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. 31, No. 10, October

Aggression Tied to Serotonergic, Structural Deficits: Intermittent Explosive Disorder. (Adult Psychiatry)
SANTA FE, N.M. -- A growing body of research suggests that intermittent explosive disorder, characterized by regular impulsive, aggressive acts, is the result of childhood abuse combined with biological predisposition, Dr. Emil F. Coccaro said at a...
Alcohol Withdrawal Worse for Older Patients: Increased Risk of Falls
CHICAGO -- Alcohol withdrawal symptoms can last longer and pose more risks for elderly patients, who often experience more prolonged and severe symptoms and need higher doses of detox medications than younger patients. "Because of these factors,...
Apathy Undermines Bonds between Spouses, Dementia Patients: Worse Than Excessive Behavior
CHICAGO -- Apathy is much more likely than excessive behavior to damage the relationship between a person with dementia and the spouse-caregiver, because it is associated with the death of reciprocal interaction. Even though excessive behavior in...
Black Women More Likely to Report Partner Abuse: Common Screening Question Not Useful
WASHINGTON -- A commonly asked safety screening question failed to detect a large percentage of women who had reported abuse in a study conducted at a Wisconsin family practice clinic, Robert L. Peralta, Ph.D., said during a poster presentation at...
Bridging the Provider-Payer Gap
If providers and payers do not work together to improve the health care system, politicians will do it for us. Physicians, hospitals, health plans, and others should join forces and lobby together for medical liability reform. Tort reform is an...
Broader World View Aids Post-Sept. 11 Resilience: More Than 7,000 People Studied: Internet Survey Participation Cathartic
WAIKOLOA, HAWAII -- People who were most resilient in the 6 months after Sept. 11, 2001, were those with more education, fewer negative changes in their existential world view, larger and more supportive social networks, and less emotional constraint...
Buprenorphine Opiate Detox Beats Anesthesia: Safety Concerns
SAN FRANCISCO -- Opiate detoxification by the rapid buprenorphine method offers clear advantages over the trendy--but far riskier--anesthesia rapid opiate detox method, Dr. Herbert D. Kleber reported at the annual meeting of the American Psychiatric...
Character
The film "Character" is based on the 1938 novel "Karakter" by Ferdinand Bordewijk. Although he is relatively unknown to the English-speaking world, Bordewijk is one of Holland's foremost 20th-century writers, and "Karakter" has earned a place in Dutch...
CMS to Accept Noncompliant Electronic Claims: HIPAA Contingency Plan. (Centers for Medicare and Medicaid Services, Health Insurance Portability and Accountability Act)
Physicians can continue to submit noncompliant electronic transactions after the Oct. 16 Health Insurance Portability and Accountability Act transaction and code sets deadline, the Centers for Medicare and Medicaid Services announced. This decision...
Conflict with Fathers Affects Suicide Reattempts: Potent Risk Factor
TAMPA, FLA. -- After a single suicide attempt, adolescents whose parental relationships include high levels of conflict with fathers are at risk for a second attempt, Barry Wagner, Ph.D., said at a meeting of the Society for Research in Child Development....
Consumer Involvement Won't Slow Health Costs: Lack of Quality Data
WASHINGTON -- Consumer involvement in selecting health care providers and services is a good idea, but it's not going to dramatically slow health care costs any time soon, Dr. Peter Kongstvedt said at a conference sponsored by the American Association...
Counseling Helps Lift Depression among Alzheimer's Caregivers: Study in U.S., U.K., Australia
CHICAGO -- Caregivers for Alzheimer's disease patients responded positively to counseling for the stresses involved in their tasks, according to a three-country study, but differences in caregiver demographics and reactions toward counseling in the...
Cultural Considerations in Psychiatric Tx. (Treatment)
Patients are less homogeneous than they were, say, 20 years ago. As a result, today's psychiatrists practicing in America must be able to treat people of many different cultures. Given these changing demographics, should we adjust our treatment of...
Cutting Behavior, Eating Disorders Linked in Some Students: Female Undergraduates
DENVER -- Cutting behavior is closely associated with bingeing and purging in female college students, Wendy D. Hoyt, Ph.D., reported at an international conference of the Academy for Eating Disorders. This finding in a large epidemiologic survey...
