To Screen or Not to Screen? Doctors Debate Post Partum Depression Testing
Depression Treatment Often Doesn't Go To Those Most In Need
Suicide Rates Climb In U.S., Especially Among Adolescent Girls
A New Study Raises Old Questions About Antidepressants And Autism
Depressed? Look For Help From A Human, Not A Computer
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And doing can be difficult when depressed.","imgSizes":{"thumbnail":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-400x266.jpg","width":400,"height":266,"mimeType":"image/jpeg"},"medium":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-800x533.jpg","width":800,"height":533,"mimeType":"image/jpeg"},"large":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-1440x959.jpg","width":1440,"height":959,"mimeType":"image/jpeg"},"fd-lrg":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-1920x1279.jpg","width":1920,"height":1279,"mimeType":"image/jpeg"},"fd-med":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-1180x786.jpg","width":1180,"height":786,"mimeType":"image/jpeg"},"fd-sm":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-960x639.jpg","width":960,"height":639,"mimeType":"image/jpeg"},"post-thumbnail":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-672x372.jpg","width":672,"height":372,"mimeType":"image/jpeg"},"twentyfourteen-full-width":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-1038x576.jpg","width":1038,"height":576,"mimeType":"image/jpeg"},"guest-author-32":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-32x32.jpg","width":32,"height":32,"mimeType":"image/jpeg"},"guest-author-64":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-64x64.jpg","width":64,"height":64,"mimeType":"image/jpeg"},"guest-author-96":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-96x96.jpg","width":96,"height":96,"mimeType":"image/jpeg"},"guest-author-128":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-128x128.jpg","width":128,"height":128,"mimeType":"image/jpeg"},"detail":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-75x75.jpg","width":75,"height":75,"mimeType":"image/jpeg"},"jmtc-small-thumb":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab-280x150.jpg","width":280,"height":150,"mimeType":"image/jpeg"},"kqedFullSize":{"file":"https://ww2.kqed.org/app/uploads/sites/27/2015/11/depression-1_enl-8de00bd92873f38cf9e6e92c3fd2c098036440ab.jpg","width":2000,"height":1332}},"fetchFailed":false,"isLoading":false}},"audioPlayerReducer":{"postId":"stream_live"},"authorsReducer":{"byline_stateofhealth_230671":{"type":"authors","id":"byline_stateofhealth_230671","meta":{"override":true},"slug":"byline_stateofhealth_230671","name":"\u003cstrong> Zhai Yun Tan \u003c/br> Kaiser Health News \u003c/strong>","isLoading":false},"byline_stateofhealth_176688":{"type":"authors","id":"byline_stateofhealth_176688","meta":{"override":true},"slug":"byline_stateofhealth_176688","name":"Rae Ellen Bichell","isLoading":false},"byline_stateofhealth_123539":{"type":"authors","id":"byline_stateofhealth_123539","meta":{"override":true},"slug":"byline_stateofhealth_123539","name":"Jon Hamilton","isLoading":false},"byline_stateofhealth_107020":{"type":"authors","id":"byline_stateofhealth_107020","meta":{"override":true},"slug":"byline_stateofhealth_107020","name":"Lynne Shallcross","isLoading":false},"adembosky":{"type":"authors","id":"3205","meta":{"index":"authors_1591205172","id":"3205","found":true},"name":"April Dembosky","firstName":"April","lastName":"Dembosky","slug":"adembosky","email":"adembosky@kqed.org","display_author_email":false,"staff_mastheads":["news","science"],"title":"KQED Health Correspondent","bio":"April Dembosky is the health correspondent for KQED News and a regular contributor to NPR. She specializes in covering altered states of mind, from postpartum depression to methamphetamine-induced psychosis to the insanity defense. Her investigative series on insurance companies sidestepping mental health laws won multiple awards, including first place in beat reporting from the national Association of Health Care Journalists. She is the recipient of numerous other prizes and fellowships, including a national Edward R. Murrow award for investigative reporting, a Society of Professional Journalists award for long-form storytelling, and a Carter Center Fellowship for Mental Health Journalism.\r\n\r\nDembosky reported and produced \u003cem>Soundtrack of Silence\u003c/em>, an audio documentary about music and memory that is currently being made into a feature film by Paramount Pictures.\r\n\r\nBefore joining KQED in 2013, Dembosky covered technology and Silicon Valley for \u003cem>The Financial Times of London,\u003c/em> and contributed business and arts stories to \u003cem>Marketplace \u003c/em>and \u003cem>The New York Times.\u003c/em> She got her undergraduate degree in philosophy from Smith College and her master's in journalism from the University of California, Berkeley. She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_362850":{"type":"posts","id":"stateofhealth_362850","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"362850","score":null,"sort":[1520240430000]},"guestAuthors":[],"slug":"to-screen-or-not-to-screen-doctors-debate-post-partum-depression-testing","title":"To Screen or Not to Screen? Doctors Debate Post Partum Depression Testing","publishDate":1520240430,"format":"audio","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Lawmakers will begin debate next month on a bill that would require doctors to screen new moms for mental health problems – once while they’re pregnant and again, after giving birth.\u003c/p>\n\u003cp>But a lot of doctors don’t like the idea. Many obstetricians and pediatricians are afraid to screen new moms for depression and anxiety.\u003c/p>\n\u003cp>“What are you going to do with those people who screen positive?” said Laura Sirott, an OB/GYN who practices in Pasadena. “Some providers have nowhere to send them.”\u003c/p>\n\u003cp>Of women who screen positive for postpartum depression, 78 percent don’t get mental health treatment, according to a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4618720/\" target=\"_blank\" rel=\"noopener\">2015 study review\u003c/a> published in the journal \u003cem>Obstetrics & Gynecology\u003c/em>. Dr. Sirott’s patients have told her the range of reasons why they don’t take her up on a referral to a psychologist.\u003c/p>\n\u003cp>“Oh, they don’t take my insurance. Or my insurance pays for three visits. I can’t take time off of work to go to those visits. It’s a three-month wait to get in to that person,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And, it’s hard to find a psychiatrist who is trained in the complexities of prescribing medications to pregnant or breastfeeding women, and who is willing to treat them, especially in rural areas.\u003c/p>\n\u003cp>“So it’s very frustrating to ask patients about a problem and then not have any way to solve that problem,” Sirott said.\u003c/p>\n\u003cp>But moms are frustrated, too. After the baby comes, no one asks about them anymore. Wendy Root Askew struggled for years to get pregnant, and when she finally did, her anxiety got worse. She couldn’t stop worrying that something would go wrong.\u003c/p>\n\u003cp>“And then after I had my son, I would have these dreams where someone would come to the door and they would say ‘Well, you know, we’re just going to wait two weeks to see if you get to keep your baby or not,’” she said. “And it really impacted my ability to bond with him.”\u003c/p>\n\u003cp>She likes the bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB2193\" target=\"_blank\" rel=\"noopener\">AB 2193\u003c/a>, because it goes beyond mandated screening. It requires health insurance companies to set up case management programs to help moms find a therapist, and to connect obstetricians or pediatricians with a psychiatric expert.\u003c/p>\n\u003cp>“Just like we have case management programs for patients who have diabetes or sleep issues or back pain, a case management program requires the insurance company to take some ownership of making sure their patients are getting the treatment they need to be healthy,” said Root Askew, who is now advocating for the bill on behalf of the group \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener\">2020 Mom\u003c/a>.\u003c/p>\n\u003cp>Health insurance companies haven’t taken a position on the legislation. It’s unclear how much it will cost them to comply, because some already have infrastructure in place for case management programs and some don’t. But there is consensus among insurers and health advocates that such programs save money in the long run.\u003c/p>\n\u003cp>“The sooner that you can get good treatment for a mom, the less expensive that condition will be to manage over the course of the woman’s life and over the course of that child’s life,” Root Askew said.\u003c/p>\n\u003cp>Doctors still have their objections. Under the bill, they could be disciplined for not screening. And screening takes time. Sometimes a doctor asks a mom how she’s sleeping, and she’s in tears for the next 30 minutes.\u003c/p>\n\u003cp>The health care system, and the incentives, aren’t set up for this, said Dr. Sirott.\u003c/p>\n\u003cp>“Currently, I get six dollars for screening a patient,” she said. “By the time I put it on a piece of paper and print it, it’s not worth it.”\u003c/p>\n\u003cp>And it’s not clear it’s worth it to the patients either. Four other states – Illinois, Massachusetts, New Jersey, and West Virginia – have tried mandated screening, and it made no difference in patient outcomes, according to \u003ca href=\"https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201300505?code=ps-site\" target=\"_blank\" rel=\"noopener\">a study\u003c/a> published in \u003cem>Psychiatric Services\u003c/em> in 2015.\u003c/p>\n\u003cp>Even with California’s extra requirements on insurance companies to facilitate care, women could still face high co-pays or limits on therapy sessions. Or, they’re so overwhelmed caring for a newborn, they never leave the house.\u003c/p>\n\u003cp>What does seem to work, according to the study, is when nurses or mental health providers visit new moms at home.