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. 8, August

Add Group Therapy to Drugs for Bipolar Disorder: Relapse Prevention a Challenge
SAN FRANCISCO -- Combining group therapy with drug treatment for patients with bipolar disorder seems to reduce the number of bbipolar episodes in this chronic illness, Dr. Kiki D. Chang said. Adjunctive psychosocial strategies in maintenance therapy...
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Advanced Dementia Not Seen as Terminal: Nursing Home Residents
BALTIMORE -- Patients with advanced dementia are generally not recognized as having a terminal condition and may not receive palliative care until death is perceived as imminent, Dr. Susan L. Mitchell said at the annual meeting of the American Geriatrics...
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AIDS Vaccine May Reduce Rate of Infection: Greater Efficacy in Nonwhites
ATLANTA -- The available results of the phase III AIDSVAX trial suggesting a lack of overall efficacy are "very preliminary" and any decision on further clinical trials with this vaccine would be premature at this time, experts agreed at a meeting...
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Almost 10% of Belgian Teens Engage in Self-Harm: Survey Results
ROME -- Epidemiologic studies have vastly underestimated the prevalence of self-harming behavior and suicidal ideation among European adolescents, Dr. Kees van Heeringen said at a meeting of the International Society for Adolescent Psychiatry. "Self-harming...
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Alternatives to Meperidine Better for Seniors: Adverse CNS Events
VANCOUVER, B.C. -- Removing meperidine from emergency department formularies would eliminate the great majority of inappropriate drug prescribing to elderly individuals in outpatient settings, Dr. Takahiro Higashi said at the annual meeting of the...
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Alzheimer's Drugs May Boost Schizophrenia Therapy: Rivastigmine, Galantamine Studied
SAN FRANCISCO -- Drugs that have been approved to treat patients with Alzheimer's disease seemed to help patients with schizophrenia when added to antipsychotic medications in two small studies presented at the annual meeting of the American Psychiatric...
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Anxiety Disorders, Depression Found in Former Anorexics: 35 Years after Presentation
DENVER -- A persistent eating disorder was evident in 55% of a cohort of Scottish anorexia nervosa patients up to 35 years after presentation, Dr. Fiona Wardell said at an international conference of the Academy for Eating Disorders. Both lifetime...
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Anxious Bipolar Patients Show Suicidal Tendencies: Ongoing STEP-BD Study
PITTSBURGH -- Bipolar patients who have some type of anxiety disorder--either current or lifetime--are significantly more likely to attempt suicide than patients without comorbid anxiety, Dr. Gary Sachs said at the Fifth International Conference on...
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Assessing Suicide: Swedish Guidelines Released: Children, Adolescents
ROME -- Swedish psychiatrists and physicians who care for suicidal adolescents have a new resource: the country's first-ever set of national clinical guidelines for treating young people who exhibit suicidal or self-harming behavior. The 2003 Swedish...
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Better Suicide Prevention Outreach Urged for Men: Novel Campaign Advocated
SANTA FE, N. M. -- American men commit suicide at a rate 4.4 times greater than women--and doing something about it will require overcoming many thousands of years of social conditioning, Alan L. Berman, Ph.D., said at the annual conference of the...
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Bipolar Disorder Misdiagnosed in Primary Care: Many Don't Seek Help
SAN FRANCISCO -- Twice as many people who screened positive for bipolar disorder sought help from primary care physicians, compared with those Who saw psychiatrists, a survey of 2,540 adults found. Primary care physicians were more likely to misdiagnose...
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Bupropion SR Helps Depressed Obese Patients: 50-Week Study
SAN FRANCISCO -- Twenty-four percent of 140 obese patients with depression lost 10% or more of their initial, body weight during up to 50 weeks on slow-release bupropion, Dr. Paul S. Bradley reported at the annual meeting of the American Psychiatric...
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Clinicians First Defense in Preparedness: CDC Director Addresses AMA
CHICAGO -- The American health care system is learning how to prepare for disasters the hard way, and the first lesson has been that front-line clinicians play a key role in identifying and working to control epidemics, Dr. Julie L. Gerberding, director...
