Two proposed psychiatric diagnoses failed to make the last round of cuts in the laborious process of revising the Diagnostic and Statistical Manual of Mental Disorders — an exhaustive catalog of symptoms used by doctors to diagnose psychiatric illness.

Gone from the latest revision are “attenuated psychosis syndrome,” intended to help identify individuals at risk of full-blown psychosis, and “mixed anxiety depressive disorder”, a blend of anxiety and depression symptoms. Both performed badly on field tests and in public comments gathered by the group in its march toward the May 2013 publication deadline.

Both have been tucked into Section III of the manual — the place reserved for ideas that do not yet have enough evidence to make the cut as a full-blown diagnosis.

What has survived, despite fierce public outcry, is a change in the diagnosis of autism, which eliminates the milder diagnosis of Asperger syndrome in favor of the umbrella diagnosis of autism spectrum disorder.

But that, too, could still be altered before the final manual is published, the group says. The APA opened the final comment period for its fifth diagnostic manual known as DSM-V on May 2, and it will accumulate comments through June 15.

Dr. David Kupfer, who chairs the DSM-5 Task Force, said in a statement that the changes reflect the latest research and input from the public.

Dr. Wayne Goodman, professor and chairman of the department of psychiatry at Mount Sinai Medical Center in New York, said he’s glad the task force is responding to feedback from professionals and the public.

“I think they are trying to listen,” he said.

Goodman agrees with the decisions to drop both of the two disorders in the latest revision.

With the “mixed anxiety and depressive disorder,” he said there was a risk that it would capture a number of people who did not qualify under a diagnosis of depression or anxiety alone.

“It could lead to overdiagnosis,” Goodman said.

He said the “attenuated psychosis syndrome” diagnosis would have been useful for research purposes to help identify those at risk of psychosis, but there was a concern that it might label people who were just a bit different as mentally ill.

“The predictive value is not clear yet,” he said. “I think it’s reasonable not to codify it until we have better definition of its predictive value.”

Goodman, who worked on DSM-4, the last revision of the manual published in 1994, and is working on the Obsessive Compulsive Disorder section of the current revision of DSM-5, said the strength of the process is that it can offer a reliable way for psychiatrists across the country to identify patients with the same sorts of disorders.

The weakness, he said, is that it largely lacks biological evidence — blood tests, imaging tests and the like — that can validate these diagnoses.

“DSM-5 is a refinement of our diagnostic system, but it doesn’t add to our ability to understand the underlying illness,” he said.

Dr. Emil Coccaro, chairman of the Department of Psychiatry and Behavioral Neuroscience at the University of Chicago Medicine, said typically changes in the DSM occur because of new data.

Coccaro, who is contributing to the new section in the DSM-5 on Intermittent Explosive Disorder, said there is no question that many people aren’t convinced that some of the diagnoses need to be changed, or that there need to be new ones added.

“This also happened the last time when they did DSM-4,” he said, but that was nearly 20 years ago.

“You can keep waiting but at certain point you have to fish or cut bait and actually come out with a new edition. that is what is happening now,” he said.

Comments to the manual can be submitted at DSM5.org

Intense fears of being in situations in which you don’t know people. this can make it hard to interact with strangers or initiate a conversation.

Anxiety to the level that it interferes with day-to-day living. this can make it difficult to use a public restroom, return an item to a store or order food in a restaurant.

Avoiding speaking to people out of fear of embarrassment.

Avoiding situations where you might be the center of attention.

Worry about reacting in ways that you know are out of proportion to the situation, or being afraid that others will notice that you look anxious.

The anxiety you feel may cause physical signs and symptoms of nervousness and fear. These may include blushing, sweating, trembling, nausea, stomach upset, confusion, heart palpitations, diarrhea and cold, clammy hands.

when interacting with other people affects you in this way, over time it may hurt your social skills, or lead to extreme sensitivity to criticism and low self-esteem.

Symptoms of social anxiety disorder tend to persist over time, but they can change. Symptoms may flare up if you’re facing a lot of stress or demands. You may have fewer problems if you can avoid situations that would make you anxious.

Talk to your doctor if your symptoms disrupt your life, such as by making you feel distressed, affecting your daily functioning or causing you to avoid activities.

Diagnosis of social anxiety disorder typically involves having a detailed discussion with your doctor or mental health care provider and often filling out psychological questionnaires or self-assessments. If a diagnosis of social anxiety disorder is reached, initial therapies — which are often used in combination — include cognitive behavioral therapy and certain anti-depressant medications.

