Every Day is an Emergency – Psychiatric Bed Shortages Nationwide

The pandemic and the parallel economic crisis have fueled new concern about access to mental health care. An estimated 40% of American adults are have a condition involving mental illness or substance abuse. In June, federal health officials reported nearly 11% percent of adults surveyed seriously considered suicide during the past 30 days.

‘Every day is an emergency’: The pandemic is worsening psychiatric bed shortages nationwide — https://www.statnews.com/2020/12/23/mental-health-covid19-psychiatric-beds/?utm_campaign=rss

We are just ten months into the Great Pandemic and I fear conditions will get worse before they get better.

Anti-psychotic Added to Antidepressant Linked to Higher Mortality

The current investigators analyzed national healthcare claims from the US Medicaid program from 2001 to 2010 for 39,582 Medicaid beneficiaries (mean age, 44.5 years; 78.5% women) diagnosed with depression. Patients with alternative indications for anti-psychotic therapy, such as schizophrenia, psychotic depression or bipolar disorder, were excluded.

After a period of at least 3 months of treatment with a single antidepressant, more than half of the patients (56.6%) augmented their treatment with one of these atypical anti-psychotics: quetiapine, risperidone, aripiprazole or olanzapine. The remaining patients (43.4%) added a second antidepressant. The average chlorpromazine-equivalent starting dose for all atypical anti-psychotics was 68 mg/day, which increased to 100 mg/day during follow-up.

A total of 153 patients died during 13,328 person-years of follow-up, including 105 who augmented with an atypical anti-psychotic and 48 who augmented with a second antidepressant.

Compared with those who added a second antidepressant, those who added an anti-psychotic had a 45% increased risk of dying during follow up (adjusted hazard ratio,1.45; 95% CI, 1.02 – 2.06).

Antipsychotic Added to Antidepressant Linked to Higher Mortality – Medscape – Oct 07, 2020. https://www.medscape.com/viewarticle/938707?src=rss#vp_1

Diabulimia

I live with “the world’s most dangerous” eating disorder

I have been struggling with diabulimia on and off since my diagnosis of type 1 diabetes in 2011, at age 30. I had just started a PhD and spent the first semester walking around campus with all the classic symptoms of type 1 diabetes: famished, dehydrated, constantly needing to urinate, and experiencing rapid weight loss. After my diabetes diagnosis, when I started injecting insulin, I gained the weight back—and then some. It didn’t take long to figure out that omitting insulin was not only an effective weight loss tool, compared with vomiting, it was a much less violent way to purge. Having a history of bulimia nervosa, I thought I had found the holy grail. I could eat what I wanted, not use insulin, and not gain weight.

And I thought Orthorexia Nervosa was bad.

Low Folate, Vitamin D Implicated in First-Episode Psychosis

 

Nutritional deficiencies, especially deficiencies in folate and vitamin D, are associated with first-episode psychosis (FEP), new research suggests.

Australian researchers found significantly lower levels of folate and vitamin D in patients with FEP, compared to healthy control persons. Limited evidence also suggested that serum levels of vitamin C were reduced in people with FEP.

Read the source article here 

Access the full study here.