My Support - April 5, 2010
I do earnestly hope this e-newsletter finds you well. Check out all the really interesting conferences coming up. Sign the petition letter to institute Laura's Law, and check out some of the newest research studies... all in this newsletter.
P.S. Please contact me at anytime: email@example.com
Proposed Draft Revisions to DSM Disorders and Criteria
The draft disorders and disorder criteria that have been proposed by the DSM-5 Work Groups can be found on these pages. Use the links below to read about proposed changes to the disorders that interest you. Please note that the proposed criteria listed here are not final. These are initial drafts of the recommendations that have been made to date by the DSM-5 Work Groups. Viewers will be able to submit comments until April 20, 2010. After that time, this site will be available for viewing only. www.DSM5.org
Dear Friend & Advocate
Summer vacation often poses a challenge for parents of children with special needs.
This break from school is a great time for your children to pursue their interests in specialized programs while relaxing and having fun. Find activities that offer positive and rewarding experiences that foster independence and self-esteem.
It's time now to start planning your family's summer schedule.
In this issue of the Special Ed Advocate, you'll find information on summer planning, guidance about choosing an activity to fit your child's needs, and resource directories of special programs. http://www.wrightslaw.com/nltr/10/nl.0330.htm
XCite Steps Summer Camp
Dear Parents and Members,
We are proud to announce Xcite Steps summer camp for 2010. Xcite Steps offers week long summer camps catered to kids, teens, and adults with developmental or cognitive challenges. Xcite Steps works hard to build and maintain an environment in which campers feel like they can be themselves, open up, make friends and most importantly have fun! We have selected fun sports, recreational activities and games coupled with exciting community outings to help inspire and develop friendships. Our qualified counselors have many years of mentoring, teaching and counseling experience coaching individuals who experience disabilities. The abilities of each camper are promoted to ensure they have the best summer camp experience ever!
Our Camp Dates will run from June 21st thru August 27th. We will be holding our Annual Spring Fling Event on May 22nd from 11-1pm at Fletcher Cove (off of Lomas Santa Fe). This is a great chance to come meet the staff, campers, parents and sign up for camp.
To sign up for camp please reach me at 858-703-7305 or firstname.lastname@example.org
This Sunday opens the most solemn and important celebration in the Christian calendar. During Holy Week, the faithful will commemorate Jesus Christ's entry into Jerusalem on Palm Sunday, His crucifixion on Good Friday and His resurrection on Easter-an inspiring story of rebirth and salvation.
There's a larger story here, though-one that belongs to people of all religions, or possibly no religion at all. It's about the role that faith and spirituality play in mental health.
There plenty of research to back up the connection: 476 studies reporting "statistically significant positive associations," according to a review of research published in the Canadian Journal of Psychiatry last year.
The article was written by Harold G. Koenig, MD, of Duke University, a leading scholar of the subject. He notes that people with bipolar and other mental illnesses find faith to be a powerful coping tool. More than that, a robust faith practice seems to protect against depression.
Why? For one thing, Koenig told bp, faith "gives people a hope that medicine and science can't give. It gives them hope that there's a plan-a good plan-and that good things can result in their life even if they're in a lot of pain." It's all in "Connecting mind, body & spirit," from our Summer 2006 issue. Read more from bp Magazine: http://www.bphope.com/Item.aspx?id=141
Please Help Implement Laura's Law in San Diego County
To sign the petition, please go to www.ipetitions.com/petition/lauraslawsandiegocounty
We need to collect at least 1000 signatures before we go to the county board of supervisors.
To: San Diego County Supervisors Greg Cox, Bill
Horn, Diane Jacob, Ron Roberts, Pam Slater-Price
From: The Undersigned Citizens of San Diego County
We, the undersigned citizens of San Diego County, hereby
petition you, the supervisors of San Diego County, to pass a resolution
implementing Laura's Law in our county.
Laura's Law (AB 1421) was passed by the California legislature in 2002 and patterned after Kendra's Law of New York. However, its implementation is not mandatory and can only be adopted by a resolution of each county's board of supervisors. Kendra's Law or similar legislation has been successfully adopted by several other states and counties throughout the US. Laura's Law is assisted outpatient treatment, sustained and mandated for those in the community most overcome by the symptoms of severe mental illness, and for those for whom current voluntary services have not worked. By providing assisted outpatient treatment, Laura's Law will create an effective tool for people with severe mental illnesses like schizophrenia to get help before they become a danger to themselves or others. It will help stop the violence committed upon them or by them. It will stop the revolving door that spins too many people in and out of hospital emergency rooms, jails, and living on the streets of our county. It will save our county and the US taxpayers from continuing to shoulder the costs of these least effective options. It will protect the rights and the safety of our citizens, especially the 40-50% of those with serious mental illnesses who have no insight into their own illness and refuse the very treatment that could help them. Individual rights are fully protected under this law as the treatment recipient must meet comprehensive criteria before mandated treatment can be ordered.
We believe that Laura's Law can be implemented in our county without diminishing funds for existing mental health programs. The San Diego Mental Health Court Calendar and Assertive Community Treatment are two programs funded by the Mental Health Services Act and now in place to support implementation.
We urge you, our supervisors, to help prevent so much needless suffering of innocent people by enabling these seriously mentally ill citizens to receive the beneficial treatment they need.
Laura's Law will bring real treatment to people who need it most.
Clinical characteristics of comorbid obsessive-compulsive disorder and bipolar disorder in children and adolescents
Gagan, J et al
Objective: To explore bidirectional comorbidity between bipolar disorder (BPD) and obsessive-compulsive disorder (OCD) in youth and to examine the symptom profile and clinical correlates of both disorders in the context of reciprocal comorbidity and ascertainment status.
