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. 5, May

Adolescent Rebellion Can Interfere with Diabetes Care
HOUSTON -- Psychiatrists can become part of a child's diabetes treatment team and provide guidance when barriers to compliance arise, Scot G. McAfee, M.D., said at the annual meeting of the American Society for Adolescent Psychiatry. They can also...
All about My Mother
"Out of the Shadow" and "Tarnation" are noteworthy documentaries in which filmmakers tell stories of their own mothers, each suffering from schizophrenia. These bold films share much common ground but differ radically in narrative style and aesthetics....
Anorexia: A Personal Recollection
The Guest Editorial by Dr. Christopher Fairburn brought back memories of my own anorexia nervosa and bulimia and my younger sister's similar but tragic anorexia, which ended in her death after 6 years of partial remissions and relapses ("Let Data Guide...
Antipsychotic Treatment: When to Measure Prolactin
NEW YORK -- Patients taking antipsychotic drugs need to have their serum prolactin measured only if they develop signs and symptoms of hyperprolactinemia, Harold E. Carlson, M.D., said at a psychopharmacology update sponsored by the American Academy...
Are We Ready for EHRs?
Electronic health record systems are promoted seemingly more for the sake of acquiring and using the technology than for specific benefits that cannot be gained in some other way ("Feds to Reward Use of Electronic Health Records," September, 2004,...
As Obesity Rates Rise, So Should Awareness of Pseudotumor Cerebri
SCOTTSDALE, ARIZ. -- The incidence of pseudotumor cerebri is rising among the obese, so physicians should keep this relatively uncommon condition in mind when obese patients present with symptoms resembling brain tumor or intracranial pressure, said...
Aspirin Prophylaxis Cuts Strokes in Healthy Women: Women Aged 65 or Older Had Reductions in Ischemic Stroke, MI, and All Major Cardiovascular Events
ORLANDO, FLA. -- Aspirin's role in preventing initial cardiovascular events in women was dramatically focused by the results of the first study to test aspirin prophylaxis in a large number of apparently healthy women, according to the Women's Health...
Autism Increase Not a Result of Reclassification
The apparent increase in autism disorders reflects an actual increase in prevalence, rather than a reclassification of other developmental disorders as autism, reported Craig Newschaffer, Ph.D., of Johns Hopkins University, Baltimore, and his colleagues....
California Health Care Purchaser Rejects HSAs: CalPERS' Chief Says Dropping Hospitals, Physician Practices Will Save Millions for Members, Taxpayers
WASHINGTON -- Despite their growing popularity, health savings accounts are not a good solution to the problem of rising health care costs, at least not for California state employees and retirees, Fred Buenrostro said at a health care congress sponsored...
CBT Effective in Pilot Study of GAD Patients
SAN DIEGO -- Data increasingly support the use of individualized cognitive-behavioral therapy in primary care as a treatment for late-life generalized anxiety disorder, Melinda A. Stanley, Ph.D., said at the annual meeting of the American Association...
Chronic Methamphetamine Use Linked to Cardiomyopathy
NEW ORLEANS -- Chronic use of methamphetamine can lead to nonischemic, dilated cardiomyopathy and profound left-ventricular dysfunction, according to a study of 53 methamphetamine users seen at a single medical center in California. "To our knowledge,...
CMS Projects 4.3% Cut in Physician Pay in 2006
Physicians could face a 4.3% cut in their Medicare reimbursements next year because of the rising cost of medical spending. Mark McClellan, M.D., administrator for the Centers for Medicare and Medicaid Services, announced during a press briefing sponsored...
Collaborating to Serve
Cultural rhetoric paints doctors and lawyers as natural enemies. In reality, both share a fundamental mission: to use specialized knowledge of systems (legal and medical) to help people in the course of their lives. Efforts to join the two professions...
Collaborative Care Helps Reduce Suicidal Ideation
SAN DIEGO -- Older adults with depression who received collaborative care from a primary care physician and a care manager had significantly less suicidal ideation compared with their counterparts who received usual care, results from a 2-year study...
