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August 2014
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Psychiatric Services

A Journal of the American Psychiatric Association Editor: Howard H. Goldman, M.D., Ph.D.
Articles  |  August 1, 2014
Veterans Rate VHA Mental Health Care

Patient perceptions of care are increasingly recognized as an indicator of health care quality. In this study, 5,185 veterans who received care for mental or substance use disorders from the Veterans Health Administration were contacted by telephone to describe their impressions of care. The questions assessed a wide range of topics, from recovery orientation to symptom relief and promptness of appointments. Despite generally favorable perceptions of care, only 32% of veterans reported symptom relief, and there was room for significant improvement across all domains.

Articles  |  August 1, 2014
Treatment-Resistant Depression: A Heavy Burden

Treatment-resistant depression exacts a heavy price in treatment costs and lost productivity, reaching into the tens of billions of dollars, but its effects on the lives of patients are just as devastating. In this literature review, the authors summarize 62 studies documenting the disease’s toll on quality of life, personal financial resources, and general health. The average patient in the included studies had experienced nearly four earlier episodes of depression, had not responded to 4.7 drug trials, and continued to meet or nearly meet criteria for severe depression.

Articles  |  August 1, 2014
Anticipated Discrimination Constrains Young Lives

Self-imposed limitations due to a fear of discrimination may be just as devastating to persons with first-episode psychosis as the outright discrimination experienced in relationships or employment. In this study, 97 persons with first-episode psychosis and a mean age of 34 were asked about experiences with actual and anticipated discrimination. Many reported having curtailed everyday activities to avoid discrimination, thereby limiting access to opportunities and community resources typically available to younger people. Is discrimination a second illness? the authors asked.

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