Cognitive behavioral therapy improves symptoms in up to 75 percent of people with social anxiety disorder. It’s based on the idea that social situations generally won’t change or go away. however, you can decrease your anxiety by changing your patterns of thinking and acting.

In therapy, you may learn to recognize and change negative thoughts about yourself. You may also practice exposure therapy, which involves gradually working up to facing situations that you fear. Social skills training, role-playing, relaxation training and stress management techniques may be part of your treatment plan.

We all have nagging worries — did I turn off the stove? did I lock the door? but for Canadians with obsessive-compulsive disorders, these thoughts get stuck, playing over and over in the mind like a broken record. And the only way to lower the volume is to perform “rituals” — behaviours such as constant checking, excessive washing or extreme hoarding to control the unwanted thoughts. Symptoms can be so severe that that some patients are unable to hold down jobs, go to school or even leave their homes.

Paul (not his real name) is a prime example. he is 14 years old and has lived with severe OCD for a decade. in his tortured world, everything must stay on his left. Paul will obsessively move, pictures, furniture, even people to his left side. he believes that if things are on his right, he will suffer extreme pain.

“I feel lots of it pain and pressure on my whole right hand side and I am very anxious and I have a hard time breathing… and I sweat a lot and shake a little… and my heart beats fast,” Paul says.

To avoid feeling the pain, he will ask his mother “Julie” to hide her hands under a blanket and order his father to keep completely still, legs uncrossed, hands placed symmetrically on both knees. His parents admit they live “like statues,” so trained by Paul to minimize their movements.

“It’s difficult to live this way, to see your son be preoccupied by everything,” says Julie.

As a toddler, Paul would ask his parents to repeat sentences over and over; threw terrifying tantrums if objects were not placed in the right order. His parents tried disciplining him. but it didn’t work. in fact, his behaviour grew more bizarre. by age five they started taking him to doctors in a desperate attempt to get help.

“You have to be a parent of a child with OCD to truly understand what is going on. Even in the first year we were wondering, what is happening to our son? What is taking over his life and ours? It really seems unbelievable,” says Julie.

“The reason we went to specialists when he was five was we wanted early treatment so he wouldn’t get entrenched and we didn’t know it was OCD. we saw many psychiatrists and psychologists. they all tried their best,” she says, trailing off shaking her head, indicating nothing worked.

Some specialists prescribed drugs that damaged Paul’s heart and liver. others put him in hospital for months at a time.

After 10 years of seeing doctors without success, Paul is trapped by distorted thinking. he can’t play outside because there are birds, trees and other houses, on his left. he is too exhausted to go to school, his life hijacked by his bizarre symptoms. he can’t even hug his parents, because they would touch him on his left, causing him pain.

“I’ve had OCD for so long I can’t even think how it will be without having some,” says Paul. “I can’t imagine myself without the OCD. I don’t know what that feels like.”

He is not alone. between 600,000 and 1.5 million Canadians will develop OCD at some point in their lives. It is the fourth most common mental disorder and among the 10 leading causes of medical disability worldwide. while some people live normally with mild symptoms, others are debilitated by the disease.

Gideon Goldman-Posluns, 23, was a normal university student and avid baseball player who developed a peanut allergy — a legitimate health problem. but his worries about the condition snowballed into an obsession and then into severe OCD.

It started innocently enough. in 2009, he ate an egg tofu wrap before heading out to a baseball game. The snack contained traces of peanut and triggered an allergic reaction and a panic attack. Physically, Gideon recovered, but mentally, he was not the same.

Gideon feared everything he ate or touched or even inhaled might have traces of peanut.

“I was in prison in my mind because everything was contaminated and I had to be very safe and clean everything,” he says.

He started washing his hands until they were raw. he wouldn’t touch doors, opening them with his feet, obsessively washing even food packages. Eventually, he was eating only apple juice, Kraft Dinner and bread alone in his bedroom. It took him four hours to eat, fearing every bite would kill him.

His friends and family thought he could simply stop these odd behaviours.

“They said I was crazy and stupid and ‘Snap out of it, it’s all in your head. It’s not the truth and logical, you can tough it out.’ well, no, I can’t,” he says.

“I was getting bounced going from psychologist to psychologist. after the third psychologist, I realized that this was not the right route and I needed specialized assistance,” says Howard.

Scouring the Internet, he found the Obsessive Compulsive Disorder Clinic at McGill University Health Centre, one of the few clinics specializing in OCD, and its director, clinical psychologist Debbie Sookman.

Gideon says that Dr. Sookman immediately recognized that his son’s case was life threatening. Paul was admitted to Royal Victoria Hospital in Montreal and stayed for six weeks.

