Clinical Psychiatry News back issues from September 2005:
PTSD Algorithm hits cyberspace.(News)(posttraumatic stress disorder)
Sep 01, 2005; ... An interactive, online treatment algorithm provides a decision tree complete with graded supporting evidence and special clinical considerations for patients with posttraumatic stress disorder. The new tool is a product of the International Psychopharmacology Algorithm Project, ...
Median compensatory Jury awards leveled off in malpractice cases.(VITAL SIGNS)
Sep 01, 2005 ... Median Compensatory Jury Awards Leveled Off in Malpractice Cases Note: Based on a nationwide database of more than ...
Groups join forces in fight for Mental Health Reform: momentum on parity bill is a top priority.(News)
Sep 01, 2005; ... WASHINGTON -- A coalition of national mental health organizations--including the American Psychiatric Association and the National Alliance for the Mentally Ill--has launched a campaign aimed at implementing some of the goals set 2 years ago by the New Freedom Commission on Mental Health. ...
Psychiatrists, others seek guidance on interrogations.(News)
Sep 01, 2005; ... WASHINGTON -- The American Psychiatric Association is in the process of hammering out a position on the role that mental health professionals should play in the interrogation of detainees at Guantanamo Bay and other prison sites around the world, Paul S. Appelbaum, M.D., told this ...
Patient safety law presents challenges.(quality management)
Sep 01, 2005; ... WASHINGTON -- The patient safety system signed into law this summer by President Bush will likely take many months to implement. But, after operating so long in an environment of liability fear, doctors may take even longer to trust it, predicted Michael O. Fleming, M.D., board chair of ...
FDA panel blocks urine test for Alzheimer's: test detects neural thread protein, but it's unclear whether that is a valid biomarker of the disease.(News)
Sep 01, 2005; ... GAITHERSBURG, MD. -- A simple, nonnvasive urine test aimed at helping physicians determine whether a patient has Alzheimer's disease is unlikely to become widely available in the near future. According to the manufacturer, what is under Food and Drug Administration review is the ...
Able Laboratories recalls all drugs.(generic prescription drugs)(Brief Article)
Sep 01, 2005; ... Able Laboratories Inc. is recalling all of its manufactured drugs because of serious concerns that the drugs were not produced according to quality assurance standards. Most of the recalled products are generic prescription drugs, including some that contain acetaminophen. The ...
FDA approves two monitoring changes for clozapine patients.(Food and Drug Administration)
Sep 01, 2005; ... ROCKVILLE, MD. -- The Food and Drug Administration has approved two major changes to the schedule for monitoring people on clozapine for agranulocytosis: the addition of absolute neutrophil count tests to regular monitoring and a reduction in the frequency of testing after 1 year of ...
Groups are seeking parity for psychiatric patients in the ED.(Emergency Medical Treatment and Active Labor Act of 1985)
Sep 01, 2005; ... WASHINGTON -- Psychiatric organizations called for greater parity in treating emergency psychiatric conditions before a technical advisory group on the Emergency Medical Treatment and Labor Act. Many issues have not been thoroughly discussed or defined in the EMTALA regulations ...
Use of SSRIs linked with birth defects.(News)
Sep 01, 2005; ... ST. PETE BEACH, FLA. -- Maternal use of selective serotonin reuptake inhibitors during pregnancy may be associated with an increased risk of certain birth defects, Sura Alwan reported at the annual meeting of the Teratology Society. Data obtained from a large, ongoing ...
Unipolar, bipolar, and psychotic depression.(treatment selection and patient outcome, differential diagnosis)
Sep 01, 2005; ... To optimize treatment selection and patient outcome, differential diagnosis of psychotic depression, bipolar depression, and treatment-resistant depression is critical. Distinguishing features of each depression subtype should assist the treating clinician in ruling out other diagnoses and ...
Treatment of sleep-related symptoms.(insomnia)
Sep 01, 2005; ... According to the chairman of the National Commission on Sleep Disorder Research (1993), "what we are dealing with here are two gigantic problems for our society-an epidemic of undiagnosed and untreated sleep disorders; and pervasive sleep deprivation with all its consequences for errors, ...
Therapy cuts risk of repeat attempted suicide in half.(News)
Sep 01, 2005; ... Cognitive therapy was effective in preventing repeat attempted suicide in a randomized controlled trial that spanned 18 months, reported Gregory K. Brown, Ph.D., of the University of Pennsylvania, Philadelphia, and his associates. Compared with usual care, the therapy cut the ...