Methods: Two samples of consecutively referred youth (ages 6-17 years) ascertained contemporaneously for respective studies of BPD and OCD were compared using clinical and scalar assessment and structured diagnostic interviews.
Results: A total of 21% (17/82) of the BPD subjects and 15% (19/125) of the OCD subjects met DSM-III-R diagnostic criteria for both disorders. In the presence of BPD, youth with OCD more frequently experienced hoarding/saving obsessions and compulsions along with a clinical profile of greater comorbidity, poorer global functioning, and higher rate of hospitalization that is characteristic of BPD. Multiple anxiety disorders (≥ 3), especially generalized anxiety disorder and social phobia, were present at a higher frequency when OCD and BPD were comorbid than otherwise. In subjects with comorbid OCD and BPD, the primary disorder of ascertainment was associated with an earlier onset and more severe impairment.
Conclusions: An unexpectedly high rate of comorbidity between BPD and OCD was observed in youth irrespective of primary ascertainment diagnosis. In youth with comorbid OCD and BPD, the clinical characteristics of each disorder run true and are analogues to their clinical presentation in youth without reciprocal comorbidity, with the exception of increased risk for obsessions and compulsions of hoarding/saving and comorbidity with other anxiety disorders.
Bipolar Disord 2010: 12: 185-195.
© 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.
Efficacy and Safety of Long-Term Fluoxetine Versus Lithium Monotherapy of Bipolar II Disorder: A Randomized, Double-Blind, Placebo-Substitution Study
Jay D. Amsterdam, M.D., and Justine Shults, Ph.D.
OBJECTIVE: The authors examined the safety and efficacy of long-term fluoxetine monotherapy, lithium monotherapy, and placebo therapy in preventing relapse and recurrence of bipolar type II major depressive episode. The authors hypothesized that fluoxetine monotherapy would be superior to lithium monotherapy with a similar hypomanic mood conversion rate. METHOD: Patients at least 18 years old who recovered from their major depressive episode during initial open-label fluoxetine monotherapy were randomly assigned to receive 50 weeks of double-blind monotherapy with fluoxetine at 10-40 mg/day, lithium at 300-1200 mg/day, or placebo. The primary outcome measure was time to relapse or recurrence. Secondary outcome measures included the proportion of patients remaining well and the frequency of hypomanic symptoms. RESULTS: There were no significant differences in clinical or demographic characteristics among the fluoxetine (N=28), lithium (N=26), and placebo (N=27) groups. The mean time to relapse was 249.9 days for the fluoxetine group, 156.4 days for the lithium group, and 186.9 days for the placebo group. The hazard of relapse was significantly lower with fluoxetine compared with lithium, and the estimated hazard of relapse with lithium was 2.5 times greater than with fluoxetine. There were no statistically significant or clinically meaningful differences in hypomanic symptoms among treatment groups over time. One patient taking fluoxetine and one patient taking placebo discontinued treatment because of hypomania. CONCLUSIONS: These findings suggest that long-term fluoxetine monotherapy may provide superior relapse-prevention benefit relative to lithium monotherapy after recovery from bipolar II major depressive episode without an increase in hypomanic mood conversion episodes.
Am J Psychiatry Published April 1, 2010
© 2010 American Psychiatric Association
Who Benefits the Most from Psychiatric Day Hospitals? A Comparison of Three Clinical Groups
Larivière, Nadine OT, PhD; Desrosiers, Johanne OT, PhD; Tousignant, Michel PHT, PhD; Boyer, Richard PhD
Comparison of the effects of psychiatric day hospital programs between homogenous clinical groups is an important issue that requires more attention. One group of day hospital patients who have not been included in most studies are people with cluster B personality disorders. The purpose of this study was to compare clinical and social participation outcomes in three groups of individuals treated in a psychiatric day hospital: patients with psychotic disorders, patients with mood and anxiety disorders, and patients with cluster B personality disorders. A pre-experimental, pre-test post-test design was used. During the first and last week of treatment, as well as 6 months after discharge, 20 participants in each group completed questionnaires on severity of symptoms, distress, accomplishment, satisfaction with social participation, and self-esteem. During the intervention, there was significant improvement in all groups on all variables, except for self-esteem in people with psychotic disorders, which remained stable. The patients with psychotic disorders showed significantly less improvement than the two other groups in severity of symptoms, distress, and self-esteem. Following discharge, the degree of change was comparable in the three groups on all variables based on between-groups analyses. However, based on within-group analyses, patients in the mood and anxiety disorders group continued to show significant improvement over time after discharge on self-esteem, accomplishment, and satisfaction with social participation, while no significant changes were seen in the other two groups. Although all three clinical groups made significant gains during their participation at the day hospital and maintained these gains after discharge, those with mood and anxiety disorders benefited the most from their day hospital experience.
Journal of Psychiatric Practice:
March 2010 - Volume 16 - Issue 2 - pp 93-102
Second annual wheelchair basketball tournament
By KENDRA HORSMAN
IU South Bend is hosting its second annual wheelchair basketball tournament on April 6 at 6 p.m. in the Student Activities Center. The cost is $3 and all proceeds will go to disability awareness on campus.
Tim Myhlhousen, president of the Students with Disabilities Union said, "The event shows a person that just because some people are disabled does not mean they can't do stuff that 'normal' people do. They just have to do it in a different way."
The IUSB men's and women's basketball team will form a co-ed wheelchair basketball team that will face off with the River City Rollers.
The River City Rollers are a local wheelchair basketball team.
The event will begin with a pre game between the River City Rollers and faculty members from IUSB. This will be followed by a half time show and the main event featuring the Titans versus the River City Rollers.
