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  • Targeting depression can help diabetes patients improve overall health :: U-M Psychiatry and Depression Center Newsroom
    of the program used pedometers to help patients set walking goals and monitor their progress Along with physical benefits exercise also helps boost one s mood Most patients entered the study with relatively good blood glucose control So while the intervention did not lead to a drop in A1C a common measurement of blood glucose levels patients did see more than a 4 point improvement in their systolic blood pressure walked about half a mile more per day and reported an improvement in their general quality of life At the end of the year 58 percent of patients who received the intervention had depression symptoms that were in remission compared to only 39 percent of the patients who did not receive counseling Health systems should consider routinely offering structured telephone psychotherapy to their patients with diabetes and depression says senior study author Marcia Valenstein M D M S an associate professor of psychiatry at the U M Medical School and VA research scientist Patients with depression and additional chronic medical conditions do better if their depression is addressed first if it is addressed systematically and if exercise is also encouraged Delivering therapy by telephone makes it feasible to reach large numbers of patients who may not attend traditional in person appointments Methods 291 patients with type 2 diabetes and significant depressive symptoms completed the study 145 received the intervention which consisted of 12 weeks of cognitive behavioral therapy over the phone followed by nine monthly booster sessions After six weeks a pedometer based walking program was introduced Depression coping and quality of life measurements were taken using standardized scales Funding The research was funded by grants from the National Institutes of Health Michigan Diabetes Research and Training Center and the Michigan Institute for Clinical and Health Research Additional authors Caroline

    Original URL path: http://ummentalhealth.info/2011/04/19/targeting-depression-can-help-diabetes-patients-improve-overall-health/ (2016-05-02)
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  • High pain med prescriptions raise risk of overdose :: U-M Psychiatry and Depression Center Newsroom
    out of an estimated 1 8 million people treated with the drugs or about 4 for every 10 000 patients with a prescription To find out whether any particular characteristic might signal that a person was at higher risk for such a problem the researchers compared the people who died of an overdose with those who didn t They found that patients who were prescribed higher doses and thus had access to more painkillers at any given time were more likely to accidentally overdose For example patients suffering from chronic or acute pain who were prescribed opioids at 100 milligrams per day or higher were between 6 and 8 times more likely to overdose than those with prescriptions for 1 to 20 mg day Painkiller users who accidentally overdosed were also more likely to have problems with substance abuse or to suffer from mental illness according to the findings which are published online today in the Journal of the American Medical Association JAMA In certain cases a high dose of opioid narcotics is appropriate For cancer patients for instance the National Cancer Institute NCI advises that when an opioid doesn t give enough pain relief doctors may increase the dose or have the patient take the painkiller more often or prescribe a stronger drug Both methods are safe and effective under your doctor s care the NCI says on its web site But patients must not increase the dose of medication on their own the NCI emphasizes Bohnert said that there are likely two explanations behind the pattern she and her colleagues observed The first she said is that people on higher doses of opioids have more opportunity to accidentally take too much medication in the course of their normal treatment The other explanation is that some patients with chronic pain intentionally misuse their drugs saving them to use recreationally and then overdose in that context Whether a particular patient in pain is at risk for misusing or abusing their drugs is something that should be considered whenever heavy duty painkillers are being prescribed Bohnert said Doctors patients and their families can work together to decide what is the right treatment for that patient she said Then they can weigh the balance of untreated pain with the risk of overdose on a patient by patient basis Dr Nora Volkow the director of the National Institute on Drug Abuse and colleagues also reported in this week s JAMA that many patients taking opioid medications get them from multiple doctors or dentists at the same time Along with more open discussion about the risks of pain medications between doctors and patients she said there needs to be better monitoring in place so that doctors can see which patients might be abusing their drugs and getting them from multiple sources But addressing the problem of opioid related overdoses is not as simple as trying to cut down on cocaine abuse for example Volkow said It is a problem that we re facing of

    Original URL path: http://ummentalhealth.info/2011/04/06/high-pain-med-prescriptions-raise-risk-of-overdose/ (2016-05-02)
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  • Caring partners central to program for depression treatment :: U-M Psychiatry and Depression Center Newsroom
    the patient s care and an outside person provides an additional point of support The program gives patients an opportunity to talk about feelings that they wouldn t have otherwise shared says John D Piette Ph D professor of internal medicine at the U M Medical School It gives the partners an opportunity to show the patient that someone does care about them and is paying attention to how they re doing Besides keeping their partner updated the automated system provides patients with immediate feedback about changes in their depressive symptoms and access to additional support tools If a patient reports an urgent health problem their doctor will also be notified Initial results have been positive with a strong majority of patients reporting improvement in managing their depression symptoms taking their medication and staying active says Piette who is also a senior research scientist with the VA Ann Arbor Healthcare System Patients also reported the program had strengthened their relationship with their partner The CarePartner Program is an initiative by the Quality Improvement for Complex Chronic Conditions group which is directed by Piette and supported by the VA and U M The group s mission is to improve health outcomes and lower costs by finding ways technology can be used innovatively and efficiently to help patients self manage chronic diseases The group s other programs have addressed management of diabetes heart failure and cancer U M s West Ann Arbor Heath Center and Saline Health Center are currently offering the CarePartners program to patients with depression Doctor and patient inquiries can be addressed to Liz Kaselitz M S W at emaccorm med umich edu or 734 845 3673 Recent Entries Dr Monica Starkman professor emeritus publishes novel based on career in psychiatry Who gets hooked on drugs who stays clean