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Conflict between Nurturance, Survival Seen as a 'Psychotoxin': Urge Patients to Taxe Action
SAN FRANCISCO -- The conflict between the universal drive toward mutual nurturance and financial demands to survive is a "societal psychotoxin" that is a significant source of distress, Dr. Roderic Gorney said at the annual meeting of the American...
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Depression's Economic Burden Unchanged from 1990 to 2000: Cost of Suicides Plummeted
SAN FRANCISCO -- The economic burden of depression in the United States remained remarkably stable throughout the 1990s, inching up just 1% in 2000 dollars from $82.2 billion in 1990 to $83.1 billion in 2000, Paul E. Greenberg reported at the annual...
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Depression Tied to Increased Ca Deaths: Antidepressant Trials Warranted
VANCOUVER, B.C. -- Depressive symptoms are an independent predictor of mortality in cancer patients, Susan Zickmund, Ph.D., said at the annual meeting of the Society of General Internal Medicine. This finding from a large, prospective study raises...
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Device Curbs Kids' TV Viewing: Ally in Obesity Prevention
DENVER -- A modest-looking little box that sits atop the family television set can be a powerful ally in preventing pediatric obesity. "I think this is a fabulous device," Dr. Susan Z. Yanovski said at an international conference of the Academy...
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Diagnostic Test for West Nile Virus Approved: First Rapid Lab Test
Federal health officials are hailing blood screening assays and the first rapid laboratory test for diagnosis of West Nile virus as major developments in the fight against the summer scourge, but they warn that early signs point to exacerbation of...
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Don't Rely on DSM-IV Criteria for Adult ADHD: Significant Impairment Common
SANTA FE, N.M. -- Diagnosing attention-deficit hyperactivity disorder in adults can be a challenge, because adults usually don't meet all of the diagnostic criteria published in the fourth edition of the Diagnostic and Statistical Manual, and frequently...
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Drugs That Dull Affect May Hinder Psychoanalysis: Patients May Miss Out
SAN FRANCISCO -- Awakening after a wild drunken evening at a wedding, Dr. Steven Leavitt felt horribly remorseful and hopeless. His depression had finally caught up with him. He needed help. It was 1966, a time when psychoanalysis was the treatment...
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Drug Therapy Advocated in Binge Eating Disorder: Topiramate, Sibutramine Promising
DENVER -- Pharmacotherapy should now be considered an option in all patients with binge eating disorder, particularly those with concomitant mood disorders, Dr. Susan L. McElroy said at an international conference of the Academy for Eating Disorders....
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Eating Disorders Construct May Face Tweaking: Possibilities for DSM-V
DENVER -- Look for fine-tuning rather than major upheavals in the revised eating disorders categorization system to be included in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, Dr. B. Timothy Walsh predicted at an international...
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Expert Advice for Keeping Good Office Staff: Acknowledge Stress
Working in a medical practice is stressful. The first step in making your office staff feel like they are part of a valued health care team is to acknowledge that stress, says Evelyn Eskin, president of Health-Power Associates Inc., a Philadelphia-based...
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FDA Gets Fibromyalgia Trial Design Advice: Arthritis Advisory Panel
BETHESDA, MD. -- Encouraged by several pharmaceutical companies investigating drugs for fibromyalgia, the Food and Drug Administration may for the first time lay some ground rules for conducting such studies. At a meeting of the FDA's Arthritis...
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Fear of Prosecution Leads to Pain Undertreatment: Electronic Prescription Monitoring
WASHINGTON -- The fear of being prosecuted for overprescribing opiates is exaggerated, according to experts who spoke at a press conference on pain management sponsored by the American Society of Law, Medicine, and Ethics. Despite some attention...
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Feds Easing into HIPAA Enforcement Gently: Compliance Update
SAN ANTONIO -- After 3 months of required compliance for the Health Insurance Portability and Accountability Act of 1996, it appears that physicians are erring on the side of caution while the government continues to err on the side of gentle reminders...
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Few Traumatized Patients Fit PTSD Criteria Found in DSM: Complex Histories
VANCOVER, B.C. -- Most severely traumatized individuals seen in clinical practice do not reflect the DSM-IV's depiction of posttraumatic stress disorder because their symptoms do not arise out of a single event and do not fit the manual's rigid pattern...
