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10 signs you may have obsessive-compulsive disorder

Hooked on hand sanitizer? Closet organized to a T? Quirks like this can usually be chalked up to personality or preference, but in some cases they may point to a more serious issue: obsessive-compulsive disorder (OCD), a condition marked by obsessive thoughts and compulsions that affects about 1 percent of U.S. adults. How can you tell if OCD tendencies are symptoms that require professional help? There's no easy test, as it's usually a matter of degree, said Jeff Szymanski, executive director of the International OCD Foundation, a Boston-based advocacy organization. Still, there are certain patterns that may indicate the full-blown disorder. Here are 10 of the most common. Hand-washing Compulsive hand-washing or hand sanitizer use is so prevalent in OCD that “washers” has become a widely accepted category of OCD patient. The urge commonly stems from a fear of germs (the most common obsession seen in OCD), but it also can be rooted in fears of making others sick or of being impure or immoral. When to seek help: If you think about germs even after washing your hands, worry that you're not scrubbing well enough, or have irrational fears about disease (such as getting HIV from a shopping cart), it could be a sign that your hand-washing is compulsive, Szymanski said. Elaborate hand-washing routines—needing to wash five times and get soap under each nail, for example—are another warning sign. Health.com: Do You Have an Anxiety Disorder…

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ADHD medications not tied to drug, alcohol abuse

Taking Ritalin and other drugs for attention-deficit/hyperactivity disorder (ADHD) doesn't affect a child's chances of trying or abusing alcohol and drugs later in life, a new review suggests. Researchers pooled data from 15 studies that included a total of 2,600 kids and teenagers with ADHD who were or were not medicated with stimulants and were followed for anywhere from 3 to 28 years. They found no clear difference in how many participants started using or abusing alcohol, cigarettes, marijuana or cocaine, based on how their ADHD was managed. “The scientific evidence suggests that the risk for alcohol and substance problems later in development, in adolescence or adulthood, doesn't seem to be strongly tied to whether or not children were previously… treated with stimulant medication,” said psychologist Steve Lee, who worked on the new study. That means parents should focus on discussing more immediate effects of stimulants with their child's doctor, such as sleep or appetite problems, he added. Kids with ADHD are known to be at higher risk of developing substance problems than those without the disorder. One analysis from 2003 suggested kids treated with stimulants were less likely to develop alcohol and drug problems than their peers with ADHD. Lee and his colleagues from the University of California, Los Angeles, wanted to see how that picture looked once more recent studies were taken into account. The researchers analyzed data related to substance use or abuse of each drug separately. For every category they looked at - alcohol, nicotine, marijuana, cocaine and other drugs - Ritalin and similar stimulants weren't tied to a clear increase or decrease in future use or abuse. That finding isn't the end of the story, the study team said. For example, it's not clear whether the effects of stimulants are different for boys and girls. And because kids in these studies were not randomly assigned to take stimulants or not, it's possible they varied in other ways that may have affected future drug and alcohol use, such as ADHD severity, the researchers write in JAMA Psychiatry. “What I say to parents when I'm talking to them about medication is, the medication is unlikely to have any adverse effects on substance use as far as we know right now,” said William Pelham, head of the Center for Children and Families at Florida International University in Miami, who wasn't involved in the new study. But, he said, “We don't have a lot of studies going into the full range of years when people (are most at risk for) substance abuse.” According to the U.S. Centers for Disease Control and Prevention, parent reports suggest that close to one in 10 kids and teens in the U.S. has ever been diagnosed with ADHD, and two-thirds of those with a current diagnosis are treated with medication such as stimulants. Those drugs can come with short-term side effects, including appetite loss and stomach aches. Because of that, “psychosocial, parent-management types of strategies probably ought to be the first line of treatment,” rather than medication, Lee said. In general, stimulants haven't been shown to have long-term side effects in the years after kids stop taking them, Pelham said - but they also don't seem to have long-term benefits. He agreed with Lee that parents should be looking to non-drug ways to improve the outlook for children with ADHD, including working closely with teachers as kids grow up. And because those youth are at higher risk of drug and alcohol problems due to their ADHD, they should have access to programs to improve decision-making skills and peer relationships, Pelham said.source : http://www.foxnews.com/health/2013/05/30/adhd-medications-not-tied-to-drug-alcohol-abuse/

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The DSM-5 is here: What the controversial new changes mean for mental health care

