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ARCHIVES 
Past Newsletter Articles
from Holiday 2004 edition:
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Cognitive Therapy used to treat Schizophrenia
Doctors are currently utilizing psychotherapy to treat some cases of schizophrenia. Psychotherapy has long been considered too soft a
treatment for schizophrenia, but recently many doctors have been using psychotherapy sessions in conjunction with medication to help remedy the disease. The first medicines for schizophrenia were developed in the 1960s to suppress the debilitating hallucinations and delusions that are the major characteristics of the disease. The drugs have improved over time, but most patients do not fully recover from the disease with medication alone. A more effective treatment was has been developed by combining psychotherapy with medication.
The current theory of treatment is that patients can experience incapacitating episodes, however, they may also have periods of cognitive stability. During these times, the combination of drug treatment and a form of psychotherapy known as cognitive behavior therapy, is most effective. Most cognitive behavior therapy involves assisting the patient in understanding how their mental illness alters their thought patterns and behavior.
The treatment combination cannot cure schizophrenia, but it can effectively help to remedy the major symptoms of the disease. Doctors are currently working on understanding how abnormal thoughts can guide behavior. Therapists work with
patients to explore their strengths and weaknesses, and patients are taught
coping strategies as they learn about their illness. The cognitive behavior therapist also tries to elicit information from patients about their own interpretation of their symptoms, specifically the delusional ideas and hallucinations. Unlike traditional
psychoanalysis, cognitive behavior therapy can be delivered over a few months and does not continue indefinitely.
For more information contact:
Peter J. Weiden, M.D.,
Director of the Schizophrenia Research Program,
SUNY Downstate and Kings County Hospital Center,
Department of Psychiatry,
Post Office Box 1203,
450 Clarkson Avenue,
Brooklyn, New York 11203;
718-270-4483; Fax: 718-270-3355;
Website: www.downstate.edu/psychiatry/default.html
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Clinical Predictors of Suicidal Acts
After a Major Depressive Episode in Patients With Major Depressive Disorder or Bipolar Disorder
Oquendo MA, Galfalvy H, Russo S,
American Journal of Psychiatry. 2004;161(8):1433-1441
Suicidal behavior is highly associated with mood disorders. The authors proposed a stress-diathesis model of suicidal behavior for disorders of mood, psychosis, and personality. They defined stressors as observable, environmental precipitants for suicidal behavior, including financial difficulties, loss, or relationship struggles. The diathesis was defined as a tendency toward pessimism and aggression/impulsivity. Individuals with these characteristics would theoretically be at a higher risk for attempting suicide, have a higher propensity for hopelessness, have a subjective sense of depression, and have fewer reasons to want to live. After their axis I diagnosis was confirmed, 308 individuals with a diagnosis of major depressive disorder or bipolar disorder were evaluated for objective symptoms of depression using the 17-item Hamilton Depression Rating Scale. Subjective severity of depression was assessed with the Beck Depression Inventory. Lifetime aggression was measured with the Brown-Goodwin Aggression Scale and the Buss-Durkee Hostility Inventory, and impulsivity was measured with the Barratt Impulsivity Scale. Subjects also received the Reasons for Living Inventory and the Beck Hopelessness Scale. At baseline, patients with and without a history of suicidal behavior were similar in terms of objective ratings of their depressive symptomatology, but the former group had higher subjective ratings of depression on the Beck Depression Inventory. In addition, those with a history of suicidal behavior also had fewer perceived reasons for living and more suicidal ideation. Thus, the authors felt that this group had a higher rating of pessimism. Also, the attempters had higher scores on baseline levels of aggressive/impulsive traits. The patients were followed for 2 years, at which point 4 subjects died via suicide and another 38 attempted suicide, making up 14% of the original cohort. The strongest predictors for future suicidal behavior were a history of a previous suicide attempt, a higher subjective rating of their depressive symptoms, and a history of cigarette smoking. In addition, both pessimism and aggression/impulsivity traits predicted future suicidal behavior. It would be useful for clinicians to evaluate patients with mood disorders for a history of pessimism, aggressive and impulsive acts, and substance usage, including nicotine dependence. Patients with these risk factors may need to be more aggressively managed to help protect them from future suicidal behaviors.
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The following article
appeared in the Intelligencer on August 1, 2004.
We thank Sarah Larson for her excellent reporting.
We at NAMI of Bucks County have been asking for increased funding for
vital Mental Health programs for many years.
The reality is that Bucks County is under-funded.
This inequity must stop. Please
read the article and call both your State Senator and State Representative
listed on page 4 of this newsletter. Only
grassroots advocacy can impact funding. Please
tell them how under-funding for crisis intervention, housing supports, PACT and
supported employment have impacted you and your family member and people with
mental illness in Bucks County. We
are forming a coalition along with other inequitably funded NAMI county
affiliates to address this issue but we need your help to impress upon our
legislators that this is an issue that needs their attention.
