Pregnant Women Eschew Meds
A minority of women believe it is safe to take depression medication while they are pregnant, according to a new survey by the Society for Women's Health Research. The survey of 1,000 women was conducted by telephone in October; 500 family and general practitioners and internal medicine specialists were also queried. Only 11% of women said they thought it was safe to take a depression therapy during pregnancy, compared with 68% of physicians. Less educated and lower income women and African American women were more likely to believe it was unsafe to take a medication. Half of women said it was safe post partum, compared with 97% of physicians. Women falsely believed that depression was a normal part of the postpartum experience and also underestimated their risk for depression at specific life stages involving hormonal transitions, according to the society. In a statement, Sherry Marts, vice president of scientific affairs for the society, said the survey shows a disconnect between physicians' beliefs about depression and women's perceptions. “The health care community needs to do a better job communicating with women about depression,” Ms. Marts said.
Secondary Depression Admits Up
In 10 years, the rate of admissions for depression as a secondary diagnosis approximately tripled, from 93 per 10,000 to 247 per 10,000, according to the Agency for Health Care Research and Quality. There were about 2.5 million hospitalizations with depression as a secondary diagnosis in 2005, compared with 930,000 in 1995. Meanwhile, hospitalizations with depression as the primary diagnosis stayed flat over that same period, at about 42 per 10,000. The numbers are from “Hospital Stays Related to Depression,” a report that draws its data from the Nationwide Inpatient Sample. That sample covers nonfederal, short-term hospitals, which account for 90% of discharges.
Katrina's Mental Health Cost
Contrary to what is observed after most disasters, mental distress seems to be on the rise on the Gulf Coast, not declining, according to results of an ongoing survey of 1,043 prehurricane residents of affected areas of Alabama, Louisiana, and Mississippi. The most recent results compare a baseline taken 5–8 months after the hurricane to a survey a year later. The project is being conducted by the Hurricane Katrina Community Advisory Group and directed by Ronald C. Kessler, Ph.D., a professor of health care policy at Harvard Medical School, Boston. Anxiety and mood disorder were reported by 31% at baseline and 34% a year later. Serious mental illness had increased from 11% to 14% of the sample; it was unchanged, however, in the New Orleans metro area. Suicidality was significantly higher at follow-up, and the incidence of posttraumatic stress syndrome doubled. “We would normally expect to find lower proportions of the population to have mental illness and suicidality this long after a disaster,” said Dr. Kessler at a Senate hearing in late October. “That we not only failed to find decreases of this sort, and actually found a number of increases, is an indication of the more severe adverse emotional effects of Hurricane Katrina than more typical disasters,” he said. The study is funded by the National Institute of Mental Health, the Federal Emergency Management Agency, and the Department of Health and Human Services.
… Hits Students Also
Schools in Alabama, Louisiana, Mississippi, and Texas that received an estimated 196,000 students displaced by Katrina have not been able to meet students' ongoing mental health needs, according to a RAND Corp. survey released in October. The researchers interviewed mental health professionals at 19 public and 11 private schools and school systems in the spring and in the fall of 2006 (Psych. Services 2007;58:1339–43). The targeted schools had student population increases of more than 10%. Though most mobilized large and effective assistance efforts early on, by the later survey, a majority of schools could not or did not continue services, according to the study. The schools cited pressure by administrators to focus again on academics, trouble reaching parents living in trailers or without reliable phone service or transportation, not enough resources, and staff burnout.
Data on Elderly Glossed Over
Food and Drug Administration regulations for drug makers conducting clinical trials encourage the inclusion of elderly participants and the reporting of data by age, but the agency is not effective in getting its medical officers to include data on elderly patients in their new drug application (NDA) reviews, according to a report by the Government Accountability Office. The report, requested by Rep. Henry Waxman (D-Calif.) and Sen. Ted Kennedy (D-Mass.), was based on a review of 36 NDAs submitted by manufacturers from January 2001 to June 2004 for drugs to treat diseases that could affect patients aged 65 years and older. All of the NDAs had at least one trial that included elderly participants, but a third of the agency's NDA reviews had no documentation on safety or efficacy for that age group. In addition, the GAO noted that reviewers are not required to establish whether there were a sufficient number of elderly participants in a trial, and if they do address sufficiency, they do not have to document their methods. Sufficiency was addressed in about a quarter of the reviews, none of which detailed the methods used, the report found.