Comments invited on latest draft of DSM
A new version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has come out every decade or so (it varies widely) since 1952. 
It hasn’t substantially changed since 1994, but the next revision is slated to come out in 2013. It’s a pretty big event, as the book’s diagnostic criteria are used around the world to determine who is diagnosed with mental disorders.
With the release of the new version, lines may shift and folks who were diagnosed with mental disorders may find themselves “undiagnosed.” Others will have labels changed and gain labels they didn’t have before.
The latest draft proposal of the May 2013 revisions, upon which public comment will be accepted until April 20, 2010, was posted on Feb. 9. APA workgroups will review the comments and begin trials soon after. Benedict Carey rounded up and evaluated some of the biggest proposed changes for The New York Times. In addition to bipolar disorders in children and autism spectrum disorders, Carey discusses the sheer significance of the changes.
“Anything you put in that book, any little change you make, has huge implications not only for psychiatry but for pharmaceutical marketing, research, for the legal system, for who’s considered to be normal or not, for who’s considered disabled,” said Dr. Michael First, a professor of psychiatry at Columbia University who edited the fourth edition of the manual but is not involved in the fifth.
“And it has huge implications for stigma,” Dr. First continued, “because the more disorders you put in, the more people get labels, and the higher the risk that some get inappropriate treatment.”
Transmitter tracks health-care workers’ washing
Despite constant reminders and a high-level of industrywide awareness, studies indicate that less than half of American health care workers wash their hands as frequently as they ought to. This contributes to the health-care-associated infections that kill tens of thousands annually. Now, NPR’s Gigi Douban reports, one Alabama hospital has resorted to high-tech monitoring devices to keep tabs on the handwashing practices of its employees.
Workers wear a special wireless transmitter, from which, Douban writes, “the hospital can tell when she entered a patient’s room, whether she washed her hands and whether she washed again on the way out. The information is sent to hospital officials, including the CEO.”
“If they’re habitually not complying, we can send them an e-mail or send them a text message, something that goes to them personally,” says Harvey Nix, CEO of Proventix, the company that developed the monitoring system at Baptist Princeton.
According to Douban, the CDC is currently investigating the effects of the technology upon the behavior of health workers.
More vets come home as result of psychiatric issues
On Shots, NPR’s Health Blog, Nadja Popovich reports on a recent Johns Hopkins study that found, more troops were evacuated from Iraq and Afghanistan in 2007 for mental health problems than for combat injuries.
The increase comes despite the military’s increased focus on combating mental health problems among American soldiers. The largest number of evacuated soldiers are still those diagnosed with “noncombat-related injuries, such as muscle and joint problems that come from carrying equipment,” but psychiatric evacuations are a growing and complex problem.
American paratroopers in Afghanistan. Photo by U.S. Army Spc. William E. Henry via Flickr… those suffering from mental health issues had a remarkably low rate of returning to full duty. “Psychiatric conditions have the lowest return to duty rates among any diagnostic group aside from combat injuries,” (study leader Steven P. Cohen, an associate professor of anesthesiology at the Johns Hopkins School of Medicine and a colonel in the U.S. Army Reserve) wrote. “But the effects are much worse, because psychiatric conditions worsen the prognosis for all other conditions.”
“Patients with PTSD — as a rule — have multiple other complaints,” he continued. “Studies have shown that most people with persistent PTSD have ongoing musculoskeletal, neurological and constitutional complaints that are unlikely to respond to treatment.”
Related AHCJ articles
Interviewing ‘profoundly affected’ soldiers
Tips for interviewing service members returning from Iraq, the Middle East or Afghanistan
NPR to air explanatory Fosamax piece tonight
Filed under: Hot Health Headline, Pharmaceuticals
NPR correspondent Alix Spiegel’s latest piece, an examination of how Merck manufactured a disease (and an epidemic) en route to turning Fosamax into a blockbuster drug, is set to air on All Things Considered tonight. 
We all know how the story ends, but the real focus is the journey. As Spiegel says, “it’s the story of how the definition of what constitutes a disease evolves, and the role that drug companies can play in that evolution.”
In the case of Fosamax, it’s a real humdinger, going all the way from a sweltering meeting room in Rome to the shady backrooms of corporate America and, just in case that isn’t Da Vinci Code enough, it even involves dubious decisions at the highest levels of government.
Update
In a sidebar added to the story after this entry was posted, journalist Gisele Grayson writes about learning that she has osteopenia.
