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. 11, November

Addressing Sexual Aggression in Children. (12-Week Group Therapy)
WASHINGTON -- A short-term group therapy program for sexually aggressive children addresses their concomitant problems as well as their victimizing behavior, Kim Bure reported at the annual meeting of the American Professional Society on the Abuse...
Adjunctive Topiramate Aids Bipolar Depression. (Three-Year Open Study)
PITTSBURGH -- The novel anticonvulsant topiramate appears to be an effective adjunct in the long-term treatment of refractory bipolar depression, Dr. Mohammad Z. Hussain said in a poster presentation at an international conference on bipolar disorder...
Agitation, Aggression Demand Clinical Acumen: Practical Psychopharmacology; What Experts Do before Study Results Are in. (Pshychopharmacology)
Although agitation and aggression are frequent problems in elderly patients with dementia, pharmacotherapy isn't always the solution. "The first question is, 'What's the diagnosis?'" said Dr. Ira R. Katz, director of the geriatric psychiatry section...
Anxiety Features Influence Bipolar Course, Treatment Response. ('Spectrum Commorbidity')
PITTSBURGH -- Although the negative effect of comorbidity on the course of bipolar disorder is widely recognized, even symptom and behaviors of other Axis I disorders that fall short of syndromal criteria may have a significant impact, Dr. Giovanni...
Augmentation Strategy Aids Treatment-Resistant Depression. (Dopamine Agonist)
PITTSBURGH -- Pramipexole, a dopamine agonist, may be an effective augmentation agent for patients with treatment-resistant depression, Dr. Paolo Cassano said at an international conference on bipolar disorder sponsored by the Western Psychiatric Institute...
Bipolarity Common in Early-Onset OCD Patients. ('Hidden Comorbidity')
PITTSBURGH -- Bipolarity is highly prevalent in children with obsessive-compulsive disorder, and in adults whose OCD began during childhood or early adolescence, Dr. F.J. Kochman said at an international conference on bipolar disorder sponsored by...
Consider Clozapine for Reducing Suicide Risk in Schizophrenia. (Effect May Persist)
BERLIN -- Reduction in suicide ris, a well-established and highly significant effect of therapy with the antipsychotic clozapine, should be considered when maing treatment decisions with schizophrenia and other psychoses, Dr. Herbert Y. Meltzer said...
Crafting the DSM-IV. (Reader Counterpoint)
In a front-page article in the August 2001 issue, Dr. Paul McHugh's recommendations for a radical makeover of the DSM in its fifth edition planned for 2007 were reported. He criticized DSM-IV for its emphasis on clinical appearance as opposed to psychologic...
DC 0-3 Enhances Diagnosis of Mental Illness in Children: The Central Importance of the Parent-Child Relationship Needs to Be Recognized. (Bridges Limits of DSM-TV)
ASPEN, COLO. -- In response to what they say are severe limitations to the DSM-IV, pediatric mental health professionals have developed DC 0-3--a novel classification system for diagnosing mental disorders in infancy and early childhood, Dr. Robert...
Depression Doesn't Impair Effectiveness of Olanzapine for Acute Mania. (Olanzapine Treatment)
PITTSBURGH -- The presence of concurrent depressive symptoms does not appear to compromise the efficacy of olanzapine for acute mania, and the drug in fact has a generally positive effect on these symptoms, Dr. Robert W. Baer said at an international...
Dopamine Agents Still First Choice for Restless Legs. (Evaluate Patients for Iron Deficiency)
CHICAGO -- Although nonpharmacologic treatment such as biofeedback may hold great promise for restless legs syndrome, the mainstay of treatment remains pharmacologic, according a panel of experts who addressed the joint annual meeting of the American...
Early Head Start Improves Child Development, Parenting Skills. (Federal Program for Kids Aged 0-3 Years)
ASPEN, Colo. -- Children's advocates are waxing enthusiastic over the interim results of an ambitious national intervention project aimed at enhancing early child development and improving parenting sills in low-income, high-ris families. Early...
