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Antidepressant Plus Antipsychotic May Cause Cardiometabolic Complications

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A new study from the 81st Scientific Sessions of the American Diabetes Association (ADA) shows that concomitant treatment with selective serotonin reuptake inhibitors (SSRIs) and second generation antipsychotics (SGAs) for mental disorders in children can have adverse effects on cardiometabolic health .

The researchers found that although treatment with either drug has been linked to cardiometabolic complications and an increased risk of type 2 diabetes, little is actually known about using both drugs at the same time.

To evaluate the cardiometabolic effects of a combination of treatments, a team led by Rupinder Thandi, BS, and colleagues from the University of British Columbia conducted a cross-sectional study of children at their facility’s Child and Adolescent Psychiatry Department.

The study

All examined patients (n = 569) were 5-18 years old; presented with a mental health diagnosis; had no endocrine, genetic, or eating disorders; and had not taken any medication that affected her metabolism.

Rupinder and team then divided the patients into 4 cohorts: SSRI and SGA treatment-naive (n = 242), only SSRI (n = 123), only SGA (n = 112) and SSRI + SGA (n = 92). Patients who received either or both drugs were given them for 7 days in the analysis analysis.

The team collected anthropometric and fasting blood samples from patients and assessed systolic / diastolic blood pressure, glucose homeostasis, and plasma lipids. Fitted linear and logistic regression models were used to determine any relationship between treatment groups and cardiometabolic risk factors.

The mean age was 13.04 for the naive population, 13.61 for the SSRI population, 11.63 for the SGA population, and 12.31 for the SSRI + SGA population.

In addition, the most common primary mental health diagnosis in all groups was anxiety disorder. Other primary diagnoses in the population were depressive disorder and ADHD.

The results

Patients who received SSRIs only received medication for an average of 5.38 months and patients who received combination therapy received an average of 8.00 months.

Overall, the researchers found that children treated with SSRI + SGA had higher z-scores on waist circumference (0.91) than children treated with SSRI only (0.48; P <0.05).

In addition, compared to SSRI-treated patients, children in the combined cohort had a higher probability of waist circumference in ≥90. Percentile (odds ratio [OR], 2.63, 95% CI; 1.34-5.18; P <0.05).

They also had higher plasma total cholesterol compared to SGA only (4.63 vs. 4.34 mmol / L; P <0.05, adjusted for age, gender, and BMI-Z scores) and a higher chance of having plasma -Total cholesterol ≥ 5.18 mmol / l (OR 2.36, 95% CI 1.05-5.30, P <0.05.

No differences in fasting plasma glucose, insulin, or insulin resistance (as measured by homeostasis model assessment of insulin resistance) were observed [HOMA-IR]) between treatment groups.

“Our results suggest major cardiometabolic complications in children treated with SSRIs and SGAs concurrently,” the researchers concluded.

The study “Effects of Concomitant Use of Selective Serotonin Reuptake Inhibitors and Second Generation Antipsychotic Drugs on Cardiometabolic Health in Children” was presented at ADA 2021.

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Pandemic Opportunity to Fix US Housing, Healthcare, Economic Problems

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  • As the delta wave of COVID begins to subside, we can see glaring holes in our nation’s resilience.
  • Whether the pandemic takes us back to the status quo or triggers reforms depends on the story the nation tells itself about what happened.
  • The pandemic was a disaster. It doesn’t have to be a missed opportunity, either.
  • Dr. Joshua M. Sharfstein is Professor of Health Policy and Management Practice at the Johns Hopkins Bloomberg School of Public Health
  • This is a split opinion. The thoughts expressed are those of the author.

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As the delta wave of the COVID pandemic begins to subside, people in the United States are dying for life to return to normal.

But it is still unclear how the new normal will differ from our pre-pandemic world. We now know that there are better ways to do things – from flexible work to telemedicine. We can also see glaring gaps in our country’s preparedness and resilience, including profound public health underfunding, enormous racial and ethnic disparities in housing, education and employment, and poor access to health care in many rural communities. Now is a golden opportunity to address these issues.

