JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENT
JAMA NEWS RELEASES
(Embargoed for Release: 3:00 p.m. CT, Tuesday, September 25, 2007)
JAMA NEWS RELEASES
ENHANCED PROGRAM FOR TREATING DEPRESSION APPEARS TO REDUCE SYMPTOMS, IMPROVE WORK PRODUCTIVITY AND BE COST-EFFECTIVE FOR EMPLOYERS
PATIENTS WITH CORONARY ARTERY DISEASE APPEAR TO HAVE INCREASED PREVALENCE OF COLORECTAL TUMORS
CONSUMPTION OF OMEGA-3 FATTY ACIDS ASSOCIATED WITH DECREASED RISK OF TYPE 1 DIABETES
JAMA REPORT (VIDEO SCRIPT)
VIDEO: Windows Media | Quicktime
ENHANCED DEPRESSION CARE PROGRAM IMPROVES CLINICAL OUTCOMES AND WORK PERFORMANCE FOR DEPRESSED WORKERS
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TV Note: This week's JAMA Report video is on an enhanced depression treatment program and its effect on symptoms and work productivity. The report will be fed Tuesday, September 25, from 9:00 - 9:30 a.m. ET and 2:00 - 2:30 p.m. ET, on Galaxy 26 (formerly Intelsat America 6) C-Band, Transponder 14, downlink frequency: 3880 vertical, audio 6.2/6.8. For more information, call 312/464-JAMA.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, September 25, 2007
Media Advisory: To contact Philip S. Wang, M.D., Dr.P.H., call Colleen Labbe at 301-443-4536. To contact editorial co-author Kenneth B. Wells, M.D., M.P.H., call Mark Wheeler at 310-794-2265.
ENHANCED PROGRAM FOR TREATING DEPRESSION APPEARS TO REDUCE SYMPTOMS, IMPROVE WORK PRODUCTIVITY AND BE COST-EFFECTIVE FOR EMPLOYERS
CHICAGO—Employees seeking treatment for depression who participated in a program that included a telephone outreach intervention had fewer symptoms, worked more hours and had greater job retention than participants receiving usual care, according to a study in the September 26 issue of JAMA.
Depression has enormous societal burdens, with annual U.S. economic costs of tens of billions of dollars due largely to productivity losses. Comparative cost-of-illness studies show that depression is among the most costly of all health problems to employers, according to background information in the article. Despite evidence that there are effective treatments, many depressed workers are untreated or inadequately treated. Employer-purchasers (those who purchase corporate health benefits) often do not invest in enhanced depression screening-treatment programs because of the uncertainty of the return-on-investment of such programs.
Philip S. Wang, M.D., Dr.P.H., of the National Institute of Mental Health, Rockville, Md., and colleagues examined the impact of a depression outreach-treatment program on the outcomes of depression symptom relief, job retention, sickness absence, and increased work productivity. The randomized controlled trial included 604 employees covered by a managed behavioral health plan who were identified in a 2-stage screening process as having significant depression. The telephonic outreach and care management program encouraged workers (n = 304) to enter outpatient treatment (psychotherapy and/or antidepressant medication), monitored treatment quality continuity, and attempted to improve treatment by giving recommendations to clinicians. Participants reluctant to enter treatment were offered a structured telephone cognitive behavioral psychotherapy. Three hundred participants received usual care.
The researchers found that measurements of depression severity were significantly lower in the intervention than in the usual care group by 6 months and at 12 months, and that patients in the intervention group were more likely to experience recovery (26.2 percent vs. 17.7 percent). Scores on the hours worked measure were significantly higher in the intervention than usual care group at 6 and 12 months. The data indicated that workers in the intervention group worked an average of two more hours per week than workers in the usual care group, which is equivalent to an annualized effect of more than two weeks of work. This overall effect was due to a higher rate of job retention (92.6 percent vs. 88.0 percent) and significantly more hours worked among employed respondents.
"The results suggest that enhanced depression care of workers has benefits not only on clinical outcomes but also on workplace outcomes," the authors write. "The financial value of the latter to employers in terms of recovered hiring, training, and salary costs suggests that many employers would experience a positive return on investment from outreach and enhanced treatment of depressed workers."
(JAMA. 2007;298(12):1401-1411. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: REDUCING THE BURDEN OF DEPRESSION
In an accompanying editorial, Kenneth B. Wells, M.D., M.P.H., and Jeanne Miranda, Ph.D., of the University of California, Los Angeles, comment on the challenge of treating depression.
"Exactly how programs to improve depression care are implemented may affect the distribution of benefits—an important issue given evidence of disparities in quality of depression care and the potential for practice-based programs to overcome disparities in depression outcomes. Developers of interventions and policies should consider implications of their design for inclusion of underserved groups who may not seek behavioral health care. Despite the extensive efforts by Wang et al to reach general employees, the majority of persons had already inquired about outpatient care. Learning how to optimize personal and societal gains by improving access to quality depression care across diverse communities through employer, practice, and community-based programs and policy changes is a next agenda for evidence-based action. As a community participant in the Witness for Wellness program recently stated: 'Depression is everybody's business.'"
