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. 7, July

Abuse Recurs Most Often in Adolescents
HONOLULU -- Adolescents are far more likely to suffer recurrent abuse than are younger children, according to an analysis of data from 18 states within the National Child Abuse and Neglect Data System. "Age matters," Dr. Vincent J. Palusci said...
ADHD Unaffected by 8-Week Course of St. John's Wort
An 8-week course of St. John's wort did not improve attention-deficit/hyperactivity disorder symptoms in what researchers described as the first-ever randomized clinical trial of the herbal remedy in children and adolescents, according to a report...
Adverse Event Confidentiality
Imagine being involved in an adverse event--one that, through no real fault of your own, caused death or serious injury to a patient. Should your future patients have a right to know of your involvement? That is the issue Florida physicians are...
Agency Launches Sentinel Surveillance System
The Food and Drug Administration has developed a new national electronic surveillance system that will allow it to search and analyze claims data and other clinical databases for possible post-market adverse events for drugs and medical devices. ...
All Antipsychotics to Get Warnings about Elderly
Labeling for conventional antisychotics will now contain warnings about an increased risk of death among elderly users with dementia-related psychosis, according to new requirements issued by the Food and Drug Administration. The labeling revision...
BMI Data for Young People: Plateau or Pause?
The apparent leveling off in the prevalence of being overweight among U.S. children and adolescents is cause for celebration, but it might not necessarily be a trend, experts say. A study by the National Center for Health Statistics (NCHS) found...
CAM Use Puts Cancer Patients at Risk for Drug Interactions
CHICAGO -- More than one-third of older patients with cancer are at risk for drug interactions because of widespread use of biologically based complementary and alternative medicine in the United States, according to population-based data presented...
Cases Show Virulence of Online Pornography
WASHINGTON -- The ubiquity of online pornography and easy access make it problematic for people who otherwise might not be susceptible to the lure of pornography. For mental health professionals, the challenge is to clarify which individuals are...
Citalopram Appears Effective for Reducing Hot Flashes
CHICAGO -- Citalopram may be an effective option for reducing hot flashes, having performed twice as well as placebo in a randomized, placebo-controlled phase III trial conducted by the North Central Cancer Treatment Group. "Hot flash relief can...
Clarity Offered on ECGs, ADHD Medications
The American Academy of Pediatrics and the American Heart Association have issued a joint statement clarifyingstate ment clarifying recent recommendations made by the AHA on evaluating and treating children and adolescents with attention-deficit/hyperactivity...
CMS Proposes Rules to Curb Marketing Abuses
The Centers for Medicare and Medicaid Services, seeking to curtail marketing abuses within Medicare Advantage and Medicare Part D prescription drug plans, has proposed new regulations that would prohibit such tactics as door-to-door marketing and cold-calling...
Collaborative Medicine Deemed Best for Patients
Patients with serious mental disorders will be best served when psychiatrists starting thinking like primary care physicians, and primary care physicians start thinking like psychiatrists, experts said at a forum on integrating physical and mental...
Cost Separates Old Migraine Drugs from New
WASHINGTON -- Newer drugs aren't any better for migraine prophylaxis than are older treatments and might be worse choices for older treatments and might be worse choices for many patients when cost is a factor. "There's no proof of increased efficacy...
DBS May Prove Beneficial in Early Parkinson's
Data from new studies suggest that patients with Parkinson's disease might benefit from deep brain stimulation surgery much earlier in their disease course, offering tantalizing hints that early surgery could actually delay progression by protecting...
Depression Affects What Mothers Feed Infants
HONOLULU -- Depressed Hispanic mothers are more likely than are nonde-pressed Hispanic mothers to supplement breast-feeding with water and flavored teas as early as 4-6 weeks and to be giving their babies soda, chips, and syrup-flavored cow's milk...
