Clinical Psychiatry News back issues from February 2007:
Inpatient suicide: respond quickly.(Practice Trends)
Feb 01, 2007; ... TUCSON, ARIZ. -- A little more than a year ago, a young psychiatric patient scaled an 8-foot barrier on the seventh floor to jump to his death in a crowded atrium after a holiday gathering at the Mark O. Hatfield Clinical Research Center in Bethesda, Md. The impact of the ...
Split decision on off-label drug use.(VITAL SIGNS)(Brief article)
Feb 01, 2007 ... <Pre> Split Decision on Off-Label Drug Use Doctors should be allowed to prescribe drugs to treat diseases or conditions other than those for which the drugs have been approved. Agree strongly (16%) Agree (29%) Disagree somewhat (23%) Disagree strongly (23%) ...
Better coordination of mental, physical health care urged: report cites early deaths of mentally ill.(News)
Feb 01, 2007; ... Psychiatrists and other members of the mental health community are working on ways to improve coordination of mental health and primary care in an effort to decrease early death among people with serious mental illness. People being treated for serious mental illness by public ...
ALS drug appears to ease resistant depression.(News)(amyotrophic lateral sclerosis)(Clinical report)
Feb 01, 2007; ... NEW YORK -- Riluzole, a drug for amyotrophic lateral sclerosis that targets glutamate cycling in the brain, can markedly improve depression in some patients who remain highly symptomatic despite treatment with other antidepressants, Dr. Steven F. Kendell reported at a symposium sponsored ...
FDA panel wants more data on TMS.(News)(Transcranial Magnetic Stimulation)
Feb 01, 2007; ... GAITHERSBURG, MD. -- A noninvasive device that delivers magnetic stimulation to the brain as a patient sits in a chair alert and awake appears to be safe, but has not been proven to be an effective treatment for depression, a federal advisory panel has agreed. At a meeting in ...
Switching to a cash practice.(ADVISER'S VIEWPOINT)
Feb 01, 2007; ... I have been in solo psychiatric private practice for 33 years and continue to truly enjoy my work. But the stress level was building because of reimbursement realities and administrative hassles, so in the fall of 2005, after a lot of thought, I opted out of all health plan and insurance ...
Girls with ADHD deserve attention.(GUEST EDITORIAL)(Attention deficit hyperactivity disorder)
Feb 01, 2007; ... Too often, girls with attention-deficit hyperactivity disorder are overlooked. As mental health professionals, we must not allow this lack of attention to continue. Certainly, boys are diagnosed with ADHD far more often than are girls. Just 10 years ago, the ratio between boys ...
What is the best way to reform the U.S. health care system?(POINT/COUNTERPOINT)
Feb 01, 2007; ... Single payer is the way to go. The health care financing organ in the United States is failing. It has all the manifestations of a patient with heart failure. We have poor output, where we can't circulate health insurance to cover the entire population, so we have ...
Prazosin for PTSD.(LETTERS)(Letter to the editor)
Feb 01, 2007 ... "Fink! Still at Large" is an oasis of cogent, integrated topical discussion. But in reading Dr. Paul J. Fink's recommendations about treating patients with sleep problems, I was surprised to find that in the three paragraphs devoted to posttraumatic stress disorder, there was no mention of ...
What about children and insomnia?(LETTERS)(Letter to the editor)
Feb 01, 2007 ... I enjoy Dr. Paul J. Fink's columns very much and generally agree with his point of view. Regarding one recent column ("Helping Patients Conquer Sleep Problems," Fink! Still at Large, December 2006, p. 11), I would be interested to hear Dr. Fink's comments about a sleep study ...
Cognitive therapy focus is good.(LETTERS)(Letter to the editor)
Feb 01, 2007; ... I very much enjoyed Dr. Robert T. London's column on Dr. Aaron T. Beck ("Cognitive Therapy Reaches a Milestone," The Psychiatrist's Toolbox, November 2006, p. 21). The piece did a great job of highlighting Dr. Beck's seminal contributions to psychiatry and psychology. ...
