It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Thursday, April 28, 2022
New approach to advance care planning preferred by Canadian long-term care residents
Researchers have developed a better way to support end-of-life planning in long-term care homes, according to a recent study.
The researchers also found that only 40 per cent of homes were routinely involving residents in end-of-life care discussions.
“Often people assume that a non-capable resident can’t participate, but there are other ways of communicating and understanding an individual’s preferences,” said George Heckman, a researcher in Waterloo’s School of Public Health Sciences and Schlegel Research Chair with the Schlegel-UW Research Institute for Aging.
The new approach to support end-of-life planning, Better tArgeting, Better outcomes for frail ELderly patients (BABEL), was found to be much more comprehensive than the usual manner in which long-term care homes conduct advance care planning.
The BABEL approach, developed by researchers at the Universities of Waterloo, Manitoba and Calgary, uses a tailored, person-centred approach based on best practices, and was designed with stakeholder input. BABEL was tested in 29 long-term care homes in three provinces: Ontario, Manitoba and Alberta.
Advance care planning is a critical process that ensures individuals’ values, wishes and preferences are understood and honoured at the end of life. BABEL achieves that by involving residents as active participants and putting their values and wishes first. Since it is hard for individuals to think about hypotheticals, the care team focuses on situations most likely to happen to a resident and how outcomes of different treatments might align with their individual goals.
“It’s a conversation that needs to happen often, as health status changes, and it involves residents, family members and the care team,” Heckman said. “As a physician, I know how important care at end of life is for individuals and their families, and this is an opportunity to get this right. BABEL certainly seems to help residents and substitute decision-makers with these otherwise challenging conversations and paves the way for more timely and comprehensive palliative care.”
Residents who participated in BABEL also avoided unhelpful and potentially harmful treatments at end of life. “Reducing the use of unnecessary treatments is often preferred at the end of life when comfort becomes a higher priority,” Heckman said.
“Reducing the unnecessary use of antibiotics in care settings also has broader benefits, given its current overuse.” The study found that lower use of antibiotics in participating residents did not impact survival.
The study, detailing the researchers’ findings, was authored by Heckman, the University of Manitoba’s Allan Garland and a team of Canadian researchers. It was published in the journal Age and Ageing. The research was funded by the Canadian Frailty Network and Research Manitoba.
BABEL (Better tArgeting, Better outcomes for frail ELderly patients) advance care planning: a comprehensive approach to advance care planning in nursing homes: a cluster randomised trial
ARTICLE PUBLICATION DATE
23-Mar-2022
Rates of handgun carriage rise among US adolescents, particularly White, rural, and higher income teens, new study finds
Boston College researchers find gun carriage rates decreased among Black, American Indian and Alaskan Native, and lower income adolescents
Chestnut Hill, Mass. (4/26/20220) – Handgun carrying increased significantly among rural, White and higher-income adolescents from 2002 to 2019, ominously escalating the risk of firearm-related death or injury for both these youths and others in their social sphere, researchers from Boston College’s Lynch School of Education and Human Development report in the latest edition of the journal Pediatrics.
The researchers found a 41 percent increase in rates of handgun carriage among youth overall, with White and higher income youth now most likely to report carriage.
Carriage rates among Black, American Indian and Alaska Native (AIAN), and lower-income adolescents decreased over the same timeframe. The report drew its data from the National Survey on Drug Use & Health, a cross-sectional, countrywide survey of adolescents ages 12-17, conducted annually from 2002-19.
Federal estimates based on the survey indicate that in 2019-20 there were an additional 200,000 adolescents reporting they have carried a firearm compared to 2002-03.
“While earlier handgun carriage research primarily focused on individual level risk factors, more recent inquiries on bearing and exposure to firearm violence have drawn attention to the importance of socio-demographic differences in carriage patterns, particularly those linked to differences in neighborhood or historical contexts, and place-based norms around bearing firearms,” report the study’s authors. “For example, U.S. southern and midwestern demographic groups tend to embrace more positive norms around gun carriage, and firearm bearing by adolescents is linked to peer and family customs around carriage.”