\u003c/p>\n\u003cp>“Despite abundant good will, there is no evidence that state policies are addressing this great need,” the study authors wrote.\u003c/p>\n\u003cp>But supporters of the proposed bill say doctors need to start somewhere. Screening is the first step in recognizing the full scope of the problem, said Mountain View psychiatrist \u003ca href=\"https://www.elcaminohospital.org/doctors/nirmaljit-dhami\" target=\"_blank\" rel=\"noopener\">Nirmaljit Dhami\u003c/a>, adding that women should be screened on an ongoing basis throughout pregnancy and for a year after birth, not just once or twice as the bill requires.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I often tell doctors that if you don't know that somebody is suicidal it doesn't mean that their suicidality will go away,” she said. “If you don't ask, the risk is the same.”\u003c/p>\n\n","blocks":[],"excerpt":"A proposed bill would require doctors to screen new moms for depression, and require health insurers to help them get care.","status":"publish","parent":0,"modified":1521474114,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":891},"headData":{"title":"To Screen or Not to Screen? Doctors Debate Post Partum Depression Testing | KQED","description":"A proposed bill would require doctors to screen new moms for depression, and require health insurers to help them get care.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"362850 https://ww2.kqed.org/stateofhealth/?p=362850","disqusUrl":"https://ww2.kqed.org/stateofhealth/2018/03/05/to-screen-or-not-to-screen-doctors-debate-post-partum-depression-testing/","disqusTitle":"To Screen or Not to Screen? Doctors Debate Post Partum Depression Testing","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcr/2018/03/MandatedPostPartumScreeningDembosky.mp3","path":"/stateofhealth/362850/to-screen-or-not-to-screen-doctors-debate-post-partum-depression-testing","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lawmakers will begin debate next month on a bill that would require doctors to screen new moms for mental health problems – once while they’re pregnant and again, after giving birth.\u003c/p>\n\u003cp>But a lot of doctors don’t like the idea. Many obstetricians and pediatricians are afraid to screen new moms for depression and anxiety.\u003c/p>\n\u003cp>“What are you going to do with those people who screen positive?” said Laura Sirott, an OB/GYN who practices in Pasadena. “Some providers have nowhere to send them.”\u003c/p>\n\u003cp>Of women who screen positive for postpartum depression, 78 percent don’t get mental health treatment, according to a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4618720/\" target=\"_blank\" rel=\"noopener\">2015 study review\u003c/a> published in the journal \u003cem>Obstetrics & Gynecology\u003c/em>. Dr. Sirott’s patients have told her the range of reasons why they don’t take her up on a referral to a psychologist.\u003c/p>\n\u003cp>“Oh, they don’t take my insurance. Or my insurance pays for three visits. I can’t take time off of work to go to those visits. It’s a three-month wait to get in to that person,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And, it’s hard to find a psychiatrist who is trained in the complexities of prescribing medications to pregnant or breastfeeding women, and who is willing to treat them, especially in rural areas.\u003c/p>\n\u003cp>“So it’s very frustrating to ask patients about a problem and then not have any way to solve that problem,” Sirott said.\u003c/p>\n\u003cp>But moms are frustrated, too. After the baby comes, no one asks about them anymore. Wendy Root Askew struggled for years to get pregnant, and when she finally did, her anxiety got worse. She couldn’t stop worrying that something would go wrong.\u003c/p>\n\u003cp>“And then after I had my son, I would have these dreams where someone would come to the door and they would say ‘Well, you know, we’re just going to wait two weeks to see if you get to keep your baby or not,’” she said. “And it really impacted my ability to bond with him.”\u003c/p>\n\u003cp>She likes the bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB2193\" target=\"_blank\" rel=\"noopener\">AB 2193\u003c/a>, because it goes beyond mandated screening. It requires health insurance companies to set up case management programs to help moms find a therapist, and to connect obstetricians or pediatricians with a psychiatric expert.\u003c/p>\n\u003cp>“Just like we have case management programs for patients who have diabetes or sleep issues or back pain, a case management program requires the insurance company to take some ownership of making sure their patients are getting the treatment they need to be healthy,” said Root Askew, who is now advocating for the bill on behalf of the group \u003ca href=\"https://www.2020mom.org/\" target=\"_blank\" rel=\"noopener\">2020 Mom\u003c/a>.\u003c/p>\n\u003cp>Health insurance companies haven’t taken a position on the legislation. It’s unclear how much it will cost them to comply, because some already have infrastructure in place for case management programs and some don’t. But there is consensus among insurers and health advocates that such programs save money in the long run.\u003c/p>\n\u003cp>“The sooner that you can get good treatment for a mom, the less expensive that condition will be to manage over the course of the woman’s life and over the course of that child’s life,” Root Askew said.\u003c/p>\n\u003cp>Doctors still have their objections. Under the bill, they could be disciplined for not screening. And screening takes time. Sometimes a doctor asks a mom how she’s sleeping, and she’s in tears for the next 30 minutes.\u003c/p>\n\u003cp>The health care system, and the incentives, aren’t set up for this, said Dr. Sirott.\u003c/p>\n\u003cp>“Currently, I get six dollars for screening a patient,” she said. “By the time I put it on a piece of paper and print it, it’s not worth it.”\u003c/p>\n\u003cp>And it’s not clear it’s worth it to the patients either. Four other states – Illinois, Massachusetts, New Jersey, and West Virginia – have tried mandated screening, and it made no difference in patient outcomes, according to \u003ca href=\"https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201300505?code=ps-site\" target=\"_blank\" rel=\"noopener\">a study\u003c/a> published in \u003cem>Psychiatric Services\u003c/em> in 2015.\u003c/p>\n\u003cp>Even with California’s extra requirements on insurance companies to facilitate care, women could still face high co-pays or limits on therapy sessions. Or, they’re so overwhelmed caring for a newborn, they never leave the house.\u003c/p>\n\u003cp>What does seem to work, according to the study, is when nurses or mental health providers visit new moms at home.\u003c/p>\n\u003cp>“Despite abundant good will, there is no evidence that state policies are addressing this great need,” the study authors wrote.\u003c/p>\n\u003cp>But supporters of the proposed bill say doctors need to start somewhere. Screening is the first step in recognizing the full scope of the problem, said Mountain View psychiatrist \u003ca href=\"https://www.elcaminohospital.org/doctors/nirmaljit-dhami\" target=\"_blank\" rel=\"noopener\">Nirmaljit Dhami\u003c/a>, adding that women should be screened on an ongoing basis throughout pregnancy and for a year after birth, not just once or twice as the bill requires.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I often tell doctors that if you don't know that somebody is suicidal it doesn't mean that their suicidality will go away,” she said. “If you don't ask, the risk is the same.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/362850/to-screen-or-not-to-screen-doctors-debate-post-partum-depression-testing","authors":["3205"],"categories":["stateofhealth_2442","stateofhealth_3012","stateofhealth_14"],"tags":["stateofhealth_3067","stateofhealth_2582","stateofhealth_2947","stateofhealth_2808","stateofhealth_28","stateofhealth_3229","stateofhealth_3212","stateofhealth_68","stateofhealth_3230","stateofhealth_2519","stateofhealth_3228"],"featImg":"stateofhealth_362852","label":"stateofhealth"},"stateofhealth_230671":{"type":"posts","id":"stateofhealth_230671","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"230671","score":null,"sort":[1472491992000]},"guestAuthors":[],"slug":"screening-positive-for-depression-doesnt-mean-youll-get-treatment","title":"Depression Treatment Often Doesn't Go To Those Most In Need","publishDate":1472491992,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Getting treatment for depression may sometimes be a regular part of health care for the “\u003ca href=\"http://www.npr.org/sections/health-shots/2016/06/30/481766112/how-therapy-became-a-hobby-of-the-wealthy-out-of-reach-for-those-in-need\">worried well\u003c/a>” that leaves those who cannot afford it to suffer by themselves.\u003c/p>\n\u003cp>A \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2546155\">new study\u003c/a> published Monday in JAMA Internal Medicine illustrates that phenomena. Most Americans who screen positive for depression don’t receive treatment — while most who did receive treatment don’t actually have the condition.\u003c/p>\n\u003cp>“Over the last several years there has been an increase in prescription of antidepressants,” said \u003ca href=\"http://profiles.columbiapsychiatry.org/profile/molfson\">Mark Olfson\u003c/a>, professor of psychiatry at the Columbia University Medical Center and lead author of the study. “In that context, many people assumed that under-treatment of depression is no longer a common problem.”\u003c/p>\n\u003cp>But Olfson found the opposite to be true after analyzing data from \u003ca href=\"https://meps.ahrq.gov/mepsweb/\">Medical Expenditure Panel Surveys\u003c/a> in 2012 and 2013 that includes questionnaires screening for depression. Of the 46,417 adults surveyed, 8.4 percent answered in ways that suggested they had depression, but only 28.7 percent of them received any treatment for it.