Unfortunately, patients like Gideon and Paul are quite common, says Dr. Sookman, who is also an associate professor at McGill University’s Department of Psychiatry.

“Every day that goes by, there are sufferers who are not getting the hope they need and getting the help they need — not able to go to school not able to work, not able to care for children, families, not able to leave the house. Patients who come into their home who have to strip and spend hours in the shower until they are tolerably clean,” she says. “Untreated OCD, in most cases, is progressively worsening to the point of disability. The patient can’t function.”

OCD can be treated successfully, but too many people with OCD spend years unable to get proper help.

The problem, says Sookman, is there aren’t enough specialized OCD clinics in Canada or therapists certified in the labour intensive treatment often needed. There are often long wait lists for treatment. some provinces don’t cover the therapy, opting to send patients to U.S. clinics.

That’s why last fall, she founded the Canadian Institute for Obsessive Compulsive Disorders. its mandate to increase the number of clinicians trained and certified in specialized OCD therapy in Canada. Forty top OCD experts worldwide are involved in the project. ictoc.org/

“The Canadian Institute for Obsessive Compulsive Disorders is a major mental health development in Canada in this field. It was desperately needed,” says Sookman, who is the president of the organization.

She wants to “make sure over time, that children, adolescents and adults across Canada get the care that they need, specialized treatment, quickly and best practice because this is a disorder that requires very quick treatment to avoid unnecessary suffering, disability.”

Treatment for OCD include medications to lower their anxiety or treat their depression. but drugs alone cannot cure the disorder.

Studies show the most effective treatment comes from within the brain. It is called cognitive behaviour therapy. Patients learn strategies to manage their anxiety. And when they are ready, they can start exposure response prevention therapy, in which they must face the very things they fear the most without performing any rituals.

Over time, anxiety diminishes as patients realize their worst fears never materialize.

“We are trying to help the individual with OCD to be less scared of their own thoughts, less scared of their own anxiety,” says Sookman.

It is challenging, time-consuming therapy that often requires three-hour sessions and daily home visits over several months.

Sookman says she’s treated some 7,000 OCD patients this way. one of her success stories is Lori Merling.

Today, Merling is an accomplished, ambitious university student. but at age 10, a family illness appeared to set off a firestorm of disturbing thoughts in Lori’s young mind.

“I would lie in bed some nights when everyone was asleep (and think) ‘What if I take a knife and kill one of my parents in their sleep?’ these were not things I wanted to do. That’s why these thoughts were disturbing to me. It was scary.”

Lori also began to fear parts of her personality would “escape” her body and “stick” on cereal boxes. as difficult as this is to comprehend, the fear of losing herself left Lori distressed, literally scraping her personality off of the box fronts and making swallowing motions to make herself feel whole.

She experienced an often misunderstood OCD symptom called “magical thinking” — for example, believing stepping on a crack will literally break your mother’s back.

“It’s horrible… You realize what you’re doing is nuts. It doesn’t make sense in the real world. It takes on a life of its own and it controls you,” says Lori.

But after seeing an American documentary on OCD, Lori diagnosed herself. With her parents’ help, she was referred to the McGill OCD clinic, where she was treated with cognitive and exposure therapy.

“It was taking my greatest fears and putting them in front of me. Deal with the pain. It was scary and awful,” she says.

But the intensive cognitive and exposure therapy worked. Lori now says she is cured.

“This is something I am proud of. It’s an achievement. It’s one of the greatest things I’ve ever achieved in my life, overcoming this disorder. I fought this battle and won,” says Lori.

Lori is now studying to become a psychologist specializing in obsessive-compulsive disorder. She also volunteers with the Canadian Institute for obsessive-compulsive disorders and supports their mission of expanding specialized treatment centres for OCD.

“I want to do for other people what was done for me. I want to liberate others from this. I know it can be done. I am living proof,” says Lori.

She says there aren’t enough resources to treat all of those afflicted with OCD in Canada.

“The cost of not doing this is greater. The cost in suffering, unnecessary health care utilization, because they are not going directly to specialists,” says Sookman.

But when patients can get treatment and follow-through, the results can be liberating.

Gideon is 18 months into his treatment. while he is taking some medication to control his anxiety, the therapy is helping him realize that he can open doors with his hands, and eat normally, as long as he avoids eating foods with peanuts. His therapy is far from over but he feels freed.

“I am able to eat. to do everything because of the medication and the specialized therapy. yes, it saved my life,” he says.

Paul is a little more than three months into his therapy. His parents say they can already see glimpses of the normal Paul within. they can move about the house freely, without worrying that if they are on his left, he will become panicked.

