China's smog taints economy, health









BEIJING — When a thick quilt of smog enveloped swaths of China earlier this month, it set in motion a costly chain reaction for the world's No. 2 economy.


Authorities canceled flights across northern China and ordered some factories shut. Hospitals were flooded with hacking patients.


A fire in an empty furniture factory in eastern Zhejiang province went undetected for hours because the smoke was indistinguishable from the haze. In coastal Shandong province, most highways were closed for fear that low visibility would cause motorists to crash. And in Beijing, the local government urged residents to remain indoors and told construction sites to scale back activity.





"These are emergency measures that have the same economic impact as a strike or severe weather," said Louis Kuijs, a Hong Kong-based economist with the Royal Bank of Scotland and formerly of the World Bank. "They're very painful."


Residents in the capital have taken to mocking their famously filthy air and its attendant health hazards with the expression "Beijing cough." Meanwhile, Shanghai's Environmental Protection Bureau has introduced a cartoon mascot to communicate daily air quality on its website: a pig-tailed girl who bursts into tears when smog reaches hazardous levels.


But economists say China's smog is no joke. As air pollution continues to obscure China's cities, the cost to the nation in lost productivity and health problems is soaring. The World Bank estimates sickness and early death sapped China of $100 billion in 2009, or just under 3% of gross domestic product. China is now home to seven of the 10 most-polluted cities in the world, according to a report by the Asian Development Bank and Beijing's Tsinghua University.


A study by Greenpeace and Peking University's School of Public Health put the cost of healthcare to treat pollution-related ailments in Beijing, Shanghai, Guangzhou and Xian at more than $1 billion last year.


Beijing resident Zhang Jian takes his 2-year-old son to a doctor regularly to treat the toddler's chronic sinus infection.


"It's definitely related to the pollution," said Zhang, 35, who wore a disposable mask at an overcrowded children's hospital recently. "My son snores and his nose is blocked constantly. It's a problem because he's too young to clear his nose like adults."


The doctor's visit and treatment cost Zhang about $320 — nearly a week's pay for the IT professional.


The Beijing government says it's considering a host of emergency measures to clear the air. Among them: limiting vehicle usage, spraying building sites to reduce dust and restricting outdoor barbecue grills.


Even China's next premier, Li Keqiang, weighed in recently on the issue. "This is a problem accumulated over a long period of time, and solving the problem will also require a long time. But we need to take action."


China's smog crisis is not unlike those experienced in London and Los Angeles in the 1950s. Public outcry ultimately led to cleaner air and tougher environmental regulations.


Environmental activists hope the same happens in China. The official response in recent weeks has raised optimism that authorities will begin addressing pollution more openly.


Until recently, state media was loathe to use the word "pollution," opting instead for the euphemism "fog."


But popular pressure is building, making it harder for policymakers to ignore the foul air in many of China's largest cities.


After the staggeringly bad bout of air pollution in the middle of this month, micro-bloggers took to posting pictures of themselves online wearing masks.


Some held handwritten signs that read, "I don't want to be a human vacuum cleaner."


The phrase became the top-trending topic on the Twitter-like Sina Weibo, attracting several million hits.


"Return my blue sky and white clouds," wrote a blogger named Xiao Yu. "If economic development needs to come with the price of such heavy pollution, I would rather go back to the 1980s."





Read More..

Palmdale woman accused of torturing her children









Neighbors of a Palmdale woman charged with assaulting and torturing two of her children said Thursday that they never even realized she had kids.


The siblings — a boy, 8, and girl, 7 — did not play outside and were rarely seen, said Cynthia Otero, who runs a day care center at a home opposite the house in the 39000 block of Clear View Court where Ingrid Brewer is alleged to have mistreated the youngsters.


Otero said that when she recently spotted the children getting out of a car, she thought Brewer, 50, "might be baby-sitting."








So neighbors in the suburban cul-de-sac were the more shocked when word spread that Brewer was arrested on suspicion of crimes against her children, she said. Brewer is being charged with eight felony counts, including torture, assault with a deadly weapon and cruelty to a child.