Disordered Eating Linked to Suicidal Ideation
BOSTON -- Disordered eating is an important risk factor for suicidal ideation in adolescents and appears to contribute an additional amount of variance above and beyond traditional risk factors, a study has shown. The findings suggest that disordered...
Do High Deductible Plans Coupled with HSAs Promote Underinsurance? Consumer-Directed Care Cuts Bureaucracy
In fact, high-deductible plans solve the problems of "underinsurance" and "overinsurance" and lead to "just-right insurance." Most economists recognize that excessive reliance on third-party payment is the source of many of our problems in health...
Do High Deductible Plans Coupled with HSAs Promote Underinsurance? the Sick and Poor Are Left Underinsured
Consumer-directed health care (CDH) is premised on the odd idea that Americans are too well insured. In policy wonks' dreams, CDH couples high-deductible insurance policies with health savings accounts (HSAs) that patients can use to pay the deductible....
Drug Testing without Patient Consent?
It's acceptable to perform drug testing in an adolescent without the patient's consent in cases of altered mental status such as intoxication or overdose or as an adjunct in the evaluation of the victim of trauma or violence, Dr. Baren said. It's...
Drug Therapy for Alcohol Dependence
Alcohol dependence is among the most common psychiatric disorders: A recent National Epidemiologic Survey on Alcohol and Related Conditions found a 12-month prevalence of 3.8% (Arch. Gen. Psychiatry 2007;64:830-42). In individuals with comorbid psychiatric...
Duloxetine Becomes the Second Drug Approved for Treatment of Fibromyalgia
The antidepressant duloxetine has been approved by the Food and Drug Administration for the treatment of fibromyalgia. The approval, announced in mid-June, makes duloxetine the second drug okayed by the agency for this syndrome. A year ago, pregabalin,...
'Estimated Average Glucose' Unit Gains Favor
SAN FRANCISCO -- Hemoglobin [A.sub.1c] levels can now be accurately expressed as estimated average glucose for most patients with type 1 and type 2 diabetes. In a multinational study presented at the annual scientific sessions of the American Diabetes...
Exams Differentiate Delirium from Dementia
SAN FRANCISCO -- Two brief mental state exams can reliably differentiate delirium from dementia in the elderly emergency department patient. Because delirium usually is caused by an organic illness, confusional symptoms may disappear once the underlying...
Extremely Preterm Birth Linked to Later Autism
HONOLULU -- Children born at less than 26 weeks' gestation are significantly more likely to have symptoms indicative of autism spectrum disorders at school age than are their classmates, according to a study of 219 children born extremely preterm matched...
Feds' Strategic Plan Boosts Electronic Health Records
If the feds have it their way, 40% of physician offices will be using certified electronic health records by 2012. The goal is part of a strategic plan for coordinating the federal government's health IT efforts over the next 4 years, and seeks...
Fink! Still at Large: A Recent Report on Suicide in the U.S. Army Shows That Suicidal Behaviors Are More Common among Young, Unmarried Soldiers. What Factors Might Make Young People More Vulnerable?
When the Army released its report, newspapers across the country (and perhaps around the world) ran headlines like this: "More U.S. Soldiers Committed Suicide in 2007 Than at Any Time Since the First Gulf War." For those of us who tend to the mental...
For Health Reform That Works, Think Globally
WASHINGTON -- Analysis of other countries' health care systems has pointed out what might work--and what won't work--in efforts to reform the U.S. health care system. At the annual meeting of the American College of Physicians, ACP senior vice president...
Foster Care: Casey Program Is a Good Model
The foster care system in the United States was designed to provide a short-term safe haven for abused or neglected children--a temporary way station of sorts for kids in crisis en route to a more stable, supportive living situation. But for many children...
Fructose Consumption Implicated in Rise of Gout
LIVERPOOL, ENGLAND -- Consumption of soft drinks containing fructose may underlie the sharp increase in gout among American adults that has occurred in recent decades, Dr. Hyon K. Choi said at the annual meeting of the British Society for Rheumatology....