Sometimes boundaries are too thick.(LETTERS)(Letter to the editor)
Feb 01, 2007; ... In the wake of Dr. Wayne S. Fenton's death allegedly at the hands of a patient, Dr. H. Steven Moffic raised the issue of Dr. Fenton's boundaries and our duty to colleagues in discussing boundary issues ("Dr. Fenton and Boundary Issues," Letters, December 2006, p. 12). Yes, ...
Enlist the media in 'war on STDs'.(LETTERS)(Letter to the editor)
Feb 01, 2007; ... Although it is good to see that syphilis rates fell 37% among African Americans and 60% among women overall from 1999 to 2004, and that we saved $5 billion in direct medical expenses due to declines in syphilis and gonorrhea between 1990 and 2003, I agree that we have a long fight ahead of ...
Psych emergencies belong in the ED.(LETTERS)(Letter to the editor)
Feb 01, 2007; ... Thank you for publishing Dr. H. Steven Moffic's letter raising ethical questions surrounding the death of Dr. Wayne S. Fenton ("Dr. Fenton and Boundary Issues," Letters, December 2006, p. 12). The many ways in which he appears to have been an exemplary clinician should not ...
Caution needed with CFS diagnosis.(LETTERS)(Letter to the editor)
Feb 01, 2007; ... The term "chronic fatigue syndrome" is best seen as a starting point rather than a diagnosis ("CDC Campaign Targets Chronic Fatigue Syndrome," December 2006, p. 52). Congestive heart failure has a combination of clinical features but numerous potential underlying causes ....
Is social phobia a disorder or not?(THE PSYCHIATRIST'S TOOLBOX)
Feb 01, 2007; ... A bright young attorney was referred to me a few years ago by his primary care physician. The attorney had passed the bar exam and had had no problems securing and scheduling job interviews, but for more than 6 months after passing the bar, he had canceled, rescheduled, or even failed to ...
Undergrads' words after trauma can predict PTSD.(Adult Psychiatry)(post-traumatic stress disorder)
Feb 01, 2007; ... HOLLYWOOD, CALIF. -- Language use in the immediate aftermath of a trauma can predict who will develop lasting symptoms of posttraumatic stress disorder, according to a poster presentation by Wendy D'Andrea-Merrins at the annual meeting of the International Society for Traumatic Stress ...
Amygdala, prefrontal cortex are keys to anxiety: bringing that knowledge to neuroimaging should help pinpoint diagnosis, treatment response.(Adult Psychiatry)(Disease/Disorder overview)
Feb 01, 2007; ... ORLANDO -- A complex interaction of genetics, childhood stress, neurocircuits, the amygdala, and prefrontal cortex structures determines how a person develops and copes with anxiety, according to a presentation at a psychopharmacology congress sponsored by the Neuroscience Education ...
Exposure therapy can prove effective in complex PTSD.(Adult Psychiatry)(posttraumatic stress disorder)
Feb 01, 2007; ... HOLLYWOOD, CALIF. -- Exposure therapy is a proven treatment for posttraumatic stress disorder, and it's even effective in complex cases, Barbara O. Rothbaum, Ph.D., said at the annual meeting of the International Society for Traumatic Stress Studies. Exposure works for ...
Data on veterans point to risk, resiliency in marriages.(Adult Psychiatry)
Feb 01, 2007; ... HOLLYWOOD, CALIF. -- Veterans with severe posttraumatic stress disorder who live with a spouse or partner are more likely to engage in some high-risk behaviors and less likely to engage in others, compared with those who live alone, Kent Drescher, Ph.D., reported at the annual meeting of ...
Treating rapid-cycling bipolar disorder: mood chart covering 6 months or a year provides a view of the illness that can clarify drug choice.(PRACTICAL PSYCHOPHARMACOLOGY)
Feb 01, 2007; ... Bipolar disorder is a disease of variation, and one important variable is cycle frequency. At any time, a significant proportion of patients are rapid cyclers--20% in the Systematic Treatment Enhancement Program for Bipolar Disorder study--who have had four or more episodes in the ...
