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. 36, No. 9, September

Adopt Guidelines for E-Mail Questions
I recently received a lengthy e-mail from a very worried woman. She claimed to be an established patient in my office, which I had no way of confirming because she did not sign her message. She asked many questions about sexually transmitted diseases...
Agent May Ease Parkinson's Psychosis Symptoms
CHICAGO -- The investigational agent pimavanserin appears to lessen the symptoms of psychosis in patients with Parkinson's disease without worsening motor function, according to data from a multicenter randomized phase II trial involving 60 patients....
Antidementia Drugs May Prolong Life in AD
CHICAGO--Continuous use of antidementia drugs is associated with a decreased risk of death in Alzheimer's patients. Specifically, those who took the medications for more than 70% of the time since being diagnosed with dementia lived an average of 3...
Antihistamine May Slow Pace of Cognitive Decline in Alzheimer's
CHICAGO -- An off-the-market antihistamine previously shown to slow cognitive decline over 1 year in Alzheimer's patients continued to preserve cognition and memory during a 6-month open-label extension trial. The drug, dimebon, also stabilized...
A Recent Study Shows That the Provision of Psychotherapy by Psychiatrists Has Declined Sharply. Is Psychiatry in Danger of Losing Psychotherapy as a Tool?
The idea of addressing these study results left me ambivalent--at first. Not only had I written about this for several years, but so had several very important leaders in American psychiatry. In the 1960s, for example, Dr. Mort Reiser and Dr. Leon...
Association between Diet, Acne Gains Footing in Literature
WAIKOLOA, HAWAII -- Most physicians, taught that diet is unrelated to the pathogenesis of acne vulgaris, dismiss as folklore the frequent questions posed by patients and family members as to whether eating greasy foods, chocolate, or other sweets causes...
Banks, Other Financial Institutions Moving into Health Care
WASHINGTON -- With health savings accounts serving as a point of entry, banks and other financial institutions are rapidly moving into the health care sector, and bankers think they have much to offer in streamlining health care transactions and bringing...
Behavioral TX Can Delay Initiation of ADHD Medication: Study Enrolled 127 Children Aged 5-12 Years
PHOENIX -- Using behavioral interventions for attention-deficit/hyperactivity disorder delayed the start of medication and reduced the dose needed in a randomized, controlled study of 127 schoolchildren. The study is the first to use behavioral...
Benzodiazepines for Major Depression
The Problem You have a patient with major depression. Symptoms include anxiety and insomnia. You prescribe an antidepressant and consider immediate augmentation with a benzodiazepine, but you are worried about the possibility that benzodiazepines...
Be Proactive in Preschool PTSD
NEW ORLEANS -- Preschool children with posttraumatic stress disorder can be diagnosed effectively when treated with trauma-focused cognitive-behavioral therapy, according to preliminary study results. It is important to take a proactive approach...
Brain Stimulation Tops Medication for Parkinson's
CHICAGO -- Preliminary data from two trials suggest that deep brain stimulation may be superior to the best medical therapy in Parkinson's disease, and that stimulating specific targets may lead to different cognitive and mood outcomes. Complete...
Children's Hostility Tied to High BP
HONOLULU -- Children who perceive the world in hostile ways are significantly more likely to have hypertension, according to a study of almost 900 children. A style of interaction marked by hostility has long been known to be a risk factor for hypertension...
Combat Deployment Boosts Alcohol Problems
A new study shows that combat deployment in Iraq or Afghanistan raises the risk of new-onset heavy weekly drinking, binge drinking, and other alcohol-related problems. The increased risks are highest among members of the U.S. Army Reserve and National...
DBS Improves Tic Severity in Tourette Syndrome Patients
CHICAGO -- Deep brain stimulation of limbic relays within the basal ganglia circuitry reduced tic severity in patients with Tourette syndrome, according to data from a small double-blind, randomized crossover study. In three patients with severe...