Doctor pay under Medicare to fall 4.3% in 2006.(Department of Health and Human Services. Centers for Medicare and Medicaid )
Sep 01, 2005; ... Physicians face a 4.3% cut to Medicare reimbursements next year unless Congress takes action to change the sustainable growth rate formula. The reduction was announced in a proposed rule that would update payment rates and revise payment policies under the program's fee ...
Moving beyond 'unarticulated suffering'.(LETTERS)(Letter to the Editor)
Sep 01, 2005 ... I applaud the attention that Dr. Robert T. London paid to the underserved field of psychooncology and the recognition that psychiatrists, working in tandem with hematologists/oncologists, can improve the quality of life of cancer patients and cancer survivors ("Psychiatry and Medicine ...
BPD revisited.(LETTERS)(Letter to the Editor)
Sep 01, 2005; ... Dr. Paul J. Fink's very important column raises a fundamental issue: Is DSM-IV selection of the label "borderline personality disorder" harmful for these patients? ("BPD: Should the Patient Be Told?" Fink! Still at Large, July 2005, p. 11.) The label fails to describe the ...
Fostering the treatment alliance.(LETTERS)(Letter to the Editor)
Sep 01, 2005 ... The pathology of borderline personality disorder consists of an expectation of rejection and a tendency to react explosively to a perception of such rejection. Usually, I have found that sharing of that formulation with the patient is very helpful, and sometimes necessary, in ...
Feds shouldn't have health care role.(LETTERS)(Letter to the Editor)
Sep 01, 2005; ... Predictably, neither of the commentators in the health savings accounts debate made an effort to correctly diagnose the problem; they just want to treat symptoms, an approach that we physicians should know is not optimal ("Will health savings accounts leave people vulnerable to ...
Correction.(Correction Notice)
Sep 01, 2005 ... In "Treating Panic Disorder and Agoraphobia," (The Psychiatrist's Toolbox, August 2005, p. 22), a statement about the way in which transference cures were viewed in analytic therapy ...
Health disparities: not just a clinical issue.(high rates of childhood obesity)
Sep 01, 2005; ... Imagine having your child exercise in the bathroom because fellow renters are sleeping in all the other rooms in your apartment, and it's too dangerous to send him outside. This was the lament of a mother in a community where we have a program to address the high rates of ...
Should experts with potential conflicts of interest be allowed to serve on FDA advisory panels?(PRO & CON)
Sep 01, 2005; ... YES What is the best thing for patients? That is the key question. Patients are best served when the experts who have the most knowledge about a medicine or disease advise officials at the Food and Drug Administration. These individuals may receive funding from a ...
Let's make health plans competitive.(medical care quality)(Editorial)
Sep 01, 2005; ... Today's health care plans primarily compete on price. In large part, that's because many employers seek to offer the lowest-cost health plans to their employees, which forces the health plans to offer the lowest possible rates. Many physicians and hospitals, in turn, accept reduced fees ...
Pain relievers.(GUEST EDITORIAL)(Cartoon)
Sep 01, 2005 ... "Congratulations on completing your residency ... ....
Health IT support saves lives.(electronic health records)(Editorial)
Sep 01, 2005; ... Physician adoption of electronic health records is woefully inadequate, and current Stark and antikickback laws are part of the problem. Congress should pass reforms that create new exceptions to these statutes so that hospital systems and other entities can choose to provide community ...
Alexithymia requires persistence, empathy.(psychotherapy)
Sep 01, 2005; ... Alexithymia is known as a patient characteristic that can have a negative outcome on psychotherapy (Compr. Psychiatry 2005;46:206-13). But many of our patients have difficulty understanding and describing their emotions, and as a result, their anxieties often are expressed as somatic ...
Hunting for good therapy.(psychotherapy)
Sep 01, 2005; ... Here's a trivia question for you: Who's the only actor to ever receive an Oscar for playing a psychotherapist? If you said Robin Williams, you're right. He was awarded Best Supporting Actor honors in 1998 for his role in "Good Will Hunting" as Sean Maguire, a psychotherapist who teaches ...
Beating dog phobias.(psychotherapy)
Sep 01, 2005; ... You have a patient who is planning to visit a good friend. The patient is looking forward to the visit but with a sense of dread--for reasons that have nothing to do with the friendship. Why the ambivalence? It's the friend's dog, which is a lovely animal that has never bitten ...
