LinkBlog
Generalized Anxiety Disorder - Patient treatment manual (pdf)
Understanding post-traumatic stress disorder
Most People are Optimists - Except for Lawyers
recommended links
Depression Is Real Coalition
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ABIL: Agoraphobics Building
Independant Lives -
Agoraphobia and Panic
Disorder Foundation -
Anxiety Disorders Association
of America - Anxiety Network Australia
- Anxiety-Panic.Com
- AnxietyZone
- Army Behavioral Health
- BrainPhysics - OCD
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Canadian Network for Mood
and Anxiety Treatments - Children of Hoarders
- Choices in Mental Health (UK)
-
Dart Foundation: Gateway to PTSD
information -
David Baldwin's
Trauma Information Pages - e-couch free personal self-help guide
- EMDR Institute, Inc.
- EMDR Network Japan
- Fear of Flying course (free)
- Healthy Minds
- Information for People with Anxiety Disorders
- Internet Guide to REBT, CBT
- Living with a Brain Disorder
- Morita Therapy
- Mayo Clinic : Depression
- Mayo Clinic : GAD
- Mayo Clinic : OCD
- Mayo Clinic : Panic Attacks
- Mayo Clinic : PTSD
- Mayo Clinic : Social Anxiety
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Medicines.org.uk - Anxiety &
Depression guides - Mind-Your-Mind Canada
- National Center for PTSD
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National Institute of Mental
Health (NIMH) - No Such Thing As Crazy
- OCD Action, UK
- OCD Ireland
- Obsessive Compulsive Foundation
- Open Minds, Open Doors
- Out of the silence - site for young people with mental illness
- Paniccure.com
- Partners With PTSD
- Prescription Drug Information
- Psychiatric Service Dog Society
- PsychNews
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Rational Emotive Behavior
Therapy (REBT) - Sane Australia
-
Shyness & Social Anxiety
Service of Australia -
Social Phobia/Social Anxiety
Association - Social Anxiety Support board
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South African Depression &
Anxiety Group - Suicide Prevention Help
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tAPir - the Anxiety Panic
internet resource -
The Panic Center (Free
CBT based programs) - The School of OCD
- UN-WHO Drug Trials Database
- U.S. Army Behavioral Health - PTSD
we support
"just don't smoke"
Yul Brynner
- Menthol cigarettes harder to quit
- Secondhand smoke in cars serious threat to kid's health
- Starting smoking young increases addiction risk
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Smoking doesn't slim girls;
stunts boys' growth - 40 reasons why you should quit smoking
- Pregnant smokers 'prime' their kids to smoke
- Smoking related coronary artery disease quickly reversed if young smokers quit
- Not ready to quit? Try cutting back
- Half smoking again within year of lung cancer surgery
- Cutting back 'compensation' increases toxin load per cigarette
- Tobacco companies upped nicotine level 11% since 1998
- Workplace passive smoke increases lung cancer risk
- Hooked by genes: The DNA sequences cigarette companies love
- Smoking causes long lasting changes to brain's bio chemistry
- Nicotine receptor stimulant trebles the odds of stopping smoking
- Bupropion, nortriptyline double chances of quitting
- Nicotine's powerful role in reinforcing smoking
- Pregnant smokers raise child's risk of stroke, heart attack
- Smoking linked to pancreatic cancer
- Neurobiology of Smokers' Cravings
- 'Low cancer risk' cigarettes as deadly as regular kind
- Quitting reduces lung cancer death risk by 70%
- Fetal nicotine exposure linked to teen attention problems
- Outdoor second-hand smoke exposure can harm
- Response to day's first cigarette predicts ease of quitting
- 'Healthy' children of smoking parents aren't really so healthy
- Children of smokers have up to five times higher levels of a nicotine toxin
- Smoking increases risk of dementia
- Smoking kills even after quitting
- Antenatal second hand smoke exposure increases child's psychological problems
- Smoking could kill 1 billion this century: WHO
- Just 1 cigarette can lead to nicotine addiction
- Smokers less likely to survive early stage lung cancer
- Smokeless tobacco delivers carcinogens more efficiently than cigarettes!
- Smoking permanently turns on genes that increase lung cancer susceptibility
- Secondhand smoke a health hazard for pets too
- Hypnosis for smoking cessation sees strong results
- Smoking doesn't burn fat
- Smoking linked to sagging breasts
- No evidence waterpipes decrease smoking harm
- Tobacco smoke + alcohol damage hearts more than either alone
anti torture campaign
- Torture experts write APA policy
- [APA] still rocked by torture debate
- Petition for psychologists
- AMA president says APA "did not accurately represent our ethical guidelines"
- Psychologists Aiding Torturers
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Annual conference endorses
APA's torture policy :( - Physicians for Human Rights call on Congress to vote No on Military Commissions Bill
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Torture is a Form of Trauma;
Trauma Causes PTSD - Psychoanalysts' association condemns torture use
- Humiliating, inhumane or degrading treatment IS torture
- Two American psychologists accused of war crimes. U.S. DoD investigating.
- DoD report proves psychologists central to POW/detainee abuse (pdf)
- 40 psychologists demand APA change policy on torture (pdf)
- Did the American Psychological Association turn a blind eye to torture for medicine precribing rights?
- Will psychologists still abet torture?
