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The National Institute on Aging and the Alzheimer's Association
has published new guidelines for the diagnosis of Alzheimer's
disease. This is the first update since the original guidelines
were created in 1984.
The guidelines include several significant changes. First, they
describe three disease stages: asymptomatic (preclinical),
thinking difficulties (mild cognitive impairment), and dementia
(Alzheimer's). This is the first formal recognition of what
research has suggested for several years now — that Alzheimer's
disease evolves gradually over many years and that physiological
changes in the brain occur a decade or more before noticeable
symptoms such as memory loss or behavioral changes.
Second, the guidelines propose — for research purposes only —
using biomarker tests in conjunction with clinical assessments to
determine whether someone might be at an early stage of
Alzheimer's. The biomarkers are still being tested, however, and
are not meant for routine use in a clinical setting.
Finally, the guidelines emphasize that although Alzheimer's
usually involves memory loss, in some cases it will cause other
symptoms first — such as difficulty in finding the right words
for something or problems seeing the "big picture" in a
Investigators, clinicians, and policy makers are hoping the
guidelines will help accelerate research on ways to prevent or at
least slow the progression of Alzheimer's.
Surveys indicate that nearly half of children with autism
spectrum disorders take some type of psychiatric medication —
most often antidepressants, antipsychotics, or stimulants. Yet a
federally funded study concluded that most of these drugs aren't
effective at treating symptoms of autism spectrum disorders.
Early intervention behavioral therapy, typically delivered at
home or in school, forms the foundation of treatment for autism
spectrum disorders. Unfortunately these therapies are labor- and
time-intensive, producing modest improvements at best. Parents
and clinicians, often desperate for additional options, have
increasingly turned to medications to alleviate symptoms such as
aggression, irritability, and repetitive behaviors, or to prevent
children from injuring themselves.
In an effort to provide clinicians and parents with better
information to guide treatment decisions, the U.S. Agency for
Healthcare Research and Quality asked investigators at the
Vanderbilt University Evidence-Based Practice Center to conduct a
review of research on various autism spectrum disorder treatments
for children 12 and younger.
People with metabolic syndrome are five times more likely than
healthy adults to develop diabetes and twice as likely to develop
Although metabolic syndrome affects nearly a quarter of all
Americans — roughly 50 million people — those with mental
illnesses like schizophrenia or bipolar disorder are especially
vulnerable. Antipsychotic medications in particular can cause
significant weight gain. Other contributing factors include
smoking, inadequate nutrition, lack of exercise, and limited
access to quality health care.
Delusional parasitosis may occur on its own or as a complication
of another disorder.
It's enough to make your skin crawl, just thinking about it:
insects, worms, fungi, or other pathogens colonizing a person's
body. When there is no proof of actual infestation, however, the
problem may be delusional parasitosis.
This poorly understood disorder has gone by different names over
the years, including Ekbom's syndrome (named for the first doctor
to identify the phenomenon as a disorder), organic hallucinosis,
unexplained dermopathy, and delusional infestation. The most
recent manifestation of delusional parasitosis may be Morgellons,
in which people believe they have been infested with fibers,
threads, and other inanimate material. None of these names
appears in the Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV). Instead,
delusional parasitosis most closely resembles what
the DSM-IV categorizes as delusional disorder,
Defined most simply, hallucinations are
false perceptions, and delusions are
false beliefs. Delusional parasitosis is a bit of a
hybrid. The phenomenon involves both
perception and belief. And the disorder's
symptoms may be based on a misinterpretation of real sensations.
This disorder may thus be related
to paresthesia (Greek for abnormal sensation),
akin to the feeling of "pins and needles."
Those with depression are more likely to lead a sedentary
lifestyle, which is a significant risk factor for heart disease.
Many elderly nursing home patients with dementia are being
prescribed antipsychotic medications, despite evidence that they
are twice as likely to die during treatment.
Dr. Michael Miller, editor in chief of the Harvard Mental Health
Letter, comments on research that examined the interaction
between antidepressant medications and pain relievers.