Sixty-two subjects, 45 with post-traumatic stress disorder (PTSD) and 17 healthy control subjects, were examined in a study of serotonin function measured by [H-3]paroxetine binding to platelet membranes. Subjects were selected from male combat exposed veterans. The mean (+/-S.D.) K-d was 0.078+/-0.045 nM for the PTSD patient group and 0.064+/-0.037 nM for the control group. The mean B-max was 934+/-238 fmol/mg protein for the PTSD patient group and 1011+/-363 fmol/mg protein for the control group. There was no significant difference between the groups for either K-d or B-max, before or after controlling for season of sampling. There were no significant differences between subjects with current PTSD and those with PTSD in the past, or between PTSD subjects with or without concurrent major depressive disorder. This study finds no relationship between PTSD, major depressive disorder and peripheral serotonin function measured by [H-3]paroxetine binding to blood platelets. (C) 1998 Elsevier Science Ireland Ltd.
The Patient Protection and Affordable Care Act (ACA) will greatly increase coverage for treatment of substance use disorders. To realize the benefits of this opportunity, it is critical to invest in the development of reliable, valid and feasible measures of quality to ensure that treatment is accessible and of high-quality. The authors review the availability of current quality measures for substance use disorder treatment and conclude there is a pressing need for additional measure development, validation and use. While there are unique challenges to developing and using quality measures for substance use disorders, the authors provide specific recommendations for research and policy changes which will increase the likelihood that patients, families and society will benefit from the increased coverage provided by the ACA.
The number of clinically trained individuals who perform research is declining. Although it is often observed that the clinician-researcher is necessary, the reasons are rarely discussed. In this article, the authors critically consider the complexities of the role of the patient-oriented clinician-researcher at the interface of behavioral health treatment and research. The authors note that patient-oriented clinician-researchers can serve as effective “bridgers” between the research and practice communities and can facilitate both the development of clinically relevant research and the dissemination of evidence-based treatments into routine clinical services. However, care needs to be taken to address the potential for ethical and role conflicts. Programs can encourage trainees to become clinician-researchers by providing opportunities for them to meet with patient-oriented clinician-researchers and by including course-work that raises their awareness of ethical and role conflicts and provides them with the skills needed to be effective “bridgers.”
Four years of data from the National Household Survey on Drug Abuse were combined to examine the characteristics of underinsurance in a sample of privately insured Americans aged 18 to 64. Among these adults, 38 percent (45 million) reported not having behavioral health coverage or not knowing their coverage. Young adults aged 18 to 25, Hispanics, Asians, adults in the lowest income level, and less educated adults were more likely to be underinsured. Untreated addictive and psychiatric problems are costly to society. Underinsurance among socially disadvantaged subgroups deserves greater attention from researchers and policy makers.