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. 5, May

Alteplase May Have Benefit 3-6 Hours after Stroke: Significant Advantage Seen over Placebo When the Smallest Lesions Were Excluded from Analysis
Ishemic stroke patients with an area of hypoperfusion larger than the area of infarct and cytotoxic damage may still benefit from alteplase 3-6 hours after stroke onset, according to a study presented at the International Stroke Conference 2008 in...
Analysis Offers Insights into Celecoxib's Cardiovascular Risk
CHICAGO -- The cardiovascular risk of celecoxib is a function of both dose and dosing schedule, as well as a patient's baseline cardiovascular risk, according to a new National Cancer Institute-sponsored pooled analysis of six randomized trials. ...
Another Study Links Cigarettes with Suicide
VIENNA -- Current or former cigarette smoking is strongly associated with an increased rate of prior suicide attempts among Hungarian psychiatric outpatients, Dr. Zoltan Rihmer reported at the annual congress of the European College of Neuropsychopharmacology....
Aripiprazole May Prevent Manic Relapse in Bipolar Disorder
VIENNA -- The atypical antipsychotic aripipra-zole demonstrated sustained long-term efficacy for prevention of manic relapse in patients with bipolar disorder, Dr. Roger S. McIntyre reported at the annual congress of the European College of Neuropsychopharmacology....
Assess Psychological Factors in Chronic Pelvic Pain Cases
FORT LAUDERDALE, FLA. -- About 75% of premenopausal women with chronic pelvic pain gain significant relief from hysterectomy, even when no apparent physiologic cause is found. But what about the other 25%? "We tend to look at fibroids and endometriosis....
A Study Shows That 'Psychological Distress' Rather Than Depression Might Increase the Risk of Stroke. How Might Psychiatrists Think of This Concept of Psychological Distress?
Psychiatry is such a screwed-up field that we cannot retain a language that is scientific and meaningful Several months ago I railed against the bastardization of the word "depression." Now we have a new one, "distress," which a recent study on...
Binge Drinking Common in Psychiatric Outpatients
SAN FRANCISCO -- A computer-based intake survey of 422 psychiatric outpatients showed that 27% reported having at least five drinks on a single occasion within the past 30 days, reported Derek D. Satre, Ph.D. In addition, 28% reported having eight...
Bisexual College Women at Greatest Risk for STDs
CHICAGO -- Bisexual college women were 60% more likely to report having a sexually transmitted disease during the past year than were their heterosexual counterparts and four times more likely to report an STD than lesbian college students, according...
Brain Regions Associated with Satiety Identified
A new imaging study that has identified areas of brain activation associated with feelings of fullness may provide new therapeutic targets to minimizing overeating. Researchers at the U.S. Department of Energy's Brookhaven National Laboratory found...
Catastrophizing Worsens Osteoarthritis Disability
FORT LAUDERDALE, FLA. -- Pain catastrophizing and pain-related fear are associated with increased disability and worse physical functioning among overweight patients with osteoarthritis, according to a study presented at the World Congress on Osteoarthritis....
Childhood Trauma Raises Risk of Adult CHD and Depression
VIENNA -- Childhood trauma was an independent predictor of coronary heart disease and major depression later in life in a study with 360 men. "Childhood trauma can have important consequences, but it is a risk factor that physicians don't usually...
Competency Is Not All or Nothing
Ahmad Edwards had a serious mental disorder with psychotic features. After shoplifting in downtown Indianapolis and being chased, he fired three gunshots, injuring two people. An FBI agent apprehended Edwards after making several requests that he drop...
Consulting with Medical Patients
Some years ago, an elderly gentleman began to experience hiccups after eye surgery. He also had a history of car-diovascular disease. After 5 days of medical intervention, such as breathing into a paper (not plastic) bag, using vagal stimulation, drinking...
Criminal Profiler Shares Some Secrets of the Trade
SAN FRANCISCO -- In 1956, frustrated by their inability to apprehend the "Mad Bomber" who had been terrorizing New York City for 16 years, police detectives paid a visit to Dr. James A. Brussel, a noted psychiatrist and a criminologist. As he examined...
Cutting BP, Not Sugar Levels, Lowers CV Risks in Diabetes
PHILADELPHIA -- Lowering blood pressure might be more effective than lowering blood sugar alone for reducing the risk of cardiovascular events in type 2 diabetes patients, according to the director of the coronary care unit at Boston Medical Center....
