TITLE: Correctional Psych: Links to 15 Articles on Addressing the Mental Health Needs of Justice-Involved Individuals in Custody & the Community
Thank you Dr. Pope.
-------- Forwarded Message --------
Correctional Psych: Links to 15 Articles on Addressing the Mental Health Needs of Justice-Involved Individuals in Custody & the Community
Psychiatric Services issued the following announcement about a curated collection of articles:
Correctional Psychiatry: Addressing the Mental Health Needs of
Justice-Involved Individuals in Custody and the Community
/Editor’s Choice provides essential curated collections from recent issues of Psychiatric Services/.
The legal aims of the correctional system are to protect the community and to punish, deter, and offer rehabilitation to the offender. These goals may be at odds with the aims of psychiatric providers working in such settings. Consequently, jails and prisons can be challenging settings for the provision of mental health services for patients, providers, and the correctional staff. Even so, encounters with the criminal justice system can create opportunities for individuals with a severe mental illness, a substance use disorder, or both to obtain needed treatment that may otherwise be unavailable or difficult to access or that an individual would not choose to pursue in the community. With the development of diversion models and community-based forensic programs, such patients now have access to unique treatment strategies addressing concomitant legal and mental health needs.
This collection provides an update regarding correctional mental health care. The provision of mental health services within correctional environments continues to pose unique challenges, such as limited access to medications that are readily available in the community. Diversion programs that transition justice-involved individuals with mental illness from traditional criminal justice pathways toward treatment may reduce the burden of severe mental illness within correctional facilities and the risks to patients in such settings. At the same time, patients may be hesitant to engage in systems that they perceive to be coercive or overbearing. Innovations in meeting the mental health needs of incarcerated and justice-involved patients remain vital due to the ongoing high prevalence of mental illness and barriers to care faced by these populations. /Brian Holoyda, M.D., M.P.H./ /Jacqueline Landess, J.D., M.D./ /Lisa B. Dixon, M.D., M.P.H. /
a) It's timely and vaguely related to the Iowa transgender material,
b) It's about a psychology professor,
c) It mentions Univ. of Florida turning over to the state government the mental health records of transgender students (!!)
See below.
Thank you Dr. Pope.
--- Forwarded Message ---
Subject: Psychology Prof Brought Millions to FL State U, Now Warns of Unsafe "Hostile Environment" for Black & LGBTQ Students, Faculty, & Staff
Date: Fri, 08 Dec 2023 07:01:51 -0800
From: [email protected]
The Tallahassee Democrat includes an article: “This professor brought millions to Florida State. Now he's leaving a 'hostile’ environment” by Walter R. Boot, Ph.D.
Here’s the author note:
Walter R. Boot, Ph.D., is a professor of psychology at Florida State University and has been a member of the FSU faculty since 2008.
Here are some excerpts:
In early 2022, “Don’t Say Gay'' became law based on the premise that the mere mention of LGBTQ people is dangerous. The run-up and aftermath of its passage involved hostile rhetoric painting queer and trans individuals as pedophiles and groomers, rhetoric that came not just from citizens but from state officials.
As it became increasingly clear that LGBTQ students, faculty, and staff at Florida State University had targets on their backs, I explained my concerns in an April 2022 email and made a simple request of FSU President Richard McCullough: give us a reason to stay.
<snip>
His response was something along the lines of, “If I say or do anything, I will be fired, and my replacement will be worse.” His office tells me that he disputes this account.
Later, I was told his refusal to express support was because “the University’s 501(c)(3) status limits the University’s participation in political advocacy.” My concerns were dismissed as mere politics. Since then, matters have only gotten worse.
In December 2022, the FBI alerted FSU to a threat of mass violence against gay people on campus. FSU has yet to acknowledge this threat publicly. We learned about it only through a newspaper article the next month after an arrest had been made.
Alarmed by this incident and concerned for campus safety, I again pressed President McCullough’s office to express support for queer and trans community members publicly. They did not.
Gov. DeSantis then demanded that universities turn over information about transgender students. Information requested included intimate information about treatments, surgeries, mental health diagnoses, and facilities that transgender students were referred to for care. FSU complied with this request, shifting its response from silence to active harm.
<snip>
Equality Florida and the Human Rights Campaign have issued travel advisories citing the very real perils of traveling to or living in Florida while queer or trans. At FSU, these perils are exacerbated by uncaring leadership.
I will be leaving FSU at the end of this year. The purpose of my message is not to change the mind of members of the administration. Any additional efforts seem futile. It is to foreshadow the experience of anyone considering FSU as their home, particularly individuals who are Black, trans, gay or lesbian, queer, or who belong to any other group currently under siege by the state of Florida.
I brought millions of dollars of funding to FSU, volunteered for service roles demanding significant commitments, and stepped up to teach classes no one else could or would. I went above and beyond what is required again and again.
Yet, President McCullough remains unwilling to even offer a few words of public support for queer and trans members of the FSU community.
If you are considering FSU as your home, do not expect them to make any effort to support or protect you in an increasingly hostile and dangerous environment for people like us. Consider your options carefully. You deserve better than what FSU has to offer.
