Longer looks: Prenatal care for dads; rise in bipolar diagnosis for children

Every week, Kaiser Health News reporter Jessica Marcy selects interesting reading from around the Web.

Time: Should Prenatal Care Be Extended To Dads?
Perhaps it's because mom has the burgeoning belly, but dads have largely been left out of prenatal care. That could be damaging to the family's health, contends research in a recent issue of the Journal of Advanced Nursing. Stressed-out, anxious pregnant women who don't receive adequate support are linked to less-than-ideal infant health outcomes. The role fathers-to-be play hasn't been studied nearly as much, but because pregnant women rely on them for support and care, researcher ManSoo Yu says it stands to reason that inattentive expectant fathers may also contribute to poorer infant health. … Yu, the study's lead author, analyzed 66 low-income Missouri couples, examining how stress and social support impacted men and women differently. ... While expectant mothers concentrate on the prenatal period, men tend to focus on the future, fretting about how they're going to afford diapers and child care. It's an important distinction and one that should be pointed out to doctors, nurses, midwives and social workers who take care of pregnant women, says Yu (Bonnie Rochman, 6/21).

Newsweek: Mommy, Am I Really Bipolar?
I have been a child psychiatrist for nearly five decades and have seen diagnostic fads come and go. But I have never witnessed anything like the tidal wave of unwarranted enthusiasm for the diagnosis of bipolar disorder in children that now engulfs the public and the profession. ... The rise of outpatient office visits for children and adolescents with bipolar disorder increased 40-fold from 20,000 in 1994-95 to 800,000 in 2002-03. … I believe, to the contrary, that there is no scientific evidence to support the belief that bipolar disorder surfaces in childhood. In fact, the opposite seems to be the case: the evidence against the existence of pediatric bipolar disorder is so strong that it's difficult to imagine how it has gained the endorsement of anyone in the scientific community. And the effect of this trendy thinking can have devastating consequences. Such children are regularly prescribed medications that are not effective in kids and have unwelcome side effects (Dr. Stuart L. Kaplan, 6/19).

The Economist: Quality, Not Quantity
America spends far more on health care than other countries, such as Britain. The waste is staggering. The main problem is loopy incentives. Under "fee-for-service" arrangements, the more tests, scans and pokes with gloved hands a hospital or clinic provides, the more it is paid. Mr Obama's health reform included only a few small nudges to change this. Topmost among them is a plan for Medicare to reward "accountable care organisations" (ACOs) for keeping people healthy, rather than lavishing treatment on them. The plan seems sensible enough. But it has provoked uproar in every corner of the health industry (6/16).

American Medical News: Oncologists Confront "Financial Toxicity" Of Cancer Care
The toxicity of chemotherapy and other drug treatments for cancer has extended beyond side effects such as nausea and nerve pain. It has now extended to a patient's ability to pay the mortgage and buy groceries while undergoing care, said the author of a study looking at the financial impact of cancer treatment. Amy Abernethy, MD, associate professor in the Division of Medical Oncology at Duke University Medical Center, helped write one of a handful of studies presented at the June meeting of the American Society of Clinical Oncology that found the rising cost of cancer care could impact treatment decisions and even lead to patients forgoing treatment because they cannot afford it. At ASCO, discussion turned toward the need for physicians to talk frankly with patients about the cost of care -- and whether patients believe the amount of life it buys is worth a bill they might not be able to pay (Pamela Lewis Dolan, 6/20).