According to authorities, Brewer reported the children missing Jan. 15, prompting a search by deputies from the Los Angeles County Sheriff's Palmdale Station. The youngsters were found hours later hiding under a blanket near a parked car on a street close to their home. They were without winter clothes in 20-degree weather, authorities said.


Sgt. Brian Hudson, a spokesman for the sheriff's Special Victims Bureau, said the children told investigators they ran away because Brewer deprived them of food, locked them in separate bedrooms when she went to work each day, bound their hands behind their backs with zip ties and beat them with electrical cords and a hammer. The youngsters also said that when they were locked in the bedrooms and needed to use the bathroom, they instead had to use wastebaskets, Hudson said.


They fled because "they were tired of being tied up and beaten," Hudson said.


Hudson said both children had injuries consistent with the alleged abuse, including marks on their wrists indicating they had been restrained and "numerous bruising and abrasions over their bodies." They told investigators the mistreatment had been happening since Halloween.


Neighbors interviewed by authorities said they had never noticed anything suspicious but "hardly ever saw the two children," Hudson said. Otero and another neighbor said Brewer did not make friends on the block.


Otero said Brewer was "unfriendly" and typically ignored verbal greetings and waves.


According to sheriff's officials, Brewer, a certified nursing assistant who works in Los Angeles and has adult children, adopted the young siblings about a year ago from foster care. They were home schooled.


Neil Zanville, a spokesman for the county Department of Children and Family Services, said his agency was legally prohibited from disclosing any case-specific information about past or present clients. But in a written statement, the agency's director, Philip Browning, called the report disturbing.


"While we cannot confirm or deny whether this family is under our supervision, I am personally looking into this situation to determine what role, if any, our department had in these children's lives," Browning said.


Sheriff's officials said Thursday that the children were "doing great" despite their injuries.


Otero lamented that they had been made to suffer.


"It's just so sad," said the neighbor, who has a 5-year-old daughter and 8-year-old twins. "I wish they would have knocked on my door. I would have helped them."


Brewer is in the custody of the Sheriff's Department, with bail set at $2 million. She is scheduled to appear in court Thursday, Hudson said.


ann.simmons@latimes.com


Times staff writer Kate Mather contributed to this report.





Read More..

Nokia CEO closes the door on a potential Android smartphone






Nokia (NOK) CEO Stephen Elop on Thursday shot down rumors that his company might be interested in developing Android-based smartphones. During Nokia’s fourth-quarter earnings call, the executive reiterated his support for the company’s Asha phones and Microsoft’s (MSFT) Windows Phone platform, while shutting the door on earlier Android rumors.


[More from BGR: Unlocking your smartphone will be illegal starting next week]






“We are clearly innovating with Microsoft around Windows Phone, and are focused on taking that to lower and lower price points,” he said, according to TechCrunch. “You will see that over time [we will] compete with Android. But at the same time we’ve said consistently — and we’re just beginning to see it in the Asha full-touch products — that we will continue to innovate around our Asha smartphone line in order to compete with the very lowest levels of Android.”


[More from BGR: Why the iOS-Android feud is so intense: It’s about core philosophy more than products]


The executive also took shots at Google (GOOG) and the openness of its Android operating system, or lack thereof.


“The situation that Android is facing, where the amount of fragmentation that you’re seeing is increasing as people take it in different directions, is of course offset by Google’s efforts to turn an open ecosystem into something that’s quite a bit more closed as you’ve seen quite recently,” Elop said.


Elop concluded by saying that Nokia is “not in a situation where we are considering something other than Windows Phone combined with what we’re doing with Asha.”


This article was originally published on BGR.com


Wireless News Headlines – Yahoo! News





Title Post: Nokia CEO closes the door on a potential Android smartphone
Url Post: http://www.news.fluser.com/nokia-ceo-closes-the-door-on-a-potential-android-smartphone/
Link To Post : Nokia CEO closes the door on a potential Android smartphone
Rating:
100%

based on 99998 ratings.
5 user reviews.
Author: Fluser SeoLink
Thanks for visiting the blog, If any criticism and suggestions please leave a comment




Read More..

