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. 33, No. 6, June

A 5-Year-Old in Handcuffs?
The handcuffing of an unruly 5-year-old girl at her school in Florida a few weeks ago gave many parties a chance to grind a favorite ax. By condemning the action, the police, the school, the teachers, the child, the mother, political posturing,...
Abuse of Dextromethorphan Is 'Rampant' among Teens
INCLINE VILLAGE, NEV. -- A 14-year-old intoxicated and confused girl is brought into the emergency department by her parents. She has nystagmus and is extremely ataxic. One of her friends reports that she may have taken some "skittles." What are...
Abuse Reported by 11% of Postmenopausal Women: Study Finds That Verbal Abuse Has Greater Impact on Health and Mental Health Than Physical Abuse
NEW ORLEANS -- Slightly more than 11% of almost 92,000 postmenopausal women reported they had been verbally and/or physically abused in the previous year by a family member or close friend, an incidence much higher than expected, Charles P. Mouton,...
Addiction to Cybersex Called Pervasive
COLORADO SPRINGS -- Children--and middle school-aged boys in particular--are becoming addicted to sex on the Internet in numbers that would startle most clinicians and parents, Ann Freeman said at a symposium on addictive disorders sponsored by Psychotherapy...
Adult ADHD: Drug Choice Includes Timing Issues
Attention-deficit hyperactivity disorder is not rare in adults. "Recent data suggest 4%-5% prevalence, but the number diagnosed is far below that. It's massively underrecognized," said Timothy E. Wilens, M.D., of Harvard Medical School and Massachusetts...
All in the Family Business
The family business is the perfect venue for psychiatry. It is the ultimate merger of self, family, and work life. About 90% of the businesses in America are essentially family businesses, ranging from large clothing makers like Levi Strauss and...
All Work and No Play? No Way!
A few years ago, Jerry Rogoff, M.D., became so engrossed in a woodworking project that he lost track of time. An intercom system links his Vermont home to a workshop on the property. At some point in the day, his wife's voice resonated over the...
Antipsychotic-Associated Weight Gain
The Problem You have a patient with schizoaffective disorder who is stabilized with olanzapine (Zyprexa). Although the patient has gained considerable weight since the initiation of olanzapine, his psychiatric condition is now stable and he does...
Antipsychotics' Effects Differ in Substance Abusers: Activation of Cytochrome P-450 System by Cigarette Smoke Appears to Play a Role in Drug Metabolism
SAN JUAN, P.R. -- Risperidone and ziprasidone increased adherence to inpatient substance abuse treatment for people with schizophrenia or schizoaffective disorder in a comparison that also included olanzapine and typical neuroleptic agents. Elizabeth...
Baby Boomers with Chronic Conditions May Overwhelm System
SAN FRANCISCO -- The baby boomers might do more than bankrupt Medicare--they could break the entire medical system, members of a panel said at the annual meeting of the American College of Physicians. With 76 million baby boomers starting to approach...
Buprenorphine Combo Aids Detoxification
NEW YORK -- Buprenorphine, particularly in combination with naloxone, offers a safe and effective approach to the office-based management of opiate addiction, Walter Ling, M.D., said at the annual conference of the Association for Research in Nervous...
Calif. Implements Psychologist Admitting Privileges
California psychiatrists are wondering whether prescribing will be next, now that newly issued state regulations allow psychologists in the state to have admitting privileges for psychiatric patients. "This would be a prelude to that, if you want...
CATIE-AD Data Presented: Conclusions to Come; Investigators Are Comparing Drug Treatments for Psychosis and Agitation in Alzheimer's Patients
SAN DIEGO -- Phase I results from the Clinical Antipsychotic Trial of International Effectiveness-Alzheimer's Disease (CATIE-AD) unveiled for the first time at the annual meeting of the American Association for Geriatric Psychiatry are so new that...
CBT Helps Patients Regain Lives, despite Pain: Opioid Therapy Offers Only Partial Relief, and Even Surgery Often Fails to Alleviate Symptoms
PALM SPRINGS, CALIF. -- Physicians who doubt that chronic pain patients need and deserve cognitive-behavioral therapy as an adjunct to other treatments need to take an honest look at how well modern medicine treats pain. Dennis C. Turk, Ph.D., said...