With the proceeds the Students with Disabilities Union wants to start building awareness about other disabilities that are not as noticeable, such as bipolar disorder.
"We want to show people that there are other disabilities that people can't always see right away," said Myhlhousen.
Broadway's Unlikely Hit Gives Hope to the Bold
By PATRICK HEALY
Published: March 28, 2010
Bipolar disorder, electroshock therapy, a yearning for peace of mind: these are not the usual elements of a successful Broadway musical. Yet "Next to Normal," which passed its one-year mark on Broadway on Saturday and is preparing for a national tour in November, now qualifies as a hit: it has earned back its $4 million capitalization, the producers said last week.
"Next to Normal" is among the 25 percent to 30 percent of Broadway shows each year that become commercial hits. And while this musical benefited from positive reviews and three Tony Awards last year, several theater producers and directors said the show's recoupment was as significant as it was unlikely, given the tough subject matter, lack of star performers and shrinking audience in a grim economy.
Next To Normal COMING TO SAN DIEGO!!! January 2011, San Diego Civic Theatre
She is bipolar. She left for the store without her meds and vanished
By CHRISTINE STAPLETON
I am going to start keeping track of local crime stories that involve someone with a mental illness. Is it me or am I just hyper-aware of any mention of mental illness in a crime story? It's been driving me crazy lately. Seems more and more stories are mentioning the mental illness of the perp or victim of a crime. Usually it is thrown in at the end of a story ... but it IS there.
Here is what I mean: Today - exactly one year after Tina Lurie vanished - local police detectives held a press conference. They said Lurie's boyfriend - an ex-con who served time for extortion, drug sales and purchase, trafficking in stolen property, burglary and robbery - is a "person of interest."
Near the end of the story we also learn this: "Police said Tina suffers from bipolar disorder and did not have her medication with her when she left home. She also had a history of alcohol abuse."
Is this a big deal? I don't know. I would like to think that my fellow journalists are finally recognizing the importance of mental illness. I covered the courts for 12 years and mental illness surrounded me every day in every kind of legal proceeding - custody hearings, sentencings, domestic violence petitions, divorces and criminal trials and even marriages.
It is everywhere. There is a risk - and it's a big one - that crime stories that mention mental illness will reinforce the ignorant belief that the mentally ill are dangerous. (Boo! Did I scare ya?) There is also a chance that with the constant pounding of stories with mental illness, the clouds will part and people will finally realize the prevalence of mental illness.
Is celebrity soul-baring spreading depression?
By JOHN NAISH
Stephen Fry said he wanted to 'to fight the public stigma and give a clearer picture of a mental illness most people know little about'
When the actor Stephen Fry revealed he suffered from bipolar disorder, he said he wanted 'to fight the public stigma and give a clearer picture of a mental illness most people know little about'.
No doubt the other celebrities who've confessed to being bipolar - Robbie Williams, Carrie Fisher and Mel Gibson - felt their revelations would help raise awareness.
But, in fact, it has had another, unintended effect, giving the condition an air of glamour and creativity.
As a result, psychiatrists and GPs are seeing a disturbing new fashion: people asking to be diagnosed as bipolar. Why would any sane, healthy person want to be labelled mentally ill?
A new report warns that people are confusing normal mood swings with the medical condition.
This has led to the phrase 'a bit bipolar' (as though you can be 'a bit pregnant' or 'a bit dead').
As the comedian Griff Rhys Jones declared in an interview: 'I'm a bit bipolar in that I will get quite down one minute and up the next.'
There is even a Facebook group page called Thinking Everyone Is A Bit Bipolar which announces: 'So everyone is a bit bipolar at some point in their life. Agree?'
The fact is that true bipolar disorder (or manic depression, as it used to be known) is a serious condition, propelling sufferers into prolonged extremes of high and low emotion that utterly disrupt their lives.
In the manic phase, they feel elated. Their heads swirl with grandiose plans, they often spend huge, unaffordable sums, talk at extreme speed and go for days without food or sleep.
They can experience psychotic hallucinations, seeing things or hearing voices.
Hot flushes, night sweats and struggling to cope. Zoe needed help, but was a new 'natural' HRT the answer?
The toxic timebomb: Researchers say gender-bending chemicals are rife but are they just the tip of the iceberg?
Don't blame your genes...change them!
At the other pole of the illness, the depressions are extremely deep and sufferers lose any sense of purpose.
The alarm over 'wannabe' self-diagnosis was raised this month by two NHS psychiatrists, Dr Diana Chan and Dr Lester Sireling, who work at community mental health clinics in North London.
This is no harmless fad, they warn in the Royal College Of Psychiatrists' official journal.
Unintended effect: Robbie Williams, Carrie Fisher and Mel Gibson felt their revelations would help raise awareness but have given the condition an air of glamour and creativity
It may lead thousands to get diagnoses that put them on harmful drugs, as well as ruining their career chances and relationships. It could even drive them to suicide.
In their report, I Want To Be Bipolar . . . A New Phenomenon, the psychiatrists note that the medical profession is seeing waves of people self-diagnosing bipolar.
Yet these patients are merely experiencing mood swings like any healthy person.
But bipolar has become aspirational as a result of celebrities publicising their mood disorders.
Three years ago it was rare to see patients turning up at GP surgeries having self-diagnosed as bipolar, Dr Chan and Dr Sireling say.
Craze too far? Kerry Katona takes Effexo to control her psychiatric condition
Not only has that changed, but it's increasingly common for patients' families to be send them for diagnosis because their 'awkward behaviour' might now gain a socially acceptable excuse with this 'favourable and even desirable diagnosis'.
The report singles out TV shows such as MTV's True Life: I'm Bipolar, and BBC's The Secret Life Of The Manic Depressive, presented by Stephen Fry.
