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. 7, July

AMA Reassesses Its Priorities amid Woes. (Mental Health Parity Supported)
CHICAGO -- With a reorganization plan on the cutting room floor, the American Medical Association might need to refocus on its priorities in order to boost ailing membership rolls. A special committee charged with reviewing the AMA's structure spent...
Antipsychotic Use Linked to Higher Incidence of Diabetes in the Elderly. (Prescription Database Analyzed)
HONOLULU -- Antipsychotic medication is associated with an increased risk of diabetes in elderly patients, according to Peter D. Feldman, Ph.D., and his colleagues. In a study that used new prescription claims for antihyperglycemic agents as a surrogate...
Antisocial Traits Exert Protective Effect in Bipolar Disorder. (Suicidal Ideation Less Prevalent)
SANTA FE, N.M. -- High levels of aggression and impulsivity are not associated with an increased risk of suicidal ideation in patients with bipolar disorder, Dr. Cheryl A. Chessick reported at the annual conference of the American Association of Suicidology....
Aripiprazole Helps Older Outpatients. (Alzheimer's Disease)
SAN FRANCISCO -- The first study to treat neuropsychiatric symptoms in elderly outpatients with Alzheimer's disease showed that the antipsychotic aripiprazole significantly reduced psychotic symptoms, compared with placebo, Dr. J. Michael Ryan said...
Baseline Cognition Might Explain Racial Disparity. (Ahead Study)
VANCOUVER, B.C. -- Differences in baseline cognitive status may explain why elderly blacks have greater functional decline and worse health outcomes over time than elderly whites, results of a study suggest. But the data do not explain why black...
Bipolar Is Far Worse for Patients Than Unipolar. (Depressive Symptoms Disruptive)
SAN FRANCISCO -- Bipolar disorder is markedly more severe and disruptive than unipolar depression, a national patient survey says. The survey results also showed that the psychosocial burden of depression in bipolar patients is significantly greater...
Can Disease Management Work for Medicare? (Fundamental Changes Needed)
BALTIMORE -- Consider these thoughts: "Neither fee-for-service nor Medicare + Choice is adequately configured to provide services for chronically ill beneficiaries," and "the Medicare data system is set up to pay bills, not to manage care. Are they...
Childhood Weight at Ages 5, 10 Years Predicts Obesity in Adolescence. (Early Interventions)
NEW ORLEANS -- Weight percentile at ages 5 and 10 was significantly correlated with overweight status in adolescence, Dr. Jennifer Singh said at the southern regional meeting of the American Federation for Medical Research. The findings support...
Children of Psychiatrists Speak out about Experiences. (Talk about Work)
SAN FRANCISCO -- If you're wondering how to be a good parent as a psychiatrist, here's a piece of advice: Don't ask your child to help out in the office on a day that you're doing electroconvulsive therapy. The experience of seeing a patient "flailing...
Combo HRT Tied to Dementia in Older Women. (Women's Health Initiative)
The new finding that estrogen plus progestin therapy is associated with an increased risk for probable dementia in older postmenopausal women reinforces the need to limit hormone replacement therapy use to short-term relief of menopausal symptoms in...
Crumbling System Tops APA President's Agenda. (Psychiatrists Called to Advocate)
The challenges facing Dr. Marcia K. Goin as the new president of the American Psychiatric Association came to life on the streets of San Francisco at the group's annual meeting. A homeless man with a history of mental problems knocked the convention's...
Depression May Be a Barrier to Cancer Screening. (Breast Cervical Ca)
VANCOUVER, B.C. -- A high burden of depressive symptoms is an independent predictor of reduced odds of undergoing appropriate screening for breast and cervical cancer, Dr. Paul A. Pirraglia said at the annual meeting of the Society of General Internal...
Depression Tx: New Tools Abound. (Transcranial Magnetic Stimulation)
SAN FRANCISCO -- A mind-numbing slew of acronyms represent a recent boom in brain-stimulating technologies to treat psychiatric and neurologic disorders. Besides the old standby ECT, there's now MST, TMS, VNS, and DBS. The newer modalities may be...