Titled “Prevalence of Adolescent Handgun Carriage: 2002-2019,” the investigation was conducted by Naoka E. Carey, J.D., a Ph.D. candidate in Applied Developmental and Educational Psychology, and Rebekah Levine Coley, Ph.D., a professor in the Lynch School’s Department of Counseling, Developmental and Educational Psychology. The study points to socio-demographic variables such as gender, education, ethnicity, religious affiliation and household income, as well as geographical location and related norms and customs as likely influencers.
Firearm injuries are the second-leading cause of death among children and adolescents, and the rates of adolescent firearm-related injuries or deaths have been on the rise, note the authors. Furthermore, exposure to firearm injuries has long-term developmental implications for youth, and has been attributed to increased future injury rates and the likelihood of engagement in firearm crime. Handguns, in contrast to other firearms, are more likely to be employed in homicides, and handgun ownership is associated with an elevated suicide risk.
“Adolescent handgun carriage is increasing among particular adolescent subgroups, indicating a remarkable change over the past 17 years,” said Coley. “Understanding such variations is critical to an understanding of fluctuating violence patterns, including rising rates of adolescent and rural suicide, and identifying which adolescents are at an increased risk of injury. Lastly, lessons learned regarding adolescent behavior from the 1990s or early 2000s may be less relevant to a more socio-demographically diverse youth population today.”
The findings call for the development of intervention programs and policy solutions specific to the different adolescent subgroups, and which address the underlying structural and sociocultural — as well as the family and individual — factors of firearm bearing.
"Gun violence is now the leading cause of death for children in the U.S. and it is absolutely critical that we address it,” said Carey, a member of the Massachusetts Juvenile Justice and Policy Board and the former executive director of Massachusetts-based Citizens for Juvenile Justice. “To do that, policy needs to be informed by what teenagers are reporting they do today, not what they were doing 20 years ago or class- or race-based assumptions about which kids carry. We hope that our study can help inform future research, and help policymakers better address the root causes of violence and childhood injury, which may look different for different communities."
Serious violence increased by nearly a quarter following the easing of COVID-19 lockdown in England and Wales, according to a new report by Cardiff University.
The University’s Violence Research Group (VRG) found an estimated 146,856 people attended A&E for violence-related injury in 2021, up 23% from 2020. Violence peaked in August 2021, reaching pre-pandemic levels, the VRG’s 21st annual report states.
The increase represents the biggest yearly rise since records began in 2001 – however, overall rates of serious violence in 2021 were lower than in the years prior to the pandemic, with long-term trends showing a steady decline.
Despite concerns COVID-19 restrictions may have increased the risk of serious violence for women and girls, the researchers found no evidence of this.
The report’s authors also studied violence in Scotland for the first time, with an estimated 8,549 people attending emergency units for violence-related injury in 2021.
“The easing of restrictions after national COVID-19 related lockdown in England and Wales was linked to the biggest increase in serious violence in a single year since our records began 21 years ago,” said Professor Jonathan Shepherd, co-author of the report.
“The easing of restrictions in 2021 was associated with a significant increase in serious violence; by August pre-pandemic levels were reached.
“Our data are the only overall measure of serious violence during the pandemic and provide evidence of how restrictions affected this during a fascinating period. Our findings also point to prevention priorities, such as earlier and more precise targeting of police resources at violence hot spots identified from A&E data. Without this detailed information police are blind to when and where half of this serious violence takes place.”
Data gathered and analysed by the VRG from 74 emergency units in England and Wales showed that in the 12 months ending 31 December 2021, an estimated 146,856 people attended for treatment of violence-related injuries, up from 27,745 in 2020.
Serious violence increases affected all age groups – among children aged 0-10 by 42%, among adolescents aged 11-17 by 20%, among young adults aged 18-30 by 29%, among those aged 31-50 by 20%, and among those aged over 50 by 16%.
Those at highest risk of violence-related injury were males, who at 3.38 per 1,000 residents were more than twice at risk than females, and those aged 18-30 (6 per 1,000 residents).