Consults Can Bring 'Miraculous' Results
NEW YORK -- Consultations in which a psychoanalyst brings an educational approach to parent-teacher interactions can lead to rapid resolution of preschoolers' behavior problems, Roy N. Aruffo, M.D., said at a meeting sponsored by the American Psychoanalytic...
Coping Skills Can Prevent or Relieve Headache Pain
SCOTTSDALE, ARIZ. -- Medications have their rightful place in headache treatment, but a strong dose of some key coping and behavioral tools can go a long way toward helping patients manage their own headaches, Alvin E. Lake III, Ph.D., said at a symposium...
COX-2 Uproar Likely to Alter Drug Trial Landscape, Expert Says
CHICAGO -- Recent events surrounding selective cyclooxygenase-2 inhibitors will have far-reaching implications for future drug trials, Gary S. Hoffman, M.D., said at a symposium sponsored by the American College of Rheumatology. Drugs under investigation...
COX-2 Withdrawals Complicate Pain Treatment
The market withdrawal of valdecoxib and the black box warnings on celecoxib and all other remaining prescription NSAIDs have rheumatologists fuming and patients worried and confused, experts say. "The American College of Rheumatology has been getting...
Cultural Sensitivity Is Essential
The call for preventive interventions for at-risk youth is sounded loudest after a tragedy borne of the absence of such interventions. After all, American culture is reactive. When bad things happen, people ask why, how, and what can be done to make...
Cytokine Tied to Depression in Pregnant Women
NEW YORK -- Macrophage migration inhibitory factor, a newly characterized cytokine that inhibits cortisol and increases production of inflammatory cytokines, may be the key to understanding depression during pregnancy, Brad D. Pearce, Ph.D., said at...
Data on Bipolar Miss Complexity
SAN FRANCISCO -- Diagnosing bipolar disorder requires not just asking the right questions but the right people, Michael J. Gitlin, M.D., said. In one national survey, more than one-third of 600 bipolar disorder patients sought help within a year...
Dear Healthcare Professional
April 2005 My Lilly colleagues and I have heard your recent questions about Zyprexa[R] (olanzapine), as well as your needs when treating your patients who are battling schizophrenia and bipolar disorder. Over the last eight years we have worked...
Depression Not Tied to Drug Use in HCV Patients
SAN JUAN, P.R. -- Depression was not significantly associated with heroin or cocaine use for methadone maintenance patients infected with hepatitis C, according to a study presented at the annual meeting of the American Academy of Addiction Psychiatry....
Donepezil Fails to Stop Progression to Alzheimer's: After 3 Years, Conversion from Mild Cognitive Impairment to Alzheimer's Comparable to Placebo
MIAMI BEACH -- Neither donepezil nor vitamin E significantly prevented more patients with mild cognitive impairment from converting to Alzheimer's disease at 3 years than placebo, according to a study presented at the annual meeting of the American...
Donepezil May Aid Memory in Down Syndrome
GRAPEVINE, TEX. -- A drug used to treat Alzheimer's disease has shown effectiveness in improving the memory of adults with Down syndrome, Duke University researchers reported. "The improvement in memory was promising," said Jennifer Sullivan, genetic...
Drug-Related Rashes Can Have Fatal Complications: Hypersensitivity Seen in 0.01%-0.1% of Patients Given Phenytoin, Carbamazepine, and Phenobarbital
NEW YORK -- Rashes are among the most common adverse drug reactions. Most are benign, but vigilance about the small percentage of eruptions that do signal serious conditions is essential. In psychiatry, this applies particularly to anticonvulsants,...
Early Sensory Input Shapes Brain's Neural Structure
NEW YORK -- The basic structure of the mind and personality are formed early in life and are resistant to change in adulthood. Those tenets are fundamental and represent the therapeutic challenges of psychoanalysis. A growing body of research explains...