\u003c/p>\n\u003cp>“The findings highlight that there are continuing challenges in aligning depression care with patient needs,” he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Adults in the lowest income group were five times more likely to be depressed compared with those in the highest income group. But they, along with uninsured adults, racial and ethnic minorities, and men, were also less likely to receive treatment.\u003c/p>\n\u003cp>On the other hand, among the 8.1 percent of adults who received treatment for depression, only 29.9 percent of them had depression and 21.8 percent of them had serious psychological distress. And those with either less serious or no depression were more likely to receive antidepressants. It’s a problem of overprescription, Olfson said, because \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21200071\">studies have shown \u003c/a>that antidepressants are not any more effective for patients with mild depression than a placebo.\u003c/p>\n\u003cp>“Being a little less aggressive in medication in mild depression would be beneficial,” he said. “There are simpler forms of psychological interventions that can be adapted for primary care.”\u003c/p>\n\u003cp>Rather than relying on these drugs, the patients can be given other treatments ranging from counseling and exercise to yoga.\u003c/p>\n\u003cp>In addition, researchers concluded that those with serious psychological distress are more likely to be treated by psychiatrists instead of general medical professionals, but this trend does not translate to older patients, African Americans, the uninsured or those with less education.\u003c/p>\n\u003cp>“Some when they have depression don’t believe they require treatment or that they could benefit from treatment,” Olfson said. “People are visiting doctors but the attention is to current, pressing medical problems.”\u003c/p>\n\u003cp>But these doctor visits can be used as an opportunity for increasing access to treatment for depression to disadvantaged populations. Olfson found that most people with untreated depression make at least one visit to a primary care doctor annually. If depression screening and mental health services can be integrated into primary care, Olfson said, there will be better access and awareness about the illness.\u003c/p>\n\u003cp>“If you give them a referral to a mental health clinic, they simply won’t go if they don’t think they have a mental health disorder,” he said. “By embedding the services within primary care, it becomes more accessible and less stigmatized.”\u003c/p>\n\u003cp>It’s an idea \u003ca href=\"http://www.healthequityresearch.org/staff.html\">Benjamin Cook\u003c/a>, director of the Health Equity Research Lab and assistant professor at Harvard Medical School, agrees on, but he said increasing access for minorities would require professionals who speak their languages and understand what type of treatment they are open to. Cook was not involved in the study.\u003c/p>\n\u003cp>“(For example) African Americans and Latinos prefer antidepressants less than whites,” Cook said. That might be an underlying reason “not to go for mental health treatment, why they might not stay at treatment for as long.”\u003c/p>\n\u003cp>This integration of services would also benefit patients who are over treated — those who receive antidepressants when they don’t need to. Olfson said many primary care doctors expressed frustrations in finding mental health professionals particularly in small and rural areas, so prescribing antidepressants might become their go-to when they don’t have resources. If there is a mental health professional right in the clinic, patients might get access to more services that a general doctor cannot offer such as counseling and psychotherapy.\u003c/p>\n\u003cp>“Depression really is a serious condition and we’re finding that so many Americans aren’t receiving care,” he said. “I hope that it (this study) brings attention to this situation.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar]\u003c/p>\n\n","blocks":[],"excerpt":"Study shows less than 30 percent of patients diagnosed with depression are treated for it. Furthermore, only 30 percent of those treated for depression actually had it. ","status":"publish","parent":0,"modified":1472577159,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":779},"headData":{"title":"Depression Treatment Often Doesn't Go To Those Most In Need | KQED","description":"Study shows less than 30 percent of patients diagnosed with depression are treated for it. Furthermore, only 30 percent of those treated for depression actually had it. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"230671 http://ww2.kqed.org/stateofhealth/?p=230671","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/08/29/screening-positive-for-depression-doesnt-mean-youll-get-treatment/","disqusTitle":"Depression Treatment Often Doesn't Go To Those Most In Need","nprByline":"\u003cstrong> Zhai Yun Tan \u003c/br> Kaiser Health News \u003c/strong>","path":"/stateofhealth/230671/screening-positive-for-depression-doesnt-mean-youll-get-treatment","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Getting treatment for depression may sometimes be a regular part of health care for the “\u003ca href=\"http://www.npr.org/sections/health-shots/2016/06/30/481766112/how-therapy-became-a-hobby-of-the-wealthy-out-of-reach-for-those-in-need\">worried well\u003c/a>” that leaves those who cannot afford it to suffer by themselves.\u003c/p>\n\u003cp>A \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2546155\">new study\u003c/a> published Monday in JAMA Internal Medicine illustrates that phenomena. Most Americans who screen positive for depression don’t receive treatment — while most who did receive treatment don’t actually have the condition.\u003c/p>\n\u003cp>“Over the last several years there has been an increase in prescription of antidepressants,” said \u003ca href=\"http://profiles.columbiapsychiatry.org/profile/molfson\">Mark Olfson\u003c/a>, professor of psychiatry at the Columbia University Medical Center and lead author of the study. “In that context, many people assumed that under-treatment of depression is no longer a common problem.”\u003c/p>\n\u003cp>But Olfson found the opposite to be true after analyzing data from \u003ca href=\"https://meps.ahrq.gov/mepsweb/\">Medical Expenditure Panel Surveys\u003c/a> in 2012 and 2013 that includes questionnaires screening for depression. Of the 46,417 adults surveyed, 8.4 percent answered in ways that suggested they had depression, but only 28.7 percent of them received any treatment for it.\u003c/p>\n\u003cp>“The findings highlight that there are continuing challenges in aligning depression care with patient needs,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Adults in the lowest income group were five times more likely to be depressed compared with those in the highest income group. But they, along with uninsured adults, racial and ethnic minorities, and men, were also less likely to receive treatment.\u003c/p>\n\u003cp>On the other hand, among the 8.1 percent of adults who received treatment for depression, only 29.9 percent of them had depression and 21.8 percent of them had serious psychological distress. And those with either less serious or no depression were more likely to receive antidepressants. It’s a problem of overprescription, Olfson said, because \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21200071\">studies have shown \u003c/a>that antidepressants are not any more effective for patients with mild depression than a placebo.\u003c/p>\n\u003cp>“Being a little less aggressive in medication in mild depression would be beneficial,” he said. “There are simpler forms of psychological interventions that can be adapted for primary care.”\u003c/p>\n\u003cp>Rather than relying on these drugs, the patients can be given other treatments ranging from counseling and exercise to yoga.\u003c/p>\n\u003cp>In addition, researchers concluded that those with serious psychological distress are more likely to be treated by psychiatrists instead of general medical professionals, but this trend does not translate to older patients, African Americans, the uninsured or those with less education.\u003c/p>\n\u003cp>“Some when they have depression don’t believe they require treatment or that they could benefit from treatment,” Olfson said. “People are visiting doctors but the attention is to current, pressing medical problems.”\u003c/p>\n\u003cp>But these doctor visits can be used as an opportunity for increasing access to treatment for depression to disadvantaged populations. Olfson found that most people with untreated depression make at least one visit to a primary care doctor annually. If depression screening and mental health services can be integrated into primary care, Olfson said, there will be better access and awareness about the illness.\u003c/p>\n\u003cp>“If you give them a referral to a mental health clinic, they simply won’t go if they don’t think they have a mental health disorder,” he said. “By embedding the services within primary care, it becomes more accessible and less stigmatized.”\u003c/p>\n\u003cp>It’s an idea \u003ca href=\"http://www.healthequityresearch.org/staff.html\">Benjamin Cook\u003c/a>, director of the Health Equity Research Lab and assistant professor at Harvard Medical School, agrees on, but he said increasing access for minorities would require professionals who speak their languages and understand what type of treatment they are open to. Cook was not involved in the study.\u003c/p>\n\u003cp>“(For example) African Americans and Latinos prefer antidepressants less than whites,” Cook said. That might be an underlying reason “not to go for mental health treatment, why they might not stay at treatment for as long.”\u003c/p>\n\u003cp>This integration of services would also benefit patients who are over treated — those who receive antidepressants when they don’t need to. Olfson said many primary care doctors expressed frustrations in finding mental health professionals particularly in small and rural areas, so prescribing antidepressants might become their go-to when they don’t have resources. If there is a mental health professional right in the clinic, patients might get access to more services that a general doctor cannot offer such as counseling and psychotherapy.