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. 10, October

Access 'Critical' for Hispanic Patients
JoEllen Brainin-Rodriguez, M.D., speaks Spanish fluently, yet even she frequently faces language barriers when trying to help her Spanish-speaking psychiatric patients. One problem is the dearth of Spanish-speaking psychiatrists, nurses, psychologists,...
Act Now to Protect Clinical, Business Records: Gulf Coast Flooding Points to Value of Storing Administrative, Scheduling Information Off-Site
The recent Gulf Coast disaster may be a wake-up call for all physicians to establish some kind of emergency backup system for their businesses. "Physicians don't always think of themselves as running a business, but they're going to think of it...
Adult ADHD Prescribing Way Up; Many Still Undiagnosed
The number of young adults, aged 20-44 years, receiving prescriptions for adult attention-deficit hyperactivity disorder has more than doubled in just 4 years, according to an analysis by Medco Health Solutions Inc. And the increase in prescriptions...
Agitation in the City of Angels
Like the torrid Santa Ana winds that often blow west from the desert across the Los Angeles basin, the complex, incendiary film "Crash"--the mother of all web-of-coincidence films and far more intricately constructed than most--sears viewers with its...
Alcohol Dependence Risk High in Bipolar II Patients
PITTSBURGH -- Patients with bipolar II disorder are at high risk for alcohol abuse and dependence, based on findings from a 20-year, longitudinal study with about 600 subjects. The findings also suggest that bipolar II disorder can be more broadly...
Alcohol Dependency: Any Treatment Helps
SANTA BARBARA, CALIF. -- People who receive any form of treatment to help them with alcohol dependency are twice as likely to recover as are those who receive no treatment. However, recovery prompted by treatment is often a slow process, and may...
Alcohol Exposure in Third Trimester May Affect Children's Higher Order Functions
SANTA BARBARA, CALIF. -- Prenatal alcohol exposure is most likely to affect children's attention problems when it occurs during the third trimester, a prospective study of 492 children determined. There is a high degree of correlation between teacher-...
Anger Management Program Works Well in the Workplace
BOSTON -- A worksite-based stress and anger management program may improve the cardiovascular health of at-risk employees, Lynn Clemow, Ph.D., said in a poster presentation at the annual meeting of the Society of Behavioral Medicine. Preliminary...
Antidepressants Better Than Benzos for GAD Long Term
SANTA FE, N.M. -- Benzodiazepines work faster than antidepressants and are prescribed more often for generalized anxiety disorder, but that doesn't make them the better choice, Alan J. Gelenberg, M.D., said at a psychiatric symposium sponsored by the...
Anxiety in Bipolar Disorder: Data on Cotreatment Are Lacking, but Anecdotally, Antimanics and Antipsychotics Have Proven Useful
Until recently, discussions of bipolar comorbidity centered on substance abuse. It is now recognized, however, that anxiety is at least as prevalent in bipolar patients and has a substantial negative effect on the course of the mood disorder. Analysis...
Approach Can Unblock Patients' Self-Compassion: Concepts from Learning Theory Can Help Therapist Get Patients' Feelings of Guilt, Shame out of the Way
LOS ANGELES -- Many patients express feelings of worthlessness or self-hate, and part of the therapist's job in short-term dynamic psychotherapy is to instill feelings of self-compassion in the patient, Leigh McCullough, Ph.D., said at a world congress...
A Single Stroke Causes Cognitive Decline in Certain Survivors
BAL HARBOUR, FLA. -- Cognition declines in the years after a single stroke for a substantial minority of patients, according to a study presented at the annual meeting of the American Neuropsychiatric Association. After the initial poststroke period,...
Celecoxib Gets New Indication, New Warning: Drug Is Now Approved for Ankylosing Spondylitis, but Black Box Highlights Risk of MI and Stroke
Celecoxib, the only cyclooxygenase-2 inhibitor left on the U.S. market, has won an additional approval from the Food and Drug Administration--but, as expected, the drug also received a black box warning on the increased risk of cardiovascular events....
Childhood Cancer Increases Adult Health Risks
ORLANDO -- Adult survivors of childhood cancers face more than four times the risk of a major health problem compared with their siblings, according to a survey of 10,397 adults diagnosed with a pediatric cancer between 1970 and 1986. Thirty years...