The most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) has arrived, and the latest changes have caused divisions among those in the psychiatric community.   Often touted as the psychiatrist’s “Bible,” the DSM is published by the American Psychiatric Association and establishes the almost universal standard by which doctors classify, diagnose and ultimately treat mental disorders – making it an essential part of the psychiatric profession.  The DSM is utilized not only by clinicians, but researchers and health insurance companies as well. Even government officials take interest in the DSM’s criteria in order to determine grant funding, insurance coverage and new health care policies. The latest version is the DSM’s fifth edition, and it is the manual’s first major revision in nearly 20 years since the publication of the DSM-IV in 1994.  The DSM-5’s release brings some radical new changes, which have been met with both praise and disgust from mental health professionals. Some of the most highly debated changes include the elimination of Asperger’s disorder and the addition of a few new controversial conditions such as cannabis withdrawal, gambling addiction and the highly contested disruptive mood dysregulation disorder (DMD). So what do these changes mean for those currently dealing with mental health disorders?  Read on to learn more about the DSM-5’s biggest changes and the possible impact they may have on mental health care. Combination of autism spectrum disorders into single category One of the most publicized changes in the DSM-5 involves grouping all of the subcategories of autism into a single category known as autism spectrum disorder (ASD).  This move effectively eliminates previously separate diagnoses of autism – including autistic disorder, Asperger’s disorder, childhood disintegrative disorder and pervasive development disorder “not otherwise specified” (PDD-NOS). This merging of categories creates a “sliding scale” for autism, meaning individuals will be diagnosed somewhere along the autism spectrum, given the personal severity of their symptoms. Many parents and health care providers have speculated that this transformation may end up excluding some of those already diagnosed with an autism disorder, like Asperger’s or PDD-NOS. “I think (exclusion from the spectrum) frankly yet to be determined, but if anything, the specificity is going to go up, meaning the false positives are going to be less likely,” Dr. Alexandar Kolevzon, associate professor of psychiatry and pediatrics at Mount Sinai Hospital in New York City, told FoxNews.com. “This universe of people with PDD-NOS – it’s possible that some of those patients may no longer meet those criteria.  Some of the debate revolves around Asperger’s, but it seems to me that most people diagnosed with Asperger’s will still be on the autism spectrum.” Over the past decade, the United States has seen a striking increase in the amount of autism diagnoses, with the Centers for Disease Control and Prevention estimating that one in 88 children suffers from an autism spectrum disorder.  According to Kolvezon, numerous epidemiological studies have found that the majority of children accounting for this incidence are those with PDD-NOS – a diagnosis given to those with communication issues and pattern behavior but who do not meet the full criteria for autism or another pervasive developmental disorder. Kolevzon said it’s possible that over-diagnosis of PDD-NOS has led to this increase in autism spectrum disorder cases. “What happens in the community is that the diagnosis of autism spectrum disorder virtually guarantees a whole host of therapies – such as speech therapy, occupational therapy, behavioral therapy, and potentially physical therapy,” Kolevzon said. “Theoretically, it’s possible that community providers and clinicians are incentivized to label kids with PDD-NOS, because it would make it more likely to receive appropriate services.” The autism spectrum disorder scale will further refine the way providers diagnose autism, Kolevzon said, by recognizing differences from person to person rather than trying to generalize them into one of four categories. The creation of disruptive mood dysregulation disorder Within the past decade, more and more children as young as 2 years old have been diagnosed with bipolar disorder, leading to the prescription of powerful antipsychotic medication that can be quite intense for children at such a young age. According to the Agency for Healthcare Research and Quality, hospital stays for childhood bipolar disorder have increased by 434 percent from 1997 to 2010.   The trend began in the mid-1990s, when doctors from Harvard University stated that bipolar disorder presented differently in children than that of adults. However, recent studies have found that many of these diagnoses were false, causing what many have described as the “false epidemic.” To combat this trend, the DSM-5 is eliminating the diagnosis of pediatric bipolar disorder and creating a brand new category called disruptive mood dysregulation disorder (DMDD), described as intense outbursts and irritability beyond normal temper tantrums in young children. While the move is meant to address an established problem, many are worried that the category will be applied too liberally. “My concern is this category will be applied to individuals where the reason for these blow ups is for something else.  You can see it in kids with anxiety disorders and ADHD….Even the head of the DSM committee asked, ‘Are we going to label kids with temper tantrums?’” Dr. Max Wiznitzer, a pediatric neurologist for UH Rainbow Babies & Children’s Hospital in Cleveland, Ohio, told FoxNews.com. “The thing is we have to make sure people are going to be rigorous in application and not just apply to any kid with temper tantrums or sleep deprivation.” ‘Dependence’ to ‘addiction,’ cannabis withdrawal and gambling disorders The DSM’s chapter on substance abuse has also undergone changes, now being called the Substance Use Disorders chapter.  The diagnostic criteria for these conditions have been expanded, but one of the biggest changes deals with the swapping of two seemingly similar words when describing these disorders: the term “dependence” is out and the term “addiction” is in. According to Dr. Yasmin Hurd, professor of psychiatry at Mount Sinai, the change is subtle but necessary. “It was quite confusing, especially with the term dependence,” Hurd told FoxNews.com.  “It had association with severe psychological dependencies, generating a lot of confusion.  Now the DSM-5 just talks about addiction, in context, being about the compulsive nature of the disorder.” For example, patients being prescribed pain medication may wind up hooked on the drug, but they are still taking the medication under the guidance of a physician.  They aren’t necessarily seeking out the medication by themselves, but if they are taken off the drug they may still have psychological withdrawal. In this case, they aren’t dependent on the drug, but they are addicted - according to the new guidelines. In addition to the word swap, new controversial categories of gambling disorders and cannabis withdrawal have been created in the DSM-5 – decisions based on multiple human and animal studies. “Experts in the field know that people who have severe cannabis use – they’ll go through cannabis withdrawal,” Hurd said. “There is a misnomer in our society that people can’t get addicted to marijuana.  That’s not true.  There are more people that meet the criteria for abuse of cannabis than any other illicit drug.” Similar to the changes made to the autism spectrum disorders, substance use disorders will also be categorized more on a sliding scale, depending on the severity of each patient’s symptoms. “You’re going to have many people with alcohol and cannabis addiction who have mild addiction, but very few heroin addicts are going to be mild,” Hurd said. Other major changes Along with the more controversial changes, the DSM-5 is also refining the criteria for post-traumatic stress disorders (PTSD), including a subtype for PTSD in preschool children.  The diagnosis for attention deficit hyperactivity disorder is also getting a revision, with the elimination of a previously required symptom and the changing of the required age of onset from age 7 to age 12. Obsessive compulsive disorder (OCD), once categorized under anxiety disorders, is now getting its own category of Obsessive-compulsive and related disorders.  Along with OCD, this category includes Body Dysmorphic Disorder (BDD), Trichotillomania (TTM, or hair pulling) and a brand new disorder called Hoarding Disorder. The DSM-5 incorporates many more changes that have psychiatrists locked in heated debate, but Wiznitzer noted that these tensions will always exist as long as doctors continue to learn more about the human brain. “Homosexuality used to be in the DSM as a psychiatric disorder; that was two versions ago,” Wiznitzer said. “Autism wasn’t even in the first two versions of the DSM, it was childhood schizophrenia.  Then we changed the criteria over time.  Basically anytime you change something, it’s always met with resistance.” Click for more information on the DSM-5.source : http://www.foxnews.com/health/2013/05/21/dsm-5-is-here-what-controversial-new-changes-mean-for-mental-health-care/