MENTAL HEALTH MILLIONS BYPASS BUCKS Fall 2004
Newsletter
By SARAH LARSON
The Intelligencer August 1, 2004
People with mental illness in Bucks County have been shortchanged millions of dollars that could have been spent on innovative treatment plans, according to advocates. Bucks gets the least amount per person in state funding for mental health programs of the five suburban Philadelphia counties, according to budget figures from the state. It is in the bottom quarter of funding when compared to all other counties. Even when other funding programs are added to the mix, Bucks remains second to last in terms of total mental health spending per capita. "It's not right, but that's the way it's been, historically," said Phil Fenster, who runs Bucks' Mental Health and Mental Retardation division. "I've brought it up to our Bucks County delegation several times, but they don't have the power to change anything alone." In the 2001-02 fiscal year, the latest for which complete figures were available, Bucks County received $20.31 per capita for mental health funding, while Montgomery County got $29.86. Delaware County received more than three times as much, and Lebanon County was first in the state with $128.89.
It is an inequity that has stretched back for decades, said Fenster, who has run the Bucks department since 1985. He said he started looking sometime in the 1990’s at why Bucks wasn't getting the money he thought it should. The answer frustrated and surprised him. In the late 1960s, psychiatric treatment began to shift from treatment in institutions to treatment in the community. To ease the transition, Presidents Kennedy and Johnson signed legislation to create mental health treatment centers in local communities, Fenster said. But the Bucks County mental health program, which began in 1968, did not jump on the bandwagon. "Apparently, when the feds gave money to communities to provide treatment centers, Bucks County, for some reason, did not start one," he said, noting that the office had a new director every few years between 1968 and 1980. "Because of the lack of consistent administration to lead the county to that money, Bucks didn't have one federally funded mental health center. We just kept getting whatever our state allocation was, year after year after year." By the time Fenster realized what had happened and went to the state with his concerns, it was too late. Budgets had shrunk, priorities had shifted, and Bucks was out of luck.
Stacey Ward, spokeswoman for the Department of Public Welfare, which oversees the counties' mental health programs, said the department has not increased its state allocation to counties in years. The current funding guidelines have been in place since the 1980s, she said. "We look at it as a maintenance budget," Ward said. "We maintain what they currently have, and they certainly are encouraged to come to us with applications for new programs."
But new programs aren't the issue, said Katharine Watson, who worked in Bucks County administration for years before becoming a state representative. Bucks' population increase since the 1980s alone should merit a bigger chunk of money, she said. She said she and other local legislators have taken those concerns to Harrisburg and are never well received. "There are inequities and they know it and it's been brought up," she said. "Part of the problem is the perception that Bucks County doesn't need it. 'This is a rich county,' I hear that constantly. Unfortunately, that translates into funding, whereby I don't think we get our fair share."
The bottom line is that patients and their families have been shortchanged, said Kathleen Campbell of Buckingham, president of the county's chapter of the National Alliance
on Mental Illness. "If we were funded equitably, that would allow us to have very important programs that are proven to work," she said. "We need better housing, supportive employment - you name it."
Subsequent funding streams have kept the Bucks program limping along, Fenster said. A 1991 program gave counties about $100,000 for every bed they closed down at a state hospital in favor of community-based treatment, he said, and a Medicaid program that started in 1997 gave additional money for more services. "That's helped the system a lot," he said. "If we didn't have that, and had to rely on our state money, we'd be pretty close to disaster."
But the loss of the basic federal and then state funding undeniably has hurt, he said. It is difficult to estimate how much money Bucks has lost over the years, but assuming an average of $2 million a year, it equals $72 million.
State Mental Health Funding
2001-2002 most recent figures available
| County |
Number
of Clients |
State
Allocation |
Average
Expenditure |
| Bucks |
5,823 |
$12,137,053 |
$2,084 |
| Chester |
1,933 |
$11,318,830 |
$5,856 |
| Mongtomery |
3,753 |
$22,396,203 |
$5,968 |
| Delaware |
6,397 |
$34,817,284 |
$5,443 |
| Philadelphia |
25,250 |
$143,631,685 |
$5,688 |
Contact
your representative today and tell him that under-funding for Bucks County
Mental Health must
stop! Our citizens deserve equitable treatment!