    Original URL path: http://ummentalhealth.info/2011/03/30/caring-partners-central-to-program-for-depression-treatment/ (2016-05-02)
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  • research :: U-M Psychiatry and Depression Center Newsroom
    story U M participates in nationwide study to compare two mood stabilizing medications for bipolar disorder January 18 2011 ANN ARBOR Mich The University of Michigan is participating in a new clinical trial to compare the effectiveness of two medicines commonly used to treat bipolar disorder U M is one of 10 sites in the Bipolar Trials Network that will participate in the national study which is supported by a federal Read this story Resurrecting the so called depression gene January 3 2011 ANN ARBOR Mich University of Michigan Health System researchers have found new evidence that our genes help determine our susceptibility to depression Their findings published online today in the Archives of General Psychiatry challenge a 2009 study that called the genetic link into question Read this story Unlocking the secrets of our compulsions December 9 2010 New findings on how rats make choices may provide insights into addiction and impulse driven behavior ANN ARBOR Mich Researchers have shed new light on dopamine s role in the brain s reward system which could provide insight into impulse control problems associated with addiction and a number Read this story Researchers track the impacts of depression during pregnancy December 9 2010 Babies born to depressed moms have higher levels of stress hormones decreased muscle tone U M study finds ANN ARBOR Mich The cocktail of hormones cascading through depressed mothers bodies may play an important role in the development of their unborn children s brains A higher level of Read this story U M study pep talks to teens in the ER reduce violence alcohol misuse August 3 2010 Teens in the ER got the message about avoiding fights and drinking study shows Ann Arbor Mich A brief motivational talk in the emergency room reduced by half the chances that

    Original URL path: http://ummentalhealth.info/tag/research/page/6/ (2016-05-02)
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  • Bias found in mental health drug research presented at major psychiatric meeting :: U-M Psychiatry and Depression Center Newsroom
    presentations were positive and 24 1 percent contained mixed results while 7 2 percent contained negative results This presentation bias in which mostly good news about medicines gets reported at meetings echoes the publication bias that has been seen in research published in major journals says Srijan Sen M D Ph D an assistant professor of psychiatry at the U M Medical School who led the study while in his residency at Yale While attending the APA s massive annual meeting he noted the large industry presence and emphasis on research involving medicines that were still on patent and being actively marketed to both psychiatrists attending the conference He teamed with Yale psychiatry resident Maya Prabhu M D M Sc now a consulting forensic psychiatrist at Yale to do a formal review This analysis suggests that the APA meeting might be being used as an opportunity to make drugs seem more effective than they are he says Meanwhile research on talk therapy treatments such as cognitive behavioral therapy which doesn t have industry backing gets less attention even though there is growing evidence that such non drug therapies can have as much effect as medicines in illnesses such as depression Since the APA meeting is a major source of continuing medical education credit for psychiatrists and a hub for psychiatry residents just starting out in the field the bias has the potential to affect their clinical care when they return home Sen notes that the research journals and funding agencies have tried to confront research bias in journal articles by requiring pharmaceutical companies to register the clinical trials they are conducting and include the registration number when publishing the study This allows interested individuals to see which trials are being reported in the medical literature and whether the trial results are interpreted according to the original study design For instance if a drug trial is designed to test long term results from a particular treatment but a paper is published showing positive results over a much shorter term that could be an indication of bias Research meetings could require a similar practice Sen says And APA could be more selective in accepting poster presentation submissions If nothing else Sen says attendees at the APA s meeting and perhaps other large gatherings of psychiatrists should be aware of the positive bias of the research they will hear about at the meeting And non industry funding for research especially research to compare older off patent drugs that aren t being marketed by industry is also important he says The federal government has funded large comparison studies in depression schizophrenia and bipolar disorder he notes and these mostly showed that the generic medications that have lost their patent protection are just as effective as newer patent protected ones But even still psychiatrists prescribe the generic ones far less often than the brand name patent protected ones The study was supported by grants MH095109 and UL1RR024986 from the National Institutes of Health In 2009