Ken Pope
Ken Pope, Nayeli Y. Chavez-Dueñas, Hector Y. Adames, Janet L. Sonne, and Beverly A. Greene
Speaking the Unspoken: Breaking the Silence, Myths, and Taboos That Hurt Therapists and Patients (APA, 2023)
Hector Y. Adames, Nayeli Y. Chavez-Dueñas, Melba J.T. Vasquez, & Ken Pope:
Succeeding as a Therapist: How to Create a Thriving Practice in a Changing World (APA, 2022)
Ken Pope, Melba J.T. Vasquez, Nayeli Y. Chavez-Dueñas, & Hector Y. Adames:
Ethics in Psychotherapy & Counseling: A Practical Guide, 6th Edition (Wiley, 2021)
“When people show you who they are, believe them the first time.”
—Maya Angelou
Iowa Senate File 538- gender transition procedures related to minors strips providers of Medicaid funding from Sept 18 forward and doesn't allow Medicaid to be used by clients for gender affirming treatment. If a counselor has a transgender client, and has used the gender dysphoria code and many others (7 pages of ICD codes) then they will be retroactively stripped of funding. I am so angry for clients and for providers. As a clinician, I feel so mad that states are telling transgender youth in lower SES that they can't be who they truly are, and now they can't even talk to a counselor. I just can't. @socialwork@Email2TootBot#SocialWork#psych#psychology#iowa#lgbtqia#transgender#transgenderrights#counseling#counselor#therapist#therapy
Christine -- This is horrible! What do you mean by retroactive? Does Iowa Senate File 538 claw back past payments? Cut providers off from Medicaid for past use of those billing codes? Does it totally drop those providers from the Medicaid program?
I'll go read this bill when I can -- clients in a moment to see.
Okay -- quick look -- seems already signed by the governor but not in force yet. Is this tied-up in court?
I'm copying a public post below from an interesting Assistant Professor of Philosophy and Data Science at UNCC (not a medical doctor or psychologist).
Everything he is discussing is TENTATIVE but very interesting. I'm sending this out now because there is so little in the popular press about what can actually be done to help people with brain fog and other Long COVID symptoms. The research is still very early, and of course medical professionals should be consulted.
The article link from Nature Magazine describes brain damage caused by SARS-CoV-2 related to cell death and especially to synapse loss, leading to cognitive impairment.
The study in Bioelectric Medicine is extremely small, yet shows the potential of nicotine patches in the treatment of Long COVID symptoms including brain fog. (Another paper from the same publication also goes into why nicotine might help with Long COVID: https://bioelecmed.biomedcentral.com/articles/10.1186/s42234-023-00104-7 )
He then points to a study on the NIH PubMed site reporting the encouragement of synapse growth from psilocybin.
A comment in the discussion thread also links to a British Medical Journal article on Metformin improving Long COVID symptoms ( https://www.bmj.com/content/381/bmj.p1306 )
There's further speculation in the discussion thread that other psychoactive substances might be helpful. There are perhaps AI bots in the discussion thread discussing psilocybin microdosing, so be aware of that and maybe not get excited that so many "people" are discussing it.
From: <https://ourislandgeorgia.net/@Wolven/111412769611401616>
Dr. Damien P. Williams
@Wolven
…HUH. Long-COVID destroys synapses, and is a major contributor to the brainfog. <https://www.nature.com/articles/s41380-022-01786-2>
This goes some way to shining a light on the promising results they've been seeing in testing nicotine patches as treatment for long covid: nicotine effects synapse formation and receptivity (tests using patches because they don't habit-form and aren't, y'know, SMOKE [<https://bioelecmed.biomedcentral.com/articles/10.1186/s42234-023-00104-7>]).
But what's super interesting to me is that another thing that's also been shown to encourage synapse growth? Is psilocybin.
<https://pubmed.ncbi.nlm.nih.gov/34228959/>
From: <https://ourislandgeorgia.net/@Wolven/111412769611401616>
~~~
#psychology #counseling #socialwork #psychotherapy #research @[email protected] @[email protected] @[email protected] @[email protected] #Vaccines #COVID #longcovid #science #medicine #hospital #brainfog #sarscov2 #metformin #nicotine #nicotinepatch #psilocybin
TITLE: Polite Example Letter to a Health-Related Website Endangering Your Privacy
THIS is the letter I wish more people would send to health-related websites and merchants when they observe a privacy problem!
fullscript.com is a service that dispenses non-pharma products to patients (like medical grade supplements) based upon doctor's orders. You have to be referred by a physician to get a patient account. They even have a way of integrating with EHR systems.
They need to get security right.
To: Fullscript Support <[email protected]>
Dear Fullscript Team:
I have always appreciated being able to order from your excellent website.
Your service strives to supply patients with supplements and medicines ordered by doctors. As such, what is ordered can give insight into medical conditions that patients may have.
You may or may not be covered by HIPAA regulations, but I'm sure you will agree that ethically and as a matter of good business practice, Fullscript would want to maintain medical privacy of patients given that medical practices trust you.
This is why I'm concerned with the HIGH level of 3rd party tracking going on throughout your product catalogue. On your login page, the Firefox web browser displays a "gate" icon to let me know that information (I believe my email address) is being shared with Facebook. This is also the case with your order checkout page (see attached screenshot showing Facebook "gate" icon, as well as Privacy Badger and Ghostery plug-in icons in upper right-hand corner blocking multiple outbound data connections).