Electronic Prescribing Projects Start to Take Hold: The Aim of New Federal Standards Is to Make It Easier and More Attractive to Use the Technology
Medicare officials have proposed new uniform standards for electronic prescribing that will govern transactions between prescribers and dispensers of prescriptions. Under the proposal, the standards would take effect in January, to coincide with...
FDA Calls for Warnings on Atypicals Used for Dementia
The Food and Drug Administration has issued a public health advisory warning physicians and patients that using atypical antipsychotics off label to treat dementia in the elderly has been associated with a higher death rate. The agency asked manufacturers...
Flag Psychosis in Evaluating Infanticidal Thoughts
NEWPORT BEACH, CALIF. -- When a new mother reports having infanticidal thoughts, how should one decide whether she poses an imminent danger to the child? The key is to assess several risk factors, Gagan Dhaliwal, M.D., said at the annual meeting of...
GID Patients Need to Be Told of Realities: Get Adolescents with Gender Identity Disorder to Develop Life Plans, Assess Levels of Family Support
HOUSTON -- Most adolescents with gender identity issues initially are treated for comorbid conditions such as depression, Flynn O'Malley, Ph.D., said at the annual meeting of the American Society for Adolescent Psychiatry. Considerations for managing...
Imaging Costs Going Up, Insurers Cracking Down
As the public focuses on problems with the safety and cost of prescription drugs, insurers are training their sights on a different cost issue: imaging procedures. On average, costs of imaging--especially high-tech procedures, such as MRI, CT, and...
Important Safety Information for Zyprexa
The most common treatment-emergent adverse event associated with Zyprexa in placebo-controlled, short-term schizophrenia and bipolar mania trials was somnolence. Other common events were dizziness, weight gain, personality disorder (COSTART term for...
Long-Term Benzodiazepine Use Appears Safe in Elderly
WASHINGTON -- Chronic benzodiazepine use by the elderly does not necessarily lead to an increased risk of death, hospital readmission, institutionalization, or functional decline, Christophe J. Bula, M.D., said at the annual meeting of the Gerontological...
Metaanalysis Sheds Light on Recidivism Risks
COLORADO SPRINGS -- A major recent metaanalysis addressing recidivism risk factors for adult sex offenders has provided a big boost for the routine use of actuarial risk instruments, Dennis Kleinsasser, Ph.D., said at a symposium on addictive disorders...
Methadone's Impact on Libido Hurts Compliance: Between 30% and 100% of Patients Using Methadone Report Sexual Dysfunction Problems
WASHINGTON -- Increased doses of methadone may be good for opioid dependence, but they might not be good for a patient's sex life. "Although it hasn't been well studied in [methadone patients], we know that sexual dysfunction as a side effect can...
NEI's Philosophy: Our Commitment
In 2002, Dr. Stephen M. Stahl conceptualized an organization dedicated to the advancement of medicine that would positively impact the quality of care for psychiatric patients. This vision gave birth to the Neuroscience Education Institute, whose stated...
New Epilepsy Drugs Cause Fewer Side Effects Than Carbamazepine
BOSTON -- A Veterans Affairs cooperative study of epilepsy in the elderly has found that two newer agents are as effective as carbamazepine at controlling seizures but are far less likely to cause unpleasant side effects in this age group than the...
New Federal Law Expected to Limit Class-Action Lawsuits
WASHINGTON -- People who have suffered adverse outcomes because of drugs or medical devices may face more delays in suing manufacturers for damages now that federal class-action lawsuit legislation has been signed into law. The law, known as the...
Omega-3 Boosts Mood throughout Pregnancy
SCOTTSDALE, ARIZ. -- With growing concerns about treatment of depression in pregnancy, omega-3 fatty acids are gaining attention as a possible treatment that might be without risk and healthful for mother and child, Marlene Freeman, M.D., said at a...
Omega-3 Fatty Acids and Depression
The Problem You have a patient diagnosed with depression, and he requests fish oil capsules containing omega-3 fatty acids. The Question Are omega-3 fatty acids efficacious in treating depression? The Analysis Our Medline search combined...
