Clinical Psychiatry News

Clinical Psychiatry News is a monthly medical and psychiatry tabloid published since 1973 by the International Medical News Group. Subjects for Clinical Psychiatry News include psychology and psychiatry. The executive editor is Denise Fulton, and Gina Henderson is a senior editor.

Articles from Vol. 35, No. 3, March

Academy Releases New Parameter on Treatment of ADHD
The American Academy of Child and Adolescent Psychiatry has released an updated version of its 10-year-old practice parameter for the assessment and treatment of children and adolescents with attention-deficit hyperactivity disorder. An underlying...
Administering ECT: Part I
Electroconvulsive therapy has been in existence since 1938, making it the biologic intervention with the greatest longevity in psychiatry. In part, this is because the procedure is one of the most potent treatments around. Inpatient psychiatrists...
Art Provides Window on Epilepsy Experience
SAN DIEGO -- Artwork created by persons with epilepsy can help others gain insight to the experiences of patients with the condition, Dr. Steven C. Schachter said at the annual meetings of the American Epilepsy Society and the Canadian League Against...
Atomoxetine May Benefit Kids with ADHD, Anxiety
SAN DIEGO -- Atomoxetine is effective and well tolerated in children and adolescents with attention-deficit hyperactivity disorder and a coexisting anxiety disorder, results from a randomized, placebo-controlled trial show. "If you have kids who...
Autism in U.S. More Prevalent Than Thought: Latest Data Partly Explained by Better Identification of Children with Autism Spectrum Disorders
The prevalence of autism spectrum disorders among children in the United States is now estimated to be 1 child in 150, up from 1 in 166, data from two studies conducted by the Centers for Disease Control and Prevention show. The CDC now estimates...
Beware of Liability Pitfalls of Electronic Health Records
WASHINGTON -- From a liability perspective, health information technology remains a double-edged sword whose parameters still need to be spelled out, experts said at a meeting sponsored by eHealth Initiative and Bridges to Excellence. "It's going...
Brief Behavioral Training Improves Insomnia
Insomnia is highly prevalent among elderly patients, but a new study suggests that a brief behavioral treatment can significantly improve insomnia in this population. In a pilot study, Anne Germain, Ph.D., and her colleagues at the University of...
Bush Proposal Targets Medicare and Medicaid
The Bush administration's budget proposal for fiscal 2008 could be bad news for physicians and hospitals. The proposal, which was sent to Congress on Feb. 5, seeks about $600 billion in net outlays to finance the Centers for Medicare and Medicaid...
Comorbid Depression Is Aggravating Factor in ADHD, Yet Goes Undertreated
SAN DIEGO -- Youth with attention-deficit hyperactivity disorder and a history of major or minor depression reported significantly greater levels of functional impairment, family conflict, and adverse and traumatic life events, compared with ADHD youth...
Conciseness, Emotion Help Make Most of Media Exposure
WASHINGTON -- Medicine and health are so often in the news that it may be worthwhile to be prepared to do interviews in a variety of media, Ms. Patricia A. Clark said at a meeting of the Society for Pediatric Dermatology. "The physician today cannot...
Cost Discussions Seldom Occur at Office Visits: Physicians Talked about Cost or Insurance for Just 12% of the 243 Prescriptions Issued to 185 Patients
TUCSON, ARIZ. -- Physicians and their patients seldom discuss new medication costs and other acquisition issues, Dr. Derjung Mimi Tarn and associates reported in a poster presentation at the annual meeting of the North American Primary Care Research...
Data Replace Dogma on Trauma, Abuse in Children
DENVER -- Accepted dogma concerning neurologic evaluation of children with suspected nonaccidental trauma is under challenge from accumulating findings from a number of studies, according to a presentation at a meeting on pediatric neurologic surgery....
Depression History a Possible Marker for Auras Following Epilepsy Surgery
SAN DIEGO -- A presurgical history of depression appears to predict the persistence of auras after an anterotemporal lobectomy in which patients became free of disabling seizures, Dr. Andres M. Kanner reported during a poster session at the annual...