Overall rates of serious violence in 2021 were lower than in the years before the pandemic, down 24% and 49% compared to 2017 and 2011, for example.
Professor Shepherd said: “The government’s 2019 assessment of public health contributions to violence prevention, signed by Sajid Javid when he was Home Secretary, concluded that even if just 5% of community safety partnerships used specified A&E data to guide their work – the tried and tested strategy known as the Cardiff Model – savings over 10 years would be almost £1bn.
“Serious violence is preventable, not inevitable.”
This 21st annual report on serious violence in England, Wales – and now Scotland – is produced by the Violence Research Group. It includes data from the National Violence Surveillance Network, led by Cardiff University’s Professor Vaseekaran Sivarajasingam.
-Ends-
The report, Violence in England and Wales in 2021: An Accident & Emergency Perspective, is attached
Professor Jonathan Shepherd is available for interview and can be contacted on 07779 490022 or shepherdjp@cardiff.ac.uk
For further information and interview requests contact:
Gerry Holt, comms & marketing, Cardiff University - 029 2087 5596 or Holtg2@cardiff.ac.uk
Cardiff University is recognised in independent government assessments as one of Britain’s leading teaching and research universities and is a member of the Russell Group of the UK’s most research-intensive universities. The 2014 Research Excellence Framework ranked the University 5th in the UK for research excellence. Among its academic staff are two Nobel Laureates, including the winner of the 2007 Nobel Prize for Medicine, Professor Sir Martin Evans. Founded by Royal Charter in 1883, today the University combines impressive modern facilities and a dynamic approach to teaching and research. The University’s breadth of expertise encompasses: the College of Arts, Humanities and Social Sciences; the College of Biomedical and Life Sciences; and the College of Physical Sciences and Engineering, along with a longstanding commitment to lifelong learning. Cardiff’s flagship Research Institutes are offering radical new approaches to pressing global problems. More at www.cardiff.ac.uk
Researchers scour Twitter to analyze public attitudes about COVID-19 vaccinations
A new study from the University of Illinois Chicago examines key themes and topics from almost three million COVID-19 vaccine-related tweets posted by individuals and explores the trends and variations in public opinions and sentiments about vaccines and vaccination programs.
Covering four months of the pandemic, Jan. 1 to April 30, 2021, the researchers used topic modeling to explore the themes and topics underlying the tweets, and used sentiment analysis to compute sentiment scores and examine weekly trends. Their findings can be found in the journal JMIR Infodemiology.
“Our study is uniquely positioned and differs from many other similar studies, as we capture and use the tweets made by the general public, excluding those made by news outlets and other organizations,” said the study’s lead author Ranganathan Chandrasekaran, professor of information and decision sciences in the College of Business Administration and professor of biomedical and health information sciences in the College of Applied Health Sciences. “We have identified changes in public attitudes towards vaccination, key concerns about vaccination, reasons behind vaccine hesitancy and poor uptake of vaccines by certain groups.”
Some of the key findings include:
The most-tweeted topic about COVID-19 vaccination was related to vaccination policy, specifically, whether vaccines needed to be mandated or optional (13.94%), followed by vaccine hesitancy (12.63%) and post-vaccination symptoms and effects (10.44%).
The proportion of positive or overly positive tweets was always greater than that of negative or overly negative tweets in all of the weeks examined. Overall, 41.62% of the tweets had a positive sentiment, 31.16% had a negative sentiment and 27.22% had neutral sentiment scores.
A large proportion of tweets about post-vaccination symptoms and side effects (40-45%) and those about conspiracy/hoax (35-45%) had negative or overly negative sentiments in all weeks of the examination. In contrast, greater proportions of tweets about vaccination disclosure (35-40%), vaccine efficacy (45-55%), clinical trials and approvals (30-40%), vaccine affordability (30-35%), vaccine regulation (30-35%), travel (35-45%), opinion leaders and endorsement (30-50%), and gratitude to health care workers (30-45%) carried positive or overly positive sentiments throughout the 16-week period of research.