That is at least one lesson in history, which is full of examples of reforms that were actually unthinkable after a crisis. But change doesn’t happen automatically. For every example of a national event that casts a long shadow over politics, there is a counterexample of an event that barely touched the national agenda.

Whether the pandemic will bring us back to the status quo or spark fundamental reforms may depend largely on the story the nation tells about the events.

Who is trusted to tell the story?

The story told initially depends on who has the credibility to be the storyteller.

In 1937, a fatal batch of a drug called Elixir Sulfanilamide killed more than 100 people. A small federal agency called the Food and Drug Administration (FDA) jumped into action and garnered public recognition by dispatching inspectors across the country to track down the remaining doses. The agency then wrote a full report explaining why the public was so vulnerable to dangerous drugs. Congress responded by passing the landmark Food, Drug, and Cosmetic Act, which for the first time in history requires drugs to be reviewed and approved prior to commercialization.

In 1976, however, a very different scenario developed. The Centers for Disease Control and Prevention (CDC) launched a campaign to immunize every “man, woman, and child” in the country against a new strain of influenza. But the feared “swine flu” pandemic never came; Worse, the vaccine was associated with some rare but serious neurological side effects. The CDC’s reputation, tarnished by harsh reporting, could do little to halt a decline in confidence in vaccines.

What story is being told?

A good story attracts attention and tells not only the tragedies that occurred, but also the heroes that prevented further damage.

In 1961, a new sedative called thalidomide caused thousands of serious birth defects in Europe – but very few in the United States because the FDA refused to approve the drug. Tennessee Senator Estes Kefauver sensed an opportunity and encouraged journalists to tell the story like a single heroic drug critic, Dr. Frances Kelsey, who saved thousands of American babies from tragedy. Kelsey subsequently appeared in all of the major national magazines and newspapers and on all major television news programs.

In contrast, the more than 12,000 deaths in the US from the H1N1 pandemic in 2009 did not result in a serious national review of what went right and wrong in the response. A desire to return to normal and move on undermined serious considerations about much-needed investments in infection risk preparedness.

What kind of energy does the story generate?

Stories that inform are important; Stories that inspire people to act are the ones that lead to the most significant reforms.

The 2017 rampage from a hotel room in Las Vegas killed 60 people and injured 411. However, this terrible tragedy resulted in few reforms. Media attention and political debates focused on the narrow issue of bumpers, which were banned by the Justice Department in 2018 and then reintroduced by an appeals court in 2021.

Less than six months later, a shooting at Stoneman Douglas High School in Parkland, Florida killed 17 people and injured 17 others. Despite local election officials predicting that “nothing” would happen because “we’ve seen this show before,” gunfire survivors attacked the gun lobby for blocking even the most sensible reforms. Young people mobilized across the country and across the country. Despite years of blocking similar regulations, Florida lawmakers quickly passed important laws that include background checks, a waiting period, and a new program to remove weapons from people who are considered extremely at risk for their use. These laws have now been passed in 19 states and the District of Columbia.

What will change after COVID-19?

This scenario is easy to imagine: the deep polarization of the nation leaves little room for storytelling or teaching. Harassed and demoralized, public health leaders and authorities are unable to gain enough trust or respect to play an important role in determining a way forward. When cases recede, policymakers fall back into their regular routines and the public welcomes a return to normal.

And yet. An alternative scenario is also conceivable. First, a source of authority emerges, such as a non-partisan national commission or body. His research not only covers why the US failed to get the best COVID responses in the world, but also why the US had one of the most unequal and divisive pandemic experiences ever.

Second, a compelling story of what happened caught the nation’s attention. Millions of Americans understand what could have been done differently and what could have been done differently to avoid unnecessary loss of life.