Clinical Drug Trials: Black Patients Are Needed
NEW YORK -- Racial disparities in access to health care will disappear only when adequate and representative samples of patients of color participate in clinical trials, Winston Price, M.D., said at the annual meeting of the National Medical Association....
Comorbid Addiction and Chronic Pain
Those living with comorbid chronic pain and addictive disorders are a difficult and somewhat neglected population. Little research exists on which to base a standard of care or treatment guidelines. Yet clinical experience indicates that chronic pain...
Data Back Broader Indication for Sodium Oxybate: Trial Results Lead Xyrem Maker to Seek Approval of Drug for Narcolepsy Symptoms beyond Cataplexy
DENVER -- Sodium oxybate (Xyrem) is effective not only for cataplexy--its only approved indication at present--but also for the other primary symptoms of narcolepsy, investigators reported at the annual meeting of the Associated Professional Sleep...
Dementia Affects Patient's View of Self-Identity Roles
Persons suffering from dementia rate their distinct self-identity roles in the past and present differently from the way their family or staff caregivers rate those roles, according to Jiska Cohen-Mansfield, Ph.D. Researchers studied 46 people attending...
Deployed Combat Medical Personnel Vulnerable to PTSD
ATLANTA -- Medical personnel returning from combat deployment experience rates of posttraumatic stress disorder only slightly below those of returning soldiers, a study has shown. Nearly 16% of medical personnel from one U.S. military hospital who...
Drug Improves Sleep Induction without Sedation
DENVER -- The novel melatonin receptor agonist ramelteon was associated with significant reductions in the time it took to fall asleep in two phase III clinical trials totaling 1,234 adults with primary insomnia, investigators reported at the annual...
Elderly Psychiatric Patients Often Overlooked or Misdiagnosed
A common perception, based on relatively few published studies, is that most psychiatric disorders other than depression occur much less frequently among the elderly. Community samples, however, suggest that many older adults who experience clinically...
Ethnicity Seems to Play a Role in Teens' Eating Disorder Risk
Culture appears to play a role in disordered eating. Black and Caribbean girls had the lowest rates of disordered eating, probably because African American culture sends teens the message that their physically attractiveness isn't completely tied...
Exploring Terrorists' Motivations
In the book "Perfect Soldiers," author Terry McDermott examines the motivations of the men behind the attacks of Sept. 11, 2001. Mr. McDermott and others have said that the hijackers saw themselves as soldiers of God. Is the kind of belief that...
Family Meals Offer Insight into Eating Disorders
MONTREAL -- Treatment for anorexia nervosa might one day use videotapes of family meals to personalize therapy for patients, according to a pilot study. Family mealtimes play a central role in anorexia nervosa, not only because of their focus on...
FDA Clears Keppra for Use in Pediatric Partial-Onset Seizure
The Food and Drug Administration approved a new pediatric indication for an antiepileptic drug as adjunctive treatment of partial-onset seizures in patients 4 years of age and older. Levetiracetam (Keppra, UCB Pharma Inc.) effectively reduced seizure...
Fears of Highly Virulent New HIV Strain Assuaged
RIO DE JANEIRO -- Fears that a new, multidrug-resistant, rapidly progressing strain of HIV-1 had surfaced in New York City have been alleviated, with researchers reporting that they have honed in on the probable source of the infection. Concerns...
For Some Bulimia Patients, Try E-Mail Therapy
MONTREAL -- Psychotherapy for eating disorders can be delivered effectively by e-mail and can reach a segment of the population that might otherwise decline treatment, Paul Robinson, M.D., said at an international conference sponsored by the Academy...
Go beyond Mirroring to Help Patients Process Intense Emotions
LOS ANGELES -- Part of the job of a psychotherapist is to help patients learn to process intense emotions, something they may not have learned properly during early development, Ronald J. Frederick, Ph.D., said at a world congress of the International...
Groups Affirm Utility of Metabolic Syndrome Dx: Diabetes Groups Rejected Use of Diagnosis, but Heart Organizations' Statement Deem It Clinically Useful
Less than a month after two major diabetes organizations called metabolic syndrome a poorly defined and misleading diagnosis, the American Heart Association and the National Heart, Lung, and Blood Institute issued a joint statement reaffirming that...