The researchers’ qualitative analysis provided some preliminary insights into the reasons behind vaccine hesitancy, such as the shorter duration of the vaccine development cycle, concerns about the effectiveness of the vaccine in controlling the virus and its variants, and general mistrust of the pharmaceutical and medical industries and governments.
This type of research based on social media data can provide rich insights for policymakers and health officials to frame appropriate policies and programs for COVID-19 vaccination and accelerate vaccine uptake by the general public, according to the researchers.
Co-authors of the study are Rashi Desai, Harsh Shah and Vivek Kumar of UIC, and Evangelos Moustakas of Middlesex University.
The work was partly funded by the UIC College of Business Administration’s Summer Research Grant Program.
A large US study published by The BMJ today finds that fewer people die from covid-19 in better vaccinated communities.
The findings, based on data across 2,558 counties in 48 US states, show that counties with high vaccine coverage had a more than 80% reduction in death rates compared with largely unvaccinated counties.
This large benefit complements the growing body of evidence indicating individual level benefits of covid-19 vaccination. A linked editorial also proposes that encouraging people to keep up to date with vaccination saves lives.
As of 11 April 2022, more than 11 billion covid-19 vaccine doses have been administered globally and the World Health Organization’s target is to vaccinate 70% of the world’s population by mid-2022.
Yet while previous vaccine studies have shown benefits at the individual level, the wider population level impact of scaling up covid-19 vaccination remains largely unknown.
To address this, researchers at the US Centers for Disease Control and Prevention (CDC) set out to estimate how increasing county coverage of vaccines affected population level mortality and incidence of covid-19.
Their findings are based on more than 30 million cases of covid-19 and over 400,000 deaths linked to covid-19 across 2558 counties, which were reported during the second year of the pandemic, between December 2020 and December 2021.
They measured effectiveness by comparing reported covid-19 incidence and mortality rates in counties with very low (0-9%), low (10-39%), medium (40-69%), and high (70% or more) vaccination coverage - defined as the percentage of adults (aged 18 and over) who had received at least one dose of a covid-19 vaccine.
After taking account of potentially influential factors, the researchers found that increased vaccination coverage in counties was associated with reduced levels of covid-19 related mortality and cases.
For example, during the first half of 2021, when the alpha variant of coronavirus was dominant, the covid-19 mortality rate was reduced by 60%, 75%, and 81% in counties with low, medium, and high vaccination coverage, respectively, compared with counties that had very low coverage.
The corresponding figures for the reduction in cases were 57%, 70%, and 80%.
Similar reductions in mortality were also seen during the second half of 2021 when the delta variant became dominant in the US, although with smaller effects on case levels.
This is an observational study, so can’t establish cause and the researchers say several limitations should be considered when interpreting these data. For example, additional markers of severe disease, such as hospital admissions, were not explored and they did not control for factors such as rules on wearing a face mask masking and physical distancing at the time, which may have affected their results.
Nevertheless, they point out that results were similar after further sensitivity analyses, suggesting that they withstand scrutiny. And they say: “Future research may benefit from evaluating macroeconomic effects of improving population health, such as changes in employment rates and gross domestic product resulting from reopening society.”
This study adds to the evidence that vaccination can prevent infection and illness on a large scale, writes Professor Christopher Dye at the University of Oxford in a linked editorial.
“The findings of this study also make clear that many more lives could have been saved, and will be saved, by encouraging people to keep up to date with vaccination in the face of waning immunity and new coronavirus variants and by achieving even higher population coverage,” he adds.
“How many lives is a matter for others to explore. Meanwhile, this new study is another confidence booster for covid-19 vaccines,” he concludes. [Ends]
Experiencing loneliness appears to lead to a higher risk of future unemployment, according to new research.
Previous research has established that being unemployed can cause loneliness, however the new study from the University of Exeter is the first to directly explore whether the opposite also applies across the working age population. Published in BMC Public Health, the study found that people who reported “feeling lonely often” were significantly more likely to encounter unemployment later. Their analysis also confirmed previous findings that the reverse is true – people who were unemployed were more likely to experience loneliness later.
