Treating depression in the workplace pays off for workers and employers

Employers prepared to pick up the cost of providing treatment for depression amongst their workers could reap benefits in terms of improved productivity and greater job retention.
A study conducted by researchers at the National Institute of Mental Health found that those workers who participated in a program that included telephone outreach intervention had fewer symptoms, worked more hours and stayed in their job longer than participants the receiving usual care.

Depression is a costly business and places enormous burdens on society; experts believe depression costs the U.S. economy tens of billions of dollars each year in terms of loss of productivity alone.

Depression is among the most costly of all health problems for employers, and though there is ample evidence that there are effective treatments, many depressed workers are untreated or inadequately treated.

Even those employers who purchase corporate health benefits many often do not invest in enhanced depression screening-treatment programs because of the uncertainty of the value of such investments.

Dr. Philip S. Wang and his colleagues examined the impact of a depression outreach-treatment program on the outcomes of depression symptom relief, job retention, sickness absence, and increased work productivity.

Their two-part randomized controlled trial included 604 employees covered by a managed behavioral health plan who were identified in a 2-stage screening process as having significant depression; 304 employees were enrolled in the enhanced care program while 300 received the program’s usual care.

Those employees reluctant to enter treatment were offered structured cognitive behavioral psychotherapy exclusively via the telephone while you purchase viagra.

The telephonic outreach and care management program encouraged workers to enter outpatient treatment such as psychotherapy and/or antidepressant medication, monitored treatment quality continuity, and attempted to improve treatment by giving recommendations to clinicians.

The researchers found that the severity of the depression was significantly lower in the intervention group than in the usual care group at 6 months and at 12 months, and that patients in the intervention group were more likely to recover.

It was also found that this group also worked significantly more hours and had a higher rate of job retention.

The researchers say the enhanced depression care of workers benefited the workers as well as the workplace outcomes, particularly in terms of recovered hiring, training, and salary costs.

They say many employers would experience a positive return on investment from outreach and enhanced treatment of depressed workers.

The study, the “Enhanced Depression Treatment and Work Outcomes,” is published in the current issue of the Journal of the American Medical Association (JAMA).

Source : www.news-medical.net

Older American Women Better Informed About Cholesterol Than Younger Women, But Gaps Remain In Knowledge And Screening

Older adult American women are better informed about cholesterol and more likely to monitor it than younger adult women, but gaps remain in cholesterol knowledge and efforts to screen for it adequately, according to results of a national survey released today by the Society for Women’s Health Research, a Washington, D.C., based advocacy organization.

More than seventy percent of women 55 and older said they have had their cholesterol tested within the past year, but almost 20 percent said they have never had their cholesterol tested, have not had it tested in the last four years, or don’t know if they’ve ever had it tested.

The American Heart Association and the National Heart, Lung, and Blood Institute recommend that everyone 20 and older should have their cholesterol measured at least once every five years.

“High cholesterol is a major risk factor for heart disease and cholesterol levels naturally rise as you age, so it is important for aging women to make sure their cholesterol score is in an acceptable range,” said Jo Parrish, vice president of communications for the Society for Women’s Health Research, a Washington, D.C., based non-profit advocacy organization.

Four in 10 (41.2 percent) women 55 and older were “very surprised” or “somewhat surprised” to learn that cholesterol levels naturally increase with age. Nearly one-third (31.1 percent) were “very surprised” or “somewhat surprised” that you can still have high cholesterol levels even if you exercise regularly and maintain a healthy diet.

A person’s total cholesterol number is made up of low density lipoproteins (LDL), high density lipoproteins (HDL) and triglycerides, another fatty substance found in the blood. A desirable level of total cholesterol is less than 200.

“Lowering your LDL level is the major goal for women and men, but there is also evidence that HDL and triglyceride levels are more important for women’s heart health than men’s,” Parrish said. “That’s why it is important for women to know about the components that make up total cholesterol and to know if their numbers are optimal.”

LDL, known as the “bad” cholesterol, deposits on the inside of your vessels to make plaques. Elevated levels of LDL increase your risk of heart disease and stroke. An optimal level of LDL is less than 100. HDL is called the “good” cholesterol because a high HDL level decreases your risk of cardiovascular disease. For women, an HDL less than 50 is considered a risk factor for cardiovascular disease.

More than half of women 55 and older surveyed did not know or incorrectly guessed the optimal levels for HDL and LDL cholesterol. Similar numbers did not know that HDL is the “good” cholesterol. Eighty percent, however, did know that less than 200 is considered a healthy range for total cholesterol. By contrast, only 63.7 percent of adult women under 45 knew that.

Heart disease typically strikes women after menopause and 10 years later in life than it strikes men.

“A healthy diet and lifestyle throughout life reduces your risk of heart disease,” Parrish said, “but as we get older and approach retirement age it is important to more closely monitor our risk factors. Fortunately, Medicare eligible patients have access to cholesterol screening through their preventive benefits package.

“Women have under utilized their Medicare preventive benefits in the past, so we want to encourage them to take advantage of these important health care services that are available to them free through Medicare.”

To help women learn more about cholesterol screening and Medicare preventive services, the Society for Women’s Health Research has posted on its Web site, http://www.womenshealthresearch.org, a non-branded brochure for consumers called “Medicare’s Preventive Care Services … To Manage Cholesterol and Your Heart Health.” The Society’s site also provides additional links to information on Medicare and heart health during September, which is National Cholesterol Awareness Month.

