Mental health watchdog Citizens Commission on Human Rights (CCHR) International announced that a ban of electroshock treatment — the practice of up to 460 volts of electricity to the brain to “treat mental disorder” — should be imminent in light of increasing reports of patients being damaged and deaths.
In Texas in the US, the only state to record deaths within 14 days of electroshock being administered, reported a death rate in recent years that represents an estimated 300 deaths nationally each year. The most frequent causes of death have been cardiac events and suicide, according to one study .
Electroshock’s brutal and sordid history ranges from its use to help slaughter pigs, to punishment, painful “aversion therapy” on homosexuals, inflicting brain damage on children and others, and to torture humans.
The US Food and Drug Administration (FDA) has never obtained a single clinical trial from the manufacturers of the electroshock devices proving their safety and efficacy. Under Section 516 of the Food, Drug and Cosmetics Act, the FDA has a duty to ban devices that present “substantial deception or unreasonable and substantial risk of illness or injury.” Electroshock, also called electroconvulsive therapy or ECT, can cause brain damage, long-term memory loss and death, constituting more than a “substantial risk” and is far from safe and effective, according to thousands of survivors’ complaints. Ignoring these dangers, the FDA has instead limited bans under this Section to prohibiting the use of powdered gloves in medical or surgical procedures and prosthetic hair fiber implants that may trigger inflammation and hypersensitivity reactions, the latter, the FDA says, were misrepresented in marketing as “safe, effective and causing little or no discomfort.”
While the FDA allows the ECT device to remain on the market, it doesn’t regulate how it is used, giving psychiatrists a free-for-all to administer it to whomever they choose. This has meant that children younger than five and toddlers have been subjected to the violence of this shock procedure in at least five states that CCHR has established through Freedom of Information Act requests. Despite a report from the United Nations committee on Torture and Other Cruel Inhuman or Degrading Treatment or Punishment that warns electroshock without consent constitutes torture, ECT continues to be given to involuntary patients without consent.
Pregnant women and their unborn babies are also not protected from ECT, despite the World Federation of Societies of Anesthesiology saying that ECT is “absolutely contraindicated” in pregnancy. Researchers of Maine Medical Center have found brain damage in a baby whose mother had undergone ECT while pregnant. The Journal of Maternal-Fetal & Neonatal Medicine also warns of potential spontaneous abortion, placental abruption, cardiac arrhythmias, fetal burn and intrauterine fetal death when a pregnant woman experiences general electrical shock. Yet, the APA claims that it’s safe during all trimesters.
Jan Eastgate, president of CCHR International, said: “Electroshock is mental euthanasia, with a long history of being used for torture and abuse. Electric shock eradicates memory. It should never be condoned or permitted because quite apart from its inhuman aspects, patients consider it bluntly criminal, especially when forced on them. Psychiatrists and the FDA pass off electric shock machines as wonderful, even though they can kill patients.” Sign CCHR’s Petition to Ban the Electroshock (ECT) Device.
The impact of any electrical shock upon a body for any purpose is very dangerous. Researchers from the University of Montreal have shown that any electric shock above 120 volts can “cause neurologic and neuropsychological symptoms in humans. Following an electrical injury, some patients may show various emotional and behavioral aftereffects, such as memory loss and symptoms of depression.” ECT uses up to 460 volts, deliberately inducing a grand mal seizure that the American Psychiatric Association (APA) says can last up to 30 minutes.
ECT: Slaughters Pigs and Tortures
ECT was invented in fascist Italy in 1937 by psychiatrist Ugo Cerletti. Darius Rejali, author of Torture and Modernity, wrote of Cerletti “having killed a few dogs by experimentation” and then “discovered that Roman slaughterhouses used electrocution to slaughter pigs.” Cerletti “discovered that pigs could be shocked several times and would revive after a few minutes.” He then applied ECT to humans, his first victim screaming that it was “deadly.” “The torture and ‘treatments’ of the insane” historically has derived from the “application to animals in abattoirs,” Rejali stated.
Cerletti’s device very rapidly pressed into political service, Rejali said. In August 2017, a paper published in History of Psychiatry documented how “The Nazi political and medical establishment” regarded ECT as a means “to empty psychiatric institutions, thereby relieving the state of the burden…” Psychiatrist Emil Gelny “added four extra electrodes to existing ECT machines, which were attached to patients’ wrists and ankles to deliver the lethal shocks after patients were knocked unconscious by the initial current applied to the head.”
