Sorry about all the JAMA this morning but there’s a lot. And this one is particularly upsetting because the US still uses psychiatry as a weapon against women, and I suppose the only difference between a private prison and a private psychiatric hospital would be the mandatory medication. And that’s pretty terrifying.

Question  How has private equity (PE) investment among US psychiatric hospitals changed in recent years, and what is the cross-sectional association of PE with geography, staffing, and quality?
Finding  About 14% of US psychiatric hospitals were owned by PE in 2021, with two-thirds of these facilities located in the southern US. In adjusted models, PE ownership was associated with lower staffing ratios but higher performance on quality measures of restraint, 7- and 30-day follow-up visits, and 30-day all-cause readmission.
Meaning  These results demonstrate that PE ownership among US psychiatric hospitals is growing, underscoring the importance of US Centers for Medicare & Medicaid Services initiatives to monitor patient experience.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2833839

May 16, 2025

CDC: Better Screening Access Drives Rise in Autism Diagnoses
https://jamanetwork.com/journals/jama/fullarticle/2834344

Someone tell the lunatics at #MAHA please.

Oh look- providing housing to people who can’t afford it actually saves money.

From the link:

Question  To what extent does a Medicaid housing benefit pilot program address the housing needs of participants, and what are the financial implications of implementing the program?
Findings  In this cohort study, 517 individuals were enrolled; top needs were rent and utility support, and service utilization mirrored these needs. Overall, the mean (SD) cost per member per month was $2225 ($1586).
Meaning  The findings of this study of a pilot program highlight a critical need for housing supports among Medicaid members and offer lessons for design and implementation of similar programs, including a key insight on the necessity of cross-sector collaboration between health care and housing organizations.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2834358

This is really interesting if you care about abortion, IVF, or women’s healthcare.

“Yet like abortion, IVF also involves embryo death. Approximately 63% of embryos created in IVF in the US are discarded outside a uterus,1 and depending on patient age, 56% to 90% of frozen embryos transferred into a uterus perish before a live birth. (The subcategories in “discarded”—destroyed, did not survive thaw, and indefinitely frozen with no plans for future use—are not quantified.1 A small number are also donated for research or to others pursuing pregnancy.)”

Rethinking the Ethical and Legal Relationship Between IVF and Abortion
https://jamanetwork.com/journals/jama/fullarticle/2834393

“Gender and Career Milestones of Mid-Career to Senior Medical Faculty Who Held Career Development Awards”
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2833835

Yeah, idk about this one.

It seems to me it’s more likely that reducing migraines reduced the symptoms that led to the patient being labeled depressed, than this medication helping depression by itself.

It would be great if it helped with depression in itself, but I know for a fact that because of my chronic illness when I answer those depression screening questions honestly the symptoms of my chronic illness make that screening in indicate I have depression when I absolutely do not. I have an energy limiting neurological disorder. And migraines lol

“Fremanezumab for the Treatment of Patients With Migraine and Comorbid Major Depressive Disorder
The UNITE Randomized Clinical Trial”
https://jamanetwork.com/journals/jamaneurology/fullarticle/2833452

@juliaro this study published in #jama talks about the cardiovascular consequences of conversion therapy.

It is damaging to people’s health. It’s actual science. Since bigots care about money shouldn’t they care that this abusive practice will cost the NHS tons of cash later on??

“Question  Are exposures to sexual orientation and gender identity change efforts (SOGICE) associated with increased risk of cardiovascular disease?
Findings  In this cohort study of 703 sexual and gender minority young adults assigned male at birth, SOGICE exposure was associated with elevated blood pressure, increased systemic inflammation, and higher odds of self-reported hypertension diagnosis.
Meaning  These results suggest that exposure to SOGICE may increase the risk of adverse cardiovascular health outcomes, underscoring the need for enforcement of bans and affirmative care approaches.”
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833579

May 12, 2025
Changes in Physical and Mental Health After the End of #SNAP Emergency Allotments
https://jamanetwork.com/journals/jama/fullarticle/2833863

Prescription Stimulant Prescribing, Nonmedical Use, and Shortages
US FDA Research and Response

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2831898

Addressing the Double Bind of Women’s Anger After Trauma

“Compounding recovery from problem anger after trauma is that healthy anger in women is pathologized. Societal forces, some universal and others culturally specific, include the perceived values of femininity, motherhood, and inappropriateness of anger in women. This is not an outdated notion—contemporary research has shown that women’s anger is unacceptable to 94% of individuals.”