Diabetes Complicates Depression and Anxiety Therapy: Increased Use of Atypical Antipsychotics Brings Weight, Glucose Metabolism, and Lipid Liabilities
News reports of an epidemic of diabetes are not exaggerated: An estimated 21 million Americans are affected with the metabolic disorder. Many will require psychiatric care. Diabetic patients are twice as likely as the general population to suffer...
Education Raises Young Women's Risk for Binge Drinking
Binge drinking is less common among British women with lower educational levels or job status when they are in their 20s than it is among those with higher educational levels or job status, but in their 30s the trend reverses, according to a new study....
Expand Commitment for Alcoholism
A 55-year-old man is found unconscious in the street and is brought to the emergency room. He has a blood alcohol level of 425 mg/dL and is delirious when he arrives. It is his fourth visit for detoxification this year; each time he was hospitalized...
Experimental Prodrug May Ease Restless Legs, Aid Sleep
CHICAGO -- An investigational gabapentin prodrug may be an effective therapy for symptoms and sleep problems associated with restless legs syndrome, Dr. Arthur S. Walters reported at the annual meeting of the American Neurological Association. The...
FDA Approves Duloxetine for Anxiety
The antidepressant duloxetine has been approved for a third indication: the treatment of generalized anxiety disorder. The manufacturer of duloxetine, Eli Lilly, announced in late February that the Food and Drug Administration had approved the selective...
Fibromyalgia and Collisions Often Unrelated, Study Suggests
WASHINGTON -- An association between a motor vehicle collision and the development of widespread body pain in some individuals was not supported by findings from an ongoing prospective study comparing two different cohorts. However, the study of...
Ford Center Hailed for Impact on Addiction TX
Betty Ford--the former first lady whose husband, 38th president Gerald R. Ford, died in December--announced in April 1978 that she was undergoing rehabilitation for addiction to prescription drugs and alcohol. Her experience led her 4 years later to...
For Resistant Depression, Try Transdermal Selegiline
ORLANDO -- Transdermal selegiline is worthwhile for patients with treatment-resistant depression because it is effective and avoids or minimizes concerns with the oral formulations of selegiline, Dr. Stephen M. Stahl reported at a psychopharmacology...
Frequency, Disability Must Guide Migraine Prophylaxis
SCOTTSDALE, ARIZ. -- Monitor patients' headache frequency and disability to guide the pharamacologic prevention of migraine, Dr. Stewart J. Tepper said at a symposium sponsored by the American Headache Society. "The goal should be to decrease migraine...
Frequency, Painfulness of Restless Legs Must Guide Treatment
BALTIMORE -- When deciding which drug to prescribe a patient with restless legs syndrome, the frequency and painfulness of symptoms are crucial to making the correct choice, Dr. Christopher J. Earley said at a neurology meeting sponsored by Johns Hopkins...
Gainsharing Arrangements Proceed Slowly
Hospitals are reluctant to offer physicians a portion of the savings generated by reducing clinical costs--a concept known as gainsharing--because of legal fears, D. McCarty Thornton, said during an audioconference on gainsharing sponsored by the Integrated...
Geriatric Hopes Rest on Improved CMS Outlays
Improved reimbursement remains the focus of efforts to shore up the nation's supply of geriatricians. Medicare's physician fee schedule for nursing home care urgently needs to be adjusted to reflect the real costs of diagnosis and treatment, according...
Health Questionnaire Predicts Cardiovascular Mortality in Arthritis
WASHINGTON -- Early functional disability is predictive of both all-cause and cardiovascular mortality in patients with inflammatory polyarthritis, Dr. Tracey M. Farragher reported at the annual meeting of the American College of Rheumatology. An...
Hormone Therapy Cuts Diabetes Risk in Women
Women considering the risks and benefits of hormone therapy should be informed of the link between hormones and a decreased risk of diabetes, especially if they are at risk for the disorder, according to Dr. Wulf Utian, executive director of the North...