Depression, Drug Abuse Predict Postpartum Suicidal Ideation
WASHINGTON -- Current major depressive episode and drug abuse appear to be significant predictors of suicidal ideation in postpartum women, according to a study of 400 women with a history of neuropsychiatric illness who were followed before and after...
Diabetes Can Bring on Sexual Intimacy Issues
San Francisco -- Consider the partners of diabetes patients when talking about sexual problems in diabetes, Lawrence Fisher, Ph.D., suggested. Although only one member of a couple may have diabetes, "Partners are very often hidden patients," Dr....
Diabetes Program a Success in Community Hospital
WASHINGTON -- A program for inpatient diabetes care that reflects current management approaches was successfully exported from an academic medical center to a neighboring inner-city community hospital, resulting in improved measures of diabetes care...
Did Black Box Warning Affect Psychiatrists More?
PHOENIX -- The proportion of clinic visits to psychiatrists involving antidepressants for youths fell compared with the proportion of visits to primary care physicians after the black box warning linking antidepressant use to suicidality in youths....
Disabilities Complicate Obesity TX
GENEVA -- One of the most common issues complicating the treatment of childhood obesity is physical or learning disabilities, according to Dr. Julian P. Hamilton-Shield of the University of Bristol (England) and Bristol Royal Hospital for Children....
Ethnicity Appears to Affect SLE Incidence, Manifestations
DESTIN, FLA. -- Ethnicity appears to play an important role in the incidence and clinical manifestations of pediatric systemic lupus erythematosus, data from a recent study suggest. Findings from the study of 87 white and 154 nonwhite children showed...
Exercise Bar Raised for Maintaining Weight Loss
Women who lose 10% or more of their body weight through diet and exercise must engage in 275 minutes per week of physical activity to maintain that weight loss beyond the initial 6 months, according to a report It appears the level of physical activity...
FDA Issues Guidance on Conflicts of Interest
Experts serving on the Food and Drug Administration's advisory committees are now subject to new rules aimed at ensuring that they do not have conflicts of interest that could bias their decisions. In early August, the FDA issued four final guidance...
Fight Childhood Obesity on Multiple Fronts
GENEVA -- Increasing physical activity levels in children and adolescents is just what the doctor should order to reverse the rate of childhood and adolescent obesity, according to Dr. Denes Molnar, professor and head of the department of pediatrics...
Fitness May Limit Brain Atrophy in Alzheimer's: The Level of Fitness Was Strongly Related to Volume in the Parietal Area and Also in the Hippocampus
CHICAGO -- Keeping fit may help reduce brain atrophy in patients with early Alzheimer's, researchers said at the International Conference on Alzheimer's Disease. An exercise-tolerance study confirmed that the hippocampus, one of the first brain...
Food Allergy Prevalence Rose over Past Decade
CHICAGO -- The prevalence of reported food allergies has risen 24% among children under age 5 years and 19% among children aged 5-17 years during the past decade, according to a study by the National Center for Health Statistics. Based on statistics...
Frequently Asked Questions about Alzheimer's
Although the symptoms of failing memory may have long provoked suspicion, a confirmed diagnosis of Alzheimer's disease brings those suspicions into stark reality for both patients and their families. The words unleash a flood of questions. Patients...
Gastric Bypass Lowers Hb[A.Sub.1c] Levels in Diabetes
NATIONAL HARBOR, MD. -- Patients with type 2 diabetes who have undergone laparoscopic Roux-en-Y gastric bypass surgery might experience a significant drop in hemoglobin [A.sub.1c] levels to below the cutoff value recommended in guidelines, according...
Guidelines Advise Early Antiretroviral TX of HIV
Initial antiretroviral treatment of HIV infection in asymptomatic adults should begin before CD4 cell counts drop below 350/mcL, according to new treatment guidelines announced Aug. 3 at the 2008 International AIDS Conference in Mexico City. The...
