Gadgetwise Blog: Is January the Time to Buy Electronics?

At the International Consumer Electronics Show in Las Vegas in early January, manufacturers tantalized consumers with new electronics soon to hit the shelves. But what does that do to the prices of current models that are being replaced? Is this a golden buying opportunity?

Yes and no. Yes for TVs, no for laptops. I’ll explain.

Decide.com, which tracks the price of electronics, studied what happened to the cost of TVs and laptops in past years after C.E.S.

What it found is that TV prices dip to near yearly lows after the show, matching holiday prices. With the average price of the top 250 TVs at $1,057, the post-show average is projected to drop an average of $211, to $846, based on data from previous  years. That is a 20 percent savings.

Laptops don’t drop so steeply. After the show, the 100 most popular laptops have historically been discounted 8 percent. This year that would mean the top 100 laptops, which average $780 in price, would be reduced $62, to $718.

Laptop price are lowest in late June through early July, right before the back to school sales, and during the last two weeks of September, after those sales, according to Decide.com’s data. At those times the discounts are typically 10 percent.

Of course, averages can be deceiving. Prices are volatile all year around, so a particular TV or computer you want could be discounted far more at any time.

There are a number of browser add-ons and apps that let you track prices of individual products, or you can use Decide.com – but it will cost you. Membership is $5 a month or $30 a year for full access.

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At Least 8 Die in Egyptian Riots after Soccer Verdict

CAIRO — An Egyptian court sentenced 21 people to death on Saturday on charges related to one of the world’s deadliest incidents of soccer violence, touching off an attempted jailbreak and a riot that killed another eight in the Mediterranean port city that is home to most of the defendants.

The verdict follows deadly clashes between police and demonstrators on Friday, the second anniversary of the uprising that overthrew Egypt’s longtime leader Hosni Mubarak. Such cycles of violence, often lasting for weeks and costing dozens of lives, have occurred regularly in the last two years.

Avid soccer fans from both teams, known as Ultras, hold the police at least partly responsible for the Port Said deaths and have criticized President Mohamed Morsi for doing little to overhaul the force.

Immediately after the verdict, two police officers were shot dead outside Port Said’s main prison when angry relatives tried to storm the facility to free the defendants. Police fired tear gas and rubber bullets, as well as live rounds, at the crowd outside the prison, killing six, security officials said.

Security officials said the military was being deployed to Port Said — the second such deployment in less than 24 hours. The army is often used to keep order by top generals who took over after Mr. Mubarak was ousted, but the military has kept a much lower profile since Mr. Morsi was elected as president in June. The military was also deployed overnight in the city of Suez after eight people died in clashes between security forces and protesters opposed to President Morsi.

Judge Sobhi Abdel-Maguid read out the death sentences related to the Feb. 1 riot in Port Said that killed 74 fans of the Cairo-based Al-Ahly team. Defendants’ lawyers said all those sentenced were fans of the Port Said team, Al-Masry. Executions in Egypt are usually carried out by hanging.

The judge said in his statement, read live on state TV, that he would announce the verdict for the remaining 52 defendants on March 9.

Among those on trial are nine security officials, but none were handed sentences Saturday, lawyers and security officials say.

Fans of al-Ahly, whose stands were attacked by the rival club Al-Masry in the Feb. 1 incident in Port Said, had promised more violence if the accused did not receive death sentences. In the days leading up to the verdict, Al-Ahly fans warned of bloodshed and retribution. Hundreds of Al-Ahly fans gathered outside the Cairo sports club in anticipation of the verdict, chanting against the police and the government.

Before the judge could read out the names of the 21, families erupted in screams of "Allahu akbar!" Arabic for God is great, with their hands in the air and waving pictures of the deceased. One man fainted while others hugged one another. The judge smacked the bench several times to try and contain reaction in the courtroom.

The verdict is not expected to calm tensions between the two rival teams. The judge is expected to make public his reasons for the death sentences March 9, when the remaining 52 defendants receive their sentences.

A Port Said resident and lawyer of one defendant given a death sentence said the verdict was nothing more than "a political decision to calm the public."

"There is nothing to say these people did anything and we don’t understand what this verdict is based on," the lawyer, Mohammed al-Daw, said.