Depression Often Occurs before Late-Onset Epilepsy in Elderly: Unexplained Relationship
CHICAGO -- An unexplained link might exist between depression in the elderly and the development of late-onset seizure disorders, Dr. Deirdre P. McLaughlin reported at a meeting of the International Psychogeriatric Association. In a study that examined...
Differences in Efficacy of Drugs for Alzheimer's Emerge at 2-Year Follow-Up: Galantamine, Rivastigmine, Donepezil
CHICAGO -- In the short term, donepezil, rivastigmine, and galantamine appear to be equally effective in treating Alzheimer's disease, a small study has found. But according to unpublished results by the same investigator, differences do emerge...
Dress Rehearsal for Disaster
When the lights suddenly went out in the late afternoon at Lenox Hill Hospital, a 652-bed community hospital in Manhattan's Upper East Side, nobody knew what had happened. By the time the Blackout of 2003 ended for us, more than 24 hours later,...
Duloxetine Appears to Ease Pain of Diabetic Neuropathy: Nondepressed Patients
WAIKOLOA, HAWAII -- Duloxetine, a dual reuptake inhibitor of serotonin and norepinephrine, appears to have an effect on descending pain modulatory systems independent of its effect on mood, as demonstrated by significant pain reduction in diabetic...
Dysmorphic Facial Features May Offer Clues about Variant of Autism: Complex vs. Essential Autism
COLUMBIA, M.O. -- Autistic children with dysmorphic facial features have a different variant of the disorder than do their nondysmorphic peers, Dr. Judith Miles said at a meeting on common pediatric problems sponsored by the University of Missouri-Columbia....
Early Puberty, Ethnicity May Contribute to Teen Smoking: Parental Monitoring Matters
TAMPA, FLA. -- Understanding preadolescent expectations about cigarette smoking may offer opportunities to assist teens in lifetime tobacco avoidance. Youths who smoke typically progress through a sequence of stages, Michiko Otsuki said at a meeting...
For Gender-Variant Children, Validation Is Key: Outreach Program for Parents
What do you tell parents when their young son refuses to act like a "normal" boy? How do you counsel parents who worry about the son who delights in dressing up in his sister's clothes or playing with her Barbie? "Parents are concerned if [the behavior]...
Genetic Advances May Revolutionize Epilepsy Tx: Human Genome Project. (Treatment)
MIAMI BEACH -- The human genome project and rapid advances in technology are leading to the discovery of the genes responsible for epilepsy. The forthcoming knowledge, coupled with anticipated advances in pharmacogenomics in particular, could usher...
Glutaminergics Promising for Cognitive, Negative Symptoms: Amino Acids for Schizophrenia
HARRIMAN, N.Y. -- Glutaminergic agents, for the most part natural substances, show considerable promise for the treatment of persistent cognitive and negative symptoms of schizophrenia, Dr. Daniel Javitt said at a meeting on psychopharmacology sponsored...
Group Therapy Helps in Metastatic Breast Cancer: Feeling Influence Healing
WAIKOLOA, HAWAII -- Supportive-expressive group therapy helps emotionally constrained women with metastatic breast cancer handle their negative feelings, an ability that has been linked to maintenance of normal diurnal cortisol patterns, Dr. David...
Higher-Dose Atypical Regimens Are Becoming More Common: Economic Pressures Distorting Tx. (Treatment)
HARRIMAN, N.Y. -- Substantially high doses of new-generation antipsychotics are being used with increasing frequency in clinical practice, Dr. Norman Sussman said at a meeting on psychopharmacology sponsored by New York University. "We're using...
Hot vs. Cold Aggression: Differences Guide Therapy: Unplanned vs. Premeditated
SAN FRANCISCO -- Differentiating between affectively "hot" and "cold" aggression in youth who have primary disorders of aggression is useful in guiding therapy, Dr. Hans Steiner said at a satellite symposium held in conjunction with the annual meeting...
