Clinical Psychiatry News back issues from May 2008:
Diversity missing from research.
May 01, 2008; ... KOLOA, HAWAII -- The reluctance to discuss differences among ethnic and cultural groups is a serious challenge for the practice of psychiatry, according to discussion group members at the annual meeting of the American College of Psychiatrists. "Pharmaceutical companies are ...
Fallout from early trauma might hinge on genes: some patients get depression, others PTSD.
May 01, 2008; ... KOLOA, HAWAII -- Genetic factors might play a role in determining who gets posttraumatic stress disorder after trauma and who gets depression, according to two studies. In addition, increasing evidence suggests that child abuse and neglect are associated with an increased risk ...
More pregnant women Getting court-ordered tx.
May 01, 2008; ... TORONTO -- The number of pregnant women entering court-mandated substance abuse programs has increased in the years since the advent of the crack cocaine epidemic, Dr. Mishka Ter-plan said at the annual conference of the American Society of Addiction Medicine. Among the more ...
Many migraineurs face serotonin syndrome.
May 01, 2008; ... VIENNA -- An estimated 700,000 Americans were at risk for serotonin syndrome in 2004 because they were simultaneously on a triptan and a selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor, according to data reported at the annual congress of the European ...
Prodrug is approved for adult ADHD.
May 01, 2008; ... The Food and Drug Administration has approved the once-daily attention-deficit/hyperactivity disorder drug Vyvanse for adults, according to Shire PLC, manufacturer of the drug. The United Kingdom-based biopharmaceutical company said it would begin promoting the new indication ...
Inhalants favored among adolescents.
May 01, 2008; ... WASHINGTON -- The drugs of choice for children aged 12 and 13 years are inhalants, surpassing pain relievers, marijuana, and any other illegal drug, with 3.4% of 12-year-olds and 4.8% of 13-year-olds using in the past year. This is according to a recent report by the Substance ...
Competency is not all or nothing.(GUEST EDITORIAL)(Editorial)
May 01, 2008; ... Ahmad Edwards had a serious mental disorder with psychotic features. After shoplifting in downtown Indianapolis and being chased, he fired three gunshots, injuring two people. An FBI agent apprehended Edwards after making several requests that he drop his weapon. The date was July 12, ...
Sometimes we do get it right.(LETTERS)(Letter to the editor)
May 01, 2008; ... As a child/adolescent psychiatrist, I want to respond to a letter by Dr. Manuel MotaCastillo criticizing several articles in CLININCAL PSYCHIATRY NEWS about treating comorbid attention-deficit/hyperactivity disorder and bipolar and conduct disorder ("Misdiagnoses of Children Must Stop," ...
Physicians group is way off base.(Brief article)(Column)
May 01, 2008; ... Apparently, the left-wing radicals have gone from doing sit-ins at the college president's office to occupying the American College of Physicians ("Internist Group Backs Use of Medical Marijuana," April 2008, p. 56)! First, they announce they're in favor of "single-payer" (aka ...
Treating intellectually disabled patients.(PRACTICAL PSYCHOPHARMACOLOGY)
May 01, 2008; ... With increasing numbers of intellectually disabled individuals living in residential settings or with their families, psychiatrists in the community are becoming more involved in their care. Many are unprepared. "Most psychiatric training programs don't include much experience ...
Aripiprazole may prevent manic relapse in bipolar disorder.(Adult Psychiatry)
May 01, 2008; ... VIENNA -- The atypical antipsychotic aripipra-zole demonstrated sustained long-term efficacy for prevention of manic relapse in patients with bipolar disorder, Dr. Roger S. McIntyre reported at the annual congress of the European College of Neuropsychopharmacology. This ...
Options expanding for bipolar disorder.
May 01, 2008; ... VIENNA -- A growing list of innovative therapies with novel mechanisms of action in bipolar disorder is available for tough-to-treat cases, Dr. Benedikt L. Amann said at the annual congress of the European College of Neuropsy-chopharmacology. All of these candidates have ...
Evidence-based psychiatric medicine: Oxcarbazepine for acute mania.(Adult Psychiatry)
May 01, 2008; ... The Problem You have a patient with bipolar disorder. He is currently in an acute phase of mania without psychosis. For various reasons, he declines treatment with lithium, valproate, carba-mazepine, or antipsychotic medications. You consider treatment with oxcarbazepine. ...
