Clinical Psychiatry News back issues from August 2006:
Untreated illness poses prenatal risk.
Aug 01, 2006; ... TORONTO -- Psychiatrists and other physicians weighing the risks versus benefits of treating mental illness during pregnancy should consider that their dilemma is not one of fetal exposure versus nonexposure, according to Dr. Zachary N. Stowe, a psychiatrist and director of the Women's ...
Vital signs.(antidepressant sales in 2005)(Table)(Brief article)
Aug 01, 2006 ... <Pre> VITAL SIGNS Zoloft Led Antidepressant Sales in 2005 Zoloft $3.1 billion Effexor XR $2.6 billion Lexapro$2.1 billion Wellbutrin XL $1.5 billion Cymbalta $0.7 billion All others ...
Depression trial results: don't augment too early: STAR*D shows remission takes time.(News)
Aug 01, 2006; ... SANTA FE, N.M. -- The STAR*D trial is providing abundant information but no simple answers about the treatment of major depressive disorder, speakers said at a psychiatric symposium sponsored by the University of Arizona. "What STAR*D has found is everything works well, sort of ....
Psychiatrists face pay cut under new CMS proposal.(Practice Trends)(Centers for Medicare and Medicaid Services )
Aug 01, 2006; ... A new proposal from the Centers for Medicare and Medicaid Services could result in a better bottom line next year for physicians who spend a lot of time on evaluation and management services but will likely mean a small cut in payments to psychiatrists. CMS officials are seeking ...
Air Force suicides drop 33% in wake of mandatory prevention program.
Aug 01, 2006; ... CHICAGO -- Communities and organizations could learn a lot about suicide prevention from the United States Air Force. Data for 1990-2002 show that within 6 years of the USAF Suicide Prevention Program implementation, suicides among Air Force personnel were down 33%. ...
Self-reports by depressed patients are not reliable.(News)(clinical trials)(Brief article)
Aug 01, 2006 ... Don't ask depressed patients whether they feel any better since starting on an antidepressant, Dr. Rush advised clinicians at the meeting. "If you ask a patient who is depressed for a global judgment, you are begging for a problem. They are not going to be accurate. They cannot ...
Diabetes drug class found protective in Alzheimer's.
Aug 01, 2006; ... MADRID -- Thiazolidinediones may reduce the incidence of Alzheimer's disease or forestall its progression in both diabetic and nondiabetic patients, researchers reported at the 10th International Conference on Alzheimer's Disease and Related Disorders. Diabetes is thought to ...
Surgeon general: no smoke is safe smoke: evidence exists to infer causal relationship between secondhand exposure, lung cancer in nonsmokers.
Aug 01, 2006; ... The science is now anything but hazy: Secondhand tobacco smoke causes premature death and disease in children and adults who don't smoke--and there is no safe exposure level, the U.S. surgeon general warned in a comprehensive new report. In a return to a public health issue last ...
Prescription drug abuse rising, especially among teens.
Aug 01, 2006; ... TORONTO -- Prescription drug abuse is growing at a faster rate than is illegal substance abuse, particularly among adolescents, Joseph A. Califano Jr. said at the annual meeting of the American Psychiatric Association. "We think the country has got to deal with this problem, ...
New schizophrenia scale hailed as more objective.(News)(negative symptoms )
Aug 01, 2006; ... BOCA RATON, FLA. -- A new scale aimed at assessing negative symptoms of schizophrenia is more objective and correlates well with the two most commonly used measures, according to a poster presentation at a meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute ...
Cardiovascular risks prevalent in schizophrenia.(News)
Aug 01, 2006; ... BOCA RATON, FLA. -- Cardiovascular risk factors--primarily hypertension, hyperlipidemia, and obesity--are highly prevalent among patients with schizophrenia, a large, ongoing international study shows. A very low percentage of participants reported use of antihypertensive or ...
Depression risk nearly doubles at start of menopause.(News)
Aug 01, 2006; ... Women entering menopause are nearly twice as likely to develop depression as are women the same age who are not yet making the transition to menopause, reported Dr. Lee S. Cohen and his associates in the Harvard Study of Moods and Cycles. "Transition to menopause has long been ...
Beating compassion fatigue.(FINK! STILL AT LARGE)(behaviour of psychotherapists)
Aug 01, 2006; ... It is common for psychotherapists to disregard their own self-care needs when focusing on helping patients, particularly when those patients are chronically ill (J. Clin. Psychol. 2002;58:1433-41). But psychiatrists are more aware than physicians in other specialties of the importance of ...