Cognitive Deficits Can Persist after Brain Injury
BAL HARBOUR, FLA. -- The cognitive impairment seen in some older adults following mild to moderate traumatic brain injury may persist for up to 2 years, according to preliminary results of a longitudinal study. Previous studies on cognitive impairment...
Combined Approach Boosts Medication Compliance
SAN JUAN, P.R. -- Patients who are struggling with medication compliance for alcohol dependence may benefit from a clinical intervention that combines medical management and brief counseling sessions, Helen M. Pettinati, Ph.D., said at the annual meeting...
Comorbid Conditions Need Integrated Treatment
MONTREAL -- Comorbid eating disorders and substance abuse are intertwined behaviorally and biologically, so the treatment of both problems must be an integrated effort, Cynthia M. Bulik, Ph.D., said at an international conference sponsored by the Academy...
'Cutting' Wounds May Be More Than Skin Deep: The Behavior May Be an Attempt by a Severely Disconnected, Depressed Teen to Gain Focus and Control
Self-injurious behavior in the form of "cutting" may not be as rare as child psychiatrists once believed, nor is it always a red flag for imminent suicide. Instead, it may be an attempt by a severely disconnected, depressed teenager to gain focus...
Details Matter in Shared Care Cases
TUCSON, ARIZ. -- In the legal arena, adherence by psychiatrists to the highest ethical standards can become virtually meaningless without detailed documentation, Barry Morenz, M.D., said at a psychopharmacology conference sponsored by the University...
Doctors Stand to Recoup Losses from Insurers
Physicians frustrated with seemingly arbitrarily denied claims will have their day in court later this year with at least six insurers, thanks to a recent Supreme Court decision to deny the plans' appeal of a class action suit. But settlements related...
Exercise Boosts Mental Health in Osteoporosis
BOSTON -- A program of regular, low-impact exercise can improve mood and executive functioning in older adults with osteoporosis, according to research in a poster presentation at the annual meeting of the Society of Behavioral Medicine. Of 16 elderly...
Family History of CHD, Stroke Strongly Tied to Future Risk
GRAPEVINE, TEX. -- A strong family history of heart disease can increase an individual's future risk for coronary heart disease fourfold, and even a moderate family history can lead to a twofold increase in risk, a population-based study has shown....
FDA Seeking Suicidality Data on 14 Anticonvulsants
The Food and Drug Administration has asked 10 manufacturers of 14 anticonvulsants to submit data on the drugs' potential to spur suicidal thoughts or acts in users. The request was almost identical to the one the agency sent last year to makers...
For Conduct Disorder, It's Nature and Nurture: Any Search for Genetic Risk Factors in Psychiatric Illnesses Must Consider Environmental Exposures
ASPEN, COLO. -- A large twin registry study has replicated the findings of an earlier landmark New Zealand study showing that polymorphisms of the monoamine oxidase A gene modify the risk of antisocial behavior in boys exposed to familial adversity,...
Genetic Psychiatric Disorders Cited in Fetal Alcohol Effects Patients
GRAPEVINE, TEX. -- The behavioral and cognitive defects in children with fetal alcohol effects may be partly attributable to genetic psychiatric disorders, researchers reported in a poster presentation at a meeting sponsored by the American College...
Genetic Variant Increases Risk of Late-Onset Alzheimer's
Strategies for the prevention and treatment of late-onset Alzheimer's disease may be improved by the identification of a gene variant that seems to increase Alzheimer's disease, according to a report by Lars Bertram, M.D., of MassGeneral Institute...
Guidelines for Nonoccupational HIV Prophylaxis
For the first time, the federal government has issued guidelines on attempting to avoid HIV infection after accidental exposure to the virus outside of the health care workplace. The Centers for Disease Control and Prevention issued guidelines call...