Third, and finally, the story gets people moving. The window of opportunity for reform may be short and obstacles of all kinds are likely to block the path to reform. Still, proponents will have a chance to advance their arguments: The pandemic was a disaster. It doesn’t have to be a missed opportunity, either.

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Students still struggle with mental health issues | News

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TEWKSBURY – About a month into the 2021-2022 school year, Tewksbury Memorial High School students are fully immersed in the busy balance of science, sports, and extracurricular activities. While many look forward to returning to a largely normal school year, that normalcy comes with potential mental health problems as students work to strike a healthy balance between school, work, and personal life.

Even before the pandemic, the mental health of adolescents and young adults was seen as a growing problem. According to the CDC Youth Behavior Risk Survey: Data Summary and Trends 2009-2019, an increasing percentage of young Americans reported feeling sad or hopeless for at least two weeks “to the extent that they did not do their usual activities could pursue “. “Over the decade.

This trend was confirmed by the Pew Research Center in Most US Teens See Anxiety and Depression as a Big Problem Among Their Peers, where it was noted that 70 percent of teenagers identified anxiety and depression as a major problem for their peers. These feelings can be emphasized in the face of a mentally and physically demanding schedule adopted by students across the country.

For comparison, a typical day in the life of many TMHS students could be something like this. The student gets up between 6 a.m. and 6:30 a.m. to arrive at 7:30 a.m. when school starts. You have a full day of class that ends at 1:50 p.m. From there they play sports or go to extracurricular activities and often don’t return home until 4 p.m. to 5 p.m. Although they have returned home, the day is not over as they can have several hours of homework depending on the course load.

This process repeats itself throughout the school week, with many students sleeping minimally in order to meet all of their obligations.

On a scale of one to 10, with one not at all busy and 10 very busy, many students at TMHS find that their timetables tend to be geared towards this model on the busier side. College students McKayla Conley and Kaylee Capone agree and find their own schedules very demanding.

“I’d say my schedule is about an 8. I only have weekends off because I play volleyball every day after school,” said Conley.

“10/10 because I have school, physical therapy and dance every day,” Capone shared.

While some students recognize the need for mental health breaks, they say that having a busy schedule can actually have a positive impact on their mental health as they keep their minds busy. However, others emphasize the need for breaks to stay refreshed and maintain the routine.

At TMHS, students tend to ask for mental breaks from most trainers and teachers if necessary.

“My schedule has both positive and negative effects on me as I like to be busy, but there are places where I need a break,” said Capone. “My teachers are usually very considerate; it really depends on which teacher I’m talking to. “

Another way to relax from a cluttered schedule in everyday school life are wellness rooms, in which students can take a short break if they are overwhelmed. Students also report using other coping mechanisms, such as listening to music, as a means of reducing stress.

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NSW premier’s $130million mental health support package as he reinstates sign language interpreter

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Dom Perrottet announces massive $ 130 million mental health support package as NSW’s prime minister discreetly hires the sign language interpreter for the press conference after a backlash

  • NSW Premier Dom Perrottet has unveiled a massive mental health package
  • The project aims to combat suicide, eating disorders and self-harm problems in adolescents
  • The money is used to finance the training of 275,000 parents, teachers and sports coaches
  • The program aims to free more mental health beds for critical care

NSW Prime Minister Dom Perrottet has unveiled a massive $ 130 million mental health program to train 275,000 people in youth suicide prevention.

The package is aimed at teachers, parents and sports coaches to train them in dealing with mental health problems in adolescents.

In addition to suicide prevention, the program will also address eating disorders and self-harm to free mental health beds so they can be prioritized for critical cases.

The project will also fund more mental health services and train master’s students in clinical psychology to work at the Young Mental Health Foundation, Headspace.

The announcement comes after Lifeline announced it had been inundated with calls during the pandemic asking for help reaching record highs day in and day out.