The latter series asked sufferers if they'd rather have the disorder or not. Most chose to 'keep' it because the mania made them feel energetic and creative.
Indeed, in interviews at the time, Fry, while lamenting the terrible depressions it caused, said he 'loved' his condition, too, for providing 'the energy and creativity that perhaps has made my career'.
In fact, clinical research shows most sufferers think their condition has a deeply negative effect.
While the exact cause is not clear, scientists believe bipolar disorder results from an imbalance in brain chemicals.
Environment may also play a significant role - stress can trigger attacks. But being bipolar also tends to run in families: more than two-thirds of sufferers have at least one close relative with the disorder or with major depression.
Last month, Stephen Fry urged patients to take part in research by Cardiff University into a possible genetic link.
The study has DNA from 3,000 volunteers but needs to double this to have a useable sample of the population. It's not only celebrity 'endorsement' that has made bipolar fashionable.
The definition of its symptoms has been steadily expanded in the mental health bible The Diagnostic And Statistical Manual Of Mental Disorders (better known as the DSM).
Originally defined only as involving persistent extremes of mania and depression, bipolar has steadily been softened until it borders on normality, to cover short periods of 'overactivity' and ' lassitude' (or weariness).
This has prompted arguments about how many patients really do have the condition.
According to the NHS, around 500,000 Britons have been diagnosed as bipolar, although recent studies suggest the incidence may be as high as 11 in every 100 - i.e. more than five million.
However, last year a U.S. study of 700 patients concluded that over half of their bipolar diagnoses may be wrong.
Even Dr Allen Frances, who helped compile the latest DSM, admits its definition of childhood bipolar disorder is too wide, prompting a 'false epidemic'.
One study found a 40-fold increase in diagnoses among teenagers since 1994. Academia has also begun to extol the condition's 'inspirational' aspect.
The clinical psychologist Kay Redfield Jamison recently outed a list of creative historical figures, such as Byron, Van Gogh and Virginia Woolf, as bipolar.
WHEN MOOD SWINGS ARE WORRYING
Mood swings are a common complaint, linked to diet, stress and hormonal changes. So how can you distinguish these from bipolar disorder? The difference lies in the duration and severity of the mood changes. In healthy people, a bad mood is usually gone in a few days; with bipolar disorder, the mood change 'fundamentally disrupts a person's life and lasts weeks or even
months. With mood swings, people can still function socially and go to work; in bipolar disorder, the mania can render people socially unstable (they may start fights, for instance), while the depression is often so bad that sufferers won't want to get out of bed or even live.
Last year literary analyst Joan Charles claimed that Robert Burns was also a sufferer.
The phenomenon for illnesses to become fashionable has a long history.
In the Victorian era, melancholia (what we'd call depression) was associated with emotional depth; torment and suffering were hallmarks of a superior sensibility.
'There's this idea that bipolar is just about being creative,' says Dr Des Spence, a Glasgow GP now increasingly contending with victims of the new fashion.
'People come clutching sheaves of Google downloads and say that they may be bipolar. I've had to convince a number they don't actually have this condition. They are just experiencing the normal highs and lows of humanity.'
Dr Spence, who recently argued in the British Medical Journal that medics are increasingly overdiagnosing illness, fears many are ticking the box marked 'bipolar' when witnessing ordinary mood swings.
'Over-diagnosis is now as big a problem as under-diagnosis.' Dr Peter Byrne, director of public education at the Royal College of Psychiatrists, adds that the celebrity culture encourages people to be more openly moody:
'There's this sense of: "If I feel it, then it's OK to say it." But when people start gushing with emotional incontinence, that's frowned upon and may even be called a disorder.'
The danger in all this, says Dr Spence, is you carry the label 'bipolar' for the rest of your life.
'You can get inappropriately medicated and the diagnosis creates potential problems with jobs. Horizons narrow, doors close, dependency increases, sickness is encouraged and optimism is snuffed out.'
Chris Joseph knows what being truly bipolar means. One of the most brilliant gurus in London's ad-land in the 1990s, he built his agency, Hook Advertising, into an award-winning company with a £10million-a-year turnover.
He bought flashy cars and a large detached home next to Richmond Park. Yet within just a few years his illness left him a broken wreck.
Chris, 52, says that his first episode was sparked by the euphoria when his wife announced she was pregnant with their first child.
At one point he stood on a balcony at Gatwick airport and scattered hundreds of pounds in notes over passengers below.
Another time he gave £5,000 worth of Middlesborough football tickets to children outside McDonald's.
His psychosis grew wilder until, he says: 'I believed I could read and understand any language, that I was acquiring the strength of a superhero. It was my calling to save the world and I was slowly but surely turning into the Messiah.
'Eventually, I smashed a picture on my father's wall and walked across the broken glass barefoot.'
His ten-year marriage broke up after another manic episode in which he vanished to Morocco, then dismantled his hotel room looking for a secret passage back to London.
He doesn't know how many spells he endured in psychiatric units, although he estimates it was at least 12. At his lowest, he contemplated suicide.
'Being compulsorily sectioned under the Mental Health Act is a horrific experience,' he says. He also once had his arm broken by a violent male nurse.
Chris - who's now published a book, Manicdotes, about his experience - lives quietly in a small village outside Middlesborough.
He has not relapsed since 2001 when he changed his lifestyle radically for a regime of calm.
He thinks it's 'horrendous' that people view his condition as aspirational: 'It's good there's less stigma, thanks to pop stars and actors saying that they suffer from it, but that works in bad ways, too. People see it as a creative illness.
'There are true bipolar people, and then there are people who suffer mood swings. I've come across both, and they are completely different.
