian Country provide no mental health services. Only half provide drug therapy treatments, and treatment often is handled by non-licensed staff at dozens of facilities.

That’s from the report by the Inspector General of the Department of Health and Human Services. It was released Friday by Montana U.S. Sen. Max Baucus, a Democrat who in 2008 requested an investigation into health care problems on reservations.

Tribal leaders on Montana’s Fort Peck Reservation last year declared a crisis after a rash of suicides at a middle school.

Associated Press

NIH funds continued research in suicide prevention in China

The National Institutes of Health Fogarty International Center has awarded $1.1 million to the University of Rochester Medical Center in support of a program that for the last 10 years has been training people in China to investigate the causes and prevention of suicide.

“Across China, a cadre of people has developed who now are becoming rigorous researchers,” said Eric Caine, M.D., chair of the Medical Center’s Department of Psychiatry and principal investigator for the program. “It has been our goal to train researchers, engage partners and build a more effective training infrastructure that would help produce more sophisticated science.’

“The research that is occurring in China is public health oriented,” Caine said. “There are lessons to learn in public mental health and preventive psychiatry that are transportable to the United States despite cultural differences.”

Suicide is a major public health problem in China. It is the fifth leading cause of death overall, and the leading cause of death for individuals in the 15-to-34-year-old age range. Although China accounts for approximately 21 percent of the world’s population, according to a recent study, 44 percent of the world’s suicides among males and 56 percent of suicides among females in one year occurred there….

Provided by University of Rochester Medical Center

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War-Torn Liberia Struggles to Care for Mentally Ill (VIDEO)

R.I. tops mental illness list

PROVIDENCE – Rhode Island has the highest rate of serious mental illness among adults in the country, according to a new federal survey published yesterday.

The study by the Substance Abuse and Mental Health Services Administration found that 7.2 percent of Rhode Islanders ages 18 or older experienced a serious mental illness at some point in the past year.

The national rate for serious mental illness is 4.6 percent. Hawaii and South Dakota shared the lowest rate, 3.5 percent.

Serious mental illness is considered one that interferes with at least one major life activity, including working or communicating.

Rhode Island also had the highest rate of adults suffering from any mental illness in the past year, according to the study. The state rate was about 24 percent, compared to just less than 20 percent nationally.

Maryland had the lowest rate, 16.7 percent.

More than 44 million people in the United States have had some kind of mental health problem in the last 12 months.

Vivian Weisman, executive director of the Mental Health Association of Rhode Island, said the numbers do not surprise her.

The state has had a high rate of depression for years, in part because of environmental triggers like high unemployment and low wages, she said.

Weisman also said Rhode Island has traditionally had a high rate of alcoholism, which is linked to depression. Domestic violence or other trauma can also lead to depression.

But Weisman suggested that part of the reason for the high rate could also be more reporting of mental illness, as the stigma is lessened and more primary care doctors are screening for it.

“We have been seeing high incidence for a long time,’’ she said. “And there has been a lot of effort to have mental illness be seen for the chronic illness it is.’’

Only about 38 percent of those with mental health problems received treatment in the past year, said Pamela Hyde, head of the Mental Health Services Administration. She stressed that mental illness is treatable and that people can recover fully.

By Erika Niedowski

Associated Press

Referral to Talk Therapy Cuts Costs, Improves Outcomes

Adults with common mental health problems such as depression and anxiety consume more health resources than those without, a new study from the United Kingdom confirms.

“This is across the board,” Professor Simon de Lusignan, MD(Res), from the Department of Health Care Management and Policy, University of Surrey, Guildford, United Kingdom, told Medscape Medical News. They have more inpatient days, outpatient and emergency department visits, and sick days than those patients without common mental health problems, he said.

Importantly, Dr. de Lusignan added, the study also shows that referring patients with common mental health problems to psychological therapy reduces healthcare utilization and sick time, and may improve adherence to drug therapy.

The improved adherence is “probably the most important finding because if people take their medications they generally will remain healthier, which will save money in the long run,” Philip R. Muskin, MD, clinical psychiatry professor at Columbia University in New York City and distinguished fellow of the American Psychiatric Association, noted in an interview with Medscape Medical News.

The study was published online October 3 in the Journal of Epidemiology and Community Health….

By Megan Brooks


A Hormone May Treat Autism, Social Disorders

Researchers are finding that a hormone in the body believed to help people form emotional bonds with each other may work to treat people with schizophrenia, autism and certain other psychiatric disorders related to social interaction.

A number of small scientific studies have been published recently suggesting that puffs of oxytocin into the nose may reduce some symptoms in people with these disorders and improve their ability to function. In particular, the hormone seemed to enhance patients’ abilities to recognize others’ emotions, which is a crucial step in improving social interactions.

Oxytocin, produced both by men and women, is nicknamed the “love hormone” because of its apparent role in building trust between people. Women, for instance produce large amounts of oxytocin during labor preceding childbirth, presumably to foster bonding with the newborn.

The hormone works by helping neurons in the brain talk to each other, although the exact mechanism isn’t understood. Researchers suggest it may increase a person’s attention to social information in the environment, make social interactions more rewarding or reduce anxiety in those situations. When sprayed in the nose, oxytocin is thought to travel along a pathway to reach the brain….


The Wall Street Journal

Talk Therapy Lifts Severe Schizophrenics

People with severe schizophrenia who have been isolated, withdrawn and considered beyond help can learn to become more active, social and employable by engaging in a type of talk therapy that was invented to treat depression, scientists reported on Monday.

These new findings suggest that such patients have far more capability to improve their lives than was previously assumed and, if replicated, could change the way that doctors treat the one million patients for whom the disorder is profoundly limiting.

The therapy — a variant of cognitive behavior therapy, which focuses on defusing self-defeating assumptions — increased motivation and reduced symptoms. In previous studies, researchers have used cognitive techniques to help people with schizophrenia manage their hallucinations and sharpen their attention and memory. The new study is the first to rigorously test using the therapy to combat so-called negative symptoms — the listlessness, exhaustion and emotional flatness that trap many people in solitary lives, playing out their days smoking in front of the TV or holed up in their homes….


New York Times

Trillion-dollar brain drain

Enormous costs of mental health problems in Europe not matched by research investment.

Brain disorders cost Europe almost €800 billion (US$1 trillion) a year — more than cancer, cardiovascular disease and diabetes put together. That’s the conclusion of a report1 commissioned by the European Brain Council that provides the most comprehensive assessment of the financial consequences of mental ailments so far.

The report’s authors argue that these enormous costs — which exceed the entire gross domestic product of the Netherlands — mean that research into brain disorders receives disproportionately little funding compared with other diseases. They call on politicians and funders to step up support for basic research on these conditions, which are so costly because they often require long-term care and erode the productivity of those affected for years or decades…


by Kerri Smith

Nature News