Damon 'hijacks' Kimmel's ABC show


NEW YORK (AP) — Matt Damon had his revenge.


The butt of a long-running joke on ABC's "Jimmy Kimmel Live," the actor opened Thursday night's show as a kidnapper who tied Kimmel to a chair with duct tape and gagged him with his own tie.


"There's a new host in town and his initials are M.D.," Damon said. "That's right, the doctor is in."


For years, Kimmel has joked at the end of his show that he ran out of time and was unable to bring Damon on as a guest. Kimmel was the silent one Thursday, watching from the back of the stage as Damon did his job.


Damon tormented Kimmel by bringing on a succession of big-name guests. Robin Williams stopped by to finish the monologue. Ben Affleck had a walk-on role. Sheryl Crow was the bandleader and performed her new single. Nicole Kidman, Gary Oldman, Amy Adams, Reese Witherspoon and Demi Moore all crowded the talk show's couch.


"I've been waiting for this moment for a long, long time," Damon said. "This is like when I lost my virginity, except this is going to last way longer than one second."


Damon's guest hosting turn came at a key time for Kimmel. ABC earlier this month moved the show to 11:35 p.m. ET and PT after a decade of airing it a half hour later, putting him in direct competition with Jay Leno and David Letterman.


Thursday's special program aimed for the same water-cooler status as a memorably lewd short film Damon made for the show a few years ago with Kimmel's then-girlfriend, Sarah Silverman. It went viral and remains probably the best-known skit in the show's history.


To twist the knife even further, Damon brought Silverman on as his final guest Thursday night, with Kimmel looking on forlornly as she likened their five-year relationship to an unfortunate trip to a hot dog vendor.


"Is there anything you'd like to say to Jimmy?" Damon asked.


"No, I'm good," Silverman replied.


Then came the sweetest revenge of all, with Damon promising to ungag Kimmel in the show's final minutes.


"Wait," he said. "I'm sorry. We're out of time."


Read More..

The New Old Age Blog: Time to Recognize Mild Cognitive Disorder?

The Diagnostic and Statistical Manual of Mental Disorders, published and periodically updated by the American Psychiatric Association, is one of those documents few laypeople ever read, but many of us are affected by.

It can make it easier or harder to get an insurance company or Medicare to cover treatments, for example. It factors into a variety of legal and governmental decisions.

And on a personal basis, a psychiatric diagnosis may be welcome (having a name and a treatment plan for what’s bothering us can be comforting) or not (are we really suffering from a mental disorder if we seem depressed after a family member dies?).

That last question refers to a change in the new DSM5, to be published in May, that has generated considerable controversy and that I discussed in an earlier post: the removal of the “bereavement exclusion,” once part of the diagnosis of Major Depressive Disorder.

Another element of the revised DSM could also affect readers: It will include something called Mild Neurocognitive Disorder. The task force revising the manual wanted to align psychiatry with the rest of medicine, which has already begun to distinguish between levels of impairment, said its chairman, David Kupfer, a University of Pittsburgh psychiatrist.

True enough, as we have reported before. Neurologists call it Mild Cognitive Impairment, a stage where cognitive decline becomes noticeable enough to affect daily functioning, yet people can still live independently and have not progressed to dementia.

In fact, a large proportion of people with mild cognitive problems never will develop dementia — but doctors and researchers cannot yet determine who will and who won’t. Biomarkers that could identify the biological brain changes that presage dementia are still years away.

Will it be helpful, then, for health professionals using the DSM5 — most of them not psychiatrists, but primary care doctors — to begin diagnosing Mild Neurocognitive Disorder? Particularly as there is no treatment that can reverse it or reliably slow its progression, if it would progress?