    Original URL path: http://ummentalhealth.info/2012/05/22/bias-found-in-mental-health-drug-research-presented-at-major-psychiatric-meeting/ (2016-05-02)
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  • U-M experts probe psychiatric diagnosis guide :: U-M Psychiatry and Depression Center Newsroom
    the grief exclusion in diagnosing major depression is just one example of a push to define psychiatric disorders according to their causes and brain pathology But Nesse and Stein point out that the rest of medicine recognizes many disorders that do not have specific causes Conditions such as congestive heart failure can have many causes Nesse said This doesn t bother physicians because they understand what the heart is for and how it works to circulate blood Furthermore he said physicians recognize symptoms such as fever and pain as useful responses not diseases These symptoms can be pathological when they re expressed for no good reason but before considering that possibility physicians look carefully for some abnormality arousing such symptoms Nesse said Likewise the utility of anxiety is recognized but its disorders are defined by the number and intensity of symptoms irrespective of the cause It s vital to recognize that emotions serve functions in the same way that pain cough and fever do and that strong negative emotions can be normal responses to challenging or anxiety provoking situations So as the DSM is revised once again Nesse urges his colleagues and concerned members of the public to adopt realistic expectations Instead of specific diseases with specific causes many mental problems are somewhat heterogeneous overlapping syndromes that can have multiple causes he said Most are not distinct species like birds or flowers They are more like different plant communities each with a typical collection of species Distinguishing tundra from alpine meadow arboreal forest and Sonoran desert is useful even though the categories are not entirely homogenous and distinct Nesse is the co author with George Williams of the book Why We Get Sick The New Science of Darwinian Medicine He is a professor of psychiatry at the U M Medical

    Original URL path: http://ummentalhealth.info/2012/02/16/psychiatric-diagnoses-why-no-one-is-satisfied/ (2016-05-02)
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  • Suicide risk among pregnant women and new moms :: U-M Psychiatry and Depression Center Newsroom
    long time But this data tells us for example that pregnant and postpartum women had a much higher incidence of conflicts with intimate partners than their counterparts Palladino continues Postpartum women were also more likely to have been identified as having a depressed mood in the two weeks prior to suicide than other women the study found Also important researchers found many similarities that did not vary significantly by pregnancy status 56 percent of all victims had a known mental health diagnosis 32 percent had previously attempted suicide and 28 percent had a known alcohol or substance abuse issue at the time of death Depression and substance use are risk factors for everyone including pregnant and postpartum women Gold adds The researchers also found that while education level and marital status were very similar across pregnant postpartum and non pregnant suicides Hispanic women were far more likely to take their own lives while pregnant 10 percent of suicides among pregnant women or within a year of pregnancy 9 percent of postpartum suicides than when not pregnant 4 percent of non pregnancy associated suicides The researchers acknowledge some inherent limitations of the data Their sample of 2 083 suicides among women of plausible child bearing age 15 54 was drawn only from the 17 states where data was available It is also was impossible to interview the victims and get a full picture of mental health conditions unreported domestic violence and other precipitating factors As a society we tend to avoid talking about suicide Gold says But it s important to try to understand and talk about risk factors if we are going to address suicide from a public health perspective Press release from UMHS News http www uofmhealth org news pregnancy suicide 1130 Additional authors Sheila M Marcus M D

    Original URL path: http://ummentalhealth.info/2011/11/30/suicide-risk-among-pregnant-women-and-new-moms/ (2016-05-02)
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  • After pregnancy loss, Internet forums help women understand they are not alone :: U-M Psychiatry and Depression Center Newsroom
    look at who uses Internet message boards after a pregnancy loss and it demonstrates a significant disparity between the women who experience loss and those who responded to the survey says lead study author Katherine J Gold M D M S W M S assistant professor of family medicine at the U M Medical School and a U M Depression Center member This suggests an important gap in support for African American parents that should be explored further By far the most common reason women gave for participating in the message boards was that it helped them to feel that their experience wasn t unique One woman explained that the most important aspect of the forums was knowing that I am not the only one this has happened to and that I am not alone in this horrible nightmare Another common theme was that the online environments provided a safe and validating space for the women to express themselves Others appreciated the ease and convenience of the Internet and their ability to spend more time composing their thoughts than they would be able to in a face to face conversation Most participants agreed that boards should have a moderator or facilitator and that health care professionals should participate Of the 908 women who answered the question 82 percent said they had learned new medical information from one of the forums The fact that so many women learned new medical information from the message boards shows what an important resource they can be in this regard says study senior author Christie Palladino M D M Sc an obstetrician gynecologist with Georgia Health Sciences University s Education Discovery Institute Gold and her colleagues are currently pursuing similar research with bereaved parents who attend in person support groups and plan to compare and

    Original URL path: http://ummentalhealth.info/2011/10/19/after-pregnancy-loss-internet-forums-help-women-understand-they-are-not-alone/ (2016-05-02)
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