Suicidality? primary care docs often fail to ask.(Adult Psychiatry)
May 01, 2008; ... SAN FRANCISCO -- In a randomized trial involving actors portraying patients with major depression, internists and family physicians usually failed to ask these patients about suicidality, even when they correctly made the depression diagnosis, Dr. Mitchell D. Feldman said at a meeting on ...
EEG test could predict antidepressant response.(Adult Psychiatry)
May 01, 2008; ... VIENNA -- A quantitative EEG bio-marker shows considerable promise for prediction of antidepressant response in major depression, Dr. Andrew J. Leuchter said at the annual congress of the European College of Neuropsychopharmacology. The biomarker is obtained via an abbreviated ...
Tough decisions surround Rx in pregnancy: the child will be exposed to illness or treatment, and 'some decisions are far worse than others.'.
May 01, 2008; ... KOLOA, HAWAII -- Labeling typically doesn't support the use of psychotropic drugs in pregnant women, but the drugs might be needed during pregnancy, according to an observational study done at Emory University, Atlanta. "What I want you to recognize is that you're going to ...
Postpartum depression may Be misdiagnosed bipolar disorder.(Adult Psychiatry)
May 01, 2008; ... PITTSBURGH -- Misdiagnosis of bipolar disorder in the postpartum period may be quite common, Dr. Verinder Sharma and his associates said in a poster presentation at the Seventh International Conference on Bipolar Disorder. Among 56 women who were consecutively referred for ...
Interventions can help couples deal with posttraumatic stress.(Adult Psychiatry)
May 01, 2008; ... BALTIMORE -- Therapists who treat posttraumatic stress disorder might be able to make the greatest therapeutic impact by bringing married couples or those in committed relationships together to work out their problems using one of three kinds of therapies, speakers said at the annual ...
Depression may predict PTSD in some cardiac patients.(Adult Psychiatry)(Clinical report)
May 01, 2008; ... BALTIMORE -- Depression at hospital admission and the recurrence of cardiac symptoms in the first year appear to predict the presence of posttraumatic stress disorder symptoms at 3 years in patients with acute coronary syndrome, results of a study presented at the annual meeting of the ...
Two-session strategy helps trauma patients avoid PTSD.
May 01, 2008; ... BALTIMORE -- Patients who receive a brief secondary prevention intervention shortly after experiencing trauma can avoid a diagnosis of posttraumatic stress disorder up to 2 years later, research presented at the annual meeting of the International Society for Traumatic Stress Studies ...
Screen ADHD patients first, heart group says.(Child/Adolescent Psychiatry)
May 01, 2008; ... The new recommendation calling for electrocardiogram screening for children with attention-deficit/hyperactivity disorder before initiating pharmacologic treatment is not based on data, according to an expert in child and adolescent psychiatry. Dr. David Fassler said that at ...
Atomoxetine not effective for ADHD/ODD.(Child/Adolescent Psychiatry)
May 01, 2008; ... Atomoxetine had no enduring effect on oppositional defiant disorder symptoms in a new report of manufacturer data from children with both ODD and attention-deficit/hyperactivity disorder. The findings from the 8-week, multi-center, placebo-controlled trial run counter to the ...
'Maladaptive' behaviors tied to sleep problems.(Child/Adolescent Psychiatry)
May 01, 2008; ... Certain parental behaviors in response to their toddlers' nighttime awakenings may pave the way for the children to have sleep problems at ages 4-6 years, so these behaviors should be considered maladaptive, according to results from a Canadian study of nearly 1,000 infants and children. ...
Parenting is crux of the cure in defiant disorder.(Child/Adolescent Psychiatry)
May 01, 2008; ... MIAMI BEACH -- It is important to confront parents about their parenting style when conveying a diagnosis of oppositional defiant disorder, a developmental pediatrics specialist advises. It is difficult to address a parenting issue, particularly in a 15-minute visit and when you ...
Establish clear goals for trauma-focused CBT.(Child/Adolescent Psychiatry)
May 01, 2008; ... SAN DIEGO -- Before Laura Merchant begins trauma-focused cognitive-behavioral therapy with children and their caregivers, she provides an estimate for them of the number of treatment sessions that will be required for effective intervention. This approach "has made a huge ...
Stress affects athletic injuries, recovery: physicians not immune to 'culture of risk,' which encourages athletes to keep playing despite pain.(Child/Adolescent Psychiatry)
May 01, 2008; ... Difficult life events and other types of stress, as well as psychological interventions, can have a marked impact on the occurrence of athletic injuries among children and adolescents, according to the authors of a review on the topic. These issues also can affect the way in ...