Aripiprazole wins out in comparison with olanzapine.(control of schizophrenia symptoms)
Sep 01, 2005; ... BOCA RATON, FLA. -- Aripiprazole and olanzapine provided similar control of schizophrenia symptoms, but aripiprazole patients gained less weight and had a better metabolic profile than olanzapine patients in a 52-week, open-label study. "Metabolic factors are a hot topic now," ...
Olanzapine vs. risperidone in schizophrenia.(leading antipsychotic drugs comparison)
Sep 01, 2005; ... The Question Olanzapine and risperidone are the leading antipsychotic drugs ("Vital Signs: Zyprexa Sales Led Antipsychotic Market in 2004," July 2005, p. 1), but which one is better for the treatment of schizophrenia? The Analysis We searched the Cochrane ...
Schizophrenia-bipolar I theory gains traction.(continuity theory)
Sep 01, 2005; ... NEW YORK -- From their first classification by Emil Kraepelin late in the 19th century, bipolar I disorder and schizophrenia have been considered distinct disease entities. But in recent years, clinicians and researchers have increasingly questioned whether the diagnoses represent points ...
Clozapine underused for black patients with psychosis.(Adult Psychiatry)
Sep 01, 2005; ... BOCA RATON, FLA. -- Clozapine is underused as a treatment for schizophrenia in African Americans, compared with white patients, despite similar baseline psychopathology and symptom improvements between the two populations after 6 months, according to a study presented at a meeting of the ...
Study backs previous findings on famine, schizophrenia.(Adult Psychiatry)
Sep 01, 2005; ... A study of schizophrenia after the Chinese Famine of 1959-1961 demonstrates that prenatal exposure to severe nutritional deficiency may increase the risk of later developing the psychiatric disorder, investigators have reported. The new findings "almost exactly replicate" the ...
Antidepressant combos show synergistic benefit.(cmbination drug therapy)
Sep 01, 2005; ... BOCA RATON, FLA. -- A combination of antidepressants with complementary effects on serotonin and norepinephrine provides earlier symptom relief than does monotherapy, according to preliminary results of a study. As a result, it appears that combination therapy is superior to ...
Comorbid insomnia-depression may respond to cotherapy.(Adult Psychiatry)
Sep 01, 2005; ... DENVER -- Coadministration of eszopiclone (Lunesta) and fluoxetine (Prozac) for newly diagnosed major depressive disorder with coexistent insomnia was associated with significantly larger and quicker improvements in both disorders than fluoxetine and placebo in a major randomized ...
Personality disorder risks.(comorbidity of anxiety and depression)(Brief Article)
Sep 01, 2005; ... Comorbid anxiety disorders in patients with major depressive disorder are associated with a greater risk of personality disorders, especially a personality disorder in cluster A or C. reported Amy Farabaugh, Ph.D., and her associates at Harvard Medical School, Boston. In the ...
Spotting preclinical Alzheimer's.(diagnosis)(Brief Article)
Sep 01, 2005; ... A metaanalysis has confirmed that multiple cognitive impairments are evident several years before the diagnosis of Alzheimer's disease, reported Lars Back-man, of the Karolinska Institute in Stockholm and his associates. The investigators based the metaanalysis on 47 studies ...
Impact of statins on cognition.(association between statins and cognition)(Brief Article)
Sep 01, 2005; ... Statins do not appear to decrease the risk of Alzheimer's disease, vascular dementia, or mixed dementia in patients aged 65 years or older. A secondary analysis of the Cardiovascular Health Study found no protective cognitive effects of any statin among 2,798 subjects (mean age ...
Combo could help smokers.(methoxsalen's interaction with cytochromes)(Brief Article)
Sep 01, 2005; ... Methoxsalen's interaction with a protein that breaks down nicotine may aid researchers in developing more potent drugs to help reduce smoking and tobacco carcinogenesis, reported Jason K. Yano, Ph.D., and his associates at the Scripps Research Institute, La Jolla, Calif. The ...
Combo Rx may speed unipolar remission.(Adult Psychiatry)
Sep 01, 2005; ... BOCA RATON, FLA. -- A combination of escitalopram and bupropion might produce early remission in as many as one-third of patients with unipolar depression, according to a pilot study presented at a meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute of ...
Quick scale tracks mood changes in primary care.(Adult Psychiatry)
Sep 01, 2005; ... BOCA RATON, FLA. -- An abbreviated Hamilton Depression Rating Scale can quickly assess depression severity and monitor patient response to treatment in a primary care setting, according to a multicenter study. Complete remission of symptoms is the optimal outcome with ...