Heavy Prenatal Alcohol Linked to Behavioral Ills: In Adolescents, Skills for Academic Achievement and Social Interaction Were Found to Be Greatly Impaired
SANTA BARBARA, CALIF. -- The psychiatric and behavioral consequences of heavy prenatal alcohol exposure on children are abundantly clear by mid-childhood and adolescence, based on studies presented at the annual meeting of the Research Society on Alcoholism....
Hypertension Control May Lower Risk of Dementia
Elderly patients with mild to moderate hypertension and lowered cognitive function show greater cognitive decline, compared with equivalent hypertensive individuals with high cognitive function, a posthoc analysis shows. The first Study on Cognition...
Is the Canadian Health Care System Better?
The Question Americans have long looked to the Canadian universal health care system as the model for delivering health care, but is Canada's delivery system really better? The Analysis To help us answer this question, we turned to a recent...
Katrina Puts Proposed Medicaid Cuts on Hold
WASHINGTON -- Among the many things put on hold by Hurricane Katrina is the fate of $10 billion in cuts to the Medicaid program that were proposed by a federally appointed commission. The Medicaid Commission, which was called for by the fiscal year...
Katrina Survivors' Psychiatric Needs Unpredictable: 'Cascade of Disasters' Magnifies Trauma
Forget everything you learned about treating survivors of the Sept. 11,2001, terrorist attacks, and the Oklahoma City bombing. The fallout from Hurricane Katrina will be unique in that the mental health challenges facing survivors will be impossible...
Look for Rigid Thinking in Psychotic Depression
SAN DIEGO -- To make a clinical diagnosis of psychotic depression, take a good history and consider how the condition differs from other depressive or psychotic illnesses, Michael J. Gitlin, M.D., said at a psychopharmacology congress sponsored by...
Low Plasma [Beta]-Amyloid Levels May Be a Marker for Cognitive Decline
WASHINGTON -- Plasma levels of [beta]-amyloid may be low in elderly patients at risk for mild cognitive impairment or even Alzheimer's disease in the near term, according to research presented at an international conference sponsored by the Alzheimer's...
Many Options Available as Treatments for SAD
ATLANTA -- Physicians have several options when treating patients with seasonal affective disorder, according to experts at the annual meeting of the American Psychiatric Association. Light therapy, antidepressants, cognitive-behavioral therapy...
Mental Health, Primary Care Collaboration Urged
NASHVILLE, TENN. -- Integrating mental health and primary care has the potential to reduce medication mistakes and improve communication among providers, experts said at the annual conference of the National Academy for State Health Policy. "This...
Methylnaltrexone Relieves Opioid-Induced Constipation
ORLANDO -- Single injections of methylnaltrexone relieved opioid-induced constipation in 4 hours for 60% of hospice and palliative care patients in a randomized, placebo-controlled phase III trial. The earliest responses occurred within 5 minutes,...
Morbidly Obese Use 10% of Health Care Dollars in U.S
CHICAGO -- Health care costs for morbidly obese adults are nearly double those of normal-weight adults, according to a study presented at the combined annual meeting of the Central Society for Clinical Research and the Midwestern section of the American...
Narrow Interpretation of CATIE Study Discouraged
A landmark study of antipsychotics won't dramatically alter prescribing patterns, but could be used by payers to limit access to more expensive atypical antipsychotics, advocates for the mentally ill predict. State Medicaid programs spend more on...
New Data on Pregnancy, SSRIs Need Perspective
TUCSON, ARIZ. -- Recent research linking use of selective serotonin reuptake inhibitors in pregnancy with neonatal withdrawal symptoms heightened concerns about treating depression during pregnancy, but depression in mothers-to-be carries its own serious...
Oral Appliances Offer TX Option for Sleep Apnea
When a patient with obstructive sleep apnea can't tolerate using a continuous positive airway pressure device, what's the next step? "The option people end up thinking about when CPAP fails is typically surgery," said Kent Moore, M.D., D.D.S., president...
Parents of Overweight Children Fail to Accurately Perceive the Problem
BOSTON -- Many parents of children who are overweight or at risk for becoming overweight don't perceive their children's weight accurately, Patricia A. Cluss, Ph.D., and colleagues said in a poster presentation at the annual meeting of the Society...
'Perfect Soldiers'
Ramzi bin al-Shibh, the coordinator of the Sept. 11 attacks, described the feelings among the conspirators just before launching their destructive mission: "These hours were awesome, for you engage in a great battle with all its dimensions, a huge...