Depression May Predict PTSD in Some Cardiac Patients
BALTIMORE -- Depression at hospital admission and the recurrence of cardiac symptoms in the first year appear to predict the presence of posttraumatic stress disorder symptoms at 3 years in patients with acute coronary syndrome, results of a study...
Despite Testing, Gonorrhea Goes Undetected in Gay Men
CHICAGO -- Up to 35% of sexually active gay men might still have undiagnosed gonorrhea infections, despite visiting a sexual health clinic for screening tests, Kristen Mahle said at a conference on STD prevention sponsored by the Centers for Disease...
Diversity Missing from Research
KOLOA, HAWAII -- The reluctance to discuss differences among ethnic and cultural groups is a serious challenge for the practice of psychiatry, according to discussion group members at the annual meeting of the American College of Psychiatrists. ...
Drinking, Smoking May Raise Early AD Risk
CHICAGO -- Heavy drinking and smoking are associated with a significantly earlier age of development of late-onset Alzheimer's disease, according to findings presented at the annual meeting of the American Academy of Neurology. In a retrospective...
Eclampsia's Neurologic Damage May Be Permanent
DALLAS -- Several years after a pregnancy complicated by eclampsia, significantly more women demonstrate subcortical cerebral white matter lesions on MRI, compared with women with a nor-motensive pregnancy. In a study of 103 women, white matter...
Educate Patients about Asymptomatic Herpes
BOSTON -- "Genital herpes is a recurrent, lifelong viral disease. This is the one thing that patients and clinicians don't like to say, but there's no way around" it, Laura J. Mulcahy said at a conference on contraceptive technology sponsored by Contemporary...
EEG Test Could Predict Antidepressant Response
VIENNA -- A quantitative EEG bio-marker shows considerable promise for prediction of antidepressant response in major depression, Dr. Andrew J. Leuchter said at the annual congress of the European College of Neuropsychopharmacology. The biomarker...
Establish Clear Goals for Trauma-Focused CBT
SAN DIEGO -- Before Laura Merchant begins trauma-focused cognitive-behavioral therapy with children and their caregivers, she provides an estimate for them of the number of treatment sessions that will be required for effective intervention. This...
Evidence-Based Psychiatric Medicine: Oxcarbazepine for Acute Mania
The Problem You have a patient with bipolar disorder. He is currently in an acute phase of mania without psychosis. For various reasons, he declines treatment with lithium, valproate, carba-mazepine, or antipsychotic medications. You consider treatment...
Excessive Daytime Sleepiness May Signal Elevated Stroke Risk
NEW ORLEANS -- People who experience routine episodes of dozing during the daytime may have a higher risk of stroke and other vascular events, according to a prospective, community-based cohort study of more than 2,000 people. The risk of stroke...
Exercise Program May Benefit Alzheimer's Patients
WASHINGTON -- A regular exercise program not only promotes flexibility, balance, and strength in elderly people with dementia, but it also might improve their mental function. "You won't get oxygen to the brain if you don't get air down into the...
Explaining 'Lung Age' Motivates Smokers to Quit
Smokers who were told their "lung age" after spirometry had more than double the rate of quitting 12 months later than did smokers who were given only a clinical measure of lung performance, according to findings of a randomized controlled trial. ...
Fallout from Early Trauma Might Hinge on Genes: Some Patients Get Depression, Others PTSD
KOLOA, HAWAII -- Genetic factors might play a role in determining who gets posttraumatic stress disorder after trauma and who gets depression, according to two studies. In addition, increasing evidence suggests that child abuse and neglect are associated...
Few Adults Follow Diabetes Lifestyle Recommendations
CHICAGO -- Few adults with diabetes and prediabetes are adhering to American Diabetes Association nutrition and activity recommendations, and even fewer with undiagnosed diabetes are doing so. After adjustment for age, gender, and race, a logistic...
Findings Based on Population Study of More Than 20,000
The study aimed at assessing what kinds of factors increase the risk of stroke clarifies the relationship between mental health and stroke, according to the lead investigator and his colleagues. Paul Surtees, Ph.D., and his colleagues conducted...
For Defendants with Retardation, Procedures Vary: Expert Witnesses in Death Penalty Cases Must Know Standards of Proof Differ from State to State
SAN FRANCISCO -- The U.S. Supreme Court decision that executing mentally retarded offenders is unconstitutional provided little guidance on how to implement the ruling. The result has been a mishmash of procedures that vary widely from state to state,...
