Clinical Psychiatry News back issues from April 2008:
Early puberty tied to risky behavior.(News)
Apr 01, 2008; ... KOLOA, HAWAII -- The earlier onset of puberty, combined with a fairly delayed set of processes that underpin cognitive development, might represent a key framework for understanding the risky behavior of adolescents, Dr. Ronald E. Dahl said at the annual meeting of the American College of ...
Psychiatry residency positions filled by U.S. seniors continue to fall.(VITAL SIGNS)
Apr 01, 2008 ... Psychiatry Residency Positions Filled By U.S. Seniors Continue to Fall ...
SSRI may improve metabolic risk factors, hostility: citalopram's benefits include weight loss.(News)
Apr 01, 2008; ... BALTIMORE -- For individuals who have high levels of hostility, treatment with citalopram not only reduces hostility but improves the cardiovascular risk factors that make up metabolic syndrome, according to data presented at the annual meeting of the American Psychosomatic Society. ...
Approval of aripiprazole might reassure parents.(News)
Apr 01, 2008; ... The Food and Drug Administration's approval of aripiprazole for the acute treatment of bipolar I disorder in children and adolescents is helpful for physicians and parents, according to an investigator in the study that led to the approval. The FDA has approved the atypical ...
STDs on rise among teenage girls.(News)
Apr 01, 2008; ... CHICAGO -- More than 3 million teenage girls have at least one sexually transmitted disease, and 15% of those have multiple infections, according to the first large study of STDs in this population. Overall, 26% of 14- to 19-year-olds were infected with at least one STD, ...
Let's achieve mental health parity now.(GUEST EDITORIAL)
Apr 01, 2008; ... As psychiatrists and other mental health professionals know very well, mental health and addiction treatment parity is long overdue in this country. The 1996 Mental Health Parity Act--sponsored by my father, the late Sen. Paul Wellstone (D-Minn.) and Sen. Pete Domenici ...
What role will genetics play in psychiatry?(POINT/COUNTERPOINT)
Apr 01, 2008; ... There is more to biology than genetics. The identification of genetic factors involved in causing psychiatric disorders like schizophrenia holds great promise. But as this information becomes available, psychiatrists also must continue to attend to what schizophrenia feels like ...
Physicians, big pharma, and deception.(GUEST EDITORIAL)
Apr 01, 2008; ... Recently, Dr. David McNeil wrote a guest editorial in these pages in which he argued that it is appropriate for doctors to give talks for pharmaceutical companies ("We Can Work With Pharma," February 2008, p. 11). In that article, Dr. McNeil made several statements and arguments ...
Misdiagnoses of children must stop.(LETTERS)(Letter to the editor)
Apr 01, 2008 ... I am a front-to-back reader of CLINICAL PSYCHIATRY NEWS. I say this first because what follows is criticism of an establishment that I question, not of a publication that I admire. I read in disbelief two news articles and one opinion piece in the January 2008 issue and would ...
Let's reject managed care.(LETTERS)(Letter to the editor)
Apr 01, 2008; ... I would like to respond to Dr. Gerald W. Grumet's Guest Editorial in CLINICAL PSYCHIATRY NEWS ("Managed Care: Can't We Do Better?" February 2008, p. 11). Let me share my experience as a psychiatrist in solo outpatient private practice. Tired of low managed care ...
'Behind-the-counter' prescribing problematic.(GUEST EDITORIAL)
Apr 01, 2008; ... Americans are desperate for ways to reduce the costs of health care and improve access to care. At the same time, physicians are frustrated with the status quo. After a 30-year campaign by the media to disparage physicians with negative stories about them; reductions in reimbursement by ...
Universal screening renews HIV debate.(GUEST EDITORIAL)
Apr 01, 2008; ... When a person discloses a positive HIV status to a partner, the disclosure eliminates many of the moral, ethical, and legal considerations inherent in the opposite scenario. Just what is our responsibility as physicians in this regard? Do we have a duty to protect and warn the known sexual ...
Combo Tx may be best for poststroke depression.(Adult Psychiatry)(Clinical report)
Apr 01, 2008; ... NEW ORLEANS -- Individuals with poststroke depression may respond best in the short term to a combination of a brief psychosocial and behavioral intervention and an antidepressant, Pamela H. Mitchell, Ph.D., reported at the International Stroke Conference 2008. Patients with two ...
Metabolic syndrome 'alarmingly high'.(Adult Psychiatry)
Apr 01, 2008; ... The prevalence of metabolic syndrome among people with serious mental disorders who are taking antipsychotics is "alarmingly high," results of a study show. In a cross-sectional study, the investigators found the prevalence of metabolic syndrome among this population was 27%, ...
