Pediatric Healthcare Professionals Playing Expanded Role In Postpartum Depression Screening.

APA Communications

06 02 2015

Good morning Dr. Velandy Manohar

Leading the News

Debate Surrounds Diagnosis, Treatment Of AD/HD.

The Washington Post (6/2, Karidis) “Health & Science” blog reports on the debate surrounding the diagnosis and treatment of attention-deficit/hyperactivity disorder (AD/HD). While some people even question if AD/HD is even a real diagnosis, “the American Psychiatric Association says there is no doubt that AD/HD exists – and it estimates that five percent of US children have the condition.” For its part, the CDC “puts the figure higher, reporting that 11 percent of US children age four to 17 had been diagnosed with ADHD as of 2011.”

        Separately, the Washington Post (6/2, Berkowitz) “Health & Science” blog reports that although websites “offer wildly mixed messages about AD/HD meds, studies show conflicting data about whether they work, and doctors don’t always agree,” those “clinicians who treat AD/HD say the decision is often fairly straightforward.” For example, “both major US child psychiatry organizations (the American Academy of Child and Adolescent Psychiatry and the American Psychiatric Association) recommend medication for AD/HD, usually in conjunction with therapy that teaches strategies to help with skills such as organization and time management.”

        Study Examines Economic Burden Of AD/HD. Medscape (6/2, Davenport) reports that adults with attention-deficit/hyperactivity disorder (AD/HD) appear to “have lower incomes and higher education costs, and they place a greater burden on the state than their unaffected siblings,” according to research presented at the 5th World Congress on Attention-Deficit/Hyperactivity Disorder. After initially identifying “5331 individuals who had been diagnosed with AD/HD in adulthood,” then controlling for confounding factors and “comorbid diagnoses,” researchers also “found that AD/HD by itself costs society more than €13,500 ($14,731) per person per year.”

Adult ADHD May Be Distinct From Childhood ADHD

Global Study Finds Some Members of General Population Report Psychotic Experiences

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Psychiatric Treatment/Disorders

Pediatric Healthcare Professionals Playing Expanded Role In Postpartum Depression Screening.

US News & World Report (6/2, Olivero) reports that “pediatric healthcare [professionals] are playing an expanded role in screening” for postpartum depression in new mothers as “research underscores the importance of healthy mother-baby relationships to an infant’s brain development.” The American Academy of Pediatrics “recommends universal surveillance and screening of postpartum depression by pediatric care [professionals], and national health care quality measures now include maternal depression,” US News reports. Insurers are also beginning to cover for screening of postpartum depression.

Government and Psychiatry

State Officials Attended Secret Meeting On King V. Burwell Options Last Month.

The Wall Street Journal (6/2, Radnofsky, Armour, Subscription Publication) reports that state officials from across the country traveled to Chicago in early May for a secret meeting to discuss their options if the Supreme Court strikes down ACA subsidies for the 34 states using the Federal marketplace. Participants at the meeting, which was organized by the Milbank Memorial Fund, said it was very unlikely that their state governors and legislatures would agree to set up an exchange if the court rules against the health law.

        House Republicans Likely Won’t Release King V. Burwell Plan Until After Ruling. The Wall Street Journal (6/2, Peterson) reports in its “Washington Wire” blog that House Majority Leader Kevin McCarthy (R-CA) said Monday that House Republicans likely won’t unveil their response to a possible Supreme Court ruling striking down the ACA’s subsidies until after the court’s decision. Some GOP lawmakers had hoped to introduce a plan before the ruling later this month, but Republicans are divided over whether to temporarily extend the ACA’s tax credits if they are invalidated in most of the country.

        The Hill (6/2, Ferris) reports that a spokesman for Ways and Means Committee Chairman Paul Ryan (R-WI), one of the three GOP chairmen tasked by McCarthy with developing a contingency plan, said, “We’ll have a plan that will be public before the ruling, but given that we don’t know exactly what they’ll say, we’ll have to wait for the ruling to have text to align with the situation.” McCarthy “underscored that the House Republicans crafting the King v. Burwell proposal have been in contact with their counterparts in the Senate who are also working on a plan.”