Dr. Ronald Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center and a member of the working group that developed the new DSM5 criteria, said he thought the newly recognized disorder would be useful. “The predementia phase is becoming increasingly important,” he told me in an interview.

Counseling could help people compensate for the memory loss and other deficits they are experiencing, for example. With a DSM-recognized diagnosis, those approaches are more likely to be covered by insurers.

Besides, “one argument against Alzheimer’s therapies is that we wait too late, when there’s too much damage to the central nervous system to repair,” Dr. Petersen said, referring to several recent disappointing drug trials. In the future, with earlier diagnoses, “you may be able to intervene, stop the process and forestall the dementia.”

But as we have seen with screening tests for other diseases, early detection does not always lead to better health or longer lives. It can, however, lead to unnecessary treatments and procedures involving risks of their own. Could that happen with Mild Neurocognitive Disorder?

“It will lead to wild overdiagnosis,” predicted Allen Frances, an emeritus professor of psychiatry at Duke and the chairman of the task force that developed the previous DSM edition. Indeed, about a quarter of people initially diagnosed with mild cognitive impairment are later determined to be normal, a prominent researcher told my colleague Judy Graham last year.

“People will get unnecessary tests and start getting weird treatments that have no proven efficacy,” said Dr. Frances, who has criticized a number of DSM5 changes. “They’re going to worry like crazy about being demented.”

Dr. Petersen agreed that it was a legitimate concern, but “by and large, we’re becoming better at distinguishing between the normal cognitive effects of aging and disease.” (The American Psychiatric Association will publish a specialized DSM for primary care physicians, Dr. Kupfer pointed out, to help guide them through diagnoses.)

It is hard for patients and families to know how to react when experts disagree. But keep in mind that contemporary health care aims for what is called shared decision-making. That means patients and professionals discuss options and weigh the risks and benefits of treatments and procedures, their likely outcomes, patients’ preferences, and come to agreement on how to proceed. This essay in the New England Journal of Medicine calls shared decision-making “the pinnacle of patient-centered care.”

So when Dr. Frances refers to the DSM5 as “a guide, not a bible,” and urges skepticism about some of its diagnoses, he is advocating an approach that patients and families should probably bring to any medical decision.

Seeking further information, asking questions, assessing options — those are reasonable responses if, a few weeks after a loved one’s death, a doctor says you may have major depression. Or if she thinks your memory loss could mean Mild Neurocognitive Disorder.

“The shorter the evaluation, the less the person knows you, the less he or she can explain and justify the diagnosis, the more tests and treatments that will result, the more a person should be cautious and get a second opinion,” Dr. Frances said.

Whatever the DSM5 says, it’s hard to argue with that.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

Lawmaker questions Disney's plan for wristband data









A congressman from Massachusetts raised questions Thursday about how Walt Disney Co. will use information it collects when it gives parkgoers new wristbands embedded with computer chips.


Edward J. Markey (D-Mass), who co-chairs a congressional panel on privacy, asked Walt Disney Co. Chairman and Chief Executive Robert A. Iger in a letter what information the park will collect with the so-called MagicBand and how it will be used.


"Widespread use of MagicBand bracelets by park guests could dramatically increase the personal data Disney can collect about its guests," he said, adding that he is particularly concerned at the prospects of Disney collecting information about children.





Disney announced recently that it plans to unveil this spring at Walt Disney World in Florida a wristband embedded with radio frequency identification chips. A unique code in each chip lets parkgoers pay to enter the park, check into Disney hotels and buy food and souvenirs, among other things.


Disney officials promoted the wristbands as a way to make visiting the park easier. The wristbands will let Disney use the data to customize future offerings and marketing pitches.


Disney officials say they have no plans yet to introduce the wristbands at Disneyland or Disney California Adventure Park in Anaheim.


In a three-page letter, Markey said he is "deeply concerned that Disney's proposal could potentially have a harmful impact on our children." He asked whether parkgoers will have a chance to opt out of sharing their information and, if not, whether Disney will share the data with other companies.


