The Medical Thread

[AKA_Monet]

Originally Posted by cheerfulgreek

lol lol lol lol

No, I just wanna read other opinions. I do wanna see that movie though. Does anyone know when it starts?

I just want to mention one more thing. Back to the DSM manual....o.k. I promise I won't bring up the the DSM anymore...lol.

I just wanted to mention something about the vaccines. There may be an overlooked alternative explanantion for this epidemic. Over time the the criteria for a diagnosis of autism have loosened, resulting in the labeling of substantially more mildly afflicted individuals as autistic. The 1980 version of the DSM required individuals to meet six of six criteria for an autism diagnosis, In contrast to that, the 1994 version, which is the version we're currently using requires individuals to meet any 8 of 16 criteria. The 1980 version contained only two diagnosis relevant to autism, DSM IV contains five including Asperger's syndrome which most researchers regard as a high functioning variant of autism.

The genetics of autism just came out... I posted it somewhere in the News and Views thread.

[cheerfulgreek]

Originally Posted by AKA_Monet

One of the HIV vaccine centers was at the Fred Hutchinson Cancer Research Center. It has just come out unfortunately that the HIV vaccine failed. It did not protect anyone from becoming infected with HIV...

There is the issue that MAYBE HSV-2 infection has some protection against HIV, BUT I just read in JAMA that may not be all the accurate...

I do not understand why a vaccine cannot be made against HIV... It does not make sense? And what bakes my noodle even more is how come folks with advance HIV disease do not get "polio" or "MMR"?

Actually the number of people living with HIV/AIDS globally has dramatically dropped, and that's not because of an actual drop in the HIV burden, but because of better counting methods in India. UNAIDS (The Joint United Nations Program on HIV/AIDS) and the World Health Organization announced some time last November that the disease's prevalence in India is around 2 million. That's still a lot when you look at the numbers alone, but if you think about it, that's down by more than half from a previous estimate of around 5 million.

[cheerfulgreek]

Originally Posted by AKA_Monet

The genetics of autism just came out... I posted it somewhere in the News and Views thread.

Thanks, I'll find it.

[AKA_Monet]

Back to mental illness treated by medication:

Do you the "mentally ill treated with meds" should have restricted freedoms in the US due to the "possibility" being a detriment to themselves or others?

What would/would not be the medical relevancy for that?

[BigRedBeta]

It's certainly a very touchy subject given the recent shootings across the country.

Medically, I'm not sure that it's up to doctors to make the decision on whether or not people can have guns. If the law states that those with diagnosed mental illnesses aren't allowed to possess firearms then that's the consequence of having a mental illness, but doctors should focus on disease and health. This isn't to say that doctors must ignore social issues with their patients, but that I think that's more of a one way street - doctors focus on social issues that affect the health of their patient (ie domestic abuse, inability to pay for meds, difficulty patients have getting to appointments b/c they don't have transportation), but shouldn't worry about how the health decisions affect the social issues in their patients. That's a very simplified view for sure, going with the one way street analogy, and I'm sure that if I thought about it, I'd be able to come up with some situations in which I don't agree with what I've just said, but on first glance, that looks like a good starting point. I probably didn't explain it that very well though...

Of course I'm of the opinion that we'd be better off with out the 2nd Amendment, but recognize it's not that easy...

[AKA_Monet]

Originally Posted by BigRedBeta

It's certainly a very touchy subject given the recent shootings across the country.

Medically, I'm not sure that it's up to doctors to make the decision on whether or not people can have guns. If the law states that those with diagnosed mental illnesses aren't allowed to possess firearms then that's the consequence of having a mental illness, but doctors should focus on disease and health. This isn't to say that doctors must ignore social issues with their patients, but that I think that's more of a one way street - doctors focus on social issues that affect the health of their patient (ie domestic abuse, inability to pay for meds, difficulty patients have getting to appointments b/c they don't have transportation), but shouldn't worry about how the health decisions affect the social issues in their patients. That's a very simplified view for sure, going with the one way street analogy, and I'm sure that if I thought about it, I'd be able to come up with some situations in which I don't agree with what I've just said, but on first glance, that looks like a good starting point. I probably didn't explain it that very well though...