Lead author Nia Morrish, of the University of Exeter, said: “Given the persisting and potentially scarring effects of both loneliness and unemployment on health and the economy, prevention of both experiences is key. Decreased loneliness could mitigate unemployment, and employment abate loneliness, which may in turn relate positively to other factors including health and quality of life. Thus, particular attention should be paid to loneliness with additional support from employers and government to improve health and wellbeing. Our research was largely conducted pre-pandemic, however we suspect this issue may be even more pressing, with more people working from home and potentially experiencing isolation because of anxieties around covid.”
The research analysed largely pre-pandemic data from more than 15,000 people in the Understanding Society Household Longitudinal Study. The team analysed responses from the participants during 2017-2019, then from 2018-2020, controlling for factors including age, gender, ethnicity, education, marital status, household composition, number of own children in household and region.
Senior author Professor Antonieta Medina-Lara said: “Loneliness is an incredibly important societal problem, which is often thought about in terms of the impact on mental health and wellbeing only. Our findings indicate that there may also be wider implications, which could have negative impacts for individuals and the economy. We need to explore this further, and it could lay the foundations for employers or policy makers to tackle loneliness with a view to keeping more people in work.”
Paper co-author Dr Ruben Mujica-Mota, Associate Professor of Health Economics in the University of Leeds’ School of Medicine, said: “While previous research has shown that unemployment can cause loneliness, ours is the first study to identify that lonely people of any working age are at greater risk of becoming unemployed. Our findings show that these two issues can interact and create a self-fulfilling, negative cycle. There is a need for greater recognition of the wider societal impacts of loneliness in the working age population.”
The paper is entitled ‘Understanding the effect of loneliness on unemployment: propensity score matching’, published in BMC Public Health. The research involved collaboration with Leeds University.
Feelings of anxiety and depression are common in people living with dementia and mild cognitive impairment, but the best way to treat these symptoms is currently unknown, as medicines often used to treat these symptoms may not be effective for people with dementia and may cause side effects.
The findings of the new and updated Cochrane Review paper are important because it is the first review showing that psychological interventions (talking therapies) are effective and worthwhile in the context of ineffective drugs for depression in dementia. The review also shows they may provide additional benefit in terms of improving patient quality of life and everyday function.
The researchers are calling for clinical guidelines for dementia to be revised to recommend psychological therapies and specifically Cognitive Behavioural Therapy (CBT).
Lead author Dr Vasiliki Orgeta (Associate Professor at UCL Psychiatry) said: “We currently have no standard treatments for depression for people with dementia, as antidepressants do not work for them. Yet, despite the lack of supporting evidence, they are still prescribed for many people living with dementia, which is an important problem given that more and more evidence is accumulating suggesting that not only they do not improve symptoms, but they may increase risk of mortality.”
“Previous evidence into the clinical effectiveness of psychological treatments has been limited. Reporting on the most up to date evidence, we found that these treatments, and specifically those focusing around supporting people with dementia to use strategies to reduce distress and improve wellbeing, are effective in reducing symptoms of depression.”
People with dementia are twice as likely as other people their age to be diagnosed with a major depressive disorder. Studies have estimated that 16% of people with dementia experience depression, but this may be as high as 40%, so there is a great need for effective treatments. Depression and anxiety can also increase the severity of the neurological impairment itself, thus reducing independence and increasing the risk of entering long-term care.
Dr Orgeta added: “Our findings break the stigma that psychological treatments are not worthwhile for people living with cognitive impairment and dementia, and show that we need to invest in more research in this area and work towards increasing access to psychological services for people with dementia across the globe. We want people who experience cognitive impairment and dementia to have the same access to mental health treatments as everyone else.”
The paper, published by the Cochrane Library as part of their database of systematic reviews, incorporated evidence from 29 trials of psychological treatments for people with dementia or mild cognitive impairment, including close to 2,600 study participants in total.