“He is less afraid of the fear the OCD creates in him. says his father David. “We’re even starting to be a bit more relaxed,” says his mother Julie.

“I was convinced nobody could help me. Nobody I saw before no one could help me,” says Paul, who hopes to return to school in September.

“I think if I keep doing all my exposures and homework, I will keep getting better and better… I want to enjoy life.”

Published: Saturday, February 25, 2012 at 12:01 a.m. Last Modified: Sunday, February 26, 2012 at 12:00 a.m.

WINTER HAVEN | Postpartum depression is far deeper and more dangerous than what’s frequently referred to as “baby blues.”

Facts QUICK CHECK

Is it baby blues, postpartum depression or postpartum psychosis?BABY BLUESMany women have the baby blues in the days after childbirth. Symptoms include:Having mood swings.Feeling sad, anxious or overwhelmed.Having crying spells.Losing your appetite.Having trouble sleeping.The baby blues usually go away within a few days or a week. POSTPARTUM DEPRESSIONSymptoms last longer and are more severe. Postpartum depression can start any time within the first year after childbirth. In addition to symptoms listed under baby blues, you could experience:Thoughts of hurting the baby.Thoughts of hurting yourself.Not having any interest in the baby.Postpartum depression needs to be treated by a doctor. POSTPARTUM PSYCHOSISOccurs in one to four of every 1,000 births, usually starting the first two weeks after childbirth. Women with bipolar disorder or schizoaffective disorder have a higher risk of postpartum psychosis. Symptoms may include:Trying to hurt yourself or your baby.seeing things that aren’t there.Feeling confused.Having rapid mood swings.Postpartum psychosis needs to be treated by a doctor. Source: U.S. Department of Health and Human Services Office on Women’s Health

“It is a very devastating disease,” said Dr. George Winny, psychiatrist and medical director of Winter Haven Hospital Center for Behavioral Health. “It is horrible for people to go through.”

Nurses at Regency Center for Women and Infants, where WHH has its childbirth unit, do depression screening with female patients who are there to give birth.

“If the score is high, they call us for ?consulting,” Winny said. “I have seen many cases of postpartum depression over the years.”

Postpartum depression and a much rarer condition, postpartum psychosis, came to Polk County residents’ attention this month with the death of 1-year-old Ishan Patel of Lakeland.

He drowned and had blunt force trauma on his face, according to autopsy results.

His mother, Neha Patel, 32, is charged with first-degree murder. Authorities said she suffered severe postpartum depression and had threatened suicide in the past.

Untreated, Winny said, the condition interferes with a mother’s inability to take care of and bond with her baby.

About 10 percent to 15 percent of women develop that condition after giving birth, said Dr. Latamia White-Green, a psychiatrist at Lakeland Regional Medical Center.

Such women aren’t able to take care of themselves or their babies, leading to feelings of being worthless, irritability, agitation and exhaustion beyond the normal stress of having a newborn. They need treatment by a doctor, White-Green said.

“The stress of caring for a newborn can take a toll,” Winny said. “You may feel overwhelmed and anxious about your ability to take care of the baby.”

In a small number of cases — fewer than 5 of every 1,000 births — the mother’s mental condition goes beyond postpartum depression into postpartum psychosis. Symptoms can include trying to hurt herself or the baby, seeing things that aren’t there, feeling confused and having rapid mood swings.

The difficulty for families and friends, as well as the mother, is determining when feelings are normal baby blues or something more serious.

Anywhere from 55 percent to 85 percent of women are likely to have some short-term baby blues, more accurately called an adjustment disorder, White-Green said.

Mood swings, crying, feeling sad or overwhelmed and other emotional reactions can occur during that period as the body goes through hormonal adjustments, she and Winny agreed.

If women or their family members feel the depression goes beyond baby blues, particularly if it interferes with the mother-child relationship, both psychiatrists advise them to call their doctors before the scheduled six-week check-up.

Too often, they’re reluctant to do that, said Teresa even, mental health therapist with Peace River Center.

“People feel they should be able to control it,” she said. “I spend a lot of time doing education on brain chemicals (and mental disorders).”

Teenage mothers are at greater risk of postpartum depression, as are mothers whose babies are born prematurely or with developmental problems.

In the case of Ishan Patel, the Lakeland baby killed, he was premature and spent months at Tampa General Hospital.

Other mothers at greater risk are those whose pregnancies are unplanned, who lack an adequate support system or who already have depression.

Cultural factors also can play a role.

“In India, women are not very vocal in talking about their feelings,” said Winny, a native of India who practiced there before coming to the United States.

