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. 31, No. 6, June

Addiction History and Opioids. (Guest Editorial)
Do not use to offer chronic pain patients the opportunity for effective pain relief from opioids just because they have a history of addiction. Such patients deserve to experience the benefits of aggressive pain management- despite their increased...
Adolescents' Due Process Protection Is Limited. (Involuntary Psychiatric Hospitalization)
NEW YORK -- Minors generally have some, but not all, of the due process protections that are afforded adults in terms of psychiatric hospitalization, and those protections vary widely from state to state, Dr. Donald Reeves said at the annual meeting...
Adolescents' Right to Refuse Treatment Hinges on State Laws. (Consult Counsel)
NEW YORK -- An adolescent's right to refuse treatment is not just a matter of age and competence. The risks and benefits of the specific intervention involved, and the laws of the particular jurisdiction also must be taken into account, Dr. Richard...
Adult Asthma Rates Stabilizing after Rising for 2 Decades. (Mixed Ethnicity May Be Risk Factor)
The number of adults with asthma is holding after rising steadily for almost 2 decades. The lifetime prevalence of adult asthma in 2001 was 11.0%, an insignificant increase from the 10.5% rate in 2000. The current prevalence of adult asthma was...
Antidepressant Treatment Falls Short in Pregnancy. (Maternal Depression)
WASHINGTON -- High scores on a depression rating scale showed that a significant proportion of women who were prescribed medication for depression during pregnancy were suboptimally treated, Dr. Irena Nulman reported at the annual meeting of the American...
Brief CBT May Improve Somatoform Disorder. (Cuts Health Care Use)
SALT LAKE CITY -- A single session of cognitive-behavioral therapy proved effective in reducing health care utilization among a group of patients with medically unexplained symptoms, Alexandra Nanke, Ph.D., reported at the annual meeting of the Society...
Children with Rheumatic Conditions Often Have Poor Quality of Life. (Fibromyalgia Especially Dismal)
SALT LAKE CITY -- Children with fibromyalgia scored particularly low on quality of life measures in a survey of 326 pediatric patients with a variety of rheumatic conditions, Tasha M. Burwinkle said at the annual meeting of the Society of Behavioral...
Child's Surgery Puts Mom at Risk for PTSD. (Bone Marrow Transplants)
BALTIMORE -- The mothers of children who undergo bone marrow transplant are at increased risk for at least some of the symptoms of posttraumatic stress disorder, Sharon L. Manne, Ph.D., said at the annual meeting of the International Society for Traumatic...
Chiropractic for Back Pain. (Alternative Medicine)
* Many patients with back pain experience at least short-term benefits with chiropractic treatments. * A very small but real risk of injury exists with cervical spinal adjustment. History of Use Spinal manipulation has been used in medical...
CMS to Explore Use of PET in Suspected Dementia. (Multidisciplinary Team to Be Convened)
WASHINGTON -- The Centers for Medicare and Medicaid Services has decided to implement a "demonstration program" to test coverage of PET scans for use in diagnosing suspected dementia, but experts disagree over whether the test is worth covering at...
Collaborative Care Boosts Patient Compliance, Physician Satisfaction. (Psychiatrists, Primary Care Physicians)
TORONTO - Collaborative treatment of mental illness by psychiatrists and primary care physicians significantly improved patient adherence, increased physician satisfaction, and cut health care costs almost in half, Dr. Wayne J. Katon reported at the...
Competency Evaluations Must Be Multifaceted. (Medical Charts Provide Key Information)
RANCHO MIRAGE, CALIF. -- Competency evaluations in the elderly cannot be rushed, except, perhaps, when a critical medical decision must be made, Dr. Carla Rodgers said at the annual meeting of the American College of Forensic Psychiatry. Even then,...
Confidentiality, Double Agency Complicate TX of Adolescents. (Knowing the Law Is Not Enough)
NEW YORK - Ethical issues such as confidentiality and double agency are likely to be pressing and complex for psychiatrists treating adolescent patients, speakers said at the annual meeting of the American Society for Adolescent Psychiatry. Guidelines...