Establishing an Effective System of Managed Behavioral Health Care. (Streamline Operations)
We already know that managed care makes too few provisions for long-term treatment of patients with chronic mental illness. Have you personally lobbied for or played an important role in improving systems of support in your state? What is your success...
Even Children Distanced from Terrorism Troubled. (Lessons from Oklahoma City)
Almost 20% of sixth-grade children still had trouble functioning 2 years after a terrorist bomb ripped through the Olahoma City federal building, even though they lived 100 miles away and new no one who was illed or injured. The troubling findings...
For Psychologists, How Much Training Is Enough? (Foundation for Prescribing)
SAN FRANCISCO - The main argument made by psychiatrists against granting prescriptive authority to psychologists is that psychologists lac the medical training needed to prescribe drugs safely and effectively. So, how much training do psychologists...
HEROIC Measures Needed to Save Managed Care. (Credibility with Public Lost)
IRVINE, CALIF. -- Managed care is over, according to the man who coined the phrase "health maintenance organization." "If managed care means organizations that combine insurance and health care competing on price and quality to serve informed consumers,...
Higher MDMA Doses Spike Heart Rate and BP. (Study of Eight Patients)
BETHESDA, MD. -- Plasma levels of the drug popularly nown as "Ecstasy" increase dramatically with increasing doses, raising heart rate and blood pressure but with no inotropic effect to compensate, Dr. John Mendelson reported at a conference on MDMA/Ecstasy...
Impulsivity a Key Characteristic of Bipolar Disorder. ('Sine Qua Non for Mania')
MADRID -- Impulsivity is a core component of bipolar disorder that distinguishes patients from control populations, even between episodes, Dr. Alan Swann said at the World Psychiatric Association International Congress 200]. A better understanding...
Knowledge of Mechanisms Continues to Emerge. (MAO Inhibitors Revisited)
The cellular antidepressant mechanisms of monoamine oxidase (MAO) inhibitors, although not completely elucidated, clearly involve changes in serotonin- and norepinephrinemediated neurotransmission, said Pierre Blier, MD, PhD, professor of psychiatry...
Malpractice Insurance Rates Hit Crisis Level. (Pennsylvania, West Virginia)
Although malpractice insurance rates are rising all across the country, the pain may be worst for physicians in two states: Pennsylvania and West Virginia. In 1996, Pennsylvania raned among the cheapest one-third of states in malpractice insurance...
MAO Inhibitors Enjoy Resurgence of Interest, Use. (MAO Inhibitors Revisited)
Fueled by diagnostic clarifications and improved recognition of patients who will benefit from therapy, monoamine oxidase (MAO) inhibitors have experienced a resurgence of clinical interest and increased worldwide use as antidepressants, including...
Mental Health Concerns Follow Terror Attacks. (Risk Highest among 8 Million New Yorkers)
MADRID -- The Sept. 11 terrorist attacs on two American cities thrust psychiatry into the mainstream of public health and the life of the community, speaers agreed at the World Psychiatric Association International Congress 2001. "We need to grow...
Mentally Ill Aren't Major Contributors to Violence. (Refuting Public Perception)
People with mental illness were not major contributors to criminal violence in one Canadian community over a 1-month period, reported Heather L. Stuart, Ph.D., and Dr. Julio B. Arboleda-Florez of Queen's University in Kingston, Ont. Data collected...
Mirtazapine Similar to SSRIs for Depression. (Works Faster in Subset of Patients)
BERLIN -- The antidepressant mirtazapine appears comparable to selective serotonin reuptae inhibitors in efficacy and tolerability for various populations of depressed patients. But in studies involving both elderly and treatment-resistant individuals,...
New MAO Inhibitors Offer Reversibility, Selectivity. (MAO Inhibitors Revisited)
In contrast to classic monoamine oxidase (MAO) inhibitors, a new generation of compounds exists with respect to reversibility and selectivity for the two isoforms of MAO, said Andrew A. Nierenberg, MD, associate professor of psychiatry at Harvard Medical...