Drug Toxicity Is Often Avoidable in Elderly Patients. (Closer Patient Monitoring Needed)
Many hospital admissions for drug-drug interactions in elderly patients are predictable and avoidable, according to Dr. David N. Juurlink of Sunnybrook and Women's College Health Sciences Centre, Toronto. On the basis of what they called the first...
Evidence Is Not Sufficient to Support Dementia Screening. (Task Force Report)
Dementia among older adults in the United States often goes undiagnosed and may continue to do so in the absence of recommendations for or against screening. The U.S. Preventive Services Task Force, an independent panel of preventive medicine experts...
Factors for Acute Suicide Risk Are Not Widely Recognized. (Overturning Conventional Wisdom)
SANTA FE, N.M. -- Much of the conventional lore about predicting suicide risk might be wrong, Dr. Jan Fawcett asserted at the annual conference of the American Association of Suicidology The suicide literature is dominated by retrospective studies,...
Family Phenotypes Provide Insight into OCD. (DSM-IV Criteria 'Not Refined Enough')
MIAMI BEACH - Symptom clusters in families with complex disorders such as obsessive-compulsive disorder and Tourette's syndrome can reveal the genetics that drive these conditions and their common comorbidities. This kind of approach of looking...
Fewer WBC Checks Urged in Clozapine Cases. (FDA Panel Votes 10-1)
GAITHERSBURG, MD. -- A federal advisory panel has agreed that the frequency of white blood cell monitoring in people on clozapine could be reduced to a once-monthly schedule after a period of biweekly monitoring. By a vote of 10-1, the Food and...
Fink! Still at Large: Wellness and Health. (Opinion)
Over the last two decades, the wellness movement has continued to gain momentum. As a result, patients are not only using alternative medicines and techniques as a substitute for mental health care, they are also splitting the transference between...
Gene Is Identified That Causes Bipolar in Some: Finding Is 'A Double, Not a Home Run'. (Families of Northern European Descent)
A research team at the University of California, San Diego, has identified a single mutation in a single gene that might play a key role in as much as 10% of bipolar disorder. The gene, G protein receptor kinase 3 (GRK3), controls a homeostatic...
Genetics Will Guide Prescribing for Hypertension. (Genotype Predicts Response)
WASHINGTON -- Advances in pharmacogenomics will help physicians "use genetic information rather than a person's skin color" when make certain prescribing decisions, Julie A. Johnson, Pharm.D., predicted at the annual meeting of the American Society...
Heart Risk Factors Hurt Depression Tx. (Another Puzzle Piece)
SAN FRANCISCO -- The total burden of cardiovascular risk factors in a patient with major depressive disorder is an independent predictor of lack of response to antidepressant therapy with fluoxetine, Dr. Dan V Iosifescu reported at the annual meeting...
High Court Ruling on Forced Meds Garners Praise: Strict Limits Placed on When the Mentally Ill Can Be Medicated against Their Will. (APA's Stance Prevails)
Mental health clinicians are praising the U.S. Supreme Court ruling that mentally ill defendants may be forcibly medicated to make them competent to stand trial--but only after prosecutors have met strict requirements. The justices overturned a...
Hispanics Less Forthcoming about Use of Antidepressants. (Probe Patients Further)
WASHINGTON -- Hispanic ethnicity may influence communication between physicians and patients, possibly affecting adherence to pharmacologic treatment, Betsy Sleath, Ph.D., said at the annual meeting of the American Society for Clinical Pharmacology...
How to Handle Difficult Patient Conversations. (Preparation)
Los ANGELES -- If you're having a difficult conversation with a patient and someone is interfering, don't hesitate to remove that person from the room, even if that "someone" is a small child, Dr. Martha Bernadett advised at the annual meeting of the...
Intervention Helped Educate Doctors about Drug Costs. (Prescribing Decisions)
An intervention aimed at educating physicians about drug costs led to modest improvements in their awareness of the financial burden of medications on their patients, Dr. Ethan A. Hahn of Mount Sinai School of Medicine, New York, and his colleagues...
