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. 34, No. 2, February

ADHD: Switching to Atomoxetine Can Help
TORONTO -- Children with attention-deficit hyperactivity disorder can be successfully cross-tapered from a stimulant to atomoxetine with significant improvements in their ADHD symptoms, Dr. Humberto Quintana reported in a poster at the joint annual...
Armodafinil Improves Daytime Wakefulness in CPAP Users
DENVER -- The investigational drug armodafinil significantly increased daytime wakefulness in patients with obstructive sleep apnea who experienced excessive sleepiness despite regular nighttime continuous positive airway pressure therapy, according...
Buprenorphine Demand Surpassing Patient Limit
SCOTTSDALE, ARIZ. -- At a recent workshop on office buprenorphine prescribing, the first question addressed was: Is the 30-patient limit likely to be revised? The urgency of the question is another sign that physicians who choose to become waiver-qualified...
Cocaine-Induced Psychosis and Schizophrenia
The Problem You are working in an emergency department. A patient presents in an acutely psychotic state, but his urine drug screen is positive for cocaine. You have no prior records or knowledge of the patient. The Question Is it possible...
Compliance Puts New Spin on Psychosis Treatment: Adolescents with Prodromal Psychosis Had Better Outcomes with Antidepressants Than Antipsychotics
ATLANTA -- Adolescents with prodromal psychosis who were being treated with second-generation antipsychotic drugs had significantly higher rates of medication noncompliance than adolescents who had the same early symptoms and were taking antidepressants,...
Computer Assessment Promising for Mild Cognitive Impairment
QUEBEC CITY -- Computerized assessment of mild cognitive impairment is an area of great promise and potential problems, Jason Brandt, Ph.D., said at a conference sponsored by the American Association for Geriatric Psychiatry. A slew of new computerized...
Coping with the Death of Young Patients
The death of a patient is the ultimate "bad outcome" in health care, yet few physicians or nurses are prepared to deal with the emotions of such experiences. Especially early in training and in hospital settings, where patient deaths are common,...
Counseling Patients about Adoption
Most adopted children begin searching for their birth parents during their teenage years. ("Children Process Adoption Throughout Early Years," CLINICAL PSYCHIATRY NEWS, December 2005, p. 37). Such searches can prove anguishing for adoptive parents....
Defending the 'Drug Man'
"The fault, dear Brutus, is not in our stars, But in ourselves, that we are underlings...." Cassius in Julius Caesar, Act I, Sc. 2, Line 145 --William Shakespeare Over the past several years, the pharmaceutical industry has replaced managed care as...
Denial May Lead to Undertreatment of Fall-Related Injuries
ORLANDO -- Denial is a frequently used coping strategy in geriatric patients with fall-related injuries and is likely a risk factor for inadequate treatment, accorording to study findings presented at the annual meeting of the Gerontological Society...
Depression Study May Help Guide Prescribing
Routine, quantitative measurement of depression symptoms and treatment side effects at every clinical visit may help physicians to determine when to change their prescribing patterns for treating depression, findings from the STAR*D study suggest....
Detox with Buprenorphine More Lasting Than Clonidine
SCOTTSDALE, ARIZ. -- Opiate addicts who go through withdrawal using buprenorphine are nine times more likely to complete their withdrawal regimen than are patients who use clonidine, a large National Institute on Drug Abuse-sponsored trial shows. ...
Dysthymia in Older Adults Needs Further Study
STOCKHOLM -- Much remains unknown about dysthymia and minor depression in older adults, particularly when it comes to differences in the pathogenesis of early- and late-onset disorders and the interaction of these disorders with comorbidities, Dr....
Early Intensive Glucose Control Slashes Risk for CVD
SAN DIEGO -- Tight glucose control early in the course of type 1 diabetes reduces the long-term risk of cardiovascular disease events by more than half, Dr. David M. Nathan reported at the annual scientific sessions of the American Diabetes Association....
Exit Talks Have Minor Effects on Injured Drinkers
BETHESDA, MD. -- Brief negotiation interviews with emergency department patients who have engaged in harmful and hazardous drinking behaviors may not be much more effective in reducing the frequency and quantity of drinking than providing simple discharge...