Sensitivity needed.(LETTERS)(Letter to the editor)
Aug 01, 2006 ... In his discussion on juries and bias, Dr. Paul J. Fink recalled an incident from perhaps a half-century ago ("Can Juries Be Unbiased?" Fink! Still at Large, April 2006, p. 9). In that incident, Dr. Fink said, a university student working as a waitress said to him: "I've been in ...
More on jury bias.(LETTERS)(Letter to the editor)
Aug 01, 2006; ... An excellent response from Dr. Fink on the issue of jury bias! I agree fully. The degeneration of our legal system finds its height in the use of jury consultants. The idea is that juries can be manipulated if one only selects the "right" juror. This has nothing to do with ...
HSAs a 'viable option'.(LETTERS)(Letter to the editor)
Aug 01, 2006; ... Most evaluations assume that the alternative to the HSA-compatible high-deductible insurance plan is a comprehensive insurance policy ("Views Mixed on Benefits of Health Savings Plans," April 2006, p. 7). But for those individuals who are unable to afford a more comprehensive ...
Opioids: assess risks and benefits.(LETTERS)(Letter to the editor)
Aug 01, 2006; ... Dr. Howard A. Heit's advice about opioids is grossly unrealistic and dangerous ("Don't Withhold Opioids From Recovering Addicts," July 2006, p. 42). I practice in an area of the country known for its high rate of substance abuse and diversion. To flatly state, as Dr. Heit does, ...
Easing the transition to college.(GUEST EDITORIAL)(surveys)
Aug 01, 2006; ... We like to think of college as a place where intellectual ideas blossom, lifetime friendships are formed, and fun rules when Friday afternoon rolls around. But another side of college reflects the pressures young adults face. The American College Health Association survey of ...
Focus on compliance in refractory depression: patients need to be told repeatedly to continue taking their medication even when they feel better.(Adult Psychiatry)
Aug 01, 2006; ... SAN FRANCISCO -- A large number of patients with major depression seem to be resistant to treatment. But a focus on compliance, proper dosing, and when to switch or augment medications can increase the probability of an initial response or convert a nonresponse to a response, Dr. Mantosh ...
Data on clozapine augmentation are scarce but do exist.(Adult Psychiatry)(care and alternative treatment to schizophrenia)
Aug 01, 2006; ... SAN FRANCISCO -- Evidence is scarce on how to treat the 30% of patients who fail to respond to clozapine, traditionally seen as the last resort in treatment-resistant schizophrenia, as well as the 50% who have partial responses to the drug, Dr. Michael Flaum said at the annual meeting of ...
Consider pregnancy risks in bipolar women.
Aug 01, 2006; ... SANTA FE, N.M. -- Don't ignore pregnancy risks when prescribing medications for bipolar disorder in a woman of child-bearing age, Dr. Marlene P. Freeman told physicians at a psychiatric symposium sponsored by the University of Arizona. Even if the patient says she has no plans ...
ECT patients taking an antidepressant appear to fare well.(electroconvulsive therapy)
Aug 01, 2006; ... TORONTO -- Refractory depression patients who undergo electroconvulsive therapy while on an antidepressant do not have any increased side effects or adverse events, but they may have an improved response, Dr. Keith Isenberg said in a poster presentation at the annual meeting of the ...
The art of Nigel Bart.(VISIONARY ART)(narrations)
Aug 01, 2006; ... Last year, Nigel Bart and his family converted an empty loft in Winnipeg, Canada, into an art gallery called Artbeat Studio. Artbeat supports and mentors professional artists through the effective use of studio space. But the Artbeat Studio's mission extends beyond helping ...
'Sequential' approach to combo Tx can work: augmenting medication with psychotherapy 'ties in with the growing emphasis on remission.'.
Aug 01, 2006; ... It has become clear in recent years that pharmacotherapy and psychotherapy are not just either/or alternatives. Many patients, such as those with severe or treatment-resistant depression, appear to do better with both treatments than with either alone. Situations in which the ...
Abuse history predicts suicidal ideation in bipolar adults.
Aug 01, 2006; ... TORONTO -- Childhood abuse is a powerful predictor of suicidal ideation and deliberate self-harm in adults with bipolar disorder, a study has shown. For that reason, inquiring about childhood maltreatment is an important component of risk assessment in bipolar patients in order to devise ...
Drug ok'd for Parkinson's dementia.(CLINICAL CAPSULES)
Aug 01, 2006 ... Revisions to the label of rivastigmine made at the time of its recent approval for treating dementia associated with Parkinson's disease include guidance on how to make this diagnosis. The Food and Drug Administration approved the cholinesterase inhibitor specifically for ...
