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. 8, August

Acute Neuropathic Pain Requires Treatment with Corticosteroids
SAN DIEGO -- Neuropathic pain can be acute instead of chronic, and treatments for the two differ. Scott M. Fishman, M.D., said at a psychopharmacology congress sponsored by the Neuroscience Education Institute. "There seems to be a prevalent belief...
ADHD Drug Eases Anxiety, Not Depression
WASHINGTON -- The attention-deficit hyperactivity drug atomoxetine does not appear to improve comorbid depression in adolescents, but it does appear to reduce comorbid anxiety in children and adolescents, according to data from two studies presented...
A Different Take on Motivation
Motivation is an essential aspect of behavior, healthy adaptation, and quality of life. As clinicians, we see disorders of increased and decreased intensity, as well as conditions of dysregulated motivation. It seems to me that thinking about motivation...
AMA Adopts Policies on Fair Prescribing, Imaging
CHICAGO -- A pharmacist's philosophy shouldn't get in the way of prescribing needed drugs to patients. That was one of the conclusions that physicians reached while addressing controversial topics at the annual meeting of the American Medical Association's...
AMA Delegates Divided on Pay-for-Performance Details
CHICAGO -- The American Medical Association's new policy on pay for performance will limit its ability to negotiate with Congress, several medical specialty society groups claim. Tensions surfaced at the annual meeting of the AMA's House of Delegates,...
Antidepressant Better Than Bulking Agent in IBS
SAN FRANCISCO -- An antidepressant often is better than a high-fiber bulking agent as first-line treatment for irritable bowel syndrome, at least for the diarrhea-predominant form of the disorder, Philip S. Schoenfeld, M.D., said at the annual meeting...
Attacks Harm Our Patients
Tom Cruise's recent antipsychiatry remarks were at best intriguing and at worst ignorant. After all, Mr. Cruise is an actor who, as far as I know, has no medical training, yet speaks with authority about medicine in general and psychiatry in particular....
Atypical Quetiapine Appears Effective for Bipolar Depression
SAN DIEGO -- The atypical antipsychotic quetiapine led to significantly greater reductions in bipolar depression than did placebo within the first week of treatment and throughout an 8-week randomized, controlled study of 511 patients. Andrew J. Cutler,...
Bipolar Boosts Depression Risk during Pregnancy: Findings Suggest 'Urgent Need' for Better Screening and Detection of Bipolar-Spectrum Disorders
PITTSBURGH -- Women with a history of bipolar disorder have an increased risk of developing depression during and after pregnancy, based on a review of more than 2,000 pregnant women. A history of unipolar depression also predisposed women to develop...
Body Dysmorphic Disorder Is Often Chronic and Undertreated
BOCA RATON, FLA. -- Most patients with body dysmorphic disorder experience it as a chronic condition and are undertreated, but cause and effect remain unclear, according to the first prospective long-term study in this population. Body dysmorphic...
Cautious Dosing Urged for Intrathecal Pain Drug
PALM SPRINGS, CALIF. -- Ziconotide is a welcome addition to alternatives for relieving pain via intrathecal infusion, but many questions remain about its dosing, side effects, and potential best use, pain specialists said at the annual meeting of the...
CDC's Message Is Clear: Overweight Is Unhealthy
Physicians must adopt a different paradigm of care to help patients combat excess weight and its accompanying health challenges, William Dietz, M.D., director of nutrition and physical activity at the Centers for Disease Control and Prevention said...
Child-Father Interaction May Predict Suicide Reattempts
ATLANTA -- Adolescents whose interactions with their fathers are negative are more likely to reattempt suicide than are those whose interactions are more constructive, Barry M. Wagner, Ph.D., and his colleagues wrote in a poster presentation at a meeting...
Childhood Sleep Apnea May Affect Memory, IQ
RANCHO MIRAGE, CALIF. -- Obstructive sleep apnea in children is associated with profound deficits in IQ, verbal comprehension, perceptual reasoning, and working memory, according to preliminary results of a case-control study at the Pediatric Sleep...
Cognitive Side Effects of Anticholinergics
The Problem You have a patient diagnosed with schizophrenia who does well with a typical antipsychotic. He experiences extrapyramidal symptoms, and treatment with an anticholinergic is indicated. You are concerned about potential cognitive side...