The psychological interventions varied somewhat, including CBT and supportive and counselling interventions, but were generally aimed at supporting wellbeing, reducing distress, and improving coping.
The review shows that psychological treatments for people with dementia may improve not only depressive symptoms but several other outcomes, such as quality of life and the ability to carry out everyday activities. Although more research is needed, the study found that these treatments may also improve depression remission. The authors say the potential of improving many outcomes with one psychological intervention may be highly cost-effective and could be key to improving quality of life and wellbeing for people with dementia.
The authors judged the evidence to be of moderate quality overall; this means it is of high enough quality to warrant clinical recommendations to support the use of psychological therapies. They say that larger studies are needed, as they may be able to identify a more substantial effect.
Co-author Dr Phuong Leung (UCL Psychiatry) said: “There is now good enough quality evidence to support the use of psychological treatments for people with dementia, rather than prescribing medications, and without the risk of drug side effects. What we need now is more clinicians opting for talk therapies for their patients and commitment to funding further high-quality research in this area.”
Dr Orgeta added: “Pharmacological treatments in dementia have been prioritised in trials for many years, as a result they benefit from more investment, so it will be important to invest more in studying psychological treatments. There is a need for novel treatments, specifically developed alongside people with dementia, their families, and those contributing to their care.”
Medical language that casts doubt, belittles, or blames patients for their health problems continues to be commonly used in everyday clinical practice, but is outdated and overdue for change, argue experts in The BMJ today.
CaitrÃona Cox and Zoë Fritz at the University of Cambridge draw on existing research to describe how such language, while often taken for granted, can insidiously affect the therapeutic relationship by altering the attitudes of both patients and physicians. They suggest how it could be changed to foster a relationship focused on shared understanding and collective goals.
Language that belittles patients includes the widely used term “presenting complaint” rather than referring to a patient’s reason for engaging with healthcare, they write. Similarly, use of words such as “denies” and “claims” when reporting a patient’s account of their symptoms or experiences, suggests a refusal to admit the truth, and can hint at untrustworthiness.
Other frequently used language renders the patient as passive or childlike, while emphasising the doctor’s position of power, they add. For example, doctors “take” a history, or “send” patients home.
The terms “compliance” and “non-compliance” (in relation to taking medication) are also authoritarian, and they suggest that doctors should focus on changing their language to instead focus on reasons why patients might not be taking prescribed medications, promoting a more collaborative doctor-patient relationship.
Patients too have objected: “Being described as ‘non-compliant’ is awful and does not reflect the fact that everyone is doing their best.”
Language that implicitly places the blame on patients for poor outcomes is also problematic, argue Cox and Fritz. For instance, the term “poorly controlled” in conditions such as diabetes or epilepsy can be stigmatising and make patients feel judged, while “treatment failure” suggests that the patient is the cause of the failure, rather than the limitations of the treatment or the doctor.
Research shows that specific word choices and phrases not only affect how patients view their health and illness but also influence doctors’ attitudes towards patients and the care and treatments offered, they explain.
For example, a study of neutral language with language implying patient responsibility (not tolerating oxygen mask v refuses oxygen mask), showed that the non-neutral term was associated with negative attitudes towards the patient and less prescribing of analgesic medication.
The authors note that using the right language “is not a matter of political correctness; it affects the core of our interactions” and say research is now needed to explore the impact that such language could have on patient outcomes.
Much of the language highlighted here is deeply ingrained in medical practice and is used unthinkingly by clinicians, they write. Clinicians should consider how their language affects attitudes and choose language that facilitates trust, balances power, and supports shared decision making.