Halt to exercise = depression?(research)
Sep 01, 2005; ... VANCOUVER, B.C. -- Regular exercisers who are forced to stop may experience depressive symptoms, Ali A. Berlin reported at the annual meeting of the American Psychosomatic Society. The findings of a study of 40 regular exercisers do not suggest that stopping exercise will induce ...
The art of Michelle Cohen.(art nouveau movement)
Sep 01, 2005; ... A love of art and a desire to teach young children have shaped the life of artist Michelle Cohen. A diagnosis of depression and schizoaffective disorder have dampened neither her enthusiasm for art nor her love of color. She was strongly influenced by painters of the art nouveau ...
Compulsive tanning may mean body dysmorphia.(body dysmorphic disorder)
Sep 01, 2005; ... ATLANTA -- A high proportion of individuals with body dysmorphic disorder are compulsive tanners, so "clinicians should be aware that compulsive tanning may be a clue to the presence of the psychological illness," Michelle Conroy, M.D., said at the annual meeting of the American ...
PTSD symptoms persist in refugees for decades.(post-traumatic stress disorder, Cambodian Civil War 1970-1975)
Sep 01, 2005; ... Cambodian refugees continue to have high rates of posttraumatic stress disorder and major depression--more than 2 decades after the end of the Cambodian civil war and resettlement in the United States, said Grant N. Marshall, Ph.D., of the Rand Corp., Santa Monica, Calif., and his ...
Psychiatric work-up need not include extensive medical testing.(psychiatric patients)
Sep 01, 2005; ... LA QUINTA, CALIF. -- Patients brought into the emergency department with a psychiatric condition probably do not need an extensive battery of laboratory tests to clear them medically, according to a small, retrospective chart study. Of 50 psychiatric patients seen in the ...
War survivors' PTSD Tx: focus on sense of control.(posttraumatic stress disorder and depression)(Brief Article)
Sep 01, 2005; ... Contrary to popular opinion, posttraumatic stress disorder and depression in war survivors appear to develop independently of a perceived lack of redress for trauma, according to the investigators of a study that was conducted in three former Yugoslav republics. Impunity for ...
Choose nonstimulants with care in ADHD.(Child/Adolescent Psychiatry)
Sep 01, 2005; ... NEW YORK -- Options are available for children with attention-deficit hyperactivity disorder who do not respond to treatment with stimulants or are troubled by side effects, but they must be chosen and used carefully, Laurence L. Greenhill, M.D., said at a psychopharmacology update ...
ADHD stimulants: no link to propensity for later drug abuse.(attention deficit hyperactivity disorder)
Sep 01, 2005; ... YOSEMITE, CALIF. -- Will my child become a dope fiend? That's a common question Robert S. McKelvey, M.D., fields from parents of children who are prescribed a class II stimulant for attention-deficit hyperactivity disorder (ADHD). "The answer is 'no,' "Dr. McKelvey ...
Anxiety disorders place huge burden on child's entire family.(child's illness)
Sep 01, 2005; ... ATLANTA -- A significant burden is placed on the family members of children and adolescents with anxiety disorders, regardless of the age of the child, Catherine Mancini, M.D., said in a poster presentation at the annual meeting of the American Psychiatric Association. The ...
Female victimization and violence.(violence research)(Brief Article)
Sep 01, 2005; ... Girls who reported being the victims of violence were 2.2 times more likely to engage in violent behavior themselves, wrote Beth E. Molnar, Sc.D., and her colleagues at Harvard University (Arch. Pediatr. Adolesc. Med. 2005;159:731-9). In a longitudinal study, a population-based ...
Family teasing hits home.(overweight of teenage girls)(Brief Article)
Sep 01, 2005; ... When family members teased middle school girls about their appearance, the teasing had a significant impact on the girls' dissatisfaction with their bodies, said Helene Keery, Ph.D., of the Eating Disorders Institute at Methodist Hospital, St. Louis Park, Minn., and her colleagues. ...
Quest for muscles and steroid use.(cross-sectional study)(Brief Article)
Sep 01, 2005; ... Both boys and girls who reported a desire to look like celebrities in magazines were significantly more likely to use products to enhance their physiques, reported Alison E. Field, Sc.D., of Harvard University, and her colleagues. In a cross-sectional study of 6,212 girls and ...
Early warning signs in boys?(childhood mental disorders)(Brief Article)
Sep 01, 2005; ... Conduct disorder symptoms in 8-year-old boys were independent predictors of substance abuse, antisocial personality, and psychotic disorders in adulthood, said Andre Sourander, M.D., of Turku (Finland) University Hospital, and his associates. The 10- to 15-year follow-up study ...