'It's got so ridiculous that some people even say seasonal affective disorder is bipolar. The drugs and lifestyle changes needed to control his condition are hardly glamorous, he adds.
'The medication, which you take for the rest of your life, makes you put on weight, and you feel constantly sluggish.
'I have to operate at a much slower pace - I even have to be careful of news of great joy, because the euphoria might send me manic.'
His work life is a shadow of its former glory: 'Employers look sideways at you when you mention bipolar. Nowadays I do the odd little bit of helping out with an advertising campaign.
'At the moment I'm helping at the local university, giving advice about manic depression.'
Dr Chan and Dr Sireling fear bipolar wannabes do not understand the ramifications of what they desire.
Perhaps Chris Joseph's experiences should be made required reading for anyone who enters a doctor's surgery requesting a diagnosis. For even in the absurd world of celebrity worship, this is certainly a craze too far.
Chris Joseph's book, Manicdotes, is published by Austin Macauley, £7.99. To contact Cardiff University about its research into a genetic link with bipolar, email: email@example.com
UCSD/VA Bipolar Disorder Research Study
Veterans Medical Research Foundation, along with UCSD and the VA Medical Center, is conducting research on how the brain changes as we age, comparing people who have been diagnosed with Bipolar I disorder to those who have not.
We are looking for patients with Bipolar Disorder to participate in our study. You will receive $160 for 7 hours of your time (spread out over 2 appointments), including a magnetic resonance imaging (MRI) brain scan, clinical assessments, memory activities, and a blood draw. Appointments are available on weekdays, evenings, and weekends.
You may be eligible if you...
- have been diagnosed with Bipolar I disorder,
- are 30-79 years old,
- have been on a stable dose of medication for 6+ weeks,
- experienced your 1st episode between the ages of 13 and 30,
- are right-handed,
- are a native speaker of English,
- & do not have uncontrolled diabetes or high blood pressure.
Contact Stephanie Taube: firstname.lastname@example.org, 858.552.8585 x2774.
Personality Disorder or Bipolar?
By RICK NAUERT PHD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on March 29, 2010
A new study suggests a widely used screening tool for bipolar disorder may incorrectly indicate borderline personality disorder rather than bipolar disorder.
The instrument in question is the Mood Disorder Questionnaire (MDQ), a brief questionnaire that assesses whether a patient displays some of the characteristic behaviors of bipolar disorder.
The test can be administered by clinicians or taken by patients on their own to determine if they screen positively for bipolar disorder. For the purposes of this study, the MDQ was scored by researchers.
Bipolar and borderline personality disorders share some clinical features, including fluctuations in mood and impulsive actions. The treatments, however, will vary depending on the individual and the diagnosis.
Principal investigator Mark Zimmerman, MD, director of outpatient psychiatry at Rhode Island Hospital, conducted a study to test the accuracy of the MDQ.
The research team interviewed nearly 500 patients using the Structured Clinical Interview for Diagnostic Statistical Manual IV (DSM-IV) and the Structured Interview for DSM-IV for personality disorders.
The patients were also asked to complete the MDQ. The research team then scored the questionnaires and found that patients with a positive indication for bipolar disorder using the MDQ were as likely to be diagnosed with borderline personality disorder as bipolar disorder when using the structured clinical interview.
Further, their findings indicate that borderline personality disorder was four times more frequently diagnosed in the group who screened positive on the MDQ.
Zimmerman says that these findings raise caution for using the MDQ in clinical practice because of how differently the disorders are treated.
"An incorrect diagnosis of bipolar disorder will usually lead to a treatment involving medications. If a patient truly has bipolar disorder, that treatment may work. However, at this time there are no approved medications to treat borderline personality disorder.
"Without an accurate diagnosis of borderline personality disorder, we may have many people in treatment who are taking medications that will not work to alleviate the characteristics of the condition from which they really suffer."
Zimmerman continues, "In addition, patients with unrecognized borderline personality disorder will not be treated with one of the effective psychotherapies for this condition.
"It is therefore vital that we develop or identify a more accurate method to distinguish between these two conditions, and adopt it into clinical practice."
Won't you join us? NAMI North Coastal Beach Walkers Team April 17, 2010 at 8am --- Look for our Booth!
We have 22 walkers so far and have raised only $1990.00--let's get out there to support this great event!!!
Join online or send a check directly to NAMI NC attn: WALKS!
THANK YOU TO ALL that have already signed on!!
Bob Brooks, Pres
PPO Box 2235
Carlsbad, CA 92018
NAMI depends on generous volunteers to raise funds and awareness at each of our Walk sites.
Common Copy Number Variations In Genes Unlikely To Contribute Significantly Toward Common Diseases
A study of the genetics of common diseases including diabetes, heart disease and
bipolar disorder has found that commonly occurring copy number variations -
duplicated or missing chunks of DNA in our genome - are unlikely to play a major
role in such diseases. http://mnt.to/a/3zK5
Prescription Drug Take Back Day
Toll Free Hotline: (877) 662-6384 Facebook.com search "Oxy Task Force"
Saturday, April 17, 2010 9am-1pm
MEET PREVENTION & TREATMENT PROVIDERS
GAIN VALUABLE INSIGHT THAT CAN HELP YOUR FAMILY AND COMMUNITY
Drop Off Your Unused Prescription Drugs No Questions Asked
6 COUNTY-WIDE LOCATIONS:
County Administration Center, 1600 Pacific Hwy, San Diego
Oceanside-Tri-City Medical Center, 4202 Vista Way Poway-Poway Sheriff 's Station, 13100 Bowron Road Encinitas- Scripps Memorial Hospital Encinitas, 354 Santa Fe Drive
El Cajon-El Cajon Courthouse, 250 E. Main Street
Chula Vista- South Bay Courthouse, 500 Third Avenue
Help reduce youth access to drugs
Proper Disposal of Prescription Drugs
Do not flush prescription drugs down the toilet or drain unless the label or accompanying patient information specifically instructs you to do so. For information on drugs that should be flushed visit the FDA's website.