Privacy Badger is a web browser plugin that detects and warns of or stops (depending upon severity) outbound information from my web browser to 3rd party URLs. Directly below is Privacy Badger's report from your checkout page:
~~~~
Privacy Badger (privacybadger.org) is a browser extension that automatically learns to block invisible trackers. Privacy Badger is made by the Electronic Frontier Foundation, a nonprofit that fights for your rights online.
Privacy Badger blocked 23 potential trackers on us.fullscript.com:
insight.adsrvr.org
js.adsrvr.org
bat.bing.com
static.cloudflareinsights.com
script.crazyegg.com
12179857.fls.doubleclick.net
12322157.fls.doubleclick.net
googleads.g.doubleclick.net
connect.facebook.net
www.google-analytics.com
analytics.google.com
www.google.com
www.googletagmanager.com
fonts.gstatic.com
ad.ipredictive.com
trc.lhmos.com
snap.licdn.com
o927579.ingest.sentry.io
js.stripe.com
m.stripe.network
m.stripe.com
q.stripe.com
r.stripe.com
~~~
Please note that I was able to successfully checkout WITH Privacy Badger blocking protections on, so most of this outbound information was NOT necessary to the operation of your website.
There are several advertising networks and 3rd party data brokers receiving some kind of information.
I am aware that a limited amount of data sharing can be necessary to the operation of a website (sometimes). I am also aware that this all is not malicious -- web development and marketing does not usually talk to the legal department before deploying tools useful to gathering site usage statistics (Crazy Egg and Google Analytics). However, these conversations need to happen.
As for "de-identified" or "anonymized" data -- data brokers collect information across several websites, and so are able to reconstruct patient identities even if you don't transmit what would obviously be PHI (protected health information). As an example, if Google sees the same cookie or pixel tracking across multiple websites and just one of them sends a name, then Google knows my name. If Facebook is sent my email address (as looks to be the case), and I happen to have a Facebook account under that same email address, then Facebook knows who I am -- and can potentially link my purchases with my profile.
The sorts of computing device data that you are collecting and forwarding here may well qualify as PHI. Please see:
Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates
<https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-online-tracking/index.html>
This HHS and OCR guidance includes many 3rd party tracking technologies.
What I would really like to see happen is:
a) A thorough look at what information your website is sending out to what 3rd parties, along with an understanding of how data brokers can combine information tidbits from multiple websites to build profiles.
b) Use of alternative marketing analysis tools that help your business. For example, there are alternatives to Google Analytics that do not share all that data with Google and still give your marketing team the data they need.
c) An examination if you are sharing information about what products patients are clicking on and/or purchasing with 3rd parties. This would be especially problematic. (Crazy Egg tracks client progress through a website, but I'm unclear if they keep the information or just leave it with you.)
d) Use of alternative code libraries that are in-house. For example, web developers frequently utilize fonts.gstatic.com, but you could likely get fonts and other code sets elsewhere or store them in-house.
I appreciate you taking time to read this and working on the privacy concerns of your patients and affiliated medical practices.
Thanks.
~~~~~~
#AI #CollaborativeHumanAISystems #HumanAwareAI #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #medicalnotes #progressnotes @[email protected] @[email protected] @[email protected] @[email protected] @socialwork @[email protected] #mentalhealth #technology #psychiatry #healthcare #patientportal #HIPAA #dataprotection #infosec @[email protected] #doctors #hospitals #BAA #businessassociateagreement #coveredentities #privacy #HHS #OCR #fullscript
TITLE: Further Adventures in the HIPAA Silliness Zone
This short essay was inspired by a video I watched going over Microsoft legal agreements, the upshot of which is that they can harvest and use ALL of your data and creations (See *1 below in References). This inspires interesting HIPAA questions to say the least:
IF you have a HIPAA agreement with Microsoft, do they actually NOT harvest or use your data? How do they track that across all their applications and operating systems to tell?
Do their HIPAA and regular legal departments even talk to each other?
If you have a HIPAA agreement for your work computers, but then access your data through home computers, are all bets off? (And what sole proprietors don't mix use of computers for both?)
Now I don't really believe that Microsoft is doing all of this. What I THINK is that their lawyers just wrote overly broad legalese to protect them from all situations. Still -- legally it leaves us hanging. I certainly don't know that they are NOT doing it.
Then, I start thinking on some of the other crazy security situations I've encountered the past few years:
-- The multi-billion dollar medical data sales vendor that bought a calendar scheduling system, then wrote a HIPAA BAA agreement in which the PROVIDER has to pay any financial damages and penalties if THEY slip-up and lose data. (*2). Gee, what could go wrong?
-- The new AI progress notes generator service that sends data to 3rd parties including Google Tag Manager, LinkedIn Analytics, Facebook Connect, and Gravatar (*3)
-- The countless data breaches currently hitting hospitals across the USA. (*4)
It's all really quite mind numbing if you are a small healthcare provider or sole practitioner. I suspect 99% of us have just tuned this all out as noise at this point. After all, do we have the time or money to take on the legal departments of multi-billion dollar corporations?
The net results of this will be helpless nonchalance, boredom, and a gradual shifting of liability to US when upon occasion data is actually leaked by our vendors. And, of course, ever more fear and uncertainty in professions already full of it. Oh, and client data flowing through data brokers everywhere.