\u003c/p>\n\u003cp>“Depression really is a serious condition and we’re finding that so many Americans aren’t receiving care,” he said. “I hope that it (this study) brings attention to this situation.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar]\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/230671/screening-positive-for-depression-doesnt-mean-youll-get-treatment","authors":["byline_stateofhealth_230671"],"categories":["stateofhealth_12","stateofhealth_2746","stateofhealth_13"],"tags":["stateofhealth_2582","stateofhealth_2808"],"featImg":"stateofhealth_230687","label":"stateofhealth"},"stateofhealth_176688":{"type":"posts","id":"stateofhealth_176688","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"176688","score":null,"sort":[1461620232000]},"guestAuthors":[],"slug":"suicide-rates-climb-in-u-s-especially-among-adolescent-girls","title":"Suicide Rates Climb In U.S., Especially Among Adolescent Girls","publishDate":1461620232,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>In the '80s and '90s, America's suicide trend was headed in the right direction: down.\u003c/p>\n\u003cp>\"It had been decreasing almost steadily since 1986, and then what happened is there was a turnaround,\" says \u003ca href=\"https://www.researchgate.net/profile/Sally_Curtin\" target=\"_blank\">Sally Curtin\u003c/a>, a statistician with the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.\u003c/p>\n\u003caside class=\"pullquote alignright\">Though they make up a very small portion of total suicides, the rate in girls ages 10-14 jumped the most, tripling over 15 years.\u003c/aside>\n\u003cp>The suicide rate has risen by a quarter, to 13 per 100,000 people in 2014 from 10.5 in 1999, according to \u003ca href=\"http://www.cdc.gov/nchs/products/databriefs/db241.htm\" target=\"_blank\">an analysis\u003c/a> by Curtin and her colleagues that was released Friday.\u003c/p>\n\u003cp>She says it's heartbreaking to work with these data. While other causes of death are on the decline, suicide just keeps climbing — and it's doing so for every age group under 75.\u003c/p>\n\u003cp>\"I've been losing sleep over this, quite honestly,\" says Curtin. \"You can't just say it's confined to one age group or another for males and females. Truly at all ages people are at risk for this, and our youngest have some of the highest percent increases.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There is one age group that really stands out — girls between the ages of 10 and 14. Though they make up a very small portion of the total suicides, the rate in that group jumped the most — it experienced the largest percent increase, tripling over 15 years from 0.5 to 1.7 per 100,000 people.\u003c/p>\n\u003cp>And, Curtin points out, in any given year, there are a lot more suicide attempts than there are suicide deaths. \"The deaths are but the tip of the iceberg,\" she says.\u003c/p>\n\u003cp>Until the suicide trend reversed upward, there had been a number of improvements in the past few decades.\u003c/p>\n\u003cp>In the late '80s, things were probably looking up partially due to \u003ca href=\"http://www.ncbi.nlm.nih.gov/books/NBK54346/\" target=\"_blank\">new antidepressants\u003c/a> that were more effective and had fewer side effects, says \u003ca href=\"http://profiles.columbiapsychiatry.org/profile/maoquendo\">Dr. Maria Oquendo\u003c/a>, a psychiatry professor at Columbia University Medical Center and president-elect of the American Psychiatric Association. \"We saw this very encouraging decrease in suicide deaths,\" she says, and the parallel between antidepressant prescription and a decline in suicide was mirrored in \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804897/\">other\u003c/a> countries. \"It was really very remarkable, and somehow that trend toward decreasing suicide rates abruptly stopped in 1999.\"\u003c/p>\n\u003cp>What changed? One possibility is economic stagnation, which left more people out of jobs and probably made it harder for people to access health care and treatment. There was also a switch from the use of cocaine and crack to use of \u003ca href=\"http://www.cdc.gov/vitalsigns/heroin/\" target=\"_blank\">heroin\u003c/a> and prescription \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm\" target=\"_blank\">painkillers\u003c/a>, which can be lethal in case of an overdose.\u003c/p>\n\u003cp>And there's also the matter of health insurance — a lot of people weren't covered or didn't have access to treatment for depression, the most common \u003ca href=\"http://afsp.org/about-suicide/risk-factors-and-warning-signs/\" target=\"_blank\">risk factor\u003c/a> for suicide. (Since 2014, however, the Affordable Care Act has \u003ca href=\"http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/\" target=\"_blank\">led to a substantial increase\u003c/a> in insurance coverage.)\u003c/p>\n\u003cp>\"Now, the other thing that we were anticipating with some dread was the aftermath of the black box on antidepressants,\" says Oquendo, referring to a \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2004/ucm108363.htm\" target=\"_blank\">warning label\u003c/a> that in 2004 the Food and Drug Administration required for commonly prescribed antidepressants.\u003c/p>\n\u003cp>The label says that in people under age 26, the medications can actually increase the risk of suicidal thoughts and actions. Research \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1408480\" target=\"_blank\">has suggested\u003c/a> that the warning scared doctors away from prescribing antidepressants to people of all ages.\u003c/p>\n\u003cp>\"And some of the increment in suicide deaths in the younger populations is potentially linked to an understandable reluctance by physicians who see these youngsters to prescribe antidepressants, even when they're aware that the individual is suffering from depression,\" says Oquendo. Research has shown that the benefits of prescribing antidepressants to mentally ill children tend to \u003ca href=\"http://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/antidepressant-medications-for-children-and-adolescents-information-for-parents-and-caregivers.shtml\" target=\"_blank\">outweigh\u003c/a> the risk of suicidal tendencies.\u003c/p>\n\u003cp>But why such a sharp rise among adolescents, particularly girls? \"We don't know what's going on, to be quite honest,\" says \u003ca href=\"https://www.linkedin.com/in/arielle-h-sheftall-9504bb67\" target=\"_blank\">Arielle Sheftall\u003c/a>, who works at the Center for Suicide Prevention and Research at the Research Institute at Nationwide Children's Hospital in Columbus, Ohio. \"We have thoughts, that maybe it's this, maybe it's that. It's really hard to pinpoint one specific risk factor that really, truly is driving this trend.\"\u003c/p>\n\u003cp>She and her colleagues \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25984947\" target=\"_blank\">study\u003c/a> the risk factors that might push a depressed child or teen to attempt suicide. One \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0193953X08000191\" target=\"_blank\">hypothesis\u003c/a> about what's going on with girls is pretty surprising: earlier puberty.\u003c/p>\n\u003cp>\"It's usually been referred to as the storm-and-stress period of life because there's just a lot of change happening all at one time,\" says Sheftall.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-176694\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM.png\" alt=\"Screen Shot 2016-04-25 at 2.27.51 PM\" width=\"1514\" height=\"1098\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM.png 1514w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-400x290.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-800x580.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-768x557.png 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-1440x1044.png 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-1180x856.png 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-960x696.png 960w\" sizes=\"(max-width: 1514px) 100vw, 1514px\">\u003c/p>\n\u003cp>Boys tend to hit peak puberty around 13 years old, and girls around 11 years old, though some studies show that girls are starting their periods earlier.\u003c/p>\n\u003cp>\"Research has shown that puberty, unfortunately, is associated with the onset of psychological disorders, specifically depression,\" says Sheftall.\u003c/p>\n\u003cp>And depression is a big risk factor for suicidal thoughts and actions. So, because of the shifting age of puberty onset, girls might be opening the door to anxiety, depression and other psychiatric disorders earlier on in life.\u003c/p>\n\u003cp>Sheftall and Oquendo say the hypothesis hasn't been carefully studied, but it's possible. Another potential factor is that girls attempting suicide could be using more lethal methods, resulting in more deaths.\u003c/p>\n\u003cp>\"It's frustrating because you want to never ever see these trends increase,\" says Sheftall. \"That's what we kind of have dedicated our lives and research to: What is causing these increases to occur?\"\u003c/p>\n\u003cp>For now, there are still more questions than answers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>If someone shows the \u003c/em>\u003ca href=\"http://afsp.org/about-suicide/risk-factors-and-warning-signs/\" target=\"_blank\">warning signs\u003c/a>\u003cem> of suicide: Do not leave the person alone, remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt, call the U.S. National Suicide Prevention Lifeline at 1-800-273-TALK (8255), and take the person to an emergency room or seek help from a medical or mental health professional.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Suicide+Rates+Climb+In+U.S.%2C+Especially+Among+Adolescent+Girls&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"After a decline throughout the '90s, suicide rates have reversed course. Suicide has increased in almost every age group over the past 15 years.","status":"publish","parent":0,"modified":1461620365,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1009},"headData":{"title":"Suicide Rates Climb In U.S., Especially Among Adolescent Girls | KQED","description":"After a decline throughout the '90s, suicide rates have reversed course. Suicide has increased in almost every age group over the past 15 years.