TITLE: Suicide Most Common Cause of Death in People w/
Schizophrenia—"Need for Continuous Suicide-Prevention Efforts for People
w/ Schizophrenia"
Thank you Dr. Pope
-- Forwarded --
The American Psychiatric Association issued the following news release:
Suicide Most Common Cause of Death in People With Schizophrenia, Study Finds
Suicide is the most common cause of death in patients who have
schizophrenia spectrum disorders, a study in Schizophrenia Bulletin has
found.
Marie Stefanie Kejser Starzer, M.D., of Copenhagen University Hospital
and colleagues analyzed data from the OPUS I study, a randomized
controlled trial of 578 patients experiencing their first episode of
psychosis. Patients enrolled in the study between January 1, 1998, and
December 31, 2000. When the patients enrolled, they were between 18 and
45 years old; had received first-time treatment for a diagnosis of
schizophrenia, schizotypal disorder, delusional disorder, acute or
transient psychosis, schizoaffective disorder, or nonspecific nonorganic
psychosis; and had not received antipsychotic medication for more than
12 weeks. They were randomized to receive treatment as usual or a
specialized early intervention that consisted of two years of assertive
community treatment (including family involvement, social skills
training, and psychoeducation) by a multidisciplinary team. Patients
were then assessed multiple times over a 20-year period.
By the end of 2021, 14.2% of the patients had died. Of those, 48.6% died
of external causes (for example, suicide or accidents) and 51.4% died of
medical conditions and diseases.
The most common cause of death was suicide, accounting for 27.8% of
deaths; followed by accidents at 13.9%; unspecified medical
abnormalities at 11.1%; and cardiovascular disease and cancer, both at 8.3%.
Death due to external causes, mostly suicide, occurred at a steady rate
throughout the study, whether the patients had received treatment as
usual or the specialized early intervention. Starzer and colleagues
wrote that this indicates a need for continuous suicide-prevention
efforts for people with schizophrenia.
“Early intervention services alone cannot address this issue, as the
risk [was] present long after [the specialized early intervention]
ended,” they wrote. “Perhaps more regular screening for suicide risk in
aging patients with schizophrenia could help prevent some of these late
suicides.”
Patients with a history of substance use had a higher risk of both
all-cause mortality and death from medical conditions and diseases.
“This underlines the importance of proper treatment of comorbid
substance use at any time after patients are diagnosed,” the researchers
wrote. They noted that the treatment of mental illness and the treatment
of substance use are often managed by separate entities. “Lack of
integrated treatment could be leading to suboptimal care for
dual-diagnosis patients, and a more multidimensional and non-categorical
treatment approach is needed.”
-- Forwarded Message ---
Subject: Many Long-Covid Symptoms Linger Even After Two Years, New Study Shows
Date: Mon, 21 Aug 2023 10:47:30 -0700
The Washington Post includes an article: “Many long-covid symptoms linger even after two years, new study shows” by Amy Goldstein.
Here are some excerpts:
People who endured even mild cases of covid-19 are at heightened risk two years later for lung problems, fatigue, diabetes and certain other health problems typical of long covid, according to a new study that casts fresh light on the virus’s true toll.
The analysis, published Monday in the journal Nature Medicine, is believed to be the first to document the extent to which an array of aftereffects that patients can develop — as part of the diffuse and sometimes debilitating syndrome known as long covid — linger beyond the initial months or year after they survived a coronavirus infection.
According to the findings, patients who suffered bouts of covid severe enough to put them in the hospital are especially vulnerable to persistent health problems and death two years after they were first infected. But people with mild or moderate cases are not spared from the consequences when compared with those who never had covid, showing an elevated risk of two dozen medical conditions included in the analysis.
The study highlights the burden that continues to confront millions of people in the United States and the nation’s health-care system even though the federal government canceled the coronavirus public health emergency three months ago and the World Health Organization has declared the pandemic no longer a public health emergency of international concern.
“A lot of people think, ‘I got covid, I got over it and I’m fine,’ and it’s a nothingburger for them. But that’s not everything,” said the study’s senior author, Ziyad Al-Aly, a clinical epidemiologist at Washington University School of Medicine in St. Louis. After a couple of years, “maybe you’ve forgotten about the SARS-CoV-2 infection … but covid did not forget about you. It’s still wreaking havoc in your body,” said Al-Aly, chief of research at the Veterans Affairs St. Louis Health Care System.
<snip>
Long covid remains a murky syndrome. Investigators participating in a growing body of research define it by different symptoms and different time frames, and some clinicians still do not always regard patients’ complaints as a serious phenomenon. According to Al-Aly, just two other known studies have used two-year time horizons, but they focused on a narrow group of symptoms, such as nervous system effects.
Estimates vary of how many people go on to suffer significant aftereffects. One analysis of nearly 5 million U.S. patients who had covid, based on a collaboration between The Washington Post and electronic health records company Epic, found that about 7 percent of those patients sought care for long-covid symptoms within six months of their acute illness. At the time, about 200 million people in the United States were known to have had covid, so that percentage translated into about 15 million with symptoms typical of long covid.