Post-MI helplessness and PTSD.(myocardial infarctions)(posttraumatic stress disorder)(myocardial infarctions causes posttraumatic stress disorder)
Aug 01, 2006 ... Clinical forms of posttraumatic stress disorder occurred in 10% of 124 adults within a year after their first myocardial infarctions, according to a poster presented at the annual meeting of the American Psychosomatic Society. Previous study finding have suggested that patients ...
Cerebral emboli seen in Alzheimer's.(Brief article)
Aug 01, 2006 ... Spontaneous cerebral emboli are significantly more common in people with Alzheimer's disease and vascular dementia, and may represent both a common pathophysiology and a potentially treatable cause of dementia. Just 1 hour of ultrasound monitoring detected emboli in up to 40% ...
Obesity tied to higher risk of mood disorders.(Survey)(Brief article)
Aug 01, 2006; ... Obesity is associated with a greater lifetime risk of having a mood or anxiety disorder but a lower lifetime risk of having a substance use disorder, findings of a U.S. epidemiologic survey show. The survey of a nationally representative sample of 9,125 adults was conducted ...
Telepsychiatry reliable for some rural patients.(Adult Psychiatry)(treatment methods)
Aug 01, 2006; ... BOCA RATON, FLA. -- Telepsychiatry is a valid and reliable way to extend depression treatment to rural settings, according to a study from researchers at the University of California, Davis. "Telepsychiatry has been hot and cold, hot and cold, and right now it's hot," Dr. Donald ...
Autism services not reaching some families: survey uncovers barriers to earlier intervention for children with Asperger's and minority children.(Child/Adolescent Psychiatry)
Aug 01, 2006; ... MONTREAL -- Among children diagnosed with an autism spectrum disorder, those with Asperger's syndrome, minority children, and those whose families do not follow one of the major autism treatment approaches fall behind others when it comes to early intervention services, service intensity, ...
Repetitive behaviors of autism linked to mood problems.
Aug 01, 2006; ... MONTREAL -- Comorbid mood and behavior problems that are present at an early age in children diagnosed with an autism spectrum disorder are associated with the frequency and severity of restrictive, repetitive, and stereotyped behaviors, a study has shown. But those comorbid ...
Soothing routines quell kids' fears of CPAP.(continuous positive airway pressure)
Aug 01, 2006; ... SAN JUAN, P.R. -- Continuous positive airway pressure can be effective for obstructive sleep apnea in children, but parents must be persistent to ensure children's acceptance of the treatment, Dr. Ann C. Halbower said at a meeting sponsored by the American College of Chest Physicians. ...
Adenotonsillectomy improves both sleep and behavior.
Aug 01, 2006; ... CHICAGO -- Adenotonsillectomy improved both sleep and behavior in a pair of studies presented at the Combined Otolaryngology Spring Meetings. Children with either obstructive sleep apnea syndrome (OSAS) or mild sleep disordered breathing (SDB) demonstrated significantly ...
Readiness is key in cognitive-behavioral therapy: children with anxiety symptoms must first understand how the treatment works to benefit.
Aug 01, 2006; ... MIAMI -- Clinicians can help children and adolescents with cognitive, physical, and behavioral symptoms of anxiety through cognitive-behavioral therapy. However, readiness for treatment must first be established, according to a presentation at the annual conference of the Anxiety Disorders ...
Special CBT protocol improves anxiety in young children.(cognitive behavioral therapy)
Aug 01, 2006; ... MIAMI -- A cognitive-behavioral therapy program designed for children aged 4-7 years significantly improves anxiety symptoms over 6 months, according to a randomized, controlled trial. Many pediatric cognitive-behavioral therapy (CBT) programs are geared toward older children ...
Consider three variables in ADHD prescribing: take characteristics of the medication, efficacy studies, and patient into account before treatment.(Child/Adolescent Psychiatry)(attention-deficit hyperactivity disorder)
Aug 01, 2006; ... MIAMI BEACH -- Three variables--medicine characteristics, efficacy study characteristics, and patient characteristics--should be considered when prescribing for attention-deficit hyperactivity disorder, said Dr. Richard Rubin at the annual meeting of the American Society for Adolescent ...
Metaanalysis shows stimulant therapy inhibits growth.(Child/Adolescent Psychiatry)(Brief article)
Aug 01, 2006; ... SAN FRANCISCO -- The question of whether stimulant therapy for attention-deficit hyperactivity disorder inhibits a child's growth has long been controversial, with well-designed studies providing conflicting results. Now, a metaanalysis has indicated that stimulant therapy ...