“We used to see a lot of anxiety disorders,” he said, but added that in India there is likely to be more family support.

“Your mother or mother-in-law might help take care of your baby there,” he said. “Here you are living with your husband and child.”

White-Green, who is African-American, said her cultural experience is that “it’s really frowned upon to be out of the house until three or four weeks after the birth.”

Isolation can increase symptoms of depression, she said, encouraging women to ask for help with child care or housework and find ways to take care of themselves. Something as simple as a hairdo or manicure may help improve mood.

Winny offers this advice for significant others of any culture to follow in the days and weeks after a child is born:

“Listen to her without judging her or offering solutions, without trying to fix things. Simply be there.”

Volunteer to help with childcare and housework without waiting for her to ask, he said. Encourage her to exercise.

[ Robin Williams Adams can be reached at or 863-802-7558. Read her blog at robinsrx.blogs.theledger.com. Follow on Twitter @ ledgerROBIN. ]

Hong Kong — (SBWIRE) — 02/27/2012 — a person’s ears can detect a very wide wide range of sounds. From the beautiful notes produced by an orchestra to the loud roars of a jet engine.But for millions of people around the globe, their ears not only interpret sounds, they also produce them. these noises, which include buzzing, humming, whistling and ringing in ears, are caused by a condition called tinnitus.Although tinnitus is not a fatal condition, the symptoms caused by it can significantly impact a person’s quality of life in a very negative way. it can interrupt a person’s sleep, concentration, judgment, family relationships and employment, and can lead to depression and anxiety.In fact according to credible estimates, between 10 and 12 million Americans suffer enough from tinnitus to seek medical attention, and more than 200 million people are severely affected by the condition worldwide.In an effort to help educate the millions of people across the globe suffering from this condition, Tinnitus Magazine recently launched their official website TinnitusMagazine.com. the website features the latest information about the array of tinnitus symptoms and causes, and discusses a multitude of natural tinnitus treatment options and tinnitus remedies.Tinnitus can be caused by a range of things, including earwax build-up, an infection in the ear, hearing loss with age, loud noise exposure, changes to bones in the ear, various foods and medicines, and more.And for the large number of sufferers, the tinnitus symptoms they exhibit cannot only be annoying, but can also interfere with their ability to lead a normal, happy life.In an effort to help provide readers with some tinnitus relief, TinnitusMagazine.com presents a collection of effective, easy-to-follow treatment options.according to Neil Hendry, Editor of Tinnitus Magazine, the magazine aims to give readers up-to-date information about the most effective tinnitus remedies and discusses the availability of a natural tinnitus cure.“You don’t need to be told that tinnitus is a serious condition that can impair the quality of your life as well as those around you,” states Hendry. “We understand you want a solution, and you want one fast. Our goal is to give you the most reliable, proven tinnitus treatment options available on the market and give you hope that there is light at the end of the tunnel.”For more information, visit TinnitusMagazine.comAbout Tinnitus MagazineFounded in 2011 and headquartered in Hong Kong, Tinnitus Magazine provides the very latest information concerning tinnitus symptoms, tinnitus causes and tinnitus treatment to their readers. More information can be found on their website.

Autism tends to go hand in hand with a variety of other mental and behavioral conditions in kids, suggests a new study that highlights the fuzzy nature of autism diagnoses themselves.

Researchers said that other disorders that often go along with autism – such as attention-deficit/hyperactivity disorder (ADHD) or learning disabilities – may complicate the diagnosis, or slow down any improvement in kids who do get diagnosed and treated early.

“The most important message that (the study) underscores is that these children tend to have multiple disabilities, not just autism,” said Johnny Matson, who studies autism spectrum disorders and intellectual disabilities at Louisiana State University in Baton Rouge but wasn’t involved in the new research.

Dr. Andrew Zimmerman from Massachusetts General Hospital for Children in Lexington and his colleagues found that the conditions they typically saw occurring together with an autism spectrum disorder diagnosis varied depending on the age of the child.

Learning disabilities were more common in the youngest kids with an autism spectrum disorder, while anxiety, speech problems and seizures were more often seen in elementary school kids and teens.

The study also found that one-third of kids who had ever been diagnosed with an autism spectrum disorder no longer had the diagnosis at the time their parents were surveyed.

The researchers note in their report, published in Pediatrics, that past studies have also found that some kids who originally have an autism spectrum disorder eventually lose that diagnosis and are no longer considered autistic.

Whether that’s due to a mistaken first diagnosis or actual changes in kids’ brains and behaviors is controversial.

