Psychiatric Treatment/Disorders
Researchers Develop New AD Progression Rate Measure.
Medscape (3/4, Kelly) reported that, according to a study published online Feb. 23 in the journal Alzheimer's Research & Therapy, "an Alzheimer's disease (AD) progression rate measure that can be calculated at the initial visit can reliably predict how quickly the individual patient will lose cognitive and other abilities." In "597 patients followed up for 15 years," researchers calculated a preprogression rate by "using a standard assessment of symptom duration in years and the baseline Mini-Mental State Examination (MMSE) score." The study authors wrote, "Since a cognitively intact individual should obtain the maximum MMSE score of 30, the preprogression rate is given by the formula: (30 − baseline MMSE)/estimated duration of symptoms in years."
Behavioral Addictions Associated With Bipolar Disorder.
MedWire (3/5, Piper) reports that, according to a study presented at a European psychiatry meeting, "patients with bipolar disorder are at increased risk for behavioral addictions." After studying "158 outpatients with bipolar disorder and 200 mentally healthy individuals," researchers found that "33% of bipolar disorder patients had at least one behavioral addiction, compared with just 13% of controls." Notably, "most common behavioral addictions, for which bipolar disorder patients scored significantly highly, were pathologic gambling, compulsive buying, and sexual and work addictions."
Small Study Indicates Infant Trauma May Be Common In Patients With Paranoid Schizophrenia.
MedWire (3/5, Piper) reports that, according to a study presented at a European psychiatry meeting, "infant trauma is common in patients with paranoid schizophrenia." After studying 37 patients with paranoid schizophrenia, researchers found that "over half (55.8%)...had suffered infant trauma," and that infant trauma was associated in particular "with hostility, unnatural movements and posture, depression, and preoccupation."
Government and Psychiatry
Sebelius Stresses Transparency At Meeting With Insurers.
The AP (3/5, Sidoti) reports that HHS Secretary Sebelius "told the nation's leading health insurers Thursday to publicly justify a spate of double-digit premium hikes that have infuriated consumers in at least a half dozen states." She met "with the CEOs of WellPoint, Aetna, Cigna, UnitedHealth Group, as well as several state insurance commissioners." After asking insurers to post "their justification for proposed rate hikes" online, Sebelius told reporters, "At the very least, we need some transparency. ... We need people to understand what's going on.
        The New York Times (3/5, A13, Stolberg, Pear) notes that during the meeting, "the President stopped by -- an appearance that was unscheduled, but clearly orchestrated -- to deliver a letter from an Ohio cancer survivor who had dropped her insurance after a 40 percent rate increase."
        The Wall Street Journal (3/5, Adamy, Johnson) characterizes the meeting as the administration scolding insurers. For their part, insurers blamed healthcare companies including pharmaceutical makers, medical-device makers, and hospitals for driving up healthcare costs, according to the Journal. They also disagreed with Sebelius that they are highly profitable.
        The Los Angeles Times (3/5, Sidot) focuses on the rate hikes, noting that "Sebelius has heard from many Americans who are concerned that they will be priced out of the market." Pushing the online justification of rate increases, Sebelius said, "That kind of rate increase is just unacceptable and unsustainable. ... At least the bright spotlight may help to discourage some of these wildly exorbitant increases from occurring."
        By the end of the meeting, "the executives emerged saying they felt they were heard when they argued that the price hikes are due to rising medical costs and other factors beyond their control," CQ HealthBeat (3/5, Norman) reports. "But there were no accords or agreements, the executives said, beyond a general consensus that more transparency is needed."
        The Hartford Courant (3/5, Sturdevant) portrays the meeting as less contentious, noting that "insurers also are eager for reform, and have pointed to medical expenses as driving costs." Meanwhile, Sebelius said, "It's a balance. ... You want companies to make money, frankly. ... But there is a large variation between insolvency, bankruptcy and making huge profits which actually then drive people out of the marketplace." Reuters (3/5, Heavey) and Bloomberg News (3/5, Nussbaum, Gaouette) also cover the story.