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For Diabetics, Drinking Tied to Mortality Drop: Up to Seven Drinks a Week
NEW ORLEANS -- People with diabetes who consume up to seven alcoholic drinks per week have a 35% reduction in all-cause mortality, compared with diabetics who abstain, according to an analysis of data from the San Antonio Heart Study. Consuming...
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Gene Discovery Links Stress to Depression: Environment, Biology Intersect
A gene that encodes a serotonin transporter protein has been identified as having a role in depression, researchers have reported. Looking at two versions of the 5-HT T gene--the long (1) allele and the short (s) allele--in a cohort of 847 New Zealanders,...
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Girl, Interrupted
Unlike most of the acclaimed books that deal with the experience of mental disorder, Susanna Kaysen's "Girl, Interrupted" had its impact without pushing any special agenda. Clifford Beers groundbreaking account, "A Mind That Found Itself," started...
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How Healthy Are the New 80-Hour Workweek Limits for Residents? Sleep Deprivation Still Widespread
VANCOUVER, B.C. -- This summer, residents in other medical specialties will discover what internal medicine residents have known for some time: The 80-hour workweek limit for physician trainees isn't all it's cracked up to be. In a reform measure...
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IM Formulations Widen Atypical Antipsychotic Uses: Intramuscular Ziprasidone, Others
HARRIMAN, N.Y. -- Atypical antipsychotics have for the most part been unavailable for emergencies and for patients whose compliance problems necessitate the use of depot formulations. But the development of intramuscular preparations has begun to change...
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Initial Insomnia May Hurt Depression Tx: Ask Patients One Question
BOCA RATON, FLA. -- "Does it take you longer than 30 minutes to fall asleep?" The way in which a patient with major depression answers that question may help predict response to acute treatment, according to a study of more than 500 patients from...
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Interpersonal Coping Is Key Early in Group Tx: Children, Adolescents
ROME -- Teaching adolescents a set of interpersonal coping skills before and during group therapy smoothes the way for more productive sessions and provides a safe place for youngsters to perfect these skills before integrating them into their larger...
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Interpersonal Therapy Viable Option in Bulimia: CBT Is Treatment of Choice
DENVER -- Interpersonal psychotherapy for bulimia nervosa is a viable alternative to cognitive-behavioral therapy, particularly in those parts of the country where practitioners adept in cognitive-behavioral therapy aren't readily available, Denise...
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It's in the Therapy Continuum
E-mail psychotherapy exists in the continuum of all the different types of psychotherapies, such as telephone, videoconference, instant message, and face-to-face sessions. Like each type, e-mail has advantages and disadvantages according to each patient's...
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Lamotrigine Approval for Bipolar I Hailed as a First: Like 'Mirror Image of Lithium'; Drug Helps Prevent Depressive Episodes
The approval of lamotrigine for bipolar I disorder marks the first time in which a drug that has its most robust effects on the disorder's depressive phase has been approved. Depressive episodes have been more difficult to treat and prevent than...
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Let's Change Our Mindset
Physicians are not immune to depression and suicidal ideation. Yet we often deny our vulnerability to the same illnesses that we treat in our patients, and further deny that getting help for depression will, in fact, fix the problem. It is time...
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Maine's Universal Health Care Plan Could Burden Physicians: Electronic Claims Required
A universal health care plan that promises to cover Maine's uninsured in 5 years could bring added hassles to that state's physicians. They'll have to be more prudent about their medical records, disclosing charges to patients, and submitting claims...
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MC4R Gene May Play Role in Satiety, but Data Needed: Melanocortin-4 Receptor
DENVER -- Caution is warranted in interpreting the discovery of a close link between binge eating disorder and mutations of the melanocortin-4 receptor gene, speakers said at an international conference of the Academy of Eating Disorders. They stressed...
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Mental Health Providers Need Attention, Too: Lessons from Terrorism
SAN FRANCISCO -- Mental health providers and chaplains who responded to terror attacks in New York, Washington, and Nairobi, Kenya, all had one issue in common: the need to talk with or listen to others. After intense days of providing whatever...