Consider Genetic Disorder in Some Milder Autism Cases
GRAPEVINE, TEX. -- Physicians need to be alert to a cause of autism that might not be immediately apparent in milder cases, a Colorado pediatrician warned. Smith-Lemli-Opitz syndrome (SLOS), a disorder caused by a defect in the cholesterol metabolic...
Contingency Management Increases Abstinence
SAN JUAN, P.R. -- Contingency management increased abstinence for alcohol abusers in an intensive outpatient program, Nancy Petry, Ph.D., said at the annual meeting of the American Academy of Addiction Psychiatry. The researchers randomized 42 alcohol-dependent...
Depression Onset, Recurrence Predict Medication Response after Acute Coronary Event
ATLANTA -- Psychiatrists treating depression associated with an acute coronary event should look to severity of a depressive episode, recurrence of major depression, and the onset of depression prior to hospitalization as predictors of drug benefit....
Depression Tied to Poor Adherence to Cardiac Rx: Results of Two Studies Show That Use of Aspirin and [Beta]-Blockers Was Lower in Depressed Patients
VANCOUVER, B.C. -- Depressed patients with coronary artery disease are less likely to take prescribed medications than are those who are not depressed, Karina W. Davidson, Ph.D., and Mary Whooley, M.D., reported in separate presentations at the annual...
Diabetes Can Complicate Depression in Pregnant Women
SAN DIEGO -- Women with diabetes and untreated depression who become pregnant face a host of risks to themselves and their fetus if their conditions are not managed properly, Laura J. Miller, M.D., warned at the annual scientific sessions of the American...
Drug Approved for Heart Failure in Black Patients
GAITHERSBURG, MD. -- The fixed-dose combination of isosorbide dinitrate and hydralazine is the first product approved specifically for treating patients in a specific racial group. The development has been lauded as a significant advance that could...
Drugs Make Other Autism Interventions Easier
SANTA FE, N.M. -- Pharmacotherapy does not cure autism, but it can make autistic children accessible to other modes of treatment, Bennett L. Leventhal, M.D., said at a psychiatric symposium sponsored by the University of Arizona. "There are no pharmacological...
Factor Ethnicity into Drug Treatment-Part 2: Patients with Slow or 'Superfast' Metabolism of Drugs Are More Common in Certain Ethnic Groups
The biologic aspects of ethnopharmacology are complex. Ethnicity cannot be reduced to genetically distinct categories, but an awareness of characteristic distributions of genotypes and phenotypes that affect pharmacokinetics can inform decisions about...
Fallacies about Anorexia Undermine Treatment: Rethinking Psychosocial Model Can Help Stop Parents from Blaming Themselves for Children's Condition
PORTLAND, ORE. -- Despite common perceptions among medical professionals and the general public, anorexia nervosa is not a psychosocial disease, Julie K. O'Toole, M.D., said at a conference sponsored by the North Pacific Pediatric Society. Rather,...
FDA Acknowledges Drug Safety System Broken
WASHINGTON -- Acknowledging that its drug safety system is inadequate, several Food and Drug Administration officials told an Institute of Medicine panel examining the issue that the agency is ready for recommendations on how to better protect the...
FDA Panel Delays Changes to Concerta Label
ROCKVILLE, MD. -- A Food and Drug Administration panel has recommended postponing changes to safety warnings in the label for Concerta, a stimulant widely prescribed for attention-deficit hyperactivity disorder. The FDA's Pediatric Advisory Committee...
Findings of Survey on Mental Illness: 'Nonsense'
The recent survey showing that almost half of Americans meet DSM criteria for a mental illness at some point in their lives raises questions about the way in which mental illnesses are classified. In fact, experts such as Paul R. McHugh, M.D., have...
Government Agency in U.K. Seeks More Data from Manufacturers of Alzheimer's Drugs
Coverage of Alzheimer's treatments in the United Kingdom is still up in the air as the agency that determines coverage seeks more data from the drug makers. "Regardless of the outcomes of the [National Institute for Health and Clinical Excellence]...
Governors Propose Strategies to Reform Medicaid Program
The Bush administration has focused on overhauling the Social Security program, but the nation's governors and health providers says the real crisis is in Medicaid. The National Governors Association (NGA) has offered a reform proposal to Congress,...