        Meanwhile, CNBC (6/2) reports that conservatives “will find themselves in a tough spot” if the court strikes down the ACA’s subsidies, “two doctors told CNBC on Monday.” Dr. Kavita Patel, a practicing physician at Johns Hopkins Medicine, said, “We’re going to have millions of people who would not get health coverage, especially in key states like Florida and Wisconsin where there are big battle ground races to be had.” Dr. Scott Gottlieb, a resident fellow at the American Enterprise Institute, said the Administration could issue new regulations that redefine what it means to be a state-run exchange. “If the administration does that, which I think they will, that’s going to put a lot of pressure on red state governors to go along, because it’s going to be very easy to for them to now comply to get the subsidies,” he said.

        White House: “No Easy Fix” If Subsidies Are Struck Down. The Hill (6/2, Ferris) reports that the Obama Administration “is casting doubt on Congress’s ability to pass an ObamaCare ‘fix’ if the Supreme Court decides later this month to gut the healthcare law’s subsidies.” White House press secretary Josh Earnest said Friday that there’s “no easy fix” to prevent the “significant turmoil” that would result from a ruling against the ACA. “With something as controversial as health care, it’s hard to imagine any sort of legislative fix passing through that legislative body,” Earnest said.

GOP May Be Unable To Use Reconciliation To Pass Full Repeal Of ACA.

Politico (6/2, Haberkorn) reports that sources say the Senate’s “parliamentarian is hinting” that Republicans will be unable to use a budget tool known as reconciliation to pass a bill repealing the ACA in its entirety “because some parts of Obamacare don’t affect the federal budget.” The article explains that the “so-called Byrd rule prevents reconciliation from being used to make policy changes that don’t affect the deficit, which is the main goal of the fast-track procedure.” That means GOP lawmakers will probably have to comb through the health law and target only policies that directly affect the Federal budget. Former staff believe Republicans won’t be able to repeal some ACA provisions that affect the private market, such as rules that set minimum standards of coverage for insurers.

        House To Hold Repeal Votes On Medical Device Tax, IPAB Later This Month. The Washington Examiner (6/2) reports in continuing coverage that the House “will vote the third week of June to repeal the Affordable Care Act’s tax on medical devices, and its provision allowing for a board of appointees to cut Medicare doctor payments if the program’s spending grows too fast, Majority Leader Kevin McCarthy [R-CA] announced in a memo to members.”

States Taking Action To Address Rising Cost Of Prescription Medicines.

National Journal (6/2, Owens, Subscription Publication) reports that “states are increasingly paying attention and taking steps to bring down the skyrocketing cost of prescription medicine.” For example, Covered California, the state’s ACA exchange, recently “voted to cap most specialty drug co-pays at $250 per month, the first exchange in the nation to set a limit.” As prescription spending in the US increased more than 13 percent last year, states are increasingly adopting legislation limiting co-pays and requiring transparency of drug production costs, with “state laws putting caps on co-pays” being “more successful.”

Psychiatry and Public Health

Study: Stricter State Alcohol Policies For Adults May Lead To Less Underage Consumption.

Reuters (6/2, Doyle) reports that according to a new study published online June 1 in the journal Pediatrics suggests that there is less reported underage drinking in states with more restrictive alcohol policies for adults. The researchers used a method called the Alcohol Policy Scale to score the effectiveness of state-level alcohol policies in addition to looking at data from Youth Risk Behavior Surveys conducted biannually between 1999 and 2011.

        MedPage Today (6/2, Walker) reports that similar effects of more restrictive alcohol policies “were observed by gender, grade level, and among Hispanic white and Hispanic youth, though the policies appeared to have no impact on non-Hispanic black youth and non-Hispanic other races.” The study was funded by the National Institutes of Health. HealthDay (6/2, Haelle) also covers the story.

Certain Painkillers, Sedatives May Be Associated With Higher Risk Of Homicide.