So what can we do? At first glance, not much. We need to be pressuring our professional associations to take on (or further take on) data security concerns including liability of giant "subcontractors" and insurance companies versus small healthcare providers. We also need to be supporting HHS and Federal government efforts to stop 3rd party trackers, including cookies, web beacons, pixel tracking, etc. from being allowable on systems related to healthcare. (*5) Bonus points if the penalties can apply mainly to larger corporations rather than hitting small provider offices hard.
Thanks,
Michael Reeder LCPC
Baltimore, MD
REFERENCES:
(*1)
The following video walks through the Microsoft Services Agreement and Microsoft Privacy Agreement to explain how Microsoft reserves the rights to use all data that you transmit through their services, or create or store in their apps (including data stored on OneDrive). It also collects information from all the programs used on your Windows machine. (This would seem to mean they can harvest data from your local hard drive, but I'm not sure.)
Microsoft Now Controls All Your Data
[https://m.youtube.com/watch?v=1bxz2KpbNn4&pp=ygUkTWljcm9zb2Z0IG5vdyBjb250cm9scyBhbGwgeW91ciBkYXRh](https://m.youtube.com/watch?v=1bxz2KpbNn4&pp=ygUkTWljcm9zb2Z0IG5vdyBjb250cm9scyBhbGwgeW91ciBkYXRh)
"("Data"), how we use your information, and the legal basis we use to process your Personal Information. The Privacy Statement also describes how Microsoft uses your content, i.e. Your communications with other people; the submissions you send to Microsoft through the Services; and the files, photographs, documents, audio, digital works, live streams, and videos that you upload, store, transmit, create, generate, or share through the Services, or any input you submit to generate content ("Your Content")."
(*2)
Full Slate: Last I checked their HIPAA, privacy, and BAA agreements. Although they reserve the right to change these agreements without notification and just post them to their website, so who knows at this point. <https://www.fullslate.com>
(*3)
Autonotes.ai: In fairness, they claim that no HIPAA data should be input into their system, even though you are writing progress notes. As of 7/30/23 they sent some sort of data to Google Tag Manager, LinkedIn Analytics, Facebook Connect, Gravatar which was severe enough that the Ghostery browser plug-in felt compelled to block or flag the transmissions. I hope they have changed this.
It should be pointed out that services similar to Full Slate and Autonotes claim that data sent to 3rd parties is not PHI and/or necessary to the operation of the service. This all could be true. I find that when Privacy Badger, or Ghostery, or my Pihole DNS server block these 3rd party transmissions that the vast majority of the time services work just fine.
Please also see Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates
<https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-online-tracking/index.html>
This HHS and OCR guidance includes the sorts of 3rd party tracking technologies often referred to as non-PHI, or de-identified. My non-lawyer mind is suspicious that violations could be found at several services.
(*4)
Just take a look at any of the daily headlines on Becker's Hospital Review:
<https://www.beckershospitalreview.com/cybersecurity.html>
(*5)
Hospital associations sue HHS over pixel tracking ban
<https://www.beckershospitalreview.com/healthcare-information-technology/hospital-associations-sue-hhs-over-pixel-tracking-ban.html>
--
#AI #CollaborativeHumanAISystems #HumanAwareAI #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #medicalnotes #progressnotes @[email protected] @[email protected] @[email protected] @[email protected] @[email protected] @[email protected] #mentalhealth #technology #psychiatry #healthcare #patientportal #HIPAA #dataprotection #infosec @[email protected] #doctors #hospitals #BAA #businessassociateagreement #Microsoft #coveredentities #privacy #HHS #OCR
I'm always a bit skeptical of presentations from tech company CEOs on
how their product areas are necessary in the mental health field.
That said, this article has a few good points:
/"Umar Nizamani, CEO, International, at NiceDay, emphasised that AI will
inevitably become an essential tool in mental health care: 'I am very
confident AI will not replace therapists – but therapists using AI will
replace therapists not using AI.'"//
/
I am beginning to think this also -- for better or worse. I took a VERY
fast 60 second look at NiceDay and it appears to be another
all-encompassing EHR, but with a strong emphasis on data. Lots of tools
and questionnaires and attractive graphs for therapists to monitor
symptoms. (I need to take a longer look later.) So data-driven could
be very good, if it does not crowd out the human touch.
/"Nizamani said there had been suicides caused by AI, citing the case of
a person in Belgium who died by suicide after downloading an anxiety
app. The individual was anxious about climate change. The app suggested
'if you did not exist' it would help the planet, said Nizamani."//
/
YIKES... So, yes, his point that care in implementation is needed is
critical. I worry at the speed of the gold-rush.
/"He [//Nizamni] //called on the industry to come together to ensure
that mental health systems using AI and data are 'explainable’,
'transparent', and 'accountable'." //
/
This has been my biggest focus so far, coming from an Internet security
background when I was younger.
/"Arden Tomison, CEO and founder of Thalamos"/ spoke on how his company
automates and streamlines complex bureaucracy and paperwork to both
speed patients getting help and extract the useful data from the forms
for clinicians to use. More at: https://www.thalamos.co.uk/
/"Dr Stefano Goria, co-founder and CTO at Thymia, gave an example of
'frontier AI': 'mental health biomarkers' which are 'driving towards
precision medicine' in mental health. Goria said thymia’s biomarkers
(e.g. how someone sounds, or how they appear in a video) could help
clinicians be aware of symptoms and diagnose conditions that are often
missed."//
/
Now THIS is how I'd like to receive my AI augmentation. Give me
improved diagnostic tools rather than replacing me with chatbots or
over-crowding the therapy process with too much automated tool data
collection (some is good). I just want this to remain in the hands of
the solo practitioner rather than being a performance monitor on us by
insurance companies. I want to see empowered clinicians.