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Metabolic Syndrome Increases Stroke Risk: Odds Ratio Higher for Women
HONOLULU -- A large, prospective, epidemiologic study has found that metabolic syndrome results in a significantly increased risk of stroke, especially in women, Bernadette M. Boden-Albala, Dr. P.H., reported at the annual meeting of the American Academy...
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Mood, Anxiety Disorders Common in Epileptics: Quality of Life Impairment
SAN FRANCISCO -- Depression in patients with epilepsy is common and associated with more severe seizures and greater impairment of quality of life than epilepsy without a comorbid mood disorder, Dr. Alan M. Ettinger reported at the annual meeting of...
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Most Child Trauma Is Caused by Chronic Terrors: Physical Abuse Is No. 1: Most Research Is in Single-Incident Trauma, but Most Cases Involve Ongoing Situations
VANCOUVER, B.C. -- More than 80% of traumatized children who require therapy have been victims of chronic or multiple terrors, rather than isolated situations such as motor vehicle accidents, natural disasters, or acts of terrorism, a surly of 39 U.S....
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Multiple Sleep Latency Test Questioned: New Protocol Suggested
CHICAGO -- The American Academy of Sleep Medicine's protocol for the multiple sleep latency test might miss at least one sleep-onset REM occurrence in more than one-fourth of cases, said Dr. Markus H. Schmidt and his colleagues at the annual meeting...
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Negative Media Portrayal of Celebrity Suicide Thwarts Copycats: Results of Comprehensive Review
SANTA FE, N.M. -- The suicide of grunge-music superstar Kurt Cobain provides a vivid demonstration of how a negative media portrayal of celebrity suicide can thwart copycat deaths, Steven Stack, Ph.D., said at the annual conference of the American...
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New Attitude Urged on Disease Management: Seen as Time Consuming
BALTIMORE -- Do the words "disease management" make you think of doing more work without any benefit? If so, that's because disease management programs haven't been doing enough to gain support from physicians, Dr. Bob Kolock said at a meeting sponsored...
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New Information Challenges the Set Point Theory of Obesity: Weight Returns Because of Inactivity
DENVER -- It's high time to toss out the long-popular set point theory of obesity, according to speakers at an international conference of the Academy for Eating Disorders. The set point theory holds that obesity entails a metabolic defect that...
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Night Eating Syndrome: Common, 'Neglected': Prevalence Rises with Obesity
DENVER -- Night eating syndrome may yet have its day in the sun. This common but underappreciated condition was first described by Dr. Albert J. Stunkard, professor of psychiatry at the University 9f Pennsylvania, Philadelphia, in 1955. Four years...
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Olanzapine More Effective against Manic Relapse: Bipolar I Disorder Study
BOCA RATON, FLA. -- Olanzapine and lithium both effectively prolonged remission in people with bipolar disorder, but olanzapine was superior at preventing relapse into mania for up to 1 year, according to a randomized, double-blind study. "We wanted...
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One-Third of Patients Want Spiritual Discussion with Physician: African Americans Made Up Half of Sample
A third of patients are seeking spiritual as well as medical attention during routine office visits, Dr. Charles D. MacLean of the University of Vermont, Burlington, and his colleagues reported. In a survey of 456 patients who were seen at primary...
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Overlap Observed in Obesity, Eating Disorders: Specialists Urged to Join Forces
DENVER -- It's high time for specialists in the traditionally separate fields of obesity and eating disorders to join forces in an integrated approach to prevention and treatment, said Diane Neumark-Sztainer, Ph.D., at an international conference of...
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Physical Ailments Hamper Patients' Reintegration: Schizophrenia, Mood Disorders
VANCOUVER, B.C. -- Patients with chronic mental illness have a demonstrably high rate of comorbid physical disorders and social problems that if left untreated are likely to seriously interfere with reintegration into the community, Dr. Harry B. Burke...
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Physician Groups Oppose Medicare Proposal: Cumbersome Enrollment Procedure
Fearing additional burdens on their practices, physician groups are asking the Centers for Medicare and Medicaid Services to withdraw its proposal on a new Medicare enrollment policy. The proposed enrollment form for physicians "contains 12 pages...
