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. 36, No. 8, August

A Call for 'Qualitists' in Psychiatry
Since I began writing this column, several colleagues have continued to ask when I was going to address the ethics of the relationship of psychiatry to the pharmaceutical industry. Is our relationship to pharma one of collegial education or big brother...
ADHD Prevalence Climbs 4% Annually among U.S. Teens
The percentage of adolescents being diagnosed with attention-deficit/hyperactivity disorder is on the rise, but prevalence rates remain constant among younger children, a new study shows. Among children aged 12-17 years, the prevalence of attention-deficit/hyper-activity...
Adolescents' Eating Disorders Can Shift over Time
SEATTLE--Sizable proportions of adolescents progress along a spectrum of eating-disordered behavior over time, highlighting the importance of early detection and intervention, Diann M. Ackard, Ph.D., said at an international conference sponsored by...
Aetna, Cigna Retain Best Payment Records
Aetna has taken over from Cigna as the fastest and most accurate national insurer when it comes to paying physicians, according to the third annual ranking of payer performance by one of the nation's largest physician management companies. Cigna...
Aetna Defends Its Use of Preferred Provider Networks
SAN FRANCISCO -- Speaking at the insurance industry's annual meeting, an Aetna executive defended the company's performance-based physician networks, saying that they were a way to keep costs down and to let patients know which physicians offered the...
Alcoholism Is Increasingly Seen as Medical Illness; U.S. Survey Also Finds Heightened Stigma
WASHINGTON -- The public became more likely to regard alcohol dependence as a medical illness over a 10-year period, but stigmatization of alcoholism increased over that period as well, the latest results of a biannual survey addressing public attitudes...
AMA Urged to Use Apology as a 'Springboard'
African American physicians are looking for action to back up the words of apology recently tendered by the American Medical Association for more than a century of racial inequity and bias. In accepting the AMA's apology, Dr. Nelson L. Adams, president...
Benefits Sustained from Eating Disorder Program
SEATTLE--Initial improvements in anorexia nervosa and bulimia nervosa achieved in an intensive residential treatment program are largely sustained 4-5 years later, Dr. Timothy D. Brewerton reported. "Data on long-term follow-up of individuals with...
Bioterrorism Threat Lives on, as Do Vaccine-Related Events
SCOTTSDALE, ARIZ. -- Despite the grateful lull that has followed Sept. 11 and the anthrax scare in 2001, bioterrorism remains a very real threat, a Food and Drug Administration counterterrorism official says. Dr. Boris Lushniak, the FDA's assistant...
CMS Proposal Ties Outpatient Pay to Quality
The Centers for Medicare and Medicaid Services has proposed an overall 3% increase in payments for outpatient hospital care in 2009, almost a full percent below the update for 2008. As expected, reporting on quality of care is being tied to the amount...
Cognitive Dysfunction May Worsen Quality of Life in Bipolar
WASHINGTON -- Poor cognitive function in patients with bipolar disorder might contribute to worse quality of life, results of a Portuguese study of 55 patients show. Poorer self-reported quality of life was significantly correlated with worse cognitive...
Cognitive Impairment-Antihistamine Link Debated
KYOTO, JAPAN -- Fexofenadine is the sole truly nonsedating antihistamine--and the only one that does not cause objectively measurable cognitive and psychomotor impairment at doses commonly used in clinical practice, said Dr. Kazuhiko Yanai. Fexofenadine...
Combination of Sleep and Weight Problems May Lower Quality of Life
BALTIMORE--Both increased weight and sleep problems were associated with children's reports of poor quality of life, based on results from a study of 100 children aged 8-12 years. Previous studies have linked poor quality of life to overweight and...
Congress Acts to Expand Parity, Reverse Pay Cuts
Congress moved a step closer to mental health parity under Medicare last month when it overrode a presidential veto of legislation that decreased cost sharing for mental health care and codified coverage of psychiatric medications. The mental health...
CV Safety Studies Needed for New Diabetes Drugs
SILVER SPRING, MD.--A Food and Drug Administration advisory panel has agreed in a 14-2 vote that developers of new drugs or biologics for type 2 diabetes should be required to conduct a long-term study evaluating cardiovascular safety or should provide...
Disordered Breathing Takes Toll on Nighttime BP
People who have sleep-disordered breathing are less likely to experience a normal nighttime decrease in systolic blood pressure, and they are at increased risk of adverse cardiac and other outcomes, according to the results of a new prospective study....
Double Trouble: Mixed Bipolar Episodes
By DSM-IV standards, mixed episodes must satisfy criteria for both manic and depressive episodes and are relatively rare in bipolar disorder, but not everyone goes by this definition. "There's a general feeling that the DSM-IV notion is overly conservative,"...