The violence began after the Port Said’s home team won the match, 3-1. Al-Masry fans stormed the pitch after the game ended, attacking Cairo’s Al-Ahly fans.

Authorities shut off the stadium lights, plunging it into darkness. In the exit corridor, the fleeing crowd pressed against a chained gate until it broke open. Many were crushed under the crowd of people trying to flee.

Survivors described a nightmarish scene in the stadium. Police stood by doing nothing, they said, as fans of Al-Masry attacked supporters of the top Cairo club stabbing them and throwing them off bleachers.

Al-Ahly survivors said supporters of Al-Masry carved the words "Port Said" into their bodies and undressed them while beating them with iron bars.

While there has long been bad blood between the two rival teams, many blamed police for failing to perform the usual searches for weapons at the stadium.

Both Al-Ahly Ultras and Al-Masry Ultras widely believe that former members of the ousted government of Mr. Mubarak helped instigate the attack, and that the police at the very least were responsible for gross negligence. It is not clear what kind of evidence, if any, was presented to the court to back up claims that the attack had been orchestrated by governmentofficials.

As is customary in Egypt, the death sentences will be sent to the nation’s top religious authority, the Grand Mufti, for approval, though the court has final say on the matter.

All of the defendants — who were not present in the courtroom Saturday for security reasons — have the right to appeal the verdict.

The incident was the world’s deadliest soccer violence in 15 years.

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Davos 2013: On Russia's To-Do List at Davos: Buff Image

DAVOS, SWITZERLAND — This year at Davos, the Russians are working hard to make a splash.

There is a House of Russia near a main hotel and a media center for Russia at the opposite end of this ski village. And then there is the bevy of Russian politicians, business folk and cultural figures on hand trying to encourage more foreign investment and correct what many of them privately concede is a poor image abroad.

Even Dmitri A. Medvedev, the former president and now prime minister, whose political standing in Russia was tarnished by a swap of offices with Vladimir V. Putin announced in September 2011, subjected himself to a highly unusual spectacle here.

Scores of Russian experts had worked with the World Economic Forum, as the conference here is known, on a presentation they called Scenarios for Russia.

The session on Wednesday, with Mr. Medvedev gamely sitting through the judgment before speaking himself, sketched out three ways that Russia, whose economy is heavily dependent on oil and gas extraction, could develop in the near future.

Based on assumptions like falling energy prices, regional inequalities and even an open split among Russian elites, none of the three possibilities was particularly optimistic. In addition, when the audience was asked to vote on the most needed development for Russia’s near future, it overwhelmingly chose the need to improve governance and overhaul government.

Given recent developments in Moscow, that may come as no surprise. Many political analysts see moves like the recent clampdown on demonstrations and the banning of American adoptions of Russian children as signals that the government is digging in, rather than opening up to change.

Mr. Medvedev’s response, though, was more tepid than many in the audience presumably hoped to hear. He simply repeated past promises, so far unrealized, that Russia will respond positively to demographic, political and economic shifts that could change the status quo.

Sergey Guriyev, a Russian economist, presented perhaps the gloomiest situation: A schism in the Russian elite that could force eventual, possibly sudden, change, in a country still haunted by memories of the 1917 Bolshevik Revolution and all that followed.

The status quo “is not sustainable simply because the Russian middle class will grow and demand reforms,” Mr. Guriyev said.

Over the past 10 years, oil and gas riches trickled down to a new middle class, he argued. “Now, more income doesn’t make people happy,” he said, adding that this Russian class “is unprecedentedly educated and rich for a country with such outdated political institutions.”

Unlike Prime Minister David Cameron of Britain, whose experience on the hustings of British politics lend him an ability to think on his feet and deliver punchy lines, Mr. Medvedev barely opened up to questioning from an audience that was about half the size of the one that packed the hall to hear Mr. Cameron on Thursday, a day after his gamble on European Union membership.

In private conversation, Russian businessmen deplored what they saw as a missed opportunity for Mr. Medvedev to give a forceful speech to the Davos crowd. But foreign investors invited to private sessions with the prime minister later Wednesday and earlier Thursday were much less inclined to criticize him.

Like the Russian business community, these investors are reluctant to speak on the record, citing the uncertainty of doing business in the country. What they also do not speak much about is the healthy return on their money.

While Russian business and the state accounted for most of the estimated $400 billion said by officials to have been invested in 2012, foreign investors get a good return on their money — some in high double digits, one banker said.