HIV Fight Needs Focus on Behavior
Preventive interventions in the now decades-old war against HIV infection seem to be plagued by a Sisyphean fate: Just when declining seropositivity rates in some populations suggest that the prevention message is making headway, the virus gains new...
Hospitalists Are Finalizing Core Curriculum
CHICAGO -- The Society of Hospital Medicine has taken a major step toward defining the core content areas and competencies for practicing hospitalists. Members of SHM got their first glimpse of a draft document at the society's annual meeting. Authors...
How to Run an Effective Meeting
"What do you discuss at office meetings?" a colleague wrote me recently. "We used to hold them monthly, and I never thought we accomplished anything. So now we don't bother anymore." It's a comment I hear fairly often. Doctors and employees alike...
Imaging Important for Secondary Headache Dx: Pathologic Organic Processes Account for Up to 16% of Emergency Visits Attributable to Headaches
ORLANDO, FLA. -- Neuroimaging is key to diagnosing relatively rare secondary headaches, one expert said at the annual meeting of the American Society of Neuroimaging. "Secondary headaches are where neuroimaging is of paramount importance," said...
Impaired Graphesthesia May Signal Early AD
BAL HARBOUR, FLA. -- Impaired graphesthesia, a prevalent finding among patients with mild cognitive impairment, may be an early sign when considered with memory loss that a patient has preclinical Alzheimer's disease, according to a study. Mild...
Improved Sleep Quality Could Aid Recovery from Alcohol Dependence
WASHINGTON -- If sleep disturbance can be managed, patients in the early stages of treatment for alcoholism may be less likely to relapse, said Peter D. Friedmann, M.D. A growing literature suggests that the sleep abnormalities that accompany both...
In Primary Care, One Question Could Reveal Alcohol Abuse
As many as one-fourth of patients in primary care settings could be engaging in hazardous or harmful drinking, and discerning that through careful screening--especially in trauma cases--can lead to better care and more accurate flagging of those who...
In Small Trial, Donepezil Safe and Effective for African Americans
SAN DIEGO -- Donepezil is safe and effective in African Americans with mild to moderate Alzheimer's disease, a 12-week open-label study demonstrated. The finding is important because African Americans are underrepresented in clinical trials even...
Insurance Woes Common for Patients with Diabetes
WASHINGTON -- Sixty-year-old Janice Ramsey used to have something in common with other Deltona, Fla., residents--she was a small business owner who had health insurance. But 7 years ago, all that changed. Ms. Ramsey's problems started when she switched...
Lamotrigine Use Rising for Bipolar Depression
SAN DIEGO -- Since lamotrigine gained approval as maintenance therapy for bipolar disorder, more physicians are using it off label as an acute treatment of bipolar depression, said Andrew J. Cutler, M.D. A show of hands at a psychopharmacology congress...
Light TX May Surpass Melatonin
SAN DIEGO -- Melatonin supplements may be popular to shift circadian rhythms. but bright-light therapy is more effective, Milton Erman, M.D., said at a psychopharmacology congress sponsored by the Neuroscience Education Institute. People with sleep...
Movement Therapy May Help Parents of Autistic Children
WASHINGTON -- Parents whose autistic children turn their lives upside down might turn to a movement therapist for help. Understanding children's nonverbal expressions can be a springboard for managing their tantrums and improving their socialization,...
MRI Opens Thrombolysis Window after Stroke
NEW ORLEANS -- The presence of a favorable pattern of cerebral perfusion on magnetic resonance imaging may tell physicians which patients with acute ischemic stroke stand to benefit from thrombolysis even hours after the onset of symptoms. Findings...
New Food Pyramid Is Drawing Mixed Reviews
While experts are applauding the inclusion of exercise in the nation's revamped food guide pyramid, they also question the value of a national dietary icon that lacks details and requires the use of a computer to interpret. The new "My Pyramid"...
New Suicide Data Highlight Toxicity of Depression: One-Third of Victims Had Current Diagnosis
BROOMFIELD, COLO. -- Forty percent of completed suicides had been diagnosed with a current mental health problem at the time of their deaths, according to the first wave of data from the new National Violent Death Reporting System. Most of those...
