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. 29, No. 12, December

ADHD's Social Deficits Become Clear with Age. (Social Skills Training May Help)
SAN FRANCISCO -- Children with attention-deficit hyperactivity disorder notice their problems with academics or behavior but seem unaware of problems with their peer relationships until adolescence, Kara M. Brooklier said at the annual meeting of the...
Antiepileptic Drugs Disrupt Reproductive Function. (Monitor Metabolic, Endocrine Effects)
ATLANTA -- Possible metabolic and endocrine effects, including bone loss and androgenization, should be kept in mind when managing women on antiepileptic drugs, Dr. Martha Morrell said at the annual meeting of the American Academy of Clinical Psychiatrists....
APA Election Highlights Concerns over Declining Membership, Managed Care: Two Candidates Vie for Top Spot
ORLANDO, FLA. -- The debate over priorities of the American Psychiatric Association continues with this year's selection of president-elect. In an era when psychiatry is pressured to provide much needed mental health services with little funding,...
Berkeley Pilot Study Examines Fee-Based E-Mail Consults. (Doctors Paid $20 per E-Visit)
About 200 physicians in California are being paid $20 each time they electronically consult with patients in an ongoing study. If such communication proves cost effective and keeps doctors and patients satisfied, Blue Shield of California plans...
Bipolar Management Demands Life Charting, Time. (Do Longitudinal Evaluation)
ATLANTA -- Diagnosis, followed by effective management, of bipolar disorder is an irreducibly difficult endeavor that requires time and a sense of timing, Dr. Russell T. Joffe said at the annual meeting of the American Academy of Clinical Psychiatrists....
Bupropion May Help Pathologic Gambling. (Small Study Marred by High Attrition Rate)
ATLANTA -- Pathologic gambling may respond to treatment with bupropion, according to a small open study reported at the annual meeting of the American Academy of Clinical Psychiatrists. These findings support the clinical relevance of an apparent...
Chart Height, Weight of Patients on ADHD Drugs. (Growth Delays Noted in 2-Year Study)
HONOLULU -- Growth reductions seen in a 2-year study of 44 children taking mixed amphetamine salts for attention-deficit hyperactivity disorder spotlight the need to monitor height and weight, Dr. Peter A. Ahmann said. Higher doses of the mixed...
Communication, Coordination Are Key to Successful Split Treatment Arrangements. (Integrating Drugs and Psychotherapy)
DESTIN, FLA. -- The integration of pharmacotherapy and psychotherapy is increasingly important in psychiatry, but the ability of psychiatrists to perform both functions has dwindled as a result of cost-containment efforts. These efforts, particularly...
Data on Extended-Release Methylphenidate Grow. (Side Effects Related to Dose)
HONOLULU -- Two of the newer versions of extended-release methyiphenidate hydrochloride effectively treated attention-deficit hyperactivity disorder in separate studies reported in poster presentations at the annual meeting of the American Academy...
Developmental Language Impairment May Be Due to Diffuse CNS Dysfunction. (Related to Other Neurologic Anomalies)
BALTIMORE -- Developmental language impairment is not due to focal pathology in a "language center" of the brain, but to a more diffuse dysfunction of the nervous system. Defined as delayed or abnormal receptive or expressive language in a child...
Don't Apply Conventional Expectations to Quality of Life with Schizophrenia. (Clinicians, Patients Disagree on Criteria)
MADRID -- Patients and their psychiatrists appear to have very different ideas about what determines quality of life in schizophrenia, Dr. Ingunn Skre said at the World Psychiatric Association International Congress 2001. "We shouldn't use our own...
DSM-IV Failings Spawn Wish List for DSM-V. (Patient-Focused, Evolving System Wanted)
ASPEN, COLO. -- Widespread dissatisfaction with the current diagnostic classification scheme embodied in DSM-IV emerged as a recurrent theme at a psychiatry conference sponsored by the University of Colorado. "The categorical boxes that we have...
Earlier Use of Antidepressants, Tapered Doses Reduce Relapse Rate Post ECT. (Dispelling Treatment Misconceptions)
SANTA FE -- Tapering doses and earlier administration of antidepressants may open the door to fewer relapses after electroconvulsive therapy, Harold Sackeim, Ph.D., said at a symposium on mood disorders sponsored by the University of Arizona. "Electroconvulsive...