Perspective
There is an agreed-upon system of physical first aid in response to disasters in this country, but no such consensus exists for psychiatric first aid. Instead, in the face of large-scale disasters, community mental health providers scurry around, trying...
Pharmaceutical Industry's Ad Guidelines Draw Fire
New voluntary guidelines for direct-to-consumer prescription drug advertising released by the Pharmaceutical Research and Manufacturers of America have drawn criticism from politicians and consumer groups who say they don't go far enough. "While...
Placing Short-Term Psychotherapy First
Recently, I read about a survey showing that almost half the patients who begin psychotherapy quit--against their therapists' recommendations. According to the article, some of the reasons for this high dropout rate are patients' unwillingness to...
Positive Thinking May Aid Mentally Ill Alcohol Abusers
SANTA BARBARA, CALIF. -- Enhancing positive thinking may be the best way to help severely mentally ill alcohol abusers reduce their dependence on alcohol, a State University of New York at Buffalo study suggests. Clara M. Bradizza, Ph.D., and associates...
Posterior Hypothalamus Stimulation Reverses Aggression in Two Cases
NEW ORLEANS -- Stimulation of a specific area of the posterior hypothalamus reduced and reversed aggressive behavior, according to a case series of two patients presented at the annual meeting of the American Association of Neurological Surgeons. ...
Preparing for Your Golden Years
At age 51, Marguerite P. Barnett, M.D., considers herself "a bit young to retire," but the thought crosses her mind. "I'm in a medical malpractice state and sometimes I think strongly about [retiring] because of stressors," said Dr. Barnett, a board-certified...
Prescription Drug Abuse Continues to Climb
WASHINGTON -- The lifetime prevalence of prescription pain reliever abuse by young adults rose from 22% to 24% from 2002 to 2004, a recent survey released by the Substance Abuse and Mental Health Services Administration shows. Pain relievers with...
Preventive Treatment Is Underused for Migraine Patients
PHILADELPHIA -- Millions of U.S. patients who could benefit from migraine prophylaxis are not being offered this treatment by their doctors, Stephen Silberstein, M.D., said at the annual meeting of the American Headache Society. Based on the results...
Program Helps Insomniacs Quit Hypnotics
DENVER -- Older adults who have longstanding hypnotic-dependent insomnia and wish to discontinue their sleep medication are largely able to do so successfully--with resultant improvement in sleep--by participating in a program focusing on gradual weaning...
Psychiatric First Aid: A Necessity
Preventive interventions and disaster mental health seem like contradictory concepts. The term "prevention" suggests some degree of preparedness and control; "disaster" implies the absence of both. Despite the paradox, prevention does have a role...
Results Mixed on Tiagabine for Insomnia
DENVER -- The anticonvulsant tiagabine (Gabitril) increased slow wave sleep in dose-dependent fashion in a 30-center randomized trial involving 232 adults with primary insomnia, James K. Walsh, Ph.D., reported at the annual meeting of the Associated...
Scans May Predict AD before Signs Appear: Technique Has Potential to Fast-Forward the Search for Preventive Measures That Could Stall Alzheimer's
WASHINGTON -- Hippocampal metabolic reductions seen on PET scans in people with no clinical signs of cognitive impairment may be able to predict who will go on to develop Alzheimer's disease and mild cognitive impairment, according to data presented...
Schizophrenia Prodrome Therapies Show Promise: Early Intervention with Antipsychotics and CBT Appears to Delay or Prevent Psychotic Breaks
ATLANTA -- Both behavioral and drug therapies during schizophrenia prodrome can delay and possibly prevent a subsequent psychotic break, Scott W. Woods, M.D., said at the annual meeting of the American Psychiatric Association. Recent studies have...
Setting an Exercise Example
American medicine has allowed itself to become lost. Our $1.8 trillion annual outlay for health care nets us a 37th place world ranking in composite health outcomes. Other industrialized countries--such as Norway, which ranks first--spend far less...
Sleep-Disordered Breathing, ADHD Are Linked in Teens
DENVER -- Adolescents with symptoms of sleep-disordered breathing had a 2.5-fold increased prevalence of inattention-type attention-deficit hyperactivity disorder in the first large, population-based study to examine this relationship, Eric O. Johnson,...
Smoking Ups Neuropsychological Toll in Drinkers
SANTA BARBARA, CALIF. -- Smoking appears to heighten neuropsychological deficits found in heavy social drinkers, researchers reported at the annual meeting of the Research Society on Alcoholism. Specifically, deficits in executive functioning and...