Autism spectrum disorders include autism, Asperger’s syndrome and “pervasive developmental disorder-not otherwise specified,” or PDD-NOS. the number of kids diagnosed with one of those conditions has spiked in recent years, with about one in every 110 kids in the United States now considered to have an autism spectrum disorder, according to estimates by the Centers for Disease Control and Prevention.

An upcoming revision of psychiatrists’ Diagnostic and Statistical Manual of Mental Disorders is expected to narrow the definition of autism and related disorders, potentially shrinking the number of children and adults who qualify for the diagnosis.

The new study included data from a phone survey of about 92,000 parents of kids age 17 and younger in the U.S. in 2007 and 2008.

Parents were asked if a doctor had ever told them their child had an autism spectrum disorder and if the child had one of the disorders currently, as well as if kids had a range of other mental and behavioral conditions such as anxiety and developmental delays.

In total, 1,366 of the parents surveyed said their kid had a past or current diagnosis of an autism spectrum disorder. in 453 of those cases, kids had at one point been diagnosed as having one of the disorders but didn’t anymore, parents said.

Compared to kids who had lost their diagnosis, the youngest kids that were still considered autistic were more likely to have a learning disability or delayed development, while elementary school kids had more anxiety disorders and teens more often had a speech problem or mild seizures and epilepsy.

In her own studies, “the kids that had more co-occurring diagnoses tended to be diagnosed (with autism) later,” when an autism diagnosis may be more definitive and stable, said Dr. Susan Levy, an autism and child development researcher from the Children’s Hospital of Philadelphia.

In addition, she told Reuters Health, “The kids that had more co-occurring diagnoses had a lot more difficulties and their progress may have been impeded,” making it harder for their autism-related symptoms to improve with treatment.

Some of the kids who ended up not having an autism spectrum disorder may have originally been diagnosed incorrectly, especially if they got the diagnosis when they were very young, researchers said.

Kids and teens in the study that had once been considered autistic but weren’t any longer were more likely to have hearing problems than those who still had an autism spectrum disorder — suggesting that those problems might have been originally mistaken for autism.

But experts disagreed about whether it’s possible for kids who are diagnosed correctly with one of the autism-spectrum disorders to improve to the point where they are no longer affected.

“When you’re autistic, you’re autistic. It’s a very stable condition,” Matson said, noting that even when symptoms improve, people with autism have to keep getting treatment and work to maintain that progress.

Zimmerman argued that recognizing autism early and starting treatment can increase the likelihood for real, lasting improvement.

“It’s not unusual to see a child start out with more severe autism and then become more moderate and even mild as the years go by. a lot of the kids are improving, and we don’t really know why, except we know there’s a lot of moldability of the developing brain,” he told Reuters Health.

“We think that earlier treatment is essential and there are reasons to think that we can improve the kids. I’m very optimistic.”

Women taking pomegranate seed oil, marketed as an alternative remedy for menopausal symptoms, got no more relief from hot flashes than women taking a pill containing sunflower oil as a placebo, according to an Austrian study.

The study, in which women took the pomegranate seed oil — which is rich in plant compounds called phytoestrogens that mimic estrogen — twice a day, was the first clinical trial of the remedy and appeared in the journal Menopause.

As many as 85 percent of women experience hot flashes — a sensation of heat, often accompanied by sweating, rapid heartbeat and anxiety — many times a day before, during or after menopause.

“In postmenopausal women, pomegranate seed oil does not significantly reduce hot flashes within a 12-week observation period, but further studies are needed to investigate the long-term effect,” wrote lead researcher Leo Auerback at the Medical University of Vienna.

His team followed 81 postmenopausal women aged 45 to 60. all the women experienced a minimum of five hot flashes a day, and had gone at least 12 months since their final menstrual period.

Each participant kept a diary of menopause symptoms and took two 30-milligram capsules of pomegranate seed oil or placebo pills daily for 12 weeks. at the start and the end of the study period, the researchers also tested their hormone levels.

At the beginning of the study, women in the treatment group reported having an average of 11.1 hot flashes a day, and women in the placebo group reported 9.9 hot flashes each day, on average.

After 12 weeks, the women taking pomegranate seed oil saw a nearly 39 percent reduction on hot flashes, to 6.8 per day, while women in the placebo group saw a drop of nearly 26 percent, to an average of 7.3 a day.

The 13 percent difference between the effects seen in the two groups was too small to credit pomegranate seed oil with any real benefit, the researchers said.

The study found no differences between the participants’ hormone levels before and after the 12-week treatment, although the women on pomegranate seed oil did report a statistically significant improvement in sleep quality and related symptoms.

