Alarming Excerpt – From “Money” magazine, this chilling quote.

“#9 SEEK SMART COUNSEL -- If you’re seeing a mental-health therapist every week, you’re probably footing much of the bill: Most health plans limit coverage to 30 visits a year. You can cut the cost by going to a certified counselor or clinical social worker (average fee: $90 an hour) instead of a psychologist (around $120). A recent survey found no difference in effectiveness.”

(Thanks to Brad Noford for submitting this – Eds.)

8 Steps for Eliminating No-Shows and Cancellations. Psychotherapy Finances. Vol. 32, No. 8.

1) Explain your policy on the phone. 2) Try to establish a connection. 3) A firm policy can still be generous. 4) Do some trouble shooting with patients around problems that keep them from getting to therapy. 5) Call clients a day in advance to remind them. 6) Don’t put off collecting for missed sessions. 7) Make up your mind how tough you are going to be. 8) Note special rules for patients with managed plans.

Grim Prospects for Health Insurers. Psychotherapy Finances, Vol. 32, No. 8

Major managed care companies are falling far short of membership goals this year – and painting a bleaker picture of future earnings – as more employers opt out of health care coverage. Stock prices are dropping as a result, with Aetna reporting a 37% drop over 5 3 months, and Cigna showing a 15% 1st ¼ loss. “Where is this industry in four, five years if it can’t control health care costs. It’s a long walk off a short pier” said health care consultant “Robert Laszewski. Health care consultants believe higher deductible plans – in which more of the burden is shifted to consumers – may be the only solution to the health care financing problem.

A Perspective on the Nation’s Antitrust Policies. P. DeLeon et.al. Professional Psychology: Research and Practice. Vol 37, No. 4, 374-383.

An in depth overview of how antitrust policies influence and limit psychologists ability to work in unison to protect and extend psychological practice. A very important political arena to understand, but quite complex. DeLeon et.al. make it a bit more palatable.

The link below takes you to a demo of Motion Induced Blindness. Why go and look?
It might explain why the driver can truthfully claim he did not see the victim run into the street. It demonstrates again the value of basic research in challenging “common sense” understandings. The phenomenon can be a metaphor for our other beliefs about accuracy of perceptions by ourselves and others.
http://www.michaelbach.de/ot/mot_mib/index.html

(Thanks to Ed Zuckerman for forwarding this link – Eds)

Prime Early Screening Test for Schizophrenia and Psychosis. For an online version of this test from Yale University go to http://www.schizophrenia.com/sztest/. Positive results on this screener indicate further testing with SIPS or other structured interviewing of patient and collaterals. to download a print copy of the screening test in HTML or PDF, go to http://www.schizophrenia.com/sztest/sipstest.html.

(Thanks to Andy Ursino for forwarding this to the Div 42 email group. Eds.)

The following pieces are from the fantastic email group of Kenneth Pope. To subscribe contact Ken at kspope@kspope.com

Healing: Relieving Back Pain by Starting With the Head. N. Bakalar. New York Times. 12/26/06.

Psychological treatments of lower back pain have a real but modest effect on pain intensity, quality of life, and physical and emotional functioning, a systematic review of recent studies has found. The paper appears in the January issue of Health Psychology.

Researchers reviewed 22 randomized controlled trials that tested psychological treatments for noncancerous chronic lower back pain against control groups that received no treatment or the usual medications and exercises. The interventions included cognitive behavioral treatment, biofeedback, relaxation and hypnosis.

Short Mental Workouts May Slow Decline of Aging Minds. S. Vendatam. Washington Post. 12/20/06.

Ten sessions of exercises to boost reasoning skills, memory and mental processing speed staved off mental decline in middle-aged and elderly people in the first definitive study to show that honing intellectual skills can bolster the mind in the same way that physical exercise protects and strengthens the body. The researchers also showed that the benefits of the brain exercises extended well beyond the specific skills the volunteers learned. Older adults who did the basic exercises followed by later sessions were three times as fast as those who got only the initial sessions when it came to activities of daily living, such as reacting to a road sign, looking up a number in a telephone book or checking the ingredients on a medicine bottle -- abilities that can spell the difference between living independently and needing help.

(Thanks to Robert Griffin for forwarding this article. Eds.)