The new study is based on electronic medical records from VA databases of nearly 139,000 military veterans diagnosed with covid early in the pandemic, from March 2020 through the end of that year. They were compared with a group of nearly 6 million veterans not known to be infected with covid during that time. Both groups were tracked every six months to the two-year mark, looking at whether those who had been infected had higher rates of about 80 conditions typical of long covid. The study also looked at hospitalizations and deaths.
For the relatively small share of covid survivors who had been hospitalized, they had a heightened risk two years later of death, subsequent hospitalization and two-thirds of the medical conditions included in the analysis. Among those conditions: cardiovascular issues, blood clotting trouble, diabetes, gastrointestinal problems and kidney disorders. The survivors and the uninfected had started out in similar health, Al-Aly said, so the findings suggest the virus actually produced the heightened risk of lingering medical problems.
For the bulk of covid survivors in the study with milder cases, their long-term risks were less but not entirely gone. By six months after having tested positive, they were no more likely to die than people uninfected by covid. And their elevated risk had virtually disappeared by then for two-thirds of the conditions measured in the study, though they still displayed greater odds after two years of medical problems involving some organ systems, including cardiovascular and gastrointestinal trouble and blood clotting, along with diabetes, fatigue and lung issues.
Francesca Beaudoin, an emergency room physician and clinical epidemiologist who directs Brown University’s long-covid initiative, said the findings “capture what we are hearing at the narrative level from patients — that … the systems [affected after recovery from covid’s acute phase] are varied, that it results in loss of quality of life, loss of work and school.” Beaudoin said patients send her updates, reporting they still cannot walk one block without becoming worn out.
The study’s good news is that some people with milder covid cases do have fewer aftereffects over time, said Eric Topol, director of the Scripps Research Translational Institute who has been immersed in coronavirus research. But he said, “you don’t see a lot of optimism in these data. It’s basically a continuation of what we see at one year.”
The Nature Medicine paper noted that the covid survivors tracked in the analysis are not entirely representative of who is most likely to develop long covid. Because the patients in the study are veterans, the group is older than typical, and nine out of 10 are men, while women account for more than half of long-covid patients in the general population.
Topol pointed out that because the study included only patients infected in 2020 — which allowed a two-year time span to follow them — they had the virus before coronavirus vaccines were widely available and before antiviral treatments such as Paxlovid had been developed. That also was a period before people tended to have built up immune defenses from one or more covid infections.
“The whole landscape has evolved,” Topol said. Compared with people infected later in the pandemic, those in the study were “a defenseless population.”
Al-Aly said he and co-authors are working on a three-year analysis and plan to assess the same patients five years and a decade after they first developed covid.
“Obviously, we can’t predict the future,” said Akiko Iwasaki, an immunologist at the Yale School of Medicine who researches long covid. But she noted that omicron — a coronavirus variant that has spawned subvariants and dominated since late 2021 — is known to cause long covid. “We would expect some sort of parallel” with the study’s findings, she said. “It’s not a different virus, even though it’s a variant.”
Covid is not the only viral outbreak that has produced long-term aftereffects. Topol noted that people who survived the 1918 influenza pandemic had an elevated risk of developing Parkinson’s disease years later, while some people who had polio in the first half of the 20th century developed a constellation of symptoms known as post-polio syndrome decades afterward.
<snip>
Slightly more than 1 million people in the United States have died of covid, according to the Centers for Disease Control and Prevention.
The WHO reports more than 103 million confirmed cases in this country.
TITLE: Lithium May Reduce Psych Hospitalizations for People w/ Bipolar
OR MAJOR DEPRESSIVE DISORDER—N=260
Thank you Dr. Pope.
-------- Forwarded Message --------
The American Psychiatric Association issued the following news release:
Lithium May Reduce Psychiatric Hospitalizations in People With Bipolar,
Major Depressive Disorder
Taking lithium may significantly reduce the risk of psychiatric
hospitalization for people who have major depressive disorder or bipolar
disorder, a study in the Journal of Affective Disorders has found.
Maurizio Pompili, M.D, Ph.D., of Sapienza University in Rome and
colleagues analyzed data from the health records of 260 adult patients
who had either major depressive disorder or bipolar disorder and had
been admitted to the psychiatric unit of Sant’Andrea University Hospital
in Rome between February 2019 and August 2020.
The researchers compared the patients’ psychiatric hospitalization rates
for the 12 months before they started taking lithium with their
hospitalization rates during the first 12 months of taking lithium.
In the 12 months before taking lithium, 40.4% of the patients were
hospitalized, whereas only 11.2% of patients were hospitalized while
taking the drug.
This represents a 3.62-fold reduction in hospitalization during lithium
treatment.
The risk of hospitalization did not differ significantly between
patients with major depressive disorder and patients with bipolar
disorder either before or during treatment with lithium, suggesting that
taking lithium similarly benefitted both groups of patients.
Pompili and colleagues wrote that this finding was “unexpected,” as
other studies have suggested that lithium is more effective in patients
with bipolar disorder than those with major depressive disorder.
