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Mental Health Disorders And Sexually Transmitted Diseases In A Privately Insured Population.

November 17, 2018October 21, 2017 by admin

Abstract

OBJECTIVES:

To consider whether patients who use mental health services in privately insured settings are also more likely to have received sexually transmitted disease (STD) or human immunodeficiency virus (HIV) diagnoses and whether this relationship extends to patients with milder mental health disorders.

METHODS:

Using frequency tables stratified by age and sex, a logistic regression model, and difference of means tests, we examined the relationship between mental health claims and STDs in a sample of 289 604 privately insured people across the United States.

RESULTS:

Patients with mental health claims were more than twice as likely as other patients to have an STD claim in the same year after controlling for confounding factors (odds ratio, 2.33; 95% confidence interval, 2.11-2.58). This relationship held for severe and milder mental health diagnoses, for male and female patients, and in each age category from 15 to 44 years...

Diagnosis And Treatment Of Syncope

November 17, 2018October 21, 2017 by admin

In the evaluation of patients with syncope, the critical first step is a detailed medical history. A diagnostic strategy based on initial evaluation is warranted. The importance of the initial evaluation goes well beyond its capability to make a diagnosis as it determines the most appropriate subsequent diagnostic pathways and risk evaluation.

THE DIAGNOSTIC STRATEGY BASED ON THE INITIAL EVALUATION

According to the Guidelines on Syncope of the European Society of Cardiology (ESC)1,2the “initial evaluation” of a patient presenting with syncope consists of taking a careful history, and a physical examination, including orthostatic blood pressure measurements and standard electrocardiogram (ECG).

Three key questions should be addressed during the initial evaluation:

• Is loss of consciousness attributable to syncope or not? Differentiating true syncope from “non‐syncopal” conditions associated with real or apparent transient loss of consciousness is generally the first diagnostic challenge and influences the subsequent diagnostic strategy....

One Psychologist’s Fight To Destigmatize Mental Illness

November 17, 2018October 21, 2017 by admin

We live in a world where going to a therapist often feels more shameful than going to see your dentist or internist. Many people still feel embarrassed and ashamed about needing help for their anxiety or depression, while they would not have those feelings if treating a cancerous growth or heart disease.

Although this stigma is slowly changing, our society still holds many misconceptions about what it means to have a mental illness. And these misconceptions or a lack of accurate information can interfere with people getting the help they need. Individuals who suffer from mental illness are not lazy, deranged, weak, or whining for attention. In fact, they are no more likely to have negative personality traits than people who don’t suffer from this type of disease. Mental health disorders are relatively common in the United States and according to some statistics 25% of the...

Parent and Child Contributions to Diagnosis of Mental Disorder: Are Both Informants Always Necessary?

November 17, 2018October 21, 2017 by admin

Abstract

To examine the unique cases contributed by parent and child informants to diagnostic classification, with the goal of identifying those diagnoses for which either or both informants are needed. The authors examined survey data from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, a 4-community epidemiology survey of 9- to 17-year-old children and their parents. Parent-child dyads (1,285 pairs) were independently interviewed by lay persons with the Diagnostic Interview Schedule for Children; a subset of these pairs (n = 247) were also interviewed by clinicians. Agreement between parents and children was examined with respect to levels of impairment, need for/use of services, and clinicians' diagnoses. Parents and children rarely agreed on the presence of diagnostic conditions, regardless of diagnostic type. Nonetheless, most child-only- and parent-only-identified diagnoses were similarly related to impairment and clinical validation, with...

Discussing the Criminal and Criminal Anthropology at Victorian Broadmoor

November 17, 2018October 21, 2017 by admin

July 10, 2015

‘It really is astounding the vogue that this puerile nonsense has obtained’: Discussing the Criminal and Criminal Anthropology at Victorian Broadmoor

The publication of Italian criminologist Cesare Lombroso’s The Criminal (1876) established criminal anthropology as an independent science. Lombroso believed that there existed a criminal type: a man or a woman with a specific anatomical configuration.[i] Criminal anthropology had a limited following in Britain. In his The Criminal, Henry Havelock Ellis criticised Lombroso for his style, impetuosity, and lack of critical analysis, but believed that it would be ‘idle to attempt to deny [the] importance of a ‘morbid element’ in criminality’.[ii] He wrote of the size and shape of criminals’ heads, of their cranial abnormalities, prominent jaws and cheekbones, of their receding chins, and of their teeth, nose, ears and beards.[iii] Prison chaplain W. D. Morrison asked:...