Hypnosis: Underused Technique
Lots of patients are seeking out medical hypnosis regularly to help them stop smoking, lose weight, sleep better, or function better sexually. They're also interested in hypnosis for other reasons, including pain, phobias, and obsessive thinking. Hypnosis...
Hypnotic May Benefit Sleep, Limit Grogginess: Not Yet FDA Approved
CHICAGO -- An investigational non-benzodiazepine hypnotic seems to be safe and effective for elderly patients with insomnia. In a clinical study, the drug provided deep, sustained sleep and a low level of next-day somnolence, compared with placebo,...
Insulin Resistance Theory Advanced: Tied to Alzheimer's, Depression
CHICAGO -- A new theory linking insulin resistance to depression and the development of Alzheimer's disease could allow clinicians to someday identify patients at risk for dementia and, perhaps, prevent it by treating the insulin dysregulation. ...
Intersubjectivity Seen as Separate from Attachment: Different from Traditional Thought
LOS ANGELES -- Intersubjectivity should be considered a major motivational drive that confers important survival advantages such as sex or the need for attachment, Dr. Daniel Stern said at a conference on attachment theory sponsored by the University...
Keep an Eye on Muscle-Obsessed Male Patients: 'Relatively New Phenomenon'
The male physique has achieved objectification status, and many men are fretting about their pecs and delts the way many women obsess about their butts and thighs. Several recent studies highlight two aspects of the male body image problem: the...
Life Story Presentations
When we think about the presentation of life stories by people who are in treatment, Alcoholics Anonymous usually comes to mind. "Speaker meetings" held by AA allow the speakers to feel that they have given something back to the community. These...
Low-Dose Morphine, Dronabinol Help Dementia: Nursing Home Patients
CHICAGO -- Australian and American dementia patients in some nursing homes are benefiting from some nontraditional pharmacotherapy. In the United States, a synthetic tetrahydrocannabinol (THC) compound called dronabinol has been found effective...
Malpractice Crisis Has Not Yet Hampered Access: Feds Study Nine States
Physician responses to the malpractice crisis have not contributed to widespread health care access problems, a General Accounting Office report has concluded. Instead, actions taken by providers in response to rising premiums have resulted mostly...
Mental Illness at Forefront of General Reform of U.S. Health Care System: Institute of Medicine Report
NEW YORK -- New recommendations for reforming the U.S. health care system are bringing mental health issues to the forefront, Ronald Manderscheid, Ph.D., said at a meeting of the World Association for Psychosocial Rehabilitation. In a follow-up...
Mentally Ill Need Us All
Over the past decade, mental health clinicians and researchers have played an important role in promoting awareness of mental health issues in general health care settings. In response, primary care providers have assumed an ever-increasing level of...
Mind/body Approach May Conquer Infertility: Target Depression
Stopping the downward spiral of emotions associated with infertility can be a key factor to successfully overcoming the condition, according to Alice D. Domar, Ph.D. Research throughout the world during the past 10-15 years has made it clear that...
Multifamily Therapy Holds Promise for Anxiety
ASPEN, COLO. -- Multifamily group therapy is a highly promising intervention for childhood anxiety disorders, Dr. Marianne Z. Wamboldt said at a meeting on stress sponsored by the University of Colorado, Denver. In her pilot study, an 8-week multifamily...
Multiple Suicide Attempters' Risk Profiles Different: These Adolescents Face Far Higher Health Risks Than Do Young Single Attempters
WAIKOLOA, HAWAII -- The 5% of adolescents who report attempting suicide more than once in the course of a year have a health risk profile "staggeringly" different from those who report trying to harm themselves once or not at all, according to a survey...
Newly Diagnosed Epilepsy Responds Well to Topiramate Monotherapy: Higher Dose More Effective
HONOLULU -- Topiramate mono-therapy proved effective in children and adolescents newly diagnosed with epilepsy, Dr. John M. Pellock reported at the annual meeting of the American Academy of Neurology. The study involved 151 children and adolescents...
New Theories Emerge about Predisposition for Alcoholism: Are Dopamine Receptors Protective?
NEW ORLEANS -- Two new theories have emerged about how genetic predisposition for alcoholism works in the brain, on the basis of research presented at the annual meeting of the Society of Nuclear Medicine. Lowered activity in the orbitofrontal cortex,...
