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U.S. suicide rates rising

Simrat Kaur Sarai, M.D., Steven Lippmann, M.D. 

Suicide is one of the 10 leading causes of death, within all groups 10-64 years of age (1). Despite consistent declines from 1986-1999, the United States experienced a 24% increase in suicide rates between 1999-2014, rising to 10-13 per 100,000 people; such fatalities included males and females for all ages 10-74 years (2). Suicide among adolescents, young adults, and middle-age persons are rising (3,4).  Adults aged 45-64 evidenced some of the largest escalations, in women up to nearly 10 and among men almost 30 per 100,000 (2).  The average annual increase in the age-adjusted suicide frequency was about 1% each year during 1999-2006 and 2% annually from 2006-2014 (3).  The male incidence in 2014 was over three times higher than that of females.
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Decline in dementia among older adults in the United States

Leo Sher, M.D.

Dementia, a deterioration in memory and other cognitive functions that leads to a loss of independent function is a major medical and social problem. Alzheimer’s disease is the most frequent cause of dementia. Dementia can also be caused by a head injury, a stroke, a brain tumor, and other causes.

JAMA Internal Medicine has published an article entitled, “A comparison of the prevalence of dementia in the United States in 2000 and 2012” (1). The authors used data from the Health and Retirement Study (HRS), a nationally representative, population-based longitudinal survey of individuals in the United States 65 years or older.
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Zika is a sexually transmitted disease

Priyanga Jayakumar, M.D., Rajashekar Reddy Yeruva, M.D., Steven Lippmann, M.D.

Following zika epidemics in 2015, this virus infection became an issue of preventing transmission and eradication. A global threat, it induces serious congenital abnormalities and neurological diseases (1). Since this viral is sexually transmitted, there are behavioral means to prevent zika transmission.

Male-to-female sexually transmitted cases are reported (1). Female-to-male and male-to-male sexual transmission of zika virus are also documented (2,3). In those cases, the saliva, serum, vaginal fluid, cervical mucus, genital or endocervical swabs, and semen contained a high viral load (1-3).
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Don't you know I'm angry?: An analysis on the limited research on anger

Amy K. Grochala, B.A., Jess G. Fiedorowicz, M.D., Ph.D.

Anger is a ubiquitous human emotion that arises when a person feels that they have purposefully been wronged or their efforts to obtain some goals have been thwarted. It can be as mild as irritability or as extreme as rage, and can be kept inward or expressed outwardly in behaviors such as violence, aggression, or hostility to others (1). Whether kept inward or expressed outwardly, anger is typically considered a negative emotion. For example, the average score to a 5-point “attitude toward anger” scale was 1.5, where 1 equals strongly disagree and 5 equals strongly agree with statements that express liking the anger experience (2).
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Does cognitive therapy prevent suicide?

Hema Madhuri Mekala, M.D., Simrat Kaur Sarai, M.D., Steven Lippmann, M.D.

Introduction

Suicide is the most common psychiatric emergency (1). Annually, 650,000 people in the United States receive treatment after attempting suicide (1). It is the seventh leading cause of death in this country. About 37,000 individuals commit suicide every year in the U.S. and one million persons worldwide die by suicide (1). The World Health Organization estimates that by 2020, suicide will be the ninth leading cause of death globally (2). About 95% of the people who commit suicide are diagnosed with a psychiatric illness (1). Patients with a history of a suicide attempt are at high risk for a reattempt in the future (2).
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Opioids in the United States

Simrat Kaur Sarai, M.D., Steven Lippmann, M.D.

Over nine million Americans consume narcotics regularly; about two million of them  evidence substance use disorders related to prescription opioid pain relievers (1,2). There were about 259 million prescriptions for opioid medications written during 2012, a four-fold increase since 1999 (3). Although the number of prescription opioids sold has nearly quadrupled, there is no change reported in the amount of patient’s pain complaints (4-7). About 25 million people initiated non-medical narcotics between 2002-2011 (8). Since 2002, non-medical utilization has reportedly declined; however, addiction treatment admissions and overdose deaths or other adverse outcomes have escalated (8). During 1997-2011, there was a 900% increase in number of individuals seeking addiction treatment (9).
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Acetaminophen use during pregnancy and behavioral problems in childhood

Leo Sher, M.D.

A British research group examined associations between offspring behavioral problems and maternal prenatal acetaminophen use, maternal postnatal acetaminophen use, and partner’s acetaminophen use (1). Acetaminophen, also known as paracetamol, relieves pain and fever and is the active ingredient in Tylenol and a large number of over-the-counter and prescription drugs. Acetaminophen is not considered a nonsteroidal anti-inflammatory drug (NSAID) because it does not exhibit significant anti-inflammatory activity. More than half of all pregnant women in the United States and Europe use acetaminophen (2,3).

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Insanity defenses recalibrated

Jacob M. Appel, M.D., J.D.
 
The recent release of would-be Reagan assassin John Hinckley Jr. serves as a reminder that while for much of the country, the three decades starting in 1980 were the ‘Reagan Era,’ forensic psychiatry remains trapped in a ‘Hinckley Era.’  Hinckley pled not guilty by reason of insanity (NGRI) and was acquitted on all charges.  In the public backlash that ensued, the federal government and the majority of states made such defenses far more difficult (1).  Many jurisdictions shifted the burden of proof to defendants, requiring “clear and convincing evidence” that mental illness prevented legal culpability.  Others switched from NGRI to a “guilty but mentally ill” approach. Four states abolished the insanity defense entirely.
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