Countertransference Can Help Sharpen Forensic Examinations. (Subjective Feelings Improve Assessments)
SAN FRANCISCO -- The use of countertransference--though mainly associated with psychotherapeutic relationships--can also be helpful to the forensic psychiatrist, Dr. David Glaser said at the annual meeting of the American College of Forensic Psychiatry....
Decreased Use of Seclusion and Restraint Encouraged; SAMFISA: Only for Safety Interventions. (Draft Action Plan Offered)
WASHINGTON -- The use of seclusion and restraint should be viewed as an option of last resort for patients with mental illness or addictive disease, said Charles Curie, administrator of the Substance Abuse and Mental Health Services Administration....
Don't Skirt Informed Consent. (Guest Editorial)
The great split inpsychiatry between biologic and psychological treatments extends back centuries in the history of medicine. Because of this dichotomy, doctors and other healers have tended to offer patients one form of treatment or the other. ...
Drug Abuse and Pregnancy. (Guest Editorial)
In the late 1990s, an estimated 3% of pregnant women used illicit drugs in early gestation, according to the Centers for Disease Control and Prevention. Pregnancy complications and poor fetal outcomes are common in these women. But drug abuse may not...
Effects of Domestic Violence Depend on Which Parent Was Perpetrator. (Peer Relationships Suffer)
TAMPA, FLA. - The effects of domestic violence manifest in children and adolescents differently depending on which parent is violent. A recent study has shown that, contrary to popular opinion, it is not always the father. "The majority of research...
Empathy Deficit in Physicians Starts in Undergraduate Years. (Compared with Other Professions)
SALT LAKE CITY -- Undergraduate students planning medical careers show significantly less empathy than those planning to enter other professions, J. Kenneth Arnette, Ph.D., reported at the annual meeting of the Society of Behavioral Medicine. Dr....
Families Sway Kids' Adherence to Asthma Rx. (Stress Has Major Impact)
KIAWAH ISLAND, S.C. -- Asthma manages asthma sufferers and their families, and not the other way around, Dr. Frederick S. Wamboldt said at a meeting sponsored by the Society of Teachers of Family Medicine. Because of that, family processes and the...
Fink! Still at Large: Surviving Patient Suicide. (Opinion)
One of the most painful experiences for a therapist is figuring out how to proceed when a patient commits suicide. Have you ever experienced this? How did you cope with the tragedy? How did that incident change the way in which you approach your practice?...
Fluoxetine, CBT, or Both May Reduce Anxiety. (Multicenter, Randomized Trial)
RENO, NEV. -- A multicenter, randomized trial of fluoxetine and comprehensive cognitive-behavioral therapy showed that both treatments as well as their combination proved to be more effective than placebo in reducing the symptoms of generalized social...
Focus Drugs on Adolescent Paraphilia Symptoms. (Antiandrogens, SSRIS Appear to Help)
NEW YORK -- Medication targeted to specific symptoms can be effective in treating juvenile sex offenders with paraphilias, but it should only be used in the context of psychosocial treatment, Dr. Fabian Saleh reported at the annual meeting of the American...
Generalized SAD Prevalence Might Surpass 6%: Social Anxiety Disorder Is Tied to Increased Risk of Dropping out of School. (Children and Adolescents)
TORONTO -- More than 6% of children and adolescents may have generalized social anxiety disorder and thus increased risks of depression, dropping out of school, and suicide. And the prevalence rate for attention-deficit hyperactivity disorder (ADHD)...
High-Dose Quetiapine Appears Safe, Effective in Older Patients. (Retrospective Chart Review)
HONOLULU -- Elderly patients with dementia seem to do well on quetiapine in dosages greater than the 200 mg/day maximum recommended by the Centers for Medicare and Medicaid Services, Dr. Franco Sicuro said in a poster presentation at the annual meeting...
Hospital Disaster Plans Must Indude a Strong Mental Health Component. (Lessons from Sept. 11)
On the morning of Sept. 11, 2001, Dr. Fuad Issa strolled through his neighborhood in the Virginia suburbs of Washington, D.C., with his wife. Their placid mood was shattered when they returned home to find a frantic message on the answering machine...