- Psychologist, Author Mary Pipher Returns APA Award Over Interrogation Policy
- Guantanamo Medical Role Likened to South Africa Under Apartheid
Deputy Army Chief of Staff for Intelligence, Lt. General John (Jeff) Kimmons, has stated that no actionable intelligence had been obtained through abusive interrogation methods in the last 5 years.
monument, Monmouth County
New Jersey.
Doctor-patient teamwork plus patience can achieve full depression remission
More than two-thirds of people who suffer from major depression can become symptom-free if they are willing to work with their doctors and try various treatments to determine which work best for them, which may involve taking different antidepressants or adding cognitive therapy to the mix.
The largest study on treatments for depression, led by UT Southwestern Medical Center, found that 67 percent of patients achieved a full remission of symptoms by the end of one to four treatment steps. An overview of the $35 million, six-year study - designated STAR*D (Sequenced Treatment Alternatives to Relieve Depression) and funded by the National Institute of Mental Health (NIMH) - appears in the November issue of the American Journal of Psychiatry.
Results showed that the chances of reaching remission were higher after the first and second treatment steps (37 percent and 31 percent respectively), than after the third and fourth steps (14 percent and 13 percent). For those who did improve or remit in fewer treatment steps, lower relapse rates were found during a 12-month follow-up than for those who required more steps to reach remission or improvement.
"The take-home message for patients is to hang in there and stay in treatment, even if several steps and various medications must be tried.""There's good news and not-so-good news," said Dr. A. John Rush, vice chairman of clinical sciences and professor of psychiatry at UT Southwestern. "The good news is that two-thirds of people can be relieved of their depression if they can hang in there for up to four treatment steps. That's pretty significant for a tough illness.
"The not-so-good news is that when more steps are needed to get to remission or meaningful improvement, the higher the risk is for having a return of the depressive episode - or a relapse," said Dr. Rush, the study's principal investigator.
STAR*D is the first benchmark study to implement specific step-by-step medication treatment guidelines based on patients' symptoms and medication side effects. This gives clinicians a "measurement-based care" approach to delivering high-quality treatment for depression.
An important feature of the landmark clinical trial is that the 3,671 patients included were treated in "real-world" settings - 41 primary-care and psychiatric clinics around the country - rather than being nonpatient volunteers, as often is the case in such studies. In addition to suffering from major depression, most had other coexisting general medical and psychiatric conditions.
All participants initially received the same antidepressant medication. Those who didn't experience remission or couldn't tolerate the medication were strongly encouraged to proceed to the next step, where they were randomized to various groups receiving subsequent treatments including cognitive therapy alone or in combination with medication, as well as several different antidepressants used alone or in combination. Once patients achieved remission or made substantial improvement, they were followed closely for another 12 months.
"The more steps it takes to get better or to remission, the more carefully a patient needs to be followed, because the more likely that individual is to have a relapse.""This report provides a summary of all the steps and a comprehensive view of outcomes from the largest depression trial ever conducted," said Dr. Madhukar Trivedi, co-author of the study and professor of psychiatry at UT Southwestern. "It offers clear evidence of what happens step-by-step and gives us a good idea of what outcomes will be the following year, if patients continue the same treatment."
Each year, about 21 million American adults - or 9.5 percent of the population - struggle with depression, often a recurring or chronic disorder. Depression frequently returns two or more times, with some episodes lasting two years or more.
"Depression is a disabling medical condition just like any other medical condition such as diabetes or congestive heart failure," Dr. Rush said. "The take-home message for patients is to hang in there and stay in treatment, even if several steps and various medications must be tried. Be patient and willing to tell your doctor if a medication isn't working, if the dosage is bothering you or if you're having side effects. Collaborate with your physician to find the right medication and dosage for you, and stay on it long enough to give it a chance to work."
For clinicians, the study emphasizes the need for careful and regular monitoring and evaluation of patients, as well as highlights the critical value of remission as the end objective, Dr. Rush said.
"Remission is the thing you really, really want to try and achieve. And, follow-up is critical," he said. "The more steps it takes to get better or to remission, the more carefully a patient needs to be followed, because the more likely that individual is to have a relapse."
While more research is needed, STAR*D offers "clues," Dr. Rush said, into the types of patients who require longer treatment for depression. These include people who suffer from other chronic medical conditions and/or additional psychiatric disorders, and individuals who have experienced longer and more disabling periods of depression before seeking treatment.
As for the one-third of individuals who didn't reach remission, possible explanations include:
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There may be some depressions for which medications don't work.
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Individual biological and genetic differences, as well as life circumstances and other medical conditions, may render some medication treatments ineffective.
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People suffering from long bouts of depression might have been helped earlier in the course of the disease, but may not achieve remission after lengthy chronic depression.
"This study emphasizes the importance of long-term management of this disease," Dr. Rush said. "The short-term matters, but the long-term matters even more."
Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, Niederehe G, Thase ME, Lavori PW, Lebowitz BD, McGrath PJ, Rosenbaum JF, Sackeim HA, Kupfer DJ, Luther J, Fava M.
Acute and Longer-Term Outcomes in Depressed Outpatients Requiring One or Several Treatment Steps: A STAR*D Report.
Am J Psychiatry. 2006 Nov;163(11):1905-17. [Abstract]