STATE SENATORS
District 6
Robert M. Tomlinson (R)
2212 Bristol Pike, Suite 3
Bensalem, PA 19020
215-638-1777; fax: 215-638-7619
rtomlinson@pasen.gov
District 10
Joe Conti (R)
10 Garden Alley
Doylestown, PA 18901
215-348-2233; fax: 215-489-5214
jconti@pasen.gov
District 12
Stewart J. Greenleaf (R)
711 N. York Road
Willow Grove, PA 19090
215-657-7700; fax: 215-657-1885
sgreenleaf@pasen.gov
District 24
Rob Wonderling (R)
427 West Main Street
Lansdale, PA 19446
215-368-1500; fax: 215-560-4896
rwonderling@pasen.gov
www.senatorwonderling.com
STATE REPRESENTATIVES
District 18
Gene DiGirolamo (R)
2444 Bristol Road
Neshaminy Valley Commons
Bensalem, PA 19020
215-750-1017; fax: 215-750-1295
gdigirol@pahousegop.com
District 29
Bernard T. O’Neill (R)
210 W. Street Rd.
Warminster , PA 18974
215-441-2624; fax: 215-441-2627 website |
STATE REPRESENTATIVES
(cont'd)
District 140
Thomas C. Corrigan, Sr. (D)
1813 Farragut Avenue
Bristol, PA 19007
215-781-2451; fax: 215-781-3443
tcorriga@pahouse.net
District 141
Anthony J. Melio (D)
6139 Emilie Road
Levittown, PA 19056
215-943-8669; fax: 215-943-2434
amelio@pahouse.net
District 142
Matthew N. Wright (R)
760 N. Woodbourne Road
Langhorne, PA 19047
215-757-8538; fax: 215-757-8510
mwright@pahousegop.com
District 143
Charles T. McIlhinney, Jr.
199 N. Broad Street, Suite 200
Doylestown, PA 18901
215-489-5000; fax: 215-489-5200 www.charlesmcilhinney.com
District 144
Katharine M. Watson (R)
1410 W. Street Road, Suite B
Warminster, PA 18974
215-674-0500; fax: 215-674-0347
www.kathywatson144.com
District 145
Paul Clymer (R)
311 N. 7th Street
Perkasie, PA 18944
215-257-0279; fax: 215-257-6350
pclymer@pahousegop.com
District 178
Scott A. Petri (R)
The Weather Vane
95 Almshouse Road, Suite 303
Richboro, PA 18954
215-364-3414; fax: 215-364-8626
spetri@pahousegop.com
www.reppetri.com
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NAMI SUPPORT GROUP PROGRAM - ABOUT THE GROUP MODEL
Fall 2004 Newsletter
The NAMI Support Group model (formerly called the "Family-to-Family Support Group model") operates differently than other, more traditional "share-and-care" groups. The NAMI Support Group model offers a set of key structures and group processes for facilitators to use in common support group scenarios. These structures come with clear guidelines to follow; used together, they encourage full group participation in support group meetings. The structures of the new model feel comfortable for both seasoned and less-experienced facilitators because they guide the support group along in every situation.
As a facilitator, how do you ensure that a support group starts and stops on time? What do you do if someone monopolizes all of the group’s time? How should you handle disrespectful group members? What should you do if someone brings up a "hot potato" subject such as suicide or involuntary commitment? What about someone who seems to have a problem that’s just not solvable? How do you ensure that quiet members in the group get a chance to participate?
Support group facilitators face these issues in their groups every day. And effective support group facilitators are the key to making any support group experience positive and productive. The NAMI Facilitator Skills Support Group training enables support group facilitators to run useful, helpful support groups. NAMI affiliates know that effective support groups are a key facet of NAMI’s grassroots organization.
In order to ensure the continuation of our programs in Bucks County, we need volunteers to become support group facilitators, especially in central and upper Bucks. If you are interested in becoming trained as a NAMI Support Group Facilitator please call us at
866-399-6264.
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A NEW NAMI PROGRAM: HEARTS & MINDS
Fall 2004 Newsletter
Research has demonstrated that people living with severe psychiatric conditions may have an increased risk of heart disease and related conditions. For this reason, NAMI has designed the Hearts & Minds program: a 13 minute inspirational video tape and a 26 page booklet. The purpose of the program is to raise awareness and provide information on:
· Diabetes
· Diet
· Exercise
· Smoking
in addition to basic information on addictions, recovery, stigma and treatment. Along with information on diabetes and sleep apnea, Hearts & Minds contains tips for exercise, diet--including a shopping list template, recipes, and a food diary.
Type ll Diabetes has become a particular concern, since research has begun to question the link between some psychiatric medications and the disease.
"The program is designed to make people want to get moving; to change something they can change in order to have a healthier life," says Kathryn McNulty, NAMI Director of Consumer Education Programs. "Reclaiming good physical health may be seen as the 'second wave' of wellness, once people begin to recover with serious mental illness."
"As a psychiatrist, I am impressed at the importance of promoting preventive cardiac care for people living with serious mental illnesses who are at increased risk," stated Ken Duckworth, M.D., NAMI Medical Director. "Hearts & Minds is NAMI's effort to advance this important topic."
"We are pleased to offer this new educational initiative at NAMI. Hearts & Minds fills a tremendous need for accurate, timely information in this area, and we are proud of this new program, " said Mike Fitzpatrick, NAMI interim Executive Director.
To view and print .pdf files containing all sections of the Hearts & Minds booklet, please visit
www.nami.org.