In the 1950s, the U.S. Central Intelligence Agency (CIA) expressed considerable interest in ECT devices. In 1951, Project Artichoke, then MK-ULTRA under Deputy CIA Director Richard Helms in 1953, aimed to control human behavior through hallucinogenic drugs and electroshock. Dr. Ewen Cameron, the first president of the World Psychiatric Association, while professor of psychiatry at McGill University in Canada in the 1950s and 60s, developed his own version of shock treatment, using the UK Page-Russell electroshock device invented in 1948. Cameron called his shock technique “de-patterning” deliberately wiping out patient memories by the use of intensive ECT. The CIA funded his work. He described the procedure on a patient to the 2nd World Congress of Psychiatry in 1957, stating: “There is complete amnesia for all events of his life.”
Electroshock ‘took away her soul’
In 2017, 60 years after Cameron’s experiments left her mother damaged for life, Alison Steel obtained a $100,000settlement from the Canadian government over Cameron’s experiments. “She was never able to really function as a healthy human being because of what they did to her,” Steel stated. “Her emotions were stripped. It took away her soul.”
Electroshock is also used for torture, including on prisoners of the French during the 1954-62 Algerian War. Journalist Gordon Thomas reported that in 1961, Moroccan king Hassan II’s security service was fully staffed with doctors who supervised a wide range of tortures of political detainees using several Page-Russell electroshock machines. Chinese dissidents and members of the religious group The Falun Gong are still subjected to electroshock and “other barbaric forms of torture designed by prison guards to humiliate and inflict maximum pain.”
Until 1973, when the APA de-classified homosexuality as a mental disorder, electroshock treatment was used in an effort to prevent or eliminate homosexual behavior. Other forms of shock included jolts of electricity administered to the skin and body, sometimes directly to the genitals. Voltage of such devices ranged anywhere from 150-200 volts and on children for behavioral control, 300-400 volts. Allegations that psychiatrists and any others recommending ECT to treat the LGBT community today are homophobic and cruel, CCHR says.
Brain Damage and Memory Loss
Yet the FDA and APA continue to ignore the perils of ECT.
- In March 2016, a coroner from Sunderland County in the UK determined Elsie Tindle died after electroshock triggered an epileptic fit which caused irreparable brain damage.
- A 2012 study published in Proceedings of the National Academy of Sciences reported a considerable “decrease in functional connectivity” between the prefrontal lobes of the brain and other parts of the brain after ECT. The most extensive long-term follow-up study indicates that “most ECT patients will never recover from the damage in the form of persistent severe mental deficits.”
- Austin, Texas, psychologist John Breeding, who heads the Coalition for the Abolition of Electroshock, said, “The bottom line is that ECT ‘works’ to the extent that it damages and disables the brain.” Breeding dispels psychiatric theories that the procedure is safer today than its “One Flew Over the Cuckoo’s Nest” days in the 60s. He says that ECT has more potential for harm than ever. Much higher voltages are employed in the modern procedure because muscle relaxants and anesthetics raise the seizure threshold, with more electricity required to produce a seizure. The greater heat and electricity themselves cause more brain cell death, he says. He concludes “Given what we know about the resulting brain damage, I think this is a form of assault…”
- Leading ECT researcher and advocate, psychologist Harold Sackeim admitted in an editorial in The Journal of ECT that “virtually all patients experience some degree of persistent and, likely, permanent retrograde amnesia.” In a January 2007 study published in Neuropsychopharmacology, Sackeim and colleagues acknowledged that ECT may cause permanent amnesia and permanent deficits in cognitive abilities, which affect ability to function.
- In 2005, Santa Barbara Superior Court Judge Denise de Bellefeuille ruled that a psychiatrist and Santa Barbarapsychiatric facility deceived its patients by failing to tell them that ECT causes irreversible memory loss. The psychiatrist (who had performed shock treatment for over 20 years), admitted that neither he nor anyone else understands how shock treatment works, and that the consent form Johnson provided to patients was “decidedly misleading in a critical regard,” concerning the permanency of memory loss.
Last year, psychologist John Read, professor of clinical psychology at the University of East London concluded from a comprehensive review of 91 studies on ECT that “Given the well-documented high risk of persistent memory dysfunction, the cost-benefit analysis for ECT remains so poor that its use cannot be scientifically, or ethically, justified.”