New Tool Spots Abuse, Neglect in Teen Addicts: 20-To 45-Minute Interview
ASPEN, COLO. -- A new structured interview demonstrates convincing clinical utility for identification of reportable abuse and neglect in youths with substance abuse and conduct problems, Dr. Thomas J. Crowley said at a meeting on stress sponsored...
Opioids Tied to Male Sexual Problems, Depression: Permanent Damage Possible
PHILADELPHIA -- Men with chronic nonmalignant pain who take long-acting opioids are subject to decreased sexual function and depressed mood, Dr. Harry Daniell reported at the annual meeting of the Endocrine Society. "Long-acting opioids are creating...
Panel Backs Memantine for Moderate, Severe Alzheimer's: FDA Approval Likely This Year
BETHESDA, M D. -- By the end of this year, the first drug to treat moderate to severe Alzheimer's disease could be approved by the Food and Drug Administration. At a meeting of the FDA's peripheral and central nervous system drugs advisory committee,...
Patient Alliance Key in Attachment Therapy: Positive Transference Important
LOS ANGELES -- The challenge in attachment therapy is to form a therapeutic alliance with a patient who finds it difficult to establish trusting relationships, Allan Schore, Ph.D., said at a conference on attachment theory sponsored by the University...
Placing Mentally Ill in Community Units No Panacea: Deinstitutionalization in the Netherlands
CHICAGO -- Housing elderly, long-term mental patients in the community doesn't necessarily mean they will become happy, well-integrated members of that community. Efforts in the Netherlands to deinstitutionalize chronically mentally ill elderly...
Postpsychotic Adjustment May Be Part of Psychosis: PPAS Is a Changing State. (Postpsychotic Adjustment State)
NEW YORK -- A psychotic episode is a traumatic event, and what appears to be a subsequent psychotic episode might actually be a normal part of the emergence from that event, Mary D. Moller said at a meeting of the World Association for Psychosocial...
Pregnant Women Wary of Taking Antidepressants: False Perceptions of Birth Defect Risk
PHILADELPHIA -- In a study of anti-depressant monotherapy use among pregnant women in their first trimester and women planning pregnancies, 95% of the participants believed that antidepressants posed a risk for birth defects and 87% believed the risk...
Probing GABA Reveals Complexity of Disorders: Gamma-Aminobutyric Acid
SAN FRANCISCO -- Drugs that modulate the effect of gamma-aminobutyric acid--a ubiquitous neurotransmitter found mostly in the central nervous system--can help treat a range of psychiatric disorders, Dr. Philip T. Ninan said at the annual meeting of...
Promising TX on Horizon for Opioid Dependence: Lofexidine, Injectable Depot Naltrexone. (Treatment)
SAN FRANCISCO -- New treatments for opioid dependence are in the pipeline in response to a growing addict population--and to the limitations of existing medications, Dr. Herbert D. Kleber said at the annual meeting of the American Psychiatric Association....
Psychoneuroimmunology Shifts Away from Stress-Based Models: Field on the Move
ASPEN, COLO. -- Psychoneuroimmunology has changed drastically since many physicians first encountered the field in medical school, Mark L. Laudenslager, Ph.D., said at a meeting on stress sponsored by the University of Colorado. The dominant theme...
Rivastigmine Switch Well Tolerated: Donepezil Patients
CHICAGO -- Alzheimer's patients who respond poorly to donepezil seem to do well with an immediate switch to rivastigmine, reported Dr. Carl Sadowsky of St. Mary's Neuroscience Center, West Palm Beach, Fla. Switching patients within 24-36 hours after...
School-Age Aggression Increases over Time; Students Become Less Likely to Target Property: Rethinking TOCA-R Scale. (Teacher Observation of Classroom Adaptation-Revised)
WASHINGTON -- School children are more likely to be aggressive toward other students than toward property, and with time, aggression toward property tends to decrease, and interpersonal aggression to increase, Kimberly T. Kendziora, Ph.D., said at...