Heart Groups Acknowledge Apnea-CVD Link
In the face of rising rates of obesity, hypertension, atrial fibrillation, and heart failure, physicians need to be mindful of the mounting evidence for a link between sleep apnea and cardiovascular disease when evaluating patients, according to a...
Hormone Therapy May Benefit Cognition, Memory
CHICAGO -- Hormone therapy might preserve cognition and memory in postmenopausal women, and even attenuate some of the cognitive deficits that occur in Alzheimer's disease, new research suggests. Controversy exists over the possible cognitive benefits...
Imaging and Measurements Predict Status of Ad Dementia
CHICAGO -- A combination of specialized brain imaging and cerebrospinal amyloid [[beta].sub.42] measurements powerfully predicts the presence--and absence--of Alzheimer's-type dementia. For several years researchers have focused on A[[beta].sub.42]...
Insomnia Is Common during Chemotherapy
CHICAGO -- The prevalence of insomnia is roughly three times greater among cancer patients than it is among the general population, according to a secondary analysis of more than 500 patients. The prevalence of insomnia that meets clinical criteria...
Lithium Still Has a Place in Bipolar Treatment: Mood Stabilizer Is Effective for Most Patients at Low Levels, but Side Effects Give U.S. Clinicians Pause
The use of lithium as a mood stabilizer remains popular in Europe, but U.S. psychiatrists increasingly tend to favor other medications to treat bipolar disorder. Some experts say that's because U.S. clinicians are more easily manipulated by pharmaceutical...
Lupus Has Many Neuropsychiatric Manifestations: Headaches, Cognitive Disorders, Psychosis, and Seizures Tend to Occur Early in the Disease Course
DESTIN, FLA. -- Neuropsychiatric manifestations of systemic lupus erythematosus occur in more than 80% of patients during the course of disease, and can pose particular challenges to clinicians caring for these patients. Not only can such manifestations...
Maneuvering Begins on Hill for Health Reform
Democrats and Republicans are so confident about the chances of some type of health reform in the next administration that staff meetings and hearings geared toward crafting legislation have been going on in earnest in both the House and the Senate,...
Many Hispanics Lack Usual Health Care Provider
WASHINGTON -- Hispanics may place significant stress on the health care system in the future, as they are projected to be the largest segment of the population by 2050, but are less likely to have a usual source of care and have less knowledge about...
Marital Status at Midlife Linked to Alzheimer's Risk Later
CHICAGO -- People who are married from mid-to late life are significantly less likely to develop Alzheimer's disease, while those who remain single face up to an eightfold increased risk, Krister Hakansson said at the International Conference on Alzheimer's...
Maternal Paroxetine Unrelated to Cardiac Malformations
MONTEREY, CALIF. -- There is no statistically significant association between paroxetine usage during the first trimester of pregnancy and an increased risk of cardiac malformations in the infants, according to a meta-analysis of nine studies. A...
MCI Tied to Type 2 Diabetes Duration and Complications
Mild cognitive impairment correlates with earlier onset of type 2 diabetes, its complications, and longer duration of the disease, according to a population-based case-control study of nearly 2,000 elderly subjects. Mayo Clinic researchers found...
Metabolic Syndrome May Hasten 'Neuroaging'
CHICAGO -- Older people with metabolic syndrome are significantly more likely to experience depression and deficits in cognition and function as they age than are their healthier peers. The presence of metabolic sydrome explained up to 34% of the...
Metabolic Syndrome Predicts Diabetes, Not CVD
Metabolic syndrome is associated with type 2 diabetes but not cardiovascular disease in elderly patients, investigators have reported. Criteria for metabolic syndrome were developed to help improve understanding of the links between insulin resistance...
Mifepristone May Limit Weight Gain from Antipsychotics
PHOENIX -- The cortisol antagonist mifepristone significantly decreased weight gain associated with the second-generation antipsychotic olanzapine in a randomized, controlled pilot study in 57 healthy men. Approved by the Food and Drug Administration...