Economic Woes May Not Slow SCHIP Expansion
Even though the Bush administration has made it nearly impossible to expand the State Children's Health Insurance Program, and the economic downturn has put a squeeze on Medicaid budgets, many states are keeping children covered and some are even expanding...
Education Key to Preventing Female Athlete Triad
SEATTLE--Education and the collaborative efforts of a team of professionals are important for preventing the female athlete triad, according to Sharon H. Thompson, Ed.D. The definition of the female athlete triad has been expanded recently, said...
Emotion-Focused Therapy Promising for Eating Disorders
SEATTLE--Patients with eating disorders who receive emotion-focused therapy experience a decrease in psychological morbidity and possible reductions in bingeing and vomiting, preliminary results of the first evaluation of this therapy for eating disorders...
English Smoking Ban Resulted in More Cessation
As many as 400,000 smokers have quit their habit as a result of England's ban on smoking in public places, according to a British cancer charity. Cancer Research UK said the Smoking Toolkit Study it supports at University College London found that...
Family-Focused Therapy May Benefit Bipolar Adolescents
KOLOA, HAWAII--Two studies show encouraging results for the effectiveness of including family-focused therapy in the treatment of adolescents with bipolar disorder. Although patients must be "stabilized and treated with the appropriate medication,...
FDA Considers Changes to Drug Label Pregnancy Info
The system that uses letters of the alphabet to categorize drugs' pregnancy and lactation risks will be eliminated and replaced by a more consistent format designed to be more comprehensive and useful to health care professionals and patients who are...
FDA Rejects 'Approvable,' 'Not Approvable' Terms
The Food and Drug Administration will no longer issue "approvable" or "not approvable" letters when a drug application is not approved. Instead, the agency will issue a "complete response" letter at the end of the review period, the FDA has announced....
Happily Married Women Report Less Insomnia
BALTIMORE--Women who are happily married in midlife report fewer sleep problems than unhappily married or unmarried women, based on data from nearly 3,000 women. Previous studies have shown that married people, especially women, consistently report...
Health Savings Accounts Catching on ... Slowly
WASHINGTON -- While health savings accounts and other forms of tax-deferred, consumer-driven health care financing options have captured the fancy of many policy makers, such options have met with a lukewarm welcome among American employers and the...
Heart Failure Patients Overestimate Life Expectancy
Ambulatory patients with heart failure tend to substantially overestimate their life expectancy, especially those who are younger or who have severe disease, investigators reported. Their misperception could "fundamentally influence medical decision...
HHS Pushes Doctors to Start Using Electronic Prescribing
Federal officials are urging physicians to begin electronic prescribing as soon as possible now that Congress has authorized bonus payments for the successful use of the technology. Under the recently enacted Medicare Improvements for Patients and...
In Practice's Losing Race, Good Health Is a Winner
Faced with 15%-18% average yearly increases in the health insurance premiums he pays for his staff, Dr. John K. Randall decided to do something about it. He staged a weight loss contest, loosely modeled after the fitness reality television show,...
Insured, Uninsured Report Access Problems
One in five Americans postponed or skipped needed medical care last year because of cost, insurance problems, or difficulty getting an appointment, according to a report from the Center for Studying Health System Change. Researchers, who compared...
International Graduates Fill Gaps in Physician Supply
ARLINGTON VA.--International medical graduates have become an integral part of providing medical care in federally designated physician shortage areas, according to results from a recent study. "Compared to U.S.-trained physicians, IMGs provide...
Laptop Dementia Screener Is Accurate, Faster Than MMSE
CHICAGO -- A quick, computerized screening test for dementia may be one step closer to reality. Researchers at the University of Florida Alzheimer's Center and Research Institute have developed the Dementia Screening Battery, a self-administered...
Med Schools Oppose Industry Gifts; AMA Sits out Debate
Medical schools and teaching hospitals should prohibit their physicians, faculty, residents, and students from taking gifts and services from drug companies, according to the Association of American Medical Colleges. Industry support for continuing...
Metformin Decreases Food Intake, Perceived Hunger
SAN FRANCISCO -- Metformin appears to exert its weight-loss effects in obese children by reducing their desire to eat and thus decreasing their food intake. A substudy of a government-sponsored placebo-controlled trial found that children taking...
Modafinil Reduces Severe Cancer Fatigue
CHICAGO -- The wakefulness-promoting drug modafinil reduced self-reported severe fatigue, according to a study of more than 600 cancer patients undergoing chemotherapy that was presented at the annual meeting of the American Society of Clinical Oncology....
New Tools Developed for End-of-Life Issues
PHILADELPHIA--Two new ways of dealing with end-of-life issues--default surrogates and physician-ordered life-sustaining treatment orders--are becoming more common in hospitals, according to several legal experts. So far, 37 states have passed default...