Hospitalist Association Gets a New Name, Renewed Focus. (Society of Hospital Medicine)
Don't call it the National Association of Inpatient Physicians anymore. The nation's largest hospitalist organization on April 1 officially changed its name to more accurately reflect the field's broader scope and rapidly growing membership base....
Including Parents in 'Split Alliance' with Teens Is Prudent Strategy. (Malpractice Risk Management)
NEW YORK -- For psychiatrists who work with adolescents, malpractice risk management requires taking measures aimed at maintaining amicable relations with the parents as well as the patient and attention to complex confidentiality issues, Dr. Alan...
Knowledge Dismal on Terrorism. (Psychiatry or Politics?)
RANCHO MIRAGE, CALIF. - As the nation flickered orange on the State Department's color-coded terror alert scale in early April, forensic psychiatrists and a medical anthropologist struggled to define terrorism within a psychiatric context. "There...
Letters
Assessing Religious Claims In his recent guest editorial, Dr. Ansar Haroun discussed the case of a defendant who said that God told him to cut the throat of a 10-year-old boy ("Delusions of Psychiatrists," April 2003, p. 14). Examining psychiatrists...
Maltreated Girls Become Troubled Mothers. (Conduct Disorder, Early Pregnancy)
TAMPA, FLA. -- Violence begets violence across generations, according to observational studies that have followed girls who exhibited aggressive behavior when young. Several such studies were presented at a meeting of the Society for Research in Child...
Maternal Pessimism May Raise Girls' Depression Chances. (Interactions with Sons More Positive)
TAMPA, FLA. -- Maternal behavior might contribute to girls' heightened risk for depression, according to the results of a new study. The study, which investigated maternal characteristics and child helplessness as risk factors for depression, unexpectedly...
Medicaid Mental Health Bears Brunt of State Cuts. (Oregon Is Case in Point)
As state budget officers try to figure out how to best squeeze blood from a stone, advocates worry that Medicaid mental health patients are increasingly falling victim to budget cuts. "I'm very alarmed about this," said Dr. Paul S. Appelbaum, immediate...
Medical Council Tackles Language Barrier Issues. (Strategies for Interpretation, Translation)
Results from a survey of leading physician organizations, medical groups, and other health care associations in California suggest that nearly half (48%) of the 293 respondents knew of an instance in which a patient's limited English proficiency impacted...
Moderate Drinking Linked with Later Onset of GAD. (Chronology Remains Unclear)
TORONTO -- Moderate drinking among older adults with generalized anxiety disorder might be related to a later age of onset, but the chronology of the two events is unclear, Jan Mohlman, Ph.D., said at the annual conference of the Anxiety Disorders...
Novelty Seeking Tied to Lower Alzheimer's Risk. (Depends on APO E Allele)
HONOLULU -- People who engage in novelty-seeking behavior or activities that involve the integration of ideas appear to have a decreased risk of developing Alzheimer's disease, Thomas Fritsch, Ph.D., reported at the annual meeting of the American Academy...
Off-Label Uses of Topiramate Gather Supporting Evidence. (Tourette's Syndrome, Binge-Eating Disorder)
SAN FRANCISCO -- Topiramate shows encouraging evidence of efficacy as off-label therapy for an eclectic array of disorders, according to studies presented at the annual meeting of the American Psychiatric Association. Among the novel but nonapproved...
OIG Finds Fault with FDA's Drug Review Process. (Workload, Fee System Blamed)
WASHINGTON -- The Food and Drug Administration's new drugs approval process needs to be changed, according to a report from the Health and Human Services Department's Office of Inspector General. The report, issued in late March, drew on interviews...
Osler's Writings Continue to Inspire Physicians. (the Quotable Osler Debuts)
The prolific writings of Sir William Osler have long provided a rich vein of epigrams, maxims, and aphorisms for the physician. "Osler wrote about character and ideals, faith and religion, medical education, professionalism, and science," said Dr....
Out-of-State Physicians Pressed for Licensure before Testifying. (Medical Malpractice Cases)
RANCHO MIRAGE, CALIF. -- Forensic psychiatrists and other physicians who offer expert legal testimony may be under increasing pressure to become licensed in states where they take the witness stand, Dr. Albert Drukteinis said at the annual meeting...