High Anxiety Rate Warrants Screening in MS
BAL HARBOUR, FLA. -- All people with multiple sclerosis should be screened for anxiety, according to a study presented at the annual meeting of the American Neuropsychiatric Association. Researchers randomly selected 100 people with multiple sclerosis...
High Body Mass Index Linked to Chronic Kidney Disease
WASHINGTON -- Add chronic kidney disease to the list of problems linked with obesity. That's the conclusion from data presented by Rebecca P. Gelber, M.D., at a conference on cardiovascular disease epidemiology and prevention sponsored by the American...
High Impairment Found in Subthreshold Bipolarity
PITTSBURGH -- Subthreshold bipolar disorder is highly prevalent and disabling, according to a nationwide survey of more than 9,000 Americans sponsored by the National Institute of Mental Health. About 2% of the U.S. adult population has subthreshold...
Impotence Drugs Not Being Prescribed Properly
SANTA FE, N.M. -- Psychiatrists underprescribe erectile dysfunction drugs, and primary care physicians prescribe them like aspirin to virtually any man who asks, H. George Nurnberg, M.D., said at a psychiatric symposium sponsored by the University...
Incentives Needed to Kick-Start Health IT Adoption: Corporate Executives Ask Feds to Be a 'Catalyst for Change' and a Collaborator with the Private Sector
The federal government should use incentives--not unfunded mandates--to accelerate the adoption of health information technology, according to a panel of corporate executives. And the government should coordinate the use of interoperable health...
Low Serum Cholesterol in Non-African Americans Associated with Suspensions
Low total serum cholesterol is associated with an increased likelihood of school suspensions and expulsions among non-African American children, said Jian Zhang, M.D., of the University of South Carolina, Columbia, and associates. The finding corroborates...
Medicare Hospital Database May Shift Doctor-Patient Relations
WASHINGTON -- The new database on hospital quality from the Centers for Medicare and Medicaid Services may herald a new era in patient assertiveness in terms of health care preferences, several experts said at a briefing sponsored by the Alliance for...
Medication Compliance Vital in Schizophrenia TX
SANTA FE, N.M. -- Finding an antipsychotic medication the patient will take is more important than finding the best medication for a person newly diagnosed with schizophrenia, Samuel J. Keith, M.D., said at a psychiatric symposium sponsored by the...
Multidisciplinary Task Can Be Used in Apathy: Team Might Include Neuropsychologist, Behavioral Therapist, and Neuropsychiatric Social Worker
BAL HARBOUR, FLA. -- Appropriate treatment of apathy, abulia, and akinetic mutism requires an accurate diagnosis of impairment type, individualized treatment, and optimized general medical care using a multidisciplinary approach, according to Barry...
Nation's Capital Latest to Attempt Tort Reform
The District of Columbia is the latest in a growing number of jurisdictions trying to combat rising malpractice insurance premiums among physicians, as legislators there battle over whether the best solution is damage caps or increased regulation of...
New Advisory on Antidepressants, Adults
The Food and Drug Administration is strongly advising health care providers and patients to be aware of a potential increased risk of suicidal behavior in adults who take antidepressants. The agency recommended a closer reading of current labeling--which...
New Study: Hypnotic Agents May Prevent Falls
DENVER -- The conventional wisdom holding that prescribing hypnotic agents for nursing home patients increases their risk of falling and hip fracture may not be correct. A recent study involving more than 34,000 Michigan nursing home residents suggests...
Older Women Not Being Counseled to Exercise
NEW ORLEANS -- Counseling about the health benefits of exercise is reaching fewer than one in three women over age 50, a national survey has shown. Many studies have shown that exercise can reduce a woman's risk of hip fracture, depression, arthritis...
On Rutgers Web Site, Teens Answer Others Teens' Questions about Sex
LOS ANGELES -- If one goes to Google on the Internet and types in the word "sex," the first Web site listed is the place where about 60,000 adolescents a day go for their sex information, with the kinds of questions they are not likely to want to ask...
Perspective
Considering the staggering number of women who develop major depression during late pregnancy and/or post partum, a no-brainer public health policy would be to have a community-wide, coherent, systemic screening process firmly in place. Unfortunately,...