Eastgate says, “To treat mental problems by electric shocks is brutality in the name of mental health care. The high death rate, severe memory loss and the brain atrophy and damage ECT causes warrants it being banned under existing FDA law.”
 “An Analysis of Reported Deaths Following Electroconvulsive Therapy in Texas, 1993-1998,” 1 Aug 2001, https://ps.psychiatryonline.org/doi/10.1176/appi.ps.52.8.1095.
 Jonathan Emord & Associates, Citizens Petition filed with the FDA Commissioner, 14 Aug. 2016, pp. 14, 27 and 42, http://emord.com/blawg/wp-content/uploads/2016/08/1-ECT-Citizen-Petition.pdf.
 A/HRC/22/53, “Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez,” United Nations, General Assembly, Human Rights Council, Twenty-second Session, Agenda Item 3, 1 Feb. 2013, p. 1, Summary.
 http://www.mindfreedom.org/kb/mental-health-abuse/electroshock/pregnancy-study, citing Jacquelyn Blackstone, Michael G. Pinette, Camille Santarpio, Joseph R. Wax, “Electroconvulsive Therapy in Pregnancy.” Obstetrics & Gynecology, 2007, American College of Obstetricians and Gynecologists, http://greenjournal.org/cgi/content/short/110/2/465.
 “Electric shock in pregnancy: a review,” The Journal of Maternal-Fetal & Neonatal Medicine, Vol. 29, 2014, Issue 2, http://www.tandfonline.com/doi/abs/10.3109/14767058.2014.1000295?journalCode=ijmf20.
 https://www.sciencedaily.com/releases/2008/05/080515113311.htm; University of Montreal. “Electric Shocks Can Cause Neurologic And Neuropsychological Symptoms.” ScienceDaily, 16 May 2008, https://www.sciencedaily.com/releases/2008/05/080515113311.htm.
 Darius Rejali, “Electricity: The Global History Of A Torture Technology,” http://www.reed.edu/poli_sci/faculty/rejali/articles/History_of_Electric_Torture.html; Petr Skrabanek, PhD., “Convulsive Therapy – A Critical Appraisal of its Origins and Value,” Irish f’.’lcdicaIJourIlo,, June 1986, Volume 79, No. 6.
 https://psmag.com/news/nazis-ruin-everything; G Gazdag, GS Ungvari, and H Czech, “Mass killing under the guise of ECT: the darkest chapter in the history of biological psychiatry,” History of Psychiatry, Sage Publications, 2017.
 Stephen Lendman, “Meet Maryam Ruhullah: A Victim of MK-ULTRA,” Countercurrents.org, 16 Feb. 2010, https://www.countercurrents.org/lendman160210.htm.
 Leonard Roy Frank, “Electroshock: Death, Brain Damage, Memory Loss, and Brainwashing,” The Journal of Mind and Behaviour, Summer and Autumn 1990; Leonard Roy Frank, Editor, “The Electroshock Quotationary,” June 2006, http://www.endofshock.com/102C_ECT.pdf, http://www.brown.uk.com/brownlibrary/FRANK.htm.
 Op. cit., Leonard Roy Frank, “The Electroshock Quotationary.”
 Leonard Roy Frank, Editor, The History of Shock Treatment, 1978.
 Gordon Thomas, Journey Into Madness, The True Story of Secret CIA Mind Control and Medical Abuse, (Bantam Books) 1989.
 Patrick Strudwick, “This Gay Man Was Given Repeated Electric Shocks By British Doctors to Make Him Straight,” Buzz Feed, 30 Sept 2017, https://www.buzzfeed.com/patrickstrudwick/this-gay-man-was-given-repeated-electric-shocks-by-british?utm_term=.orlQxe4JR#.coV1dRZOn.
 https://www.huffingtonpost.com/jamie-scot/shock-the-gay-away-secrets-of-early-gay-aversion-therapy-revealed_b_3497435.html; https://www.madinamerica.com/2014/09/fda-panel-rejects-aversive-therapy-shock-devices/; https://www.masslive.com/news/index.ssf/2016/07/inside_judge_rotenberg_center.html.
 https://www.madinamerica.com/2014/09/fda-panel-rejects-aversive-therapy-shock-devices/; https://books.google.com/books?id=qpcuDwAAQBAJ&pg=PT137&lpg=PT137&dq=aversion+therapy+electroshock+used+70+volts+of+electricity&source=bl&ots=3dqOdCCa7X&sig=-ddCLbjl6FUOI6LspJdjZEBm4-M&hl=en&sa=X&ved=2ahUKEwiawZX-p8fcAhWWFjQIHf8ACNk4ChDoATADegQIAxAB#v=onepage&q=aversion%20therapy%20electroshock%20used%2070%20volts%20of%20electricity&f=false.