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FROM CHILD TO ADULT
The signs of future adult psychiatric disorders are usually noticeable in childhood, but diagnostic labels don't help much in making the prediction. That's one conclusion of a long-term study including 1,000 residents of Dunedin, New Zealand, who were followed by researchers from birth. When they were interviewed at age 26, almost every person diagnosed with a psychiatric disorder in the previous year—mainly anxiety and mood disorders and substance abuse — had also had an earlier psychiatric diagnosis. Three-quarters of these diagnoses had been made before age 18 and more than half before age 15. (No data on psychiatric disorders were recorded before age 11.) A group of related childhood behavior problems—attention deficit disorder (hyperactivity, distractibility, and impulsiveness), conduct disorder (aggression, cruelty, stealing, lying, serious rule violations), and oppositional defiant disorder (ill temper, spitefulness, habitual defiance of adult authority) —were linked to most adult psychiatric disorders. From one-quarter to nearly two-thirds of adults with a variety of psychiatric disorders had a diagnosis of conduct disorder or oppositional defiant disorder as children. Children with conduct disorder were more likely to develop antisocial personality and alcohol and drug problems than adults -- no surprise. But they were also as likely to suffer adult depression as people with childhood depression; more likely to have adult eating disorders than people with childhood depression and anxiety; and almost as likely to have adult anxiety disorders as people with childhood anxiety. Adult schizophreniform disorder (delusions and hallucinations, disorganized speech and behavior) followed conduct disorder almost as often as it followed childhood anxiety and depression.
The authors suggest that psychiatric disorders may eventually be reclassified to explain these connections. Meanwhile, they propose that a better understanding of conduct disorder and related behavior problems in children and young adolescents would help in preventing adult psychiatric disorders.
Kim-Cohen I, et al. "Prior Juvenile Diagnoses in Adults with Mental Disorder: Developmental Follow-Back of a Prospective-Longitudinal Cohort; Archives of General Psychiatry (July 2003): Vol. 60. No.7, pp. 709-17. APRIL 2004 HARVARD MENTAL HEALTH LETTER.
http://www.health.harvard.edu/hhp/publication/view.do?name=M
COMING
TO YOUR STATE - A PREFERRED DRUG LIST
Oregon
is one of 30 states that have recently implemented or plan to implement
a preferred/ approved drug list (PDL) to control Medicaid prescription drug
spending. In the past couple of years,
Medicaid's preferred list of drugs has emerged as a way for Medicaid to
control the growing cost of prescription drugs. In Oregon, the preferred drug
list is voluntary for physicians to follow and does not include a prior
authorization/approval
of drugs. However, Oregon
officials
have now made changes to that plan. The plan requires an "evidence-based" review of a drug's effectiveness. This review would be conducted by an independent body, which would drive the choice of medications before the state considered costs. The PDL legislation also mandates that doctors be allowed to prescribe non-preferred medications, by indicating on a script that a drug is medically necessary for a patient. But, because a voluntary PDL does not work as effectively as mandated policy in controlling costs, Oregon has now added a prior authorization requirement. Doctors have to first contact the state for approval before prescribing medication not listed on the preferred drug list.
The Depression and Bipolar Support Alliance (DBSA) is extremely concerned about the enactment of a preferred drug list. Patients who need medication and are on Medicaid should be the first and foremost consideration. Setting up barriers to patients getting the drugs they need—drugs that are prescribed by their doctors—can only result in care that is less than effective and less than what every patient deserves. Doctors should decide, with their patients, what drugs the patient should be taking. That decision should be based on medical consideration, not on financial considerations or on the state's desire to control care and costs. It is quite possible that at least 30 other states are considering adopting the Oregon model—maybe more. We're asking that your DBSA chapter send the attached letter to your state's governor and legislators asking them to reconsider this policy—which is sure to cause serious suffering and less-than-appropriate care. For some patients, the result could literally be life or death. You can copy the attached letter and send to your governor and legislator's by regular mail or by e-mail. (We do know that legislators prefer to receive correspondence via e-mail.)
Go to the following link: http://capwiz.com/ndmda/dbq/officials/?lvl=L
Click on your state; enter your address/ zip code. This will take you to a page listing your federal and
state legislators. Click on your governor's or legislators' names which will take you to a page with his/her photo and contact information and a link that says "Send Message." You can copy and paste the attached letter in this space or write your own message and send immediately. If you have any questions or need additional information, please contact DBSA's External Relations Department at
externalrelations@DBSAlliance.org
or call 312/988-1153. Thank you.
Sample letter regarding Medication Restrictions by Medicaid - Copy this letter and send per instructions above, please...
To prevent a patient from getting what is medically appropriate is simply bad care. It is also bad public policy, since experience shows that the most appropriate treatment is usually the most cost effective in the long run. Individual treatment plans, particularly for mental illness, are essential. The treating physician, in consultation with his/her patient must make treatment decisions that are based on the clinical experience of the physician and the individual needs of the patient. One's ability to tolerate side effects or meet treatment regimen requirements, for example, can greatly impact adherence with the specific course of treatment.