Of course I'm of the opinion that we'd be better off with out the 2nd Amendment, but recognize it's not that easy...

You bring up a relevant medical situation. In no way should a physician make that decision. But the diagnosis of any mental illness starts at the doctors office or worse yet, the psychiatric ward. Making it well within the realm of medical doctors to have a very strong comment about the issuance of guns.

The problem is people who have traumatic experiences, like some PTSD, who need medications to ease their difficulties.

Unfortunately, very few mental illnesses are actually treated by any medication given and the 2-pronged treatment is not followed through, like bipolar 2 with lithium treatment then talk therapy, preferably cognitive therapy. And let's not get into stress management...

[cheerfulgreek]

Originally Posted by AKA_Monet

Back to mental illness treated by medication:

Do you the "mentally ill treated with meds" should have restricted freedoms in the US due to the "possibility" being a detriment to themselves or others?

What would/would not be the medical relevancy for that?

This is a really good question. I guess I would have to say yes. I was talking about something similar to this in another thread regarding athletes. Well, it wasn't that similar, but is was related to testosterone and how it effects human behavior.

When doctors prescribe medication to mentally ill patients, there are some restrictions that the patient is put under by the doctor, to keep them from endangering themselves or others, rather it be driving a car, cooking, ect ect. Personally, I think mentally ill patients should be forced into treatment even if they're not an imminent threat to themselves or others. The government estimates that there are about 2 million people in the United States who have been forced into mental institutions, and under federal law are banned from owning any kind of firearm.

[AKA_Monet]

Originally Posted by cheerfulgreek

This is a really good question. I guess I would have to say yes. I was talking about something similar to this in another thread regarding athletes. Well, it wasn't that similar, but is was related to testosterone and how it effects human behavior.

When doctors prescribe medication to mentally ill patients, there are some restrictions that the patient is put under by the doctor, to keep them from endangering themselves or others, rather it be driving a car, cooking, ect ect. Personally, I think mentally ill patients should be forced into treatment even if they're not an imminent threat to themselves or others. The government estimates that there are about 2 million people in the United States who have been forced into mental institutions, and under federal law are banned from owning any kind of firearm.

A person not inflicting harm on others or him/herself cannot be legally "forced" into treatment. In fact, it is against the law to do place them in "hospital" (sanitarium). They have to be willing to go and sign themselves in for treatment. Now, if they get arrested, usually for hurting someone or him/herself, they can be placed in the psych ward. If they accept treatment options, and rarely they do, they let them out at a defined period of time.

The second issue is I do not want any law enforcement official diagnosing anyone. That is NOT their job, nor in their contracts. Of course, they do make a call whether to simply arrest for criminality vs. psychotic behavior. But, I can tell you, many cops do NOT want the make the diagnosis. Only a trained healthcare professional should make that determination. And I also know that psych evaluation is a high stress job and the money is not that great to give full effort into it...

A psychologist or psychiatrist has it rather nicely, but the length in time to be trained is what deters people from pursuing those positions. They have to be dedicated. Same with a Social Worker (license clinical and/or Masters level) and with them they suffer burn out relatively easily.

One can only go as far as the patient is willing to let them go...

Sadly, the onus is on the patient with these particular diseases: There is no overt pathology, there is not a blood diagnostic test, there is barely a DNA microarray on the illness and the drugs have severe side-effects that does not directly affect the target organ and moreover takes 2-3 weeks for quasi-stability with short pharmakinetics of ~6 hours... Who would want to be a drooling, headachy, dud for 12 hours out the day when alcohol and weed are cheaper?