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"176688 http://ww2.kqed.org/stateofhealth/?p=176688","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/04/25/suicide-rates-climb-in-u-s-especially-among-adolescent-girls/","disqusTitle":"Suicide Rates Climb In U.S., Especially Among Adolescent Girls","nprImageCredit":"Eva Bee","nprByline":"Rae Ellen Bichell","nprImageAgency":"Ikon Images/Getty Images","nprStoryId":"474888854","nprApiLink":"http://api.npr.org/query?id=474888854&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/04/22/474888854/suicide-rates-climb-in-u-s-especially-among-adolescent-girls?ft=nprml&f=474888854","nprRetrievedStory":"1","nprPubDate":"Sun, 24 Apr 2016 08:33:00 -0400","nprStoryDate":"Fri, 22 Apr 2016 00:02:00 -0400","nprLastModifiedDate":"Sun, 24 Apr 2016 08:33:17 -0400","nprAudio":"http://pd.npr.org/anon.npr-mp3/npr/me/2016/04/20160422_me_suicide_rates_climb_in_us_especially_among_adolescent_girls.mp3?orgId=1&topicId=1128&d=229&p=3&story=474888854&t=progseg&e=475226628&seg=7&ft=nprml&f=474888854","nprAudioM3u":"http://api.npr.org/m3u/1475228397-c4b6d7.m3u?orgId=1&topicId=1128&d=229&p=3&story=474888854&t=progseg&e=475226628&seg=7&ft=nprml&f=474888854","path":"/stateofhealth/176688/suicide-rates-climb-in-u-s-especially-among-adolescent-girls","audioUrl":"http://pd.npr.org/anon.npr-mp3/npr/me/2016/04/20160422_me_suicide_rates_climb_in_us_especially_among_adolescent_girls.mp3?orgId=1&topicId=1128&d=229&p=3&story=474888854&t=progseg&e=475226628&seg=7&ft=nprml&f=474888854","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In the '80s and '90s, America's suicide trend was headed in the right direction: down.\u003c/p>\n\u003cp>\"It had been decreasing almost steadily since 1986, and then what happened is there was a turnaround,\" says \u003ca href=\"https://www.researchgate.net/profile/Sally_Curtin\" target=\"_blank\">Sally Curtin\u003c/a>, a statistician with the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.\u003c/p>\n\u003caside class=\"pullquote alignright\">Though they make up a very small portion of total suicides, the rate in girls ages 10-14 jumped the most, tripling over 15 years.\u003c/aside>\n\u003cp>The suicide rate has risen by a quarter, to 13 per 100,000 people in 2014 from 10.5 in 1999, according to \u003ca href=\"http://www.cdc.gov/nchs/products/databriefs/db241.htm\" target=\"_blank\">an analysis\u003c/a> by Curtin and her colleagues that was released Friday.\u003c/p>\n\u003cp>She says it's heartbreaking to work with these data. While other causes of death are on the decline, suicide just keeps climbing — and it's doing so for every age group under 75.\u003c/p>\n\u003cp>\"I've been losing sleep over this, quite honestly,\" says Curtin. \"You can't just say it's confined to one age group or another for males and females. Truly at all ages people are at risk for this, and our youngest have some of the highest percent increases.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There is one age group that really stands out — girls between the ages of 10 and 14. Though they make up a very small portion of the total suicides, the rate in that group jumped the most — it experienced the largest percent increase, tripling over 15 years from 0.5 to 1.7 per 100,000 people.\u003c/p>\n\u003cp>And, Curtin points out, in any given year, there are a lot more suicide attempts than there are suicide deaths. \"The deaths are but the tip of the iceberg,\" she says.\u003c/p>\n\u003cp>Until the suicide trend reversed upward, there had been a number of improvements in the past few decades.\u003c/p>\n\u003cp>In the late '80s, things were probably looking up partially due to \u003ca href=\"http://www.ncbi.nlm.nih.gov/books/NBK54346/\" target=\"_blank\">new antidepressants\u003c/a> that were more effective and had fewer side effects, says \u003ca href=\"http://profiles.columbiapsychiatry.org/profile/maoquendo\">Dr. Maria Oquendo\u003c/a>, a psychiatry professor at Columbia University Medical Center and president-elect of the American Psychiatric Association. \"We saw this very encouraging decrease in suicide deaths,\" she says, and the parallel between antidepressant prescription and a decline in suicide was mirrored in \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804897/\">other\u003c/a> countries. \"It was really very remarkable, and somehow that trend toward decreasing suicide rates abruptly stopped in 1999.\"\u003c/p>\n\u003cp>What changed? One possibility is economic stagnation, which left more people out of jobs and probably made it harder for people to access health care and treatment. There was also a switch from the use of cocaine and crack to use of \u003ca href=\"http://www.cdc.gov/vitalsigns/heroin/\" target=\"_blank\">heroin\u003c/a> and prescription \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm\" target=\"_blank\">painkillers\u003c/a>, which can be lethal in case of an overdose.\u003c/p>\n\u003cp>And there's also the matter of health insurance — a lot of people weren't covered or didn't have access to treatment for depression, the most common \u003ca href=\"http://afsp.org/about-suicide/risk-factors-and-warning-signs/\" target=\"_blank\">risk factor\u003c/a> for suicide. (Since 2014, however, the Affordable Care Act has \u003ca href=\"http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/\" target=\"_blank\">led to a substantial increase\u003c/a> in insurance coverage.)\u003c/p>\n\u003cp>\"Now, the other thing that we were anticipating with some dread was the aftermath of the black box on antidepressants,\" says Oquendo, referring to a \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2004/ucm108363.htm\" target=\"_blank\">warning label\u003c/a> that in 2004 the Food and Drug Administration required for commonly prescribed antidepressants.\u003c/p>\n\u003cp>The label says that in people under age 26, the medications can actually increase the risk of suicidal thoughts and actions. Research \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1408480\" target=\"_blank\">has suggested\u003c/a> that the warning scared doctors away from prescribing antidepressants to people of all ages.\u003c/p>\n\u003cp>\"And some of the increment in suicide deaths in the younger populations is potentially linked to an understandable reluctance by physicians who see these youngsters to prescribe antidepressants, even when they're aware that the individual is suffering from depression,\" says Oquendo. Research has shown that the benefits of prescribing antidepressants to mentally ill children tend to \u003ca href=\"http://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/antidepressant-medications-for-children-and-adolescents-information-for-parents-and-caregivers.shtml\" target=\"_blank\">outweigh\u003c/a> the risk of suicidal tendencies.\u003c/p>\n\u003cp>But why such a sharp rise among adolescents, particularly girls? \"We don't know what's going on, to be quite honest,\" says \u003ca href=\"https://www.linkedin.com/in/arielle-h-sheftall-9504bb67\" target=\"_blank\">Arielle Sheftall\u003c/a>, who works at the Center for Suicide Prevention and Research at the Research Institute at Nationwide Children's Hospital in Columbus, Ohio. \"We have thoughts, that maybe it's this, maybe it's that. It's really hard to pinpoint one specific risk factor that really, truly is driving this trend.\"\u003c/p>\n\u003cp>She and her colleagues \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25984947\" target=\"_blank\">study\u003c/a> the risk factors that might push a depressed child or teen to attempt suicide. One \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0193953X08000191\" target=\"_blank\">hypothesis\u003c/a> about what's going on with girls is pretty surprising: earlier puberty.\u003c/p>\n\u003cp>\"It's usually been referred to as the storm-and-stress period of life because there's just a lot of change happening all at one time,\" says Sheftall.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-176694\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM.png\" alt=\"Screen Shot 2016-04-25 at 2.27.51 PM\" width=\"1514\" height=\"1098\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM.png 1514w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-400x290.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-800x580.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-768x557.png 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-1440x1044.png 1440w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-1180x856.png 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/Screen-Shot-2016-04-25-at-2.27.51-PM-960x696.png 960w\" sizes=\"(max-width: 1514px) 100vw, 1514px\">\u003c/p>\n\u003cp>Boys tend to hit peak puberty around 13 years old, and girls around 11 years old, though some studies show that girls are starting their periods earlier.\u003c/p>\n\u003cp>\"Research has shown that puberty, unfortunately, is associated with the onset of psychological disorders, specifically depression,\" says Sheftall.\u003c/p>\n\u003cp>And depression is a big risk factor for suicidal thoughts and actions. So, because of the shifting age of puberty onset, girls might be opening the door to anxiety, depression and other psychiatric disorders earlier on in life.\u003c/p>\n\u003cp>Sheftall and Oquendo say the hypothesis hasn't been carefully studied, but it's possible. Another potential factor is that girls attempting suicide could be using more lethal methods, resulting in more deaths.\u003c/p>\n\u003cp>\"It's frustrating because you want to never ever see these trends increase,\" says Sheftall. \"That's what we kind of have dedicated our lives and research to: What is causing these increases to occur?\"\u003c/p>\n\u003cp>For now, there are still more questions than answers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>If someone shows the \u003c/em>\u003ca href=\"http://afsp.org/about-suicide/risk-factors-and-warning-signs/\" target=\"_blank\">warning signs\u003c/a>\u003cem> of suicide: Do not leave the person alone, remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt, call the U.S. National Suicide Prevention Lifeline at 1-800-273-TALK (8255), and take the person to an emergency room or seek help from a medical or mental health professional.