The patient's situation, including cultural, economic, social and genetic factors, and the impact those factors may have on treatment adherence and effectiveness can only be adequately evaluated and addressed within the doctor/patient relationship. We appreciate the current economic environment states are facing and understand the need for states to find ways of saving money. What we cannot support, however, is any mechanism that is used to justify restrictions on a broad selection of medications that are critical for the survival of the millions of people living with depression and bipolar disorder. Doctors should decide, with their patients, what medications the patient should be taking. That decision should be based on medical consideration, not on financial considerations or on the state's desire to control care and costs.
Bipolar Disorder and
Schizophrenia: A Common Basis?
Schizophrenia
and bipolar disorder are usually regarded as distinct major mental illnesses
that affect different brain functions, run in different families, and respond
to different treatments. But the symptoms sometimes coincide—hallucinations
and delusions during periods of mania or depression, depressive episodes in
schizophrenia. Some medications are useful for both disorders. And in a
condition called schizoaffective disorder, symptoms of both bipolar disorder
and schizophrenia occur.
Now
scientists conducting autopsies at Johns Hopkins have made a discovery
suggesting that the resemblance between these two disorders have a genetic
basis.
Using DNA chip technology, they compared the expression (activation) of more than 20,000 genes in the preserved brains of 15 people with schizophrenia, 15 with bipolar disorder, and 15 with neither disorder. After correcting for possible effects of medications, they found that a number of genes were expressed in the third group but not in the first two. These genes are among those responsible for the synthesis of myelin, the insulating sheath that facilitates the transmission of signals by nerve cells. More than a dozen proteins used to make myelin were deficient in the brains of schizophrenic and bipolar patients. The genes affected were not the same in both disorders, but there was considerable overlap.
A next step, the authors say, is to determine whether the brain regions affected by this under activation of myelin-related genes are different in the two forms of major mental illness.
Tkachev D, et al. "Oligodendrocyte Dysfunction in Schizophrenia and Bipolar Disorder," Lancet
(September 6, 2003): Vol. 362, pp. 798-805.
Family
Studies of Schizophrenia Research
|
Our
speaker on April 15, Dr. Raquel E. Gur, Director of the Neuropsychiatry
Program, leads the Family Studies of Schizophrenia Research at the
University of Pennsylvania. The NIMH will be funding this study over the
next 5 years. Their goal is to find the specific causes of schizophrenia,
schizoaffective disorder, and related brain disorders.
This is done by studying people with brain disorders and their
family members. It is
believed that brain disorders are caused by a combination of both genetic
and environmental factors. Many
questions remain about the genetic and non-genetic factors that contribute
to brain disorders. The goal
of their research is to provide answers to these questions in order to
improve treatment and identify persons who are at risk for developing a
brain disorder.
Many
people affected with schizophrenia and their family members have expressed
frustration with how confusing and at times ineffective the diagnosis and
treatment of brain disorders can be.
To many, it often seems that diagnoses and medications change
without clear reason or beneficial effect.
Research that leads to a
more precise |
|
understanding
of the causes of brain disorders will help to resolve these problems.
Through basic research like theirs, the following benefits may
become possible:
·
New treatments may be
developed that better target the causes of brain disorders, leading to
increased relief from symptoms with fewer side effects.
·
Diagnoses may be based on
laboratory tests rather than a description of symptoms, making diagnosis
more reliable and treatment more focused.
·
Well individuals in
families with a history of schizophrenia may obtain more informative
genetic counseling about the level of risk for illness in themselves and
other relatives.
·
Persons at risk may be
identified and the onset of illness may be delayed or possibly prevented
with appropriate treatment.
The
Program is seeking to include families with at
least one person who |
|
is
diagnosed with Schizophrenia or Schizoaffective Disorder.
They also seek to includeclose relatives (e.g., siblings, children,
grandparents, grandchildren, aunts, uncles, nieces, nephews).
The extended family members do not
need to be ill to participate. From
each participant they obtain written informed consent and ask that each
person complete a family interview, a diagnostic interview,
neuropsychological testing, and provide a small sample of blood for
genetic analysis. They also
ask the person to participate in some simple tasks studying brain
function. The procedure can be completed over 2 days, and much of it can
be done at home. Their study does not require any change in current
treatment. All information is
kept confidential. Each person who participates in the study could
potentially receive anywhere from $35 and up to $330 (depending on how
many tasks are completed). If
you have more questions, or would like to speak directly to one of their
staff, you may call them at 215-615-4115 and ask for one of the research
coordinators for the Family Study |
Acute Respite Care
- One of the Best Kept Secrets in Bucks County
NAMI
Bucks receives numerous calls from people searching for help in
overcoming the difficult environmental stresses and psychiatric
emergencies that occur from time to time in the management of mental
illness. Lenape Valley Foundation offers an Acute Respite Care
Program for those occasions that require short term, professional
assistance. The service is designed to be an alternative to
inpatient psychiatric care and/or to provide a secure environment which
would provide an accelerated discharge from an inpatient setting.