New Model Reveals Schizophrenia's Path. (Novel MRI Technique)
Severe childhood-onset schizophrenia starts as a subtle defect in the parietal region and then rapidly engulfs the brain in a wave of tissue destruction that spreads anteriorly over the cortex and terminates at the frontal eye fields, according to...
Omega-3 Fatty Acids Safe for Pregnant Women with Mood Disorders. (Efficacy Not Yet Established)
SANTA FE, N.M. -- Omega-3 fatty acids are well tolerated, nontoxic, and appear to be safe in pregnancy--characteristics that have made them attractive for many patients with mood disorders, Dr. Lauren Marangell said at a symposium on mood disorders...
Opioid Overuse. (Guest Editorial)
Recently, at the annual meeting of American Academy of Pain Medicine, I heard speaer after speaer advocating more liberal use of opioids in the treatment of all types of pain without distinguishing among acute pain, chronic pain, headache, neuropathic...
'Partial Syndrome' Eating Disorders Worth Treating. (Often Resolve Spontaneously)
BERLIN -- "Partial syndrome" eating disorders, which are considerably more common than the corresponding full-blown conditions, are associated with a substantial degree of psychopathology and deserve clinical attention, Dr. Palmiero Monteleone said...
Patient Reactions to Terrorism All over the Map. (Some Patients Even Improving)
Carl Sherman New YORK - After Sept. 11, the psychiatric consensus was that clinical repercussions in the community would unfold over time. Beyond the obvious vulnerability of individuals with a history of severe trauma, most psychiatrists agreed...
People with HIV Are Heavy Mental Health Users. (2,864 Patients Surveyed)
Adults under care for HIV infection are nearly five times as liely to use mental health or substance abuse services than are those in the general population, according to a survey of a nationally representative sample of 2,864 people infected with...
Psychiatry and the AIDS Epidemic: 20 Years Later. (Mortality Down, Mental Health Use Up)
Psychiatry does not seem to have changed much after 20 years of AIDS, but the epidemic greatly changed the lives of some psychiatrists. Most psychiatrists have few, if any, patients with HIM. Those who do tap AIDS experts for consults. Beyond the...
Psychotic Depression Is a Separate Disorder. (Target HPA Axis)
PHOENIX, ARIZ. -- Accumulating evidence of fundamental biologic and clinical differences between psychotic and nonpsychotic forms of depression suggests that the two conditions require different treatment strategies. In particular, it appears that...
Psychotic Depression: Use Polypharmacy, ECT. (Atypical Monotherapy Unproved)
NEW ORLEANS - Despite advances in pharmacotherapy, electroconvulsive therapy remains the most effective treatment for psychotic depression, and an antidepressant-antipsychotic combination remains the drug treatment of choice, Dr. Robert N. Golden said...
PTSD Screening, Treatment Outreach Program Takes Shape. (Fallout from Terrorism)
As the immediacy of Sept. 11 recedes and the events become part of the history of life in the United States, psychiatrists and other mental health professionals in New Yor City and Washington, D.C., are preparing for a new challenge: preventing posttraumatic...
Recovering from Schizophrenia. (Guest Editorial)
A more holistic approach is needed in treating schizophrenia. For me and for many others, coping with schizophrenia is more lie coping with the loss of dreams than coping with the loss of dopamine. The field of psychiatry has become entrenched in...
Scans Find Chess Masters Organize Data Differently. ('Chunking Theory' of Memory)
Differences in focal gamma-band activity in the brains of master versus amateur chess players may explain the disparity in their cognitive sills and predict performance in the game, according to researchers. Chess experts differ from amateurs not...
Should Psychologists Be Granted Prescription Privileges? (Pro & Con)
YES It is unnecessary to complete a fall medical education learn to prescribe psychotropic medications. There are data from innumerable sources that demonstrate this. In most countries, many health care providers don't go to school for 4 years before...
St. John's Wort Raises the Risk of Rejection in Transplant Patients. (Interferes with Cyclosporine)
NEW YORK -- St. John's wort can decrease blood levels of cyclosporine, which can be problematic for transplant patients given the in-u-n anosuppressant s narrow therapeutic range, Dr. Adriane Fugh-Berman said at a meeting on botanical medicine sponsored...