VA Urged To Allow Marijuana Use As PTSD Treatment.
The Columbus Ledger-Enquirer (3/4, Gierer) reported that the Marijuana Policy Project is advocating that Department of Veterans Affairs (VA) be allowed to "use marijuana in the treatment of post-traumatic stress disorder (PTSD)." The Project "says the VA forbids its doctors from recommending medical marijuana to veterans, even in the 14 states where medical marijuana is legal," based on advice from the DEA.
        Company Using Technology To Help With PTSD. On its website, KXRM-TV (3/4, Prince) reports that Great Life Technologies "has been at the forefront of integrating bio-energetic testing, wave interference, and sophisticated electronic technology," and is now "using this technology to assist veterans with PTSD -- free of charge."

Iowa House Defeats Bill Requiring Insurance Companies To Cover Specialty Hospitals.
The AP (3/4, Aujla) reported that the Iowa House voted down a bill Wednesday that would have required insurance companies to cover patients admitted to specialty hospitals. The defeat was narrow, with a 39 to 31 vote. Opponents said the measure would have taken patients -- and therefore revenue -- away from community hospitals, which are required to maintain emergency rooms and treat the uninsured.
Utah Senate Passes Anti-Federal Health Reform Bill.
The Salt Lake Tribune (3/5, Stewart) reports that a "pared-down version of a controversial anti-federal health reform bill passed the [Utah] Senate on Thursday and likely is to be enacted." The bill "would require state agencies to report to the Legislature before implementing any healthcare program enacted by Congress. A previous version of the bill went further, raising constitutional concerns because it would have required the Legislature and governor to endorse the federal plan before an agency could adopt it." It now must be reconciled with the state House bill "before heading to the governor, who is inclined to sign it."
Psychiatry and Public Health
Asthmatics More Than Twice As Likely To Have Depression, Anxiety Than Non-Asthmatics.
HealthDay (3/4, Gordon) reported that, according to a study published in the March issue of the journal Chest, "people with asthma are more than twice as likely to have depression or anxiety as people who don't have the" condition. After reviewing "data from 186,738 adults who had participated in the US National Health Interview Survey between 2001 and 2007," CDC researchers found that "among all of the study participants, the average prevalence of serious psychological distress was three percent, but in people with asthma, the rate of serious psychological distress was 7.5 percent."
Utah Report Shows Individual Communities' Violence And Injury Profiles.
The Salt Lake Tribune (3/5, Adams) reports that, after looking "at 17 injury-related categories, from assaults to suicides," for 61 areas, the Utah Department of Health was able to, for the first time, show "how communities rate when it comes to violence and injuries." The state agency wants the report data to "spur local governments to consider injury-prevention programs and initiatives tailored to their communities." As an example, one community, Magna, "had the highest rate in the state of emergency-department visits due to motor-vehicle crashes," and town council president Todd Richards made a connection, listing "a handful of roads in the community that are dangerous and in need of state and county attention."

 
Japanese Women Getting Thinner.
The Washington Post (3/4, Harden) reported that Japanese women are becoming thinner at the same time as US women are getting heavier. Twenty-five years ago, Japanese women "were twice as likely to be thin as overweight; now they are four times more likely to be thin." Meanwhile, "for US women of all ages, obesity rates have about doubled since 1980, rising from 17 percent to 35 percent." Child psychiatrist Hisako Watanabe, MD, of Japan's Keio University School of Medicine, attributed the weight-loss phenomenon to the social pressure of "women looking critically at other women." Meanwhile, public health officials are concerned that caloric restriction could interfere with women's metabolisms and may be behind declining birth weights.
APA in the News
Psychiatrist Says Gap Remains In Turning Autism Science Into Parenting, Teaching Strategies.