(JAMA. 2007;298(12):1451-1453. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, September 25, 2007
Media Advisory: To contact Annie On On Chan, M.D., Ph.D., email: aoochan{at}hku.hk.
PATIENTS WITH CORONARY ARTERY DISEASE APPEAR TO HAVE INCREASED PREVALENCE OF COLORECTAL TUMORS
CHICAGO—Patients in Hong Kong who were newly diagnosed with coronary artery disease had nearly twice the prevalence of colorectal tumors and cancers, with this association stronger in persons who had smoked or have the metabolic syndrome, according to a study in the September 26 issue of JAMA.
Colorectal cancer is the second most prevalent cancer worldwide, with an estimated 1 in 20 healthy individuals eventually developing the disease. Coronary artery disease (CAD) is the leading cause of death in the United States and other industrialized countries, according to background information in the article. Colorectal neoplasm ("precancerous" tumors or cancer) and coronary artery disease (CAD) share similar risk factors, and their co-occurrence may be associated.
Annie On On Chan, M.D., Ph.D., of the University of Hong Kong, China, and colleagues investigated the prevalence of colorectal cancer and colorectal neoplasms in patients with newly diagnosed CAD. Participants in the study were from Hong Kong and were recruited for screening colonoscopy after undergoing coronary angiography for suspected CAD from November 2004 to June 2006. Presence of CAD (n = 206) was defined as at least 50 percent diameter narrowing in any one of the major coronary arteries; otherwise, patients were considered CAD-negative (n = 208). An age- and sex-matched control group was recruited from the general population (n = 207).
The researchers found that colorectal neoplasms and advanced lesions were more prevalent (34.0 percent and 18.4 percent, respectively) in the CAD-positive group than in the CAD-negative (18.8 percent and 8.7 percent) and general population (20.8 percent and 5.8 percent) groups. The prevalence of cancer was 4.4 percent, 0.5 percent, and 1.4 percent, in the CAD-positive, CAD-negative, and general population groups, respectively. Fifty percent of the cancers in the CAD-positive participants were early stage.
The researchers also found that both the metabolic syndrome and history of smoking were strong independent predictive factors for the positive association between advanced lesions and CAD.
Regarding the association between these two diseases, the authors speculate: "Both colorectal neoplasm and CAD probably develop through the mechanism of chronic inflammation. Inflammation is now recognized as being pivotal in the pathogenesis of atherosclerosis and, hence, CAD. Colorectal cancer is also thought to progress through the pathway of inflammation."
(JAMA. 2007;298(12):1412-1419. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, September 25, 2007
Media Advisory: To contact Jill M. Norris, M.P.H., Ph.D., call Caitlin Jenney at 303-724-1520.
CONSUMPTION OF OMEGA-3 FATTY ACIDS ASSOCIATED WITH DECREASED RISK OF TYPE 1 DIABETES
CHICAGO—Preliminary research suggests that in children at increased risk for type 1 diabetes, dietary intake of omega-3 fatty acids was associated with a reduced risk of pancreatic islet autoimmunity, which is linked to the development of diabetes, according to an article in the September 26 issue of JAMA.
"Type 1 diabetes mellitus is an autoimmune disease that is characterized by the destruction of insulin-producing beta cells in the pancreatic islets. Although it is not yet known what initiates the autoimmune process, it is likely that both genetic background and environmental factors contribute to the disease process," the authors write. Certain dietary factors have been associated with the onset of type 1 diabetes as well as the autoimmune process that leads to the disease.
Jill M. Norris, M.P.H., Ph.D., of the University of Colorado at Denver and Health Sciences Center, Denver, and colleagues examined whether consumption of omega-3 and omega-6 fatty acids are associated with the development of pancreatic islet autoimmunity (IA; development of antibodies against the cells in pancreas that produce insulin) in children. The study, conducted between 1994 and 2006, included 1,770 children at increased risk for type 1 diabetes, defined as either possession of a high diabetes risk HLA (human leukocyte antigen) genotype or having a sibling or parent with type 1 diabetes. The average age at follow-up was 6.2 years. Islet autoimmunity was assessed in association with reported dietary intake of polyunsaturated fatty acids starting at age 1 year. Fish is the primary source of marine polyunsaturated fatty acids. Childhood diet was measured using a food frequency questionnaire (FFQ).
A case-cohort study (n = 244) was also conducted in which risk of IA by polyunsaturated fatty acid content of erythrocyte membranes (outer portion of the red blood cell) was examined.