Patient apathy linked to poor glycemic control in diabetes.(Adult Psychiatry)
Feb 01, 2007; ... TUCSON, ARIZ. -- Apathy is not recognized as a psychiatric disorder, but treating it may improve glycemic control in patients with type 2 diabetes, according to a poster presented at the annual meeting of the Academy of Psychosomatic Medicine. Dr. Prasad R. Padala reported that ...
The art of Lanham Bundy.(VISIONARY ART)
Feb 01, 2007; ... Lanham Bundy says some people think of her paintings as examples of surrealism. But she doesn't see her work that way. "It's hard to label things, but I consider myself a contemporary artist--with some definite influences from different periods," said Ms. Bundy, who is 45. "All ...
Line of research could advance schizophrenia Tx.(Adult Psychiatry)
Feb 01, 2007; ... NEW YORK -- Overexpression of cannabinoid receptors and hyperactivity of the brain's endogenous endocannabinoid system may be responsible for the delusions and aberrant associations characteristic of schizophrenia, Steven Laviolette, Ph.D., said at the annual meeting of the National ...
Small study: olanzapine effective against trichotillomania.(Adult Psychiatry)
Feb 01, 2007; ... PARIS -- Trichotillomania was highly responsive to olanzapine in a small, randomized, placebo-controlled trial that suggests repetitive hair pulling may be closer to tics and Tourette's syndrome than to other obsessive-compulsive disorders. Eleven of 13 patients (85%) on ...
Have you treated patients with gambling problems that would be considered pathological? what medications have you used to help these patients manage their problems?(FINK! STILL AT LARGE)
Feb 01, 2007; ... Pathological gambling, also known as gambling addiction, is quite prevalent. Using the term "addiction" gives us some clues to the kind of psychopathology found in someone who cannot stop gambling. It has also been referred to as compulsive gambling, but I think that all addictions have a ...
Veterans with PTSD require tailored approach: some military organizations have implemented programs aimed at spotting problems in early stages.(Adult Psychiatry)(post-traumatic stress disorder)
Feb 01, 2007; ... HOLLYWOOD, CALIF. -- Military veterans with posttraumatic stress disorder can be especially difficult to treat, Mark Creamer, Ph.D., said at the annual meeting of the International Society for Traumatic Stress Studies. "The very first controlled trials of treatment for PTSD ...
Prolonged exposure is best Tx for women with PTSD.(Adult Psychiatry)(posttraumatic stress disorder)
Feb 01, 2007; ... HOLLYWOOD, CALIF. -- Results from the largest randomized controlled trial ever comparing two types of psychotherapy for posttraumatic stress disorder indicate that for women, therapy involving prolonged exposure to the original trauma is significantly better than therapy focusing on ...
Preschoolers tolerate methylphenidate.(CLINICAL CAPSULES)(Brief article)
Feb 01, 2007; ... Adverse events were well tolerated in a majority of 3- to 5-year-olds who took methylphenidate for ADHD, based on data from 183 children, said Tim Wigal, Ph.D., of the University of California, Irvine, and his colleagues. Although methylphenidate's safety had been studied in ...
ADHD and Tourette's: all in the family.(CLINICAL CAPSULES)(Brief article)
Feb 01, 2007; ... Tourette's disorder and ADHD may not have the same genetic cause, but cases in which the two conditions occur comorbidly tend to run in families, said Dr. S. Evelyn Stewart of Harvard University, Boston, and her associates. To determine the possible connection between ADHD and ...
Externalization in daytime wetters.(CLINICAL CAPSULES)(Brief article)
Feb 01, 2007; ... Children aged 7-9 years who wet their pants during the day have significantly more parent-reported psychological problems than do children with no daytime wetting, based on data collected from 8,213 children as part of a longitudinal study. The clinical implication is that early ...