The nationally representative telephone survey of 524 adult U.S. women was conducted by GfK Custom Research North America, June 29-July 1, on behalf of the Society for Women’s Health Research. Support for the survey was provided by Dezenhall Resources. The non-branded brochure on cholesterol screening and Medicare preventive services was developed by Abbott Laboratories.

The Society for Women’s Health Research is the nation’s only non-profit organization whose mission is to improve the health of all women through research, education and advocacy. Founded in 1990, the Society brought to national attention the need for the appropriate inclusion of women in major medical research studies and the need for more information about conditions affecting women exclusively, predominately, or differently than men. The Society advocates increased funding for research on women’s health; encourages the study of sex differences that may affect the prevention, diagnosis and treatment of disease; promotes the inclusion of women in medical research studies; and informs women, providers, policy makers and media about contemporary women’s health issues. Visit the Society’s Web site at http://www.womenshealthresearch.org for more information.

Society for Women’s Health Research (SWHR)
1025 Connecticut Ave. NW, Ste. 701
Washington, DC 20036
United States

Source : www.medicalnewstoday.com

Symptomatic Testosterone Deficiency Relatively Rare In Men

A new study reveals that relatively few men, only 5.6 percent of the male population, actually suffer from low testosterone accompanied by clinical symptoms. That percentage, however, rises substantially with age.

Low testosterone levels are typically defined as less than 300 ng/dL (nanograms per deciliter) of total testosterone and less than 5 ng/dL of free testosterone. Free testosterone is the amount of the hormone unbound to other proteins and is “free” to work inside the body. “Low levels of testosterone impact many aspects of male physiology,” said Andre B. Araujo, Ph.D., a research scientist at the New England Research Institutes in Watertown, Mass., and lead author of the study. “This is particularly significant because the ongoing aging of the U.S. male population is likely to cause the number of men suffering from androgen deficiency to increase appreciably.”

Consistent with a recently issued Clinical Practice Guideline from the Endocrine Society, symptomatic androgen deficiency in the study by Araujo and colleagues is defined as low total and free testosterone plus the presence of low libido, erectile dysfunction, osteoporosis or facture, or two or more of the following symptoms: sleep disturbance, depressed mood, lethargy, or diminished physical performance.

For this study, the researchers analyzed data on 1,475 randomly selected men enrolled in the Boston Area Community Health (BACH) Survey. The survey tracked subjects between the ages of 30 79 and compiled complete data on factors such as testosterone, symptoms of hormone deficiency, and medications that may impact sex hormone levels. Among all men in the study (mean age 47.3 plus-or-minus 12.5 years), approximately 24 percent had low total testosterone and 11 percent had low levels of free testosterone. Interestingly, while low testosterone levels were associated with symptoms, many men with low testosterone levels were asymptomatic (e.g., among men aged 50 years and older 47.6 percent were asymptomatic).

“Since these men would not likely come to clinical attention,” said Araujo, “it may be important to determine whether there are clinical risks to missing these asymptomatic men with low testosterone levels.” Overall, only 5.6 percent of men in the study had symptomatic androgen deficiency. For those men in the upper range of ages in the study (70 years or older), however, the percentage increased to 18.4 percent.

The researchers predicted that by the year 2025 there may be as many as 6.5 million American men 30-79 years of age with symptomatic androgen deficiency, an increase of 38 percent from year 2000 population estimates.

“This study did not assess whether men with symptomatic androgen deficiency are good candidates for testosterone therapy,” said Araujo. “Well designed randomized placebo controlled trials would be needed to address the risks and benefits of testosterone therapy.”

The BACH Survey was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (Grant DK 56842). Analyses for the current study were supported through an unrestricted educational grant from GlaxoSmithKline.

A rapid release version of this paper has been published on-line and will appear in the November 2007 issue of the Journal of Clinical Endocrinology & Metabolism, a publication of The Endocrine Society.

Founded in 1916, The Endocrine Society is the world’s oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology. Today, The Endocrine Society’s membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology.

Source : www.medicalnewstoday.com

Studying The Effects Of Negative Emotion On Memory

Do you remember exactly where you were when you learned of the Sept. 11 terrorist attacks? Your answer is probably yes, and researchers are beginning to understand why we remember events that carry negative emotional weight.

In Current Directions in Psychological Science, a journal of the Association for Psychological Science, Boston College psychologist, Elizabeth Kensinger and colleagues, explain when emotion is likely to reduce our memory inconsistencies.

Her research shows that whether an event is pleasurable or aversive seems to be a critical determinant of the accuracy with which the event is remembered, with negative events being remembered in greater detail than positive ones.

For example, after seeing a man on a street holding a gun, people remember the gun vividly, but they forget the details of the street. Functional Magnetic Resonance Imaging (fMRI), studies have shown increased cellular activity in emotion-processing regions at the time that a negative event is experienced.

The more activity in the orbitofrontal cortex and the amygdala, two emotion-processing regions of the brain, the more likely an individual is to remember details intrinsically linked to the emotional aspect of the event, such as the exact appearance of the gun.

Kensinger argues that recognizing the effects of negative emotion on memory for detail may, at some point, save our lives by guiding our actions and allowing us to plan for similar future occurrences. “These benefits make sense within an evolutionary framework,” writes Kensinger. “It is logical that attention would be focused on potentially threatening information.”

This line of research has far-reaching implications in understanding autobiographical memory and assessing the validity of eyewitness testimony. Kensinger also believes that this research may end insight into the symptoms of posttraumatic stress disorder.

Source : www.medicalnewstoday.com