Is antipsychotic-induced diabetes reversible?(EVIDENCE-BASED PSYCHIATRIC MEDICINE)
Apr 01, 2008; ... The Problem You have a patient with schizophrenia who is considering treatment with an antipsychotic medication. After reviewing the potential irreversibility of tardive dyskinesia, the patient questions you about antipsychotic-induced diabetes. The Question ...
Call issued for better PMDD diagnostic criteria.(Adult Psychiatry)
Apr 01, 2008; ... KOLOA, HAWAII -- The DSM-IV criteria for premenstrual dysphoric disorder need to be improved, Dr. Meir Steiner said at the annual meeting of the American College of Psychiatrists. "What is wrong with the DSM criteria for PMDD?" he asked rhetorically All the questions listed have ...
Getting details is key in exposure therapy.(Adult Psychiatry)
Apr 01, 2008; ... KOLOA, HAWAII -- One way to guide posttraumatic stress disorder exposure therapy is to help patients gradually describe their trauma in as much detail as possible, Barbara Olasov Rothbaum, Ph.D., said at a premeeting session of the annual meeting of the American College of Psychiatrists. ...
For vets, social supports can facilitate treatment.(Adult Psychiatry)
Apr 01, 2008; ... BALTIMORE -- Veterans who receive treatment for posttraumatic stress disorder appear more likely to use social supports to get around barriers that block many from getting treatment. But after veterans get into treatment, those who are older and have more severe symptoms may be ...
The art of Derrick Williams.(VISIONARY ART)
Apr 01, 2008; ... Derrick Williams' work sells, but he doesn't paint for the money. "As long as I'm able to [paint], I'll do it," says Mr. Williams, who has had several exhibitions recently through his affiliation with the Fountain Gallery in New York City. "I feel that this is a calling." ...
Targeted protocols may lower risk for HIV.(Adult Psychiatry)
Apr 01, 2008; ... BALTIMORE -- Women who were sexually abused as children appear to fare no better with trauma-focused group therapy than with present-focused group therapy in improving behaviors associated with risk for HIV infection, according to research presented at the annual meeting of the ...
A recent review shows that SSRIs have a mild positive impact on mild depression that is comparable with placebo. What are the implications for treatment?(FINK! STILL AT LARGE)
Apr 01, 2008; ... For 20 years, we have been hearing about the miracle of the selective serotonin reuptake inhibitors. "Living With Prozac" by Debra Elfenbein (Harper San Francisco, 1995) was a best seller, and everyone was prescribing the drugs. Meanwhile, the drug companies produced clone after clone of ...
The tennis racket and the mind.(THE PSYCHIATRIST'S TOOLBOX)
Apr 01, 2008; ... Some years ago, I received a telephone call from a potential patient who wanted to know whether I could help him improve his tennis game. I had done some work in helping people improve their concentration in studying techniques and in certain types of theatrical performances, and ...
Watching stressful soccer match doubles risk of CV event.(Adult Psychiatry)(cardiovascular )
Apr 01, 2008; ... Watching an important soccer match that triggered intense emotional stress more than doubled the risk of an acute cardiovascular event in a German study. Dr. Ute Wilbert-Lampen and her associates studied cardiovascular (CV) event rates in the Munich area during the month-long ...
Monitor antipsychotic-related weight gain.(Adult Psychiatry)
Apr 01, 2008; ... NEW YORK -- Taking baseline measurements of fasting blood glucose, lipids, weight, and waist circumference and monitoring those measures are essential to the early identification of metabolic complications in patients taking atypical antipsychotics, Dr. Harold E. Carlson said. ...
Remission faster in meth-induced psychosis.(Adult Psychiatry)
Apr 01, 2008; ... MIAMI BEACH -- It can be difficult to distinguish symptoms of psychosis induced by methamphetamine from those of schizophrenia. In a comparison study, for example, researchers found significant differences on only 2 of 41 neuropsychiatric tests. Negative symptoms were important ...
Antidepressant therapy after STAR*D.(PRACTICAL PSYCHOPHARMACOLOGY)
Apr 01, 2008; ... Most episodes of major depression can be resolved with pharmacotherapy, but finding the right approach is often a protracted process. In the multicenter Sequenced Treatment Alternatives for Resistant Depression (STAR*D) study, nearly 70% of patients achieved remission. But ...