Eating Disorder Relapse Risk Linked to Self-Esteem, Motivation. (Impulsivity, Ego Syntonicity Influence Risk)
BERLIN -- Self-esteem, motivation, and impulsivity are key predictive factors in the outcome of eating disorder treatment, including the possibility of relapse, Dr. Katherine Halmi said at the Seventh World Congress of Biological Psychiatry. Ego...
Endocrine Test Predicts Antidepressant Response: Drop in Prolactin Secretion Is a Good Sign. (Dopaminergic Tone May Be Key)
MADRID -- Blunted pituitary response to thyrotropin-releasing hormone, as indicated by reduced prolactin secretion, predicts a good response to antidepressant therapy, Dr. Fabrice Duval said in a poster presentation at the World Psychiatric Association...
Inpatient Today, Inmate Tomorrow: 60% of Inpatients Arrested within 3 Months
BOSTON -- The overrepresentation of bipolar disorder in prison populations may reflect gross defects in community treatment marked by frequent, brief hospitalizations and little outpatient care, Dr. Cameron Quanbeck said at the annual meeting of the...
Inquiries Heighten Stress for Emergency Workers. (Firefighters, Police, Paramedics)
BOSTON -- Postmortem reviews," such as internal investigations, coroner's inquests, and public hearings magnify the effects of stressful events on firefighters, police, ambulance drivers, and other emergency workers, Cheryl Regehr, Ph.D., said at the...
Insurers Survey New Mothers about PPD. (Edinburgh Postnatal Depression Scale Used)
Experts disagree on whether a postpartum depression screening program started by several health insurers is a good way to reach patients who may be suffering from the condition. Approximately 20 health plans, under a subcontract with mental health...
Integrating Drugs, Therapy a Delicate Balancing Act. (Drugs May Inhibit Psychotherapy)
DESTIN, FLA. -- Achieving success with pharmacotherapy in a psychiatric patient requires good psychotherapy with that patient, Dr. Daniel K. Winstead said at a psychiatric conference sponsored by Tulane University. Only by knowing and working with...
Integration Is Key to Survival
Psychiatry in the 21st century is threatened--from without as well as within. Increasingly, other professions are trying to take over whole areas of mental health. For neurologists, who practice "brainiatry," and for primary care physicians, psychologists,...
Jury Is Still out on Use of HRT for Perimenopausal Depression. (Few Older Women Participate in Trials)
NEW ORLEANS -- Data on the role of hormone replacement therapy for menopause-associated mood disorders look promising, but only well-documented treatments such as selective serotonin reuptake inhibitors are appropriate first-line approaches at this...
Lamotrigine Rivals Lithium in Effectiveness for Acute Mania. (Randomized, Controlled Trial)
ATLANTA -- Lamotrigine appeared as effective and well tolerated as lithium for the treatment of acute mania in a randomized, double-blind, controlled trial reported by Dr. Liviu Ichim at the annual meeting of the American Academy of Clinical Psychiatrists....
Lithium Decline Reflects Economic, Not Clinical Trends: Since 1965, 24 Studies Have Reported a Drop in Bipolar Recurrence with Lithium. (Valproate Garners 70% of the Market)
ATLANTA -- Reports of lithium's demise as an effective drug for bipolar disorder have been greatly exaggerated, Dr. Frederick Goodwin said at the annual meeting of the American Academy of Clinical Psychiatrists. The perception that the drug "stopped...
Malingering Pet Owners Score Drugs from Vets. (Good Dogs, Bad Owners)
BOSTON -- Most physicians are alert for patients who pretend illness to gain drugs. But the possibility may be overlooked when the "patient" isn't human. Dr. Herbert LeBourgeois III reported four cases of apparent malingering "by proxy in animal,"...
Mental Health Staff Harassed, Stalked by Patients. (Expert Intervention Crucial)
BOSTON -- Although serious harassment and stalking of mental health professionals by patients are relatively rare, milder cases are common and can cause psychiatrists serious distress and disruption, Dr. Renee Binder said at the annual meeting of the...
Mood Disorders Tend to Evolve over Time. (Raised Expression of Genetic Predisposition)
ASPEN, COLO. -- Depression and other mood disorders not only tend to become more frequent and severe in vulnerable individuals over the course of a lifetime, but the same trend increasingly is occurring within society at large, Dr. Steven L. Dubovsky...