Milnacipran Could Improve Fibromyalgia-Related Pain
CHICAGO -- The antidepressant milnacipran appears to provide sustained pain relief in patients with fibromyalgia. In a 28-week, randomized blinded extension trial in 449 patients with fibromyalgia, durable pain relief and improved overall well-being...
Music and Mental Health
"Thou holy art how oft in hours of sadness, When life's encircling storms about me whirled, Hast thou renewed warm love in me and gladness, Hast thou conveyed me to a better world, Unto a happier better world." --First stanza from "An Die Musik (To...
Navigating Adolescent Grief
"So many feelings and so much pain Your death really hurt me; I'll never be the same I try to express it, try to explain So many feelings and so much pain." These lyrics by Thomas A. Dalton, a West Plam Beach, Fla.--based music therapist and licensed...
Nerve Stimulation Shows Efficacy for Migraine: Technique Associated with Fewer Headache Days, Less Intense Pain in Patients with Refractory Headache
BOSTON -- The efficacy of occipital nerve stimulation in the first clinical trial of its use in the treatment of refractory migraines suggests that the technique may be a promising option for individuals who have not responded to medication or other...
Omega-3 Fatty Acids May Reduce New-Onset Atrial Fibrillation Risk
TORONTO -- Patients with cardiovascular disease on an oral regimen of omega-3 fatty acid had a 73% reduced risk for developing atrial fibrillation in a retrospective, observational study of more than 11,000 patients. Although the study controlled...
Once-Weekly Statin Dosing Avoids Adverse Effects
TORONTO -- A once-a-week dose of rosuvastatin was at least partially effective and tolerable for 37 patients who had previously been unable to stay on statin therapy because of adverse effects. Although the once-weekly regimen did not bring down...
Passage of Genetics Law Is Perfect Bookend
The passage of the Genetic Information Nondiscrimination Act in late May, ushered in what Sen. Edward Kennedy (D-Mass.) called "the first civil rights bill of the new century of the life sciences." Under the legislation, U.S. citizens now are afforded...
Peer Program Targets Eating Disorders in Athletes
SEATTLE -- A peer-led program appeared to be successful in decreasing the risk of eating disorders among female college athletes, according to early results involving 64 participants. The risk of eating disorders among female college women generally,...
Perinatal Depression Patients Want Flexibility in Therapy
PHOENIX -- Flexibility in scheduling would help depressed women access cognitive-behavioral therapy during or just after pregnancy, a survey of 24 women found. A little more respect would be nice too, they said. Results of the qualitative survey...
Perspective
If you have models for how life works, you feel a sense of mastery and power because, as a result of knowing, you can adjust your thinking and behavior to make yourself less vulnerable. This is a critical component of building resiliency in bereaved...
Quality-of-Life Impact Significant in Psoriasis: Canadian Survey Finds That Only 24% of Respondents Reported Satisfaction with Their Current Treatment
MONTERAL -- Moderate to severe psoriasis significantly impairs physical and psychosocial functioning and represents a potentially serious detriment to the well-being of patients, according to a survey of more than 500 Canadians with the condition....
Rehabilitation and the Psych Patient
Rehabilitation is an important aspect of the treatment of psychiatric inpatients. Only with rehabilitation can those with severe and persistent mental illness come close to getting their lives back. This month, CLINICAL PSYCHIATRY NEWS spoke with...
Risk Factors Identified for Early Heavy Drinking
WASHINGTON -- Tobacco use and the expectation of social and physical pleasure from alcohol consumption significantly predict the transition to heavy drinking among adolescents and young adults, a 5-year study of more than 200 people shows. Tobacco...
Risky Sex Behaviors Seen with Continued Drinking
WASHINGTON -- Drug-using heavy drinkers who continue to get drunk at least weekly after alcohol treatment are more than four times as likely to engage in HIV-related sexual behaviors as are those who abstain after treatment, a study of more than 200...