HealthDay (6/2, Norton) reports that a study published June 1 in the journal World Psychiatry, “based on records from nearly 960 Finnish adults and teenagers who had been convicted of homicide between 2003 and 2011,” suggests that people on certain prescription painkillers and benzodiazepine sedatives, compared to those on antidepressants, may “have an increased likelihood of homicide.” While researchers caution that their findings “do not prove that painkillers or sedatives drive certain people to murder,” they stressed that the results “should offer some reassurance on the safety of antidepressants.” Medical Daily (6/2, Scutti) also covers the study.

Emotional Health Of Cancer Caregivers May Affect Mental Health Of Loved Ones They Are Caring For.

HealthDay (6/2, Dallas) reports that the results of a 900-participant study published June 1 in Cancer Epidemiology, Biomarkers & Prevention suggests that “the emotional health of cancer caregivers may affect the mental health of the loved ones they are caring for.” The study found that “when their husbands, wives or partners experience symptoms of depression, cancer survivors are more likely to develop depression themselves, say researchers at the US National Cancer Institute (NCI).”

Changes In Circadian Rhythms Affect Physical, Mental Health, Medication Response.

On the front of its Personal Journal section, the Wall Street Journal (6/2, D1, Beck, Subscription Publication) reports on the science of chronobiology that is helping researchers to understand how changes in circadian rhythms affect humans’ physical and mental health, as well as response to medication.

APA in the News

New Treatments Examined For People With Depression.

On the front of its Personal Journal section, the Wall Street Journal (6/2, D1, Petersen, Subscription Publication) reports on new treatments for depression, including interpretation or cognitive bias modification-interpretation, cognitive control training, transcranial direct current stimulation, and games played on the computer. These new treatments, when combined with traditional therapies such as medication and cognitive behavioral therapy, may help retrain the brains of people with depression. The Journal points out the need for novel depression treatments, mentioning a large 2006 study in the American Journal of Psychiatry, a publication of the American Psychiatric Association, that revealed that only about a third of people taking Celexa (citalopram) for depression achieved a remission.

Small Study: BD May Be Associated With Altered Brain Development In Teens.

Medscape (6/2, Brooks) reports, “Areas of the brain involved in the regulation of emotion develop differently in adolescents with bipolar disorder [BD],” according to a study published online May 29 in the journal Biological Psychiatry. After obtaining “two high-resolution MRI scans roughly two years apart in 35 adolescents with bipolar I disorder (BPI) and 37 healthy adolescents,” researchers found that teens with BD displayed “greater gray matter reduction over time and less white matter expansion compared with healthy adolescents.” Maria A. Oquendo, MD, president-elect of the American Psychiatric Association, who was not involved with the study, commented, “This study adds to the burgeoning literature on bipolar disorder and underscores the need for more work in this area.” The study received funding from the National Institute of Mental Health and the National Institute for Drug Abuse, among others.

Practice Management

CMS Releases 2013 Medicare Billing Data.

The New York Times (6/2, B6, Abelson, Subscription Publication) reports that the Centers for Medicare and Medicaid Services “unveiled on Monday the latest round of Medicare billing by the nation’s hospitals and” physicians. The 2013 data include information about billing for and services of clinicians, covering about 950,000 practitioners “who received $90 billion in Medicare payments.” Andy Slavitt, acting administrator of CMS, said, “These data releases will give patients, researchers, and [clinicians] continued access to information to transform the health care delivery system.” According to data, Medicare’s highest physician payments “went to hematologists and oncologists, although much of their reimbursement includes the cost of expensive cancer drugs.”

        The AP (6/2, Alonso-Zaldivar) reports “HHS says its analysis showed that anesthesiologists, orthopedic surgeons, ophthalmologists and emergency medicine” physicians “are among the most highly paid specialists.” According to the AP, joint replacement was the most common hospital procedure that Medicare paid for in 2013, “accounting for nearly 450,000 inpatient admissions and $6.6 billion in payments.”

        Bloomberg News (6/2, Tracer, Chen) reports that Medicare “paid at least 3,900 individual health-care [professionals] at least $1 million in 2013, according to a Bloomberg analysis of data from the Centers for Medicare & Medicaid Services.” On average, physicians were reimbursed about $74,000, “though five received more than $10 million.”

