More Women Are Developing Multiple Sclerosis Than Men

Multiple Sclerosis

Over time, more women are developing multiple sclerosis than men.

In 1940, the ratio of women to men with MS in the United States was approximately two to one. By 2000, that ratio had grown to approximately four to one.

"That's an increase in the ratio of women to men of nearly 50 percent per decade," said study author Gary Cutter, PhD, of the University of Alabama at Birmingham School of Public Health. "We don't yet know why more women are developing MS than men, and more research is needed."

Cutter said researchers will need to explore multiple changes that have occurred for women over the last several decades, including the use of oral contraceptives, earlier menstruation, obesity rates, changes in smoking rates, and later age of first births.

"We also need to ask the general questions about what women do differently than men, such as use of hair dye and use of cosmetics that may block vitamin D absorption," he said. "At this point we're just speculating on avenues of research that could be pursued."

Cutter said the largest increase in the ratio has been for those whose MS started at younger ages.

For the study, researchers examined a database (the North American Research Committee On Multiple Sclerosis, or NARCOMS, hosted at Barrow Neurological Institute in Phoenix, Ariz.) of 30,336 people with MS and determined the male/female ratio according to the year the disease was diagnosed and the age of the person when the disease started.

Concerned Foreign Service Officers Warning On Mental Health Treatment

Mental Health of Foreign Service Officers

A recent article comments by the State Department's spokesperson, and recent efforts to poll Foreign Service Officers on mental health issues related to overseas postings prompt Concerned Foreign Service Officers to issue the following warning to members of the Foreign Service:

PTSD and other stress - or trauma-related mental illnesses are serious problems requiring medical care, and CFSOs urges anyone who may be suffering from such disorders to seek immediate treatment. We strongly urge, however, that FSOs seek such treatment from a private mental health care provider, and not through the Office of Medical Services of the U. S. Department of State (M/MED).

Concerns about the effect of mental health care treatment on security clearances, as reported in USA Today by former DG Pearson, are real. CFSOs has seen numerous cases where even allegations of mental health issues, ranging from PTSD to depression to marital discord to stress-related substance abuse have been referred by M/MED to Diplomatic Security (DS), usually resulting in recommendations to revoke a clearance. The issue is aggravated by the fact that M/MED keeps medical records related to such cases, including initial diagnoses, outside of normal medical files, in administrative files shared with, and sometimes even stored by, DS.

The State Department has asserted that such files are not subject to the HIPAA Act. Consequently, medical information will be shared with DS, with Human Resources employees, and even with security services of other agencies which may clear an employee, but not with the employee him/herself. It may take an employee three or four years to be able to access such information through the Privacy Act, and access may be denied completely. It is M/MED's stated policy not to remove or amend inaccurate information in its files, meaning that if a medical interview is inaccurately portrayed by the recording psychiatrist, it will stand as fact. We have seen cases where DS has based clearance revocations on 12-year-old medical information regarding conditions of which the employee has demonstrably been cured. We have also seen cases where files were destroyed, leaving employees with revoked clearances and no evidence to dispute. The Office of Medical Services has one patient and one patient only: The U. S. Department of State. As stated by a former Director of Mental Health Services, their "job is to prevent people like you from ever serving overseas again."

M/MED continues to maintain improper files, to withhold information from patients, and to regard themselves as "cops in doc's clothing." For these reasons, we urge any employee seeking mental health treatment to obtain such treatment privately. The employee may still be required to share information with M/MED and DS, but at least the employee will be able to compel HIPAA Act compliance and have a legal record, beyond the State Department's ability to suppress, of what actually transpired.

Survey Shows Wide Gap In Meeting World's Mental Health Care Needs

Mental disorders rank among the top ten illnesses causing disability " more than 37 percent worldwide " with depression being the leading cause of disability among people ages 15 and older, according to the Global Burden of Disease and Risk Factors published in 2006. Yet, the world's mental health care needs are largely going unmet, especially in less developed nations and in high-income countries, according to results from a new survey of 17 countries conducted as part of the World Health Organization ,, s (WHO) World Mental Health Survey Initiative. The results of the initiative, partially funded by the National Institutes of Health ,, s National Institute of Mental Health (NIMH), were published in The Lancet in September 2007.

"Good treatments are available for many mental disorders. Yet, the world continues to struggle with the very real challenge of providing these services to the people who most need them," said NIMH Director Thomas R. Insel. "The WHO survey unmistakably reinforces the urgency that we must do better."

Philip S. Wang, M. D., Dr. P.H., currently director of the NIMH Division of Services and Intervention Research, and colleagues analyzed data from face-to-face interviews on mental health service use with 84,848 adults across all economic spectrums in countries around the world. Respondents were asked about anxiety, post-traumatic stress, mood, and substance abuse disorders. They were also asked if they received any services in the past year for mental disorders; and if so, what types of services they had used, such as general medical professional, mental health professional, religious counselors or traditional healers.

The survey found that mental health service use varied significantly among the 17 countries. Overall, fewer people in less developed countries with mental disorders sought services compared with people in developed countries. In addition, the survey found that people in countries spending more of their gross national product (GDP) on health care used services more often. The U. S. population used services more than any other country, at 18 percent. By comparison, 11 percent of France ,, s population used services. The lowest rate of services use was 1.6 percent in Nigeria.

In all countries surveyed, women were more likely than men to seek mental health services. Additional results of countries surveyed found that,

* middle-aged people were more likely to receive services than those younger or older;

* people with more education were more likely to seek out services for mental problems; and

* married people were less likely to use mental health services than unmarried people.

Most of those who sought care for mental disorders received help from the general medical sector (primary care doctors, nurses) rather than specialized mental health services (psychiatrists, psychologists), religious or community counselors, or complementary and alternative medicine providers (including traditional healers). Among those receiving services, a substantial number of survey respondents reported that they did not receive minimally adequate services. The survey defines minimally adequate services as at least eight visits to any service sector, or being in ongoing treatment at the time of the interview, or receiving a medication for at least one month with four or more visits to a medical professional over a 12-month period.

Inadequate services were most commonly found in low-income countries, but even in some high-income countries, people received inadequate services. For example, in the United States, only 18 percent received minimally adequate services " much lower than any other high-income country. The next lowest level of minimally adequate services in a high-income country was 32 percent, in Japan. France and Germany had the highest level of adequate services, at 43 percent each.

"Although people sought and used services more in the United States, most did not receive adequate care " evidence of a striking disconnect in the U. S. mental health care system," said Dr. Wang, who conducted the research while he was at Harvard University. "We need to help developing countries implement more effective mental health care services, but we also need to do a better job at home. The global mental health care situation appears dire," concluded Dr. Wang.