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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. 32, No. 9, September
Abbreviated Depression Scale Proves as Effective as HAM-D17
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PARIS -- A 7-item rating scale for depression was as effective as the standard 17-item Hamilton Rating Scale for depression in a study with 142 patients. Although the 17-item scale is considered the standard, "questions about its internal consistency,...
Adjunctive Use of Anticonvulsants in Psychosis
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Until recently, the use of anticonvulsants for schizophrenia seemed a classic instance of practice being forced beyond the research base by the exigencies of patient care. Research is starting to catch up, though, as two randomized controlled trials...
Age, APO E Allele Predict Dementia Progression
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PHILADELPHIA -- A combination of age and the presence of the apolipoprotein E [epsilon]4 allele can identify which patients with mild cognitive impairment are most likely to progress to dementia in the long term, Dr. Pieter J. Visser reported at the...
Alcohol Abstinence Drug Wins FDA Approval: Acamprosate Is Thought to Help Alcohol-Dependent Patients Who Are Not Drinking at Start of Treatment
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The recent approval of acamprosate in the United States provides the first new pharmacologic treatment for treating alcohol dependence in a decade--and the first believed to target the changes in chemical abnormalities that occur in the brains of alcoholics....
Alzheimer's Risk Factor May Affect Cortical Atrophy
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BALTIMORE -- Nondemented adults with the apolipoprotein E [epsilon]4 genetic risk for Alzheimer's disease may have a higher risk for accelerated brain atrophy, Prabha Siddarth, Ph.D., said in a poster presentation at the American Association for Geriatric...
Alzhemed May Stabilize Cognitive Function: Investigational Drug Appears to Prevent Formation of Amyloid Fibrils in Brain-A Hallmark of Alzheimer's
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PHILADELPHIA -- Alzhemed, an investigational drug believed to prevent formation of amyloid fibrils in Alzheimer's patients, was safe and showed hints of efficacy in a phase II study, Dr. Paul A. Aisen said at the Ninth International Conference on Alzheimer's...
Antidepressants May Need 8 Weeks to Take Effect
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PARIS -- A patient with depression may take as long as 8 weeks to respond to treatment with an antidepressant, and the length of this possible lag is often underestimated by physicians, Dr. Andrew A. Nierenberg said at the 24th Congress of the Collegium...
Ask 10 Questions before Buying an Electronic Records System
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WASHINGTON -- Carefully assess your needs before you select an electronic medical record system, Dr. Jijo James said at the annual National Managed Health Care Congress. "We've been talking about EMRs for 15 years now in various shapes and forms,"...
Behavioral Therapies Can Put Sleep Problems to Rest
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LAS VEGAS -- Behavioral therapies can break the habits and misconceptions that cause chronic insomnia, provided that psychiatric or medical problems are not at play, Dr. Bashir Chaudhary said at a meeting on primary care sponsored by the Southern Medical...
Black Physicians Push for Equitable Medicare Care
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SAN DIEGO -- Physicians who treat black Medicare patients are less likely to be board certified and more likely to lack some clinical resources, compared with physicians seen by white patients, a recent study suggested. The study caused a stir at...
Children and ADHD: 52.9% Get Rx Treatment
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HONOLULU -- Only half of children with attention-deficit hyperactivity disorder are being treated with medication, according to a study from the Centers for Disease Control and Prevention. The study, which used data from the National Health Interview...
Compliance Tougher in Schizophrenia
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MIAMI -- Human nature makes compliance with medication difficult with any illness, but it becomes particularly challenging for people with schizophrenia, Dr. Samuel J. Keith said at a psychopharmacology update sponsored by the University of Miami....
DEA Guidelines Clarify Issues of Opioid Use and Misuse
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Physicians who appropriately prescribe opioids to treat chronic pain can rest assured that they will not be investigated by federal agents, according to new guidelines for pain management issued jointly by the Drug Enforcement Agency and national pain...
Dexamethasone Suppression Test Can Indicate Suicide Risk
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MIAMI -- A dexamethasone suppression test can identify patients at increased risk of suicide, according to a follow-up study presented at the annual conference of the American Association of Suicidology. Researchers striving to identify an endocrine...