Intensive use of stimulants at start often beneficial in ADHD.(Child/Adolescent Psychiatry)
Feb 01, 2007; ... ORLANDO -- Start with a long-acting stimulant for treatment of attention-deficit hyperactivity disorder for most patients, increase the dose before adding a short-acting drug, and monitor response with a rating scale, Dr. Peter S. Jensen advised at a psychopharmacology congress sponsored ...
Psychological impact of diabetes less intense on children.(Child/Adolescent Psychiatry)
Feb 01, 2007; ... COPENHAGEN -- Parents of children with type 1 diabetes intensely experience the psychological impact of the disease, according to new study findings. "Both parents and children may need counseling to help them cope with worries associated with the disease," Douglas C.A. Taylor ...
Children more resilient than adults in absorbing severe events.(Child/Adolescent Psychiatry)
Feb 01, 2007; ... SAN DIEGO -- Children of parents who lost their jobs in the past 3-5 months were more likely to develop psychopathology if they reported three or more moderate to severely stressful life events in the past year than children who reported fewer such events, Dr. Karen L. Weihs reported in an ...
Impaired nonverbal behaviors may portend autism.(Child/Adolescent Psychiatry)
Feb 01, 2007; ... ATLANTA -- Early identification and intervention are crucial to a good long-term outcome in children with autism, experts agreed at the annual meeting of the American Academy of Pediatrics. The disorder can be tricky to diagnose; when in doubt, the child should be referred for ...
Web survey predicts risk of adolescent depression.(Child/Adolescent Psychiatry)
Feb 01, 2007; ... SAN ANTONIO -- Physicians may be able to quickly and accurately assess and stratify an adolescent's 1-year risk of developing new-onset major depression using a 20-item checklist, Dr. Benjamin W. Van Voorhees said at the annual meeting of the Society for Prevention Research. ...
Biofeedback eases recurrent abdominal pain.(Child/Adolescent Psychiatry)
Feb 01, 2007; ... ORLAND -- Therapeutic biofeedback reduces pain intensity, pain frequency, and health care utilization among children with recurrent abdominal pain, according to two posters presented at the annual meeting of the North American Society for Pediatric Gastroenterology, Hepatology, and ...
Customize treatment to needs of adolescent with depression.(Child/Adolescent Psychiatry)
Feb 01, 2007; ... MENDOZA, ARGENTINA -- When it comes to adolescents with depression, psychiatrists would do well to tailor treatment to the individual needs of each patient, Dr. Harold I. Eist said at the 6th World Congress on Depressive Disorders. Adolescence is a turbulent period with enormous ...
Remission rate of 66% seen after 12 weeks of fluoxetine.(Child/Adolescent Psychiatry)
Feb 01, 2007; ... SAN DIEGO -- More than two-thirds of children and adolescents with major depressive disorder who were treated with fluoxetine were in remission by week 12 of treatment, yet almost half of remitters had at least one residual symptom by week 12. The findings are important because ...
Loss and grief can lead to 'bereavement overload'.(Geriatric Psychiatry)
Feb 01, 2007; ... PHILADELPHIA -- Loss is inevitable for the elderly, and with loss comes grief. Losses are not just the deaths of loved ones, friends, and acquaintances. The elderly also experience loss and grief with their diminished ability to do things. It can cause them to lose a sense of ...
Ask elderly patients about religious, spiritual beliefs.(Geriatric Psychiatry)
Feb 01, 2007; ... PHILADELPHIA -- Religious and spiritual beliefs often play an important role in the lives of the elderly and should be taken into account by health care workers who care for geriatric patients. Physicians and others who care for the elderly should take a spiritual history of ...
Folic acid may improve cognitive performance.(Geriatric Psychiatry)
Feb 01, 2007; ... Older adults who took 800 mcg of folic acid daily for 3 years showed significantly less cognitive decline than those who took placebo, according to a randomized, double-blind trial. Three years of folic acid supplementation gave an individual the performance of someone 4.7 years ...
High folate intake may lower AD risk.(Geriatric Psychiatry)
Feb 01, 2007; ... High intake of folate decreased the risk of Alzheimer's disease in a predominantly Hispanic and African American cohort of elderly people, according to a recently published study. There was a statistically significant association between AD risk and combined dietary and ...