PTSD seen in teens near ground zero.(posttraumatic stress disorder due to terrorist attacks )(Brief article)
Aug 01, 2006; ... A total of 83 (7.4%) of 1,122 high school students who lived in the borough of the Bronx in New York City at the time of the Sept. 11, 2001, terrorist attacks met the criteria for posttraumatic stress disorder (PTSD) based on questionnaires completed at school 8 months after the attacks. ...
Race and mother/daughter sex talks.(Brief article)
Aug 01, 2006; ... Ethnicity was a significant predictor of mothers' discomfort in discussing sex-related topics with their daughters, according to data from surveys of 6,929 adolescent girls and their biological mothers. Compared with white mothers, Asian mothers were more than five times as ...
Stutterers struggle with emotions.(Brief article)
Aug 01, 2006; ... Children who stutter are significantly more emotional in stressful situations compared with their non-stuttering peers, a study shows. To compare the differences in emotional regulation, Jan Karrass, Ph.D., and colleagues at Vanderbilt University in Nashville, Tenn., examined ...
Sleep disorder manifestations vary by patient.
Aug 01, 2006; ... SAN JUAN, P.R. -- Treating the manifestations of sleep disorders requires a broad understanding of patients' circumstances, Donald Bliwise, Ph.D., said at the annual meeting of the American Association for Geriatric Psychiatry. For example, both restless legs syndrome (RLS) and ...
Anxiety, sleep problems predict late-life depression recurrence.
Aug 01, 2006; ... BOCA RATON, FLA. -- Residual anxiety symptoms and sleep disturbances predicted recurrence of late-life depression in a study presented as a poster at a meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute of Mental Health. "We know residual ...
Nearly half of elderly may have prescription errors.
Aug 01, 2006; ... SEATTLE -- Almost half of a sample of elderly persons in Los Angeles were taking medications that they probably should not have been, and the likelihood of such a problem rose sharply with the number of medications they were taking, Gretchen E. Alkema said at the annual research meeting of ...
Risk factors suggest preclinical Parkinson's: look for excessive daytime sleepiness, olfactory dysfunction, constipation, and slow reaction time.(Geriatric Psychiatry)
Aug 01, 2006; ... WASHINGTON -- The presence of constipation, poor olfaction, slow reaction time, and excessive daytime sleepiness in any combination strongly suggests the presence of preclinical Parkinson's disease, according to findings from the ongoing Honolulu-Asia Aging Study presented at the World ...
Lowering homocysteine fails to boost cognitive performance.(Editorial)
Aug 01, 2006; ... Elevated homocysteine levels may not be a risk factor for cognitive decline in older patients, despite previous evidence, reported Jennifer A. McMahon, Ph.D. She and her colleagues at the University of Otago, New Zealand, conducted a 2-year randomized, double-blind, ...
Methylphenidate may improve apathy associated with dementia.
Aug 01, 2006; ... CHICAGO -- Methylphenidate may be effective in the treatment of apathy associated with dementia of the Alzheimer type, Dr. Prasad Padala and associates reported in a poster at the annual meeting of the American Geriatrics Society. Results from an open-label study in 13 patients ...
One session can lower prenatal alcohol use.
Aug 01, 2006; ... TORONTO -- A single-session intervention can reduce prenatal alcohol use among at-risk pregnant women, especially those with higher reported alcohol consumption at baseline, Dr. Grace Chang reported at the annual meeting of the American Psychiatric Association. Additionally, ...
Group therapy can help pathological gamblers.
Aug 01, 2006; ... SPARKS, NEV -- Pathological gambling is a serious and increasingly prevalent addiction, but it is treatable--particularly with group therapy, Denise F. Quirk said at the annual meeting of the American College of Preventive Medicine. During the last decade, restrictions on ...
'Adaptive design' promoted for alcoholism, depression treatment.(Addiction Psychiatry)
Aug 01, 2006; ... BOCA RATON, FLA. -- Clinicians treating alcohol abuse or depression could improve outcomes by adopting a strategy gaining popularity among psychiatry researchers, according to several presentations at a meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute of ...
Smoking cessation plans work, but not accessed.(Addiction Psychiatry)
Aug 01, 2006; ... BETHESDA, MD. -- Tobacco cessation programs that employ telephone quit lines and counseling and nicotine replacement therapy are highly effective, and they should be offered to more smokers and users of smokeless tobacco, according to a panel of physicians, other health care providers, and ...