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Suicide+Rates+Climb+In+U.S.%2C+Especially+Among+Adolescent+Girls&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/176688/suicide-rates-climb-in-u-s-especially-among-adolescent-girls","authors":["byline_stateofhealth_176688"],"categories":["stateofhealth_2746"],"tags":["stateofhealth_2615","stateofhealth_2582","stateofhealth_68","stateofhealth_112"],"featImg":"stateofhealth_176689","label":"stateofhealth"},"stateofhealth_123539":{"type":"posts","id":"stateofhealth_123539","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"123539","score":null,"sort":[1450122234000]},"guestAuthors":[],"slug":"a-new-study-raises-old-questions-about-antidepressants-and-autism","title":"A New Study Raises Old Questions About Antidepressants And Autism","publishDate":1450122234,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Taking antidepressants during the second or third trimester of pregnancy may increase the risk of having a child with autism spectrum disorder, according to a study of Canadian mothers and children published Monday in JAMA Pediatrics.\u003c/p>\n\u003cp>But scientists not involved in the research say the results are hard to interpret and don't settle the long-running debate about whether expectant mothers with depression should take antidepressants.\u003c/p>\n\u003cp>\"This study doesn't answer the question,\" says \u003ca href=\"https://depts.washington.edu/chdd/iddrc/res_aff/king.html\" target=\"_blank\">Bryan King\u003c/a>, program director of the autism center at Seattle Children's Hospital and a professor of psychiatry and behavioral sciences at the University of Washington. \"My biggest concern is that it will be over-interpreted,\" says King, who wrote an \u003ca href=\"http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/jamapediatrics.2015.3356\" target=\"_blank\">editorial\u003c/a> that accompanied the study.\u003c/p>\n\u003cp>[contextly_sidebar id=\"ONRQqYisGaSBHQw05Fp9AlZXivzN4qqx\"]\"It kind of leaves you more confused,\" says \u003ca href=\"http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=asb11&DepAffil=Psychiatry\" target=\"_blank\">Alan Brown\u003c/a>, a professor of psychiatry and epidemiology at Columbia University who studies risk factors for autism. \"Mothers shouldn't get super worried about it,\" he says.\u003c/p>\n\u003cp>One reason it's confusing is that there's strong evidence that mothers with depression are more likely than other women to have a child with autism, whether or not they take antidepressants during pregnancy. King and Brown say that makes it very hard to disentangle the effects of depression itself from those of the drugs used to treat it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Earlier this year, a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/?term=Clements+Perlin+Autism+antidepressant\" target=\"_blank\">study\u003c/a> of several thousand U.S. children found that prenatal antidepressant exposure did not increase the risk of autism spectrum disorder. In 2013, a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24255601\" target=\"_blank\">study\u003c/a> of nearly 670,000 Danish children also found no association between prenatal exposure to antidepressant medication and autism spectrum disorder.\u003c/p>\n\u003cp>But a 2013 \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/?term=Rai+BMJ+autism+antidepressant\" target=\"_blank\">study\u003c/a> of more than 4,400 Swedish children concluded that in utero exposure did increase the risk that a child would develop autism. And a 2011 \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21727247\" target=\"_blank\">study\u003c/a> of about 300 children with autism in California concluded that antidepressants \"may modestly increase the risk\" of an autism spectrum disorder.\u003c/p>\n\u003cp>The Canadian \u003ca href=\"http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/jamapediatrics.2015.3356\" target=\"_blank\">study \u003c/a>looked at more than 145,000 children born in Quebec from 1998 to 2009. It found that children whose mothers took antidepressants during the second or third trimester of pregnancy were 87 percent more likely to be diagnosed with autism spectrum disorder.\u003c/p>\n\u003cp>[contextly_sidebar id=\"oo6VpLDe5DAc6MqxeIYOUn3R0qAoB7zr\"]The study tried to account for depression's effect on risk by identifying mothers with a history of psychiatric disorders. It also compared mothers who stopped taking antidepressants during the first trimester with mothers who continued taking the medications.\u003c/p>\n\u003cp>Those steps allowed the team to conclude that the 87 percent increase was \"above and beyond\" the risk posed by depression itself, says \u003ca href=\"http://pharm.umontreal.ca/faculte/lequipe/corps-professoral/fiche/anick-berard/\" target=\"_blank\">Anick Berard\u003c/a>, the study's senior author and an epidemiologist and biostatistician at the University of Montreal. Berard has done other studies that linked antidepressants to birth defects and has worked as a consultant for plaintiffs who are suing companies that make antidepressants.\u003c/p>\n\u003cp>Other scientists aren't so sure that Berard's study truly shows a risk associated with antidepressant use. Mothers who kept taking antidepressants may have had more severe depression, they say. Also, they say, the increase in risk was so small that it might have been a chance finding.\u003c/p>\n\u003cp>An 87 percent increase \"sounds very concerning,\" King says. But the figure is based on just 31 children who developed autism after being exposed to antidepressants. And many of these children would have developed autism anyway, he says.\u003c/p>\n\u003cp>The absolute risk numbers are small, Berard says. But she says a secondary analysis showed that the risk was highest for women who took drugs called SSRIs, which affect serotonin levels. And serotonin plays an important role in brain development, she says. The number of women using only other types of antidepressants was very small, so it was impossible to draw conclusions about their safety.\u003c/p>\n\u003cp>\"We have to be vigilant, even if the risk is small,\" Berard says. \"Maybe we should rethink our treatment process.\"\u003c/p>\n\u003cp>King responds that untreated depression can result in poor nutrition, sleep problems and stress, all of which can affect the health of a developing fetus. So pregnant women who are concerned about taking antidepressants should consult with their doctor before taking any action, he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Better information about the risks of antidepressants and other factors may emerge from a large, ongoing \u003ca href=\"https://projectreporter.nih.gov/project_info_description.cfm?aid=8960823&icde=27426089&ddparam=&ddvalue=&ddsub=&cr=1&csb=default&cs=ASC\" target=\"_blank\">study\u003c/a> of children born in Finland, says Brown, who is the study's principal investigator. Those results may be available in the next few years.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+New+Study+Raises+Old+Questions+About+Antidepressants+And+Autism&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"A study finds that taking antidepressants while pregnant may increase a child's risk of autism. But is the real culprit depression itself?","status":"publish","parent":0,"modified":1450153742,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":743},"headData":{"title":"A New Study Raises Old Questions About Antidepressants And Autism | KQED","description":"A study finds that taking antidepressants while pregnant may increase a child's risk of autism. But is the real culprit depression itself?","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"123539 http://ww2.kqed.org/stateofhealth/?p=123539","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/12/14/a-new-study-raises-old-questions-about-antidepressants-and-autism/","disqusTitle":"A New Study Raises Old Questions About Antidepressants And Autism","source":"NPR","sourceUrl":"http://www.npr.org/sections/health-shots/2015/12/14/459665937/a-new-study-raises-old-questions-about-antidepressants-and-autism","nprImageCredit":"Adam Hester","nprByline":"Jon Hamilton","nprImageAgency":"Getty Images/Blend Images","nprStoryId":"459665937","nprApiLink":"http://api.npr.org/query?id=459665937&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/12/14/459665937/a-new-study-raises-old-questions-about-antidepressants-and-autism?ft=nprml&f=459665937","nprRetrievedStory":"1","nprPubDate":"Mon, 14 Dec 2015 12:52:00 -0500","nprStoryDate":"Mon, 14 Dec 2015 11:03:00 -0500","nprLastModifiedDate":"Mon, 14 Dec 2015 12:52:58 -0500","path":"/stateofhealth/123539/a-new-study-raises-old-questions-about-antidepressants-and-autism","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Taking antidepressants during the second or third trimester of pregnancy may increase the risk of having a child with autism spectrum disorder, according to a study of Canadian mothers and children published Monday in JAMA Pediatrics.\u003c/p>\n\u003cp>But scientists not involved in the research say the results are hard to interpret and don't settle the long-running debate about whether expectant mothers with depression should take antidepressants.\u003c/p>\n\u003cp>\"This study doesn't answer the question,\" says \u003ca href=\"https://depts.washington.edu/chdd/iddrc/res_aff/king.html\" target=\"_blank\">Bryan King\u003c/a>, program director of the autism center at Seattle Children's Hospital and a professor of psychiatry and behavioral sciences at the University of Washington. \"My biggest concern is that it will be over-interpreted,\" says King, who wrote an \u003ca href=\"http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/jamapediatrics.2015.3356\" target=\"_blank\">editorial\u003c/a> that accompanied the study.