Risky Sex Studied in HIV Positive
MEXICO CITY -- About one-third of HIV-positive adults have recently engaged in sexual behavior that could put others at risk for infection, but the factors associated with such behavior differ for women, heterosexual men, and men who have sex with...
Self-Reports Can Track Adherence in Diabetes
KEYSTINE, COLO. -- The most popular method of assessing patient adherence to type 1 diabetes management instructions consists of a look at glycosylated hemoglobin values. This, however, is one of the least reliable means of doing so, "and I don't...
Short REM Sleep Linked to Overweight in Children
Shortened sleep duration, particularly shortened REM sleep, is associated with overweight in children and adolescents, a recent report shows. Given the high prevalence of both overweight and sleep deprivations in modern society, "family-and school-based...
Simvastatin-Amiodarone Interaction Prompts Alert
Patients on amiodarone and simvastatin should not take more than 20 mg of the statin a day, because of an increased risk of rhabdomyolysis when the two drugs are used together, according to a Food and Drug Administration alert. "This risk is dose-related...
SSRIs, SNRIs Raise Risk of Upper Gastrointestinal Bleeding
Antidepressants that block action on the serotonin reuptake mechanism appear to raise the risk of upper gastrointestinal bleeding to the same degree that antiplatelet drugs do, a new report shows. In a case-control study involving more than 11,000...
Survey Addresses Pediatricians' Role in Identifying, Treating Mental Illness
Survey results suggesting that pediatricians are more comfortable identifying--but not treating--most children's mental health problems are consistent with previous findings, a leading child and adolescent psychiatrist says. "With the exception...
Systematic Desensitization in 10 Steps
In previous discussions about behavioral strategies that can be used to treat patients in anxiety-provoking situations, I have referred to the procedures of reciprocal inhibition and systematic desensitization. Several psychiatrists and psychologists...
Temporary Weight Loss Helps Type 2 Patients
Weight loss in the years immediately following a diagnosis of type 2 diabetes is associated with significant, long-term improvement in glycemic and blood pressure control even if the weight is later regained back to baseline levels, according to a...
Terazosin Helps Ease Drug-Induced Sweating
PHOENIX -- All 16 patients involved in preliminary open-label trials responded to off-label treatment with terazosin for antidepressant-treatment with terazosin for antidepressant induced excessive sweating. Between 5% and 14% of patients on a selective...
They'rrrre Baaaaack! Harry and Louise Redux
Harry and Louise, who became infamous in a 1993-1994 television ad lambasting the Clinton administration's health care reform plan, were dragged briefly out of mothballs to appear in a new commercial that urged Congress and the next president to make...
Tricyclic Beat SSRI for Parkinson's Patients
PHOENIX -- Nortriptyline was more effective than paroxetine or placebo in treating depression in patients with Parkinson's disease, an 8-week pilot study of 52 patients found. The study, while small, is the largest placebo-controlled trial of treating...
Tricyclics and SSRIs Show Efficacy for Treatment of Irritable Bowel Syndrome
SAN DIEGO -- There is a strong rationale as well as some evidence supporting the use of tricyclic antidepressants and selective serotonin reuptake inhibitors for the treatment of irritable bowel syndrome, Dr. Lin Chang said at the annual Digestive...
Try These Tips to Discuss Sexual Problems with Diabetes Patients
San Francisco -- People with diabetes frequently experience sexual problems, but many physicians are reluctant to broach the subject. However, "you don't need to be Dr. Ruth to open up these conversations," Mitchell S. Tepper, Ph.D., said at the...
U.S. Grade Goes Lower on Health Care Report Card
Access to care has declined significantly since 2003, with 42% of all working-age adults either uninsured or underinsured in 2007, according to a national health system scorecard from The Commonwealth Fund, which found that health care system performance...
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