Acute Respite is a program that offers Bucks County residents age 18 and
above a voluntary alternative to inpatient psychiatric care. |
The
client must meet one or more of the following criteria:
a..
Experiencing an emergency mental health crisis or at risk of
psychiatric hospitalization
b.. Needs an emergency mental health respite from a stressful
living environment
c.. Needs a step-down from an inpatient setting
d.. Needs a planned mental health respite
All
Acute Respite residents must meet the following requirements:
a.. Willing to participate in individual and group activities
b.. Capable of all personal care activities
c.. Possess the ability to avoid all alcohol and illegal drug use
and criminal behavior
d.. Have a residence in place for discharge |
What Does the Acute Care Program Provide?
a.. Provides 24 hour a day staffing
b.. Admission availability 24 hours a day
c.. Education and supervision with client's daily medication regime
d.. Immediate access to the full continuum of behavioral healthcare service
e.. Two convenient locations: one in Doylestown and one in Levittown
f.. Active linkage to community-based behavioral health service and crisis intervention
g.. Provides a home-like environment
h.. Affordable
Lenape
Valley Foundation Acute Respite Care Program:
For
Information and/or Admission
Doylestown:
215-345-7523
Levittown: 267-580-1031 |
Varieties of
Schizophrenia
|
Researchers
at the University of Pennsylvania have developed a new classification of
schizophrenic patients based on memory disturbances and certain brain
features. Researchers tested schizophrenic patients and controls for the
ability to learn and remember. All subjects were also given MRI (magnetic
resonance imaging) scans to observe brain structure and positron emission
tomography (PET) scans to measure brain blood flow and energy consumption.
It
turned out that the 245 patients could be divided into three groups. The
first, including about 20% of the patients, consisted mostly of young men
who developed schizophrenia early in life.
Their
symptoms included poor attention, disorganized thinking, and incoherent
speech. Their memory deficits resembled Alzheimer's disease in some
ways—poor recall, many false memories, and poor recognition memory. Yet
they did not have particularly serious delusions or negative symptoms
(apathy, emotional unresponsiveness). |
The
temporal lobes of
the cerebral cortex and the hippocampus, centers of emotion and memory,
were smaller and less active than average. The authors call this the
cortical type of schizophrenia.
A
second group, which they call the subcortical type, comprised about a
third of the patients. They also suffered from limited speech, poor
attention, and disordered thinking, but their memory problems resembled
Huntington's disease more than Alzheimer's—less memory loss overall,
fewer false memories, and better recognition memory. However, this group
had the most serious symptoms, both positive (delusions and
hallucinations) and negative.
Surprisingly,
their brain activity, as measured by PET scans, seemed no different from
that of normal controls.
But
their MRI scans revealed thinning in the gray matter of the frontal
cortex, which governs planning, judgment, and initiative. Their
temporal lobes looked relatively normal. |
The
third group, comprising 50% of the schizophrenic patients, had only mild
memory problems. Their symptoms and brain abnormalities were a mix of
milder forms of the features found in the other two groups. Yet they had
more enlargement of the brain's fluid-filled cavities, the ventricles
(suggesting general atrophy of brain tissue), than the cortical group
and more tissue loss in the temporal lobes than the subcortical group.
This suggests to the authors that their classification represents real
differences of kind and of origin, rather than just differences in the
severity of schizophrenic symptoms.
Turetsky
BI, et al. "Memory-Delineated Subtypes of Schizophrenia:
Relationship to Clinical, Neuroanatomical, and Neurophysiological
Measures," Neuropsychology (October 2002): Vol 16, No.4, pp.
481-90. HARVARD MENTAL HEALTH LETTER www.health.harvard.edu
MARCH 2003
|
BUCKS COUNTY CARING NEIGHBOR PROGRAM
By Michelle Haines from “Be About Recovery Now” Center at Lenape Valley Foundation
What and where is Bucks County Caring Neighbor program? We can answer that question!
Bucks County Caring Neighbor is a program that was implemented by Lenape Valley Foundation and funded by the Bucks County Mental Health office in 1994. The program was developed to provide non-therapeutic support to individuals with a diagnosis of mental illness. The support is provided by a volunteer who spends time with the individuals either by phone or in person weekly and monthly. Recruitment for the program speaks for all of Bucks County’s residents who are interested in same gender volunteer positions. These positions require compassion, a minimum of once a week phone call, and a once a month visit or outing. Matches get together bi-yearly to celebrate their gift of friendship, compassion and honor their dedication at a local restaurant or other specified event. The volunteer position is low or no cost. It is a sharing of time, wisdom, experience, and friendship to participants in mental health services throughout Bucks County. Participants gain friendship designed to reach beyond diagnosis and treatment. It is a friendship of giving – a gift of time. The motto of the program is: All people have dreams; Some dream of money; Many dream of power; Some dream of fame and fortune; The biggest dream of all is Friendship!