A spokesman for Markey said his office had not received a response from Disney on Thursday, but in a statement to The Times, the company said participation in the wristband program was optional.


"In addition, guests control whether their personal information is used for promotional purposes, and no data collected is ever used to market to children," the statement said.


If parkgoers agree to release such information it can be used for marketing, Disney officials confirmed.


hugo.martin@latimes.com





Read More..

California unions grow, bucking U.S. trend









The latest snapshot of the U.S. working class shows that unions are in trouble, their ranks thinning amid a backlash against organized labor and a still sputtering economy.


But California and a few nearby states in the Southwest are showing a vastly different picture — labor's ranks are on an upswing. The Golden State's union organizers signed up more than 100,000 new members last year, while the nation as a whole shed 400,000, according to data released Wednesday.


The reason: Latino workers.





After working hard to get here, many Latino immigrants demand respect in the workplace and are more willing to join unions in a tough economic environment, organizers say.


"There's an appetite among these low-wage workers to try and get a collective voice to give themselves opportunity and a middle-class lifestyle," said Steve Smith, a spokesman for the California Labor Federation.


Just 12.5% of the workforce was represented by unions nationwide in 2012, down from 13% the year before. But 18.4% of California's workforce was represented by a union last year, according to data from the Bureau of Labor Statistics.


The nation is paying attention to labor's ability to gain traction in states such as California.


Strong membership in California could help unions negotiate higher wages, lobby the Legislature and fend off anti-labor attacks that have become common in the Midwest. Unions in once pro-labor states like Wisconsin and Michigan have been put on the defensive by legislation aimed at eroding the bargaining power of public-sector unions.


Labor's more optimistic proponents say that California could serve as a blueprint for unions across the country as they seek to stem membership declines. The trend comes amid forecasts that the Latino population in the U.S. is likely to double in two decades.


"This has a lot to do with the changing demographics of the workforce in these states," said Ruben Garcia, a labor law professor at the University of Nevada Las Vegas. "The big campaigns in the carwash industry in L.A., the janitors in Houston and the people who work on the Strip here tend to be an immigrant Latino workforce that's willing to stand up at the workplace, sometimes with great risks."


Workers fed up with years of stagnant wages may be motivated to join a union for financial reasons. Last year, union members made $943 a week, on average, while non-union members made $742, according to the BLS.


With the economy still shaky, many California workers are also looking for more job security.


Jackie McKay, 48, is one of the new crop of California union members. A nurse in the intensive-care unit at Community Hospital Long Beach, McKay said she and colleagues decided to try to organize after a new company took over the hospital and nurses weren't comfortable with the way they were being treated.


"We were sort of seeking out someone that we felt was on our side," she said. "We needed some backup."


The Long Beach nurses voted 94 to 30 to unionize in December.


"California is doing far better than most other states and far better than the national trend" in union membership, said John Logan, a professor of labor and employment at San Francisco State University. "Unions have had both dynamic organizing efforts and very effective political influence."


Employees are often hesitant to do anything risky at work when the economy is bad and jobs are scarce. Organizers say they were successful because they harnessed frustration with growing nationwide inequality to engage members during the recession.


"To be successful in organizing unions in the United States in 2013, it's not enough just to appeal to workers on the basis of their own individual problems," said David Johnson, organizing director of the California Nurses Assn., which added five new hospitals last year. "There has to be a broader vision set forth so that people see unions and the labor movement as an answer to the corporate domination and the Wall Street greed that has devastated our country."


Still, the labor movement faces significant challenges in applying moderate successes in California to the rest of the country.


Michigan and Indiana both became "right to work" states last year, meaning unions can't collect dues as a condition of employment. Legislators in Wisconsin and Ohio recently supported bills restricting the bargaining rights of public-sector unions, though the law in Ohio was reversed by referendum.


Those actions were reflected in the numbers put out by the Bureau of Labor Statistics. The percentage of people represented by unions last year in Wisconsin fell to 12%, from 14.1% in 2011, while Indiana experienced a significant drop in union membership, to 10% of the workforce, from 12.4% the previous year.