No Evidence of 'Chemobrain' Seen in Small Sample of Breast Cancer Patients
CHICAGO -- Chemotherapy-related cognitive impairment was infrequent in a small study of 30 patients who underwent adjuvant chemotherapy for nonmetastatic breast cancer. "People could be making decisions about whether or not to have chemotherapy...
Obama Plan Combines Public and Private Systems
With Sen. Barack Obama (D-Ill.) set to become the Democratic Party's presidential nominee, experts continued to scrutinize his plans to reform health care. The centerpiece of Sen. Obama's plan is a public-private system that would allow people to...
Only 4% of Physicians Have Comprehensive EHR
About 17% of U.S. physicians have electronic health records in their offices, but only 4% of those doctors have comprehensive systems, according to a survey of more than 2,700 physicians nationwide. However, more physicians are planning to purchase...
Oregon Reviews 10 Years of 'Death with Dignity'
PHILADELPHIA--While physicians in much of the United States struggle with issues surrounding end-of-life care, those in Oregon may help their terminally ill patients end their lives because of the state's groundbreaking, 10-year-old Death With Dignity...
Overall Child Well-Being Has Improved, New Report Finds
WASHINGTON -- Today's young people engage in less risky behavior, are healthier, and have better access to educational opportunities than their parents did when they were teens, a recent report suggests. But the overall gains that have been made...
Panels Discourage Black Box Warning on AEDs; Antiepileptic Drug Patients Should Get Medication Guide Explaining Suicidality Risk, Members Suggest
BELTSVILLE, MD.--A boxed warning about an increased suicidality risk with the use of antiepileptic drugs should not be added to the labels of drugs in this class, but patients prescribed these drugs should receive information about this risk with every...
Parkinson's TX May Raise Risk of Impulse Control
CHICAGO -- Evidence continues to mount that dopaminergic therapy increases the odds of impulse control disorders in patients who have Parkinson's disease. Dopamine agonist (DA)-treated patients had two-to threefold elevated odds of having a current...
Patient Questionnaire for Depression Helpful
PHOENIX--Clinicians in 17 diverse outpatient psychiatric practices across the United States reported that having patients complete a simple, short questionnaire about depression at each visit was helpful in 93% of visits and led to treatment changes...
Perspective
Most adult patients with panic disorder spend years trying to figure out what is wrong with them. They undergo cardiac evaluations for their heart problems, gastro evaluations for the butterflies in their stomachs, neurological exams for their light-headedness,...
Physicians Urged to Engage Pay for Performance
WASHINGTON -- Physicans may never embrace pay for performance with open arms, but they do need to get in the game. That was the message delivered by policy experts speaking at meeting of annual research meeting of Academy Health. Hospitals have...
Physicians Were Distressed to Learn of the Psychiatric Patient Who Died While Waiting to Be Seen in a Brooklyn Hospital. How Can Such Tragedies Be Prevented?
Several weeks ago, JAMA published a commentary, "Physicians Behaving Badly," detailing some of the inhumane ways in which doctors (and, I might add, hospital staff and office personnel) treat patients (JAMA 2008;300:21-2). The recent incident, ending...
Political Insiders Think Health Reform Is Likely in 2009
SAN FRANCISCO -- With a new president and a likely Democratic majority in the House and Senate, conditions will be ripe for health care reform in early 2009, a bipartisan group of political insiders predicts. The Democrats who spoke at Institute...
Pregabalin for Generalized Anxiety Disorder
The Problem You have a patient with generalized anxiety disorder who previously has been treated with selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitors, and buspirone with inadequate relief. In an attempt to avoid...
Prolactin May Be Key Link between Stress, Psoriasis
KYOTO, JAPAN -- Prolactin may be a key mediator in the pathway by which psychological stress triggers and exacerbates psoriasis, Dr. Ewan A. Langan said at an international investigative dermatology meeting. This raises the intriguing prospect that...
Race May Play Role in Dx of Schizophrenia, Bipolar Disorder
WASHINGTON -- Clinicians appear to be more likely to diagnose black patients with schizophrenia than white patients, even after controlling for symptom presentation, according to a study of more than 200 patients. "The findings suggest that a racial...
Rapid Response May Predict Binge Eating Outcome
SEATTLE--The predictive utility of a rapid response to treatment for binge eating disorder and obesity depends on the type of treatment, a randomized, controlled trial shows. It also is important to identify predictors, because many patients with...
Reevaluate Adolescents' Need for Antipsychotics: In Study, Protective Effect of Long-Term Use Was Offset by 'Shocking' Weight Gain
PHOENIX--To continue second-generation antipsychotics in adolescents with bipolar disorder after their psychosis or aggression has stabilized may not be helpful beyond 6 months of therapy, preliminary data from a randomized, controlled trial suggest....