Russians often particularly cite China as a rival for foreign attention and money. Reuben Vardanian, a financier now at Russia’s giant Sberbank, said that while many businesspeople, domestic and foreign, saw that their activities “are much more profitable in Russia than in China,” the Chinese gave a greater sense of certainty.

While the circle of foreigners now interested in Russia is widening, Mr. Vardanian told a meeting of mostly Russian reporters, foreigners still often lament that “we can’t understand the rules of the game.”

“They don’t want to deal with, say, Mr. Vardanian, who is then replaced by Mr. Ivanov, and then by Mr. X,” he said. “They want to deal with rules.”

This article has been revised to reflect the following correction:

Correction: January 25, 2013

An earlier version of this article misspelled the first name of Reuben Vardanian, a financier at Sberbank, as Ruben.

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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..

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.”

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IHT Rendezvous: France Is Sweet on 'Sugar Man'

A love story is developing between the French and Rodriguez, the Detroit-born musician who flopped in the 1970s, was a star without knowing it in apartheid South Africa and was rediscovered last summer in the United States when the documentary “Searching for Sugar Man” was released.

The film tells the extraordinary story of a talented and philosophical musician who spent his life working in construction while struggling to bring up his three daughters, and the mind-boggling mutual discoveries in 1997: for him, that he was more famous than the Rolling Stones in South Africa, and for South African fans (who believed him to be dead), that he was alive.

The Swedish-U.K. film by Malik Bendjelloul which has made more than $3 million at the box office in the United States, has been nominated for an Academy Award in the documentary category. In France the now-70-year-old Rodriguez has created something of a frenzy: the soundtrack album is among Sony France’s top sales on iTunes. Sony had planned on putting fewer than 3,000 CDs in stores, but after calls from vendors who sensed something was up, made 15,000 copies available.

“It is an honor and a pleasure,” said Rodriguez in an email message last week from Detroit about his popularity in France. “I’ve been to France a couple of times now. It feels like I’m on top of the world.”

The French public has had a tradition of adopting American artists that it considers underappreciated in the United States, from Josephine Baker to Woody Allen, from Paul Auster to Ben Harper. Le Figaro newspaper recently dubbed Rodriguez the “unloved” singer.

David Nivesse, from ARP Selection, the film’s French distributor, and Christophe Servel Molvaer, project manager for Sony Music Legacy, France, say that it all started last November when Rodriguez came to Paris for a private concert following a preview of the documentary.

“He played for half an hour and you could hear a pin drop. There were 600 people in the room and he got a standing ovation,” Mr. Servel Molvaer recalled. “I had never heard of him before. But from the beginning I was captivated by this soul-folk. It’s something magical, and people love his music from the moment they hear it.”

“Music is a language all it’s own,” wrote Rodriguez. “I’ve been playing ‘La Vie En Rose’ a lot lately when I’m looking for sounds. It’s the notes and the rhythms— that is what speaks to me. I’m a music lover. I do vocal against guitar. Sometimes it’s like any words will work. A lot of songs out there have fewer words than guttural sounds like oohs and ahhs and grunts. That works for some people too. I’m glad the French like my stuff. It’s had a long life and I feel lucky for that.”

“Searching for Sugar Man” was released Dec. 26 in just two Paris cinemas. It has beaten all records at the Left Bank Saint Germain movie theater where it is playing. It’s now playing in other cities in France including Bordeaux, Rennes and Nancy.

“We thought the film would do well but this is exceptional,” Mr. Nivesse said.

Rodriguez is playing concerts around the world now. One gig was scheduled for this June at La Cigale, a major Paris venue. It sold out within 72 hours. Another concert was added at the Zenith (capacity 6,500). He is also expected to play at the major French summer music festivals.

“I’ve been working 25 years in the business and never met anyone like this, with so much charisma, even though he doesn’t say much,” said Mr. Servel Molvaer.

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Euro Watch: Data Point to Slow Recovery in Euro Zone

The euro zone economy took a step closer to recovery this month as the rate of decline in the bloc’s private sector eased more than expected, a business survey showed on Thursday.

But in an indication of the hurdles left to scale, Spain’s unemployment surged to 26 percent in the fourth quarter, a record high since measurements began in the 1970s, as a prolonged recession and deep spending cuts left almost 6 million people out of work at the end of last year.