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Polypharmacy among Elderly: Top Five Reasons: Start with Lower Doses
HONOLULU -- The overmedication of the elderly is tied to five major explanations, according to Dr Helen Edelberg. Among the most likely possibilities: 1. The patient has been at the same dose for many years Physiologic changes associated with...
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Practical Psychopharmacology: Balance Risks, Benefits in Treating Behavioral Symptoms of Dementia
Cognitive deficits may be the hallmark of dementia, but behavioral manifestations often figure prominently as well. One study reported behavioral changes such as apathy, agitation, and anxiety in nearly 90% of an Alzheimer's clinical population...
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Preliminary Report Aimed at Improving Depression Tx: Response, Remission, Recovery Defined
SAN FRANCISCO -- A proposal for more detailed definitions of what constitutes a response to treatment, remission, and recovery in patients with major depression should help clinicians evaluate the success of therapy and decide when to change or add...
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Protections in Clinical Trials Still Called Lax: Gelsinger Death Notwithstanding
WILMINGTON, DEL. -- Despite the controversy following the death of University of Pennsylvania patient Jesse Gelsinger, little has changed in the regulation of clinical trials, according to Arthur Caplan, Ph.D., director of the Center for Bioethics...
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Psychiatrists Worry about Atypicals, Diabetes: Agents Used despite Concerns
SAN FRANCISCO -- Most psychiatrists think that some atypical antipsychotics trigger metabolic illness, according to a survey by RoperASW. Yet most of the psychiatrists also said they would still use such agents for initial therapy, according to...
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PTSD Therapy at VA Hospitals Raises Questions: Antipsychotics Prescribed at 20% Rate
SAN FRANCISCO -- Department of Veterans Affairs'physicians prescribed antipsychotics to 20% of patients with depression and comorbid posttraumatic stress disorder despite little evidence that the drugs improve PTSD, Dr. Kiran K. Taylor said. The...
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PTSD Therapy Should Help People Move On: Don't Retraumatize
VANCOUVER -- Too many therapeutic approaches for posttraumatic stress disorder make patients revisit precipitating episodes over and over again, essentially keeping patients helpless, locked in their troubled histories, Dr. Bessel van der Kolk said...
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Recognize Special Needs of Refugees with PTSD: Cross-Cultural Psychiatry
VANCOUVER, B.C. -- It's generally a mistake to write a prescription during a refugee's first visit for symptoms of posttraumatic stress disorder; state the diagnosis too soon, and you've already got two strikes against you, Dr. Wahan Wanis said at...
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Reflections on Chestnut Lodge
Chesnut Lodge in Rockville, Md., was a flagship mental hospital, listed among U.S. News & World Report's top 20 psychiatric institutions. People from across the nation and around the world were sent to the hospital when other treatments failed....
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Remission Rates Shown Higher with Venlafaxine Than SSRIs: Major Depression
SAN FRANCISCO -- Venlafaxine outperformed selective serotonin reuptake inhibitors in achieving remission in major depression, according to a pooled analysis of data from 33 randomized, double-blind, comparative clinical trials. Venlafaxine is a...
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Routine Screening Strategy Needed for ADHD in Adults: Many Cases Missed
SAN FRANCISCO -- Most previously undiagnosed adults with childhood-onset attention-deficit hyperactivity disorder self-refer to the psychiatrist or primary care physician who finally makes the diagnosis, according to a new practice survey. Fifty-six...
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Screen All Sleep Apnea Patients for Long QT Syndrome: Sudden Death Risk
VANCOUVER, B.C. -- The elevated risk of sudden cardiac death known to exist in patients with obstructive sleep apnea may be attributable to an increased propensity to long QT syndrome in these sleep-disordered individuals, Dr. Natalia Volkova reported...
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Self-Cutting May Indicate Attempt to Reach the Inaccessible: Act Represents Transformation
ROME -- Self-cutting in adolescents may indicate the emergence of repressed feelings and signal an evolving desire to express and process these feelings. "Self-cutting is a desperate attempt to reach something that's inaccessible, and it represents...
