How to Find Mental Health Care When Money Is Tight – NYTimes.com

Posted on November 7, 2012 by Maurice Preter MD

See my comment on proper choice of treatment based on expert diagnostic evaluation in prior post. Self-diagnosis is just as bad as self-treatment. I will blog Jeff Kahn’s and my piece in HR executive in the next post.

>>IMAGINE this situation. You fall into a deep malaise. Friends say you need help, but you don’t have insurance (or the insurance you do have has very limited mental health benefits), and you worry that extra bills will only add to your malaise. So you do nothing.

via Patient Money – How to Find Mental Health Care When Money Is Tight – NYTimes.com.

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Getting Medical Help for the Mind

Posted on November 7, 2012 by Maurice Preter MD

Getting Medical Help for the Mind

Some helpful ideas even three years later but the article does not address the issue of quality mental health diagnosis and proper choice of treatment.

In Anxious Times, Medical Help for the Mind as Well as the Body

via Patient Money – Getting Medical Help for the Mind as Well as the Body – NYTimes.com.

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Treating Headaches – Podcasts & Handouts for Patients & Clinicians | UW Family Medicine

Posted on November 7, 2012 by Maurice Preter MD

Very useful compendium from the University of Wisconsin Dept. of Family Medicine web site.
The relevance of much of the material especially regarding anti-inflammation goes well beyond the treatment of headache.

An Integrative Approach to Recurring Headaches

via Treating Headaches – Podcasts & Handouts for Patients & Clinicians | UW Family Medicine.

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TBI and PTSD Get $100 Million in Research Money | The Military Wire – seattlepi.com

Posted on November 6, 2012 by Maurice Preter MD

TBI and PTSD Get $100 Million in Research Money

Traumatic Brain Injury TBI and Post Traumatic Stress Disorder PTSD are diagnosed and treated is about to get a major overhaul. Or at least that is the hope as the Department of Veterans Affairs and the Department of Defense announced they are investing more than $100 million in research to improve diagnosis and treatment of mild Traumatic Brain Injury and Post-traumatic Stress Disorder.After some major drama and confusion within the Army channels where up to 40 percent of PTSD diagnosis were overturned, the DOD and VA have teamed up with a common goal to deliver improved diagnosis and quality of care.That common goal comes at a price of $100 million…just in the research to improve the care. According to Defense News, “more than 15 percent of service members and veterans suffer impaired functioning as a result of PTSD.” What does that work out to for each affected Veteran? If my calculations are correct, roughly $300 per veteran. Not bad in my opinion; but we’ve not yet talked about the cost of the actual care.At the end of the day, can one really put a price on a potential cure that will improve the lives of those affected service members and their families after they’ve sacrificed so much?Two groups, The Consortium to Alleviate PTSD and the Chronic Effects of Neurotrauma Consortium will be jointly managed by VA, and by the Congressionally Directed Medical Research Programs, on behalf of the DOD. Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson stated, “These consortia will bring together leading scientists and researchers devoted to the health and welfare of our nation’s service members and veterans.”As a side note, this year alone, approximately 3,400 researchers will work on more than 2,300 projects with nearly $1.9 billion in funding.

via TBI and PTSD Get $100 Million in Research Money | The Military Wire – seattlepi.com.

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Effects of APOE on brain white matter microstructure in healthy adults

Posted on November 5, 2012 by Maurice Preter MD

Articles

Effects of APOE on brain white matter microstructure in healthy adults

Lars T. Westlye, PhD,

Ivar Reinvang, PhD,

Helge Rootwelt, PhD and

Thomas Espeseth, PhD

+ Author Affiliations

From the Department of Psychology (L.T.W., I.R.), Center for the Study of Human Cognition, University of Oslo, Oslo; Centre for Advanced Study (L.T.W., I.R., T.E.), Oslo; and Department of Medical Biochemistry (H.R.), Division of Mental Health and Addiction (T.E.), Oslo University Hospital, Oslo, Norway.

Correspondence & reprint requests to Dr. Westlye : l.t.westlye@psykologi.uio.no.

View Complete Disclosures

Abstract

Objectives: APOE is related to cholesterol transport and clearance and brain white matter (WM) properties involving myelin, of which cholesterol is a major component. Diffusion tensor imaging enables in vivo investigations of brain WM, and could increase our understanding of the pathways leading to Alzheimer disease. The main objective was to investigate the association between APOE and diffusion tensor imaging–derived indices of WM microstructure.

Methods: Healthy participants were assessed on a range of neuropsychological measures, genotyped, and underwent MRI. A total of 203 volunteers (aged 21.1–69.9 years, mean = 47.6, SD = 14.9) with APOE genotypes ϵ2/ϵ3 (n = 30), ϵ3/ϵ3 (n = 113), and ϵ3/ϵ4 (n = 60) were included.

Results: There were widespread increases in mean and radial diffusion in carriers of the ϵ3/ϵ4 alleles compared with ϵ3/ϵ3 with medium to strong effect sizes (Cohen’s d = 0.77–0.79). No interactions between genotype and age were observed, indicating relatively stable differences from early adulthood. The results were independent of presence of dementia in close family. We also observed increased mean and radial diffusion and decreased fractional anisotropy in carriers of the ϵ2/ϵ3 alleles compared with ϵ3/ϵ3 carriers. No significant differences were found between ϵ2/ϵ3 and ϵ3/ϵ4.

Conclusions: APOE affects microstructural properties of the brain WM from early adulthood, but the specific allelic effects do not directly reflect the associated risk of developing Alzheimer disease. The role of APOE in cholesterol transport, the high density of cholesterol in myelin, and the specific effects on radial diffusivity support a putative functional role of APOE in modulating myelin-related processes in the brain.

Footnotes

Study funding: Supported by the Research Council of Norway (grant 204966/F20 to L.T.W., grant 177458/V50 to T.E., and grant 154313/V50 to I.R.) and the Centre for Advanced Study at the Norwegian Academy of Sciences and Letters (I.R., T.E., and L.T.W.). The funding organizations had no role in the design or conduct of the study; in the collection, analysis, or interpretation of the data; or in the preparation, review, or approval of the manuscript.

via Effects of APOE on brain white matter microstructure in healthy adults.

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