Residents who wish to give a gift of time may reach the Bucks County Caring Neighbor program at 215.957.2204, extension 5905.
Leaving Some Children Behind
by Maria Belen Assusa, NAMI Child & Adolescent Action Center
The
No Child Left Behind Act is potentially the most important school initiative to
come along since the country embraced compulsory education in the early 20th
century. But the goal of providing all children with qualified teachers and
high quality schooling may slip away unless Congress provides the money needed
to do the job and holds the line against groups that are working to undermine
the law.
Those interest groups are especially peeved by a provision that requires the
states to raise achievement levels for all categories of students, including
children with disabilities, who have usually been shunted into separate classes
and excluded from state achievement tests. A hard-core faction of school
administrators and legislators argues that the six million children who receive
special education services under federal law will never catch up and should be
exempted from higher standards.
Congress has thus far rejected this argument and must continue to do so. The
percentage of children with cognitive disorders, like retardation, that make it
impossible for them to learn is relatively small. No Child Left Behind has
already established flexible procedures for states that wish to exempt these
children from the requirements of the law.
But many of the children who have been dumped into special education classes
are not disabled. They are teachable children who have fallen behind or who
present disciplinary problems. Among those with disabilities, perhaps as many
as 70 percent are teachable children who suffer from learning or
language-related disorders.
These children tend to flower when provided with teachers who know how to teach
them - but such teachers are rare in public schools. According to federal
estimates, only about a quarter of all teachers know how to teach reading to
the 4 in 10 children who do not catch on automatically. Critics of No Child
Left Behind want to abandon disabled children by counting them out of the push
for higher standards. The better solution is for well-trained teachers to help
them succeed.
Psychoeducation Is Effective - We Know It, Science Affirms It...
Let’s Do Something About It!
Seizing
an opportunity to take advantage of an Office of Mental Health (OMH) funding
focus on "best practices" for the upcoming year, NAMI Bucks County is
stressing psychoeducation as the program to fund for FY2005-2006.
Properly
run family education programs reduce patient relapses by more than 50%, reported a
1995 National Institute of Mental Health (NIMH)-sponsored study called PORT (for
Patient Outcomes Research Team). It was an exhaustive compilation of research on
effective treatments for schizophrenia and is considered one of the most authoritative benchmarks in mental health. Although most of its recommendations dealt with medication, family psychoeducation was cited as one of two non-medication approaches most likely to succeed (along with Assertive Community Treatment - ACT).
Several states that have implemented family psychoeducation have reported changed attitudinal mindsets of clinicians and social workers. Rather than looking at families as a "pathological" influence or hindrance, trained and enlightened clinicians see families as collaborators and equal participants in the recovery and renewal system, ensuing reports point out.
Since psychoeducation is rated as one of the best practices, NAMI members must unite in supporting this program and in advocating for its implementation throughout the county. The programs we are advocating to get support for are: NAMI’s Family to Family Education Program, NAMI’s Peer to Peer Recovery Education Program, NAMI’s Provider Education Program, NAMI’s Hand to Hand Program for Parents of children with brain disorders and NAMI’s Parents and Teachers as Allies.
Gene
More Than Doubles Risk Of Depression Following Life Stresses
| National
Institute of Mental Health Washington
Among
people who suffered multiple stressful life events over 5 years, 43
percent with one version of a gene developed depression compared to only
17 percent with another version of the gene, say researchers. No matter
how many stressful life events they endured, people with the
"long" or
protective version experienced no |
more depression than people who were
totally spared from stressful life events. The short variant appears to
confer vulnerability to stresses, such as loss of a job, breaking up with
a partner, death of a loved one, or a prolonged illness. Measuring such
pivotal environmental events — which can include infections and toxins
as well as psychosocial
traumas |
—
might be the key to unlocking the secrets of psychiatric genetics. The
researchers suggest that effects of genes in complex disorders like
psychiatric illnesses are most likely to be uncovered when such life
stresses are measured, since a gene's effects may only be expressed, or
turned on, in people exposed to the requisite environmental risks.
|
NIMH
Underfunds Research into Serious Mental Illnesses
| The
National Institute of Mental Health (NIMH) continues to underfund
scientific research into serious mental illnesses, in spite of the
illnesses’ enormous economic and societal costs, according to a report
released today by the Treatment Advocacy Center and Public Citizen. |
NIMH
has
allocated funds to research irrelevant to its core mission, leaving
serious mental illnesses grossly underfunded compared to other diseases.