Screen for Depression in Patients Older Than 85: Underrecognized, Undertreated
CHICAGO -- Depression is underrecognized and undertreated by physicians who care for the oldest old, Dr. Max Stek reported at a meeting of the International Psychogeriatric Association. Depression is poorly studied and poorly understood among elderly...
Sexual Aversion an Issue for Borderline Patients: New Observation. (Borderline Personality Disorder)
SAN FRANCISCO -- Sexual aversion appears to be far more common in patients with borderline personality disorder than has been previously recognized, Mary C. Zanarini, Ed.D., said at the annual meeting of the American Psychiatric Association. This...
Side Effects Guide Antipsychotic Drug Choices: Atypicals vs. Typicals
SAN FRANCISCO -- Atypical antipsychotics may or may not be more effective in treating schizophrenia than their first-generation cousins. That means clinicians choose antipsychotics largely based on side effects and patient preferences. Experts on...
Signs of Autism Show as Early as 6 Months: Study of High-Risk Siblings
TAMPA, FLA. -- Children who are ultimately diagnosed with autism show developmental abnormalities as early as 6 months of age, Rebecca J. Landa, Ph.D., said at a meeting of the Society for Research in Child Development. In the first longitudinal...
Six Key Questions Provide a Quick Screen for Autism: Two Negative Prompt Referral
COLUMBIA, Mo. -- There are 23 questions on the Modified Checklist for Autism in Toddlers, but physicians can use just the 6 key questions to screen quickly for autism, Janet E. Farmer, Ph.D., said at a meeting on common pediatric problems sponsored...
Small Amounts of GHB Can Cause Respiratory Depression or Death: GABA Useful in Dependency Tx. (Gamma-Hydroxybutyrate, Gamma-Aminobutyric Acid, Treatment)
SAN FRANCISCO -- New insights are coming to the fore about illicit drugs, including new "club drugs" and those that have been on the scene for many years. Contrary to public perception about these recreational agents, substantial morbidity and mortality,...
Stress Plays Key Role in Substance Dependence: Core Elements of Success
ASPEN, COLO. -- The psychological therapies of proven efficacy for substance dependence share several key elements, Dr. Thomas J. Crowley said at a meeting on stress sponsored by the University of Colorado. First, they all emphasize that the therapist...
Thyroid Hormone T3 Doesn't Boost Effectiveness of SSRIs: Clash with APA Guidelines. (American Psychiatric Association)
PHILADELPHIA -- The thyroid hormone T3, when taken along with a selective serotonin reuptake inhibitor, provides no extra benefits for patients with major depression, according to a study that was presented at the annual meeting of the Endocrine Society....
Tool May Help Diagnose Personality Disorders: SWAP-200-A to Be Released by Next Spring. (Shedler-Western Assessment Procedure)
ROME -- A new psychiatric assessment tool that is being developed could change the way adolescent personality disorders are diagnosed and classified. The Shedler-Westen Assessment Procedure 200-item Q-sort for Adolescents (SWAP-200-A) to be released...
Tools May Miss Depression in African American Patients: Standard Questionnaires Fall Short
PHILADELPHIA -- Depression may present differently in African Americans than in whites, especially in African American men. This may explain the relatively low rate of diagnosed depression in African Americans, L. DiAnne Bradford, Ph.D., said at...
Treating Bipolar Depression
When it comes to treating bipolar depression, there seems to be consensus on two points: It is responsible for the lion's share of disability in the disorder, and it is exceptionally difficult to treat. Studies have found that more than 60% of people...
Use Caution When Adding Rx to Atypicals: Augmenting Psychotropics Ill Advised. (Another Antipsychotic Drug)
HARRIMAN, N.Y. -- As a general principle, other psychotropics should be combined with an atypical antipsychotic cautiously and only when truly necessary, Dr. Rajiv Tandon said at a meeting on psychopharmacology sponsored by New York University. ...
Zolmitriptan Effective TX for Menstrual Migraine: Significant, Sustained Relief. (Treatment)
CHICAGO -- The first randomized controlled trial to prospectively evaluate the efficacy of a triptan in the acute treatment of true menstrual migraine found that oral zolmitriptan provides significant and sustained relief, said Dr. Michael Tuchman...