Fluportal.org stays on top of H1N1
While H1N1 seems to have peaked in many states – at least for now – Fluportal.org’s resources to cover the pandemic are still growing. Recent highlights include tips for using American Public Media’s Public Insight Network (which we’ve mentioned before in conjunction with a ProPublica story on health care reform), a few interesting photos with creative commons licenses (like a collection of H1N1 street art).
One of the creative commons licensed shots of H1N1 street art spotlighted by fluportal.org. Photo by Brazilian artist guitavares via Flickr.
Fluportal also has tackled some media ethics issues related to the outbreak, notably in a post where staff from PRI’s The World had to consider how to frame the German medical establishment’s reluctance to recommend the H1N1 vaccine. After all, they did not want to confuse listeners or have a negative impact on public health, but they also weren’t going to “censor” the sincere opinions of German doctors, even if they conflicted with CDC advice.
Related
Public broadcasters have H1N1 site for journalists
NPR answers H1N1 questions
With H1N1 and the mini-pandemic of rumors that seem to follow it on the rise, NPR brought out the big guns in an attempt to answer reader/listener questions and get the facts straight.
NPR’s health editors, Joe Neel and Anne Gudenkauf, teamed up with Dr. Andrew Pekosz and Dr. William Schaffner to tackle your questions.
Pekosz is an expert on viruses and immunology and a professor at Johns Hopkins Bloomberg School of Public Health. Schaffner is an infectious disease expert and professor at Vanderbilt University.
They answer questions like “Do H1N1 and other flu vaccines work?”; “Are they dangerous?”; “Who’s immune?”; “Should I be vaccinated for both H1N1 and typical seasonal flu?” and more.
Hensley cast as ‘Johnny Appleseed’ in profile
Medical Marketing & Media’s Matthew Arnold profiled AHCJ member Scott Hensley, of the NPR Health Blog, calling him “digital health journalism’s Johnny Appleseed” for his role in starting health blogs at media behemoths such as The Wall Street Journal and National Public Radio.
Scott Hensley (Photo by Duncan Moore)
The piece covers Hensley’s transition from the medical device industry to the media, his rise through the ranks and his attitude toward blog post topic selection.
In addition to the usual channels, Covering Health readers will remember Hensley from his distinguished run of contributions here, between his stints at the WSJ and NPR.
How hysterectomies spurred Dartmouth Atlas’ birth
Filed under: Conflicts of interest, Government, Health care reform, Health data, Hospitals, Hot Health Headline
In the first of a three-part series on health care costs in America, NPR’s Alix Spiegel tells the story of the birth of the Dartmouth Atlas, how some of its founder’s earliest research changed the health care delivery system in Maine and what it tells us about health and money. Spiegel unspools the story as a series of questions, the answer to each of which pushed researchers and physicians closer to an understanding of what drives health care costs in America.
The story kicks off in the mid ’60s when John Wennberg, now famous (among health reporters, at least) as the father of the Dartmouth Atlas, got a grant to study the best way to expand health technology to rural Vermont. To answer that question, Wennberg asked what health care was actually delivered in the state. From there, he discovers massive geographical differences in the frequency of procedures such as hysterectomies, and the questions and answers tumble neatly into line like so many dominoes.
Part two of the series, focusing on how active patient participation drives up costs, will air next week on NPR’s Morning Edition. In the third installment, Spiegel will examine the cost impact of direct-to-consumer advertising of prescription drugs.
Walking school bus hopes to cut traffic, obesity
Just in time for International Walk to School Day (Oct. 7), Bobbie O’Brien of public radio station WUSF-Tampa reports on a county health department in Florida that’s become the latest local group to join the walking school bus movement.
The idea behind the program is to “Have children, with one or more adult along for safety’s sake, walk to school in organized groups,” NPR’s Mark Memmot writes. “They get exercise, traffic around the schools gets better and everybody benefits.”
Related
For a thorough primer on covering obesity, AHCJ members should check out “Covering Obesity: A Guide for Reporters” slim guide.
Hensley: New FDA chief looks to be tough
According to NPR Health Blog’s Scott Hensley, newly confirmed FDA Commissioner Margaret Hamburg sounds like she means business.
Hamburg vowed to speed things up around FDA headquarters, calling the agency’s processing times for some routine tasks “unacceptable.” She also proposed a new system of publishing “close-out letters” on the FDA Web site when companies resolve a problem about which they had been formally warned by the FDA, presumably in the hopes that violators with clean up their act faster with the added motivation of a publicized clean bill of health.
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
