Mental Health Disparities Between Hispanic and Non-Hispanic Parents of Childhood Cancer Survivors.

Mental Health Disparities Between Hispanic and Non-Hispanic Parents of Childhood Cancer Survivors.

Pediatr Blood Cancer. 2013 Mar 19;
Meeske KA, Sherman-Bien S, Hamilton AS, Olson AR, Slaughter R, Kuperberg A, Milam J

BACKGROUND: Parents of childhood cancer survivors (CCS) experience considerable distress related to their child’s cancer. However, little is known about cultural variation in this experience. We examine parental distress, specifically symptoms of post-traumatic stress (PTSS) and depression, comparing Hispanic and non-Hispanic parents of CCS. PROCEDURE: Seventy-nine Hispanic and 60 non-Hispanic parents of CCS (currently aged 14-25, off treatment ?2 years) completed questionnaires assessing demographics, depression, PTSS, perceived stress, and child’s health status/quality of life (QOL). t-Tests and chi-square statistics were used to compare differences in demographic characteristics between Hispanic and non-Hispanic parents and multivariable regression was used to determine independent risk factors associated with parental PTSS and depression. RESULTS: Hispanic parents were significantly younger, had less education, lower incomes and reported significantly more PTSS and depressive symptoms than non-Hispanic parents (all P-values?HubMed – depression

The Cost Effectiveness of Pharmacological Treatments for Generalized Anxiety Disorder.

Pharmacoeconomics. 2013 Mar 20;
Mavranezouli I, Meader N, Cape J, Kendall T

BACKGROUND: Generalized anxiety disorder (GAD) is one of the most prevalent anxiety disorders, with important implications for patients and healthcare resources. However, few economic evaluations of pharmacological treatments for GAD have been published to date, and those available have assessed only a limited number of drugs. OBJECTIVE: To assess the cost effectiveness of pharmacological interventions for patients with GAD in the UK. METHODS: A decision-analytic model in the form of a decision tree was constructed to compare the costs and QALYs of six drugs used as first-line pharmacological treatments in people with GAD (duloxetine, escitalopram, paroxetine, pregabalin, sertraline and venlafaxine extended release [XL]) and ‘no pharmacological treatment’. The analysis adopted the perspective of the NHS and Personal Social Services (PSS) in the UK. Efficacy data were derived from a systematic literature review of double-blind, randomized controlled trials and were synthesized using network meta-analytic techniques. Two network meta-analyses were undertaken to assess the comparative efficacy (expressed by response rates) and tolerability (expressed by rates of discontinuation due to intolerable side effects) of the six drugs and no treatment in the study population. Cost data were derived from published literature and national sources, supplemented by expert opinion. The price year was 2011. Probabilistic sensitivity analysis was conducted to evaluate the underlying uncertainty of the model input parameters. RESULTS: Sertraline was the best drug in limiting discontinuation due to side effects and the second best drug in achieving response in patients not discontinuing treatment due to side effects. It also resulted in the lowest costs and highest number of QALYs among all treatment options assessed. Its probability of being the most cost-effective drug reached 75 % at a willingness-to-pay threshold of £20,000 per extra QALY gained. CONCLUSION: Sertraline appears to be the most cost-effective drug in the treatment of patients with GAD. However, this finding is based on limited evidence for sertraline (two published trials). Sertraline is not licensed for the treatment of GAD in the UK, but is commonly used by primary care practitioners for the treatment of depression and mixed depression and anxiety. HubMed – depression

Corticostriatal connectivity and its role in disease.

Nat Rev Neurosci. 2013 Apr; 14(4): 278-91
Shepherd GM

Corticostriatal projections are essential components of forebrain circuits and are widely involved in motivated behaviour. These axonal projections are formed by two distinct classes of cortical neurons, intratelencephalic (IT) and pyramidal tract (PT) neurons. Convergent evidence points to IT versus PT differentiation of the corticostriatal system at all levels of functional organization, from cellular signalling mechanisms to circuit topology. There is also growing evidence for IT/PT imbalance as an aetiological factor in neurodevelopmental, neuropsychiatric and movement disorders – autism, amyotrophic lateral sclerosis, obsessive-compulsive disorder, schizophrenia, Huntington’s and Parkinson’s diseases and major depression are highlighted here. HubMed – depression

To Treat or Not to Treat Perinatal Depression With Antidepressant Medication: Effects on Infant Growth.

Am J Psychiatry. 2013 Mar 20;
Parry BL

HubMed – depression

Efficacy of venlafaxine extended-release monotherapy for first-episode depression with painful physical symptoms.

Neuroreport. 2013 Mar 18;
Huang X, Li C, Luo YL, Wang B, Ji JL

Pain is the most common symptom reported in both the general population and the general medical setting. The aim of this study is to evaluate the effectiveness, tolerance, and safety of venlafaxine extended-release (XR) monotherapy in treating first-episode outpatients fulfilling the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for major depressive disorder with associated painful physical symptoms. Of the 102 outpatients enrolled, 86 (84.3%) completed the study. Venlafaxine XR treatment (75-225 mg/day) was followed by a significant decrease in the total scores for the 17-item Hamilton Depression Rating Scale from baseline to the second weekend (t value=16.12, P<0.0001) and at every subsequent visit (weeks 4, 6, and 8, all P<0.0001). Significant differences were also found in the mean Visual Analog Scales for overall pain and the mean medical outcomes study pain measures from baseline to the second weekend (t value=14.99, P<0.0001; t value=12.59, P<0.0001) and at every visit (all P<0.0001). At the end of the eighth week, venlafaxine XR achieved response and remission rates of 68.6 and 40.2%, respectively. The remission rate for pain responders (improvement in Visual Analog Scale overall pain from baseline to last observation ?50%) was significantly greater than that for pain nonresponders (56.1 vs. 20.0%, P<0.0001). The most common (?10%) adverse events were nausea (31.4%), dizziness (26.5%), and somnolence (22.5%). Venlafaxine XR is possibly an effective and safe option in the treatment of depression and associated painful physical symptoms. HubMed – depression