Is Rapid Opiate Detox a Cure? (Guest Editorial)
For patients addicted to opiates, detoxification and withdrawal can be highly unpleasant experiences. During my years in addiction medicine, I've watched many detoxification schemes wax and wane in popularity. At first, we let patients detox on...
Ketamine: A Therapeutic Agent and an Addictive Party Drug. (Potential for Use, Abuse)
RANCHO MIRAGE, CALIF. -- It's taken on the sly at rave parties, but it's administered as an anesthetic in emergency rooms and veterinary offices. Occasionally used by psychotherapists to aid in anaclitic "rebirthing" therapy ketamine is also addictive...
Letters
Belief or Hallucination? In his guest editorial, Dr. Ansar Haroun did not reveal even the most elementary anamnestic data about the defendant he examined ("Delusions of Psychiatrists," April 2003, P. 14). This deficiency makes it difficult for...
Long-Acting, Injectable Risperidone on Horizon. (Approval Expected This Year)
SAN FRANCISCO -- The first long-acting, injectable atypical antipsychotic medication is likely to win approval before the end of the year, but U.S. clinicians will have to overcome their aversion to injectable antipsychotics to take advantage of it....
Malpractice and Suicide: What the Plaintiffs Must Prove to Win. (Know the Four D's)
CRYSTAL CITY, VA. - Psychiatrists aren't expected to predict the future, but they are expected to assess, identify, and evaluate their patients' potential risk for suicidal behaviors. "You are also expected to put reasonable treatment plans or interventions...
Many Issues Converge in Teenage Pregnancy. (beyond Abstinence Promotion)
NEW YORK -- A grasp of the psychological matrix of teenage pregnancy is essential in addressing the continuing problem. Prevention efforts should include compassionate support as well as broader sex education, Dr. Marilyn Benoit said at the annual...
Medical Causes Behind 55% of Bankruptcies. (Mental Illness Accounts for 11%)
VANCOUVER, B.C. -- More than 1 million American adults each year face bankruptcy because of medical issues, according to estimates based on a new survey. Among all debtors filing for bankruptcy, 55% of those surveyed cited one or more medical causes...
Medicare Officials Defend Local Coverage Decisions. ('Inequities and Inefficiencies')
BALTIMORE -- Federal agencies disagree about whether Medicare should continue to have two types of coverage policies: local coverage decisions that affect only a certain geographic area, and national coverage decisions that affect beneficiaries nationwide....
Medication Overuse Headache Might Be Culprit. (Migraines 'Transform')
SAN DIEGO -- Make sure to rule out medication overuse headache before prescribing prophylactic agents in patients with suspected migraines, Dr. Barbara Scherokman advised at the annual meeting of the American College of Physicians. Medication overuse...
Modafinil Treats Core Symptoms of ADHD. (Children Aged 6-13)
SAN FRANCISCO - The novel wake-promoting agent modafinil improves the core symptoms of attention-deficit hyperactivity disorder in children both at school and home, according to two randomized, double-blind clinical trials presented at the annual meeting...
Monkeypox Signals Threat of Emerging Infections. (U.S. Officials on Edge)
Like severe acute respiratory syndrome and West Nile virus before it, the monkeypox virus outbreak in the upper Midwest offered more evidence that emerging infectious diseases no longer respect national, or even continental, boundaries. Monkeypox...
Mood Stabilizers Treat Impulsivity in Cluster B Disorders. (Affective Instability Also Improves)
SAN FRANCISCO -- Mood stabilizing drugs effectively target the impulsivity that constitutes a core symptom domain common to a wide range of personality disorders and impulse-control disorders, Dr. Eric Hollander said at a satellite symposium held with...
MRI Reveals Cerebral Atrophy in Type 1 Diabetic Patients. (Accelerated Aging)
HONOLULU -- An MRI study of young, otherwise healthy individuals with type 1 diabetes has revealed significant cerebral atrophy that may underlie cognitive deficits, Dr. Richard K.T. Chan reported at the annual meeting of the American Academy of Neurology....