The Palm Beach (FL) Post (3/5, Isger) reports that despite the exponential amount of knowledge gained from autism research over the past decade, psychiatrist and autism expert Fred Volkmar, MD, who defined "Asperger syndrome for the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders in its 4th edition," and for a time worked on the draft of the 5th edition, maintains that translation of "all that science into strategies" to "help parents or teachers of these children has lagged." This weekend, Dr. Volkmar and other experts will take part in the 7th Annual Palm Beach Mental Health Research Symposium in which they will discuss "causes and treatments for...schizophrenia, depression, autism, and post-traumatic stress disorder."
Practice Management
US Hospitals Stepping Up Efforts To Buy Physician Group Practices.
The Indianapolis Star (3/4, Lee) reported that "hospitals...across the country are stepping up efforts to hire doctors and buy large physician group practices, partly to help the hospitals attract valuable referrals for specialized care." Physicians "benefit by stabilizing their income, escaping the costs of running their own offices, and leaving tough negotiations over health insurance reimbursement to the hospitals." The Star pointed out that "the proportion of doctors in solo or two-physician practices in the nation dropped from 40.7 percent in 1996-97 to 32.5 percent in 2004-05, according to a 2007 study released by the Center for Studying Health System Change, a nonprofit research group."
Database Expands To Accommodate Disciplinary Reports On All Licensed Healthcare Professionals.
American Medical News (3/4, Sorrel) reported that a new rule published in the Federal Register expands the "scope of the National Practitioner Data Bank to include disciplinary information, not just on physicians, but on all licensed healthcare professionals," including "nurses, chiropractors, podiatrists and physician assistants." Previously, the "data bank collected negative findings only against physicians and dentists by state licensing agencies, such as medical boards, or credentialing bodies, such as hospitals," while information on "other health professionals...was gathered in a separate reporting database."
Other News

Washington State Analyzes Deaths From Physician-Assisted Suicide.
The New York Times (3/5, A17, Yardley) reports, "At least 36 terminally ill people died last year after taking lethal medication prescribed by doctors under Washington State's new physician-assisted suicide law, according to a state report (pdf) released Thursday, the first since the law went into effect a year ago." Oregon released a similar report this week, finding that "59 people died last year from lethal medication prescribed under the law; 95 prescriptions were filled." According to the Times, "most patients who died under the law in Washington last year had cancer." All "cited 'loss of autonomy' as a reason for seeking" the medication.
        McClatchy (3/5, Sherman) reports that "of those that died, 37 had cancer, four had degenerative diseases, such as Lou Gehrig's disease, four had respiratory diseases, and two were listed as 'other.' Nineteen were Medicare or Medicaid patients and 12 had private insurance."
Feeling Younger May Help Older People Retain Cognitive Abilities.
US News & World Report /National Science Foundation (3/4) reported that "if you feel old beyond your own chronological years, you are probably going to experience a lot of the downsides that we associate with aging," but "if you are older and maintain a sense of being younger, then that gives you an edge in maintaining a lot of the abilities you prize," according to Markus H. Schafer, co-author of a new study. After comparing "people's chronological age and their subjective age to determine which one has a greater influence on cognitive abilities during older adulthood," researchers found that "people who felt young for their age were more likely to have greater confidence about their cognitive abilities a decade later," and while "chronological age was important...the subjective age had a stronger effect."

Obama Calls On Congress To End Debate, Vote On Health Reform.
President Obama Wednesday urged Congress to proceed to a final, up-or-down vote on healthcare reform. Much of the coverage casts Obama's comments as an endorsement of the "reconciliation" strategy denounced by Republicans. The CBS Evening News (3/3, lead story, 3:30, Couric) reported that the move is "sure to anger Republicans, who will try to use that to their advantage in congressional elections next November." Obama, CBS' Reid added, addressed "an audience of doctors and nurses," and in "a tone that was forceful and even defiant at times...said the debate is over, it's time to pass healthcare reform." Of GOP demands that the debate start over, for example, Obama said, "Insurance companies aren't starting over. They're continuing to raise premiums and deny coverage as we speak."