Neuroimaging Studies: Disease Response or Cause? (Chicken-or-Egg Question about Results)
HONOLULU -- Most neuroimaging studies that compare normal brains with those of people with neuropsychiatric disorders conclude that the differences seen identify the causes of the psychopathology. If subsequent studies show that medication relieves...
New Laws Address Student Mental Health. (Take Time to Talk to Students)
A movement is underway to ban psychotropics from schools. Some states have passed laws that prohibit schools from discussing such drugs with parents. Have any of your patients been affected? How do you counsel parents and school officials on the...
Personality Trait May Predispose Patients to Depression, Relapse. (Low Sensitivity to Reward)
MADRID -- Low sensitivity to reward is a personality trait that may increase vulnerability to depression and put recovered patients at an increased risk of relapse, Dr. A. Pinto said in a poster presentation at the World Psychiatric Association International...
Pindolol Accelerates Effectiveness of SSRI Response. (Effect Limited to First 2 Weeks)
MADRID -- The [beta]-blocker pindolol enhances the efficacy of certain antidepressants but in a strictly time-limited fashion, Dr. Javier Ballesteros said in a poster presentation at the World Psychiatric Association International Congress 2001. ...
Progress in Bipolar Genetics Slow, but Promising. (Multiple Genes Involved)
ATLANTA -- There is little question of an inherited predisposition to bipolar disorder, but the details have proven difficult to unravel, with strong candidate genes emerging on four different chromosomes, Dr. J. Raymond DePaulo said at the annual...
PROs Enlisted to Educate Doctors on Bioterrorism. (Information Transmitted in 1-2 Days)
WASHINGTON -- The Centers for Disease Control and Prevention is enlisting the aid of peer review organizations to speed the delivery of accurate clinical information on bioterrorism. "Special Alert" is the insignia of the new rapid distribution...
Psychotropics Useful in Managing Chronic Pain; Practical Psychopharmacology: What Experts Do before Study Results Are in. (Psychopharmacology)
Chronic pain is no stranger to the psychiatrist's office. In some patients, it is a secondary part of the clinical presentation; in others, it's the primary reason the patient has been referred. Regardless of the pain's origin, antidepressants and...
PTSD Responds to Mix to Drugs, Psychotherapy. (Consider CBT, SSRI)
ASPEN, COLO. -- The state of therapeutics in postrraumatic stress disorder can be described in a word as confusing, Dr. John A. Talbott said at a psychiatry conference sponsored by the University of Colorado. "Frankly, it's a mess," he said. "The...
Should the Centers for Medicare and Medicaid Services Scrap the CPT? (Pro & Con)
YES In July, Senate Minority Leader Trent Lott wrote to Health and Human Services Secretary Tommy G. Thompson asking him to consider abandoning the CPT coding system. In his letter, Sen. Lott (R-Miss.) noted that the American Medical Association...
SSRIs Stand Alone in Treating Pediatric Depression. (Fluoxetine Maintains Recovery)
HONOLULU -- New data confirm the effectiveness of selective serotonin reuptake inhibitors in treating major depression in children and adolescents, Dr. Graham J. Emslie said at the annual meeting of the American Academy of Child and Adolescent Psychiatry....
Suspect Bipolar Disorder? Try Mood Stabilizer First. (Use before Antidepressants)
ASPEN, COLO, -- Most psychiatrists today see nothing but complex cases of mental illness--a situation created, in part, by primary care physicians' suboptimal treatment of earlier, simpler episodes in the same patients, Dr. Steven L. Dubovsky said...
Trend toward ADHD Subtyping Is Premature. (Use 'Nos' Diagnostic Category More Often)
ASPEN, COLO. -- The time has come for psychiatrists to make much greater use of the "not otherwise specified" diagnostic designation in cases of attention-deficit hyperactivity disorder, thereby reversing a major and regrettable decade-long trend toward...
Wanted: Child Psychiatrists. (Guest Editorial)
My father, once a foster child, was able to thrive and succeed in life largely because of an accidental encounter with a nurse who provided a "secondary relationship" that gave him hope, skills, and happiness. Unfortunately, for the more than 500,000-700,000...