Gabapentin Withdrawal
The Problem Many of the patients at your long-term psychiatric treatment center (also known as a state prison) receive treatment with gabapentin for chronic pain or seizure disorders. Some inmates may well be using their gabapentin prescriptions...
Gastric Bypass Improves Sexual Function in Men
ORLANDO -- Gastric bypass surgery leads to significant improvement in the sexual dysfunction experienced by many morbidly obese men, according to a recent study. The effects of surgical weight loss on sexual function are not well studied, although...
Google, Microsoft Vie to Lead Health IT Change: Eventually, System Will Enable Patients to Schedule Appointments, Refill Prescriptions, and Use Other Tools
WASHINGTON -- Search engine giant Google has joined software giant Microsoft in an attempt to revolutionize health care information technology, one patient at a time. Google launched Google Health this spring with an aim of establishing itself as...
Health Care Reform: Top 10 Obstacles
I am a strong and consistent supporter of health care reform, but perhaps I have be come a bit jaded from the unsucessful efforts I've witnessed over the past 20 years. To have real reform, it is necessary to provide adequate health insurance to...
Identifying Endophenotypes Can Help Guide Treatment of Autism
BALTIMORE -- Identifying shared endophenotypes might help clinicians characterize neurobehavioral syndromes and plan treatment, said a specialist in neurobehavioral development. An endophenotype is a subset of features of a syndrome that are more...
Impact of Apnea on Cognition Highly Variable
FORT LAUDERDALE, FLA. -- Some children with sleep-disordered breathing experience significant cognitive deficits, but not all do, and identification of those at risk remains a clinical challenge, according to a sleep medicine expert. The range of...
Integrating Psychiatric, Physical Care Also Can Lead to Cost Savings
Treatment at an integrated behavioral/physical health care clinic not only reduced emergency department admissions among patients with serious mental illness but also saved a health care company $32,000/patient in psychiatric care costs. The clinic,...
Law Limits Third-Party Use of Genetic Info
Patients will soon be able to undergo genetic testing without fear of discrimination from either their health insurers or their employers, thanks to a new law signed by President Bush. The Genetic Information Nondiscrimination Act (H.R.493), which...
Medicare Advisers Protest Agency's Plan to Publish PQRI Data
WASHINGTON -- A panel of Medicare advisers warned agency officials against moving forward with a proposal to make public a list of doctors participating in a voluntary federal quality reporting effort. The Physician Quality Reporting Initiative...
Medicare Changes Quality Reporting Initiative
Physicians now have nine options for submitting quality data to Medicare under the Physician Quality Reporting Initiative. The new options include three ways to submit claims-based data and six registry-based methods for reporting (see box). For...
Mediterranean Diet Protects against Diabetes in Some
A Mediterranean diet high in vegetables, fruits, and cereal grains and low in meat can significantly reduce the risk of diabetes in initially healthy people, according to a large Spanish cohort study published online May 30 in BMJ. In a median of...
Methylnaltrexone Relieves Opioid-Induced Constipation
A single dose of methylnaltrexone relieved opioid-induced constipation three times more often than did placebo in a phase III clinical trial of 133 terminally ill patients, investigators have reported. The treatment did not interfere with analgesia...
More Drugs for Type 2 Expected on Market Soon
PHILADELPHIA -- The number of incretins available to treat type 2 diabetes is set to expand in the near future, said Dr. Marie E. Mc Donnell, director of inpatient diabetes at Boston Medical Center. Liraglutide, a once weekly formulation of exenatide...
Nashville Clinic Focuses on Immigrant Groups
WASHINGTON -- When Dr. David Gregory worked to open a health clinic for the uninsured in 1991, he thought that he would be treating residents of the nearby housing projects. Most of the residents were African Americans. Since then, however, Siloam...