Sexual Orientation and Its Relation to Mental Disorders and Suicide Attempts: Findings From a Nationally Representative Sample

November 17, 2018October 21, 2017 by admin

Abstract

To compare the rates of all Axis I and II mental disorders and suicide attempts in sexual orientation minorities with rates in heterosexuals using a nationally representative sample. Data used were from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2 (n = 34 653, response rate = 70.2%). Cross-tabulations and multivariate logistic regression analyses were performed to determine differences in rates of mental disorders and suicide attempts by sexual orientation. All analyses were stratified by sex. Compared with their heterosexual counterparts, lesbians and bisexual women demonstrated a 3-fold increased likelihood of substance use disorders, and gay and bisexual men showed twice the rate of anxiety disorders and schizophrenia and (or) psychotic illness, even after accounting for mental disorder comorbidity. Suicide attempts were independently associated with bisexuality, with odds 3 times higher than in heterosexuals. Findings from our study emphasize the fact that sexual orientation...

Why Are Religious Delusions And Hallucinations So Prominent In Patients With Serious Mental Health Diagnoses, Especially Schizophrenia?

November 17, 2018October 21, 2017 by admin

In patients with a diagnosis of schizophrenia, often delusions exist that either exalt the status of the patient (eg, the patient is God's representative on earth) or denigrate the patient (eg, God is sending messages to the patient specifying his/her sinfulness and need to be punished). Are there sociological or neurological explanations for the high prevalence of religious delusions and hallucinations?

Popular Answers

The schizoid constellation comprises a number of typical symptoms, present in greater or lesser amounts, further mitigated through numerous indiosyncratic aspects of each case, the time of onset, the number of years, and of course the individual triggers. The easiest way to answer that question - employing Occams razor for the least-words-being-the-best - would go to the essense of the communication with God business. Think of what would happen igf the pipeline from experience to memory suddenly developed leaks - the continuity of your memory...

The Effectiveness of Psychotherapy

November 17, 2018July 13, 2017 by admin

Abstract.

Consumer Reports (1995, November) published an article which concluded that patients benefited very substantially from psychotherapy, that long-term treatment did considerably better than short-term treatment, and that psychotherapy alone did not differ in effectiveness from medication plus psychotherapy. Furthermore, no specific modality of psychotherapy did better than any other for any disorder; psychologists, psychiatrists, and social workers did not differ in their effectiveness as treaters; and all did better than marriage counselors and long-term family doctoring. Patients whose length of therapy or choice of therapist was limited by insurance or managed care did worse. The methodological virtues and drawbacks of this large-scale survey are examined and contrasted with the more traditional efficacy study, in which patients are randomized into a manualized, fixed duration treatment or into control groups. I conclude that the Consumer Reports survey complements the efficacy method, and that the best features...

Mental Health By the Numbers

November 17, 2018October 22, 2017 by admin

Prevalence of Mental Illness

Approximately 1 in 5 adults in the U.S.—43.8 million, or 18.5%—experiences mental illness in a given year. Approximately 1 in 25 adults in the U.S.—9.8 million, or 4.0%—experiences a serious mental illness in a given year that substantially interferes with or limits one or more major life activities. Approximately 1 in 5 youth aged 13–18 (21.4%) experiences a severe mental disorder at some point during their life.

For children aged 8–15, the estimate is 13%. 1.1% of adults in the U.S. live with schizophrenia.

2.6% of adults in the U.S. live with bipolar disorder.

6.9% of adults in the U.S.—16 million—had at least one major depressive episode in the past year.

18.1% of adults in the U.S. experienced an anxiety disorder such as posttraumatic stress disorder, obsessive-compulsive disorder and specific phobias...

Drugs That May Cause Muscle Weakness Or Wasting

November 17, 2018October 22, 2017 by admin

Muscle problems have many possible causes. Inflammation of the muscle, called myositis, causes muscle weakness and wasting. Several types of drugs are linked to the development of myositis in some people. These include some recreational drugs, antibiotics, chemotherapy drugs, drugs affecting the hormonal system, drugs for cholesterol as well as heart and stomach drugs.

Recreational Drugs

Consumption of some recreational drugs is known to cause muscle problems. Alcoholic myopathy, also known as alcoholic rhabdomyolysis, is a condition in which the skeletal muscle breaks down during an alcohol binge or withdrawal from chronic use. If mild it may cause no symptoms. It can lead to muscle weakness and wasting, and if severe the proteins released from muscle break down into the blood and can damage the kidneys. A binge on cocaine can also cause muscle tissue to break down...