On-Call Emergency Care Issue Revives Debate
WASHINGTON -- On-call emergency care dominated the agenda at the inaugural meeting of the Department of Health and Human Services technical advisory group on the Emergency Medical Treatment and Labor Act. EMTALA, enacted in 1986 to ensure public...
Our Role as Advocates
According to Allan Peterkin, M.D., author of "The Psychiatrist's Little Book of Wisdom," one of the roles of a psychiatrist outside of the office is to be an advocate for the mentally ill. Do you agree with Dr. Peterkin's assertion? If not, why...
Patch May Work Best for Teen Smokers
Nicotine patches may help more adolescent patients addicted to tobacco to abstain from smoking than placebo, according to the results of one of the few double-blind, randomized trials of its kind. In the pilot study, significantly more adolescents...
Perspective
To quote George Clinton of Funkadelic, "You don't drink what I drink; You don't smoke what I smoke: You don't think like I think; You don't joke like I joke. I got a thing, you got a thing, everybody's got a thing." Everybody has a thing, and a...
Physicians: Medicare Formula Is Priority in Reform
WASHINGTON -- Congress should fix Medicare's payment formula before taking on any new reforms to pay physicians on the basis of quality, medical organizations testified at a hearing of the House Ways and Means health subcommittee. If impending cuts...
Prenatal, Maternal Factors Tied to Later Suicidal Behavior
Certain prenatal and maternal factors may be associated with attempted or completed suicide in offspring, according to Ellenor Mittendorfer-Rutz and her colleagues at the Karolinska Institute, Stockholm. In a large cohort study involving more than...
Psychiatrists Responding to Tsunami Tragedy: Disaster Psychiatry Outreach Hopes to Train Local Leaders in Sri Lanka to Work as Counselors
Members of Disaster Psychiatry Outreach who traveled to Sri Lanka after the late December tsunami say their initial efforts to assist survivors are just the beginning. "What we did was the easy part," Craig Katz, M.D., cofounder and president of...
Raising a Child with Special Needs
It's been 10 years since Elyse May was born with congenital adrenal hyperplasia, but her mother, Michelle May, M.D., remembers the experience as if it were yesterday. While Dr. May suspected that her daughter had congenital adrenal hyperplasia,...
Recommended Exercise Also Curbs Depression
VANCOUVER, B.C. -- The amount of exercise that is recommended for general public health is also an effective treatment for depression, Andrea L. Dunn, Ph.D., reported at the annual meeting of the American Psychosomatic Society. Despite many intervention...
Report Documents Magnitude of U.S. Substance Abuse: Data Show Children Face Multiple Risks
About half of children in America--nearly 36 million of them--live in homes where a parent or other adult uses tobacco, drinks heavily, or uses illicit drugs. That's one of the sobering facts contained in "Family Matters: Substance Abuse and the...
Reservists Face More Mental Illness
COLORADO SPRINGS -- As U.S. troops rotate home from Iraq, the psychosocial problems they bring with them tend to differ depending upon whether they are active duty or National Guard reservists, Thomas L. Jewitt, M.D., said at a symposium on addictive...
Risperidone Augmentation of Clozapine Works! Risperidone Augmentation of Clozapine Doesn't Work! A Tale of Two Protocols
"It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of...
Schiavo Case Shows Need for Clarity
The case of Terri Schiavo serves as a lesson for physicians: Make sure that you explain things in terms that both patients and their families can understand. From what I have read and heard, it is clear that Ms. Schiavo was in a persistent vegetative...
Secondary Headaches More Common in Elderly
SCOTTSDALE, ARIZ. -- Headache management in the elderly involves consideration of factors not often seen in younger patients, Jerry W. Swanson, M.D., said at a symposium sponsored by the American Headache Society. The possibility of secondary headache...
Sex Offender Therapy Becoming More Holistic
COLORADO SPRINGS -- Therapists who start to treat sex offenders will quickly find that the work differs from any other form of psychotherapy, according to speakers at a symposium on addictive disorders sponsored by Psychotherapy Associates. The...