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Up to 1 in 5 children suffer from a mental disorder, CDC says

Up to 20 percent of children in the United States suffer from a mental disorder, and the number of kids diagnosed with one has been rising for more than a decade, according to a report released on Thursday by the U.S. Center for Disease Control and Prevention. In the agency's first-ever study of mental disorders among children aged 3 to 17, researchers found childhood mental illnesses affect up to one in five kids and cost $247 billion per year in medical bills, special education and juvenile justice. Children with mental disorders - defined as “serious deviations from expected cognitive, social, and emotional development” - often have trouble learning in school, making friends, and building relationships later in life, the report said. They are more likely to have other chronic health problems, such as asthma and diabetes, and are at risk for developing mental illnesses as adults. “This is a deliberate effort by CDC to show mental health is a health issue. As with any health concern, the more attention we give to it, the better. It's parents becoming aware of the facts and talking to a healthcare provider about how their child is learning, behaving, and playing with other kids,” Dr. Ruth Perou, the lead author of the study, said in an interview. “What's concerning is the number of families affected by these issues. But we can do something about this. Mental health problems are diagnosable, treatable and people can recover and lead full healthy lives,” Perou added. The study cited data collected between 1994 and 2011 that showed the number of kids with mental disorders is growing. The study stopped short of concluding why, but suggested improvements in diagnoses as one possible explanation “Changes in estimated prevalence over time might be associated with an actual change in prevalence, changes in case definition, changes in the public perception of mental disorders, or improvements in diagnosis, which might be associated with changes in policies and access to health care,” the study said. Perou said more research was needed to determine the specific causes of mental disorders, and that greater awareness could lead to an uptick in diagnoses. A host of environmental factors, including chemical exposure and poverty, can also affect a child's mental health, she said. Lead, for example, is known to be “one of the biggest toxins to impact behavior and learning,” Perou said. Poor children are at a higher risk for developing certain conditions, according to the study. The most prevalent mental health diagnosis, as reported by parents, was Attention Deficit/Hyperactivity Disorder (ADHD), which affects 6.8 percent of children. Also common were behavioral conduct problems (3.5 percent), anxiety, which consists mostly of fears and phobias (3 percent), depression (2.1 percent) and autism spectrum disorders (1.1 percent). Many of these disorders occur together, the report said. Boys were found more likely to have most of the listed disorders except for depression and alcohol abuse, which affect more girls. The study also noted that suicide, which can be precipitated by an untreated mental illness, was the second leading cause of death (after accidents) among children 12 to 17 years old. The CDC report was based on multiple other studies that collected data and interviewed children and their guardians about their diagnoses, habits, behaviors and other factors.source : http://www.foxnews.com/health/2013/05/17/up-to-1-in-5-children-suffer-from-mental-disorder-cdc-says/

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Potential treatment for Parkinson’s, Alzheimer’s, dementia discovered

A drug currently being used to treat leukemia has been found to help halt the production of toxic proteins in the brain linked to Alzheimer’s disease, Parkinson’s disease and various forms of dementia. Researchers from Georgetown University successfully used small doses of the drug nilotinib, used to treat chronic myelogenous leukemia (CML), to eliminate abnormal protein build-up in the brains of mice. The scientists targeted the alpha-Synuclein and tau proteins, which have been previously implicated in the development of Parkinson’s disease, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), Huntington’s disease, Lewy body dementia and other neurodegenerative conditions. …

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