Apparently some people have to be told that using AI services in the
cloud to compose medical letters is a violation of HIPAA.
Now what I would like to see with all the AI-assisted EHR systems
currently being developed (EPIC, Oracle, Amazon, etc.) is not only BAA
contracts in place with the tech companies, but also:
a) Separate AI systems that don't share data with the main AI system.
(So the Hospital AI database would be separate from the general AI
database), or
b) Much better: Separate AI software and databases that are held
internal to the Hospital's own computer servers with restricted Internet
access to the outside.
This is wholly feasible, yet somehow I have a low trust level of it
occurring.
For any private practice people out there playing with AI on a small
office scale, I'm not a lawyer, but what I would recommend are a) AI
systems that can be run on a desktop (not in the cloud), and b) cutting
them off from Internet or severe restrictions on where those desktops
can call out to since you likely don't know what's in the code of the AI
you downloaded!
*Iowa health system warns against using ChatGPT to draft patient letters*
<https://www.beckershospitalreview.com/cybersecurity/iowa-health-system-warns-against-using-chatgpt-to-draft-patient-letters.html>
/Iowa City-based University of Iowa Health Care is warning employees
against the use of ChatGPT for its potential to violate HIPAA.../
--
#AI #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt
#artificialintelligence #psychology #counseling #socialwork
#psychotherapy #EHR #medicalnotes #progressnotes
@[email protected] @[email protected]
@[email protected] @[email protected] @[email protected]
@[email protected] #mentalhealth #technology #psychiatry #healthcare
#patientportal
#HIPAA #dataprotection #infosec @[email protected] #doctors #hospitals
#BAA #businessassociateagreement
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can read it or subscribe at @[email protected]
.
Since 1991 The National Psychologist has focused on keeping practicing psychologists current with news, information and items of interest. Check them out for more free articles, resources, and subscription information: <https://www.nationalpsychologist.com>
.
EMAIL DAILY DIGEST OF RSS FEEDS -- SUBSCRIBE:
<http://subscribe-article-digests.clinicians-exchange.org>
.
READ ONLINE: <http://read-the-rss-mega-archive.clinicians-exchange.org>
It's primitive... but it works... mostly...
This instance proved uniquely unpopular despite lots of marketing. I'll get around to removing the links to it in bot posts and emails and Mastodon graphics eventually.
It might have made sense to keep it open if Lemmy was going to offer private forums for vetted members anytime in the near future (therapists like privacy in discussions) but this objective is barely on the developer's radars.
I am definitely keeping https://mastodon.clinicians-exchange.org open and would encourage you to join that site if you are in need of a Mastodon instance and work at all broadly speaking in the field of mental health.
The research found that kids with ASD and ADHD couldn't clear out BPA and another similar compound called Diethylhexyl Phthalate (DEHP) with as much efficiency as other kids, potentially leading to longer exposure to their toxic effects.
IF these compounds are more prevalent recently, and IF the toxic effects are what cause the ADHD symptoms, THEN we might end up with newly ADHD and autistic adults who don't get diagnosed as such because there is no childhood history of such.
This AI will follow along and take the session notes for the doctor by
listening to the office visit. It will also bring up charts and records
through voice command and prompt the doctor to do routine things during
the office visit. It's due out early next year.
This could be very helpful.
However I can imagine a few kinks in the office visit process initially:
Patient: "Doctor, my knee hurts"
AI: "REMEMBER TO MAKE A FOLLOW-UP APPOINTMENT"
Patient: "What was that?!"
Doctor: "Oh pay no attention -- that is just the new AI system everyone
has to consent to for treatment. It will help us during the session."
AI: "HAVE YOU EXAMINED THE KNEE X-RAY YET?"
Doctor: "AI, pull up the knee x-ray"
Patient: "This is my first visit, there is no knee x-ray yet."
AI: "REMEMBER TO SCHEDULE A KNEE X-RAY"
Doctor & Patient Together: "We don't know if we need a knee x-ray yet!"
Patient: "It started hurting yesterday"
Doctor: "Jump up on the table and I'll take a look at it"
AI: "SHALL I SUMMON A NURSE TO WATCH TO GUARD AGAINST ALLEGATIONS OF
IMPROPRIETY?"
Doctor: "NO!"
Doctor: "It does look a bit red. Does this hurt?"
Patient: "A bit when you touch there and I bend it."
AI: "SHALL I SCHEDULE THE KNEE X-RAY NOW?"
Doctor: "SHUT UP! AI -- Silent mode now!"
Office visits are going to be fun the next few years while this gets sorted.
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can subscribe at @PsychResearchBot
Private, vetted email list for mental health professionals: https://www.clinicians-exchange.org
Open LEMMY instance for all mental health workers: https://lem.clinicians-exchange.org
.
If you ever wonder why psychotherapists sometimes stop taking insurance
in the United States, there are lots of reasons. Low pay is the typical
one.
Hassle is another.
I'm trying to catch-up on billing this fine Sunday afternoon. The last
thing I need is a billing rabbit hole to get stuck in...