Sensitivity to anesthesia greater for depressed women.(Adult Psychiatry)
Apr 01, 2008; ... SAN FRANCISCO -- Depressed women have a deeper reaction to general anesthesia and thus are less likely to become aware during surgery, a preliminary study of 26 women suggests. Women who scored higher for depression on the Beck Depression Inventory-Second Edition (BDI-II), or ...
Urge parents to guide teens' cell phone use.(Child/Adolescent Psychiatry)
Apr 01, 2008; ... CHICAGO -- Clear parental expectations about adolescents' cell phone use can support family relationships, a survey of 196 parent-adolescent dyads shows. Helping parents realize this can assist them in launching their adolescents toward adulthood, said Robert S. Weisskirch, ...
Cyberbullying is common, psychologically damaging.(Child/Adolescent Psychiatry)(Report)
Apr 01, 2008; ... CHICAGO -- Bullying over the Internet is common, and it is associated with symptoms of psychopathology in boys and girls, according to researchers at the University of Florida in Gainesville. "Peer victimization using the medium of cyberspace ... carries similar negative ...
Bullies and victims feel worthless, sad, unsafe.(Child/Adolescent Psychiatry)
Apr 01, 2008; ... Adolescents who are involved in bullying--either as a victim, bully, or both--are more likely than bystanders to report feelings of low self-worth and sadness and to feel unsafe in their school. These issues are most troubling in children who are both bullies and victims, Dr ....
Responsiveness to external cues tied to obesity.(Child/Adolescent Psychiatry)
Apr 01, 2008; ... BALTIMORE -- Children with greater body mass indexes appear to be more responsive to external food cues and less responsive to internal satiety signals, a study involving almost 11,000 children shows. The findings, presented at the annual meeting of the American Psychosomatic ...
Wheeled sports: benefits are long term.(Child/Adolescent Psychiatry)(Brief article)(Clinical report)
Apr 01, 2008; ... Adolescents who engage in frequent school-based or extracurricular physical activity--especially Rollerblading, skateboarding, and bicycling--are up to 48% less likely to become overweight or obese in early adulthood, Dr. David Menschik and his colleagues reported. These wheeled ...
Secrecy, nondisclosure in adolescence explored: new research shows 'stronger manifestation of the darker side of secrecy' among younger teenagers.(Child/Adolescent Psychiatry)
Apr 01, 2008; ... CHICAGO -- Until recently, research on secrecy in adolescence focused largely on the emotional and physical costs of hiding misdeeds or risky behavior from parents. But an investigation conducted a few years ago into both the advantages and disadvantages of secrecy in ...
Pain Tx can improve cognition, lift depression: to get handle on extent of patients' pain, ask them direct questions and pay attention to nonverbal cues.(Geriatric Psychiatry)(Disease/Disorder overview)
Apr 01, 2008; ... ORLANDO -- Pain is a comorbid condition too often overlooked in the setting of geriatric psychiatry, despite the potential for better mental health outcomes when it is treated, Dr. Jordan F. Karp said at the annual meeting of the American Association for Geriatric Psychiatry. "I ...
Stoicism, safety concerns may limit pain management.(Geriatric Psychiatry)
Apr 01, 2008; ... ORLANDO -- Despite a high prevalence of chronic pain in older adults, adherence to pain medications is low--fueled largely by patients' stoicism, beliefs about pain and aging, and concerns about safety and addiction, according to Dr. Stephen Thielke, a psychiatrist at the University of ...
Use caution when prescribing for insomnia.(Geriatric Psychiatry)
Apr 01, 2008; ... MINNEAPOLIS -- Metabolic changes and comorbid conditions are just a few of the factors that challenge clinicians when they treat insomnia in older adults. "The predictability of your giving drug X to patient A and knowing what is going to happen goes way down. That's the bottom ...
Older women face higher depression burden.(Geriatric Psychiatry)(Clinical report)
Apr 01, 2008; ... The burden of depression is disproportionately higher among older women than older men because of their greater susceptibility to depression and--once depressed--their greater tendency to have persistent depression and their lower probability of death, suggest the results of a longitudinal ...
Nursing homes seeking psychiatric consultants.(Geriatric Psychiatry)
Apr 01, 2008; ... SALT LAKE CITY -- Geriatric psychiatrist consultants can relieve some of the burden on nursing homes and help provide optimal care, the medical director of a large system of senior-living facilities said. Good geriatric psychiatrists are hard to find, but it's important to ...