[SoEnchanting]

Originally Posted by AKA_Monet

A person not inflicting harm on others or him/herself cannot be legally "forced" into treatment. In fact, it is against the law to do place them in "hospital" (sanitarium). They have to be willing to go and sign themselves in for treatment. Now, if they get arrested, usually for hurting someone or him/herself, they can be placed in the psych ward. If they accept treatment options, and rarely they do, they let them out at a defined period of time.

The second issue is I do not want any law enforcement official diagnosing anyone. That is NOT their job, nor in their contracts. Of course, they do make a call whether to simply arrest for criminality vs. psychotic behavior. But, I can tell you, many cops do NOT want the make the diagnosis. Only a trained healthcare professional should make that determination. And I also know that psych evaluation is a high stress job and the money is not that great to give full effort into it...

A psychologist or psychiatrist has it rather nicely, but the length in time to be trained is what deters people from pursuing those positions. They have to be dedicated. Same with a Social Worker (license clinical and/or Masters level) and with them they suffer burn out relatively easily.

One can only go as far as the patient is willing to let them go...

Sadly, the onus is on the patient with these particular diseases: There is no overt pathology, there is not a blood diagnostic test, there is barely a DNA microarray on the illness and the drugs have severe side-effects that does not directly affect the target organ and moreover takes 2-3 weeks for quasi-stability with short pharmakinetics of ~6 hours... Who would want to be a drooling, headachy, dud for 12 hours out the day when alcohol and weed are cheaper?

I was about to respond here and say that you can in fact hospitalize someone with a mental illness involuntarily, but then I went online and found out the Baker Act is only a Florida statute and not everywhere! Guess you learn something every day...

[BigRedBeta]

SoEnchanting - have you taken the medicine shelf yet? I'm still 5 and a half weeks away, but the sheer weight of information we've gone over already has me worried (I'm going to put in some major time studying this weekend :O). Just started outpatient clinic this week - clinic's boring, but we have those small group sessions for half the day and they've been kicking my butt. I can't imagine having to study everything we've gone over on my own...hope you're managing okay.

I just thought of this but...I have a copy of our class notes (put together by some third years about 5 years ago and since passed down from class to class) on google documents, I could share them with you if you're interested. They're not super well organized, but it might be helpful, just to see the scope of things we've discussed...Let me know.

[SoEnchanting]

Originally Posted by BigRedBeta

SoEnchanting - have you taken the medicine shelf yet? I'm still 5 and a half weeks away, but the sheer weight of information we've gone over already has me worried (I'm going to put in some major time studying this weekend :O). Just started outpatient clinic this week - clinic's boring, but we have those small group sessions for half the day and they've been kicking my butt. I can't imagine having to study everything we've gone over on my own...hope you're managing okay.

My IM shelf is this Friday!

Scared to death since I've been told this one and Surgery are the worst ones. I've finished reading FA and MKSAP. Now I'm just doing online questions.. and praying... a lot.

And why am I on greekchat right now LOL...? I might need to put myself on internet punishment until the weekend.

I did outpatient at the beginning, and it was so much slower than inpatient medicine. At least you have more study time, I hope. Pray for me this week!

P.S. I'm about to PM you my email address. I'd appreciate any and all help!

[AKA_Monet]

Originally Posted by SoEnchanting

I was about to respond here and say that you can in fact hospitalize someone with a mental illness involuntarily, but then I went online and found out the Baker Act is only a Florida statute and not everywhere! Guess you learn something every day...

Here is an interesting article...

The thing is, one cannot be forced psych ward hospital "INVOLUNTARILY"---UNLESS there is a severe crisis, such as those incidents that engage law enforcement and healthcare emergency...

[SoEnchanting]

Originally Posted by AKA_Monet

Here is an interesting article...

