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Direct-to-Consumer (DTC) Advertising of Psychiatric Drugs in Popular Magazines:
How are Mental Disorders Portrayed?
Health Sciences Library System, University of Pittsburgh
ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)
In this study sample of DTC psychiatric drug ads:
prescription medication is a controversial topic.
Psychiatric drugs make up 13% of all
While the “fine print” drug information (typically
advertised prescription drugs derived by a
HOW ARE MENTAL DISORDERS
located on an adjoining page) is strictly regulated
by the Federal Drug Administration (FDA), the
visual components of DTC print ads are guided by
Only females or only males appear in 40% of
In this small descriptive study, the demographics
only a simple subjective phrase: pictorial matter
portrayed in the aggregate ads do not adequately reflect
the prevalence of mental disorders in the general
Only two races are portrayed (white and
population. Only ads for the antidementia drug Aricept
The potential for visuals to sway consumer
correspond to prevalence rates for
perceptions away from the information content is
85% of patients depicted are white.
Alzheimer’s disease by sex, age, and race.
Young, white women exclusively represent
Consumers generally recognize that emotional appeals
This poster endeavors to raise awareness among
are used to market products, including medications.
medical librarians about these issues by:
99% of patients display positive affect, leading
However, those consumers with impaired decisional
capacity -- a hallmark of mental disorders -- may be
Examining visual portrayals of patients with
to unrealistic expectations that the drug
especially vulnerable to the imagery contained in DTC
provides an easy cure; minimal failure rates; or
minimal side effects (which are known to be
ads. Consequently, marketing of psychiatric drugs has
greater potential for negative impact on the health of
substantial for many psychiatric drugs).
Despite suffering considerable incidence of
According to a 2002 FDA survey, 41% of patients do not
read any of the brief summary (the “fine print”) for
Providing pros and cons of the DTC ad debate.
medications advertised in magazines. The ad imagery
and its underlying allusion may speak louder than words
− Adults are not represented in stimulant ads.
Better Homes & Gardens. 2005; 83(1):73
In addition, ad portrayals that do not provide balanced
A content analysis was conducted for 11 popular
information could lead to, or reinforce stereotypes (e.g.,
magazines (257 issues) published in 2005 to
certain mental disorders afflict only females, or only
obtain direct-to-consumer (DTC) prescription
whites), or provide false expectations about the drug’s
advertisements for psychiatric drugs that contained
efficacy (e.g., 99% of patients display positive affect).
STUDY SAMPLE ADS
1) photographic depictions of patients, and
ANTIDEPRESSANTS for treatment of depression
CHARACTERISTIC Bipolar 1
information (‘fine print’) on an adjoining page.
THE DEBATE OVER
Popular magazines were selected from among 60
that ranked highest in total advertising and
OF PRESCRIPTION DRUGS
circulation revenue for the year 2004. Categories
represented include women’s and men’s interests,
business, health, home, lifestyle, general, and
PROPONENTS claim that ads:
OPPONENTS claim that ads:
• Pharmaceutical companies spent $4 billion+ in
A hand search of the 257 magazine issues yielded:
Ad for Abilify depicts young white woman, back to camera, looking down a
The United States and New Zealand are the only
(in order of total advertising Prescription
Caption: “Treating bipolar disorder takes understanding.”
countries that permit DTC advertising.
revenue, 2004) 1
American Psychiatric Association. Diagnostic and statistical manual of mental disorders.
4th ed. Text Revision (DSM-IV-TR). Washington, DC: American Psychatric Association;
Bipolar 1 disorder DSM-IV criteria: at least one manic episode
Sports Illustrated. 2005 Dec 12; 103(23):26.
Bipolar 2 disorder DSM-IV criteria: history of hypomanic and
Endicott, RC. Magazine 300. Advertising Age. 2005;76(39):S1-5.
Fitzpatrick AL, Kuller LH, et al. Incidence and prevalence of dementia in the
Cardiovascular Health Study. J Am Geriatr Soc. 2004 Feb;52(2):195-204.
Hollon MF. Direct-to-consumer marketing of prescription drugs: a current perspective forneurologists and psychiatrists. CNS Drugs. 2004;18(2):69-77.
Karpiak CP, Norcross JC. Lifetime prevalence of mental disorders in the general
SLEEP DISORDERS: INSOMNIA
population. In: Koocher GP, et al. editors. Psychologists' desk reference. 2nd ed. New
York: Oxford University Press; 2005. p. 3-7.
Prevalence by Age and Sex
Kessler RC, Berglund P, et al. Lifetime prevalence and age-of-onset distributions of DSM-
IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005
% any sym ptom of
insom nia* (m ean)
National Sleep Foundation. Summary findings of the 2005 Sleep in America poll [Web
yielded 20 distinct (non-duplicate) ads for these
document]. 2005 [cited 2006 April 10].<http://www.sleepfoundation.org/
seven psychiatric drugs which comprise the study
Prescription drug advertising, 21 C.F.R. § 202 [Web document]. 2005 [cited 2006 April
10]. <http://www.accessdata.f da.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?
United States Public Health Service Office of the Surgeon General. Mental health:
culture, race and ethnicity: a supplement to mental health: a report of the surgeon
general. Rockville, MD: Department of Health and Human Services; 2001.
Visser SN, MS, Lesesne CA. Mental health in the United States: prevalence of diagnosis
and medication treatment for attention-deficit /hyperactivity disorder--United States,
2003. Morbidity and mortality weekly report. CDC surveillance summaries. 2005 Sep 2;
One antidementia agent:
Weissman MM, Bruce ML, Leaf PJ, et al. Affective disorders. In: Robins L, Regier D
editors. Psychiatric disorders in America : the epidemiologic catchment area study. New
York : The Free Press; 1991. p. 53-80.
Ambien (Zolpiden Tartrate)
Incidence (per 1,000) by Age & Race
Welch Cline RJ, Young HN. Marketing drugs, marketing health care relationships: a
content analysis of visual cues in direct-to-consumer prescription drug advertising.
Young D. FDA examines direct-to-consumer advertising data. Am J Health Syst Pharm.
* Insomnia symptoms inc lude: diffic ulty falling
asleep; awake a lot during the night; woke too
early and c ouldn't get bac k to sleep.
Sourc e: National Sleep Foundation (2005)
Better Homes & Gardens. 2005; 83(4):145
Better Homes & Gardens. 2005; 83(8):75
Better Homes & Gardens. 2005; 83(3):81
The author thanks Ammon Ripple, MLS, for guidance
Note: sources for prevalence are listed in fol ow ing sections.
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SJN is a 58 year old Caucasian male with early onset dementia that first became symptomatic about 6 years earlier with progressive decline over that period of time. SJN’s highest level of education was a BSBA in accounting and thereafter he worked primarily as an accountant. SJN initially presented depression and with memory related problems, such as an inability to recall if he had carried out