Expect Higher Standards in Research
Peer-reviewed research should provide clear guidance to clinical practice. However, there is considerable information that we as physicians have a right to expect from peer-reviewed research but are not getting. This deficiency makes it harder for...
Extra Vitamin D Fails to Cut Fibromyalgia Pain
SAN DIEGO -- Vitamin D supplementation did not lessen fibromyalgia symptoms in a small trial, a finding that casts doubt on the theory that vitamin D deficiency underlies some patients' pain and that screening vitamin D levels would identify patients...
Feds Offer Warning on Rx Assistance with Part D
Some Medicare beneficiaries may still qualify for extra help in purchasing drugs through patient assistance programs, despite the new Medicare Part D drug benefit that started last month. But pharmaceutical manufacturers that offer assistance will...
Five Children in Minnesota Test Positive for Poliovirus
A small outbreak of poliovirus infection has been reported among unvaccinated children living in rural Minnesota. All cases to date have been linked to the live attentuated virus used in the oral polio vaccine, according to the Minnesota Department...
Gender Differences Observed in Beliefs of AA Participants
SANTA BARBARA, CALIF. -- Men and women are similarly devoted to long-term participation in Alcoholics Anonymous, progressing at about equal rates through the 12 steps that define the voluntary, nonprofit program for problem drinkers. But a study...
Gene Expression May Be 'Therapeutic Target' for Stroke
SAN DIEGO -- Characteristic patterns of gene expression in blood samples can now identify patients with migraine, Tourette's syndrome, neurofibromatosis type 1, tuberous sclerosis type 2, Down syndrome, and early ischemic stroke, among other diseases,...
Genetic Screening for AD Appears Beneficial
WASHINGTON -- Screening for the [epsilon]4 form of the apolipoprotein E gene may be more likely to provide psychological benefit than harm to the adult children of people with Alzheimer's disease, Dr. Robert C. Green said at an international conference...
Hallucinations Are Not 'Benign' in Parkinson's Disease
SAN DIEGO -- So-called benign hallucinations associated with dopaminergic treatment for Parkinson's disease rarely remain "benign," calling into question the accuracy of the term. Researchers at Rush University in Chicago studied the clinical progression...
Hearing Loss Linked to 'Unsuccessful' Aging
ORLANDO -- Elderly persons with hearing loss are more likely to describe themselves as aging unsuccessfully, compared with their peers who hear well, despite the absence of any other chronic conditions, according to a study presented as a poster at...
HIV Notification, Counseling Soar with Rapid HIV Testing
QUEBEC CITY -- The use of rapid human immunodeficiency virus testing has had a profound impact on primary care settings in New Jersey, Dr. Denise Young reported in a poster at the annual meeting of the North American Primary Care Research Group. ...
Ischemic Stroke Triggers Race against the Clock
For every hour an acute ischemic stroke is untreated, the human forebrain loses 120 million neurons, 830 billion synapses, and 447 miles of myelinated fiber--the equivalent of 3.6 years of normal aging. The numbers lend a new urgency to the phrase...
Lithium Lowers Suicide Rates in Bipolar Disorder: Metaanalysis Shows Treatment Is Linked to Fivefold Drop in Attempts, Completions
PITTSBURGH -- Lithium is an effective and underused agent for curbing the risk of suicide and suicide attempts in patients with bipolar disorder. In a quantitative metaanalysis of 31 studies that assessed lithium's ability to cut suicide attempts...
Mental Health Care for the Caregiver
People with Alzheimer's disease are not the only ones who suffer from its devastating effects. Family caregivers of Alzheimer's patients are also at risk for a range of psychosocial, emotional, and even physical problems. This population also falls...
MRI Helps Distinguish Cognitive Impairments: Use of Technology Has Potential to Lead to Subtype-Specific Prophylaxis or Therapy
PORTO, PORTUGAL -- MRI used in combination with neurologic/neuropsychometric evaluations enables physicians to distinguish among three subtypes of mild cognitive impairment, thus potentially permitting early and effective subtype-specific prophylaxis...
Narcolepsy Drug Is Safe, Effective for ADHD
TORONTO -- Modafinil is safe and effective in treating pediatric attention-deficit hyperactivity disorder, decreasing symptom scores twice as much as placebo, according to two posters presented at the joint annual meeting of the American Academy of...
