Edwards To Announce Proposal To Address PTSD In Veterans

Post-Traumatic Stress Disorder

Presidential candidate and former Sen. John Edwards (D-N.C.) on Monday during a speech at Plymouth State Universityin New Hampshire plans to announce a proposal to address the high rateof post-traumatic stress disorder in combat soldiers who return fromthe wars in Iraq and Afghanistan, as well as other issues related tohealth care for veterans, the AP/Wichita Eagle reports. According to the Department of Veterans Affairs,the number of veterans who experienced PTSD increased by 70% — or by20,000 cases — during the last fiscal year. The proposal would allowveterans to seek counseling for PTSD at health care facilities outsidethe VA system.

In addition, the proposal would increase thenumber of PTSD counselors employed by VA and ask family members to helpidentify cases. The proposal also would increase the time betweendeployments for soldiers who return from the wars in Iraq andAfghanistan. A Defense Departmentstudy conducted earlier this year found that insufficient time betweendeployments can lead to higher rates of PTSD or increased mental stress.
Theproposal also would provide all veterans with a comprehensive medicalexamination as part of a "Homefront Redeployment Plan."
Edwardssaid that he would finance the proposal, which would cost about $400million, through the elimination of certain tax breaks loopholes andincreased efficiency in tax collection practices. "I strongly believewe must restore the sacred contract we have with our veterans and theirfamilies and that we must begin by reforming our system for treatingPTSD," Edwards said in a copy of the speech (Elliot, AP/Wichita Eagle, 11/12). In related news, Caucus4Priorities,which supports a reduction in military spending and increased spendingfor health care and other social programs, on Friday endorsed Edwardsand promised to help him campaign in Iowa (Leys, Des Moines Register, 11/10).
Americans for Health Care
Americans for Health Care, a group organized by the Service Employees International Union, will hold mock caucuses in several states to promote health care as an issue in national and local elections, the Nevada Appealreports. In addition, the group will provide voters with an analysis ofthe health care proposals offered by presidential candidates.
Thegroup supports proposals that would ensure access to affordable,quality health care for all U.S. residents; focus on preventive care;and reduce costs (Dornan, Nevada Appeal, 11/8).
Clinton Record on Health Care ‘Concealed,’ According to Los Angeles Times
The Los Angeles Times on Sunday examined how, although presidential candidate Sen. Hillary Rodham Clinton(D-N.Y.) "presents herself as the candidate best able to give thenation better health care at lower prices" because of the "searingexperience she gained in trying to overhaul the health care systemduring her husband’s presidency," a "big part of that history is beingconcealed."
According to the Times, hundreds ofpages of "memos and correspondence involving the health care plan ofthe early 1990s have been withheld, leaving a gap in a historic periodwhen Clinton undertook one of the most ambitious domestic policy foraysever attempted" (Nicholas, Los Angeles Times, 11/11).
Opinion Piece Addresses Giuliani Position on Health Care
Presidential candidate and former New York City Mayor Rudy Giuliani(R) "is so busy offering dissembled statistics on how lethal England’shealth care system is to men with prostate cancer" that he "fails tosee just how free-market-friendly universal coverage would be," St. Petersburg Timesstaff writer Robyn Blumner writes in an opinion piece. Blumner writes,"Employer-sponsored health insurance is a historical accident that isnow crippling American competitiveness," and, "from a macroeconomicperspective, universal coverage would not weaken the free market asGiuliani asserts" but would "bolster and energize just about everyaspect of it."
According to Blumner, many U.S. residents mustremain in their current jobs because of the health insurance that theyreceive through their employers. Blumner concludes, "If you’re one ofthose employees stuck in a miserable job year after year for the healthbenefits, Giuliani has good news for you: At least you aren’t likely todie of prostate cancer" (Blumner, St. Petersburg Times, 11/11).

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U.S. Antidepressant Use Rises Twofold

Between 1996 and 2005, use of antidepressants in the United States doubled while the use of psychotherapy (talk therapy) declined significantly. Antidepressants are now the most commonly prescribed class of drugs in America, surpassing prescribed blood pressure medications.
Results of the study, which were published in the August issue of the Archives of General Psychiatry, show that during the ten-year period, antidepressant use rose from 5.84 percent to 10.12 percent. This translates to an estimated increase from 1.3 million to 27 million users older than six years of age. The study population included a total of 18,993 individuals in the 1996 survey and 28,445 in the 2005 survey.
The increase in antidepressant use varied across sociodemographic groups. Among African Americans, the rate of antidepressant use was 3.61 percent in 1996 and 4.51 percent in 2005. In the Hispanic population, the respective rates were 3.72 and 5.21 percent.
The study’s authors speculate that antidepressant use has risen for several reasons, including an actual rise in major depression, the FDA approval of several new antidepressants during the study period, and a general expansion in the availability of mental health treatment.
It also appears that antidepressant use has continued to increase since the 2005 figures were documented. According to a report by Scott Hensley on National Public Radio on August 5, 2009, the group Wolters Kluwer Health Pharma Solutions state that total prescriptions for antidepressants was 230 million in 2008, which was an increase of 27 million, or 13 percent, from 203 million in 2005.
It is unknown whether this upward trend of antidepressant use will continue, especially in view of the current economic crisis. A recent study (July 2009) published in Lancet, for example, reports that “the rising rates of suicide and murders in the population are directly associated to the growing unemployment rates originated by the economic downturn.” Whether the financial turmoil experienced by millions of people will translate into a rise in antidepressant use remains to be seen.