'Targeted' Naltrexone: Last Call for Alcohol. (Abstinence Not a Goal)
MADRID -- The "targeted" I" use of naltrexone, in which the drug s paired with alcohol consumption, can be an extremely effective therapy for alcohol addiction. But programs in the United Sates and elsewhere rarely follow such a protocol, Dr. David...
Terrorism Blows Health Care off Political Agenda. (from Medicare Reform to Bioterror)
WASHINGTON -- The attacs of Sept. 11 have pushed issues such as stem cell research, Medicare prescription drug benefits, and health care for the uninsured out of the congressional limelight, Dean Rosen said at a meeting sponsored by the American Health...
Three 'Mis-Es' Responsible for Unsafe Herbal Use among Patients. (Misuse, Misrepresentation, Mislabeling)
NEW YORK -- The potential hazards of herbal medicines result in large part from misuse, misrepresentation, and mislabeling, Dr. Varro Tyler said at a meeting on botanical medicine sponsored by the Columbia-Presbyterian Medical Center. The abuses...
Transdermal Selegiline Could Spur Increased Use of MAO Inhibitors. (MAO Inhibitors Revisited)
Reformulation of the classic monoamine oxidase (MAO) inhibitor selegiine into a transdermal delivery system could spar increased use of MAO inhibitors in the treatment of major depression. By avoiding the gastrointestinal tract, the Selegiline Transdermal...
Twin Studies Suggest Genetic Link to Impulsivity: A Factor in Many Psychiatric Ills. (Candidate Gene Identified)
MADRID -- Impulsivity, a core component of a number of psychiatric conditions, appears to be related to serotonin neurotransmission and may be influenced in part by a specific receptor gene, Dr. Frederic Moeller said at the World Psychiatric Association...
Unfamiliar Syndrome May Follow Terrorism in U.S. ('Disruptive Anxiety Syndrome')
MADRID -- As a consequence of the September terrorist attacs on New Yor and Washington, D.C., American psychiatrists may expect to see "disruptive anxiety syndrome," a constellation of symptoms that has become well nown in other countries, according...
Unraveling Varied Roles for MAO. (MAO Inhibitors Revisited)
Improved understanding of the molecular biology and activity of monoamine oxidases (MAOs) has provided new insights into the role of the enzymes in psychiatric illness and into the development of the next generation of neuropharmaco-logic compounds,...
Venlafaxine Helps Social Function in Depression. (Randomized, Controlled Trial)
MADRID -- A 13-wee course of treatment with the serotonin-nonpinephrine reuptae inhibitor venlafaxine improved social adjustment in depressed patients significantly more than placebo and was more effective in this regard than tricyclic antidepressant...
Watch for Signs of 'Post-Terrorism Stress Disorder'. (Oklahoma City Survivors)
Avoidance and numbing symptoms, which are relatively uncommon manifestations of post-traumatic stress disorder, singled out some of the most troubled survivors of the 1995 bombing of the Alfred P. Murrah Federal Building in Olahoma City, according...
Why Bipolar Patients Skip Their Medications. (Beliefs, Attitudes Predictive)
PITTSBURGH -- Adherence to mood-stabilizing medication appears to be largely a matter of attitude, Dr. Jan Scott said at an international conference on bipolar disorder sponsored by the Western Psychiatric Institute and Clinic. Beliefs patients...
Why Parents Fight over Child's Play. (Sideline Rage)
Stabbings, beatings, and bench-clearing brawls are not unusual in youth athletic leagues. But it's parents, not the ids, who are the guilty parties. "The rules are turned upside down, and the people who are supposed to be in control are acting lie...
Work-Family Conflict Spurs Burnout. (Major Stressor)
MORAN, WYO. -- New insights into the toll on psychological health exacted by wor-family conflict hold vital lessons for woraholism-prone physicians, Wayne M. Sotile, Ph.D., said at a conference sponsored by the American College of Cardiology. Physicians...
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