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.”
TITLE: Across U.S., Conservatives Target Bans on LGBTQ+ "Conversion Therapy"—Bans Repealed After Threats of Lawsuits Based on Freedom of Religion & Speech
My commentary: As I have said many times, I fully expect our various mental health professions in the USA to split into conservative/fascist and democratic/progressive associations -- each with its own "ethics" code -- in the near future.
Thank you Dr. Pope for summary below.
Michael Reeder, LCPC
-------- Forwarded Message --------
The Associated Press released an article: “In Iowa and elsewhere, bans on LGBTQ+ ‘conversion therapy’ become a conservative target.”
Here are some excerpts:
One of Iowa’s largest cities repealed its ban on “conversion therapy”… after a Christian organization threatened legal action, part of a deepening national movement to challenge protections for LGBTQ+ kids.
The city council in Waterloo voted this week to remove its restrictions after Liberty Counsel warned in a letter June 30 that it would “take further action” if the city did not repeal the ordinance by August 1. It was enacted in May.
The organization, which is based in Orlando, Florida, argued the ordinance infringes on the constitutional right to free speech and acted on behalf of a therapist in Waterloo “who was concerned about the implications of this on the practice of counseling,” Mat Staver, Liberty Counsel founder and chair, said in an interview in which he promised further litigation targeting states.
In Iowa and across the country, efforts are spreading to curb the rights of LGBTQ+ kids and adopt restrictions on gender and sexuality in classrooms, youth sports and medicine.
In recent years, local bans on conversion therapy in Florida also fell with the help of Liberty Counsel, which describes itself as a Christian ministry that is “restoring the culture by advancing religious freedom, the sanctity of human life and the family.”
Such therapy has been discredited and is opposed by, among others, the American Medical Association and the American Psychiatric Association, citing research that shows it leads to increased risk of suicide and depression.
“The mental health mainstream believes that one, that these practices don’t really work, and two, that they may cause harm,” said Dr. Jack Drescher, a Columbia University psychiatry professor and editor of the chapter on gender dysphoria in the psychiatric association’s diagnostic manual.
<snip>
Laws prohibiting mental health professionals from attempting to change a minor’s sexual orientation or gender identity are on the books in 22 states and Washington, D.C., according to the Movement Advancement Project, an LGBTQ+ rights think tank. In 13 states, including Iowa, some municipalities have adopted their own provisions.
The issue has the potential to come to a head in the next year if the U.S. Supreme Court decides early this fall to hear the appeal of a Washington state therapist, Brian Tingley, whose lawsuit was dismissed.
While early lawsuits similar to Tingley’s failed, a Supreme Court ruling in 2018 prompted a new round of cases, said Christy Mallory, legal director at the UCLA School of Law’s Williams Institute, which researches sexual orientation and gender identity. That ruling invoked free speech protections to block a California law that required anti-abortion centers to provide information about abortion.
In 2020, a panel of three federal judges in Florida relied in part on that 2018 ruling and became the first federal appeals court to block ordinances in Boca Raton and Palm Beach County that banned conversion therapy. Liberty Counsel represents the two therapists who won that case.
The diverging federal rulings in the Washington and Florida cases may be a reason for the U.S. Supreme Court to weigh in this term, bringing another high-profile LGBTQ+ issue to the docket.
Staver is confident the Supreme Court will strike down bans in the near future. And Liberty Counsel has imminent plans to sue over statewide bans, he said.
“I think it is a losing proposition for any state or local government to have one of these laws, and they would be wise to repeal them before they also are sued,” Staver said.
In Iowa, Senate Democrats and a Republican in the House introduced bills for conversion therapy bans that didn’t make it out of subcommittees in 2020. That was the last time there was a concerted effort for a ban in the state, said Damian Thompson, public policy director at Iowa Safe Schools, an organization that advocates for LGBTQ+ children.
Meanwhile, in Iowa and elsewhere, laws have since been passed to prohibit teachers from raising gender identity and sexual orientation issues with students through grade six, to restrict the restrooms transgender students can use, and to ban treatments like puberty blockers and hormone therapy for trans minors. Many are facing challenges in court.
Republican lawmakers say the laws are designed to affirm parents’ rights and protect children. The issues have become flashpoints in the race for the 2024 Republican presidential nomination.
But many parents and advocates worry about the deterioration of the rights and safety of LGBTQ+ kids.
In Waterloo, a city of over 65,000, Councilor Jonathan Grieder said he had heard concerns about conversion therapy happening in the area. He worked with Thompson at Iowa Safe Schools to draft an ordinance after watching statewide efforts stall but a ban pass in another Iowa city, Davenport, and in Linn County.
The Waterloo council approved it 6-1 in May, but overturned it 4-3 on Monday amid the prospect of costly litigation.
Archer Trip, of neighboring Cedar Falls, addressed the council before the repeal vote as a “survivor of conversion therapy” who had been placed there in high school.
“It does not work. Now, I am a proud queer man, but I am also here to protect everyone else,” Trip said. “We should protect our children.”
Archer’s twin sister, Nic Trip, who was also put in conversion therapy, testified: “Unfortunately, not all parents always make the safest decision for their children. What is the line of what is OK to do to our children?”
Mayor Quentin Hart said, not mentioning the Liberty Counsel, that there was “threat of impending litigation moving forward,” which put the members in a “tough situation.”
“I don’t believe that the Waterloo City Council are cowards,” Hart said. “I believe that they do have a decision to make tonight.”
The decision disappointed Thompson, who said Iowa Safe Schools will continue to advocate for local bans despite far-right groups’ success in turning a “common sense” issue into a “wedge culture war” one.
“Which is a shame,” Thompson said, “because in the meantime it only results in more kids being victimized and more kids, ultimately, receiving lifelong trauma.”
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)
“The most potent weapon in the hands of the oppressor is the mind of the oppressed.”
—Steve Biko (1946-1977), anti-apartheid activist & co-founder of the South African Students' Organization
-- 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.