Presenting complaint: use of language that disempowers patients
ARTICLE PUBLICATION DATE
27-Apr-2022
2 out of 3 women with depression or anxiety say they’ve reached their “breaking point,” yet more than half wait a year before seeking treatment
Six in 10 of the women surveyed with depression or anxiety diagnosis say they have been ignored or dismissed by family, friends, and/or partners about their mental health concerns
VIDEO: A NEW NATIONAL SURVEY, THE GENESIGHT MENTAL HEALTH MONITOR, FOUND THAT WHEN FEELING OVERWHELMED, WOMEN SAY THEY “JUST NEED TO TAKE A BREAK,” WITH NEARLY A THIRD BELIEVING THEY JUST NEED TO TRY HARDER. TWO THIRDS OF WOMEN WITH DEPRESSION AND ANXIETY SAY THEY ARE REACHING A BREAKING POINT WITH REGARD TO THEIR MENTAL HEALTH, YET MANY ARE WAITING A YEAR OR MORE TO SEEK TREATMENT — IF THEY EVER DO. THIS BREAKING POINT CAN INCLUDE A NEGATIVE IMPACT OR A SIGNIFICANT STRAIN ON ANYTHING FROM SOCIAL LIFE OR CARING FOR LOVED ONES AT HOME TO PROFESSIONAL WORK. FOUR OUT OF 10 WOMEN NOT DIAGNOSED WITH DEPRESSION OR ANXIETY ALSO SAY THEY HAVE REACHED OR ARE REACHING THIS POINT.view more
CREDIT: GENESIGHT MENTAL HEALTH MONITOR
Two out of three women diagnosed with depression or anxiety say they have reached or are approaching their breaking point regarding their mental health, according to the GeneSight® Mental Health Monitor, a new nationwide survey from Myriad Genetics, Inc. (NASDAQ: MYGN).
This breaking point can include a negative impact or a significant strain on anything from social life to caring for loved ones at home to professional obligations. Four out of 10 women without a diagnosis of depression or anxiety say they have reached or are reaching this point.
When feeling overwhelmed, nearly three in four (72%) of women say they "just need to take a break,” with 31% believing “I need to try harder.” Only 13% said they thought “I should see a doctor” when feeling overwhelmed.
“Women often feel pressure to ‘hold it all together’ and not admit when they are struggling,” says Dr. Betty Jo “BJ” Fancher, a family medicine and psychiatric physician assistant with a doctorate of medical science and a masters in psychopharmacology. “Yet, if you are sobbing on the floor of your shower, throwing things in anger or repeatedly screaming into a pillow, these are signals that you have crossed a line and should see a healthcare provider about your mental health.”
Delaying mental health treatment is common among the women surveyed. In fact, more than half (51%) of women diagnosed with anxiety and/or depression waited at least one year before seeking treatment – or never sought treatment at all.
“The GeneSight Mental Health Monitor found that women are waiting more than a year – longer than a pregnancy – to get the mental health treatment they need,” noted Rachael Earls, PhD, a medical science liaison with Myriad Genetics, makers of the GeneSight test. “Pregnant women don’t go a year without pre-natal care to protect their or their baby’s health. Why live with a mental health condition that can impact every aspect of your life until you reach a breaking point?”
According to the survey, the top reasons women diagnosed with depression or anxiety delayed treatment are:
“I thought it was ‘just a phase’ or that I could get over it on my own” (60%)
“I didn’t want anyone to know I was struggling” (50%)
“I didn’t want to take medication” (31%)
“I couldn’t afford treatment” (26%)
“I didn’t have health insurance” (19%)
“I didn’t have time to seek treatment” (18%)
Will my concerns be validated or ignored?
The reluctance by some women to seek treatment may be rooted in how their mental health concerns have been received by family and friends.
Six in 10 of the women surveyed with depression or anxiety diagnosis say they have been ignored or dismissed by family, friends, and/or partners about their mental health concerns. Less than half of women (44%) say they talk to friends or family to relieve stress and anxiety.
“I have friends who won’t talk to their parents about how they are struggling because they are afraid of their parents’ reaction,” says Ansley, daughter of Dr. Fancher and a senior at the University of Georgia, who has been diagnosed with depression, anxiety and ADHD. “Therapy has helped me, so I know the benefits of talking to someone about your mental health. When friends or classmates say they are suffering with depression or anxiety, I encourage them to reach out to someone and get the help they need.”