Evaluation for Civil Commitment of Sex Offenders: A Survey of Experts

November 17, 2018October 23, 2017 by admin

Abstract

At this study's commencement, 17 states had enacted sex offender civil commitment legislation. Although each statute outlines broad criteria that must be met, civil commitment evaluators are given considerable latitude in how to conduct their assessment. Forty-one experts who conduct sex offender civil commitment evaluations were surveyed to identify the usual practice of these evaluators. A great deal of agreement exists across experts regarding the conduct of sex offender civil commitment evaluations. However, these patterns appear quite different from the usual practice outlined in other types of forensic evaluations. Experts in sex offender civil commitment endorsed documentation as the core method for evaluation. The majority of evaluators reported the assessment of paraphilias, substance abuse, other Axis I disorders, Axis II disorders, and psychopathy as essential to the evaluation. Virtually all survey respondents utilized actuarial risk assessment measures, primarily the Static-99, in assessing for risk of...

Sexual Assault, Irresistible Impulses, And Forensic Psychiatry In Sweden

November 17, 2018October 23, 2017 by admin

Abstract

After forensic psychiatry was firmly established in Sweden in the 1930s, many rapists and individuals charged with assaulting children underwent a forensic psychiatric examination. The physicians found that most of them had not been “in control” of their senses or not “in complete control” of their senses at the time of the crime. If the court ordered a forensic psychiatric examination, the defendant had a very good chance of either being discharged or having his sentence reduced considerably. By the 1950s psychological perspectives began to dominate in forensic psychiatry. In the forensic records of the 1950s we can notice a shift from a biomedical to a socio-psychological perspective, and crime was increasingly related to conditions that were not seen as mental derangement from a legal point of view. As a result, it became less and less common, from the...

Medication-Induced Sexual Dysfunction

November 17, 2018October 23, 2017 by admin

Target Audience and Goal Statement

This activity is intended for psychiatrists, primary care physicians, psychologists, neurologists, pharmacists, and other mental health professionals.

The goal of this activity is to provide current treatment protocols and clinical strategies for the treatment and management of psychiatric disorders and to update the clinician and the researcher on the latest developments in psychiatry and mental health.

Upon completion of this activity, participants will be able to:

1.Distinguish among the various subtypes of bipolar disorder. 2.Review aspects of violence and some of its causes. 3.Delineate recent findings in the treatment of sexual side effects of psychotropic medications.

Media Influences on Teen Sexual Behavior

November 17, 2018October 23, 2017 by admin

American teenagers are exposed to substantial amounts of sexual content on television. Though it is widely believed that this exposure affects teens, there has been surprisingly little scientific investigation of this issue. To address this knowledge gap, RAND conducted a multi-year year study that broke new scientific ground as the first to examine whether adolescents' viewing of sexual content on television predicts their subsequent behavior and health outcomes. The study found that:

Teens who watch a lot of television with sexual content are more likely to initiate sexual intercourse in the following year (see figure). Frequent exposure to TV sexual content was associated with a significantly greater likelihood of teen pregnancy in the three years following exposure. Portraying the risks of sex in television shows appears to help educate teens about the potential consequences of sexual behavior...

Sexual Signaling at a Nightclub

November 17, 2018October 23, 2017 by admin

Alek is a physical space where typically males of a species congregate to display sexual signals meant to impress the discerning females (see Fiske, Rintamäki, & Karvonen, 1998 for a review of such species across many taxa). Click here to see a male Greater Sage-Grouse engaging in lekking behavior. In a few rare role-reversal species, it is the females who engage in lekking behaviour as a means of attracting prospective male suitors (cf. Funk & Tallamy, 2000). In my work, I have long argued that many consumer phenomena are nothing more than forms of lekking behavior. In the human context, men and women use sex-specific products as sexual signals. For additional details see my books The Evolutionary Bases of Consumption, and The Consuming Instinct: What Juicy Burgers, Ferraris, Pornography, and Gift Giving Reveal About Human Nature; also see one of my earliest Psychology Today posts here on the use of Porsches as a lekking signal; ...

Pharmacological Interventions with Adult Male Sexual Offenders

November 17, 2018October 23, 2017 by admin

Introduction

The treatment of sexual offending behaviors is complex and involves multiple etiologies, individualized risk reduction and risk management needs, and heterogeneous biopsychosocial, interpersonal, and legal factors. Clinicians and researchers have attempted to identify approaches which promise the greatest success in addressing these behaviors. Findings from a meta-analysis examining the effectiveness of various treatment interventions for adult sex offenders indicated that, when used in combination with other treatment approaches, biological interventions like testosterone-lowering hormonal treatments may be linked to greater reductions in recidivism for some offenders than the use of psychosocial treatments alone (Losel and Schmucker, 2005). Other data, described below, suggest that non-hormonal psychotropic medications can also be effective supplements to standard therapeutic interventions for sex offenders as well.

This document is designed to provide an overview of key issues pertaining to the use of hormonal and non-hormonal agents to...