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Nearly one in five Americans, or 45 million adults, experienced some form of mental illness last year, according to a major US government survey published on Friday.
The 18-25 age group reported the most mental illness, and more women than men were afflicted, said Peter Delany, a doctor who heads behavioral research at the Substance Abuse and Mental Health Services Administration.
“One in five people have suffered from a mental illness in the past year. That is a lot of people,” Delany told AFP.
About one in 20 individuals, or around 4.8 percent of the population, met the criteria for having a serious mental illness.
The study defined mental illness as “a diagnosable mental, behavioral, or emotional disorder in the past year, regardless of their level of functional impairment.”
A vast number of conditions could fall under that category, including anorexia, bulimia, bipolar disorder, kleptomania, depression, obsessive compulsive disorder, voyeurism, pathological gambling or insomnia.
Some of the same disorders could also land a person onto the “severe mental illness” side if he or she experienced the effects to such a degree that they caused a major disruption to daily life.
Mental illness was classified as severe when it “resulted in serious functional impairment, which substantially interferes with or limits one or more major life activities.”
Severe mental illness would typically interrupt a person’s life for at least two weeks and could include bipolar episodes, psychosis and attempted suicide as well as more extreme mood or eating disorders.
Delany described as “significant” the findings that a full 30 percent of the 18-25 age group reported suffering some form of mental illness in the survey, which was carried out in 2009.
“These are the people that are going to college. These are the people that are going into the workforce. These are the individuals that are getting married and starting families,” said Delany.
“In many cases, all of these groups aren’t really getting significant help.”
Women were more likely to have experienced mental illness, with 23.8 percent of women reporting such disorders compared to 15.6 percent of men.
Delany said the survey did not go into the causes of mental illness, but that the male-female findings were consistent with the bulk of clinical research today.
The annual survey is the largest of its kind undertaken by the US government.
Researchers obtain the results by visiting residences door-to-door and handing people a small audio-CASI computer and headphone set with which they can privately answer the survey.
Delany said the research compiled responses from 68,000 people aged 12 and older who were not living in institutions, jails or on the street, and were not members of the US military.
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Examining data on drug prescriptions to more than 5 million Americans over six months, the researchers found that just over 3 percent were filled but not picked up from the pharmacy.
Although that overall figure is low, the results suggest that such prescription “abandonment” contributes to the larger problem of patients’ non-adherence to their medication regimens.
“I’d say it’s a small but meaningful contribution,” said lead researcher Dr. William H. Shrank, of Harvard Medical School and Brigham and Women’s Hospital in Boston. That’s partly because certain patients had increased odds of not picking up their prescriptions, Shrank noted in an interview.
He and his colleagues found that those prescribed drugs with higher price tags were more likely to leave the medications unclaimed at the pharmacy, as were those receiving first-time prescriptions for a particular type of medication.
And that, Shrank said, points to areas where there is room for improvement. A number of studies have shown that people with chronic health problems, including high blood pressure, diabetes and heart disease, commonly fail to take their prescription medications as prescribed.
To find out why, Shrank’s team wanted to look at one aspect of the larger picture: how often patients simply never pick up their prescriptions from the pharmacy. Their study, published in the Annals of Internal Medicine, also looked for clues that might explain the patients’ behavior and flag problems that doctors and pharmacists could address.
The researchers used data from CVS Caremark, a national retail pharmacy chain and pharmacy benefits manager that also funded the study. They focused on 10.3 million prescriptions filled by more than 5 million patients in 2008.
Of those prescriptions, 3.3 percent were abandoned — meaning the medication was bottled but returned to stock when the patient did not pick it up after two weeks.
Not all those patients necessarily went untreated. In just under half of cases, the patient bought a prescription for another medication in the same drug class within 30 days, sometimes at a different pharmacy.
But 1.8 percent of all drugs prescriptions were returned to stock and apparently not replaced with an alternative.
Certain prescriptions had a higher likelihood of not being picked up: New prescriptions were nearly three times as likely as others to go unclaimed, for instance. Patients with complex prescription regimens for multiple health problems were more likely to abandon one or more of their medications.
And prescriptions for opiate drugs were least likely to be abandoned — perhaps because patients’ need for painkillers is more acute, the authors speculate, or the drugs’ potential for resale is greater.
The strongest predictor of prescription abandonment, however, was price: Drugs that cost more than $50, and those with a co-payment of $40 to $50, were three to five times more likely to go unclaimed than medications with no patient co-payment.
It’s not surprising that patients were more likely to abandon higher cost drugs, according to Shrank. “I think this is telling us that ‘sticker shock’ is real,” he said.
“Patients often don’t know the cost of a drug until they arrive at the pharmacy.” To help avoid that, Shrank suggested that when patients are given a new prescription, they ask the doctor about the price.