Diagnoses of Vascular Dementia on the Rise; Cost per Patient Higher Than Other Subtypes
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PHILADELPHIA -- Vascular dementia has been diagnosed with increasing frequency over the last decade, particularly among African Americans, Dr. P. Murali Doraiswamy said in a poster presentation at the Ninth International Conference on Alzheimer's Disease...
Disaster Outreach: New for Psychiatry
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For Dr. Ira Brenner, practicing disaster psychiatry involves everything from taking people to get a sandwich to waiting with them to see whether their loved one's DNA has been found. "It's a whole new way of thinking about helping people, because...
Distinguish Chronic and Acute Suicide Risk in Bipolar Patients
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SANTA FE, N.M. -- Indications of chronic suicide risk often fail to predict acute risk in bipolar patients, Dr. Jan Fawcett said at a psychiatric symposium sponsored by the University of Arizona. It's important to differentiate chronic from acute...
Donepezil May Delay Alzheimer's by 18 Months: TX Failed to Halt Disease in MCI Patients
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PHILADELPHIA -- Treatment with donepezil significantly slowed, but ultimately could not prevent, the progression of patients from mild cognitive impairment to Alzheimer's disease in a placebo-controlled, 3-year study with 769 patients. The clinical...
Drug Ads: Let's Use Them as Learning Tools
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Pharmaceutical advertisements are having problems with women. The latest evidence comes from a group of scholars at the Women's Health Program at the University of Toronto. Their study. "Who Is Portrayed in Psychotropic Drug Advertisements?" (J. Nerv....
Duloxetine Gains FDA Approval for Major Depression: Trials of 6,000 Adults with Major Depressive Disorder Show SNRI's Efficacy
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Approval of duloxetine hydrochloride by the Food and Drug Administration offers an additional drug for the treatment of major depressive disorder that affects both serotonin and norepinephrine. In a statement announcing the approval, Dr. Stephen...
Dye Eases Intraoperative Imaging of Aneurysms: Technique Using Indocyanine Green May Provide Alternative to Digital Subtraction Angiography
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ORLANDO, FLA. -- A new imaging technique allows quick assessment of cerebrovascular aneurysm procedures during surgery, offering surgeons the ability to alter device placement and potentially improve patient outcomes, according to data presented at...
Eating Disorders Missed, Misdiagnosed in Men
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The 15-year-old swimmer who came into Dr. Joel Jahraus' office recently could hardly be accused of not eating much--after all, he was consuming up to 4,000 calories daily. Unfortunately, even that many calories weren't enough to keep up with his frantic...
Emphasize Fitness over Weight Loss to Fight Chronic Diseases
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QUEBEC CITY -- Physical inactivity, more than obesity, is to blame for a large chunk of America's battle with chronic illness, according to Dr. Steven N. Blair president and CEO of the Cooper Institute, a nonprofit research and education center in...
Escitalopram Effective for Long-Term Treatment of GAD
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PHOENIX, ARIZ. -- Anxiety scores continuously improve over at least 24 weeks in patients with generalized anxiety disorder who take escitalopram, Dr. Jonathan R.T. Davidson said in a poster presentation at a meeting of the New Clinical Drug Evaluation...
Expert Offers Screening Lineup for Unexplained Mental Retardation
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CAMBRIDGE, MASS. -- Children with unexplained mental retardation should undergo genetic screening with comparative genomic hybridization when standard cytogenic techniques fail to detect chromosomal abnormalities, according to Dr. Jeff Milunsky. ...
Feds to Reward Use of Electronic Health Records
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WASHINGTON -- A new report from the Department of Health and Human Services outlines 12 strategies aimed at bringing electronic health records into clinical practice, interconnecting physicians, personalizing care, and improving population health....
Former Chief Defends Medicare Act
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CHICAGO -- The Medicare Modernization Act is here to stay, former Medicare chief Tom Scully said at a conference sponsored by America's Health Insurance Plans. Even if Sen. John F. Kerry (D-Mass.) is elected president and the Democrats take control...