The researchers added that the marked drop in hot flashes seen in both groups was likely attributable to a so-called “placebo effect” — a trend seen in most studies of treatments for menopausal symptoms that include a placebo control.

“Like most herbal remedies, there is no clear evidence that it is effective at reducing menopause symptoms,” said Silvina Levis, who specializes in geriatrics at the University of Miami Miller School of Medicine in Florida but did not take part in the study.

Previous research has found that soy supplements and red clover extract, which also contain phytoestrogens, are not effective at reducing menopause symptoms such as hot flashes.

The current study was funded by German herbal supplement maker PEKANA, which also supplied the supplements.

Currently, only hormone therapy — medications containing synthetic estrogens — is approved for the treatment of hot flashes in the United States.

The United States teen birth rate declined 6% in 2009 and is now at a record low, according to The National Campaign to Prevent Teen and Unplanned Pregnancy. Despite this progress, it is still the case that 3 in 10 girls get pregnant by age 20.

The National Campaign has organized National Teen Pregnancy Awareness Day to help teens think carefully about sex, relationships, contraception, the possibility of pregnancy, and the lifelong challenges of being a parent. On may 4, teens nationwide will be asked to visit StayTeen.org to participate in a number of online activities – including the popular National Day Quiz (appropriate for age 13+) – that delivers teen pregnancy prevention messages and challenges them to think carefully about what they might do "in the moment."

Links – North Shore Youth Health Service was founded in 1973 to address these “in the moment” issues – teen pregnancy and other reproductive health concerns. its mission to empower young people to make informed, responsible decisions about their health, well-being, and sexuality continues today.

Access to reliable information about sexuality and sexual health is critical for adolescent girls. a sexually active teen who does not use contraception has a 90% chance of becoming pregnant within a year. last year, 56% of the chlamydia cases and 41% of the gonorrhea cases in Illinois occurred in young women ages 15-24.

Links’ Clinic fills the need for confidential, affordable access to routine gynecological care, birth control, pregnancy testing, and testing and treatment for sexually transmitted infections (STIs) for youth ages 13-25. Links’ counselor is always available during the clinics to provide additional support related to unplanned pregnancy, a positive STI test, or relationship concerns.

The Women’s Clinic is offered Monday and Thursday evenings, plus one Saturday morning per month. Suzanne Hales, Clinic Supervisor for over 10 years, talked about the Female clinic, “In addition to our volunteer doctors and nurses, we have over thirty volunteers from the community who know how to relate to young people. Many of our younger clients come in a little scared. our volunteers put them at ease, offer them non-judgmental support and educate them about STIs and birth control choices. our motto is ‘Prevention through Education’ so we always try to educate a little with every visit.”

Suzanne pointed to a note from one young woman, who recently wrote about her clinic experience. The client wrote, “Links has changed my life because it made me realize how important protection is and that it is so important to make smart choices in life. The counselors are so supportive and friendly here. I am so happy I found this place.”

Traditionally, Links’ clients have been high school age women who prefer not to use their family health insurance because they want their use of reproductive healthcare services to remain confidential. For the last two years, Links has seen an increase of uninsured clients in the 19-25 age group. Most of these young women are working part-time or in entry-level jobs with no health insurance benefits. While Links charges nominal fees for medical care and birth control, no one is ever turned away due to an inability to pay. Without Links, these young women would be unable to get the gynecological care – and the access to birth control – they need.

While about 95% of Links’ clients are female, the Clinic serves young men as well. The Male Clinic is offered the first and third Tuesday evening of each month. Suzanne explains, “We have two wonderful volunteer urologists who come in to see the young men. At our Male Clinic, we always talk about condoms as being an answer for both birth control and STI prevention. The use of condoms is so important, and they are available just about anywhere.”

One couple, who has utilized the services of both the Female and Male Clinics, recently wrote, “We have been a couple for almost seven years and Links has helped us in so many ways. you are all so friendly and the confidentiality is greatly appreciated. The cost is very helpful too as we’re both college students.”

Teen pregnancy and unplanned pregnancy among young adults is at the root of a number of public health and social challenges. Links is pleased to support the National Day to Prevent Teen Pregnancy and will continue its work on the front lines of the effort to reduce unplanned pregnancy right here in our local community. Loren Hutter, MD, who has served as Links’ Medical Director since 1995, adds, “Despite the progress that has been made in lowering the teen birth rate the past few years, we need to continue to help young people to postpone pregnancy until they are truly ready to be parents. I’m happy to be a part of the solution here at Links.”