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"It kind of leaves you more confused,\" says \u003ca href=\"http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=asb11&DepAffil=Psychiatry\" target=\"_blank\">Alan Brown\u003c/a>, a professor of psychiatry and epidemiology at Columbia University who studies risk factors for autism. \"Mothers shouldn't get super worried about it,\" he says.\u003c/p>\n\u003cp>One reason it's confusing is that there's strong evidence that mothers with depression are more likely than other women to have a child with autism, whether or not they take antidepressants during pregnancy. King and Brown say that makes it very hard to disentangle the effects of depression itself from those of the drugs used to treat it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Earlier this year, a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/?term=Clements+Perlin+Autism+antidepressant\" target=\"_blank\">study\u003c/a> of several thousand U.S. children found that prenatal antidepressant exposure did not increase the risk of autism spectrum disorder. In 2013, a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24255601\" target=\"_blank\">study\u003c/a> of nearly 670,000 Danish children also found no association between prenatal exposure to antidepressant medication and autism spectrum disorder.\u003c/p>\n\u003cp>But a 2013 \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/?term=Rai+BMJ+autism+antidepressant\" target=\"_blank\">study\u003c/a> of more than 4,400 Swedish children concluded that in utero exposure did increase the risk that a child would develop autism. And a 2011 \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21727247\" target=\"_blank\">study\u003c/a> of about 300 children with autism in California concluded that antidepressants \"may modestly increase the risk\" of an autism spectrum disorder.\u003c/p>\n\u003cp>The Canadian \u003ca href=\"http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/jamapediatrics.2015.3356\" target=\"_blank\">study \u003c/a>looked at more than 145,000 children born in Quebec from 1998 to 2009. It found that children whose mothers took antidepressants during the second or third trimester of pregnancy were 87 percent more likely to be diagnosed with autism spectrum disorder.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The study tried to account for depression's effect on risk by identifying mothers with a history of psychiatric disorders. It also compared mothers who stopped taking antidepressants during the first trimester with mothers who continued taking the medications.\u003c/p>\n\u003cp>Those steps allowed the team to conclude that the 87 percent increase was \"above and beyond\" the risk posed by depression itself, says \u003ca href=\"http://pharm.umontreal.ca/faculte/lequipe/corps-professoral/fiche/anick-berard/\" target=\"_blank\">Anick Berard\u003c/a>, the study's senior author and an epidemiologist and biostatistician at the University of Montreal. Berard has done other studies that linked antidepressants to birth defects and has worked as a consultant for plaintiffs who are suing companies that make antidepressants.\u003c/p>\n\u003cp>Other scientists aren't so sure that Berard's study truly shows a risk associated with antidepressant use. Mothers who kept taking antidepressants may have had more severe depression, they say. Also, they say, the increase in risk was so small that it might have been a chance finding.\u003c/p>\n\u003cp>An 87 percent increase \"sounds very concerning,\" King says. But the figure is based on just 31 children who developed autism after being exposed to antidepressants. And many of these children would have developed autism anyway, he says.\u003c/p>\n\u003cp>The absolute risk numbers are small, Berard says. But she says a secondary analysis showed that the risk was highest for women who took drugs called SSRIs, which affect serotonin levels. And serotonin plays an important role in brain development, she says. The number of women using only other types of antidepressants was very small, so it was impossible to draw conclusions about their safety.\u003c/p>\n\u003cp>\"We have to be vigilant, even if the risk is small,\" Berard says. \"Maybe we should rethink our treatment process.\"\u003c/p>\n\u003cp>King responds that untreated depression can result in poor nutrition, sleep problems and stress, all of which can affect the health of a developing fetus. So pregnant women who are concerned about taking antidepressants should consult with their doctor before taking any action, he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Better information about the risks of antidepressants and other factors may emerge from a large, ongoing \u003ca href=\"https://projectreporter.nih.gov/project_info_description.cfm?aid=8960823&icde=27426089&ddparam=&ddvalue=&ddsub=&cr=1&csb=default&cs=ASC\" target=\"_blank\">study\u003c/a> of children born in Finland, says Brown, who is the study's principal investigator. Those results may be available in the next few years.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+New+Study+Raises+Old+Questions+About+Antidepressants+And+Autism&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/123539/a-new-study-raises-old-questions-about-antidepressants-and-autism","authors":["byline_stateofhealth_123539"],"categories":["stateofhealth_13"],"tags":["stateofhealth_155","stateofhealth_2582"],"featImg":"stateofhealth_123540","label":"source_stateofhealth_123539"},"stateofhealth_107020":{"type":"posts","id":"stateofhealth_107020","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"107020","score":null,"sort":[1447348074000]},"guestAuthors":[],"slug":"depressed-look-for-help-from-a-human-not-a-computer","title":"Depressed? Look For Help From A Human, Not A Computer","publishDate":1447348074,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Almost 8 percent of Americans 12 and older dealt with depression at some point between 2009 and 2012. With that many of us feeling blue, wouldn't it be nice if we could simply hop on the computer in our pajamas, without any of the stigma of asking for help, and find real relief?\u003c/p>\n\u003caside class=\"pullquote alignright\">\n\"It's an important, cautionary note that we shouldn't get too carried away with the idea that a computer system can replace doctors and therapists.\"\u003cbr>\n\u003ccite>Dr. Christopher Dowrick, University of Liverpool \u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Online programs to fight depression are already commercially available, and while they sound efficient and cost-saving, a study out of the U.K. reports that they're not effective, primarily because depressed patients aren't likely to engage with them or stick with them.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.bmj.com/cgi/doi/10.1136/bmj.h5627\" target=\"_blank\">study\u003c/a>, which was published in \u003cem>The BMJ\u003c/em> on Wednesday, looked at computer-assisted cognitive behavioral therapy and found that it was no more effective in treating depression than the usual care patients receive from a primary care doctor.\u003c/p>\n\u003cp>Traditional cognitive behavioral therapy (CBT) is considered an effective form of talk therapy for depression, helping people challenge negative thoughts and change the way they think in order to change their mood and behaviors. Online CBT programs have been \u003ca href=\"http://opinionator.blogs.nytimes.com/2015/06/19/depressed-try-therapy-without-the-therapist/\" target=\"_blank\">gaining popularity\u003c/a>, with the allure of providing low-cost help wherever someone has access to a computer.\u003c/p>\n\u003cp>A team of researchers from the University of York conducted a randomized control trial with 691 depressed patients from 83 physician practices across England. The patients were split into three groups: one group received only usual care from a physician while the other two groups received usual care from a physician plus one of two computerized CBT programs, either \"Beating the Blues\" or \"MoodGYM.\" Participants were balanced across the three groups for age, sex, educational background, severity and duration of depression, and use of antidepressants.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>After four months, the patients using the computerized CBT programs, or cCBT, had no improvement in depression levels over the patients who were only getting usual care from their doctors. \"Uptake and use of cCBT was low, despite regular telephone support,\" the study authors wrote. Almost a quarter of participants dropped out within four months, and patients noted the \"difficulty in repeatedly logging on to computer systems when they are clinically depressed.\"\u003c/p>\n\u003cp>\"It's an important, cautionary note that we shouldn't get too carried away with the idea that a computer system can replace doctors and therapists,\" says \u003ca href=\"https://www.liv.ac.uk/psychology-health-and-society/staff/christopher-dowrick/\" target=\"_blank\">Christopher Dowrick\u003c/a>, a professor of primary medical care at the University of Liverpool, who wrote an accompanying \u003ca href=\"http://www.bmj.com/content/351/bmj.h5942\" target=\"_blank\">editorial\u003c/a>. \"We do still need the human touch or the human interaction, particularly when people are depressed.\"\u003c/p>\n\u003cp>The lack of patient engagement in this study means these programs aren't the panacea that busy doctors and cost-conscious health care officials might be hoping for, Dowrick wrote in the editorial. Yet it's important to note that the study was conducted in a primary care setting, he says, because many other studies on cCBT that show some benefit have been conducted in psychological settings, where patients might be more motivated to engage with these kinds of online programs.\u003c/p>\n\u003cp>Despite the unenthusiastic findings of the study, Dowrick says that do-it-yourself treatments like cCBT can still be effective. But they're more likely to succeed when people have relatively mild symptoms of depression or are in a recovery stage – the participants in this study were mostly in the category of moderate to severe depression, he says. Computerized CBT is also more likely to succeed, he adds, if the patients are open to seeking help on a computer and when they have a \"reasonable amount\" of guidance as they go through the program, preferably from a therapist. In this study, he says, participants each totaled roughly six minutes of telephone support and guidance.