Union membership fell fairly consistently in Rust Belt states as manufacturing jobs, once a labor stronghold, were sent overseas. The decline in unionized manufacturing isn't likely to shift as companies make efforts to return manufacturing to the United States. Auto companies, for instance, have built new plants in the South, an area traditionally resistant to unionization.


Unions don't have the same appeal to workers who change jobs frequently and think of themselves as independent workers, said Michael Lotito, a partner at the labor law firm Littler Mendelson.


"Unions are really struggling to find a message that resonates with individuals such as it did with my father's generation," he said.


But demographic shifts can be only positive for unions in the next few years, said Harley Shaiken, a labor professor at UC Berkeley. Labor has built new alliances and is going into a new, proactive phase, he said.


"Reports of labor's death have been greatly exaggerated," he said.


alana.semuels@latimes.com





Read More..

Go forth and Tweet! Pope sees web networks as “portals of truth”






VATICAN CITY (Reuters) – Pope Benedict urged Catholics on Thursday to use social networks like Twitter and Facebook to win converts, as he launched his own smartphone app streaming live footage of his speeches.


The websites – often associated with endless postings of idle gossip and baby photos – could be used as “portals of truth and faith” in an increasingly secular age, the pontiff said in his 2013 World Communications Day message.






“Unless the Good News is made known also in the digital world, it may be absent in the experience of many people,” the 85-year old Pope said in the a letter published on the Vatican‘s website.


The Holy See has become an increasingly prolific user of social media since it launched its ‘new evangelization’ of the developed world, where some congregations have fallen in the wake of growing secularization and damage to the Church’s reputation from a series of sex abuse scandals.


The Pope himself reaches around 2.5 million followers through eight Twitter accounts, including one in Latin.


Belying his traditionalist reputation, the Pope praised connections made online which he said could blossom into true friendships. Online life was not a purely virtual world but “increasingly becoming part of the very fabric of society,” he said.


Social networks were also a practical tool that Catholics could use to organize prayer events, the pope suggested. But he called for reasoned debate and respectful dialogue with those with different beliefs, and cautioned against a tendency towards “heated and divisive voices” and “sensationalism”.


The websites were creating a new “agora”, he added, referring to the gathering spaces that were the centers of public life in ancient Greek cities.


The speech coincided with the launch of ‘The Pope App’, a downloadable program that streams live footage of the pontiff’s speaking events and Vatican news onto smartphones.


Pope Benedict‘s embrace of new media responds to the Church’s concern that it is invisible on the internet.


The Vatican commissioned a study of internet use and religion prior to the pope’s Twitter debut, which found the majority of U.S. Catholics surveyed were unaware of any significant Church presence online.


(Reporting by Naomi O’Leary; editing by Andrew Heavens)


Social Media News Headlines – Yahoo! News





Title Post: Go forth and Tweet! Pope sees web networks as “portals of truth”
Url Post: http://www.news.fluser.com/go-forth-and-tweet-pope-sees-web-networks-as-portals-of-truth/
Link To Post : Go forth and Tweet! Pope sees web networks as “portals of truth”
Rating:
100%

based on 99998 ratings.
5 user reviews.
Author: Fluser SeoLink
Thanks for visiting the blog, If any criticism and suggestions please leave a comment




Read More..

Paris Opera Ballet names Millepied of 'Black Swan'


PARIS (AP) — Benjamin Millepied, the "Black Swan" choreographer who helped transform Natalie Portman into an obsessed, paranoid ballerina for the film and later married the actress, was named director of the Paris Opera Ballet on Thursday.


Millepied, 35, is a former principal dancer with the New York City Ballet who left in 2011 to create his own dance company in Los Angeles, L.A. Dance Project. He'll start at the Paris company in October 2014, when the current dance director, Brigitte Lefevre, retires.


Millepied and Portman, who have a son, met during the making of "Black Swan," Darren Aronofsky's psychological thriller that stars Portman as a ballet dancer.