The thing is, one cannot be forced psych ward hospital "INVOLUNTARILY"---UNLESS there is a severe crisis, such as those incidents that engage law enforcement and healthcare emergency...

http://www.psychlaws.org/PressRoom/faqonbakeract.htm

[cheerfulgreek]

Originally Posted by AKA_Monet

A person not inflicting harm on others or him/herself cannot be legally "forced" into treatment. In fact, it is against the law to do place them in "hospital" (sanitarium). They have to be willing to go and sign themselves in for treatment. Now, if they get arrested, usually for hurting someone or him/herself, they can be placed in the psych ward. If they accept treatment options, and rarely they do, they let them out at a defined period of time.

The second issue is I do not want any law enforcement official diagnosing anyone. That is NOT their job, nor in their contracts. Of course, they do make a call whether to simply arrest for criminality vs. psychotic behavior. But, I can tell you, many cops do NOT want the make the diagnosis. Only a trained healthcare professional should make that determination. And I also know that psych evaluation is a high stress job and the money is not that great to give full effort into it...

A psychologist or psychiatrist has it rather nicely, but the length in time to be trained is what deters people from pursuing those positions. They have to be dedicated. Same with a Social Worker (license clinical and/or Masters level) and with them they suffer burn out relatively easily.

One can only go as far as the patient is willing to let them go...

Sadly, the onus is on the patient with these particular diseases: There is no overt pathology, there is not a blood diagnostic test, there is barely a DNA microarray on the illness and the drugs have severe side-effects that does not directly affect the target organ and moreover takes 2-3 weeks for quasi-stability with short pharmakinetics of ~6 hours... Who would want to be a drooling, headachy, dud for 12 hours out the day when alcohol and weed are cheaper?

lol lol lol My God did this give me the giggles.

Despite a few publicized cases, of people with a serious mental illness committing violent crimes, patients with psychosis are responsible for a small amount of the violence in our society. Recent studies show that people with a psychotic illness have a modest increase in the odds of violent behavior. But other factors, including drug abuse and poverty are much stronger contributors to violence. I know people with mild cases of mental illness can't be forced into treatment, I was just saying that I think they should. For example, look at the Virginia shootings. The killer was treated for severe anxiety disorder and continued receiving therapy throughout his younger years in highschool, but then he was taken off of the therapy and whatever special education he was receiving. When he got to college he was stalking women, and professors even suggested that he get counseling. None of this would have happened if he would have been getting some kind of special education along with threapy. Though, in his case, this was a severe mental illness, but I honestly think the mild case patients should be forced into treatment too.

[AKA_Monet]

Originally Posted by cheerfulgreek

lol lol lol My God did this give me the giggles.

Despite a few publicized cases, of people with a serious mental illness committing violent crimes, patients with psychosis are responsible for a small amount of the violence in our society. Recent studies show that people with a psychotic illness have a modest increase in the odds of violent behavior. But other factors, including drug abuse and poverty are much stronger contributors to violence. I know people with mild cases of mental illness can't be forced into treatment, I was just saying that I think they should. For example, look at the Virginia shootings. The killer was treated for severe anxiety disorder and continued receiving therapy throughout his younger years in highschool, but then he was taken off of the therapy and whatever special education he was receiving. When he got to college he was stalking women, and professors even suggested that he get counseling. None of this would have happened if he would have been getting some kind of special education along with threapy. Though, in his case, this was a severe mental illness, but I honestly think the mild case patients should be forced into treatment too.

If you could give me some of the references for that I would greatly appreciate it!

Well, that is the issue about college... People do not HAVE TO GO TO college for special treatments, because ultimately, it is a choice to go. Where as PUBLIC EDUCATION is not a choice for young people under 18 years old... I do agree that all universities and colleges should improve their student services and do better outreach for the success of the student. But, there are nearly 20,000+ or more with commuters, and not everyone can be watched, nor do the colleges want to get into the business of that. Otherwise, it is just as institutional as prisons.

The VT killer should have been at a place were he could obtain support that he needed to be optimal for his successful function... But that still lays it squarely on the sufferer which also does not help the grieving families...

Do you think a "one size fits all" can help in these kinds of cases?