 Emily Reynolds, “The cruel, dangerous reality of gay conversion therapy,” Wired, 7 July 2018, https://www.wired.co.uk/article/what-is-gay-conversion-therapy.
 Petra Silfverskiold, “Electric shock therapy led to Sunderland patient having permanent fit,” Daily Mail (UK), 10 Mar. 2016, http://www.sunderlandecho.com/news/local/all-news/electric-shock-therapy-led-to-sunderland-patient-having-permanent-fit-1-7786233.
 Peter Breggin, “New Study Confirms Electroshock (ECT) Causes Brain Damage,” Huffington Post, 9 Apr. 2012, https://www.huffingtonpost.com/dr-peter-breggin/electroshock-treatment_b_1373619.html.
 John Breeding, Ph.D., “Electroshocking Children: Why It Should Be Stopped,” Mad in America, 11 Feb. 2014, https://www.madinamerica.com/2014/02/electroshocking-children-stopped/.
 Op. cit., John Breeding, Ph.D., “Electroshocking Children: Why It Should Be Stopped”; John Breeding, Ph.D., “Chapter 9: Electroshock,” http://www.wildestcolts.com/psych_opp/d-electroshock/1-shock.html.
 Ibid, John Breeding, Ph.D., “Electroshocking Children: Why It Should Be Stopped.”
 Ibid., citing, Sackeim et al., “The Cognitive Effects of Electroconvulsive Therapy in Community Settings” Neuropsychopharmacology, Volume 32, Number 1, 2007.
 Charles D. Morgan, “Milestone case: Hospital ordered to cease shocking patients,” https://suemypsychiatrist.wordpress.com/category/ect/.
 John Read, Chelsea Arnold, “Is Electroconvulsive Therapy for Depression More Effective Than Placebo? A Systematic Review of Studies Since 2009,” Ethical Human Psychology and Psychiatry Volume 19, Number 1, 2017, pp. 5-23(19), http://www.ingentaconnect.com/content/springer/ehpp/2017/00000019/00000001/art00002.
Sexual minority adolescents more likely to experience mental health problems
Sexual minorities were around five times more likely to experience high depressive symptoms (54% vs 15%) and self-harm (54% vs 14%). They also had lower life satisfaction (34% vs 10%), lower self-esteem and were more likely to experience all forms of bullying (i.e. peer bullying 27% vs 10%) and victimisation (i.e. sexual assault/harassment 11% vs 3%) .
New research, published in The Lancet Child and Adolescent Health, found that adolescents from sexual minorities (those attracted to same sex or both sexes) are more likely to experience mental health problems, adverse social environments and negative health outcomes in contrast to their heterosexual counterparts.
The research – entitled ‘Mental health, social adversity & health-related outcomes in sexual minority adolescents: findings from a contemporary national cohort’ – aimed to rectify the lack of contemporary data in Generation Z (people born between 1995 and 2015) regarding the disparity in adverse outcomes faced by sexual minority young people who have grown up in this Century – a time of advances in rights for sexual minorities.
In order to gain a better understanding of these outcomes researchers from the University of Liverpool and University College London analysed information on almost 10,000 adolescents born between 2000-2002 who are taking part in the Millennium Cohort Study (MCS).
The researchers analysed mental health (e.g. depression, self-harm), social (e.g. victimisation, bullying), and health-related outcomes (e.g. weight perception, substance use) in sexual minority (629) versus heterosexual (9256) adolescents at age 14 years. They also estimated the number of co-occurring difficulties in each group.
The researchers found that sexual minorities were around five times more likely to experience high depressive symptoms (54% vs 15%) and self-harm (54% vs 14%). They also had lower life satisfaction (34% vs 10%), lower self-esteem and were more likely to experience all forms of bullying (i.e. peer bullying 27% vs 10%) and victimisation (i.e. sexual assault/harassment 11% vs 3%) .