Studies Suggest, But Don’t Confirm, Bullying-Suicide Connection

Researchers have repeatedly found signs of an apparent connection between bullying and suicide in children, according to a new review of studies from 13 countries. Nevertheless, there is no definitive evidence that bullying makes kids more likely to kill themselves.
Still, “once we see that there’s an association, we can act on it and try to prevent it,” said review lead author Dr. Young-Shin Kim, an assistant professor at Yale University School of Medicine’s Child Study Center.
According to international studies, bullying is common and affects anywhere from 9 percent to 54 percent of children. In the United States, many have blamed bullying for spurring acts of violence, including the Columbine High School massacre.
Kim said her interest in bullying grew several years ago when she visited South Korea and heard several new slang terms referring to bullies and their victims. The words reflected “an elaborated system of bullying,” she said.
In the United States, adults scoff at bullying and say, “Oh, that’s what happens when kids are growing up,” according to Kim, who argues that bullying is a serious situation that causes major problems for children — perhaps even contributing to suicidal thoughts and actions.
In the new review, Kim and a colleague analyzed 37 studies that examined bullying and suicide among children and adolescents. The studies took place in the United States, Canada, several European countries (including the United Kingdom and Germany), South Korea, Japan and South Africa.
The review findings appear in the latest issue of the International Journal of Adolescent Medicine and Health.
Almost all of the studies found connections between bullying and suicidal thoughts among children. Five reported that bullying victims were two to nine times more likely to report suicidal thoughts than other children were.
Not just the victims were in danger: “The perpetrators who are the bullies also have an increased risk for suicidal behaviors,” Kim said.
However, the designs of the studies made it impossible for researchers to determine conclusively whether bullying leads to suicide, Kim said. In addition, the authors report that most of the studies failed to take into account the influence of factors like gender, psychiatric problems and a history of suicide attempts.
The review by Kim and colleagues is useful because it compiles what researchers know into one place and is consistent with evidence that “bullying experiences should be taken seriously,” said Stephen Russell, director of the Frances McClelland Institute for Children, Youth and Families at the University of Arizona.
As for the connection between bullying and suicide in teens, Russell said it relates to identity and self-worth, with bullies undermining teens who are trying to figure out who they are and what they think about themselves.
Kim is working on research that will explore whether bullying actually causes suicide, although she acknowledges it will be difficult for researchers to get a firm grasp on a cause-and-effect relationship. To confirm a definitive link, researchers would have to rule out the possibility that some unknown factor makes certain children more susceptible to both bullying and suicide.
Russell said it is difficult to figure out the extent to which suicidal thoughts and attempts actually predict suicide. “Not everyone who commits suicide is known to have thought about it or to have had prior attempts — and certainly not everyone who thinks about it or even attempts it will make a serious attempt or complete suicide,” he said.
For now, Kim said, the existing research should encourage adults to pay more attention to bullying and signs of suicidal behavior in children. “When we see kids who are associated with bullying, we should ask them if they’re thinking about hurting themselves,” she said. “We should evaluate and prevent these things from happening.”
A researcher who studies teen suicide agreed: “We need to keep at it; not studying it and trying to intervene is just not an option,” said David Jobes, professor of psychology at The Catholic University of America.

Gene Exists that Affects Chances of Depression but Has Small Impact

There is strong evidence that depression has a genetic foundation and researchers have found a particular variant, often referred to as the depression gene, which may increase the chances that a person will suffer. However, researchers from the University of Michigan say that although they have found more evidence of the gene’s existence, the effect is probably pretty small.

Genetic Variation Probably Accounts for 5-7% of Chances of Developing Depression

Dr. Srijan Sen, an assistant professor of psychiatry at the University of Michigan Medical School, and colleagues examined evidence from 54 studies conducted between 2001 and 2010 that specifically focused on the 5-HTTLPR region of a gene called SLC644. This gene is responsible for coding the serotonin transporter and 5-HTT is the major site of serotonin reuptake. A variant to the 5-HTTLPR s allele is associated with an increased risk of developing depression under stress.
Serotonin is a neurotransmitter that helps relay messages from one area of the brain to another. Brain cells most influenced by serotonin are those that control mood, appetite, sleep, memory and learning and other social behavior. Researchers believe that an imbalance in serotonin levels leads to depression.
Although many studies strongly support the existence of a “depression gene”, Dr. Sen says that having the genetic variant probably only accounts for about 5 to 7 percent of one’s likelihood of developing clinical depression. There are likely other genetic factors involved, he stresses.
However, a better understanding of this region of the serotonin transporter gene may be able to help predict those with a predisposition toward depression and perhaps better individualize treatment and provide support to those at risk.
"Over the last ten years, there are more and more people looking at how to promote positive emotions instead of just playing defense against the negative ones," says Sen. "For those with a genetic predisposition towards depression, it will become very important to learn how to promote positive emotions and resilience in these patients to ward off a possible episode of depression."
Medication development is another area that could benefit from this knowledge. Currently, there are many who do not respond positively to the most popular class of antidepressant medications, known as SSRIs, or selective serotonin reuptake inhibitors. Genetic research may help pharmaceutical makers develop a better drug to help those who suffer from depression due to this gene mutation.