Need for Control Drives Assisted Suicide Requests: Patients Who Went through with Assisted Suicide Wanted to Be Self-Reliant until the End, Studies Show
SANTA ANA PUEBLO, N.M. -- The key factor motivating the terminally ill to seek assisted suicide under Oregon's Death with Dignity Act--a sense of control--should prompt a rethinking of end-of-life care, Dr. Linda Ganzini said at the annual meeting...
Novel Drug Boosts Smoking Cessation Rates: Varenicline Is a Safe and Effective Treatment for Breaking the Smoking Addiction Cycle, Studies Find
DALLAS -- The first agent from a new drug class was safe and effective in helping patients stop smoking in three phase III studies that involved more than 3,000 patients. Treatment with varenicline, a selective nicotinic acetylcholine receptor partial...
Only the Lonely
Haruki Murakami, arguably Japan's preeminent contemporary novelist, who wrote the short story upon which the new film "Tony Takitani" is based, is a cartographer of human existence. He explores and maps the boundaries between the real and the fantastic,...
OSA-Hypopnea Syndrome: Atrial Overdrive Pacing Not Useful
Atrial overdrive pacing proved ineffective in most cases of obstructive sleep apnea-hypopnea syndrome, while nasal continuous positive airway pressure showed strong efficacy, according to a comparison study by Greek researchers. Dr. Emmanuel N....
Package Insert Rule Aims to Improve Patient Safety
Prescription drug package inserts will soon have a new format that Food and Drug Administration officials believe will reduce the risk of medical errors. A goal of the "major revisions" recently announced by the FDA is to prioritize warning information...
Paratonia in Patients: A Clinical Marker of Alzheimer's Disease?
SAN DIEGO -- The presence of paratonia in patients with Alzheimer's disease may be a sign of cognitive decline, according to the results of a small study. "Paratonia may be useful as a way of looking at the progression of Alzheimer's disease, because...
Payment System Thwarts Obesity TX Efforts
With the obesity epidemic growing, physicians are facing a payment system that hasn't caught up. Although coverage varies by payer, most Medicare carriers do not pay for office visits coded only for obesity and the same is true for most private...
Perspective
If children in this country were denied access to the polio vaccine despite the undeniable proof that it prevents the devastating disease, the uproar about the ethical implications would be unprecedented. Yet the failure to implement proven psychosocial...
Physician-Rating Game Fraught with Difficulty
WASHINGTON -- The lists of "best doctors" published in magazines may not be all they're cracked up to be, several speakers said at a health care competition conference sponsored by Health Affairs journal and the Center for Studying Health System Change....
Physicians, Others Face Greater Risk of Developing Parkinson's
Physicians and individuals with 9 or more years of education are at an increased risk of developing Parkinson's disease, according to a study by Dr. Roberta Frigerio of the Mayo Clinic in Rochester, Minn., and her colleagues. Individuals such as...
Postdeployment Screening Seeks to Uncover Potential Problems
SAN FRANCISCO -- The Department of Defense conducts a thorough medical screening of each service member returning from a theater of operations, but civilian physicians must still be on the lookout for combat-related illnesses, Maj. Robert B. Wenzel,...
Prolonged Exposure Therapy Lessens PTSD Symptoms
TORONTO -- Prolonged exposure therapy appears to significantly reduce symptom severity in patients with posttraumatic stress disorder associated with combat or terrorist attacks, according to an Israeli study presented at the annual meeting of the...
Psych Disorders Common in Kids with HIV
SANTA ANA PUEBLO, N.M. -- Whether infected at birth or through risky behavior, youth with human immunodeficiency virus/acquired immunodeficiency syndrome often have psychiatric disorders, Dr. Maryland Pao said at the annual meeting of the Academy of...
'Psychological Autopsy' Can Help Explain Death: A 16-Item Checklist Can Be Used to Help Determine If a Patient's Death Was Accidental or Self-Inflicted
MONTREAL -- A psychological autopsy can be helpful in determining the causes of a patient's death, Dr. Elena Swartz said at the annual meeting of the American Academy of Psychiatry and the Law. The idea of a psychological autopsy began at the Los...