Late-life sexuality presents problems, rewards: nursing homes face competing values and principles involving safety, dignity, and decision making.(Geriatric Psychiatry)
Apr 01, 2008; ... SALT LAKE CITY -- Most Americans find it difficult to accept late-life sexuality, according to Dr. Andrew S. Rosenzweig. "Our culture still has this pervasive negative attitude about late-life sexuality in terms of discreet silence, distaste, and tunnel vision," said Dr ....
Marriage challenges change as couples become elderly.(Geriatric Psychiatry)
Apr 01, 2008; ... PHILADELPHIA -- Marriage undergoes stress as a couple becomes elderly, partly because "the goals of middle age are gone," Erlene Rosowsky, Psy.D., said at a conference sponsored by the American Society on Aging. "In middle age, the goal is getting there, but in older age, ...
Perspective.(Community Psychiatry)
Apr 01, 2008; ... Risk factors are not predictive factors because of the presence of protective factors. This truism should be the mantra of preventive mental health. Depression in adolescent girls has been linked to an increase in high-risk sex behavior and, consequently, pregnancy. Yet, not all ...
Depression and repeat pregnancy in teen mothers.(PREVENTION IN ACTION)
Apr 01, 2008; ... Depression in adolescent mothers is linked to an increased risk of rapid subsequent pregnancy, and these findings should come as no surprise. In a secondary analysis of data drawn from two consecutive longitudinal risk reduction interventions, Dr. Beth Barnet and her colleagues ...
Brain trauma trials may finally be paying off.(Neuropsychiatric Medicine)
Apr 01, 2008; ... HONOLULU -- Disappointing clinical trial results should not suggest that outcomes cannot be improved in traumatic brain injury, only that methodologies may need to be refined and study populations equalized as promising approaches come to the fore, Dr. D. James Cooper said during a plenary ...
No cognitive benefit seen for donepezil.(Neuropsychiatric Medicine)
Apr 01, 2008; ... NEW ORLEANS -- Donepezil had no effect on cognitive impairment in a recent study of patients with vascular dementia, but the acetylcholinesterase inhibitor was associated with significant improvement on several measures of executive function, Dr. Martin Dichgans reported at International ...
Parasomnias require thorough evaluations.(Psychosomatic Medicine)
Apr 01, 2008; ... SCOTTSDALE, ARIZ. -- Even though sleepwalking, night terrors, and other parasomnias are usually benign and do not call for specific interventions, Dr. Teofilo L. Lee-Chiong Jr. urged that they be thoroughly evaluated in children and adults. Violent and potentially injurious ...
Obstructive sleep apnea hypopnea raises risk of crashes.(Psychosomatic Medicine)
Apr 01, 2008; ... Patients with obstructive sleep apnea hypopnea had a greater rate of motor vehicle crashes than did matched controls, and they were three times more likely to be involved in crashes involving personal injury, according to researchers in British Columbia. "Our data indicate that ...
Moderate drinking cuts heart event risks by 38%.(Psychosomatic Medicine)
Apr 01, 2008; ... COLORADO SPRINGS -- Former non-drinkers who initiated moderate alcohol consumption in middle age experienced a 38% reduction in cardiovascular events over 4 years, compared with continued nondrinkers in the Atherosclerosis Risk in Communities study. "The current American Heart ...
U.S. cancer death rates show 15-year decline.(Across Specialties)
Apr 01, 2008; ... From 1990-1991 to 2005, cancer death rates per 100,000 U.S. population declined by 18.4% among men and 10.5% among women, even though the actual number of deaths increased slightly from 2004 to 2005, according to an annual report issued by the American Cancer Society. That ...
Diabetes may improve stroke outcome for some.(Across Specialties)
Apr 01, 2008; ... CHICAGO -- Patients with ischemic strokes have poorer outcomes and higher mortality if they have hyperglycemia, and the prognosis appears to be even worse among those with no history of diabetes mellitus, according to findings from an observational study presented at the annual meeting of ...
Guidelines issued on cocaine use, chest pain.(Across Specialties)
Apr 01, 2008; ... Patients who present with cocaine-associated chest pain or myocardial infarction should be treated similarly to patients with traditional acute coronary syndromes, with some exceptions, according to Dr. Jim McCord and his associates on the American Heart Association's acute cardiac care ...
Tips offered for managing atopic dermatitis.(Across Specialties)
Apr 01, 2008; ... LA JOLLA, CALIF. -- How has your sleep been? When's the last time your skin was totally clear? Those are the two questions Dr. Lawrence F. Eichenfield asks his atopic dermatitis patients. "It's amazing how families don't tell you about sleep disturbance unless you ask about it," ...