Should 'Apathy' Get More Attention in DSM-V? Research Meeting Proposed to Identify Ways to Reliably Measure This Common Presenting Symptom
BAL HARBOUR, FLA. -- The status of apathy should be elevated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, according to a presentation at the annual meeting of the American Neuropsychiatric Association. Apathy...
Study Links Current Smoking to Risk of Suicidal Behavior
Daily cigarette smokers are 1.82 times more likely to have suicidal thoughts or to attempt suicide, compared with those who had smoked in the past, results from a large prospective study have demonstrated. Previous studies have suggested that there...
Substance Use Predictors Found in Psychotic Major Depression
SAN JUAN, P.R. -- Just as with major depressive disorder, bipolar disorder, and schizophrenia, substance use disorders occur at a high rate in patients with psychotic major depressive disorder, according to a study presented at the annual meeting of...
Technology Extends Reach of the Bully
HOUSTON -- In the age of 24-hour technology, bullying no longer stops at the playground border. Cyber bullying is a form of harassment using text messages, e-mail, and Web sites. This high-tech approach allows children and adolescents to engage...
The Art of Deborah Standard
Encaustic painting is the creative method of choice for Deborah Standard. Encaustic consists of pigment, available in powder form or in wax sticks, that's mixed into molten beeswax. Carnauba, a vegetable wax, can be used in addition to beeswax, and...
The Death Penalty and Youth
The recent ruling by the U.S. Supreme Court that will abolish the execution of offenders who are under the age of 18 years is a splendid one. In fact, I am reluctant to question it. But why stop there? I have found this topic engaging and daunting...
The Healing Power of Humor
Humor has the power to heal. That's true in physical and emotional healing. This means that humor can play a key role in the therapeutic relationship. Humor, like love, is difficult to study, but studies suggest that humor and laughter affect...
The Terms of Address in Therapy May Merit a Closer Look
NEW YORK -- The way clinician and patient address each other is rarely examined in psychotherapy and psychoanalysis, but it should be. "Names contain core material, nuggets of inner life, revealing how we see ourselves and relate to others. It is...
Treating Depression in Schizophrenia
Depressive symptoms have been recognized as part of schizophrenia since the latter was first described by Eugen Bleuler. However only with the DSM-IV was this comorbidity granted a measure of official status, with "postpsychotic depressive disorder...
Treatment Approaches to Phobias
Most of what Dr. Robert T. London discusses about phobias, and especially fear of flying and their treatments, seems practical and often works ("Treating Fearful Flyers," The Psychiatrist's Toolbox, March 2005, p. 27). But I would like to add a few...
U.K. Considers Pulling Four Antidementia Drugs
A British proposal to remove four antidementia drugs from the National Health System formulary is unlikely to affect Medicare coverage of these agents, but some experts in the United States worry that it could influence private payers here. The...
VA Study: Untreated Anxiety, Depression Found
SAN DIEGO -- Most patients with chronic obstructive pulmonary disease have at least moderate levels of anxiety or depression, results from a Veterans Affairs hospital study showed. In fact, most such patients have anxiety as well as depressive symptoms,...
West Virginia Sees Malpractice Improvement after Reform
The malpractice environment may be starting to improve for emergency physicians in West Virginia 2 years after a comprehensive medical liability reform bill was enacted in the state. "It's probably too early to see a huge improvement," said Frederick...
What We Can Learn about Addiction
Recently I attended a continuing medical education program at Columbia University's College of Physicians and Surgeons. The program focused on the use of the partial opioid agonist buprenorphine for treating opioid dependence in an office practice....
Yoga Alleviates Fibromyalgia Pain in Small Study
VANCOUVER, B.C. -- Yoga may be an effective adjunct to medical treatment for patients with fibromyalgia, Malinda L. Breda, Ph.D., reported at the annual meeting of the American Psychosomatic Society. There are many reasons why yoga is an attractive...