Today's rabbit hole -- trying to figure out why once of my insurance
panels keeps paying significantly different rates on the same CPT 90837
billing code (the code for a roughly one hour session). A LARGE
difference in fact.
Took a long time... drum roll...
I'm paid LESS for POS 02 (place of service telehealth AWAY from home)
versus POS 10 (place of service telehealth AT home).
Cause, yeah -- that makes sense.
So, yes, I'm required to code whether or not a client is at home for
telehealth. Why? No idea. (I suppose I do need to know the address
in case I need to send an ambulance or something.)
This all was made especially fun by:
a) The insurance company does not publish a rate schedule. No way to
know if I'd get a check or a claw-back if I inquire about the discrepancy.
b) The client has co-insurance. So the co-insurance rate varies by
place of service (POS) too. Client pays a percentage (%) of the total
amount I'm due.
It's crazy-making. And "crazy" is a term I usually avoid. Except when
discussion the American health system.
TITLE: Psilocybin‐assisted psychotherapy for treatment‐resistant
depression: Which psychotherapy?
From the abstract, looks like interpersonal psychotherapy and intensive
short-term dynamic psychotherapy are the most promising candidates.
I'll have to give this a full read later.
This might be of special interest to psychotherapists in and around
Washington, DC which has legalized psilocybin. Of course, it being
available recreationally is not the same as a therapeutic regime -- but
therapeutic clinics are emerging rapidly in the area.
TITLE: Good Therapy Credit Card Info and Security / 3rd Party Tracking
Yes, I actually do ask myself why I bother anymore, in case you are
wondering.
This stuff is so ubiquitous now as to be all but unavoidable.
That said, perhaps multiple letters from their customers (such as the
one below) might sway thinking?
www.goodtherapy.org
Dear Good Therapy Support:
[email protected]
I just updated my payment information with a new credit card.
In order to do this, I had to turn off "Brave Shields" -- basically a
web browser feature that blocks 3rd party tracking (cookies, web
beacons, sending data out to outside URLs). The web page would not
display with shields up.
*In payment transactions on multiple other websites I have NEVER had to
turn off my 3rd party tracking blockers.**
*
This is disconcerting -- makes me wonder how secure your website is.
Please consider changing this.
Also -- although I will never use your Good Therapy Verified Seal widget
-- its abilities to collect data for tracking, analysis, and advertising
from mental health websites is in very poor judgement. This stops only
just slightly short of a HIPAA violation as anyone looking at a
therapist's website is certainly considering mental health help. Data
from multiple such widgets and trackers across websites is used all the
time by 3rd party aggregators to discover the full name and identity of
visitors.
This is disappointing behavior that has lowered my trust in your
organization.
Thanks,
Michael Reeder
#psychology #counseling #socialwork #psychotherapy #legal
@[email protected] @[email protected]
@[email protected] @[email protected] @[email protected]
@[email protected] #mentalhealth #technology #psychiatry #healthcare
#HIPAA #dataprotection #infosec @[email protected] #doctors #hospitals
#BAA #businessassociateagreement #patientprivacy #goodtherapy
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can subscribe at @[email protected]
Disclaimer: The data in this column come from either mainstream news
media sources or scientific research published in peer-reviewed
journals (each category can be determined by following the links in
the reference section). This column's author acknowledges the cultural
bias of the world scientific community in its belief that the
scientific method is the most viable available alternative for
assessing COVID-19 and its effects in an objective manner through a
structured process of observable and repeatable hypothesis testing.
Summary: Hospitalizations from COVID-19 rose for an eighth straight
week to 18,871 people/week see "COVID Hospitalizations Rise for Eighth
Week in a Row" under Virology & Epidemiology).
Moderna says its upcoming COVID-19 vaccine should work against the
BA.2.86 variant that has caused worry about a possible surge in cases
(see "New Moderna Vaccine to Work Against Recent COVID Variant" under
Vaccomes, Treatment & Testing).
COVID vaccines will have a new formulation this year, according to a
decision announced today by the US Food and Drug Administration that
will focus efforts on circulating variants. The move pushes last
year's bivalent vaccines out of circulation because they will no
longer be authorized for use in the United States (see "New COVID
Vaccines Force Bivalents Out" under Policy).
The CDC is not specifically saying whether long COVID patients should
get the new COVID boosters, flu shots, or RSV vaccines, and the Food
and Drug Administration (FDA) referred similar questions to the CDC
(see "Should Long COVID Patients Get the Flu, RSV, and New Booster
Shots?" under Policy).
Research continues to show that early intervention with antibiotics
reduces the risk of fatality from COID-19 (see "Early Empiric
Antibiotic Use in Patients Hospitalized With COVID-19" under Vaccines,
Treatment & Testing).
In ICU-patients ≥70 years old, COVID-19 is associated with greater
mortality rates than bacterial or viral pneumonia (see "Increased
Mortality in ICU Patients ≥70 Years Old With COVID-19 Compared to
Patients With Other Pneumonias" under COVID Complications).
After the US Food and Drug Administration authorized new monovalent
COVID vaccines, the CDC recommended the new booster vaccinations for
everyone (see "Universal Monovalent COVID Vaccines Backed by CDC"
under Policy).