Perspective.(Community Psychiatry)(chronic pain)
Aug 01, 2006; ... People who have chronic pain are extraordinarily clear about the devastating impact this problem has on their psychological balance. The resulting sense of helplessness often generates a great deal of grief, depression, stress, pessimism, and loneliness. People who have never ...
Cast a wide net with chronic pain.(prevention in action)
Aug 01, 2006; ... Chronic pain cuts wide. One out of every five people lives with some sort of chronic pain. Of that 20%, one-third are not able or are only minimally able to maintain an independent lifestyle because of it, according to the International Association for the Study of Pain. And ...
Critical, unmet needs identified for suicidology.(Community Psychiatry)
Aug 01, 2006; ... SEATTLE -- The field of suicidology still has a distance to go before it attains the status of a mature discipline that informs clinical practice, Lanny Berman, Ph.D., said at the annual conference of the American Association of Suicidology. Nothing makes this point more ...
Postpartum suicide risk soars after infant death: risk is 19.6-fold greater among women with history of psychiatric hospitalization, large study shows.
Aug 01, 2006; ... SEATTLE -- The risk of a maternal postpartum suicide attempt increases more than threefold after a fetal or infant death, findings of a large case-control study show. An analysis that linked Washington state hospital records to detailed state-mandated fetal birth and death data ...
Confidentiality waiver can prevent lawsuit after patient suicide.(Community Psychiatry)
Aug 01, 2006; ... SEATTLE -- Obtaining a written waiver of confidentiality should be a routine early priority when treating patients for depression, an anxiety disorder, or any other psychiatric condition associated with increased suicidality, Skip Simpson said at the annual conference of the American ...
Psychosis rarely begets murder, experts say: demographics better predict violence than does mental illness--except for substance abuse disorder.(Forensic Psychiatry)
Aug 01, 2006; ... TORONTO -- Even movies and popular songs refer to the idea that there are dark and dangerous mentally ill persons who have the capacity to become "psycho killers." The more appropriate term, however, might be "personality disorder killer," according to those leading a session at ...
Don't rely on self-report during forensic assessments.(Forensic Psychiatry)
Aug 01, 2006; ... SAN DIEGO -- Relying on examinee self-report during forensic assessment is ill-advised, Jerry J. Sweet, Ph.D., said at the annual meeting of the American Neuropsychiatric Association. "Self-report in general is often unreliable," said Dr. Sweet, director of the neuropsychiatry ...
MAO inhibitor is approved for Parkinson's.(monoamine oxidase)
Aug 01, 2006; ... The recent approval of an irreversible monoamine oxidase inhibitor for treating Parkinson's disease includes an indication for patients with early disease as well as for those with more advanced disease who are already on levodopa. Last month, the Food and Drug Administration ...
CBT more effective than zopiclone for insomnia.(cognitive behavioral therapy)(Editorial)
Aug 01, 2006; ... Cognitive-behavioral therapy led to greater improvements in a variety of sleep measures than did zopiclone in adults with insomnia, Norwegian researchers report. Borge Sivertsen, Psy.D., of the University of Bergen, Norway, and his colleagues found in a randomized, ...
Structured sleep eases transformed migraines.
Aug 01, 2006; ... LOS ANGELES -- A structured sleep modification program significantly reduced the frequency and intensity of headaches in women with transformed migraines, University of North Carolina researchers reported at the annual meeting of the American Headache Society. The strength of ...
A hypno-behavioral approach to migraine.
Aug 01, 2006; ... For thousands of years, medical scientists and clinicians have studied and tried to treat the painful and often debilitating headache that is migraine. In my experience of treating patients with chronic pain, headache--particularly migraine--has been the most common problem. ...
Study: 44% of patients had visual auras with migraine attacks.(Brief article)
Aug 01, 2006; ... LOS ANGELES -- Visual disturbances may be far more common among patients with migraines than previously believed, according to a study presented at the annual scientific meeting of the American Headache Society. Dr. Abouch V. Krymchantowski and Dr. Marcus V. Adriano of the ...
Topiramate reduces chronic headache days.
Aug 01, 2006; ... LOS ANGELES -- The anticonvulsant drug topiramate significantly eased chronic daily headaches, one of the most intractable forms of headache to treat, in a randomized, placebo-controlled trial conducted at 46 U.S. centers. Although subjects continued to experience headaches on ...
Open-ended question can reveal impact of migraine.
Aug 01, 2006; ... LOS ANGELES -- Health care providers asked lots of questions during videotaped, real-life office visits by patients with migraines, but almost always failed to ask the one question that would indicate whether they should prescribe a preventive medication. That question: "Can you ...