New HIV Cases on Rise among Those under 25. (Open Approach to TX Is Crucial)
MIAMI -- More than half of all new HIV infections in the United States now occur in those under age 25 years, so strategies to retain adolescents in health care are crucial, two experts said at a meeting sponsored by the American Foundation for AIDS...
Oxycodone Deaths Tied to Drug Abusers, Not Patients. (Polypharmacy Prevalent)
NEW ORLEANS -- The vast majority of deaths reported in association with the use of oxycodone were related to drug abuse and not patient use, according to a study conducted by Purdue Pharma L.P. The study, conducted in response to intense media attention...
Parental Separation Does Not Increase Risk of Drug Abuse. (Relationship with Parents More Important)
SEATTLE. -- The relationship a male adolescent has with his parents is more important in determining the likelihood that he will use drugs than whether he lives in an intact family; Dr. J.C. Suris said at the annual meeting of the Society for Adolescent...
Paroxetine May Increase Suicide Risk in Children. (Safety Data Pending)
Paroxetine should not be used to treat depression in children or adolescents with major depressive disorder, according to the Food and Drug Administration. Paroxetine (Paxil) has not been shown to be effective for the treatment of depression in...
Phototherapy Is Beneficial for Mood Disorders. (Systematic Evidence Review)
SAN FRANCISCO -- Phototherapy is beneficial as primary therapy for seasonal affective disorder and other types of depression, according to a systematic evidence review conducted by the American Psychiatric Association Committee on Research on Psychiatric...
Physician Retirees Find It Costly to Volunteer. (Roadblocks to Care)
Retired physicians across the country are discovering that it can get expensive to volunteer their services at a free clinic. Dr. Martin Gonzalez, a retired physician in Oak Park, Ill., was turned away from a homeless shelter after he offered his...
Postpartum Depression Hurts Kids. (Boys More Adversely Affected Than Girls)
SAN FRANCISCO -- Postpartum depression is the most common illness in the postpartum period yet the least commonly recognized and treated, Dr. Shaila Misri reported at a satellite symposium held with the annual meeting of the American Psychiatric Association....
Practical Psychopharmacology: Diverse Strategies Helpful in Pathological Gambiling. (Psychopharmacology)
When the call to "place your bets" proves irresistible, the result can be financial catastrophe, family disintegration, and even suicide. A persistent and recurrent maladaptive pattern of behavior severe enough to meet DSM-IV criteria for pathological...
Prenatal Cocaine Exposure Has Influence on IQ. (Special Education Needed)
SEATTLE -- At age 7, children prenatally exposed to cocaine are 1.5 times more likely to require special education services compared with children not exposed to cocaine, results from a large study suggest. These effects remained significant even...
Prenatal Exposure to Marijuana Is Tied to Hearing Problems. (Cigarette Smoke Different)
SEATTLE -- Children prenatally exposed to marijuana are two times more likely than unexposed children to fail a standard hearing test by age 7, Dr. Beth Nordstrom said at the annual meeting of the Pediatric Academic Societies. In addition, children...
Psychiatrists Unprepared for Genetic Counseling. (Need for Knowledge Is Great)
SAN FRANCISCO -- Psychiatrists performed poorly in a quiz of their genetic knowledge, and most of them said they do not feel prepared to discuss genetic information about psychiatric illness, according to a survey of 352 psychiatrists. Although...
Quetiapine Promising for Developmental Disorders. (Children and Teens)
SAN FRANCISCO -- Moderate- to high-dose quetiapine shows potential utility and good tolerability in the treatment of children and adolescents with developmental disorders, Dr. Antonio Y. Hardan reported at the annual meeting of 'the American Psychiatric...
Responding to Disasters. (Guest Editorial)
Psychiatrists are in a position to make unique contributions during the community's response to disaster. First, we are already practiced in tolerating and conceptualizing uncertainty boundary confusion, and extremely ambivalent feelings. Second, we...