About 103 million Americans had COVID-19, and about a third of those
led to long COVID. New data indicate that some cases of long COVID-19
might be going unidentified because the patient's initial infection
wasn't detected (see "Some People With Long COVID Tested Negative for
COVID-19" under COVID Complications).
Although SARS-CoV-2 infection among young children typically results
in mild infection, it can result in serious illness, including
multisystem inflammatory syndrome in children, long-term sequalae, and
death. mRNA COVID-19 vaccination provides protection against
symptomatic SARS-CoV-2 infection for at least 4 months after
vaccination among children aged 3–5 years (see "Safety Monitoring of
mRNA COVID-19 Vaccine Third Doses Among Children Aged 6 Months–5
Years" under Vaccines, Treatment & Testing).
A new meta-analysis has shown that SGLT2 inhibitors do not lead to
lower 28-day all-cause mortality compared with usual care or placebo
in patients hospitalized with COVID-19 (see "SGLT2-inhibitors: No
Benefit in Hospitalized COVID-19" under Vaccines, Treatment &
Testing).
The COVID-19 booster vaccine typically causes transient, clinically
insignificant elevations in glucose levels in people with type 1
diabetes (see "COVID Booster May Transiently Raise Glucose Levels in
T1D" under Vaccines, Treatment & Testing).
"Cost May Lead Many to Skip COVID Testing: Why That's a Problem" (see
under Media News).
The May 11, 2023 termination of the PHE has made it increasingly
difficult to accurately track COVID-19 new cases or fatalities.
However, new variants of concern continue to emerge, with consequent
infections and deaths.
Since the termination of the PHE, data on vaccination rates are no
longer being tracked. The last known US COVID-19 vaccination rates
(May 10, 2023) are as follows: full
vaccination (two initial doses) 69.3%; at least one updated booster
dose: 17% (see "Track Covid-19 in the U.S." under
Vaccines, Treatment & Testing). "Our World in Data" stopped trying to
track US booster rates on August 30, 2022 and shows a flat line since
then.
#psychology #counseling #socialwork #psychotherapy #research
@[email protected] @[email protected] @[email protected]
@[email protected] #Vaccines #COVID #longcovid #science #medicine
#covid19 #coronavirus #sars-cov-2 #covidisnotover #CDC
@[email protected] @[email protected] @[email protected]
#depression #anxiety #sleep #brainfog #stillnotover
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can subscribe at @[email protected]
Disclaimer: The data in this column come from either mainstream news
media sources or scientific research published in peer-reviewed
journals (each category can be determined by following the links in
the reference section). This column's author acknowledges the cultural
bias of the world scientific community in its belief that the
scientific method is the most viable available alternative for
assessing COVID-19 and its effects in an objective manner through a
structured process of observable and repeatable hypothesis testing.
Summary: The updated vaccine that better protects against currently
circulating strains of the virus that causes COVID-19 may be available
as soon as next week (see "New COVID Shots Could Be Available Next
Week" under Vaccines, Treatment & Testing).
The increase in cases of COVID-19 in the northern hemisphere is
worrying healthcare authorities around the world, who are aware that
these countries usually experience a peak in respiratory infections
during the winter months (see "WHO 'Concerned' About COVID Increase in
Northern Hemisphere" under Virology & Epidemiology).
COVID-19 hospitalizations have been on the rise for weeks as summer
nears its end. COVID-19 hospitalizations rose by 19% last week and
COVID deaths by 21%, according to figures from the CDC. More than half
the states, 26, had a "substantial increase" in hospital admissions
(see "COVID-19 Hospitalizations and Deaths on the Rise" and "5
Questions for COVID Experts: How Concerned Should We Be?" under
Virology & Epidemiology).
COVID metrics have risen steadily since June after reaching the lowest
point since the pandemic started. However, just 7% of U.S. adults are
"very worried" about getting COVID-19 (see "COVID Metrics Tick Up, but
Americans Aren't Worried: Poll" under Media News).
The CDC and the World Health Organization have dubbed the BA 2.86
variant of COVID-19 as a variant to watch (see "Q&A: What to Know
About the New BA 2.86 COVID Variant" under Virology & Epidemiology).
However, BA.2.86 does not have a heightened ability to evade the
protection of COVID vaccines or immunity from prior infection (see
"Highly Mutated COVID Strain Can't Evade Immunity as Feared" under
Virology & Epidemiology).
Close and prolonged contact with someone with COVID-19 can more than
quadruple the risk of getting the virus (see "This Is When You're Most
at Risk for 'Leaky' COVID Immunity" under Virology & Epidemiology).
It's estimated that 1 out of 8 people with COVID develop long COVID.
Of those persons, 44% also experience headaches. Research has found
that many of those headaches are migraines — and many patients who are
afflicted say they had never had a migraine before (see "Long COVID
and New Migraines: What's the Link?" under COVID Complications).
Severe COVID infections may lead to lasting damage to the immune
system (see "Severe COVID May Cause Long-Term Cellular Changes: Study"
under COVID Complications).
COVID-19 may negatively affect the wound healing process while
increasing the mortality rate amongst patients with multiple or severe
comorbidities undergoing limb salvage procedure (see "Retrospective
Review of Complications and Outcomes in COVID-19–Positive Patients
With Comorbidities Undergoing Limb Salvage Procedures in a Tertiary
Care Wound Center" under COVID Complications).