Sexual minorities were also at increased odds of trying cannabis (16% vs 6%) trying alcohol (67% vs 52%), perceiving themselves as overweight (49% vs 33%), and dieting to lose weight (66% vs 44%).
Sexual minorities experienced more negative outcomes at the same time. For example, sexual minorities experienced 1.4 out of 3 mental health difficulties on average whereas heterosexual adolescents experienced 0.4 out of 3 on average. Overall cumulative difficulties experienced were 9·4 out of 28 for sexual minority youth versus 6·2 for heterosexual youth.
The lead author, Rebekah Amos, said: “Our current study provides much needed population-based estimates indicating pronounced differences in mental health, social, and health-related outcomes between sexual minority and heterosexual adolescents in the UK. We find that sexual minority adolescents are five times more likely to be depressed and self-harm and 2-3 times more likely to be bullied and be victimised, illuminating the scale of current adversities this group of adolescent are facing.”
Dr Praveetha Patalay, study co-author, said: “The study exposes the vast disparities in a range of outcomes between sexual minority and heterosexual young people, highlighting the need for further prevention efforts and intervention at the school, community and policy level to ensure sexual minority adolescents do not face lifelong adverse social, economic and, health outcomes.”
Dr Ross White, clinical psychologist and study co-author, said: “The study findings highlight the need for mental health professionals, teachers, parents and young people to work together to co-create systems of support that will allow young people to flourish irrespective of their sexual orientation. An important aspect of this work will be to foster societal attitudes that celebrate diversity, recognise common humanity and nurture compassion for one-self and others.”
Rebekah Amos added: “Despite high profile policies such as the legalisation of same sex marriage in 2013 in England, Wales and Scotland and the introduction of sexual orientation as a protected characteristic during these adolescents’ lifetime, the evidence presented here indicates that large inequalities in social and health outcomes still exist for sexual minority adolescents growing up in the 21st Century.”
8 Tips for promoting men’s health
Here are a few tips that can help ensure the success of men’s health programs.
Men tend to shy away from clinical medical services and formal health care programs, leaving community-based programs to help fill the gap. But not all programs are created equal. This is according to a study – “Community-based men’s health promotion programs: eight lessons learnt and their caveats”, which was published in the journal Health Promotion International – that shows that the programs that succeed are those that recognize and adapt to the social forces that uniquely affect men.
So for University of British Columbia (UBC) nursing professor John Oliffe, who led the study that reviewed community-based programs in Canada, Australia, New Zealand, UK and the US, there are a few tips that can help ensure the success of men’s health programs.
Recognize the forces that affect men’s health: The UBC research points out that social factors can significantly affect health, including race, culture, socioeconomic status, education and income levels. Dudes Club, a program based in Vancouver’s Downtown Eastside, succeeds because its content is tailored to its largely Indigenous clientele. Events include culturally based activities and elder-led circles, and clients are reporting improved mental, spiritual, physical and emotional well-being as a result.
Physical activity builds connections: Activity-based programs that link to masculine ideals such as problem-solving and physical prowess work well. Men’s Sheds, a program that runs in Australia, Canada and a few other countries, successfully attracts men with woodworking activities, computer tutorials, gardening and informal social events.
Safe spaces help men open up: Many men are reticent to talk about health challenges or talk about personal issues, but programs–like prostate cancer support groups–can expand their comfort zone by creating safe spaces for sharing experiences and discussing sensitive topics.
Knowledge can combat stigma: Many men who are experiencing health challenges like depression or suicidal thoughts lack knowledge about their condition, which further fuels any stigma they may already feel. Community-based programs can promote health literacy and tackle stigma by using simple, non-judgmental language to describe health conditions, Oliffe said.
Men-focused environments work well: No surprise, “men-friendly” community spaces and activities–such as sports events or competitions–work better in recruiting men to health-related programs than strictly clinical programs. Oliffe points to a few examples, including some European soccer clubs, that draw men in to join exercise and healthy eating programs.
A clear vision for the program is a must: Programs must have tangible benefits, clear goals and strong, collaborative leaders. Dads in Gear– developed to assist dads to quit smoking–recruited participants with an offer of free meals and child care. It emphasized the need for participants to actively work for their well-being, and it encouraged the men to independently sustain their healthy practices after completing the program.
