Medical updates in the news

By Alan Koenigsberg, M.D.

Having reviewed several major psychiatric conditions these last several weeks, I now turn to an update of some important medical news.

1. The World Health Organization (WHO) recently declared the
COVID-19 health emergency status to be over. They continued to state that COVID-19 is a real threat and concern to the health of all nations, but the emergency status has changed.

Unfortunately, many people have interpreted this declaration to mean that COVID-19 is no longer something to worry about, they don’t need more vaccinations or masking is not necessary. Nothing could be further from the truth.

Newer, bivalent vaccines have now been available for months and the booster is recommended. Here’s the situation: Yes, far fewer people are dying of COVID-19 now, given the vaccines and treatments available. Yes, the emergency declaration is now formally over. However,
COVID-19 is still around, still mutating, still causing illness, long
COVID-19 and pregnancy complications and people are still falling ill.

Unlike influenza, it is not seasonal and it is my professional opinion that everyone who is eligible should be vaccinated and boosted, along with continued handwashing and wearing masks in crowded indoor situations.

2. Mammograms: Until recently, the United States Preventive Services Task Force (USPSTF) recommended that most women start getting screening mammograms at age 50 and every two years afterward. Before then, the recommendation had been to start screenings at age 40. A few weeks ago, the USPSTF modified its recommendations again to begin mammogram screenings at age 40 and again every two years.

These recommendations are considered for the general population. There are some women who may be at higher risk, some at lower. I would suggest that women collaborate with their gynecologists to determine what is optimal for each of them.

3. Melatonin dietary supplement products: A recent study, published last month, examined 25 different over-the-counter melatonin products. The results varied all over the board: One product contained 74 % of the stated amount, another contained over three times the stated amount, one product had no melatonin.

The FDA does not regulate supplements, so the adage “let the buyer beware” is very true in this arena. If you are interested in buying a supplement, I suggest you discuss this with the pharmacist and ask for a reputable brand that is certified.

4. Psychotherapy is in the news. Again. Several recent articles in The New York Times and elsewhere have cropped up, discussing ideas about the efficacy of psychotherapy. A few thoughts from someone who has provided psychotherapy to patients throughout my career:

Psychotherapy and counseling are different processes.

The intent of psychotherapy is to enhance self-awareness.

The intent of counseling is to provide advice.

These are different treatment options and are intended to provide different goals. While doing psychotherapy, I strive to rarely give clear advice, but instead, to help the patient look internally to rely on their own experiences and thinking skills and to discern what holds them back.

In counseling, I would give clear advice on what to do.

They are both important and effective options and it’s important to understand the differences.

It seems as though the more recent articles are discussing situations in which exceptions are noted; relatively inexperienced therapists are overwhelmed, have had modest to poor personal psychotherapy and training and seem puzzled.

For doctorate-level therapists, I have found they have had better personal psychotherapy and are more experienced, have better boundaries and are better at providing high-quality care.

Alan Koenigsberg, M.D., is a practicing psychiatrist and clinical professor of psychiatry at UTSW Medical School in Dallas.

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