Despite available treatment options, fewer than two in 10 women believe they will ever be free from anxiety or depression symptoms.
CAPTION
Ansley Fancher can relate to the two thirds of women polled in the new GeneSight Mental Health Monitor nationwide survey who say they are at or near their breaking point. After trying to manage her depression and anxiety on her own, she began therapy and took the GeneSight test, which helped inform her clinician’s medication treatment decision. She is now studying to become a psychologist to help others with mental health needs.
CREDIT
GeneSight Mental Health Monitor
Getting personalized treatment
Six in 10 women diagnosed with depression or anxiety agree that taking a prescription medication was the most helpful step in treating their anxiety or depression symptoms, more than any other action or treatment option offered in the survey, including therapy.
Only about 30% of women who have been prescribed psychiatric medication are aware of genetic testing that may help their physicians with prescribing decisions – and only 8% of these respondents have had genetic testing. Yet, 67% of diagnosed women whose doctor did not use genetic testing said they wish their doctor had told them about and/or offered a genetic test that could provide information about how their genes may affect medication outcomes.
Dr. Fancher orders the GeneSight test to get personalized genetic information about her patients that helps her understand how they may metabolize or respond to certain medications commonly used to treat depression, anxiety, ADHD and other mental health conditions.
“Having the genetic information from the GeneSight test at my fingertips to help inform my medication selection makes me a better provider,” said Dr. Fancher.
Ansley’s mental health provider also uses the GeneSight test. “She made adjustments based on my results, and I am happy to say that everything is working really well,” said Ansley.
For more information on how genetic testing can help inform clinicians on treatment of depression, anxiety, ADHD, and other psychiatric conditions, please visit GeneSight.com. To download graphics, a multimedia video and other information regarding the survey, please visit GeneSight.com/Mental-Health-Monitor.
CAPTION
Mental health clinician BJ Fancher, DMSc, helped her own daughter, Ansley, find a clinician to treat her anxiety. Now, both are trying to encourage women to be more open about their mental health issues and more receptive to seeking treatment.
CREDIT
GeneSight Mental Health Monitor
About the GeneSight® Mental Health Monitor The GeneSight Mental Health Monitor is a nationwide survey of U.S. adults conducted online by ACUPOLL Precision Research, Inc. from Feb. 25 – March 11, 2022, among a statistically representative sample (n=1000) of adults age 18+. The survey included a representative sample of women diagnosed with depression and anxiety. The margin of error in survey results for the total base population at a 95% confidence interval is +/- 3%.
About the GeneSight Test The GeneSight Psychotropic test from Myriad Genetics is the category-leading pharmacogenomic test for 64 medications commonly prescribed for depression, anxiety, ADHD, and other psychiatric conditions. The GeneSight test can help inform clinicians about how a patient’s genes may impact how they metabolize and/or respond to certain psychiatric medications. It has been given to more than 1.5 million patients by tens of thousands of clinicians to provide genetic information that is unique to each patient. The GeneSight test supplements other information considered by a clinician as part of a comprehensive medical assessment. Learn more at GeneSight.com.
About Myriad Genetics Myriad Genetics is a leading genetic testing and precision medicine company dedicated to advancing health and well-being for all. Myriad discovers and commercializes genetic tests that determine the risk of developing disease, assess the risk of disease progression, and guide treatment decisions across medical specialties where critical genetic insights can significantly improve patient care and lower healthcare costs. Fast Company named Myriad among the World’s Most Innovative Companies for 2022. For more information, visit www.myriad.com.
Myriad, the Myriad logo, BRACAnalysis, BRACAnalysis CDx, Colaris, Colaris AP, MyRisk, Myriad MyRisk, MyRisk Hereditary Cancer, MyChoice CDx, Prequel, Prequel with Amplify, Amplify, Foresight, Precise, FirstGene, Health.Illuminated., RiskScore, Prolaris, GeneSight, and EndoPredict are trademarks or registered trademarks of Myriad Genetics, Inc. or its wholly owned subsidiaries in the United States and foreign countries.
