This week, we dig into the risks that threaten veterans with bipolar disorder, a look at wildly different cases of lithium toxicity, and a study of eating disorders in the transgender community.
All Three Point to a Startling Trend Among Veterans
While the latest federal data shows a downturn in veteran suicides – especially among those with mental health conditions – the problem persists.
A recent Veterans Health Administration (VHA) research project – appearing in The Journal of Clinical Psychiatry – calls out multiple risk factors tied to suicides among veterans living with bipolar disorder.
Researchers monitored 126,655 VHA patients diagnosed with bipolar disorder for half a decade, starting in 2014. More than 700 of those patients killed themselves before the end of the study.
The study’s authors discovered that specific demographic factors – such as being male, white, non-Hispanic, and unmarried – made them more likely to commit suicide. Historical clinical indicators also played a part. Those included:
- A lack of medical comorbidities.
- Homelessness.
- And being flagged as a high suicide risk previously.
Additionally, frequent emergency department visits and benzodiazepine prescriptions of 30 days or longer emerged as other noteworthy risk factors.
It’s also worth mentioning that while psychiatric comorbidities didn’t independently drive up the risk of suicide, benzodiazepine use persisted as a significant concern. Patients prescribed benzodiazepines for extended periods also faced an elevated overdose risk.
The findings suggest that VHA’s suicide prevention efforts should emphasize careful monitoring of patients prescribed benzodiazepines. The authors also urge more diligent surveillance of newly diagnosed patients, along with those who’d started to distance themselves from the VHA.
This research emphasizes the importance of targeted interventions, and how they can improve clinical outcomes and curb suicide rates among this already vulnerable population. The authors also advise beefing up safety planning for patients on benzodiazepines while ensuring continued mental health care engagement.
IN OTHER PSYCHIATRY AND NEUROLOGY NEWS
- This week, The Primary Care Companion for CNS Disorders published a report on two patients with very different presentations of lithium toxicity.
- JCP presents a subreddit analysis on the eating disorders that haunt the transgender and gender diverse communities.
- Another PCC case study explores a pair of patients who responded to biofeedback-based behavioral interventions for functional vomiting.
- Also in JCP this week, research that backs up the argument that single psilocybin treatment is safe in the longer term and could even offer long-lasting clinical benefits.
- And, finally, we return to our periodic series on “Emerging Approaches in Schizophrenia.”