Evaluate to perpetuate: Every program should carry out a consistent and formal evaluation process, Oliffe advises. This helps to support future funding efforts and ensures the program is working as well as it should.
‘Pop-ups’ are OK: And finally, don’t expect to sustain or expand every program, says Oliffe, as some might be best considered “pop-ups”. Once they’ve hit their goal, they can be retired and regarded as the seed for future ideas.
2/3 of parents cite barriers in recognizing youth depression
Teens and preteens are no strangers to depression: 1 in 4 parents say their child knows a peer with depression; 1 in 10 say a child’s peer has committed suicide.
Telling the difference between a teen’s normal ups and downs and something bigger is among top challenges parents face in identifying youth depression, a new poll suggests.
Though the majority of parents say they are confident they would recognize depression in their middle or high school aged child, two thirds acknowledge barriers to spotting specific signs and symptoms, according to the C.S. Mott Children’s Hospital National Poll on Children’s Health at the University of Michigan in the US.
Forty percent of parents struggle to differentiate between normal mood swings and signs of depression, while 30% say their child is good at hiding feelings.
“In many families, the preteen and teen years bring dramatic changes both in youth behavior and in the dynamic between parents and children,” says poll co-director Sarah Clark. “These transitions can make it particularly challenging to get a read on children’s emotional state and whether there is possible depression.”
Still, a third of parents polled said nothing would interfere with their ability to recognize signs of depression in their child.
“Some parents may be overestimating their ability to recognize depression in the mood and behavior of their own child,” Clark says. “An overconfident parent may fail to pick up on the subtle signals that something is amiss.”
The poll also suggests that the topic of depression is all too familiar for middle and high school students. One in four parents say their child knows a peer or classmate with depression, and 1 in 10 say their child knows a peer or classmate who has died by suicide.
Indeed, rates of youth suicide continue to rise. Among people ages 10 to 24 years old, the suicide rate climbed 56% between 2007 and 2017, according to the Centers for Disease Control and Prevention.
“Our report reinforces that depression is not an abstract concept for today’s teens and preteens, or their parents,” Clark says.
“This level of familiarity with depression and suicide is consistent with recent statistics showing a dramatic increase in suicide among… youth over the past decade. Rising rates of suicide highlight the importance of recognizing depression in youth.”
Compared to the ratings of their own ability, parents polled were also less confident that their preteens or teens would recognize depression in themselves.
Clark says parents should stay vigilant on spotting any signs of potential depression in kids, which may vary from sadness and isolation to anger, irritability and acting out. Parents might also talk with their preteen or teen about identifying a “go to” adult who can be a trusted source if they are feeling blue, Clark says.
Most parents also believe schools should play a role in identifying potential depression, with seven in 10 supporting depression screening starting in middle school.
“The good news is that parents view schools as a valuable partner in recognizing youth depression,” Clark says.The bad news is that too few schools have adequate resources to screen students for depression, and to offer counseling to students who need it.”
Clark encourages parents to learn whether depression screening is taking place at their child’s school and whether counseling is available for students who screen positive. Given the limited resources in many school districts, parents can be advocates of such efforts by talking to school administrators and school board members about the importance of offering mental health services in schools.
The Mott Poll report is based on responses from 819 parents with at least one child in middle school, junior high, or high school.
Depression is – of course – an important issue in the LGBTQIA community. One study done in November 2018, for instance, found that half of LGBT people (52%) said they’ve experienced depression in the last year; one in eight LGBT people aged 18-24 (13%) said they’ve attempted to take their own life in the last year; and almost half of trans people (46%) have thought about taking their own life in the last year, 31% of LGB people who aren’t trans said the same.
First case of sexually transmitted dengue confirmed in Spain
Health authorities confirmed a case of a man spreading dengue through sex. This is a world first for a virus which – until recently – was largely thought to be transmitted only by mosquitos.
No, getting bitten by mosquitos isn’t the only way you can get dengue.
In Spain, health authorities confirmed a case of a man spreading dengue through sex. This is a world first for a virus which – until recently – was largely thought to be transmitted only by mosquitos.
The case involves a 41-year-old man from Madrid who contracted dengue after having sex with his male partner, who got the virus from a mosquito bite during a trip to Cuba and the Dominican Republic.