Government Still Owns Most Academic Medical Centers
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SARASOTA, FLA. -- Most academic medical centers in the United States are still government owned, though several-teaching hospitals have made the conversion from public to private ownership, Dr. John A. Kastor said at a meeting sponsored by the Association...
Hallucinations and Antipsychotic Treatment
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The Problem A patient presents with depression and auditory hallucinations. He is facing a number of very serious felony charges, so you consider the possibility of malingering. Since malingering is a diagnosis of exclusion, and in the interest...
Hippocampus Size on MRI Flags Risk of AD
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PHILADELPHIA. -- An MRI brain image that shows a small hippocampus can identify those patients with mild cognitive impairment who have the highest risk of progressing to Alzheimer's disease, based on a study with 190 patients. Patients who had a...
Immaturity and Low IQ May Predict Psychosis: Small Study of Adolescents Suggests That a Broader Neurobiologic Basis for Psychosis Might Exist
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BAL HARBOUR, FLA. -- Adolescents with psychosis demonstrate neurodevelopmental abnormalities that, when combined with age and intelligence testing, correctly discriminate them from adolescents without mental illness, Dr. David Arciniegas reported in...
Initiative Aims to Fight Leading Causes of Death
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The American Cancer Society, the American Diabetes Association, and the American Heart Association have joined forces to help Americans lower their risk of cancer, diabetes, heart disease, and stroke, which together account for nearly two out of every...
Leaders Urged to Better Manage Fears about Terrorism
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WASHINGTON -- The federal government needs to do a better job of protecting its citizens' mental resiliency in the wake of terrorist attacks. Dr. Michael Barnett said at a meeting on the psychosocial effects of terrorism sponsored by the University...
Legal Strategies Protect Personal, Practice Assets
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MIAMI BEACH -- Effective strategies aimed at protecting physician wealth from malpractice or other litigation include diluting the value of your practice, forming corporations and limited partnerships, directing assets to offshore irrevocable trusts,...
Long-Term Imipramine Can Induce Bluish-Gray Hyperpigmentation
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VICTORIA, B.C. -- Bluish-gray hyperpigmentation has now been reported in 11 patients taking the tricyclic antidepressant imipramine, Dr. Andrei Metelitsa said at the annual conference of the Canadian Dermatology Association. In all of those cases,...
Long-Term Use of Beta Carotene Beneficial
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PHILADELPHIA -- Long-term beta carotene supplementation could significantly reduce the risk of developing Alzheimer's disease, Francine Grodstein, Sc.D., reported at the 9th International Conference on Alzheimer's Disease and Related Disorders. ...
Media's Negative Use of 'Psychosomatic' Can Add to Stigma
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The word "psychosomatic" is often used pejoratively in newspaper media, and that usage might be damaging to patients and the newly minted psychiatric subspecialty of psychosomatic medicine, according to Dr. Jon Stone of the Western General Hospital,...
Medicare to Cover More Preventive Services: CMS Touts Lipid and Diabetes Screening Benefits, but Some Worry about Funding and Increased Volume
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Get ready to offer more preventive services to Medicare beneficiaries in the coming year. On Jan. 1, 2005, Medicare will start paying physicians for "Welcome to Medicare" physicals and for cardiovascular and diabetes screening tests; coverage for...
Medication Useful as Adjunct to Psychotherapy in PTSD
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SAN FRANCISCO -- Medication can provide a beneficial adjunct to psychotherapy in children with posttraumatic stress disorder, Dr. Jamshid A. Marvasti said at the annual meeting of the American College of Forensic Psychiatry. Studies have shown that...
Memantine Shows Efficacy for Mild to Moderate AD in Phase III Study
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PHILADELPHIA -- Memantine was safe and effective for treating mild to moderate Alzheimer's disease in a phase III study with 403 patients that ran for 24 weeks. If this result leads to U.S. approval of memantine for treating mild to moderate Alzheimer's...
Methamphetamine Use in Pregnancy May Flag More Abuse
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SAN FRANCISCO -- Woman who use methamphetamine during pregnancy face an increased risk of polydrug use, poverty, delayed prenatal care, and out of home placement of their newborns, compared with women who do not use the drug, Dr. Penny Grant reported...