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Sensory-Based PTSD Therapy May Prove More Calming Than Words: Alternative Coping Strategies
VANCOUVER, B.C. -- Terror registers most sharply in the subcortical brain, not the prefrontal cortex, explaining why talk-based therapies for posttraumatic stress disorder often have limited success, Dr. Bessel van der Kolk said at a meeting on Posttraumatic...
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Should All Substance Abuse Treatment Services Be Required to Adhere to Licensure Standards?
YES It's true that there are some differences between regulations for pharmacologically based treatment programs and those for drug-free treatment programs. But that's not the same as saying that anyone can open up a shop called "Treatment" and escape...
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Sibutramine Effective in Major BED Domains: Binge Eating Disorder
DENVER -- The use of sibutramine as a treatment for binge eating disorder in obese patients is now supported by two "very lovely" randomized double-blind placebo-controlled trials that have moved the appetite suppressant to the head of the list of...
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Social Context Plays Key Role in Treatment of Postwar Syndromes: Perceptions of Risk, Responsibility
SAN FRANCISCO -- Social attitudes and historical context influence the way in which postwar syndromes are characterized, defined, and treated, Lt. Col. Charles C. Engel, MC, USA, said at the annual meeting of the American Academy of Psychoanalysis...
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Some Trauma Victims More Phone to PTSD: Patients Who Dissociate
SAN FRANCISCO -- People who experience dissociation during traumatic events are prime candidates for the development of posttraumatic stress disorder, Dr. David Spiegel said at the annual meeting of the American Academy of Psychoanalysis and Dynamic...
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SSRIs Can Treat Depression after Traumatic Brain Injury: Off-Label Use
SAN FRANCISCO -- Selective serotonin, reuptake inhibitors should be regarded as the first-line pharmacologic treatment for depression in patients with traumatic brain injury, Dr. David B. Arciniegas said at a satellite symposium held in conjunction...
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State Legislators Cutting Health Programs Reforming Malpractice Laws-Again: Medicare, SCHIP
WASHINGTON -- Budget cuts and tort reform are the hot health care items on legislators' plates so far this year, just as they were last year, Susan Laudicina said at a press briefing sponsored by the Blue Cross and Blue Shield Association. "If I...
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Stress-Induced Amenorrhea Responds to Cognitive-Behavioral Therapy: Infertility Therapy Alternative
DENVER -- Cognitive-behavioral therapy is an effective treatment for women with stress-induced anovulation, Rebecca M. Ringham reported at an international conference of the Academy for Eating Disorders. The psychological intervention results not...
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Suit Seeks Halt to Resident Match Day Program: Fixed Slots, Fixed Pay
WILMINGTON, DEL. -- The Resident Match is fundamentally anticompetitive and represents an effort to depress the wages and opportunities of medical residents, according to a lawsuit Fried by former and current residents. As the suit drags on in court,...
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Take Steps to Handle Referrals for Depression: Discuss Measures of Disease Severity
SAN FRANCISCO -- Data show that collaboration between primary care physicians and psychiatrists improves primary care of patients with depression--but what does that collaboration look like? Psychiatrists can take specific steps to build a good...
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Trial to Test Interferon in West Nile Virus Patients
A multicenter clinical trial is recruiting patients who may be infected with West Nile virus. The study will assess whether rapid and aggressive treatment with interferon alfa-2b can prevent severe neurologic sequelae or death in such patients,...
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Try Mirtazapine or Escitalopram for Speedy Onset: Small Data Sets Cited
SAN FRANCISCO -- When you need the quickest possible antidepressant effect, consider choosing mirtazapine or escitalopram for treatment or combining a selective serotonin reuptake inhibitor with pindolol or olanzapine, Dr. Robert M.A. Hirschfeld said....
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Utah's Youth Suicide Prevention Program Praised: Prior Contact with Juvenile System
SANTA FE, N.M. -- An innovative approach to youth suicide prevention is being pioneered in Utah. The program capitalizes on the finding that nearly two-thirds of teen suicides in the state had prior contact with the juvenile court system. The statewide...
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