Tailor dementia treatment to each patient.(Geriatric Psychiatry)
May 01, 2008; ... Cholinesterase inhibitors and memantine are not one-size-fits-all drugs that can be prescribed to every patient with dementia and should only be employed after assessing each drug's risk/benefit profile in light of an individual patient's needs, according to a new set of clinical ...
One of first prevalence studies finds more MCI in men.(Geriatric Psychiatry)
May 01, 2008; ... CHICAGO -- Men have more mild cognitive impairment than women do, yet there is no gender difference in the prevalence of dementia, according to the results of one of the first studies to measure mild cognitive impairment prospectively in a population-based setting. The findings, ...
Sleep, cognitive problems might be linked.(Geriatric Psychiatry)(Brief article)
May 01, 2008; ... SAN FRANCISCO -- Reports of difficulty falling asleep were associated with poorer performance on some cognitive measures in a study of 174 elderly community-dwelling blacks. Self-reported sleep trouble appears to be a unique predictor of cognitive performance, even after ...
Guidelines on way for treating sleep disorders.(Geriatric Psychiatry)
May 01, 2008; ... SAN FRANCISCO -- Sleep should be viewed as a vital sign, and primary care physicians should address sleep disturbances routinely in all visits with older adults, Dr. Harrison G. Bloom said at the annual meeting of the Gerontological Society of America. "Although there has been ...
Drinking, smoking may raise early AD risk.(Geriatric Psychiatry)
May 01, 2008; ... CHICAGO -- Heavy drinking and smoking are associated with a significantly earlier age of development of late-onset Alzheimer's disease, according to findings presented at the annual meeting of the American Academy of Neurology. In a retrospective analysis of 686 patients ...
Lively limbs limit sleep in cognitively impaired.(Geriatric Psychiatry)
May 01, 2008; ... Frequent nighttime leg movements were significantly associated with sleep disturbance and less total sleep in a study of 102 elderly people with cognitive impairment. Previous research had shown that sleep time varies from approximately 6 to 10 hours in nursing home residents ...
Vitamin E may increase survival in Alzheimer's.(Geriatric Psychiatry)
May 01, 2008; ... CHICAGO -- Vitamin E supplementation at doses of 2,000 IU/day appeared to be associated with improved survival in a retrospective case analysis of patients who had Alzheimer's disease. The results, presented at the annual meeting of the American Academy of Neurology, were seen ...
Exercise program may benefit Alzheimer's patients.(Geriatric Psychiatry)
May 01, 2008; ... WASHINGTON -- A regular exercise program not only promotes flexibility, balance, and strength in elderly people with dementia, but it also might improve their mental function. "You won't get oxygen to the brain if you don't get air down into the alveoli," said Marge A. Coalman, ...
Another study links cigarettes with suicide.(Addiction Psychiatry)
May 01, 2008; ... VIENNA -- Current or former cigarette smoking is strongly associated with an increased rate of prior suicide attempts among Hungarian psychiatric outpatients, Dr. Zoltan Rihmer reported at the annual congress of the European College of Neuropsychopharmacology. This finding ...
Binge drinking common in psychiatric outpatients.(Addiction Psychiatry)
May 01, 2008; ... SAN FRANCISCO -- A computer-based intake survey of 422 psychiatric outpatients showed that 27% reported having at least five drinks on a single occasion within the past 30 days, reported Derek D. Satre, Ph.D. In addition, 28% reported having eight or more drinks at one time ...
Study assesses 1-year substance use remission in native American veterans.(Addiction Psychiatry)
May 01, 2008; ... CORONADO, CALIF. -- One-year remission from substance abuse disorder among Native American veterans does not reduce the prevalence of mood and anxiety disorders, gambling disorders, or posttraumatic stress symptoms, results from a community survey demonstrated. However, 1-year ...
Undocumented adolescents: building hope.(PREVENTION IN ACTION)
May 01, 2008; ... The guidance offices of many of this country's large urban middle schools and high schools--particularly those in economically depressed areas--are teeming with what psychiatrist Dr. Dean DeCrisce of New York University Medical Center refers to as a "lost population"--undocumented ...
Partner violence takes toll on women's health.(Community Psychiatry)
May 01, 2008; ... Intimate partner violence against women not only inflicts obvious injury but also contributes to the overall burden of disease through its association with mental, gynecologic, and gastrointestinal disorders, according to an observational study of nearly 25,000 women from various countries ...
For defendants with retardation, procedures vary: expert witnesses in death penalty cases must know standards of proof differ from state to state.