Physicians Resist Alcoholism Rx
SANTA BARBARA, CALIF. -- Newer pharmacologic treatments for alcohol dependence roughly double abstinence rates and significantly reduce heavy alcohol use among patients who return to drinking, a growing body of evidence suggests. But skepticism...
Physician Tax Plan Prompts Debate in Michigan
Michigan physicians are divided over efforts by Gov. Jennifer Granholm (D) to pass a physician tax that would help increase payments to Medicaid providers in the state. Under the governor's proposal, a 2.28% gross receipts tax would be levied on...
Piercings and Tattoos Possibly Linked to Suicidality; Here's the Question: Is Body Modification a Marker for Increased Risk, or a Sort of Substitute Activity?
BROOMFIELD, COLO. -- Body modification enthusiasts--individuals who undergo piercing, tattooing, and/or scarification--have a high rate of self-reported prior suicide attempts, David Lester, Ph.D., said at the annual conference of the American Association...
Pledges to Delay Sex Do Not Stop STDs: Findings Put New Spin on Programs That Stress Abstinence as Only Way to Avoid Infections
Teens who take a sexual abstinence pledge delay their sexual debut for a few years, but they have just as many sexually transmitted infections as nonpledgers, probably because they are more likely to engage in noncoital sex and aren't as likely to...
Postpartum Depression: Education Needed
He is not a doctor--nor does he play one in the movies. Yet actor Tom Cruise claims to be an expert in psychiatry--including postpartum depression. The most obvious problem with putting himself out on that limb is that the thousands of women who have...
Pregnancy Often Triggers Bipolar Relapse, Studies Show
PITTSBURGH -- Pregnancy can trigger a relapse in women with bipolar disorder, especially if they stop their mood-stabilizing treatment. Although data from several studies are conflicting, a prospective study showed that about two-thirds of women...
Prescribing Exercise May Improve Cognition in Obese Kids
BOSTON -- A prescription for exercise may do more than boost obese children's physical health. It also may improve how they think, results of a study have shown. The findings are consistent with recent work demonstrating exercise-induced improvements...
Promoting Self-Regulation Skills Can Help Abusive Teens
DENVER -- Fostering skills in affect self-regulation and attachment among sexually abusive adolescents is a necessary foundation for effectively treating their sexual behavior problems, Kevin Creeden said at a meeting of the National Adolescent Perpetration...
Psych Consults Often Unavailable for Sex Offenders
DENVER -- A surprising number of community-based and residential treatment programs for juvenile sex offenders don't have psychiatric consultation readily available, Joanne Smith-Darden said at the annual meeting of the National Adolescent Perpetration...
Psychosocial Therapy Is Good Adjunct to Drugs in Bipolar
PITTSBURGH -- Psychosocial therapy can be a useful adjunct to drug therapy in patients with bipolar disorder, based on results from a study with 175 patients. The study's findings also documented the high prevalence of medical comorbidities in patients...
Psychotherapy Can Reduce Mood Disorder Relapse
SANTA FE, N.M. -- Psychotherapy can work at least as well as medication, and often prevents relapse in mood disorder patients who do not do well on pharmacotherapy alone, Ellen Frank, Ph.D., said at a psychiatric symposium sponsored by the University...
Ramelteon Improves Chronic Insomnia in Elderly
BOCA RATON, FLA. -- The newly approved drug ramelteon significantly reduced sleep latency and increased total sleep time in a phase III study of elderly patients with chronic insomnia. In addition, researchers reported no evidence of next-day residual...
Reserve Polysomnography for High-Risk Sleep Apnea
PORTLAND, ORE. -- Polysomnography may be the gold standard in the diagnosis of obstructive sleep apnea, but in children it should be reserved for high-risk patients, Mark A. Richardson, M.D., said at a conference sponsored by the North Pacific Pediatric...
Revisiting a Classic: The Snake Pit
The title of Anatole Litvak's 1948 classic film, "The Snake Pit," conjures violent images of harsh care of the mentally ill. In fact this melodramatic movie is historically important for its surprisingly sophisticated, well-nuanced depiction of psychiatry...
Ropinirole Approved for Restless Legs Syndrome
MIAMI BEACH -- The antiparkinsonism drug ropinirole is now indicated for the treatment of adults with moderate to severe restless legs syndrome. The Food and Drug Administration approved the new indication based on three randomized, double-blind,...