Psych services benefit emergency departments.(Geriatric Psychiatry)(Clinical report)
Feb 01, 2007; ... TUCSON, ARIZ. -- Dementia may be overdiagnosed and delirium overlooked when geriatric patients with vague symptoms are brought to emergency departments, Dr. Lesley Wiesenfeld suggested at the annual meeting of the Academy of Psychosomatic Medicine. Dr. Wiesenfeld reviewed the ...
Screening tool may help identify alcohol use.(Addiction Psychiatry)
Feb 01, 2007; ... ORLANDO -- It is a good idea to routinely ask patients--particularly those with risk factors for dependence--about their alcohol use, George F. Koob, Ph.D., said at a psychopharmacology congress sponsored by the Neuroscience Education Institute. However, patients are not always ...
Motivations of opioid and stimulant abusers differ.(Addiction Psychiatry)
Feb 01, 2007; ... BOSTON -- College students who abuse opioids do so for different reasons than students who abuse stimulants, according to research presented at the annual meeting of the American Public Health Association. Opioid users were more likely to report that they used the drugs to ...
Perspective.(Community Psychiatry)
Feb 01, 2007; ... Few psychiatrists are focused on the public health maxim of "prevention, prevention, prevention." In fact, psychiatrists typically focus only on helping sick people, not preventing people from getting sick, so conversations about prevention often have little traction in the psychiatric ...
Nurturing mental health in children.(PREVENTION IN ACTION)
Feb 01, 2007; ... Half of all lifetime cases of mental illness begin by age 14. This observation from a study by Harvard University's Ronald C. Kessler, Ph.D., and his colleagues, in addition to findings that early identification can prevent years of suffering and the risk of illnesses becoming ...
When can incompetent defendants be restored?(Forensic Psychiatry)
Feb 01, 2007; ... CHICAGO -- The first evidence-based support for clinical factors that may help to predict when a criminal defendant who is incompetent to stand trial can be restored to competence was presented at the annual meeting of the American Academy of Psychiatry and the Law. Dr. Douglas ...
Research into seizure prediction devices advances: no adverse events have been reported in the two ongoing phase III implanted device studies.(Neuropsychiatric Medicine)
Feb 01, 2007; ... CHICAGO -- Ongoing clinical trials for two implanted devices designed to interrupt or predict seizures herald an area of clinical research that has quickly gained ground during the last 5 years, Dr. Brian Litt said at the annual meeting of the American Neurological Association. ...
Variant of MET gene linked to increased risk of autism.(Neuropsychiatric Medicine)
Feb 01, 2007; ... Researchers have discovered that a common genetic variant of the MET receptor tyrosine kinase on chromosome 7q31 is associated with a 2.27-fold risk of having autism. This new finding corroborates other works in autism which "indicate altered organization of both the cerebral ...
Early treatment may promote medication-overuse headache.(Pan Medicine)
Feb 01, 2007; ... SCOTTSDALE, ARIZ. -- Early treatment of migraine can contribute to development of medication-overuse headaches in pain-adverse patients, Dr. James R. Couch warned at a symposium sponsored by the American Headache Society. These patients will take their pills every time they ...
Better patient interviews may aid migraine treatment.(Pain Medicine)
Feb 01, 2007; ... SCOTTSDALE, ARIZ. -- Open-ended questions during patient interviews elicit the best information for guiding the management of patients with migraine headache, Dr. Richard B. Lipton said at a symposium sponsored by the American Headache Society. Yet closed-end questions focusing ...
Personality trait can worsen rheumatoid arthritis symptoms.(Pain Medicine)
Feb 01, 2007; ... TUCSON, ARIZ. -- A psychological trait associated with heightened awareness of bodily distress may help to explain why some rheumatoid arthritis patients suffer more from achiness, malaise, and fatigue than do others with similar disease severity, Dr. Ilana M. Braun reported at the annual ...