Portman won the best actress Academy Award or her performance in the movie.


Read More..

The New Old Age Blog: Grief Over New Depression Diagnosis

When the American Psychiatric Association unveils a proposed new version of its Diagnostic and Statistical Manual of Mental Disorders, the bible of psychiatric diagnoses, it expects controversy. Illnesses get added or deleted, acquire new definitions or lists of symptoms. Everyone from advocacy groups to insurance companies to litigators — all have an interest in what’s defined as mental illness — pays close attention. Invariably, complaints ensue.

“We asked for commentary,” said David Kupfer, the University of Pittsburgh psychiatrist who has spent six years as chairman of the task force that is updating the handbook. He sounded unruffled. “We asked for it and we got it. This was not going to be done in a dark room somewhere.”

But the D.S.M. 5, to be published in May, has generated an unusual amount of heat. Two changes, in particular, could have considerable impact on older people and their families.

First, the new volume revises some of the criteria for major depressive disorder. The D.S.M. IV (among other changes, the new manual swaps Roman numerals for Arabic ones) set out a list of symptoms that over a two-week period would trigger a diagnosis of major depression: either feelings of sadness or emptiness, or a loss of interest or pleasure in most daily activities, plus sleep disturbances, weight loss, fatigue, distraction or other problems, to the extent that they impair someone’s functioning.

Traditionally, depression has been underdiagnosed in older adults. When people’s health suffers and they lose friends and loved ones, the sentiment went, why wouldn’t they be depressed? A few decades back, Dr. Kupfer said, “what was striking to me was the lack of anyone getting a depression diagnosis, because that was ‘normal aging.’” We don’t find depression in old age normal any longer.

But critics of the D.S.M. 5 now argue that depression may become overdiagnosed, because this version removes the so-called “bereavement exclusion.” That was a paragraph that cautioned against diagnosing depression in someone for at least two months after loss of a loved one, unless that patient had severe symptoms like suicidal thoughts.

Without that exception, you could be diagnosed with this disorder if you are feeling empty, listless or distracted, a month after your parent or spouse dies.

“D.S.M. 5 is medicalizing the expected and probably necessary process of mourning that people go through,” said Allen Francis, a professor emeritus at Duke who chaired the D.S.M. IV task force and has denounced several of the changes in the new edition. “Most people get better with time and natural healing and resilience.”

If they are diagnosed with major depression before that can happen, he fears, they will be given antidepressants they may not need. “It gives the drug companies the right to peddle pills for grief,” he said.

An advisory committee to the Association for Death Education and Counseling also argued that bereaved people “will receive antidepressant medication because it is cheaper and ‘easier’ to medicate than to be involved therapeutically,” and noted that antidepressants, like all medications, have side effects.

“I can’t help but see this as a broad overreach by the APA,” Eric Widera, a geriatrician at the University of California, San Francisco, wrote on the GeriPal blog. “Grief is not a disorder and should be considered normal even if it is accompanied by some of the same symptoms seen in depression.”

But Dr. Kupfer said the panel worried that with the exclusion, too many cases of depression could be overlooked and go untreated. “If these things go on and get worse over time and begin to impair someone’s day to day function, we don’t want to use the excuse, ‘It’s bereavement — they’ll get over it,’” he said.

The new entry for major depressive disorder will include a note — the wording isn’t final — pointing out that while grief may be “understandable or appropriate” after a loss, professionals should also consider the possibility of a major depressive episode. Making that distinction, Dr. Kupfer said, will require “good solid clinical judgment.”

Initial field trials testing the reliability of D.S.M. 5 diagnoses, recently published in The American Journal of Psychiatry, don’t bolster confidence, however. An editorial remarked that “the end results are mixed, with both positive and disappointing findings.” Major depressive disorder, for instance, showed “questionable reliability.”

In an upcoming post, I’ll talk more about how patients might respond to the D.S.M. 5, and to a new diagnosis that might also affect a lot of older people — mild neurocognitive disorder.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..