Patient Safety Measures Don't Go Far Enough. (Hospital Processes Outdated)
WASHINGTON -- The measures touted by the Leapfrog Group as ways to improve patient safety in hospitals are a good idea, but they're not enough by themselves, Dr. Mary Cooper said at the annual National Managed Health Care Congress. For example,...
Patients' Poor Literacy Can Jeopardize Tx, Create Anxiety. (Experts Urge 'Plain Language')
WASHINGTON - Two-thirds of all physicians are unaware of the fact that there's a health literacy problem in the United States, Dr. Joseph Riggs said at a press conference on health literacy sponsored by the American Medical Association. Patients'...
Permanent ID Number Smooths Medicare Equipment Claims. (Make Sure Documentation Is Complete)
WASHINGTON -- It pays to have and use a permanent physician ID number when ordering medical equipment claims for Medicare patients. According to the Department of Health and Human Services, using temporary or surrogate identification numbers could...
Post-Sept. 11 Coping Styles Differ for Kids, Parents. (Children Prefer Doing Things)
Observations of how children and parents deal with traumatic events have emerged from the events of Sept. 11, 2001. Some of these insights were presented during a teleconference that was sponsored by the Society for Research in Child Development:...
Practical Psychopharmacology
Treating Comorbid Bipolar Disorder and ADHD Some clinicians have questioned the high reported rates of comorbid attention-deficit hyperactivity disorder in bipolar adults, but when it comes to preadolescents, there is "not much controversy," said...
Promote Your Practice: Find a Good PR Firm. (Set Goals and a Budget)
Set goals and a budget before you hire a public relations firm to promote your practice, "otherwise it's going to be a scattershot effort," says Scott Farmelant, senior vice president of Boston-based Regan Communications Group, a public relations firm....
PTSD Diagnosis Abused in Employment Litigation. (Look to DSM-IV-TR for Criteria)
RANCHO MIRAGE, CALIF. -- "Junk science" has led to widespread misuse of posttraumatic stress disorder diagnoses in employment litigation, a California labor and employment lawyer said at the annual meeting of the American College of Forensic Psychiatry....
Reel Life. (American Beauty)
Most critics and filmgoers saw "American Beauty" as a black-comic, ironic caricature of dysfunctional suburbia that culminates in a weirdo looking at a dead guy, and (apparently) enjoying it. Even at that level, the film was a critical and popular...
Reimbursement Urged for Certain E-Mail Consults. (CMS against Separate Payments)
SAN DIEGO - The American College of Physicians is calling on Medicare and private insurers to reimburse physicians for certain types of e-mail consultations. Some private insurers already have begun to pay their physicians for e-mail consultations,...
Risperidone May Prevent Falls in Dementia Patients. (Decreased Wandering)
HONOLULU -- Risperidone in a dosage of 1 mg/day seems to decrease the risk of falling in ambulatory demented patients, Dr. Ira R. Katz reported at the annual meeting of the American Association for Geriatric Psychiatry. This effect is probably the...
Routinely Monitor Fatigue in Ca Patients. (Updated Guidelines)
HOLLYWOOD, FLA. - Fatigue should be evaluated as a vital sign at every encounter with cancer patients, according to updated treatment guidelines issued at the annual conference of the National Comprehensive Cancer Network. Many studies have shown...
Schizophrenia, Bipolar Link Found. (Disorders May Share Gene Complex)
Bipolar disorder may be associated with a gene complex that previously was associated with schizophrenia, results of a new genetic study show. The discovery marks the first time that bipolar disorder and schizophrenia have been associated consistently...
Screen for Cognitive Decline at All Stages of HIV. (Impairment May Predict Mortality)
MIAMI -- A critical aspect of managing a patient with HIV infection is to actively screen for central nervous system dysfunction--including early, subclinical signs--at all stages of the disease, Dr. Karl Goodkin said at a meeting sponsored by the...
Seizure Rx Topiramate Shown Safe for Preventing Migraines. (Two Randomized Trials)
HONOLULU - Topiramate, previously approved as an adjunctive therapy for a variety of seizure types, appears to be safe and effective in the prevention of migraine headaches, according to two studies presented at the annual meeting of the American Academy...