New Policy Stresses Competence in Palliative Care
Palliative care applied to all stages of illness--whether terminal or not--is an integral part of caring for patients with chronic or advanced respiratory and critical illnesses, the American Thoracic Society has said in a new clinical policy statement....
New Treatment Options Can Help Smokers Quit
Many new and effective treatment strategies are available that clinicians can employ to help patients quit tobacco use, according to an updated Clinical Practice Guideline released recently by the U.S. Public Health Service. Use of multiple interventions,...
Ongoing Trial Compares Anorexia Therapies
SEATTLE -- The relative efficacy of three treatments for anorexia nervosa appears to shift with long-term follow-up according to the results of an ongoing' analysis of data from a randomized, controlled trial. The treatment that was the most efficacious...
Perspective
The fact that the foster care system is failing to provide sufficient protective factors for children is offensive. At some point, the science will become so clear that not to do certain things for foster children will be considered unethical. With...
Physicians Face 5.4% Cut in Medicare Payments
Barring action by Congress, physicians will face a 5.4% cut in Medicare payments on Jan. 1, 2009. Officials at the Centers for Medicare and Medicaid Services projected the 2009 fee cut based on a statutory formula that uses the controversial sustainable...
Physician Suicide Rates Suggest Lack of Treatment: Greater Awareness of Depression Needed
Each day in the United States, roughly one doctor dies by suicide. Studies over the past 4 decades have confirmed that physicians--especialy women physicians--die. by suicide more frequently than people in other professions or those in the general...
Pioglitazone Cuts Risk of Progression to Diabetes
SAN FRANCISCO- people with impaired glucose tolerance were 81% less likely to develop type 2 diabetes over a 3-year period if treated with pioglitazone, according to a prospective, randomized, double-blind, placebocontrolled study of 602 patients....
Progression from MCI to Dementia Affected by Gender
Risk factors for mild cognitive impairment and progression from mild cognitive impairment to dementia are not the same for men and women, findings from a population-based study of 6,892 adults aged 65 years and older show. Identifying the risk factors...
Proton Pump Inhibitors Not Helpful in Asthma without Reflux
TORONTO -- Treatment with a proton pump inhibitor did not improve asthma control in patients with poorly controlled asthma and minimal or no symptoms of gastroesophageal reflux, according to results from a large study presented at an international...
Psychosocial Assessment Is Key for Teens in Emergency Departments
SAN DIEGO -- Given that adolescents account for 10%-15% of all emergency department visits and arrive for reasons ranging from sexually transmitted infections to mental health disorders, it is important to conduct a thorough psychosocial assessment...
QoL, Cancer Outcome Linked in Meta-Analyses
CHICAGO -- Feeling better overall translates to better survival for cancer patients, based on the results of two studies presented at the annual meeting of the American Society of Clinical Oncology and involving more than 10,000 cancer patients. ...
Ready or Not, National Provider Identifier Policy Is Implemented
WASHINGTON -- Medicare has stopped accepting claims that contain outdated provider identifying numbers, even if the claims also include a National Provider Identifier--despite concerns voiced by physician groups that many are still not ready. The...
Reduced Hippocampus Volume Tied to Cannabis Use
Heavy cannabis users show marked reduction in hippocampus volume on high-resolution 3-T MRI imaging, investigators have reported. The volume reductions appear to correlate with the degree of exposure to the drug, according to Murat Yucel, Ph.D.,...
Refractory Asthma Persists despite New Guidelines
TORONTO -- A substantial proportion of patients with severe refractory asthma are unable to become well controlled despite the availability of updated guidlines, even in subspecialty care, according to Dr. Amandeep S. Gill of the Medical College of...
Screening for Diabetes Fails to Lower Mortality
SAN FRANCISCO -- A population-based screening program for type 2 diabetes does not decrease all-cause, cardiovascular, or cancer-related mortality over a 5-year period, according to a large randomized controlled trial presented at the annual scientific...