May 01, 2008; ... SAN FRANCISCO -- The U.S. Supreme Court decision that executing mentally retarded offenders is unconstitutional provided little guidance on how to implement the ruling. The result has been a mishmash of procedures that vary widely from state to state, Dr. Clarence Watson and Dr. Kenneth ...
Criminal profiler shares some secrets of the trade.
May 01, 2008; ... SAN FRANCISCO -- In 1956, frustrated by their inability to apprehend the "Mad Bomber" who had been terrorizing New York City for 16 years, police detectives paid a visit to Dr. James A. Brussel, a noted psychiatrist and a criminologist. As he examined the evidence, Dr. Brussel developed ...
Catastrophizing worsens osteoarthritis disability.(Pain Medicine)
May 01, 2008; ... FORT LAUDERDALE, FLA. -- Pain catastrophizing and pain-related fear are associated with increased disability and worse physical functioning among overweight patients with osteoarthritis, according to a study presented at the World Congress on Osteoarthritis. "In the ...
When other opioids fail, consider levorphanol for refractory pain.(Pain Medicine)
May 01, 2008; ... TAMPA -- Levorphanol appears to be an attractive option for the treatment of refractory pain that does not respond to other opioids, based on a case series of 31 patients presented at the annual meeting of the American Academy of Hospice and Palliative Medicine and the Hospice and ...
Smoking may increase risk of developing neuropathic pain.(Pain Medicine)
May 01, 2008; ... ORLANDO -- In a community sample of 205 adults with chronic pain of any type, neuropathic pain was documented in almost two-thirds of those who smoked, compared with one-third of those who did not smoke, Dr. Todd G. Call reported at the annual meeting of the American Academy of Pain ...
Lamotrigine may improve pelvic pain, depression.(Pain Medicine)
May 01, 2008; ... BALTIMORE -- The anticonvulsant lamotrigine shows promise for reducing pain and improving mood symptoms associated with chronic pelvic pain, particularly in women with the vulvovaginal subtype. In a study of 43 women with chronic pelvic pain,researchers at the University of ...
Consulting with medical patients.(THE PSYCHIARIST'S TOOL BOX)
May 01, 2008; ... Some years ago, an elderly gentleman began to experience hiccups after eye surgery. He also had a history of car-diovascular disease. After 5 days of medical intervention, such as breathing into a paper (not plastic) bag, using vagal stimulation, drinking glasses of water rapidly, ...
Psychiatric diagnoses common in chronic idiopathic urticaria.(Psychosomatic Medicine)
May 01, 2008; ... Nearly half of all patients with chronic idiopathic urticaria have Axis I psychiatric diagnoses and 45% have Axis II diagnoses, a new study shows. Obsessive-compulsive disorder (OCD) and major depression were the most common Axis I diagnoses among 89 consecutive patients with ...
Skin-related anxiety affects exercise intent.(Psychosomatic Medicine)
May 01, 2008; ... Social anxiety stemming from acne or other skin conditions might keep people from exercising, say results of a survey of 50 adults selected from an acne support group. Exercise is important for overall health and skin health, but data from previous studies have shown that people ...
Childhood trauma raises risk of adult CHD and depression.(Psychosomatic Medicine)
May 01, 2008; ... VIENNA -- Childhood trauma was an independent predictor of coronary heart disease and major depression later in life in a study with 360 men. "Childhood trauma can have important consequences, but it is a risk factor that physicians don't usually think about," Dr. Viola ...
High diastolic blood pressure linked to cognitive impairment.(Psychosomatic Medicine)
May 01, 2008; ... NEW ORLEANS -- Increased diastolic blood pressure levels are associated with cognitive impairment, findings from the Reasons for Geographic and Racial Differences in Stroke study suggest. More than 27,800 participants from REGARDS--a long-term, ongoing study designed to ...
Hostility, fasting glucose linked in black women.(Psychosomatic Medicine)
May 01, 2008; ... BALTIMORE -- African American women with high levels of hostility show increased levels of fasting glucose. In addition, patients' proportion of trunk fat appears to play a role in the association between hostility and glucose metabolism, results from two posters presented at the annual ...
Light and melatonin can reset circadian rhythm.(Psychosomatic Medicine)
May 01, 2008; ... SCOTTSDALE, ARIZ. -- Before traveling from California to South Africa, Dr. Alon Y. Avidan prepared for the time change by spending afternoons in his office, out of the sun. After he arrived in South Africa, he awoke between 5 a.m. and 7 a.m. every morning and took a walk for an hour or ...