To dispose of prescription drugs not labeled to be flushed, you may be able to take advantage of community drug take-back programs or other programs, such as household hazardous waste collection events, that collect drugs at a central location for proper disposal. Call your city or county government's household trash and recycling service and ask if a drug take-back program is available in your community.
If a drug take-back or collection program is not available:
- Take your prescription drugs out of their original containers.
- Mix drugs with an undesirable substance, such as cat litter or used coffee grounds.
- Put the mixture into a disposable container with a lid, such as an empty margarine tub, or into a sealable bag.
- Conceal or remove any personal information, including Rx number, on the empty containers by covering it with black permanent marker or duct tape, or by scratching it off.
- Place the sealed container with the mixture, and the empty drug containers, in the trash.
Office of National Drug Control Policy 750 17th St. N.W., Washington, D.C. 20503 p (202) 395- 6618 f (202) 395-6730
Bipolar In Order
John M. Grohol, Psy.D. | 29 March 2010, 4:19 pm
Tom Wootton's new book, Bipolar In Order, asks the reader to approach bipolar disorder (otherwise known as manic depression) from a different light. Rather than viewing this mental health condition as a problem needing a cure, he asks that you look at it for what it is - a different way of living life with a different set of parameters.
Those parameters are the mood swings commonly associated with bipolar disorder - the mania and the depression. Wootton (who is also a Psych Central blogger) suggests that how you work with this concern is really a matter of perspective and "mind over matter." He invokes a great deal of this through the components that make up "results worth striving for," which include:
- Clear insight
- True freedom
- Real stability
- Self mastery
Identifying what's needed and how exactly to achieve it are two very different things. This book does a very good job in describing what a different way of looking at bipolar disorder looks like, but ultimately it is up to the person to engage in the "Bipolar Advantage" treatment model that Wootton advocates to achieve the goals he lays out. In other words, this is not a "how-to" book, but more of a roadmap for a plan of treatment and living life with bipolar disorder.
In the first part of the first half of the book, Wootton lays out his roadmap for living with bipolar disorder not as a disorder or condition that needs to eradicated and "cured," but one that needs to be better understood and accepted - and even embraced - by oneself. Embraced in the sense of understanding the pros and cons of one's moods and finding a balance to bring them into a state where one can live with them and leverage them to improve one's life. In Wootton's world view, you still have mania, you've just learned to ride the wave rather than fight it. And the wave is lessened by appropriate psychotherapy, medication and other treatment strategies.
Certainly this is a world view worth of more attention and understanding by mental health professionals, who all too often see their job as to simply remove all the symptoms of a mental disorder. In doing so, they hope to remove the disorder itself from the person.
But with some disorders, like bipolar, we often talk about patients living with these disorders their entire life. So rather than talking about living with something as though it were a disability, why not look at how a person can put them into bettering their own lives by leveraging the symptoms for their intrinsic benefits?
The second part of the first half of the book talks more about the definition of bipolar disorder and the traditional way it is defined. Wootton then challenges the reader to re-examine these definitions from a different perspective, one of ability rather than disability.
In this section, he also emphasizes the point that the language we use often pre-defines things (in a mindless, not mindful, manner) by putting them into categories. This categorization that humans do is generally helpful in allowing us to make sense of the world. But it also limits our thinking and in doing so, limits our potential.
The second half of the book is taken up by describing the approach of the Bipolar Advantage program. This program, designed by Wootton, emphasizes a multidisciplinary perspective that includes the following components:
- Peer coaching
- Relationship counseling
- Mind skills counseling
- Spiritual counseling
- Family and friends
- Addictions counseling
- Career management counseling
- Financial coaching
- Physical rehabilitation therapy
- Nutrition counseling
- Fitness coaching
- Primary care physician
Obviously not every person with bipolar disorder will need or benefit from every component. But he and his co-authors describe what each of these components do and what a person with bipolar disorder can expect from them. They also describe how the component integrates into the rest of the treatment team approach, how it's assessed and measured, the goal setting done for the component, and finally its treatment emphasis. It's a helpful outline for treatment and not just living with bipolar disorder, but ensuring that one's life is lived fully.
It's an idealistic approach to treatment that I think most mental health conditions would benefit from. Sadly, in this country anyway, few of those things are covered under our health insurance, so to get this approach today requires a substantial out-of-pocket financial commitment.
Sometimes I would've found the book a bit easier to get through if the author had used existing terms for describing some of what he thinks is valuable. For instance, the idea of mindfulness is being aware of yourself in your surroundings and environment and acting with deliberate regard for your behaviors (e.g., not engaging in mindless activities). For most, this is a part of attaining self-mastery or self-determination - you first need to be aware of what you do in order to ensure you have control over it. So I had wished that Wootton would have used this more common term - mindfulness - over the terms he chose to use instead. I also sometimes had difficulty following the author's train of thought in some chapters, but I thought that overall, the book was an easy read.
I found Tom Wootton's Bipolar In Order a unique perspective on bipolar disorder, something the author himself has. If you or a loved one lives with bipolar disorder, the book is worth taking a look at for a very different and much-needed perspective on this disorder..
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Risperidone Long-Acting Injectable Monotherapy in the Maintenance Treatment of Bipolar I Disorder
Jorge A. Quiroza, Lakshmi N. Yathamb, Joseph M. Palumboa, Keith Karchera, Stuart Kushnera, Vivek Kusumakara
Received 17 August 2009; received in revised form 14 January 2010; accepted 20 January 2010. published online 15 March 2010.