The manufacturing survey published by Markit supports European Central Bank President Mario Draghi’s assertion that the 17-nation currency union is benefiting from “positive contagion” but still hints at an economic contraction in the first quarter of 2013.

Markit’s Flash Composite Eurozone Purchasing Managers’ Index, which surveys around 5,000 companies and is seen as a good growth indicator, jumped to 48.2 from December’s 47.2, beating expectations for a rise to 47.5.

While the index has now held below the 50 mark that separates growth from contraction in all but one of the last 17 months, Markit said the data suggested conditions in the bloc were improving.

“We shouldn’t get too gloomy about those numbers,” Chris Williamson, a data collator at Markit, said. “There is a turning point that took place towards the end of last year and the beginning of this year so things are picking up. Any downturn is looking likely to end in the first half.”

He added, however, that the manufacturing index was “still consistent” with gross domestic product in the 17-country bloc falling at a quarterly rate of about 0.2 percent to 0.3 percent.

The euro zone economy contracted in the second and third quarters of last year, meeting the technical definition of recession, and the downturn is expected to have deepened in the fourth quarter.

Earlier data from Germany, Europe’s largest economy and the bloc’s growth engine, showed its private sector expanded at its fastest pace in a year.

In neighboring France, data from Markit showed that business activity shrank in January at the fastest pace since the trough of the global financial crisis. The preliminary composite purchasing managers’ index, covering activity in the services and manufacturing sectors combined, came out at 42.7 for the month, slumping from 44.6 in December.

Spain’s unemployment rate rose to 26 percent in the fourth quarter of 2012, or 5.97 million people, the National Statistics Institute said on Thursday, up from 25 percent in the previous quarter and more than double the European Union average.

“We haven’t seen the bottom yet and employment will continue falling in the first quarter,” José Luis Martínez, a strategist with Citigroup, said.

Spain sank into its second recession since 2009 at the end of 2011 after a burst housing bubble left millions of low-skilled laborers out of work and sliding private and business sentiment gutted consumer spending and imports.

Efforts by Prime Minister Mariano Rajoy’s government to control one of the euro zone’s largest deficits through billions of euros of spending cuts and tax increases have fueled general malaise, further hampering demand.

Still, Mr. Draghi of the E.C.B. is taking an optimistic view, declaring earlier this month that the euro zone economy would recover later in 2013 and that there was now a “positive contagion” effect in play.

Europe’s top central banker cited falling bond yields, rising stock markets and historically low volatility as evidence for this, causing several forecasters to ditch expectations for an imminent cut in euro zone interest rates.

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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.”

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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.”

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IHT Rendezvous: Save a Tree, Use Real Cork

ESTREMOZ, Portugal— I had always thought plastic wine corks and screw caps were tacky, but now I have a good reason for avoiding them.

Buying wine with real corks helps preserve the cork forests of Portugal and the wider western Mediterranean, which are, it turns out, ecological marvels. I write about the discovery, on a recent trip to Portugal, in my latest Green column.

Cork oaks and their scrubby cousins, holm oaks, are well adapted to the hot dry summers of the region. They help prevent these places from turning into deserts. Their stands are rich in plants and — when the farmers restrain themselves from shooting everything in sight — animals, especially birds.

What’s unique about cork is that the thick bark can be harvested from the trees without cutting them down. A skilled crew hacks the bark off with axes. If done right, it grows back. You can see the process in this introduction to cork forests by Luisa Nunes and Carlos Reis:

So the cork oaks form the basis of a sustainable industry that has existed for centuries. The cork is harvested every summer for wine stoppers and other uses. The trees don’t need fertilizer. They are hard not to love.

Synthetic corks are the enemy of this ecologist’s heaven. They have slashed the world market share of real cork by perhaps 20 percent in the last decade, according to Wine Intelligence, a London research concern. That has brought down prices, reducing incentives to grow and maintain cork groves.

One needs a lot of patience and dedication to grow cork. The trees can only be harvested every decade or so and require years—some people say up to 50—from the time they are originally planted to when they can be first harvested. You are doing it for your grandchildren or for the ecosystem, and that is not always an easy sell in the 21st century.

Fortunately, cork trees are protected in Portugal, the leading producer.

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