When the man’s dengue infection was confirmed in September, it puzzled doctors because he had not traveled to a country where the disease is common. An analysis of the sperm of the two men was carried out and it revealed that not only did they have dengue, but that it was exactly the same virus which circulates in Cuba.
Dengue is transmitted mainly by the Aedes Aegypti mosquito, which grows in number in densely-populated tropical climates, such as the Philippines.
Though it kills 10,000 people a year and infects over 100 million, the disease is fatal only in extreme cases, though symptoms are extremely unpleasant, including high fever, severe headaches and vomiting. It is particularly serious – and deadly – in children.
In the Philippines, the Department of Health reported a total of 271,480 dengue cases from January to August 31 this year, prompting it to declare a national dengue epidemic. As of end-August, an estimated 1,107 people have died of dengue in the country.
Improved support after self-harm needed to reduce suicide risk
To reduce the high risk of suicide after hospital attendance for self-harm, improved clinical management is needed for all patients – including comprehensive assessment of the patients’ mental state, needs, and risks, as well as implementation of risk reduction strategies, including safety planning.
Risk of suicide following hospital presentation for self-harm is very high immediately following hospital discharge, emphasising the need for provision of early follow-up care and attention to risk reduction strategies
To reduce the high risk of suicide after hospital attendance for self-harm, improved clinical management is needed for all patients – including comprehensive assessment of the patients’ mental state, needs, and risks, as well as implementation of risk reduction strategies, including safety planning.
The results are from an observational study spanning 16 years and including almost 50,000 people from five English hospitals, published in The Lancet Psychiatry journal.
“The peak in risk of suicide which follows immediately after discharge from hospital underscores the need for provision of early and effective follow-up care. Presentation to hospital for self-harm offers an opportunity for intervention, yet people in are often discharged from hospital having not received a formal assessment of their problems and needs, and without specific aftercare arrangements. As specified in national guidance, a comprehensive assessment of the patients’ mental state, needs, and risks is essential to devise an effective plan for their follow-up care,” says study author Dr. Galit Geulayov, Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK.
It has been estimated that every year there are approximately 200,000 presentations to emergency departments in hospitals across England following acts of non-fatal self-harm. Self-harm is associated with increased mortality, especially by suicide. Approximately 50% of individuals who die by suicide have a history of self-harm, with hospital presentation for self-harm often occurring shortly before suicide.
The new study compared the risk of suicide following hospital presentation for self-harm according to patient characteristics, method of self-harm, and socioeconomic deprivation. It also estimated the incidence of suicide by time after hospital attendance, adjusting for gender, age, previous self-harm, and psychiatric treatment.
The study included 49,783 people aged over 15 years who presented to hospital after non-fatal self-harm a total of 90,614 times between 2000-2013. The authors followed these patients for 16 years (until the end of 2015), and the study included five hospitals (one in Oxford, three in Manchester and one in Derby).
Within the 16 year follow up, 703 out of 49,783 people died by suicide – with the incidence of suicide being 163 per 100,000 people per year.
Around a third of these deaths occurred within a year of the patient attending hospital for non-fatal self-harm (36%, 252/703 deaths), and the study confirmed the high risk of suicide in the first year after presentation to hospital for self-harm (the incidence of suicide in the year following discharge from hospital was 511 suicides per 100,000 people per year – 55.5 times higher than that of the general population).
The authors found that risk was particularly elevated in the first month (the incidence of suicide in the month following discharge from hospital was 1,787 per 100,000 people per year – close to 200 times higher than in the general population) – with 74 out of 703 people in the study dying by suicide within a month.
The authors note that men were more likely to die by suicide following hospital presentation of self-harm than women, people who attended hospital more than once for non-fatal self-harm were more likely to die by suicide than those with a single presentation, and age was associated with risk (with risk increasing 3% with each year of age).
In addition, those who lived in less deprived areas had a higher risk of death by suicide than those who lived in the most deprived areas, but this contrasts with a large body of evidence and might be explained by higher rates of psychiatric disorders in this group in this study – more research is needed. The authors also note that some forms of self-harm were more strongly linked to subsequent suicide, but advise against including detail of this kind in media reporting.
Suicide is a big issue in the LGBTQIA community. In 2018, for instance, a study found that a total of 37% of trans respondents reported having seriously considered suicide during the past 12 months and 32% had ever attempted a suicide. Offensive treatment during the past three months and lifetime exposure to trans-related violence were significantly associated with suicidality.