        Also focusing on the program’s biggest billers, the Wall Street Journal (6/2, Weaver, Barry, Stewart, Subscription Publication) reports that the top 1 percent of billers accounted for 17.5 percent of all Medicare payments in 2013, up from 16.6 percent in 2012.

        Also covering the story are Modern Healthcare (6/1, Subscription Publication), MedPage Today (6/2), Medscape (6/2), the Pittsburgh Post-Gazette (6/2, Twedt), the Poughkeepsie (NY) Journal (6/1), the Bergen (NJ) Record (6/2), and Fierce Health Finance (6/2, Budryk).

Professor: Physicians May Be Sued Less If They Communicate Better With Their Patients.

Aaron E. Carroll, MD, a professor of pediatrics at Indiana University School of Medicine, writes in the New York Times (6/2, Subscription Publication) “The Upshot” that “what might help physicians avoid being sued is getting along better with their patients. Or at least, they could become better communicators.” Carroll cites several studies where patients noted a lack of communication lead to low satisfaction as well as an increased chance that they sued their physicians.

        Sharing Of Physician Notes Increases Patient Engagement. The Kaiser Health News (6/2) reports on the rise and benefits of patients having access to their physician’s notes. According to the article, “this kind of note-sharing got a kick-start five years ago when researchers from Harvard Medical School joined forces with the Pennsylvania-based Geisinger Health System and Harborview Medical Center in Seattle to launch a high-profile pilot program called Open Notes.” The program is “part of the health system’s growing focus on patient engagement – the idea that more informed people will take better care of themselves, improving their health while lowering costs.”

Other News

Small Study Ties Alzheimer’s-Linked Amyloid Proteins To Poor Sleep.

The CBS News (6/2, Kraft) website reports that a study published in the June issue of the journal Nature Neuroscience “suggests that a good night’s sleep may play an important role in helping protect the brain against memory decline associated with Alzheimer’s.” In a study involving 26 older adults who were cognitively normal, investigators “found that a deficit in deep non-REM sleep, a sleep cycle associated with memory retention, was associated with a higher risk of buildup of brain proteins which are believed to play a role in triggering Alzheimer’s disease.” In turn, that “buildup of toxic beta-amyloid proteins in the brain then leads to further sleep deprivation.”

        TIME (6/2, Park) reports that “the higher amount of amyloid and the disturbed sleep were also associated with worse performance on simple paired-word memory tests, which the researchers gave the volunteers both before and after a night’s sleep.”

        HealthDay (6/2) points out that the “26 mentally healthy adults ages 70 to 79” recruited for the study “underwent brain imaging to assess plaque buildup, and were asked to remember pairs of words before and after a night’s sleep.” While participants slept “overnight, researchers measured their brain waves, and the next day they conducted MRI scans during the memory testing.”

Study: State Policies Meant To Increase Organ Donations Have Had Little Impact.

HealthDay (6/2, Preidt) reports that a study published online June 1 in JAMA Internal Medicine suggests that “many state policies meant to increase organ donations and transplant rates have had almost no impact.” Researchers found that “between 1988 and 2010, the number of states with at least one of six major measures designed to boost the organ supply increased from seven to 50.” The current “study offers more proof that the current organ donation and transplant system in the United States needs a major overhaul, said” psychiatrist Sally Satel, MD, of the Yale University School of Medicine, the author of an editorial accompanying the study.

Monday's Lead Stories

• Study: Blasts May Artificially Age Troops’ Brains.  • Study: Use Of Hospice Services May Have Little Effect On Depressive Symptoms Of Surviving Spouses.  • House To Focus On Repealing Device Tax, IPAB After King Ruling.  • Clinton Said To Plan Policy Proposals About Substance Abuse, Mental Health Issues.  • Women’s Group Campaign For Approval Of Women’s Libido Treatment.  • US Court Of Appeals Rules Pharmaceutical Maker Engaged In Anticompetitive Practices.  • CMS To Issue New ACO Regulations Soon.