Sertraline: Less Postpartum Depression Recurrence. (Started Shortly after Delivery)
WASHINGTON -- Sertraline therapy started shortly after delivery was shown to be effective in preventing the recurrence of postpartum depression in women who were at increased risk, Dr. Katherine Wisner said at the annual meeting of the American Society...
'Sinus' Headache Is Probably a Migraine. (Sumatriptan Effective)
HONOLULU - The overwhelming majority of "sinus" headaches are actually migraine headaches, according to a large clinical trial reported by Dr. Curtis P. Schreiber at the annual meeting of the American Academy of Neurology. The 3,038 patients in...
Social Skills Training Aids Functioning of Troubled Adolescents. (Use Learning-Based CBT)
New YORK -- Social skills deficits are common among adolescents, particularly those with psychiatric problems, and re-mediation can be a "very helpful" intervention, Dr. Allen Fay said at the annual meeting of the American Society for Adolescent Psychiatry....
Some Teens Prone to Hopelessness Depression. (Pessimism, Low Self-Esteem)
TAMPA, FLA. -- Vulnerable adolescents with low self-esteem and a negative view of their lives are at risk for developing hopelessness depression, John Abela, Ph.D., reported at a meeting of the Society for Research in Child Development. These findings...
Start Cholinesterase Inhibitor Immediately after Alzheimer's Dx. (Improves Cognitive Function)
BALTIMORE -- Treatment with a cholinesterase inhibitor should start as soon as a patient is diagnosed with Alzheimer's disease and be continued for life, Dr. Adam Rosenblatt said at a meeting on Alzheimer's disease and other dementias sponsored by...
Study of Bipolar Amish Raises Contradictions. (Childhood Symptoms Not Constant)
MIAMI BEACH -- Bipolar disorder in Amish children may manifest without hypersexuality or disruptive disorders, prospective data from a long-term study suggest. "We also found the prodromal symptoms follow an episodic pattern in these children, just...
Take Steps to Avoid Liability during Disaster Outreach. (Risk Management)
CRYSTAL CITY, VA. -- A good bedside manner can go a long way particularly after a disaster; psychiatrists who are nice to patients rarely have complaints or malpractice claims lodged against them, Charles D. Cash said at an international congress on...
Transdermal MAO Inhibitor Patch Effective for ADHD. (No Dietary Restrictions)
WASHINGTON -- A transdermal patch containing the selective monoamine oxidase inhibitor selegiline applied daily appeared effective and well tolerated in a pilot study of children and adolescents with attention-deficit hyperactivity disorder, Michael...
'Truth Serum' Interviews Yield Mixed Memories. (True and False Stories Surface)
RANCHO MIRAGE, CALIF. -- Administering so-called truth serums to terrorism suspects may produce false as well as true memories, based on a videotape that was presented at the annual meeting of the American College of Forensic Psychiatry. The videotape...
Urge Social Phobia Patients to Broaden Circle of Friends. (Interpersonal Relationships Are Key)
Toronto -- Cognitive-behavioral therapy has done a poor job of addressing interpersonal relationships in the treatment of social anxiety disorder, John Walker, Ph.D., said at the annual conference of the Anxiety Disorders Association of America. ...
Use Rigor in Screening Patients for Alcoholic Liver Disease. (Length of Abstinence Is Key)
TUCSON, ARIZ. -- Patients with alcoholic liver disease are good candidates for liver transplants if they are screened using rigorous criteria, Dr. Terry D. Schneekloth said at the annual meeting of the Academy of Psychosomatic Medicine. The critical...
Use Risk Management to Avoid Losing Lawsuits. (Don't Underestimate Value of an Apology)
VAIL, CoLo. - "Whom have you talked to about this case?" is one of several questions doctors may be asked in depositions for a malpractice case, said Susan West, RN., director of risk management at the University of Colorado Health Sciences Center....
Ziprasidone Helps Manage Severe Agitation. (Intramuscular Injections)
SAN FRANCISCO -- Rapid-acting intramuscular ziprasidone may offer significant advantages over conventional management of patients presenting to the psychiatric emergency service with acute severe agitation, Dr. Steven G. Klotz said at the annual meeting...
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