        The Los Angeles Times (3/4, Levey, Hook) describes Obama's words as "impassioned" and as "the strongest, most specific language the President has used to drive his healthcare plans forward." In its lead story, ABC World News (3/3, lead story, 4:20, Tapper) likewise reported, "The President seemed assertive and fired up, and after his remarks, he went back to the Oval Office where he told an aide, 'I feel good about where we are.'" Obama was shown saying, "Every idea has been put on the table. Every argument has been made. Everything there is to say about healthcare has been said. I believe the United States Congress owes the American people a final vote on healthcare reform." NBC Nightly News (3/3, story 2, 2:40, Todd) said the White House plan included "additional Republicans ideas like medical malpractice reform, and elimination of two special deals made specifically to win over the votes of Democrat senators in Nebraska and Florida."
        The Christian Science Monitor (3/4, Feldmann) reports that Obama's "goal is to finish the legislation by March 29, when Congress begins Easter recess." But, the AP (3/4, Espo) notes that "while Obama said he wanted action within a few weeks, Senate Majority Leader Harry Reid (D-NV) seemed to hint a final outcome could take far longer." Reid said, "We remain committed to this effort, and we'll use every option available to deliver meaningful reform this year."
        In a front-page story, the New York Times (3/4, A1, Stolberg, Pear) also reports, "Privately, Senate leadership aides said Mr. Obama's deadline could be difficult to meet," since "the final language must still be sent to the nonpartisan Congressional Budget Office for evaluation, a process that takes time. Many aspects of the legislation remain unresolved, and rank-and-file Democrats in the House remain deeply uneasy over both the substance of the bill and the process by which it would be adopted." USA Today (3/4, Wolf, Fritze), the Washington Post (3/4, Murray, Montgomery), the Washington Times (3/4, Rowland), Roll Call (3/4, Bendery), AFP (3/4, Knox) and the Wall Street Journal (3/4, Meckler, Adamy) also cover the story.
        Apparent Obama Reversal On Use Of Reconciliation Noted. The CBS Evening News (3/3, story 2, 1:00, Couric) reported that "in 2007, when...Obama was a senator, he criticized the use of the reconciliation process in healthcare reform. Is this a case of where you stand depends on where you sit?" Schieffer replied, "I guess it does, because the people of the out party is always against reconciliation and the one that has the majority always thinks it's the right way to go. The President was in the minority then and now he knows Democrats are in the majority."
From the American Psychiatric Association
On March 2, the Senate passed the "Temporary Extension Act of 2010," which postponed the 21% Medicare physician payment until April 1. Discussions are still underway in the House and Senate on the next steps that will be taken to address the Medicare payment crisis. For the full update.

Psychiatric Treatment/Disorders
Gastric Bands May Lead To Psychological Problems, Depression.
The UK's Telegraph (3/4, Smith) reports that, according to research presented at a UK diabetes conference, "Obese people who have a band fitted around their stomach to help them lose weight may end up thin, but can suffer from low self-esteem" and psychological problems. After recording the experience of 25 patients one year after gastric banding, researchers found that the majority of patients "struggled with the shift in mindset required to deal with their desire and ability to eat." In fact, some "said losing the opportunity to eat as a coping strategy left them struggling to cope with distressing life events."
Childhood Adversities May Have Additive Associations With Onset Of Psychiatric Disorders.
MedWire (3/4, Levy) reports that, according to a study published in the February issue of the Archives of General Psychiatry, "childhood adversities (CAs) have significant subadditive associations with the onset of psychiatric disorders throughout the life course." After analyzing "CAs and lifetime Diagnostic and Statistical Manual of Mental Disorders-IV disorders assessed in the US National Comorbidity Survey Replication involving 9,282 adults," Harvard researchers "found that 44.6% of all childhood-onset psychiatric disorders and 25.9% to 32.0% of later-onset disorders were attributed to CAs."