Treatment adherence is a significant problem in patients with bipolar disorder. This study was designed to determine the efficacy of risperidone long-acting injectable (LAI) in the maintenance treatment of bipolar I disorder.
Eligible patients with current or recent manic or mixed episodes (n = 559, aged 18-65 years) were treated with open-label oral risperidone for 3 weeks (period II) and open-label risperidone LAI for 26 weeks (n = 501; period III). Patients who maintained response (n = 303) were randomly allocated 1:1 to placebo injections (n = 149) or to continue risperidone LAI (n = 154) for up to 24 months (period IV).
Most (77%) patients on risperidone LAI received a dose of 25 mg every 2 weeks during period IV. Time to recurrence for any mood episode (primary outcome variable) was significantly longer in the risperidone LAI group versus placebo (p < .001); the difference was significant for time to recurrence of elevated-mood episode (p < .001) but not time to recurrence of depressive episode (p = .805). Weight gains ≥7% (compared with the period's baseline) occurred in 15% of patients in period III; in 12% of patients on risperidone LAI and 3% of patients on placebo in period IV.
Risperidone LAI monotherapy significantly delayed the time to recurrence of mood episodes, versus placebo, in this controlled, randomized study in patients with bipolar I disorder. Risperidone LAI was tolerable and no new safety concerns emerged compared with previous studies of risperidone LAI.
Over-Diagnosis of Bipolar May Harm Children
By RICK NAUERT PHD Senior News Editor
In the mid-1990s the criteria for a diagnosis of bipolar disorder was informally significantly expanded to include children. A new study examines the impact of this shift with the suggestion that troubled children diagnosed with bipolar disorder may fare better with a different diagnosis.
Researchers at The Hastings Center support an emerging approach which gives many of those children a new diagnosis called Severe Mood Dysregulation (SMD) or Temper Dysregulation Disorder with Dysphoria (TDD).
The findings come soon after proposed revisions to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) were opened to public comment.
In a paper published in Child and Adolescent Psychiatry and Mental Health, Erik Parens and Josephine Johnston examine the evolution of the diagnosis of bipolar disorder in children and its dramatic increase since the criteria for diagnosis broadened.
They emphasize that there is vigorous debate in pediatric psychiatry about whether symptoms in children accurately reflect the criteria for bipolar disorder, particularly for mania.
The increase in cases has led to concerns about accurately defining psychiatric disorders in children as well as the safety and efficacy of resulting pharmacological treatment.
It is difficult to diagnose psychiatric disorders in children, Parens and Johnston write, and many children receiving bipolar diagnoses exhibit behaviors that do not closely fit the disease's criteria.
"Using new labels such as SMD or TDD reflects that physicians do not yet know exactly what is wrong with these children or how to treat it," said Johnston. "Facing up to this uncertainty could lead to better treatment recommendations and more accurate long-term prognosis."
A new diagnostic category would also help reframe the research agenda.
Their findings come from an interdisciplinary series of workshops funded by a grant from the National Institute of Mental Health. Participants included psychiatrists, pediatricians, educators, bioethicists, parents, and social scientists. Erik Parens is a senior research scholar and Josephine Johnston a research scholar at The Hastings Center, a bioethics research institution.
Among the workshop conclusions:
The bipolar label may fit poorly many of the children who have received it over the last decade.
There is debate about what children's symptoms represent. For example, what is characterized as mania in children is very different from its features in adults. Mania is a hallmark feature of bipolar disorder, formerly known as manic-depressive disorder.
The bipolar label, which has a strong genetic component, can distract from addressing the family or social context.
Physicians must be forthcoming with families about uncertainties and complexities in the diagnosis and treatment of bipolar disorder in children.
Current training practices and reimbursement policies may leave some psychiatrists and pediatricians unable to deliver the comprehensive care that these children need.
The authors also note that, while experts sometimes disagree about labels, the workshop group universally agreed that "children and families can suffer terribly as a result of serious disturbances in children's moods and behaviors," and that these troubled children desperately need help.
They also write, "It is a deeply regrettable feature of our current mental health and educational systems that some DSM diagnoses are better than others at getting children and families access to [needed] care and services."
Source: The Hastings Center
SAMHSA, Ad Council, and Inspire USAFoundation Launch National Suicide Prevention Campaign for Teens
Suicide Is the Third Leading Cause of Death Among 15- to 24-Year-Olds
SAMHSA, along with the Ad Council and the Inspire USA Foundation, today launched a new Teen Suicide Prevention national public service campaign, the first teen suicide prevention effort from SAMHSA to utilize a national mass media strategy, as well as a robust digital outreach program.
The public service announcement (PSA) campaign-We Can Help Us-was developed out of the acquired insight that, although many teens encounter the same tough times, many also develop positive solutions to help overcome them. The campaign empowers teens by reminding them that there are ways to get through whatever problems they face and directs them to visit reachout.com to hear stories from others who successfully conquered their tough times.
The campaign includes TV, radio, and print advertising, and mall and
in-school posters and viral videos. The reachout.com Web site features stories from teens, as well as tips to help cope with tough issues and links to resources, including the National Suicide Prevention Lifeline, for teens who need immediate help. The PSAs will be distributed widely in the national media this week.
We hope your organization can help extend the campaign's reach to youth who may be at risk and amplify these potentially lifesaving messages. To view the PSAs, the press release, and more details about how your organization can help support the campaign, please view the National Suicide Prevention Campaign for Teens Multimedia News Release. You can also visit SAMHSA's Web site or the Ad Council Web site to learn more.