Last year, Links served 724 young people in its clinics and responded to 674 requests for information and referrals about sexuality issues. more information about Links and its Clinics is available at linksyouth.org, or by calling 847.441.6191 ext. 1. more information about the National Day to Prevent Teen Pregnancy is available at thenationalcampaign.org.

A new study from Yale University raises additional concerns about the use of antidepressants.

The study pooled and examined data from previous research trials and found that, while the vast majority of depressed people who take medication improved significantly (and much more than if they were given sugar pills), those who do not improve–about 20 percent in this study–actually did worse than they would have on sugar pills.

This stark finding–that a fifth of depressed patients would actually be better off with placebos than real antidepressant pills–means that doctors must be very alert to who is responding to antidepressants and who is not.  they need to select antidepressants carefully, matching the likely effects and side effects with a patient’s particular symptoms, then change medications within weeks, when indicated for particular patients.

For patients, this study means that they should be telling their doctors when antidepressants seem to be making them feel more anxious or less energized or even sadder, as soon as they have those experiences. because “riding it out” for eight weeks or longer, in order to “get the therapeutic effect” of particular medications may be unwise.  When antidepressants don’t seem to be improving things, and instead seem to be making a person’s condition worse, other medications or other treatment modalities should be used, instead.

The notion of stopping medicine that seems to be causing trouble, rather than helping, might seem obvious, but some clinicians have traditionally believed that patients need to “ride out” feeling badly on antidepressants, until the therapeutic effects can take hold.  This remains a judgment call, but the Yale data makes it plain that looking to alternatives, instead of looking to the future, might be the wiser course.

While it has become commonplace for family physicians and even nurses to prescribe antidepressants, this study also highlights the importance of patients seeking out experts who use psychiatric medications routinely and who have a good reputation for getting good results with them.  Prescribing antidepressants is a clinical art, no different than prescribing a regimen of heart medications for folks with cardiac illness.  You wouldn’t want to rely on me to treat your cardiac arrhythmia and you probably don’t want to rely on anyone other than a psychiatrist (and one who has a good deal of experience using both psychotherapy and medications) to treat your major depression.

In my practice, I often change patients’ antidepressants relatively quickly, in order to minimize side effects and achieve early reductions in symptoms.  I often add medicines that augment the antidepressant’s effectiveness, or that target particularly troubling symptoms, like anxiety or sleeplessness.  I sometimes use psychopharmacologic strategies to eliminate or reduce side effects.  This requires that I be in frequent touch with patients and that I be willing to take action quickly and decisively.  It also requires that I listen very carefully to the nuances of what patients tell me about how they are feeling on these powerful medicines.

I always have told people that they should be very active managers of their own psychiatric care. now, the data is stronger than ever supporting the importance of being willing to speak up and make it clear when something different or something more need be done.

Dr. Ablow is the author of “Inside the Mind of Casey Anthony.” he is a psychiatrist and member of the Fox News Medical A-Team. Dr. Ablow can be reached at info@keithablow.com. His team of Life Coaches can be reached at lifecoach@keithablow.com.

Almost everything nowadays is digital or will be accessed through digital means.

So it is little surprise that, at the first mysterious twinge in the chest or shortness of breath, we self-diagnose by Googling our symptoms.

A growing body of research shows that many people are visiting ‘Dr Google’ first before seeing their usual doctor.

Many websites on the internet deal with online medical information, providing people with crucial tips about their health through the internet.

This includes providing possible illnesses when one provides symptoms.

Some studies show that as many as 60 per cent of internet users consult the internet to diagnose their aches and pains, rather than consult a real doctor, or before they see their doctor.

In some cases, however, self-diagnosis leads to anxiety mainly because of misdiagnosis.

Some, because of misdiagnosis, arrive at their health provider convinced they have some horrendous diseases like cancer when in fact it is something minor.

Although the internet can be a treasure trove of medical information, it can also lead to the creation of a condition called in IT circles as “cyberchondriacs”.

This happens where a person is inundated with information about every disease under the sun, they start to imagine they have them all, and hit the panic button.

In their minds, every mole is skin cancer.

A nosebleed is surely a sign of a tumour. Headache? must be skyrocketing blood pressure.

We’ve all done at least once. Whether it’s a dull ache in your chest or a persistent case of the hiccups, you turn to the internet to diagnose yourself with a minor symptom and end up convinced you’re suffering from cardiac arrest or neurological disorders.

Many people prefer searching for information about their health because some health problems are very personal and they find the internet a secure and anonymous way to get answers.

This shielding mechanism motivates patients to shoot questions that they would otherwise avoid if they visited the physician and had a face-to-face consultation.