From 1997 to 2002, the period covered by the report, the NIMH budget
doubled from $661 million to $1.3 billion. However, the proportion of
money spent on research of
|
serious
mental
illnesses - defined as schizophrenia, bipolar disorder, autism, and severe
forms of depression, panic disorder and obsessive-compulsive disorder -
fell by 11 percent, to only 28.5 percent of its budget.
For a detailed report go
to http://www.psychlaws.org |
Gene
Found for Obsessive Compulsive Disorder
|
Reuters October 23, 2003
WASHINGTON
(Reuters) - U.S. and Japanese researchers said on Thursday they had found
a genetic mutation that causes obsessive-compulsive disorder and other
mental illnesses and said some patients had a second mutation that made
their conditions worse. The
rare finding could make it easier to discover good treatments for the
disorder, one of the top 10 leading causes of disability worldwide.
Dr.
Norio Ozaki of Fujita Health University School of Medicine in Toyoake,
Japan and colleagues at several U.S. institutions -- including the
University of Pittsburgh and Yale University -- worked on the study,
published in the journal Molecular Psychiatry.
The
gene is called the human serotonin transporter gene, hSERT, and helps
control how the body uses serotonin, a message-carrying chemical or
neurotransmitter linked with mood. |
Some
anxiety drugs and antidepressants target serotonin, but the researchers
said patients with the mutations are not helped by these drugs.
"In
all of molecular medicine, there are few known instances where two
variants within one gene have been found to alter the expression and
regulation of the gene in a way that appears associated with symptoms of a
disorder," said Dr. Dennis Murphy of the National Institute of Mental
Health, who worked on the study.
The
researchers analyzed DNA from 170 people, including 30 patients with
obsessive-compulsive disorder (OCD), 30 with eating disorders such as
anorexia and 30 with seasonal affective disorder -- which can cause
depression and other symptoms in dark winter months. They
also looked at the DNA of 80 healthy people.
A
specific mutation in the hSERT gene was seen in two patients with OCD and families |
but
not in other patients.
With
such a rare mutation showing up, the researchers believe it is likely to
be found in other families with OCD and related disorders.
They
interviewed relatives of the patients and found 6 of the 7 people with the
mutation had an obsessive-compulsive disorder, and some also had anorexia,
Asperger's syndrome, which is a form of autism, social phobia or were
abusers of alcohol.
A
second mutation was found in hSERT in two patients, giving them a
"double dose." The patients and their siblings had especially
difficult to treat versions of OCD, the researchers said.
THANKS
to Mental Health E-News is a service of the New York Ass'n of Psychiatric
Rehabilitation Services |
Books on
Cognitive Behavioral Therapy
|
NAMI Bucks'
October Program meeting was well attended and created lots of interest.
Our speaker, Dr. J. Russell Ramsay, has given us a list of books on
Cognitive Behavioral Therapy (CBT) which could be helpful to our members.
They are as follows:
Depression: Feeling Good/Feeling Good
Handbook by David Burns; Mind
Over Mood by Dennis Greenverger, PhD & Christine Padesky, PhD |
Panic
Disorder/Anxiety:
Don’t Panic by Reid
Wilson; An End to Panic by Elke
Zuercher-White; Anxiety and Phobia
Workbook by Ed Bourne
Obsessive
Compulsive Disorder:
Stop Obsessing by Edna
Foa & Reid Wilson; Brain Lock
by Jeffrey Schwartz
Bipolar
Disorder: Bipolar
Disorder: A Cognitive Therapy Approach by Cory Newman |
Schizophrenia: Cognitive-Behavioral Therapy of
Schizophrenia by D. Kingdon & D. Turkington
Suicide:
Choosing to Live by Tom Ellis
& Cory Newman
|
While it may seem like an impossible choice to make, many
parents' only option is to give up custody in order to get help for their
children.
Copyright 2003 Richmond Newspapers, Inc.
Richmond Times Dispatch (Virginia)
October 26, 2003 Sunday City Edition
These parents are beaten, physically and mentally, every day of their lives.
Their children, the children they love, hit them, kick them, pinch them, bite them, spit on them. Their children, who are driven by mental illnesses and disabilities, literally go wild, smashing doors and toys and household appliances. They destroy their own rooms and trash the family home. They attack their brothers and sisters, try to kill the family cat.
Yet despite all of that, their parents love them deeply and would do anything for them.
These parents spare nothing in caring for their children. They spend nearly all their time and money on their troubled children, often to the detriment of any other in the family.
These parents try everything, along the way learning to be medical clinicians and amateur psychologists and nurses and pharmacists.
Inevitably, they are beaten down. And when that occurs, when their inconsolable, irretrievable, incomprehensible 9-year-old son attempts suicide, or when their already difficult daughter goes over the top upon reaching puberty, or their out-of-control older son kicks his younger brother in the head as hard as he can, they go searching for help.
That's when they find out that they may have to give up their child to get it.
full
story
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|
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