ADHD and moderate mental retardation.(Attention deficit hyperactivity disorder)(Brief Article)
Sep 01, 2005; ... Risperidone was associated with a greater reduction of attention-deficit hyperactivity disorder symptoms compared with methylphenidate in children with moderate mental retardation, said Alceu Gomes Correia Filho, M.D., of the Federal University of Rio Grande do Sul, Brazil, and colleagues ....
Zolmitriptan spray effective as migraine Tx.(Child/Adolescent Psychiatry)
Sep 01, 2005; ... PHILADELPHIA -- For the first time, the triptan, zolmitriptan nasal spray has been found to be effective in the short-term treatment of migraines in adolescents, Paul Winner, D.O., reported at the annual meeting of the American Headache Society. Seven triptans are currently ...
Comorbid conduct disorder secondary to depression.(Child/Adolescent Psychiatry)
Sep 01, 2005; ... SANTA FE, N.M. -- A study of children's autonomic responses to reward and negative mood induction suggests that when conduct disorder and depression are comorbid, depression is the primary disorder. In a poster presentation at the annual meeting of the Society for ...
Imaging breakthroughs reveal early AD changes.(Geriatric Psychiatry)
Sep 01, 2005; ... WASHINGTON -- Imaging techniques designed to enable identification of preclinical Alzheimer's disease were showcased in numerous presentations at an international conference sponsored by the Alzheimer's Association. Preclinical Biochemical Changes Using magnetic ...
Gentle exercises can lead to improved balance.(frail elderly)
Sep 01, 2005; ... NASHVILLE, TENN. -- Practicing postural and strength exercises twice a week leads to significant increases in balance and overall activity among the frail elderly, Sue Scott said in a poster presented at the annual meeting of the American College of Sports Medicine. The fear of ...
Late-onset bipolar patients not as ill as counterparts.(differences between early-onset and late-onset bipolar disorder)
Sep 01, 2005; ... People who first develop bipolar disorder at age 60 years or older are less ill overall than are those with the more typical pattern of early-onset bipolar disorder, said Martha Sajatovic, M.D., of the University Hospitals of Cleveland, and her associates. The researchers used a ...
Insomnia may blunt response to antidepressants.(elderly patients)
Sep 01, 2005; ... DENVER -- Chronic insomnia in depressed elderly patients confers roughly a ninefold increased risk of continued depression after as much as 12 months of antidepressant therapy, Wilfred Pigeon, Ph.D., reported at the annual meeting of the Associated Professional Sleep Societies. ...
Modify depression treatment for older patients: comorbidities are common, so the initial dosage of any agent should be low and titration cautious.(PRACTICAL PSYCHOPHARMACOLOGY)
Sep 01, 2005; ... Depression among the elderly is, in most ways, no different than in younger adults. It responds to the same drugs, but patient factors, presentation, and context must be appreciated for optimal treatment. The most prominent age-linked difference is the prevalence of potentially ...
Intervention improves vertigo and reduces risk of falling.(disequilibrium of aging)
Sep 01, 2005; ... BOCA RATON, FLA. -- Vestibular rehabilitation and balance retraining reduced vertigo and falls in a study of 100 community-dwelling elderly patients with disequilibrium of aging. The intervention also improved gait and overall quality of life in the study conducted at the ...
Watch for the hallmarks of 'pseudoaddiction'.(Addiction Psychiatry)
Sep 01, 2005; ... PALM SPRINGS, CALIF. -- Patients suffering severe, inadequately treated chronic pain can closely resemble drug addicts, posing diagnostic and management challenges for addiction and pain special-its, and primary care physicians. John Femino, M.D., calls them "pseudoaddicts," a ...
Bupropion not as successful in poorer, less motivated smokers.(Addiction Psychiatry)
Sep 01, 2005; ... NEW ORLEANS -- Low-income smokers prescribed bupropion in primary care settings are less successful with smoking cessation than participants in controlled trials, according to a study presented at the annual conference of the Society of Teachers of Family Medicine. Multicenter ...
Mental illness flares for some patients in rehab.(Addiction Psychiatry)
Sep 01, 2005; ... SANTA BARBARA, CALIF. -- Psychiatric symptoms are common among people with substance abuse disorders, but in most patients those symptoms improve over the course of residential substance abuse disorder treatment. A recent Veterans Affairs study sheds light on patients whose ...