Sleep Deprived? Tips to Try for Restful Shut-Eye
Holly J. Kramer, M.D., finds it ironic that, given the emphasis in recent years on medical residents getting enough sleep to perform optimally, no one seems to be thinking about the well-being of attending physicians when it comes to getting adequate...
Sleep-Disordered Breathing May Lead to Irreversible Cognitive Deficits
ATLANTA -- Cognitive deficits in children treated for sleep-disordered breathing may not be totally reversible, Jane F. Gaultney, Ph.D., of the University of North Carolina-Charlotte, and her associates reported in a poster session at a meeting of...
Spectrum Mania Bridges Unipolar/bipolar Gap
PITTSBURGH -- About a third of patients with unipolar depression actually have "lifetime spectrum mania," which means they also have symptoms of mania and anxiety disorders, based on results from a study with 148 patients. Lifetime spectra mania...
SSRIs May Be Linked to Risk of Gastrointestinal Bleeding
CHICAGO -- A preliminary analysis of hospital admissions suggests that selective serotonin reuptake inhibitors may be associated with a significant risk of gastrointestinal bleeding, Michael Jones, M.D., said at the annual Digestive Disease Week. ...
Tender Point Criteria for Fibromyalgia Called Flawed
DESTIN, FLA. -- The tender point criteria commonly used to diagnose fibromyalgia are not useful and in fact may even explain why the disease appears to disproportionately affect women. Daniel Clauw, M.D., said at a rheumatology meeting sponsored by...
Testosterone Replacement a Double-Edged Sword: Impact of Supplementation Is Largely Positive, but Adverse Effects Found among Men on Highest Doses
SAN DIEGO -- Testosterone supplementation trims visceral fat, builds skeletal muscle, improves muscle strength, and promotes overall sexual function in healthy older men, according to studies presented at the annual meeting of the Endocrine Society....
The Art of Leora Miller
Leora Miller derives inspiration for her paintings from the work of 19th and 20th century painters Edward Hopper, Vincent Van Gogh, and especially Kathe Kollwitz. Kollwitz's work depicted the impoverished and working poor of her native Germany just...
'The Last Well Person'
Despite uncounted advances in medicine, the death rate remains one per person, the same as always, Nortin M. Hadler, M.D., reminds us in "The Last Well Person: How to Stay Well Despite the Health-Care System" (Montreal and Kingston [Ont.]: McGill-Queen's...
Training May Help Weight-Preoccupied Women: Women's Self-Esteem, Self-Concept Improve after Engaging in Extensive Strength-Building Program
NASHVILLE, TENN. -- Weight training appears to change the way women with characteristics of disordered eating perceive their body size, Annie C. Wetter, Ph.D., wrote in a poster at the annual meeting of the American College of Sports Medicine. Dr....
Treating Panic Disorder and Agoraphobia
Thousands of people are seen in emergency departments nation-wide for chest tightness, shortness of breath, dizziness, and perfuse sweating accompanied by shaking, tingling in the extremities, and an imminent sense of doom. These patients are routinely...
Treatment Response and Compliance Are Rarely Absolute in Schizophrenia
NEW YORK -- In schizophrenia, black-and-white thinking fails to capture the reality of treatment response and compliance. An appreciation of the wide middle ground can help clinicians understand relapse issues and the relative efficacy of antipsychotics,...
VNS Therapy Is Approved for Severe Depression: Strict Conditions Placed on Use of Device
The Food and Drug Administration's approval of vagus nerve stimulation for treatment-resistant depression makes it the first device since electroconvulsive therapy to be approved for a psychiatric disorder. "This may be the first of a series of...
Weigh Nondrug Options for Postpartum Depression
NEW YORK -- Nonpharmacologic treatments are particularly worth considering when mood problems develop during pregnancy and in the postpartum period, Linda S. Mullen, M.D., said at an obstetrics symposium sponsored by Columbia University and New York...
Will Health Savings Accounts Leave People Vulnerable to Bankruptcy?
YES When we studied more than 900 people who had filed for personal bankruptcy, more than half of them cited medical causes (Health Aff. [Millwood] Feb. 2, 2005; [Web exclusive]). This was true even though three-quarters of the debtors had health...