Rhythm Therapy Can Stabilize Bipolar Patients. (Encourage Gradual Lifestyle Changes)
PITTSBURGH -- Taking steps as simple as going to bed and waking up at consistent times each day helps some bipolar patients maintain mood stability, especially in the face of psychosocial stress. Ellen Frank, Ph.D., described interpersonal and social...
Risk Factors Flag 12-Step Program Dropouts. (Those Using Drugs after 1 Year Vulnerable)
SAN FRANCISCO -- For the first time, a study has identified which substance-abusing patients may be more likely to drop out of 12-step self-help groups and ways that clinicians can help them stick with the programs. Plenty of data support a better...
Should Rapid HIV Testing Be Available over the Counter? (Pro & Con)
YES If the goal of medicine is patient empowerment, why not allow patients the opportunity to go to a pharmacy buy a rapid HIV test, and test themselves in the privacy of their own homes? The link to medical care in our current system of HIV...
Surgeon General's Report Helped to Energize Suicidology. (National Prevention Programs Now Exist)
SANTA FE, N.M. -- Suicidologists are basking in the realization that their field has entered an unprecedented golden age. "The last 5 years have been the most exciting time in history to be involved in suicidology," Alan L. Berman, Ph.D., executive...
The Hours. (Reel Life)
Virginia Woo 's novel "Mrs. Dalloway" is enjoying newfound popularity, and the credit belongs to producer Scott Rudin's splendid film "The Hours." Rudin achieved this remarkable success by mixing some of the best of British theater talent and three...
Three Simple Questions Identify Migraine. (Few Sufferers Get Diagnosis)
HONOLULU - A positive response on two out of three questions provides a simple yet powerful way to identify migraine headaches, Dr. David W. Dodick reported at the annual meeting of the American Academy of Neurology. A positive response on any two...
Treat Male Sexual Dysfunction Comprehensively. (Look at Smoking, Illicit Drug Use)
SAN DIEGO -- Male sexual dysfunction is a couple's problem, often replete with emotional undercurrents and medical components, and as such, usually deserves a comprehensive evaluation rather than just a prescription for the little blue pill. That's...
TX Noncompliance, Depression Intertwined. (Chronic Disease Patients)
SAN FRANCISCO -- Psoriasis and lupus patients who swear they're taking their medication may not be, according to two studies on compliance presented at the annual meeting of the American Academy of Dermatology. Dr. Mark Goodfield and Dr. Sameh S....
Wait 6-8 Weeks before Switching Antipsychotics. (Don't Give Up Too Soon)
SAN FRANCISCO -- Psychiatrists need to be a little more patient when treating first episodes or acute exacerbations of schizophrenia, Dr. Ira D. Glick said. Too many clinicians give up on an antipsychotic too soon and switch medications before 6-8...
Weight-Loss Programs May Benefit Schizophrenics. (Patients Who Are on Antipsychotics)
SAN FRANCISCO -- Schizophrenic patients lost weight during the course of two small, nonrandomized studies of weight-loss programs for patients on atypical antipsychotics, agents that tend to cause weight gain. The results of these studies suggest...
Western U.S. Is Next Frontier for West Nile Virus. (Summer Forecast)
West Nile virus may march westward during the summer of 2003, promulgating disease in record numbers in the Great Plains, the West, and Alaska, two Harvard University investigators predict. In the meantime, physicians are urged to stay alert to...
We've Got to Work Together. (Guest Editorial)
Screening effectively for depression, particularly older patients, requires a gentle and sensitive approach. I use several tools and strategies that vary depending on the patient. When asking patients how they feel, I use words that I know they'll...
When Is Suicide Not Suicide? (Guest Editorial)
It's time to stop using two widely quoted statistics about suicide. One holds that 15% of all depressed patients die by suicide. The other states that 5% of patients on dialysis kill themselves. These misleading figures are based on outdated notions...
Whites More Likely to Get Narcotics for Pain. (Insurance Status, Age Also Factors)
VANCOUVER, B.C. -- White patients with chronic nonmalignant pain are more likely to receive narcotics than black ones, even though black patients have significantly higher average pain scores, Dr. Mark E. Pasanen reported at the annual meeting of the...