The risk of hospitalization also did not differ significantly between
patients who took only lithium and patients who also took other
psychotropic medications, with the exception of patients who also took
antipsychotics: Patients who took an antipsychotic along with lithium
had 21.1 times the odds of being hospitalized than those who did not
take an antipsychotic.
“An association of co-treatment with an antipsychotic plus lithium among
patients who required hospitalization probably represents greater
illness severity,” the researchers wrote.
Last RT - many mental health providers I know (myself included, though less often nowadays) use zoom for clinical work/meetings/teletherapy. We’ve been told by the company itself, by the health insurance industry, and by our agencies that it’s HIPAA compliant and safe/ confidential to use.
Is anyone out there talking about or able to explain the implications of the TOS change for this use case? #socialwork#telehealth#zoom#HIPAA
I have started sending out cold mails to professors in #socialwork seeking a graduate research opportunity/position in their respective labs. if you are or know of a professor who is #hiring and wish to take masters student for Social Work, I'm opened for recommendations to reach out to them.
TITLE: YouTube Pseudo-Psychology, Algorithm Traps, and How I Got Set-Up
to Look Like I Cheat
My wife and I share a YouTube Premium subscription. A few weeks ago I
was scrolling through YouTube recommendations when I came across a video
on different male personality types.
"Sure", I thought, "I'm a therapist -- why not check it out". So I
watched the video as it invited me to try and decide which type of male
I was as they described them. I noticed they made the "Sigma Male"
sound the most attractive -- which was a bit odd -- but I thought little
more about it.
A few weeks later (tonight), up popped a video on 10 characteristics of
a "Sigma Male". I was curious, so I watched it. They spent the whole
video making "Sigma Males" seem like super heroes. Suspicious now, I
went to the channel these videos were coming from to look around.
I was displeased to see that 10% of the videos were on male personality
characteristics, and 90% of the videos were dedicated to how Sigma
Males Get Women. Video after video of how to bag yourself a blonde or
brunette. Yuck.
You can guess where this is going -- now our shared YouTube
recommendations list is full of how-to videos on attracting hot women.
The uncool thing is I have never watched any such video to deserve
this. The really uncool thing is my wife will be spotting this
tomorrow. Happily -- she is very understanding and not the jealous type.
Besides -- she can always look at my view history. I'll also be sending
her this message. :)
Is there actually a valid psychological theory outside pop psychology
including "Sigma Males"? When I Google it, I get lots of pop psychology
websites, including something called the "Incel Wiki".
Now I do feel slightly ill.
-- Michael
APPENDED NOTE:
I sent the original note above out a few days ago on a national psych
listserv and it engendered some relevant psychological discussion on how
AI and algorithms effect the mental health of our clients.
Happily my wife thought the note and situation above hilarious (I
thought she might).
Part of what was so troubling to me here was the clear funneling process
being executed on vulnerable young men on YouTube:
STEP 1: Grab guys just interested in learning about themselves. (Or
psychotherapists interested in personality systems.)
STEP 2: Make "Sigma Males" sound like the most attractive type so they
are identified with. (Lonely geeks are recast as desirable lone wolf
types with all the skills of alpha males.)
STEP 3: Game the YouTube algorithm so the next recommendations are how
"Sigma Males" get women. (I decided to bail at this point so I am not
going to view what is being recommended. Judging by the fact that "Sigma
Male" connects in Google searches to Incel websites, I shutter to think...)
[It's possible that "Sigma Male" is a term from a legitimate personality
system, but if so, its been at least partially co-opted by pop psychology.]
A discussion commenter stated: /"The mental health challenge is to help
people become aware of how AI is taking over their lives so that they
can manage the AI rather than have the AI manage them."/
My new resolve to periodically create new YouTube profiles to get out of
old tracking algorithms is one example of an adaptation.
*People need other ways to escape tracking to get out of boxes* -- like
the old BBS (bulletin board systems) that let you read (or not read)
every community comment from every poster without algorithms tailoring
your newsfeed.
*People need tools to recognize when they are being herded into specific
ways of thinking.* Like many of our political silos. Like my original
example above of an interest in male psychology potentially leading to
Incel-like "education" on how to be a "Sigma Male" who gets all the women.
*Businesses need some government regulation in what tracking they can do
-- in all environments, but especially the free ones.* People may need
to return to PAYING for their information sources so they themselves are
not the product.
Ironically, it was GOOGLE, whose "I'm feeling lucky" button below the
search engine field used to take users to a random website somewhere on
the Internet.
*We are now in need of actively maintaining personal ways to randomly
escape our information bubbles so as to better recognize them.**
***
-- Michael
*Michael Reeder, LCPC
*
*Hygeia Counseling Services : Baltimore / Mt. Washington Village location*
*410-871-TALK / michael(at)hygeiacounseling.com*
#psychology #socialwork #psychotherapy #research #incel #AI
#artificialintelligence #youtube #mentalhealth @[email protected]
@[email protected] @[email protected] @[email protected]
#Algorithms #personalitytests @silos