Eli Lilly Said to Play Down Risk of Top Pill. A. Berenson. New York Times. 12/17/06.

The drug maker Eli Lilly has engaged in a decade-long effort to play down the health risks of Zyprexa, its best-selling medication for schizophrenia, according to hundreds of internal Lilly documents and e-mail messages among top company managers. The documents, given to The Times by a lawyer representing mentally ill patients, show that Lilly executives kept important information from doctors about Zyprexa’s links to obesity and its tendency to raise blood sugar -- both known risk factors for diabetes.

Deadly Connection Between Diabetes and Alzheimer’s and Dementia.

AGEs form in the brains of Alzheimer’s sufferers early in the disease process and elevated blood sugars in those with diabetes increase the formation of AGEs. With skyrocketing incidence rates that are expected to soar even higher in the future, diabetes is rapidly transforming the health landscape of the United States and other Western nations. It is no exaggeration to say that diabetes now looms as one of the most costly, destructive medical epidemics of the early 21st century. New research suggests that those with insulin resistance or diabetes are at significantly higher risk of developing one of today’s most devastating and incurable neurological disorders: Alzheimer’s disease. The emerging connection between diabetes and Alzheimer’s is yet another compelling reason for those who value their health to address issues of impaired insulin sensitivity before it is too late. Although diabetes is an emerging epidemic, it is also wholly preventable and reversible through strategies that incorporate dietary changes, lifestyle modifications, and nutritional supplementation.

FDA Approves J&J Antipsychotic. J. Dooren. Wall Street Journal. 12/21/06.

The Food and Drug Administration approved a schizophrenia drug from Johnson & Johnson that the company is counting on to shore up its franchise of medicines for mental illness.

The once-a-day pill called Invega is derived from Risperdal, another drug used to treat schizophrenia and other mental illnesses, which is Johnson & Johnson’s best-selling product, with $3.55 billion in revenue in 2005. Generic Risperdal, or risperidone, could be on the market as early as 2008.

More Americans Left Uninsured. J. Graham, Chicago Tribune. 8/30/06.

“The ranks of Americans without medical coverage grew by 1.3 million people last year, the Census Bureau reported Tuesday. The increase lifted the number of uninsured Americans to a record 46.6 million, 15.9 percent of the total population. By comparison, five years earlier, 38.7 million people were uninsured, or 14 percent of the population. It’s increasingly a middle-class problem. In households with incomes of $50,000 a year or more, 17 million people had no insurance last year, up 1.5 million from 2004. In contrast, more low-income people received coverage from public programs. Of the 1.3 million additional people who were uninsured last year, 961,000 reported working full-time--continuing evidence of companies cutting spiraling costs by dropping medical coverage.”

Ketamine for Depression. T. Hampton. Journal of the American Medical Association. Vol. 296 No. 12.

A preliminary study by researchers at the National Institute of Mental Health has found that a single intravenous dose of ketamine can provide symptom relief for some individuals with treatment-resistant depression (Zarate ZA et al. Arch Gen Psychiatry. 2006;63:856-864). In the randomized, placebo-controlled, double-blind crossover study, 18 treatment-resistant depressed patients were assigned to receive either a single intravenous dose of ketamine or placebo. Ketamine improved depression symptoms within 1 day in 71% of patients receiving the drug, and 29% of these were nearly symptom-free. While none of the patients in this study experienced serious adverse effects, ketamine (which is usually administered in higher doses as an anesthetic) is unlikely to become a widely used treatment for depression because of potential adverse effects, including hallucinations and euphoria. Ketamine blocks a neuronal protein, the N-methyl-D-aspartic acid receptor, which binds to and is activated by glutamate. The investigators are now studying other areas of the glutamate system with the hope of discovering more precise targets for new medications.

Men, women get turned on equally fast.

A new McGill University study that used thermal imaging technology for the first time ever to measure sexual arousal rates has turned the conventional wisdom that women become aroused more slowly than men on its head. “Comparing sexual arousal between men and women, we see that there is no difference in the amount of time it takes healthy young men and women to reach peak arousal,” said Dr. Irv Binik, psychology professor and founder and director of the Sex and Couple Therapy Service of Royal Victoria Hospital.