Among patients with ARF due to COVID-19 pneumonia who fail HFNC, delay
of intubation beyond 24 h is associated with increased mortality (see
"Delayed Intubation Associated With In-hospital Mortality in Patients
With COVID-19" under Vaccines, treatment & Testing).
Crippling symptoms, lost careers, and eroded incomes: This is the
harsh reality for doctors suffering with long COVID, according to the
first major survey of physicians with the condition (see "One in Five
Doctors With Long COVID Can No Longer Work: Survey" under COVID
Complications).
EU regulators have recommended authorizing an updated COVID-19 vaccine
from Pfizer and its German partner BioNTech which targets the dominant
XBB.1.5 variant of Omicron, putting it on track to become the third
adapted shot by the two companies to be approved in the bloc (see "EU
Regulators Back Pfizer's Updated Vaccine for Dominant Omicron
Subvariant" under Policy).
The May 11, 2023 termination of the PHE has made it increasingly
difficult to accurately track COVID-19 new cases or fatalities.
However, new variants of concern continue to emerge, with consequent
infections and deaths.
Since the termination of the PHE, data on vaccination rates are no
longer being tracked. The last known US COVID-19 vaccination rates
(May 10, 2023) are as follows: full
vaccination (two initial doses) 69.3%; at least one updated booster
dose: 17% (see "Track Covid-19 in the U.S." under
Vaccines, Treatment & Testing). "Our World in Data" stopped trying to
track US booster rates on August 30, 2022 and shows a flat line since
then.
Charles M. Lepkowsky, Ph.D.
Solvang, CA
clepkowsky(at)gmail.com
#psychology #counseling #socialwork #psychotherapy #research
@[email protected] @[email protected] @[email protected]
@[email protected] #Vaccines #COVID #longcovid #science #medicine
#covid19 #coronavirus #sars-cov-2 #covidisnotover #CDC
@[email protected] @[email protected] @[email protected]
#depression #anxiety #sleep #brainfog
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can subscribe at @[email protected]
Okay all -- It's early days for figuring out how to help people with
Long COVID.
That said, a bit of promising research is starting to surface.
I'm taking the unusual step of emailing EVERYONE because at this point
many of you with anxiety and depression symptoms may have some Long
COVID (brain fog, sleep issues, the depression or anxiety itself!).
A good write-up about what Long COVID is can be found here. Yes, you
can had a trivial case of COVID-19 and still get Long COVID symptoms for
days, weeks, months, or years. Some cases of it are somewhat "mild": https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
*The bottom-line of the video is right at the end. For long COVID:
-- Get outside one hour per day.
-- May cover up if sensitive to sun (near UV rays will get through
clothing anyway)
-- Best if in nature (surrounded by green)
-- Do not look directly at sun (duh)
-- May wear a hat (near UV rays will get through clothing anyway)
-- Sitting in a sunny window no longer good enough (most glass now has
to be certified to block the rays we want)
He also promises to talk about how intermittent fasting may help in a
future video.
*
Roger Seheult, MD is the co-founder and lead professor at https://www.medcram.com/
He is Board Certified in Internal Medicine, Pulmonary Disease, Critical
Care, and Sleep Medicine and an Associate Professor at the University of
California, Riverside School of Medicine. He is also an ER doctor.
Before the pandemic, MedCram mainly seemed to be training for doctors to
pass exams. Since the start of COVID, Dr. Seheult has done occasional
more accessible videos for the general public on COVID-related topics.
To actually understand why something this simple may help -- and listen
to some research, please watch:
#psychology #counseling #socialwork #psychotherapy #research
@[email protected] @[email protected] @[email protected]
@[email protected] #Vaccines #COVID #longcovid #science #medicine
#covid19 #coronavirus #sars-cov-2 #covidisnotover #CDC
@[email protected] @[email protected] @[email protected]
#depression #anxiety #sleep #brainfog
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can subscribe at @[email protected]
Private, vetted email list for mental health professionals: https://www.clinicians-exchange.org
Open LEMMY instance for all mental health workers: https://lem.clinicians-exchange.org
.
A 3-year-old short video, but a good one from SciShow -- a
consumer-oriented YouTube science show which is generally well-done.
Goes into:
-- ADHD and sleep disorders overlaps
-- Chicken and the egg problem -- which comes first
-- Altered Circadian Rhythm & ADHD correlation
-- Sleep Onset Insomnia: Is treating it a way to improve ADHD symptoms
(pretty much YES, although more research would be good)
Lots of research, although mostly children's studies. Should many
people with ADHD be taking melatonin?
The Overlooked Connection Between ADHD and Sleep*
*
By SciShow Psych. About 6 minutes long.
#ADHD #ADD #attention #psychology #socialwork #mentalhealth #sleep
#melatonin #sleeponsetinsomnia #CircadianRhythm #counseling
@[email protected] @[email protected] @[email protected]
@[email protected] @[email protected] #counselors #counseling
.
.
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can subscribe at @[email protected]
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.
One of the things I've been so impressed by is how #SocialWorkers know such a broad range of resources. Now as a #therapist (through a #counseling program), I'm feeling like my program skips this piece of the puzzle. I'm trying to figure out how to learn it on my own. For example, I recently learned our area has a ton of free legal clinics and money workshops (some with childcare!), which is awesome. How do social workers learn about what types of resources exist?
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.