Refractory Depression in Elderly Too Complex for Guidelines
ALBUQUERQUE, N.M. -- A survey of 50 psychiatrists from across the country provides insight into treatment of refractory depression in the elderly, Dr. William Apfeldorf said at a psychiatric symposium sponsored by the University of New Mexico, Albuquerque....
Sleeping Problems in Mood, Anxiety Disorders: Make Sure That Primary Antidepressant Prescribed Does Not Aggravate Patient's Sleep Problems
Nearly every psychiatric disorder has sleep disturbance as a potential symptom. Sleep should be an object of inquiry in the initial assessment. Asking the patient about sleep is "a useful way to build rapport: Most people are quite concerned and...
Some Patients Respond Well to Reduced Doses of Atomoxetine
TORONTO -- Reducing the dose of atomoxetine may be possible for children with attention-deficit hyperactivity disorder who have responded well to the medication, Dr. Jeffrey Newcorn reported in a poster at the joint annual meeting of the American Academy...
Some Symptoms of PDD Respond to Medications: Pharmacotherapy Has Shown Some Promise for Reducing Aggression, Inattention, and Hyperactivity
TORONTO -- Some symptoms associated with autism--including hyperactivity, inattention, stereotypy, and aggression--can be improved with pharmacotherapy, Dr. Christopher McDougle said at the joint annual meeting of the American Academy of Child and...
Study Clarifies Effects of Outpatient Commitment
MONTREAL -- Outpatient commitment can be a useful tool if it is implemented for a long enough period and combined with more frequent services, Dr. Marvin S. Swartz said at the annual meeting of the American Academy of Psychiatry and the Law. "We...
Study Links Polycystic Ovary Syndrome with Depression
MONTREAL -- A total of 35% of those with polycystic ovary syndrome also had depression in a case-control study of 206 women. "We recommend that women with PCOS should be routinely screened and adequately treated for depression," study investigator...
Study Should Ease Concerns on Newer Antidepressants: Suicide Risk Fell 60% after Treatment
Psychiatrists say a new study should help convince the public that newer antidepressants do not appear to be associated with a risk of suicide. In the study of about 60,000 enrollees at Group Health Cooperative (GHC), a nonprofit health care system...
Symptoms of Pediatric Delirium Often Overlooked, Mistreated
SANTA ANA PUEBLO, N.M. -- Pediatric delirium is rarely discussed in the medical literature and hardly ever diagnosed in practice, but Dr. Susan Beckwitt Turkel contends that children may be as vulnerable as elderly patients. "I think when we say...
Targeted Prevention Getting Attention
SANTA ANA PUEBLO, N.M. -- Studies aimed at preventing psychiatric illnesses in targeted populations are relatively new, promising, and problematic, researchers said at the annual meeting of the Academy of Psychosomatic Medicine. "Over the past 40...
Teens' Illicit Drug Use Down, but Rx Abuse Up
WASHINGTON -- Use of illegal drugs among adolescents continues to decline modestly, but abuse of some prescription drugs is increasing, according to a survey of 49,000 students in 400 secondary schools nationwide. Overall, the use of any illicit...
The Art of Karen Blair
The Web site for artist Karen Blair starts out with a striking statement: "All the pictures and all the writing on this site are my own. It is an honest place. My blood carries the template for schizophrenia. Because of what my blood made my brain,...
The Challenges of Caring for an Aging Parent
Now in his fifth year of dementia, 86-year-old Leonard Winakur doesn't know what day it is. If he's not sleeping when his son Dr. Jerald Winakur drops by for a visit (as Dr. Winakur does nearly every day), sometimes he'll engage his son in superficial...
Treating Stage Fright
Treating performers with stage fright--when the anxiety and avoidance are stressful enough to become a social phobia--is therapeutically challenging and rewarding. With our help, however, many patients suffering from this disorder can learn to push...
Try Integrated Psychotherapy for Complex Issues
STOCKHOLM -- Integrated individual psychotherapy may be the best method for addressing complex issues that are often unique to geriatric patients, Dr. Joel Sadavoy said at the 12th Congress of the International Psychogeriatric Association. "The...