Onset of Hallucinations Varies between Dementia Types
MIAMI BEACH -- Onset time of visual hallucinations can help clinicians distinguish between dementia with Lewy bodies and Alzheimer's disease, according to a study presented at the annual meeting of the American Academy of Neurology. Patients with...
Oral Contraceptives Not Tied to Depression
LOS ANGELES -- Oral contraceptive pills do not cause mood swings or depression in most adolescents. On the contrary, overall, it appears that oral contraceptives increase positive mood and decrease negative mood, Mary A. Ott, M.D., said at the annual...
Panic Symptoms Common in Diabetes Patients
VANCOUVER, B. C. -- Panic symptoms affect many patients with diabetes and are linked to depression and diabetes-related disability, Evette Ludman, Ph.D., and her associates reported in a poster presentation at the annual meeting of the American Psychosomatic...
Part D Benefit May Facilitate Formulary Appeals
WASHINGTON -- Patients may find it easier to appeal denials of payment for medications under Medicare's new Part D prescription drug benefit than they do under other health programs, an analyst said during a meeting of the Medicare Payment Advisory...
Pay for Performance: The Right Ingredients
WASHINGTON -- Mix a little money with solid incentives physicians can relate to, and you've got a successful recipe for a pay-for-performance program, Ronald P. Bangasser, M.D., said at the annual National Managed Health Care Congress. Physicians...
Perspective
Simple is a recipe, complicated is building a rocket, and complex is crafting prevention messages relevant to a society as diverse as the United States. With respect to HIV prevention messages and interventions, heterosexual messages may look very...
Prescribing Models Shape Personality Disorder Tx: One Approach to Prescribing Medication Is to Use the Axis I Disorder Most Closely Related as a Guide
ATLANTA -- Clinicians often must rely on empirical data to guide psychopharmacologic treatment in patients with personality disorders, since few clinical trials have examined the efficacy of these medications in the context of Axis II disorders. ...
Primary Care Falling Short in Treating Depression
SAN DIEGO -- Results from two studies presented during poster sessions at the annual meeting of the American Association for Geriatric Psychiatry paint a bleak picture of how primary care physicians are treating late-life depression. Even though...
Psychiatric Disorder Rate High among Regular Opioid Users
VANCOUVER, B. C. -- Psychiatric disorders are common among people taking opioid medications, Mark D. Sullivan, M.D., reported at the annual meeting of the American Psychosomatic Society. Data from the first population-based investigation of psychiatric...
Psychiatry and Medicine Working Together
A recent column I read in CLINICAL PSYCHIATRY NEWS ("Bouncing Back From Serious Illness." April 2005, p. 98) took me back to therapy groups I ran for cancer patients in the 1970s with Dr. Edward Amorosi, a hematologist/oncologist at New York University...
Recent Declining Suicide Rates Not Tied to Antidepressant Use
BROOMFIELD, COLO. -- The steep rise in antidepressant prescribing over the last several decades and the temporally associated decline in suicide rates in many Western countries are not causally related, Annette Erlangsen, Ph.D., said at the annual...
Recommendations Offered on Curbing Medical School Debt
U.S. medical schools need to improve their tuition- and fee-setting processes to help students pay off their debts, the Association of American Medical Colleges concluded in a new study. The future affordability of a U.S. medical education may be...
Risk Reduction Helps Tame Teen Gambling: Adolescents with Pathological Gambling Problems May Have Comorbid Psychiatric Conditions
HOUSTON -- Relatively few adolescents develop a serious problem with gambling, so the issue may be one of "harm reduction" rather than the treatment of an addiction, said Gagan Dhaliwal, M.D., at the annual meeting of the American Society for Adolescent...
School Policies Turn Pranks into Sex Offenses
COLORADO SPRINGS -- Overidentification of adolescents as sex offenders is a growing problem in a time of public clamor for get-tough policies on crime. Paul M. Isenstadt said at a symposium on addiction disorders sponsored by Psychotherapy Associates....