NSW Premier Dom Perrottet (pictured) has unveiled a massive $ 130 million mental health program to train 275,000 people in youth suicide prevention

“It is the untold story of the pandemic,” said the Prime Minister on Sunday. “There are a lot of young children who make it difficult … go through a very emotional and difficult time.

“The pandemic has caused immense suffering for many people – young people, business owners, people who have lost their jobs not just once but twice.

“We had 300,000 people last year who lost their jobs just to go back to work and then lost their jobs again.

“This is in west Sydney, this is in regional New South Wales, this is in east Sydney, from north to south – mental health makes no difference.”

He added, “This funding means parents, children and the most vulnerable in our community will get the help they need now.

“In managing the economic recovery from this pandemic, we must also support people’s mental wellbeing.

“Our people here in New South Wales have made enormous sacrifices and many families have suffered – and it’s hard.

“We as a state must ensure that we continue to invest record amounts of money in providing this support to the people who need it.”

The program will also tackle eating disorders and self-harm to free mental health beds so they can be prioritized for critical cases.  (In the picture a patient undergoing psychiatric treatment)

The program will also address eating disorders and self-harm to free mental health beds so they can be prioritized for critical cases. (In the picture a patient undergoing psychiatric treatment)

NSW recorded 301 cases of locally acquired Covid-19 in the 24 hours to 8 p.m. on Saturday, with an additional 10 deaths and 619 people in the hospital, including 137 in intensive care.

At the press conference to announce the cash injection, an AUSLAN sign language interpreter was hired again after counter-reactions when he was dismissed by the new Prime Minister immediately after he took office.

The move was welcomed with a post on social media: “It’s good to see that the edict has been repealed without a foreign interpreter”.

Another added: “At least the outsiders are back with NSW Pressers. Maybe Dom’s team is reading the room. ‘

How is the $ 130 million Mental Health Package being spent in NSW?

$ 35 million over a two year period to increase the capacity of mental health clinic staff. NSW Health will have access to resident psychologists and psychiatrists and other mental health professionals to set up an additional 60,000 psychiatric consultations and 85,000 consultations with other mental health professionals, including psychologists.

$ 20 million over 18 months to offer young people up to 55,000 additional services through their local headspace center. In addition, it enables master and doctoral students in psychology as well as students of social and occupational therapy internships in headspace centers. Supervised students conduct psychological examinations and clinical sessions for young people.

$ 14 million over two years to train 275,000 people in suicide prevention training. The training is aimed at high school teachers and auxiliary staff; Parents; Youth influencers (e.g. sports coach, club manager); Community groups and peer leaders.

$ 21 million over four years to employ 18 Aboriginal Care Navigators and 18 Aboriginal peer workers. These roles will connect Australian Aborigines to a range of culturally appropriate mental health and suicide prevention services.

The package announced by Premier Dom Eprrottet (pictured) will also fund more psychiatric services and training master’s clinical psychology students to work at the Young People’s Mental Health Foundation, Headspace

The package announced by Premier Dom Eprrottet (pictured) will also fund more psychiatric services and training master’s clinical psychology students to work at the Young People’s Mental Health Foundation, Headspace

$ 16.5 million over four years to fight eating disorders and fund the Butterfly Foundation to admit NSW residents to their National Eating Disorders Center in Wandi Nerida, Queensland.

$ 6 million over two years to build the capacity of clerks and clerks to support child protection professionals at high risk of trauma.

$ 5 million over two years to fund a scholarship program for events benefiting the local community.

$ 3 million over a year to help sports organizations in NSW implement mental health and wellbeing initiatives.

$ 3 million over a year to give 12- to 24-year-olds with complex trauma and eating disorders access to private beds. This is being tested in the South Western Sydney Local Health District.

$ 2.6 million over two years to expand the services of the Gidget Foundation and offer an additional 280 psychological sessions each month.

$ 3.2 million over four years to build a Multicultural Mental Health Line.

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