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Being depressed can mean feeling \"lost in your own little small, negative, dark world,\" Dowrick says. Having a person, instead of a computer, reach out to you is particularly important in combating that sense of isolation. \"When you're emotionally vulnerable, you're even more in need of a caring human being,\" he says.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">http://www.kaiserhealthnews.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Depressed%3F+Look+For+Help+From+A+Human%2C+Not+A+Computer&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n","blocks":[],"excerpt":"Researchers asked people with depression to use an online cognitive behavioral therapy program at home. It helped no more than primary care visits. Most said they were too depressed to use it.","status":"publish","parent":0,"modified":1447351660,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":12,"wordCount":710},"headData":{"title":"Depressed? Look For Help From A Human, Not A Computer | KQED","description":"Researchers asked people with depression to use an online cognitive behavioral therapy program at home. It helped no more than primary care visits. Most said they were too depressed to use it.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"107020 http://ww2.kqed.org/stateofhealth/?p=107020","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/11/12/depressed-look-for-help-from-a-human-not-a-computer/","disqusTitle":"Depressed? Look For Help From A Human, Not A Computer","source":"Kaiser Health News","sourceUrl":"http://khn.org","nprByline":"Lynne Shallcross","nprStoryId":"455743090","nprApiLink":"http://api.npr.org/query?id=455743090&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/11/12/455743090/depressed-look-for-help-from-a-human-not-a-computer?ft=nprml&f=455743090","nprRetrievedStory":"1","nprPubDate":"Thu, 12 Nov 2015 10:24:00 -0500","nprStoryDate":"Thu, 12 Nov 2015 10:24:00 -0500","nprLastModifiedDate":"Thu, 12 Nov 2015 10:26:36 -0500","path":"/stateofhealth/107020/depressed-look-for-help-from-a-human-not-a-computer","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Almost 8 percent of Americans 12 and older dealt with depression at some point between 2009 and 2012. With that many of us feeling blue, wouldn't it be nice if we could simply hop on the computer in our pajamas, without any of the stigma of asking for help, and find real relief?\u003c/p>\n\u003caside class=\"pullquote alignright\">\n\"It's an important, cautionary note that we shouldn't get too carried away with the idea that a computer system can replace doctors and therapists.\"\u003cbr>\n\u003ccite>Dr. Christopher Dowrick, University of Liverpool \u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Online programs to fight depression are already commercially available, and while they sound efficient and cost-saving, a study out of the U.K. reports that they're not effective, primarily because depressed patients aren't likely to engage with them or stick with them.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.bmj.com/cgi/doi/10.1136/bmj.h5627\" target=\"_blank\">study\u003c/a>, which was published in \u003cem>The BMJ\u003c/em> on Wednesday, looked at computer-assisted cognitive behavioral therapy and found that it was no more effective in treating depression than the usual care patients receive from a primary care doctor.\u003c/p>\n\u003cp>Traditional cognitive behavioral therapy (CBT) is considered an effective form of talk therapy for depression, helping people challenge negative thoughts and change the way they think in order to change their mood and behaviors. Online CBT programs have been \u003ca href=\"http://opinionator.blogs.nytimes.com/2015/06/19/depressed-try-therapy-without-the-therapist/\" target=\"_blank\">gaining popularity\u003c/a>, with the allure of providing low-cost help wherever someone has access to a computer.\u003c/p>\n\u003cp>A team of researchers from the University of York conducted a randomized control trial with 691 depressed patients from 83 physician practices across England. The patients were split into three groups: one group received only usual care from a physician while the other two groups received usual care from a physician plus one of two computerized CBT programs, either \"Beating the Blues\" or \"MoodGYM.\" Participants were balanced across the three groups for age, sex, educational background, severity and duration of depression, and use of antidepressants.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>After four months, the patients using the computerized CBT programs, or cCBT, had no improvement in depression levels over the patients who were only getting usual care from their doctors. \"Uptake and use of cCBT was low, despite regular telephone support,\" the study authors wrote. Almost a quarter of participants dropped out within four months, and patients noted the \"difficulty in repeatedly logging on to computer systems when they are clinically depressed.\"\u003c/p>\n\u003cp>\"It's an important, cautionary note that we shouldn't get too carried away with the idea that a computer system can replace doctors and therapists,\" says \u003ca href=\"https://www.liv.ac.uk/psychology-health-and-society/staff/christopher-dowrick/\" target=\"_blank\">Christopher Dowrick\u003c/a>, a professor of primary medical care at the University of Liverpool, who wrote an accompanying \u003ca href=\"http://www.bmj.com/content/351/bmj.h5942\" target=\"_blank\">editorial\u003c/a>. \"We do still need the human touch or the human interaction, particularly when people are depressed.\"\u003c/p>\n\u003cp>The lack of patient engagement in this study means these programs aren't the panacea that busy doctors and cost-conscious health care officials might be hoping for, Dowrick wrote in the editorial. Yet it's important to note that the study was conducted in a primary care setting, he says, because many other studies on cCBT that show some benefit have been conducted in psychological settings, where patients might be more motivated to engage with these kinds of online programs.\u003c/p>\n\u003cp>Despite the unenthusiastic findings of the study, Dowrick says that do-it-yourself treatments like cCBT can still be effective. But they're more likely to succeed when people have relatively mild symptoms of depression or are in a recovery stage – the participants in this study were mostly in the category of moderate to severe depression, he says. Computerized CBT is also more likely to succeed, he adds, if the patients are open to seeking help on a computer and when they have a \"reasonable amount\" of guidance as they go through the program, preferably from a therapist. In this study, he says, participants each totaled roughly six minutes of telephone support and guidance.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Being depressed can mean feeling \"lost in your own little small, negative, dark world,\" Dowrick says. Having a person, instead of a computer, reach out to you is particularly important in combating that sense of isolation. \"When you're emotionally vulnerable, you're even more in need of a caring human being,\" he says.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">http://www.kaiserhealthnews.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Depressed%3F+Look+For+Help+From+A+Human%2C+Not+A+Computer&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/107020/depressed-look-for-help-from-a-human-not-a-computer","authors":["byline_stateofhealth_107020"],"categories":["stateofhealth_2407","stateofhealth_13"],"tags":["stateofhealth_2582","stateofhealth_68"],"featImg":"stateofhealth_107021","label":"source_stateofhealth_107020"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2023/08/possible-5gxfizEbKOJ-pbF5ASgxrs_.1400x1400.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2021/10/ATC_1400.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://ww2.kqed.org/news/wp-content/uploads/sites/10/powerpress/1440_0018_AmericanSuburb_iTunesTile_01.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://ww2.kqed.org/news/wp-content/uploads/sites/10/powerpress/1440_0017_BayCurious_iTunesTile_01.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://ww2.kqed.org/app/uploads/2021/10/BBC_1400.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2021/12/CodeSwitchLifeKit_StationGraphics_300x300EmailGraphic.png","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2019/07/commonwealthclub.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. Plus, KQED’s Bianca Taylor brings you the local KQED news you need to know.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2022/02/Consider-This_3000_V3-copy-scaled-1.jpg","imageAlt":"Consider This from NPR and KQED","officialWebsiteLink":"/podcasts/considerthis","meta":{"site":"news","source":"kqed","order":"7"},"link":"/podcasts/considerthis","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1503226625?mt=2&at=11l79Y&ct=nprdirectory","npr":"https://rpb3r.app.goo.gl/coronavirusdaily","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM1NS9wb2RjYXN0LnhtbA","spotify":"https://open.spotify.com/show/3Z6JdCS2d0eFEpXHKI6WqH"}},"forum":{"id":"forum","title":"Forum","tagline":"The conversation starts here","info":"KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.","airtime":"MON-FRI 9am-11am, 10pm-11pm","imageSrc":"https://ww2.kqed.org/app/uploads/2022/06/forum-logo-900x900tile-1.gif","imageAlt":"KQED Forum with Mina Kim and Alexis Madrigal","officialWebsiteLink":"/forum","meta":{"site":"news","source":"kqed","order":"8"},"link":"/forum","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz","npr":"https://www.npr.org/podcasts/432307980/forum","stitcher":"https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast","rss":"https://feeds.megaphone.fm/KQINC9557381633"}},"freakonomics-radio":{"id":"freakonomics-radio","title":"Freakonomics Radio","info":"Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. 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