Second-Generation Antidepressants Differ Mainly in Safety
PHOENIX -- Second-generation antidepressants do not differ significantly from one another in efficacy or effectiveness, a study funded by the federal Agency for Healthcare Research and Quality shows. Some differences were found, however, in the...
Shorter Wear Times for Daytrana Patches Effective
Children with attention-deficit/hyperactivity disorder who wore Daytrana methylphenidate transdermal patches for stretches of 4 or 6 hours experienced improvements in their ADHD symptoms, results from a multicenter controlled trial of 117 young patients...
Smoking Associated with Cognitive Decline in Middle Age
Smoking is associated with a decline in reasoning ability and with memory deficit as early as in middle age, according to a study of more than 5,000 people. People who quit smoking before they reach middle age, however, show little of this adverse...
Students' Risky Behavior Improving over Time
Fewer high school students are engaging in certain high-risk health behaviors today, compared with their counterparts in the early 1990s, according to data from the 2007 national Youth Risk Behavior Survey. Large numbers of adolescents are still...
Study: Gambling Common among Disabled
WASHINGTON -- people with intellectual disabilities do exhibit pathological gambling behavior, and gambling in general is common in this population, a study of 79 people in the Las Vegas area shows. Two of the study participants (2.5%) met DSM-IV-TR...
Surgical Neovagina May Not Provide Sexual Satisfaction
NEWPORT BEACH, CALIF. -- Women with vaginal agenesis who undergo laparoscopic Davydov surgery to create a neovagina may have impaired sexual function, compared with controls, a study of six such patients found. The findings of the small study contradict...
Taranabant Aids Weight Loss, Improves Metabolism
GENEVA -- Overweight and obese patients achieved significant weight loss and improved metabolic parameters using taranabant, according to interim results from a 2-year study. Taranabant is a structurally distinct, highly selective cannabinoid-1...
Tarenflurbil Slows Decline in Early AD
A drug that inhibits the formation of neurotoxic amyloid-[[beta].sub.42] peptides slowed functional decline in patients with mild Alzheimer's disease by 46%, Dr. Gordon K. Wilcock and his colleagues have reported. Patients who took the drug for...
Teens + Marijuana: (Still) a Dangerous Mix
As psychiatrists with expertise in addiction medicine, we applaud the recent White House report on the impact of marijuana use on adolescents. The report, released in May by the Office of National Drug Control Policy, high-lights the clinically...
Teens Want Doctors to Initiate Discussion of Sexual Issues
NEWPORT BEACH, CALIF. -- Adolescents want their doctors to bring up the topic of sexuality, but few physicians do, a survey of 388 teenagers revealed. The majority of adolescents said they would be comfortable being asked any of 11 questions about...
The Challenge of Treating Facial Tics
Facial tics and tic-like movement that spreads to the shoulders, parts of the torso, or other parts of the body are difficult to treat. The patients I've treated with tic disorders had one thing in common: They knew that the tics worsened when they...
The Promises and Perils of Proximity
Perhaps you have encountered a situation that is comparable to one of the following: * A relative has alcohol and other drug abuse problems and seems to resist getting appropriate treatment. * You work in a small town. The secretary at your clinic...
TORDIA Results Offer Guidance
PHOENIX--The only prospective, rando, controlled comparison of treatment for resistant depression in adolescents is yielding new insights about efficacy and suicidality through several post hoc analyses. The selective serotonin reuptake inhibitor...
Use of Zolpidem Appears Safe during Pregnancy
WASHINGTON -- Even though the sleeping aid Zolpidem does cross the placenta, use of the drug during pregnancy does not appear to significantly affect outcomes, a study of 45 women shows. The study, presented as a poster at the annual meeting of...
We Need Data on Ethnic Groups
Dr. Maria A. Oquendo and others identified some of the barriers that limit research among ethnic and cultural groups ("Diversity Missing From Research," May 2008, p. 1). I would like to add to this list a few more challenges to the systematic review,...