In Tourette's, Focus on Comorbidities
NEW YORK -- Tourette's syndrome treatment should be targeted to improve comorbidity rather than on the characteristic vocal and motor tics, Dr. John T. Walkup said at a psychopharmacology update sponsored by the American Academy of Child and Adolescent...
Is 'Do No Harm' Really Possible?
At breakfast the morning of Dec. 15, 2006, my wife looked up from the morning newspaper with a look of distress and said: "This is so sad. Those doctors must feel badly about what happened." I peered over to see the front page headlines of the Milwaukee...
Large Study of Binge-Eating Disorder Is a First
CHICAGO -- Treatment outcomes for obese patients with binge-eating disorder differ by disease severity and negative affect, a large study of patients with this disorder shows. "We are trying to identify a particular subset of the population [that...
Medication Tips Help Treat Difficult Bipolar
ORLANDO -- Management of difficult-to-treat bipolar disorder can be facilitated with medication tips presented at a psychopharmacology congress sponsored by the Neuroscience Education Institute. "It's getting easier to diagnose unipolar depression...
Mentally Ill Face Increased Cardiovascular Risk
People who have severe mental illness are at double to triple the risk of dying from coronary heart disease or stroke at all ages, compared with people who are not mentally ill, reported David P.J. Osborn, Ph.D., and his associates. The social deprivation...
More Data Show Positive Effects of Aspirin on Brain Matter
ATLANTA -- Aspirin, even at low doses, appears to prevent age-related declines in gray and white matter integrity in brain regions that typically show the earliest neuropathological changes associated with Alzheimer's disease, according to Lee Ryan,...
My Wish List for Psychiatry
I have always been an optimist, but it is difficult for me to see a bright future for the specialty of psychiatry. The progress we have made over the last 50 years has been miraculous. However, these very miracles have split us into two discrete...
New Guidelines Tout Early Arthritis Management
The availability of more effective arthritis drugs and monitoring techniques has created a critical window of opportunity when joint destruction can be averted and function maintained. To help clinicians make the most of this period, an expert committee...
Obese Patients Are at Increased Risk for Trauma Complications
PALM BEACH, FLA. -- Obese patients with critical injuries from blunt trauma have worse outcomes than do leaner patients, according to a single-center review of more than 1,500 patients. However, the new data were not able to show an increased risk...
Oncology Nurses Reduce Depression in Cancer Patients
TUCSON, ARIZ. -- A psychiatric intervention conducted by specially trained oncology nurses significantly reduced depression for cancer patients enrolled in a clinical trial presented at the annual meeting of the Academy of Psychosomatic Medicine. ...
Oral Appliances a Top Option for Mild to Moderate Apnea
MONTREAL -- Oral appliances are equally effective as continuous positive airway pressure therapy in patients with mild to moderate obstructive sleep apnea, but not in those with severe disease, according to a randomized trial. "We've now shown clearly...
Orlistat Wins Approval as OTC Weight-Loss Drug
Orlistat will soon be available to consumers without a prescription, making it the first weight-loss product available over the counter that has been recognized as safe and effective. The approval of orlistat (Alli) by the Food and Drug Administration...
Overactive CNS Processing Tied to Fibromyalgia: When Viewed Together, Neuroimaging Studies Show Strong Neurobiologic Underpinnings of Disorder
An "overwhelming" amount of data now suggest that patients with fibromyalgia and a number of overlapping pain syndromes have augmented pain or sensory processing in the central nervous system, resulting in real differences in pain tolerance, judging...
Perspective
The lack of integration between the management of emotional and physical wellness in psychiatric patients is largely a consequence of the absence of a true public health philosophy among physicians. Most medicine is practiced by looking for symptoms...