Polysomnography study: migraine linked to disturbed sleep in children.(Psychosomatic Medicine)
May 01, 2008; ... CHICAGO -- Sleep apnea was observed in more than half of children with migraine in a study presented at the annual meeting of the American Academy of Neurology. Polysomnography revealed sleep apnea in 56% of children with migraine, compared with 30% of those with nonmigraine ...
Altered brain response seen in IBS patients.(Psychosomatic Medicine)
May 01, 2008; ... Patients with irritable bowel syndrome have altered brain responses to the anticipation of pain and to pain itself, which might make them more sensitive to painful stimuli, reported Dr. Steven M. Berman and his colleagues from the Center for the Neurobiology of Stress at the University of ...
A study shows that 'psychological distress' rather than depression might increase the risk of stroke. How might psychiatrists think of this concept of psychological distress?(FINK ! STILL AT LARGE.)
May 01, 2008; ... Psychiatry is such a screwed-up field that we cannot retain a language that is scientific and meaningful Several months ago I railed against the bastardization of the word "depression." Now we have a new one, "distress," which a recent study on causes of stroke equates with ...
Findings based on population study of more than 20,000.(Psychosomatic Medicine)
May 01, 2008; ... The study aimed at assessing what kinds of factors increase the risk of stroke clarifies the relationship between mental health and stroke, according to the lead investigator and his colleagues. Paul Surtees, Ph.D., and his colleagues conducted a large population study of more ...
Assess psychological factors in chronic pelvic pain cases.(Across Specialties)
May 01, 2008; ... FORT LAUDERDALE, FLA. -- About 75% of premenopausal women with chronic pelvic pain gain significant relief from hysterectomy, even when no apparent physiologic cause is found. But what about the other 25%? "We tend to look at fibroids and endometriosis. It behooves us to look at ...
Prolapse surgery may improve body image and depressive symptoms.(Across Specialties)
May 01, 2008; ... HOLLYWOOD, FLA, -- Reconstructive surgery for pelvic organ prolapse not only improves physical distress but can significantly improve a woman's body image and depressive symptoms, according to results of a prospective, case-control study. "Body image can be used as an indicator ...
Multidisciplinary approach works best for vulvodynia.(Across Specialties)
May 01, 2008; ... CHICAGO -- Vulvodynia is best managed with a multidisciplinary approach with a multidisciplinary approach using a wide variety of therapeutic options, Dr. Hope K. Haefner said at a conference on vulvovaginal diseases sponsored by the American Society for Colposcopy and Cervical Pathology. ...
Eclampsia's neurologic damage may be permanent.(Across Specialties)
May 01, 2008; ... DALLAS -- Several years after a pregnancy complicated by eclampsia, significantly more women demonstrate subcortical cerebral white matter lesions on MRI, compared with women with a nor-motensive pregnancy. In a study of 103 women, white matter lesions were observed in 16 of 39 ...
Racial health disparities in elderly teased out.(Across Specialties)(Clinical report)
May 01, 2008; ... SAN FRANCISCO -- Several analyses of data from a longitudinal study of 3,075 elderly African American and white patients have helped identify some of the causes of health disparities between races in older adults, sometimes with surprising results. Investigators presented their ...
Lipid lowering reverses cognitive decline in some atrial fibrillation.(Across Specialties)
May 01, 2008; ... VIENNA -- Potent cholesterol-lowering therapy appears to reverse neurocognitive decline in normolipidemic elderly patients with atrial fibrillation, Dr. Elke Wezenberg said at the annual congress of the European Society of Cardiology. If this new finding from the small pilot ...
High midlife cholesterol increases Alzheimer's risk.(Across Specialties)
May 01, 2008; ... CHICAGO -- High cholesterol levels in midlife are associated with an increased risk of Alzheimer's disease and vascular dementia, data from a large, diverse cohort suggest. The analysis of more than 9,500 people showed that those patients with midlife total cholesterol levels of ...
Educate patients about asymptomatic herpes.(Across Specialties)
May 01, 2008; ... BOSTON -- "Genital herpes is a recurrent, lifelong viral disease. This is the one thing that patients and clinicians don't like to say, but there's no way around" it, Laura J. Mulcahy said at a conference on contraceptive technology sponsored by Contemporary Forums. Other ...
Syphilis rate rises most in gay men, African Americans.(Across Specialties)
May 01, 2008; ... CHICACO -- The rate of syphilis in the United States has increased for the 7th consecutive year, jumping 12% from 2006 to 2007, according to preliminary evidence released by the Centers for Disease Control and Prevention. The upsurge was driven largely by a 14% rise in cases of ...