A study published in LGBT Health in 2016, meanwhile, emphasized the importance of strengthening family support and acceptance as part of a positive intervention.
The authors of this newer study note that holistic assessment of risk factors is required, and warn that no single characteristic will help predict later suicide.
“While awareness of characteristics which increase the risk of subsequent suicide can assist as part of this assessment, previous studies indicate that individual factors related to self-harm are a poor means to evaluate the risk of future suicide. These factors need to be considered together, followed by risk reduction strategies, including safety planning, for all patients,” says Professor Hawton, Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK.
The authors note that their study focuses on three cities in England and the findings may not necessarily apply to the whole of the country.
Writing in a linked comment, Dr. Annette Erlangsen, Danish Research Institute for Suicide Prevention, Denmark, notes that there is a range of treatment options available following presentation of self-harm in emergency departments (including referrals to psychiatric wards after psychosocial assessments, outpatient treatment for patients not under immediate risk of self-harming, and – in some countries – specialized suicide prevention clinics) but many countries send patients home with a referral to their GP or do not refer at all.
She says: “The bottom line is–while the body of evidence of effective intervention is growing, we need to help people who present with self-harm. Operating in such a scenario is challenging but the numbers are clear; we need to ensure that patients receive support immediately when presenting and implement a continuation of care after discharge.”
Trouble sleeping? Insomnia symptoms linked to increased risk of stroke, heart attack
The results suggest that if we can target people who are having trouble sleeping with behavioral therapies, it’s possible that we could reduce the number of cases of stroke, heart attack and other diseases later down the line.
People who have trouble sleeping may be more likely to have a stroke, heart attack or other cerebrovascular or cardiovascular diseases, according to a study published in the November 6, 2019, online issue of Neurology, the medical journal of the American Academy of Neurology.
“These results suggest that if we can target people who are having trouble sleeping with behavioral therapies, it’s possible that we could reduce the number of cases of stroke, heart attack and other diseases later down the line,” said study author Liming Li, MD, of Peking University in Beijing, China.
The study involved 487,200 people in China with an average age of 51. Participants had no history of stroke or heart disease at the beginning of the study.
Participants were asked if they had any of three symptoms of insomnia at least three days per week: trouble falling asleep or staying asleep; waking up too early in the morning; or trouble staying focused during the day due to poor sleep. A total of 11 percent of the people had difficulty falling asleep or staying asleep; 10 percent reported waking up too early; and 2 percent had trouble staying focused during the day due to poor sleep. The researchers did not determine if the people met the full definition of insomnia.
The people were then followed for an average of about 10 years. During that time, there were 130,032 cases of stroke, heart attack and other similar diseases.
People who had all three symptoms of insomnia were 18 percent more likely to develop these diseases than people who did not have any symptoms. The researchers adjusted for other factors that could affect the risk of stroke or heart disease including alcohol use, smoking, and level of physical activity.
People who had trouble falling asleep or staying asleep were 9 percent more likely to develop stroke or heart disease than people who did not have this trouble. Of the 55,127 people who had this symptom, 17,650, or 32 percent, had a stroke or heart disease, compared to 112,382, or 26 percent, of the 432,073 people who did not have this symptom of insomnia.
People who woke up too early in the morning and could not get back to sleep were 7 percent more likely to develop these diseases than people who did not have that problem. And people who reported that they had trouble staying focused during the day due to poor sleep were 13 percent more likely to develop these diseases than people who did not have that symptom.
“The link between insomnia symptoms and these diseases was even stronger in younger adults and people who did not have high blood pressure at the start of the study, so future research should look especially at early detection and interventions aimed at these groups,” Li said.
Li noted that the study does not show cause and effect between the insomnia symptoms and stroke and heart disease. It only shows an association.
A limitation of the study was that people reported their own symptoms of insomnia, so the information may not have been accurate.
Also, the researchers did not ask participants about having sleep that was not refreshing; this is another common symptom of insomnia.
The question that needs to be asked: How is this relevant particularly to the LGBTQIA community?
Sleep may be fundamental to health, but a study found that lesbian, gay and bisexual adults reported more sleep problems than their heterosexual counterparts. This suggests that sleep difficulties may underlie a number of mental and physical health problems experienced by sexual minorities.