Modafinil Shows Limits in Non-Sleep Deprived
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PHILADELPHIA -- Modafinil is not an effective enhancer of cognition in healthy, non-sleep-deprived individuals, according to the largest study to date on the subject. Modafinil (Provigil) is indicated for use to improve wakefulness in patients with...
Neurologists Characterize More of Their Headaches as Migraines
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VANCOUVER, B. C. -- Neurologists report having more migraines than other physicians, which may mean the stated prevalence rate of migraine needs to be revised upward. Of 135 neurologists, 50% reported having had a migraine during the past year,...
NYU Think Tank Is Focusing on Prevention: Mental Health Prevention Center's Mission Is to Promote Early Detection and Prompt Intervention
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Not that long ago, the idea that diabetics could measure their blood sugar while resting comfortably at home was unimaginable. Fast forward to the future, and it's entirely possible that an equally simple device will be available to measure when mental...
Open Source EHRs Offer Time-Intensive Option
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Dr. Volker Bradley, a retired surgeon from Claremont, N.H., wasn't willing to spend $200,000 on an electronic health records system. Instead, he spent about $20,000 on hardware, installation, and upgrades to an open source EHR system for his five-physician...
'Pathological Bias' Being Considered for DSM-V: Some Fear That Inclusion May Provide an Excuse for People Charged with Engaging in Racist Behavior
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SAN DIEGO -- Racism, a concept absent from DSM-IV, is under consideration for inclusion in DSM-V under the rubric "pathological bias," Dr. Carl C. Bell said at the annual meeting of the National Medical Association. In addition to racism, pathological...
Patients Willing to Pay for Online Interactions with Physicians
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FORT LAUDERDALE, FLA. -- There are stumbling blocks to increasing online interactions with patients, but payment isn't one of them, Dr. Allen Wenner said at a meeting sponsored by the Medical Records Institute. "People will pay the money," said...
Physician Unions Bad for Patients, Report Says: The AMA Is 'Disappointed' That the Report Failed to Recognize the Impact of Insurance Consolidation
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Allowing physicians to bargain collectively "will harm consumers financially and is unlikely to result in quality improvements." according to the Department of Justice and the Federal Trade Commission. The comments were made as part of a 361-page...
Pregabalin Could Be Next Step in Fibromyalgia Tx: Neuromodulator's Approval Expected This Year for Neuropathic Pain, Generalized Anxiety, and Epilepsy
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BERLIN -- The door stands wide open awaiting new, more effective therapies for fibromyalgia--and pregabalin seems poised to gain first entry, Dr. Dan Buskila said at the annual European Congress of Rheumatology. Pregabalin is an investigational...
Psychologists Debate Canadian Prescribing Plan: For Some, Reliance on Physicians Who Are Unfamiliar with the Patient in Question Is Cause for Concern
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HONOLULU -- A program aimed at encouraging psychologists to prescribe through a Canadian pharmacy is prompting concern, even among psychologists themselves. The session on the program held at the annual meeting of the American Psychological Association...
Puffer Fish Toxin Alleviates Refractory Cancer Pain in Trial
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VANCOUVER, B. C. -- A novel pain drug from puffer fish poison showed an analgesic effect that lasted up to 2 weeks following intramuscular injection in patients with refractory cancer pain, Dr. Neil Hagen said at the annual meeting of the American...
Should Minors Have Over-the-Counter Access to Plan B Emergency Contraception?
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YES Teens are one of many groups vulnerable to unintended pregnancies. Each year, there are 800,000 teen pregnancies in the United States--more than in any other industrialized nation. Most of those pregnancies are unintended. Increased use of...
Smoking Cessation Improves Antipsychotics' Effect
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PHOENIX, ARIZ. -- Cigarette smoking is commonplace in many psychiatric facilities, but authorities have been reluctant to ban the practice for fear that withdrawing nicotine may worsen symptoms in patients taking antipsychotic medication. It appears,...
Somatization Severity Reduced a Year after CBT
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NEW YORK -- Cognitive-behavioral therapy may produce enduring and clinically meaningful reductions in the discomfort and physical disability of patients with somatization disorder, Lesley A. Allen, Ph.D., reported in a poster presentation at the annual...