A lower cost alternative might be available. Pharmacists could also work more closely with doctors to make them aware of drug prices and lower cost alternatives, the authors write.
As for the greater likelihood of new prescriptions being abandoned, that could signal that some patients do not fully understand why they are being put on a new drug, according to Shrank.
He again advised people to talk to their doctors, and ask questions any time they do not understand the reasons for a drug prescription.
Shrank and his colleagues also found that prescriptions sent to the pharmacy electronically had a 64 percent greater chance of abandonment than those prescribed the old-fashioned way — either hand-delivered by patients or phoned or faxed in by the doctor.
But, Shrank said, “that does not mean that electronic prescriptions are bad.”
One reason for their higher likelihood of abandonment is that, unlike paper prescriptions brought in by patients, electronic prescriptions arrive at the pharmacy regardless of a patient’s intention to ultimately pick up the drug.
But it’s also possible that patients not given a paper prescription are more apt to forget about the medication.
Shrank said that it might be helpful for doctors who use electronic prescribing to give patients written reminders to make sure they remember that their medication will be awaiting them at the pharmacy.
Overall, the study findings “shed light on an important component of medication non-adherence,” according to an editorial published with the report.
One remaining question is how such prescription abandonment ultimately affects people’s health, write Drs. Michael D. Murray, of Purdue University College of Pharmacy in Indianapolis, and Jeff Harrison of the University of Auckland in New Zealand.
In some cases, they note, a patient’s decision not to pick up a drug — out of concern for side effects, for instance, or because he or she already has an adequate supply — may turn out to have positive effects, or none at all.
On the flip side, Murray and Harrison point out, the fact that a patient picks up a prescription does not necessarily mean that he or she ends up taking it.
Shrank said that studies need to keep investigating the various and complex reasons that people do not use their medications as prescribed.
“We need to have a better understanding of how we can help patients adhere to their medications,” he said.
SOURCE: Annals of Internal Medicine, online November 15, 2010.
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Lyrica is a medication used for several conditions including treating partial seizures in adults, treating individuals who suffer with fibromyalgia, treating nerve pain in individuals who have Diabetes, and treating pain associated with shingles. I suffer with fibromyalgia, and while I do not take Lyrica for my pain, I personally know several other people who take this medication to treat their fibromyalgia pain. Lyrica can cause many common side effects, including weight gain, itchy skin or rash, feeling tired or fatigued, feeling anxious, dizziness, drowsiness, balance and coordination difficulties, constipation, blurred vision, abdominal pain, muscle or joint pain, memory and/or concentration difficulties, and dry mouth. One of my friends who takes Lyrica for her fibromyalgia pain told me she gained 60 pounds in a matter of a couple of months. Several other friends also told me they had experienced weight gain when they started taking Lyrica. While some of my friends chose to stay on the medication for their fibromyalgia pain because it worked so well for them, others went off of it due to the amount of weight they gained while on the medication. You may be able to combat some of the weight gain associated with taking Lyrica by eating portioned meals and eating low fat or fat-free foods. If you are able, exercising regularly may also help combat weight gain. In order to combat constipation, you can take stool softeners or laxatives. I recommend that you speak to your doctor about what the best course of action is in dealing with your personal situation. If you experience trouble with your memory, you can write things down, make lists, and leave yourself post-it notes in order to remind yourself of the things you need to do, important dates, and appointments. In order to deal with itchy skin, you may want to try SARNA, an anti-itch lotion, which is now available over-the-counter. You may find SARNA in the pharmacy section of department stores, drug stores, and grocery stores. Some individuals experience severe allergic reactions to Lyrica. If this happens, you need to go to the emergency room or contact your doctor immediately. Severe allergic reactions to Lyrica include swelling of the face, tongue, neck, lips, and/or throat, difficulty breathing, and hives. You will also want to contact your doctor immediately if you experience muscle pain or weakness accompanied by a fever and/or feel tired, start bleeding or bruising easily, experience quick weight gain, or if your feet and/or hands swell. Pfizer also notes that individuals who are or have struggled with alcohol or drug abuse may be more likely to misuse this medication, as Lyrica makes some individuals feel “high”. Lyrica medication treats nerve pain in individuals with Diabetes and fibromyalgia as well as to treat partial seizures in adults. While all medications have side-effects, there are some things you can do to cope with them. If you think you may benefit from taking Lyrica, talk to your doctor about your symptoms, condition, and circumstances. You and your doctor can decide if Lyrica is right for your specific situation. Sources: Lyrica: http://www.lyrica.com/content/main_home.jsp Yahoo Health: Lyrica: http://health.yahoo.com/nervous-medications/pregabalin/healthwise–d05508a1.html
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