Sexual Abuse Accusations Color Custody Battles: Consider Child's Age, Physical or Mental Disabilities, Feelings of Alienation When Evaluating Allegations
HOUSTON -- Sexual abuse allegations in a child custody case are not always true, and even professionals who work with these children can have trouble distinguishing fact from fantasy in the children's stories, Joseph Kenan, M.D., said at the annual...
Somatization Scores May Predict Success of Outpatient TX for Headache
BOSTON -- A test measuring somatization can predict which patients with chronic headaches will benefit from outpatient care and which ones won't--and will instead require intensive inpatient therapy, according to a new study. The next step is to...
Soothing the Anxious Patient: Calculated Combinations
Issue Medication combination is often necessary to achieve optimal anxiety control. Actions Combining medications with different mechanisms of action can be synergistic. Benefits Understanding the mechanisms of action of medication classes can...
Standards for Bariatric Procedures under Review
The rush to offer bariatric surgery to the growing number of obese Americans has resulted in a proliferation of procedures performed, sometimes without the necessary experience to manage those high-risk patients. It's unclear if more deaths or complications...
Strive for Confidentiality in Talks about Drugs
SCOTTSDALE, ARIZ. -- Physicians need to talk seriously with adolescents about raves, the drug scene, family, and school to detect dangerous problems, an Arizona pediatrician advised physicians attending a pediatric update sponsored by Phoenix Children's...
Success of EHR System Hinges on Planning
BOSTON -- To successfully implement an electronic health record system, set clear and specific goals and involve your clinical and administrative staff in all of the planning. Jerome H. Carter, M.D., said at a congress sponsored by the American Medical...
Suicide Way Down among Elderly, but Not All News Is Good
BROOMFIELD, COLO. -- The suicide rate among elderly Americans is dramatically lower today than at any time in at least the last 75 years, John L. McIntosh, Ph.D., said at the annual conference of the American Association of Suicidology. That's the...
The Art of Linda Hoard
Some of Linda Hoard's work can be described as "photorealistic"--which means it so closely resembles photographs that it appears not to have been created by brushstrokes. Upon close inspection, however, it looks as if the colors in her work are more...
The Soul of a Pedophile
Given the repugnance of pedophilia, feature films on this theme have appeared with surprising frequency. From Fritz Lang's 1931 film, "M," starring Peter Lorre as a homicidal pederast, to Pedro Almodovar's recent film, "Bad Education," about priestly...
Think Aspirin for Intracranial Arterial Stenosis
High-dose aspirin is just as effective as warfarin in treating intracranial arterial stenosis, and appears much safer, with significantly lower rates of death, myocardial infarction, and major hemorrhage over 2 years, Marc Chimowitz, M.B., and colleagues...
Toxicology Shows Antidepressants Present in 21% of Suicide Completers
BROOMFIELD, COLO. -- Eleven percent of 123 youth suicide completers and 21% of 2,674 adults who died by suicide tested positive for the presence of an antidepressant in a comprehensive multistate study, Catherine Barber said at the annual conference...
Trajectory of Adolescent Substance Abuse Can Begin as Early as Preschool
ASPEN, COLO. -- Surveys consistently show that 90% of all youths have experimented with drugs and alcohol by the time they finish high school. Yet only a minority develop substance abuse problems, Paula D. Riggs, M.D., said at a psychiatry conference...
Use Factors Besides Efficacy to Guide Neuropathic Pain TX
SAN DIEGO -- Medications for chronic neuropathic pain share similar efficacy, so choose therapy based on safety, tolerability, and ease of use, according to Scott M. Fishman, M.D. "Each drug that we use has been studied in one or two different neuropathic...
Violence in U.S. Families Is a Serious Public Health Problem
ORLANDO, FLA. -- With millions of Americans suffering from partner violence, child abuse, and elder abuse, physicians should watch for signs and symptoms of battering, ask patients whether they are victims, and intervene when appropriate, Cathy L....
Why Do Kids Kill?
An altercation between a 13-year-old pitcher and a 15-year-old spectator that escalated into murder with a baseball bat recently rocked the California community of Palmdale. The younger boy's team had just lost its first game of the season. What are...