Waking Up: Climbing Through the Darkness Featuring Terry Wise
Wednesday, May 26, 2010
Luncheon and Program: 11:30am-1:30pm
Hyatt Regency La Jolla · 3777 La Jolla Village Drive · La Jolla, 92037
REGISTER ONLINE>> http://www.jfssd.org/site/MessageViewer?dlv_id=7241&em_id=3241.0
Drawing from personal experience, author Terry Wise brings her audience behind the closed doors of a therapy office in Waking Up: Climbing Through the Darkness. She reveals powerful insights about depression and suicide, and the entire process of recovery-for people on both sides of the couch. Waking Up is a highly-acclaimed book that provides a roadmap for the restoration of emotional health.
A former Boston trial attorney, Wise devoted her life to international public speaking and full-time writing after losing her spouse to Lou Gehrig's Disease (ALS) and surviving a suicide attempt. Wise serves on the boards of several national organizations and is the recipient of a National Mental Health Award for "distinguished achievement and work that has had a major impact on the depression community."
$38 prior to May 12, 2010; $42 thereafter · Complimentary Parking
More Information: (858) 637-3231
CEUs available for LCSWs and MFTs
"When Terry lectures on her experience overcoming depression and the temptation to suicide, she not only stirs the emotions of her audience. She invariably moves several people to come up to her afterward and tell her of their own experiences, and how heartened they were to learn of her victory over depression. I am convinced that she saves lives and pulls people out of the darkness that envelopes them."
Rabbi Harold S. Kushner, Bestselling Author of When Bad Things Happen to Good People
"Waking Up is the story of a brave woman who dared to love and found that love left her abandoned in the valley of the shadow of death. And it is the story of a courageous therapist who dared to care about that woman, to lend her strength until she grew strong enough to continue on her own, to believe in her despite everything, until she learned to believe in herself, who took her by the hand and led her out of the shadows and into the sunlight."
Rabbi Harold S. Kushner, Bestselling Author of When Bad Things Happen to Good People
The Mental Health Committee of Jewish Family Service of San Diego provides resources and services for coping and living with mental illness and seeks to eliminate the stigma by increasing community awareness.
Linda Janon - Founder of the Mental Health Committee
Generously Underwritten by Caryl Lees Witte
The family of Sarah Rogers would like to thank everyone who prayed and helped look for their loving wife,mother, daughter, sister and friend. It is with deep sadness to report that Sarah's body was located this afternoon, Saturday, March 13, 2010, 1/2 mile from where her vehicle was found near Clinton, Maine. Sarah was located by a resident who lives off the Turnpike in the rear of his property. Preliminary reports indicate that Sarah passed away from hypothermia. The Medical Examiner has confirmed her identity.
The dreaded "C" word
Dear Friend & Advocate
It's time to contemplate the dreaded "C" word - whether your child is 14 years old and you are starting to think about college or you are a tireless self-advocate who is determined to take the next logical step upward in your life.
Parents of students with disabilities are often surprised to learn that their college-bound kids are no longer eligible for services.
In this issue of the Special Ed Advocate you will find information to help you plan ahead, choose a postsecondary school, find ways to finance continuing education and advice about challenges students with disabilities will encounter as they make the transition from high school to postsecondary education. http://www.wrightslaw.com/nltr/10/nl.0316.htm
ROSS GREENE COMING TO SAN DIEGO!!!
SAVE THE DATE - Treating The Challenging Child
REGISTRATION OPENS ON MARCH 15th
SPEAKER: Ross W. Greene, Ph.D.
Clinical Professor in the Department of Psychiatry Harvard Medical School
Dr. Greene is the originator of the Collaborative Problem Solving (CPS) approach and author of the recently released book, Lost At School: Why Our Most Vulnerable, At-Risk Kids Still Fall Through The Cracks and How We Can Help Them. He is also author of the highly acclaimed book, The Explosive Child, along with a third book, Treating Explosive Kids: The Collaborative Problem Solving Approach.
Dr. Greene's research has been funded by, among others, the Stanley Research Institute, the National Institute on Drug Abuse/National Institutes of Mental Health, the U.S. Department of Education, and the Maine Juvenile Justice Advisory Group. He lectures widely throughout the world and his work has been featured on the Oprah Show, Dateline NBC, The Morning Show, Good Morning America, and National Public Radio.
The Collaborative Problem Solving Approach (CPS) model posits that challenging behavior is a form of developmental delay and the by product of lagging cognitive skills. The CPS model helps teach lagging cognitive skills to solve the problem while reducing the challenging behaviors. The model is a dramatic departure from conventional practice and is highly effective in families, schools, group homes, inpatient, residential, and juvenile detention facilities. Participants will leave with an understanding of the of the CPS model and practical assessment and intervention tools that can used
in diverse settings.
Physicians, nurses, psychologists, therapists, social workers, counselors, managers and staff working
in social services and the behavioral health field.
- Describe why conventional reward and punishment procedures may not be effective for many challenging kids. Review research on motivation and behavior change
- Identify strategies to assess the various cognitive skills that are central to handling life's social, emotional, and behavioral challenges
- Identify and prioritize unsolved problems precipitating challenging behavior
- Discuss the three basic mechanisms by which adults handle problems and unmet expectations in kids (Plans A, B, and C) and what is accomplished by each
- Discover how to effectively implement Plan B to develop a helping relationship, solve problems, teach lagging cognitive skills, and reduce the frequency and intensity of challenging behavior
Registration Fee: $40 in advance · FREE CEUs
Scholarships available for Family, Youth and Students
For further information, please contact Erin Scally or Lorena Duarte at (866) 910.2600 ext 1700
Conference funded by:
County of San Diego Commission on Children, Youth and Families; and San Diego Children's System of Care Training Academy and First 5 San Diego