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2831149

Conversion therapy causes cardiovascular issues according to science:

Question  Are exposures to sexual orientation and gender identity change efforts (SOGICE) associated with increased risk of cardiovascular disease?
Findings  In this cohort study of 703 sexual and gender minority young adults assigned male at birth, SOGICE exposure was associated with elevated blood pressure, increased systemic inflammation, and higher odds of self-reported hypertension diagnosis.
Meaning  These results suggest that exposure to SOGICE may increase the risk of adverse cardiovascular health outcomes, underscoring the need for enforcement of bans and affirmative care approaches.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833579

I was afraid to read this because I’m really sick of the stigma of chronic pain.

I got one of those “did you know there are other treatments for pain besides opioids” letters from medicare yesterday. Seems like a tolling attempt when the stuff they list (like massage and acupuncture) aren’t usually covered by Medicare. None of us can afford regular out of pocket massage.

This is a regular thing that they send, but the terrifying difference is that this letter had a paragraph about how part D plans can change the formulary at any time throughout the year.

I think they’re warning me that they’re going to stop covering pain medication for chronic pain. And the timing of this article being sent out again makes me even more suspicious.

“Editorial
February 17, 2025
Integrating Buprenorphine Into Chronic Pain Treatment—Putting the Choice in VOICE”
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2830025

Question:  Is the influenza vaccine alone or with a COVID-19 vaccine associated with change in menstrual cycle length?
Findings:  In this cohort study of 1501 participants, in individuals with regular menstrual cycles, a temporary small but statistically significant increase in menstrual cycle length (<1 day) with receipt of an influenza vaccine, with or without a COVID-19 vaccine, based on vaccination in the follicular phase was found.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833217

#JAMA #study #vaccines #covid #influenza
#fertility

I was afraid to read this one. I thought it would tell me horrible things. But it’s not bad.

Incidence and Prevalence of Reported Euthanasia Cases in Belgium, 2002 to 2023
“Meaning  These findings suggest that the euthanasia safeguards implemented in Belgium appear effective, as patterns in euthanasia reflect the initial effects of legislation, harmonization across subgroups, and the impact of an aging population.”

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833177

Question  What are the mental and somatic health outcomes among Danish transgender persons?
Findings  This national register-based cohort study comprising 3812 Danish transgender persons and 38 120 cisgender controls found significantly higher odds for mental and somatic health diagnoses among transgender persons. Mental health diagnoses and use of psychopharmacologic drugs coexisted with somatic diagnoses and use of drugs for somatic diseases.
Meaning  This study suggests that higher mental and physical morbidity could be associated with stress of belonging to a gender minority group and should be considered as an integrated part of transgender care.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833189

Oh look: The Shingles Vaccine seems to help prevent dementia. It makes sense, herpes viruses can damage the brain by causing encephalitis or meningitis (I confuse those a lot so I don’t remember I’m sorry) so it makes sense that this could protect the brain.

“Question  What is the effect of herpes zoster vaccination on the probability of receiving a new diagnosis of dementia?
Findings  In this quasi-experimental study using electronic health record data from Australia, being eligible for herpes zoster vaccination based solely on date of birth significantly decreased the probability of receiving a new dementia diagnosis during 7.4 years by 1.8 percentage points.
Meaning  By taking advantage of a quasi-experiment, this study provides evidence for a beneficial effect of herpes zoster vaccination for preventing or delaying dementia that is more likely to be causal than the associations reported in the existing correlational evidence.”
https://jamanetwork.com/journals/jama/fullarticle/2833335

It’s not a coincidence that this was sent out last week, and that they appear to be targeting women who want to have a career.

They’re coming for our #ADHD meds.

From the link:

Although women aged 35 to 64 years experienced the largest increase in dispensed prescription stimulants, the prevalence of misuse was lowest among this demographic at about 14%. In comparison, nearly 37% of women aged 18 to 35 years reported misuse.

https://jamanetwork.com/journals/jama/fullarticle/2833100

RIP #CDC

“Fleming noted that he was particularly concerned that #HIV prevention efforts had been “substantially cut,” that the National Institute for Occupational Safety and Health (#NIOSH ) is ‘essentially gone,’ and that staff members who worked on cancer clustershad been fired.”
“The April 2 letter also listed asthma, tobacco use, violence prevention, lead poisoning, reproductive health, global health threats, birth defects, and #disability and injury prevention as CDC programs affected by the firings.”
https://jamanetwork.com/journals/jama/fullarticle/2833210

What are the recent trends and epidemiological findings in invasive group A Streptococcus (GAS) infections in 10 US states?:

https://jamanetwork.com/journals/jama/fullarticle/2832277