Severe Psoriasis Appears to Be Potent Risk Factor for Stroke
KYOTO, JAPAN -- Severe psoriasis appears to be a potent risk factor for stroke independent of the traditional stroke risk factors, Dr. Rahat S. Azfar said at an international investigative dermatology meeting. She presented a casecontrol study drawn...
Simpler Frailty Assessment Recommended for Nursing Homes
SALT LAKE CITY -- Diagnosing frailty in a nursing home resident can be a time-consuming undertaking. According to Dr. John E. Morley, a generally accepted definition of frailty is useful but not practical for most nursing homes because they don't...
Sleep and Memory: Can Learning Be Enhanced?
The history of sleep and memory research began with Ebbinghaus in 1885. Research remained dormant for some time, but by the late 1980s, studies involving trampolining (Percept. Mot. Skills 1988;6:635-45), intensive study of a foreign language (Int....
Sleep Apnea Increased Mortality in 14-Year Study
BALTIMORE--Moderte to severe sleep apnea significantly increased the risk of all-cause mortality, according to 14 years of follow-up data from a large community sample. "Sleep apnea is a disease of public health significance," said Nathaniel Marshall,...
Sodium Oxybate May Improve Sleep in Fibromyalgia Patients
PHOENIX--Preliminary data on the off-label use of sodium oxybate suggest that it improved sleep in a randomized, placebo-controlled study of 151 patients with fibromyalgia who completed 8 weeks of treatment at 21 medical centers. The study enrolled...
SOFAR Focuses on Military Families
Alone soldier, bandaged up to his elbow, stood amid a crowd of clinicians, parents, and teachers, telling the story of a bad day in Iraq. His audience had gathered at Boston Medical Center to discuss the impact of war and terrorism on children,...
Some See Psychosocial Barriers to Weight Loss
SEATTLE--Money and time are the leading barriers to seeking weight-loss treatment among overweight and obese adults, but stigma and a belief that one is too heavy for treatment become more influential barriers as people get heavier. Little is known...
Take Practical Approach to Menopause Management
CALGARY, ALTA. -- Reassurance, relief, and reassessment are hallmark factors in the practical management of menopause. "We need to remind women that menopausal symptoms are normal," Dr. Cynthia Stuenkel said at the annual meeting of the Society...
Teenage Bisexuality Associated with Risky Sexual Behaviors
NEW YORK -- More than 10% of teens in New York City public high schools who have ever had intercourse reported bisexual behavior in a 2005 survey, according to a recent analysis. Those teens reported a higher prevalence of risky behaviors, including...
Three Trials Provide Guidance on Race, Ethnicity: In STEP-BD, Response to Treatment for Psychosis Was 40% for White Patients and 0 for Black Patients
PHOENIX--Teasing out any differences in the success of psychiatric treatment by race or ethnicity is hampered by a dearth of data on minorities, but secondary analyses of major studies on depression, bipolar disorder, and schizophrenia provide some...
Treating Gambling Difficult in Military
WASHINGTON -- Military personnel are at risk for problem gambling, but it is often difficult for them to get adequate treatment, according to the director of a Veterans Affairs program for problem gamblers. In 2002, there were 1.4 million active...
Treating Pediatric Panic Disorder
Monsters in the closet. Bogeymen under the bed. Flying shadow creatures cast by bedroom curtains blowing in the breeze. These are the stuff of childhood fears--all of which are readily dismissed as products of overactive imaginations and emotional...
Treating Situational Anxiety
Former Texas Sen. Phil Gramm's recent comment that we are in the midst of a "mental recession" did not go over well on the campaign trail. However, we psychiatrists know that today in America, we do find ourselves in a state of national anxiety. ...
Try Gabapentin, Antidepressants for Hot Flashes
CHICAGO -- Gabapentin and four newer antidepressants significantly reduce hot flash activity, according to a meta-analysis of 10 placebo-controlled studies that was presented as a poster at the annual meeting of the American Society of Clinical Oncology....
Type 2 Diabetes Doesn't Affect Alzheimer's Risk
WASHINGTON -- Type 2 diabetes did not increase the risk of onset or progression of Alzheimer's disease in older adults, according to results from a study of more than 700 individuals presented in a poster at the annual meeting of the American Geriatrics...
Varenicline Curbs Alcohol Cravings, Increases Abstinence in Smokers
WASHINGTON -- The antismoking drug varenicline also appears to curb alcohol cravings in smokers who are heavy drinkers, results of a small pilot study show. Nondependent heavy drinkers taking varenicline (Chantix) were more likely to be abstinent...