For best results, consider migraine complex.(Pain Medicine)
Feb 01, 2007; ... SCOTTSDALE, ARIZ. -- Acute migraine cannot be managed effectively without a therapeutic partnership between doctor and patient, and a full understanding of the disabling features of each patient's headache episodes, Dr. Lawrence C. Newman said. "Most of us are focused on the ...
CPAP may lower stroke risk for apnea patients.(Psychosomatic Medicine)
Feb 01, 2007; ... SALT LAKE CITY -- Studies consistently show a link between obstructive sleep apnea and stroke, with the most recent data showing that sleep apnea is an independent risk factor for stroke and death. The cumulative data in regard to sleep apnea and stroke suggest that patients ...
Ramelteon is effective for some insomnia patients.(Psychosomatic Medicine)
Feb 01, 2007; ... ORLANDO -- Ramelteon is effective for a subset of patients with insomnia, according to a presentation at a psychopharmacology congress sponsored by the Neuroscience Education Institute. In addition, because the agent works on melatonin receptors, a potential off-label use is for patients ...
Sleep study demonstrates poor CPAP compliance.(Psychosomatic Medicine)(Clinical report)
Feb 01, 2007; ... SALT LAKE CITY -- Continuous positive airway pressure adherence rates are suboptimal, findings from a study of sleep clinic patients suggest. Of 528 adults diagnosed with obstructive sleep apnea and followed for a mean of 5 months, 63% had relatively poor adherence (use of less ...
Post-MI anxiety more common among women: be sure to start patients on anxiolytics quickly after anxiety is diagnosed post myocardial infarction.(Psychosomatic Medicine)
Feb 01, 2007; ... CHICAGO -- The high anxiety that many women have after an acute myocardial infarction may explain their high complication rate, compared with men, and it may offer a new way to improve patient outcomes. "Early recognition and effective treatment of anxiety immediately after a ...
Biopsychosocial model effective for patients with comorbid pain.(Psychosomatic Medicine)
Feb 01, 2007; ... ATLANTA -- A biopsychosocial approach may offer the most effective way to manage chronic pain in patients with a comorbid mood or substance use disorder without compromising recovery processes, Martin D. Cheatle, Ph.D., said at the Southeastern conference on alcohol and drug addiction. ...
Meditation helps breast cancer patients after Tx.(Psychosomatic Medicine)
Feb 01, 2007; ... SAN ANTONIO -- The mindfulness-based stress reduction program developed by Jonathan Kabat-Zinn, Ph.D., appears to be beneficial to patients with early-stage breast cancer in the immediate posttreatment period as they transition to survivorship, Cecile Lengacher, Ph.D., reported at a breast ...
Tamoxifen benefit lasts 10 years, new data show: the relative risk of breast cancer was reduced by a highly significant 29%, compared with placebo.(Across Specialties)
Feb 01, 2007; ... SAN ANTONIO -- A new 10-year follow-up from a landmark clinical trial of tamoxifen for breast cancer prevention indicates that the benefit continues strongly throughout the next half decade following completion of the standard 5 years of therapy, whereas adverse events are confined to the ...
Low-fat diet may prevent some recurrent breast cancers.(Across Specialties)
Feb 01, 2007; ... SAN ANTONIO -- A low-fat diet that achieved modest weight loss in women with early-stage breast cancer resulted in a striking 54% reduction in cancer relapse or death among those with hormone receptor-negative tumors, according to a second interim analysis from the Women's Intervention ...
Groups unite to prevent heart disease in diabetes.(Across Specialties)
Feb 01, 2007; ... Diabetologists and cardiologists are joining forces to address the issue of cardiovascular disease in patients with diabetes. In North America, new joint guidelines from the American Heart Association (AHA) and the American Diabetes Association (ADA) focus on the primary ...
Review gives nod to PDE-5 inhibitors in men with diabetes.(Across Specialties)
Feb 01, 2007; ... Phosphodiesterase type 5 inhibitors should be considered a primary treatment for erectile dysfunction in men with diabetes mellitus, according to a meta-analysis published recently in the online issue of the Cochrane Database of Systematic Reviews. The review called the drugs ...