Fifty-eight children became positive for IA during follow-up. Adjusting for HLA genotype, family history of type 1 diabetes, caloric intake, and total omega-6 fatty acid intake, total omega-3 fatty acid intake was inversely associated with IA risk (a 55 percent reduced risk). The association was strengthened when the definition of the outcome was limited to those positive for two or more autoantibodies. In the case-cohort study, omega-3 fatty acid content of erythrocyte membranes was associated with a 37 percent decreased risk of IA.
"Our study suggests that higher consumption of total omega-3 fatty acids, which was reported on the FFQ, is associated with a lower risk of IA in children at increased genetic risk of type 1 diabetes," the researchers write.
(JAMA. 2007;298(12):1420-1428. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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JAMA REPORTS
VIDEO: Windows Media | Quicktime
ENHANCED DEPRESSION CARE PROGRAM IMPROVES CLINICAL OUTCOMES AND WORK PERFORMANCE FOR DEPRESSED WORKERS
INTRO:
People who suffer from depression often have trouble performing well at work. But a new study says that a systematic program to identify depression and promote effective treatment for depressed workers can improve their symptoms, and their work productivity. Mavis Prall explains in this week’s JAMA Report.
VIDEO:
NAT SOT UP FULL FOR :04
Young woman "on the street" interview
AUDIO:
"I myself have suffered from depression and counseling helped me."
VIDEO:
B-ROLL
Professional people walking on city sidewalks… no faces showing
At "counseling" cuts to psychotherapist with patient
AUDIO:
DEPRESSION IS VERY COMMON, AND CAN NEGATIVELY AFFECT A PERSON’S ABILITY TO WORK. COUNSELING CAN BE EFFECTIVE. SO, WHAT IF EMPLOYERS OFFERED DEPRESSED EMPLOYEES ACCESS TO A DIFFERENT KIND OF DEPRESSION CARE.
VIDEO:
SOT/FULL
@ :18
Super: Philip Wang, M.D., Dr.P.H.
National Institute of Mental Health
Runs :09
AUDIO:
"We took this study on to see whether, if you enhance the care of depression, whether you can actually improve not only people’s depressive symptoms but also their lost work productivity."
VIDEO:
B-ROLL
Hold bite up through name
NIMH sign
Dr. Wang talking to colleague in office
Man picking up fax
AUDIO:
DR. PHILIP WANG (pronounced WONG) AND COLLEAGUES AT THE NATIONAL INSTITUTE OF MENTAL HEALTH WERE AMONG THE RESEARCHERS WHO CONDUCTED THE STUDY. THEY SCREENED WORKERS AT SIXTEEN NATIONAL COMPANIES FOR DEPRESSION.
VIDEO:
SOT/FULL
Philip Wang, M.D., Dr.P.H.
National Institute of Mental Health
Runs :17
AUDIO:
"Half the workers who were found to be depressed were assigned to an enhanced depression care program consisting of telephone support from a care manager, and the option of telephone psychotherapy for those who weren’t interested in traditional in person treatments like in-person psychotherapy or medications."
VIDEO:
B-ROLL
Women talking in hallway
GFX/JAMA COVER
AUDIO:
THE OTHER HALF GOT USUAL CARE, WHICH WAS ADVICE TO SEEK DEPRESSION TREATMENT ON THEIR OWN. THE STUDY LASTED A YEAR, AND THE FINDINGS APPEAR IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.
VIDEO:
SOT/FULL
Philip Wang, M.D., Dr.P.H.
National Institute of Mental Health
Runs :10
AUDIO:
"The group that was given the enhanced depression care was 40% more likely to recover from depression at the end of the 12-month period. They were also 70% more likely to still be working."
VIDEO:
B-ROLL
Woman talking on phone, then working at her desk, going through files
AUDIO:
AND THOSE IN THE ENHANCED CARE GROUP WORKED ON AVERAGE TWO MORE HOURS PER WEEK COMPARED TO DEPRESSED WORKERS IN THE USUAL CARE GROUP. DR. WANG SAYS THE BENEFITS OF THE ENHANCED CARE ON WORKER PRODUCTIVITY ARE LIKELY TO OUTWEIGH THE FINANCIAL COSTS TO EMPLOYERS.
VIDEO:
SOT/FULL
Philip Wang, M.D., Dr.P.H.
National Institute of Mental Health
Runs :14
AUDIO:
"Currently employers view healthcare benefits for their workers as just costs and essentially a black hole from which they get no benefit. Our results suggest that healthcare benefits are actually an investment opportunity for employers and a way to improve their bottom line."
VIDEO:
B-ROLL
Woman working at her desk/computer
AUDIO:
THIS IS MAVIS PRALL WITH THE JAMA REPORT.
TAG:
Most people in the enhanced care group chose telephone counseling over in-person treatment. The study authors say that this program could save employers money down the road by keeping workers performing well, rather than incurring hiring, training and salary costs to replace depressed workers. For more information, visit www.jama.com.