Some Groups Call for Mandates on Minority Participation
WASHINGTON -- More needs to be done to encourage minority patients and providers to participate in clinical drug trials, several speakers said at a meeting sponsored by the Alliance of Minority Medical Associations, the National Association for Equal...
Stress Management Skills Help with Chronic Ills: Patients with Heart Disease, Diabetes Might Do Better Physically and Mentally after Coping Skills Training
WASHINGTON -- Increasing evidence suggests that patients with chronic conditions such as diabetes and heart disease who receive coping skills training do better physically and mentally, Redford B. Williams, M.D., said at the annual meeting of the American...
Study Detects Some 'Heretics' among AA Program Faithful
SANTA BARBARA, CALIF. -- A comprehensive 10-year study of Alcoholics Anonymous participants has unveiled several surprising, sometimes counterintuitive findings about the program's influence over a membership that numbers more than 1.2 million in the...
Study Links Restless Legs Syndrome to Cardiovascular Disease
DENVER -- Restless legs syndrome was associated with a significantly increased prevalence of cardiovascular disease in the Wisconsin Sleep Cohort Study, John W. Winkelman, M.D., reported at the annual meeting of the Associated Professional Sleep Societies....
Study Says Oral Contraceptives Ameliorate Premenstrual Worsening of Depression
ATLANTA -- The use of oral contraceptives appears to decrease the premenstrual worsening of depressive symptoms, Hadine Joffe, M.D., said at the annual meeting of the American Psychiatric Association. In preliminary research, the use of augmentation...
Symptoms May Worsen at First with Fluoxetine
BOCA RATON, FLA. -- Early worsening of symptoms after initiation of fluoxetine for major depressive disorder occurs in approximately 30% of patients and is associated with poorer outcomes and an increased likelihood of discontinuation, Cristina Cusin,...
Taking Heart History Is Good Idea When Prescribing Stimulants
ORLANDO -- When prescribing stimulants for children, play it safe and screen for heart conditions, said Howard Schubiner, M.D., at a meeting sponsored by the American Academy of Pediatrics. Although population-based studies fail to show a significant...
Texas Doctors Cautiously Optimistic about Tort Reform
When it comes to tort reform in Texas, physicians there say "so far, so good." In 2003, the state enacted a tort reform law similar to that of California, including a $250,000 cap on noneconomic damages. So far, that's been good news for Texas physicians,...
The Art of Amy Koy
Amy Koy started her long, arduous road to a college education with a lie. She answered "no" to a question on her application to Radcliffe College to hide the fact that she had been in therapy for anorexia. That lie only compounded the pain and strife...
Therapeutic Hypothermia Guidelines Urged in TBI
SCOTTSDALE, ARIZ. -- The next revision of 9-year-old guidelines for management of severe traumatic brain injury should endorse patient cooling, Donald Marion, M.D., chair of a committee evaluating the evidence on therapeutic hypothermia, said at the...
The Value of 'Parking Lot Therapy'
An impressive amount of knowledge and experience has been gained over the years in adapting clinical practice to the needs of the homeless. But a great deal remains for all of us to learn. It's well known that engagement and treatment strategies...
Vicious Circle of Comorbidity Links Medical, Mental Illness
NEW YORK -- Schizophrenia and bipolar disorder pose a triple health threat: The conditions themselves are associated with a higher prevalence of serious medical illness, some drugs used to treat them increase disease risk, and affected individuals...
Voices from the Storm: Emergency Docs Share Their Stories
Television and the popular media conveyed Hurricane Katrina's destructive impact on the survivors and on property. But the catastrophe's human toll also emerged powerfully in the voices of emergency physicians. Through the following e-mails, emergency...
Women Closing Gap in Risky Drinking, Driving
SANTA BARBARA, CALIF. -- Longitudinal data from a large national alcohol abuse survey suggests that the gender gap is narrowing with regard to drinking and driving: Women's rates of risky alcohol-related driving behaviors are actually increasing in...
Young Breast Ca Patients at Higher Risk of Distress
BOSTON -- The psychosocial needs of young breast cancer patients should be viewed in a different context than those of older women, said Lidia Schapira, M.D. "Premenopausal women with breast cancer are at greater risk of psychological distress at...