Physicians Split over Ethics of Accepting Sample Medications
TUCSON, ARIZ. -- Physicians are divided over whether it is ethical to use free sample medications in their primary care practices, Nancy Sohler, Ph.D., and Dr. Diane McKee reported at the annual meeting of the North American Primary Care Research Group....
Poor Reading Linked to Psychopathy
Adolescents with poor reading skills are significantly more likely to exhibit psychiatric disorders than are adolescents who have adequate reading skills, reported David B. Goldston, Ph.D., of Duke University, Durham, N.C., and his associates. Although...
Possible Cardiac, Psychiatric Risks Prompt FDA to Mandate ADHD Medication Guides
The Food and Drug Administration has sent letters to all manufacturers of medications approved for the treatment of attention-deficit hyperactivity disorder, instructing them to develop patient medication guides within 30 days as a way to notify patients...
Postmarketing Studies of VNS Yielding No Surprises So Far
GAITHERSBURG, MD. -- No unexpected safety findings have emerged in the early phases of two postmarketing studies of the vagus nerve stimulation device in patients with depression, according to the manufacturer. Updates on the two studies of the...
Promoting Physical Health among Mentally Ill
If physical and mental health were represented as two rings of a Venn diagram, the overlap between the two circles would be substantial, as the state of one often affects the other. If, however, the two rings represented the typical models of care...
Risks of Mental Disorders Differ between New Mothers, Fathers
New mothers are at increased risk for severe mental disorders from the birth of a first child through 3 months post partum. Fathers are at no such risk, a finding that challenges the proposal that severe postpartum mental disorders also affect men....
Sales of Energy Drinks Top $3 Billion-But at What Cost?
Energy drinks are all the rage, and the media--along with the millions of people who use the drinks--are buzzing. At the same time, there has been surprisingly little research into the potential health hazards of the caffeine- and sugar-laden drinks...
Screening for Postpartum Depression Is Inadequate
WASHINGTON -- Most hospitals rely on passive means, such as handouts or television, to educate women about postpartum depression (PPD), according to findings in a study of Iowa hospitals. Surveys were mailed to the 76 Iowa hospitals that provide...
Self-Cutting, Burning Reported by Up to 15% of German Ninth Graders
SAN DIEGO -- About 11% of ninth graders reported acts of deliberate self-harm in the form of cutting or burning themselves one to three times in the previous year, while an additional 4% reported performing such behavior more than four times in the...
Senate Committee Dubious about Expansion of SCHIP
WASHINGTON -- As a Senate panel opened debate on reauthorization of the State Children's Health Insurance Program, legislators had doubts about expanding coverage to an estimated 9 million children who are eligible but who have not yet been enrolled....
Sleep Disorders May Affect Pregnancy Outcomes
SCOTTSDALE, ARIZ. -- Even mild sleep disorders have the potential to affect fetal outcomes during pregnancy, Dr. Susan M. Harding advised at a meeting on sleep medicine sponsored by the American College of Chest Physicians. Recent research suggests...
Smoking Raises Risk of RA in Some Women
Smoking raises the risk of rheumatoid arthritis in older white women who are not genetically predisposed to the disease, according to Dr. Lindsey A. Criswell of the University of California, San Francisco, and her associates. Researchers looking...
Some Suicidal Patients Leave Emergency Department Too Soon
TUCSON, ARIZ. -- Preliminary results from a study of psychiatric patients who left an emergency department without treatment suggest many were anxious, agitated, and at risk for harm to themselves and others. Among patients in the initial review,...
State Legislators Pursue Insurance Mandates, Transparency
WASHINGTON -- State legislation mandating health insurance will continue, with "at least 12 more states going to debate bills to expand employer participation coverage" in 2007, according to Susan Laudicina, director of state services research for...
Statin Users Risk MI by Quitting Treatment, Taking Lower Doses
Approximately 300-400 statin users each year experience a preventable heart attack because of suboptimal dosing and early discontinuation of the drug, according to a large observational study in the Netherlands published by the European Heart Journal....
