Disease Management Update
Volume V, No. 20
September 11, 2008

Dear Healthcare Intelligence Network Client,

Depression and suicide too often go hand-in-hand. Depression is the most common cause of suicide, with 80 percent of depression left untreated. According to the CDC's 2008 Report, over 32,000 suicides are reported each year, along with 395,000 treated cases of near-fatal self-inflicted wounds --- making it the eleventh-highest cause of death in Americans. September 7th to 13th is National Suicide Prevention Week, and this week's Disease Management Update focuses on this tragic plight, as well as the disease of depression that is often behind it.

Your colleague in the business of healthcare,
Laura Greene
Editor, Disease Management Update

Please pass this along to any of your colleagues or, better yet, have them sign up to receive their own copy at http://www.hin.com/freenews2.html where you can also learn about our other complimentary news services.

Table of Contents

  1. Increase in Youth Suicide Rate May Reflect Emerging Health Crisis
  2. Disease Management Q&A: Combining Depression and Anger Management
  3. HealthSounds Podcast: Sensationalizing Suicide in the Media
  4. Exercise Lessens Depression in Pregnancy
  5. Survey of the Month: Healthcare Trends in 2009
  6. Depression and DM: Beyond the Stigma to Identification and Treatment

1. Increase in Youth Suicide Rate May Reflect Emerging Health Crisis

A sudden and dramatic increase in pediatric suicides may reflect an emerging trend rather than a single-year anomaly. Following a decade of steady decline, the suicide rate among U.S. youth younger than 20 years of age increased by 18 percent from 2003-2004 — the largest single-year change in the pediatric suicide rate over the past 15 years. Although worrisome, the one-year spike observed in 2003-2004 does not necessarily reflect a changing trend. Therefore, researchers examined national data on youth suicide from 1996-2005 in order to determine whether the increase persisted from 2004-2005, the latest year for which data are available.

Researchers estimated the trend in suicide rates from 1996-2003 using log-linear regression. Using that trend line, they estimated the expected suicide rates in 2004 and 2005 and compared the expected number of deaths to the actual observed number of deaths. Researchers found that although the overall observed rate of suicide among 10 -to 19-year-olds decreased by about 5 percent between 2004 and 2005 (the year following the spike) both the 2004 and 2005 rates were still significantly greater than the expected rates, based on the 1996-2003 trend.

“The fact that this significant increase in pediatric suicides continued into 2005 implies that the alarming spike witnessed from 2003-2004 was more than just a single-year anomaly,” said Jeff Bridge, Ph.D., lead author and a principal investigator in the Research Institute at Nationwide Children’s Hospital. “We now need to consider the possibility that the increase is an indicator of an emerging public health crisis.”

To learn more about this research, please visit:

2. Disease Management Q&A: Combining Depression and Anger Management

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Mary Beth Chalk, chief operating officer for Resources For Living.

Question: How can you best integrate anger management into a depression management program?

Response: (Mary Beth Chalk) When we complete our depression assessment, we have self-directed programs to combat anger. We also have anger-specific modules so we can work with individuals on different skill sets for expressing and managing anger. Also, if they have an EAP in place, a referral into the EAP is appropriate at that point to connect them with a professional who can work with them on a structured anger management approach.

For more details on depression management programs, please visit:

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HealthSounds Podcasts delivers a free weekly audio interview with a healthcare innovator to your e-mailbox. Listen to thought leaders answer key questions about the most pressing issues and trends in healthcare — impact of retail clinics, implications of Web 2.0 for healthcare, medical home models and much more. To sign up for our free email newsletters, please visit http://www.hin.com/freenews2.html

3. HealthSounds Podcast: Sensationalizing Suicide in the Media

When it comes to suicide, more often than not, the media focuses too much on the tragedy of the situation and sends the message that it cannot be prevented. But according to Dr. John Draper, director of the National Suicide Prevention Lifeline, there is a silent majority of suicide survivors who have another message — suicide isn't inevitable, and it can be prevented. Dr. Draper and Amanda Lehner, technology communications coordinator for the National Suicide Prevention Lifeline, discuss LifelineGallery.org and how this social network hopes to connect with patients with its use of story-telling avatars.

To listen to this complimentary HIN podcast, please visit:

4. Exercise Lessens Depression in Pregnancy

Exercise can help expectant moms in mind as well as body. A new study from Penn State University (PSU) suggests that women who stay active and are more positive about their changing shapes might protect themselves from depression both during and after pregnancy. Researchers surveyed 230 Pennsylvania women throughout pregnancy and the postpartum period about their symptoms of depression, exercise habits and feelings about weight, appearance and other aspects of body image.

Women who experienced depressive symptoms early in pregnancy tended to report later pregnancy and postpartum depression, the authors found. What is new, though, are the findings about the role of body image and exercise behavior in relation to pregnancy and postpartum depressive symptoms. Women who experienced higher levels of depression symptoms also reported less satisfaction with their appearance throughout the trimesters of pregnancy.

“Our study supports the psychological benefits of exercise to improve body image and lessen depressive symptoms,” said lead study author Danielle Symons Downs, associate professor of kinesiology and obstetrics and gynecology at PSU.

To learn more about this research, please visit:

5. Survey of the Month: Healthcare Trends in 2009

A faltering economy, a presidential election and a number of other factors continue to drive changes in the healthcare industry. Want to know how other healthcare organizations are preparing for what the healthcare industry will bring in 2009? Complete HIN's Survey of the Month on Healthcare Trends in 2009 by September 30 and you’ll get a free executive summary of the compiled results.

To participate in this survey and receive its results, please visit:

6. Depression and DM: Beyond the Stigma to Identification and Treatment

With the economic burden of depression and its co-morbidities estimated at $83 billion annually --- hitting employers hardest in the form of lost workdays, compromised productivity and workplace accidents --- the healthcare industry is formalizing programs for early identification, adequate treatment and medical adherence of individuals with depressive disorder. This is no small task, given the challenges of screening depression severity, overcoming the stigma of mental illness, and educating PCPs on the value of this initiative. In an online survey, HIN asked its audience for details on current and planned initiatives for depression and DM. To download this complimentary white paper, please visit:
Contact HIN:
Editor: Laura M. Greene, lgreene@hin.com;
Sales & Marketing Coordinator: Deirdre McGuinness, dmcguinness@hin.com;
Publisher: Melanie Matthews, mmatthews@hin.com

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