Stem Cell Battle Continues
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WASHINGTON -- Sensing an opening made larger by President Ronald Reagan's death, stem cell research advocates have stepped up their campaign to overturn or loosen the Bush Administration strictures on the field. By early summer, the effort seemed...
Stop Smoking on the Big Screen
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It's been years since cigarettes have been advertised on television, and that's good news for millions of kids who watch TV programs every day. But these same children are bombarded with images of smoking almost every time they go to a movie or...
Summer Shocker
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For the past 2 years the psychiatry department at the University of British Columbia and Pacific Cinematheque, an art/repertory theater in downtown Vancouver, have presented "Frames of Mind," a monthly film series featuring movies with psychiatric...
Supreme Court Ruling on HMOs Irks Physicians
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The Supreme Court's recent ruling that patients cannot sue their health maintenance organizations will be detrimental to patients, according to leaders from several physician organizations. "It is a bad thing for patients," said Dr. Michael Fleming,...
Telepsychiatry Equal to Office in Depression Study
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Telepsychiatry could be a viable alternative to conventional, in-person sessions for treating depression, Dr. Paul Ruskin and his associates reported. This is encouraging news for people who live far from a treatment center, as well as for those...
Telepsychiatry: More Feasible in More Settings
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The patients of Dr. Jacobo Mintzer and his colleagues are part of a unique, six-site telepsychiatry network. Dr. Mintzer assembled the statewide network, part of the Alzheimer's Research and Clinical Programs at the Medical University of South Carolina...
The Art of Philip Brubaker
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Philip Brubaker has been taking pictures since he was about 10 years old. "My parents gave me a really simple camera," he said. "I would take pictures of things around the house--like my cat." Now Mr. Brubaker--who has been diagnosed with bipolar...
The Challenge of Geriatric Care
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This should be a golden age for geriatric mental health care. Medicare pays for psychotherapy and other mental health services. There's been a gradual growth in empiric-based evidence for the effectiveness of psychotherapy, including evidence that...
The Importance of Cultural Competence
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Psychotherapists who work with patients whose culture encourages them to keep their issues to themselves face a special challenge. How can we help patients who historically have been taught and/or modeled to remain tight-lipped? When Pride Gets...
Think Restless Legs in Sleep-Disturbed Patients
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BETHESDA, MD. -- Physicians owe it to their patients to learn about restless legs syndrome, a neurologic disorder that usually presents as a sleep complaint and is remarkably disabling--more than even most sleep experts appreciate, Dr. Mark W. Mahowald...
Trichotillomania: Finding Solutions
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Some years ago, I treated a woman who had been diagnosed with trichotillomania. This patient, who made her living as a trial attorney, had become courtroom phobic after she began pulling the hairs out of her eyebrows and feeling self-conscious about...
Two Insurers Pushing Evidence-Based Medicine
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CHICAGO -- In a trade-off designed to encourage Tennessee physicians to use evidence-based medicine, one insurer is paying for phone calls, e-mails, and other services that are not usually reimbursed. In the first phase of the project, BlueCross...
Two Predictors of Bipolar Relapse Identified
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PARIS -- Among patients with bipolar I disorder, those with a history of rapid cycling and those who presented with a mixed-index episode had the highest risk of a quick relapse. Dr. Mauricio Tohen said in a poster presentation at the 24th Congress...
Venlafaxine and Paroxetine Both Relieve Social Anxiety
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PHOENIX, ARIZ. -- Venlafaxine XR and paroxetine appear equally effective in the treatment of generalized social anxiety disorder, according to a poster presentation by Dr. Nicholas DeMartinis at a meeting of the New Clinical Drug Evaluation Unit sponsored...
When the Exam Room Is the Grocery Store
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The next time someone approaches you for medical advice outside of a clinical setting--whether it's at the mall, at the grocery store, or at a party--think twice before offering any. Dr. Sylvia Cruess, an endocrinologist and associate professor...
Ziprasidone Approved for Acute Bipolar Mania
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The recent approval of ziprasidone for treating acute bipolar mania was based on two studies of hospitalized patients. Those studies found that this atypical antipsychotic was significantly more effective than placebo in alleviating symptoms over a...