Internist group backs use of medical marijuana.(Across Specialties)
Apr 01, 2008; ... Medical marijuana works for some HIV and cancer patients in situations where no other drug is effective, and patients and physicians should not be prosecuted for using it, according to an internist who said he has prescribed it for more than a dozen patients. Dr. Josiah D. Rich ...
Cognitive defects found in sickle cell worsen with age.(Across Specialties)
Apr 01, 2008; ... ATLANTA -- Neuropsychological dysfunction and undetected brain injury affect the majority of adults with sickle cell disease, even though they are neurologically intact, according to research presented at the annual meeting of the American Society of Hematology. "These defects ...
Payments uncertain as insurers' settlements expire.(Practice Trends)
Apr 01, 2008; ... LAS VEGAS -- As more of the agreements signed by several large insurers to settle a class action suit alleging inappropriate billing practices expire, the possibility is increasing that the companies will return to the same behavior, especially given that many are being accused of ...
States looking inward as health tabs grow and tax revenues fall.(Practice Trends)
Apr 01, 2008; ... WASHINGTON -- With health care expenses accounting for the single largest expense in their budget, states are increasingly looking for solutions from within, not from the federal government, according to an annual accounting of state legislative trends compiled by the Blue Cross and Blue ...
Health care spending projected to reach $4.3 trillion by 2017.(Practice Trends)
Apr 01, 2008; ... Health care spending in the United States is projected to consume nearly 20% of the gross domestic product by 2017, according to estimates from economists at the Centers for Medicare and Medicaid Services. Health care spending growth is expected to remain steady at about 6.7% a ...
Mental health parity progress.(POLICY & PRACTICE)
Apr 01, 2008; ... The House of Representatives last month passed its version of a bill that would put mental health coverage on equal footing with benefits for physical conditions. The Paul Wellstone Mental Health and Addiction Equity Act (H.R. 1424) passed 268-148; it now has to be reconciled with a Senate ...
MD mental health visits frequent.(POLICY & PRACTICE)
Apr 01, 2008; ... In 2005, Americans went to see a physician more often for depression and other mental health issues than for back problems, high blood pressure, and trauma-related reasons, according to the Agency for Healthcare Research and Quality. There were 156 million physician office visits for ...
Suicide tops violence admissions.(POLICY & PRACTICE)
Apr 01, 2008; ... Suicide attempts and self-injury accounted for the greatest portion of violence-related treatment at hospitals in 2005, according to another AHRQ report, "Violence-Related Stays in U.S. Hospitals, 2005." Sixty-six percent of violence-related admissions were for attempted suicide or ...
Rx abuse worries Americans.(POLICY & PRACTICE)
Apr 01, 2008; ... Prescription drug abuse is as big a problem as illegal drug abuse, said respondents to a Wall Street Journal/Harris Interactive health care poll conducted in late February. Slightly less than half of those surveyed said they keep prescription medicines in a place whether others can't ...
Woodcock named CDER head.(POLICY & PRACTICE)
Apr 01, 2008; ... Dr. Janet Woodcock has been named director of the Food and Drug Administration's Center for Drug Evaluation and Research. Dr. Woodcock, a rheumatologist, served as director of CDER in the 1990s and has been acting director since October 2007. The drug industry's chief lobbying group, ...
FDA would expand Promotion.(POLICY & PRACTICE)
Apr 01, 2008; ... The FDA last month proposed guidance to let drug and medical device makers distribute medical or scientific journal articles and reference publications on unapproved uses of their products. Drug and device makers had been allowed to disseminate such materials under guidelines set by the ...
Latest figures put diabetes costs at $174 billion yearly.(Practice Trends)
Apr 01, 2008; ... WASHINGTON -- At least 24 million Americans have diabetes, which cost the nation $174 billion in direct and indirect expenditures in 2007, according to the American Diabetes Association. The ADA released data that were compiled from a variety of mostly federal sources, including ...
Medicare's top 10 therapy classes in 2006.(DATA WATCH)
Apr 01, 2008 ... <Pre> Medicare's Top 10 Therapy Classes in 2006 Percentage of all Part D prescriptions Antihypertensives 25.0 Lipid regulators 7.4 Antidepressants 5.1 Diabetes drugs, noninsulin 5.0 Analgesics, narcotic ...
Sex and the psychiatric clinician.(THE ETHICAL WAY)
Apr 01, 2008; ... <Pre> "Lord, what fools these mortals be!" --Shakespeare's A Midsummer Night's Dream </Pre> It's April, the month of my favorite holiday: April Fool's Day. We are all foolish at times, whether at work or elsewhere, but let's hope we can learn from the fallout. Certainly, ...