Some good and bad news for President Bush's bold New Freedom Initiative, which will test the mental wellbeing of every American citizen, including preschool children. Anyone who fails to meet the psychiatrist's exacting standards will be invited to take one of the new antipsychotic or antidepressant drugs.
The good news for George is that he'll be tilling very fertile soil. A new study has discovered that 31 million Americans - 15 per cent of the adult population - suffer from at least one type of personality disorder. Roughly half of these have obsessive-compulsive disorder, and a sizeable minority is paranoid and harbours an unusual distrust of others.
The survey, carried out by the American Psychiatric Association, was based on in-depth interviews with 43,000 adults as a representative sample of the entire population.
Psychiatrists recognize 10 personality disorders, seven of which were well represented in the survey.
The bad news for George is that the US Food and Drug Administration has just issued a safety alert on the antipsychotic drugs. They can increase your chances of developing hyperglycaemia and diabetes, the agency has discovered.
Janssen Pharmaceutica, manufacturer of Risperdal (risperidone) has been the first to conform, and has already issued its alert to doctors. In some cases drug-induced hyperglycaemia has been so extreme that the patient has died, the alert reads.
It will be interesting to see if the new warning stays the hand of the prescribing doctor, because little seems to have done so thus far. The use of antipsychotic drugs by low-income families in Tennessee nearly doubled between 1996 and 2001. The growth has mainly been among children diagnosed with attention deficit/hyperactivity disorder (ADHD), even though the drugs should not be prescribed to children.
Not that the news about antidepressants is very much better. A recent study confirms the alarming findings of earlier trials that antidepressants, and especially the SSRIs (selective serotonin reuptake inhibitors), can increase the risk of suicide among teenagers.
The suicide risk is similar for all the antidepressants, even for Prozac (fluoxetine), which earlier studies had not linked to suicidal behaviour.
(Sources: Journal of Clinical Psychiatry, July 2004; FDA website; Archives of Pediatric Adolescent Medicine, August 3, 2004. Journal of the American Medical Association, 2004; 292: 338-343).
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