Streamlining of DSM-IV Gambling Diagnostic Criteria Urged
CHICAGO -- Results of a psychometric evaluation of pathological gamblers indicates that 2 of the 10 DSM-IV criteria for this condition could be eliminated without changing the validity of the diagnosis, according to Dr. Mark Zimmerman, who presented...
Teens' Violent Recidivism Drops after Intervention
FORT MYERS, FLA. -- Enhancements made to a program for first-time violent adolescent offenders and their parents continue to significantly reduce violence recidivism rates, compared with standard community service, according to a follow-up study. ...
Teens with Epilepsy Face More Social Hurdles
SAN DIEGO -- Studies have suggested that the social environment can be a rocky place for children with epilepsy, Joan K. Austin, D.N.S., said at the annual meetings of the American Epilepsy Society and the Canadian League Against Epilepsy. According...
The Art of Lynne Taetzsch, Ph.D
First inspired by her grandmother, who made artificial flowers, Lynne Taetzsch, Ph.D., started drawing and painting portraits of family and friends as a child. She studied art at several institutions, including Rutgers University in Newark, N.J.,...
The Comfort and Curse of Paranoia
Florian Henckel von Donnersmarck recently made his feature film debut as writer-director of "The Lives of Others," a highly successful project that had consumed him for 5 years. Winner last month of the Oscar for Best Foreign Language Film, "Lives"...
Thorough Depression TX Must Address Residual Symptoms
ORLANDO -- Hunt for insomnia and fatigue after depression treatment because they are the most common residual symptoms, advised presenters at a psychopharmacology congress sponsored by the Neuroscience Education Institute. An estimated 35%-45% of...
Topiramate Could Reduce Pediatric Migraine Frequency
PITTSBURGH -- Topiramate appears to be a good choice for preventing pediatric migraine, including basilar migraine, researchers reported at the annual meeting of the Child Neurology Society. The drug was approved for treatment of adult migraine...
Torcetrapib's Failure May Not Doom HDL Raisers: Increased Mortality May Be Related to the Drug's Hypertensive Effects and to Accelerated Atherogenesis
The demise of torcetrapib may be a "bitter disappointment" to researchers, but it's too soon to give up on the entire class of HDL cholesterol-raising agents, several of which are still under development, experts say. "While this is a huge setback...
Varenicline, Antidepressants Help Smokers Quit
Varenicline triples the likelihood that a smoker will quit, compared with placebo, and bupropion and nortriptyline double the odds, according to a pair of evidence reviews published Jan. 24. The Cochrane Collaboration review of varenicline, a nicotine...
VA's Health IT System: A Model of Innovation
Over the last decade, health care within the Department of Veterans Affairs has transformed itself from a notorious near failure to a national model for quality improvement, leaving many asking how they can incorporate those lessons. The answer...
We Must Reclaim Our Specialty
A friend of mine, a 42-year-old woman, called me a few weeks ago and asked about some lower back pain she was experiencing. She had no history of arthritis or rheumatism, had suffered no recent back injuries, had not physically exerted herself, and...
What Role Might a Mental Health Professional Play in Helping a Patient Such as the Missouri Boy Who Was Kidnapped, Held for 4 Years, and Found Only after the Capture of a Second Boy? How Would You Begin to Work with Such a Patient?
The recent kidnappings uncovered in Missouri, with one child being held for 4 years and the other for a couple of days, reveal a problem that has been under cover for decades and makes palpable our fear about our children's safety. Parents are more...
White-Matter Deficit Seen in Stuttering Children
ATLANTA -- Children who stutter have been found to have deficiencies in white-matter organization in a tract that interconnects the frontal speech/motor planning region and the posterior speech comprehension region, suggesting that inefficient connectivity...
With Bowel Disease, Parents' Anxiety Worse Than Children's
INDIANAPOLIS -- Parents of children with inflammatory bowel disease perceive the effects of their children's illness more intensely than do the children themselves, according to Carin L. Cunningham, Ph.D. "Treating physicians need to be aware of...