Guidelines on Way for Treating Sleep Disorders
SAN FRANCISCO -- Sleep should be viewed as a vital sign, and primary care physicians should address sleep disturbances routinely in all visits with older adults, Dr. Harrison G. Bloom said at the annual meeting of the Gerontological Society of America....
Health Reform Possible Even in Slowing Economy
ARLINGTON,, Va. -- Health care reform can be achieved even in difficult economic times, several speakers said at the annual meeting of the Association of Health Care Journalists. "I think past history shows us that major social initiatives do happen...
High Diastolic Blood Pressure Linked to Cognitive Impairment
NEW ORLEANS -- Increased diastolic blood pressure levels are associated with cognitive impairment, findings from the Reasons for Geographic and Racial Differences in Stroke study suggest. More than 27,800 participants from REGARDS--a long-term,...
High Midlife Cholesterol Increases Alzheimer's Risk
CHICAGO -- High cholesterol levels in midlife are associated with an increased risk of Alzheimer's disease and vascular dementia, data from a large, diverse cohort suggest. The analysis of more than 9,500 people showed that those patients with midlife...
Hostility, Fasting Glucose Linked in Black Women
BALTIMORE -- African American women with high levels of hostility show increased levels of fasting glucose. In addition, patients' proportion of trunk fat appears to play a role in the association between hostility and glucose metabolism, results from...
Inhalants Favored among Adolescents
WASHINGTON -- The drugs of choice for children aged 12 and 13 years are inhalants, surpassing pain relievers, marijuana, and any other illegal drug, with 3.4% of 12-year-olds and 4.8% of 13-year-olds using in the past year. This is according to...
In Search of Sublime Psychiatry
"One should practice morality urgently, as if the god of death had seized one by the hair." --paraphrase of Sanskrit by Daniel Herwitz, director, University of Michigan's Institute for the Humanities By the time you read this column, we will...
Interventions Can Help Couples Deal with Posttraumatic Stress
BALTIMORE -- Therapists who treat posttraumatic stress disorder might be able to make the greatest therapeutic impact by bringing married couples or those in committed relationships together to work out their problems using one of three kinds of therapies,...
Lamotrigine May Improve Pelvic Pain, Depression
BALTIMORE -- The anticonvulsant lamotrigine shows promise for reducing pain and improving mood symptoms associated with chronic pelvic pain, particularly in women with the vulvovaginal subtype. In a study of 43 women with chronic pelvic pain,researchers...
Light and Melatonin Can Reset Circadian Rhythm
SCOTTSDALE, ARIZ. -- Before traveling from California to South Africa, Dr. Alon Y. Avidan prepared for the time change by spending afternoons in his office, out of the sun. After he arrived in South Africa, he awoke between 5 a.m. and 7 a.m. every...
Lipid Lowering Reverses Cognitive Decline in Some Atrial Fibrillation
VIENNA -- Potent cholesterol-lowering therapy appears to reverse neurocognitive decline in normolipidemic elderly patients with atrial fibrillation, Dr. Elke Wezenberg said at the annual congress of the European Society of Cardiology. If this new...
Lively Limbs Limit Sleep in Cognitively Impaired
Frequent nighttime leg movements were significantly associated with sleep disturbance and less total sleep in a study of 102 elderly people with cognitive impairment. Previous research had shown that sleep time varies from approximately 6 to 10...
'Maladaptive' Behaviors Tied to Sleep Problems
Certain parental behaviors in response to their toddlers' nighttime awakenings may pave the way for the children to have sleep problems at ages 4-6 years, so these behaviors should be considered maladaptive, according to results from a Canadian study...
Medical Costs Are Much Higher in OCD Than Depression
PITTSBURGH -- Medical costs and use of outpatient medical services are much greater among people with obsessive-compulsive disorder than among those with depression, according to the findings of a study that examined the differences in Florida Medicaid...
More Pregnant Women Getting Court-Ordered TX
TORONTO -- The number of pregnant women entering court-mandated substance abuse programs has increased in the years since the advent of the crack cocaine epidemic, Dr. Mishka Ter-plan said at the annual conference of the American Society of Addiction...
More Training Needed on Smoking Cessation
Too many mental health professionals view the treatment of psychiatric patients who smoke as a primary care issue, according to a leading researcher in the field. "But our patients do not necessarily receive regular primary care," says Judith J....
Multidisciplinary Approach Works Best for Vulvodynia
CHICAGO -- Vulvodynia is best managed with a multidisciplinary approach with a multidisciplinary approach using a wide variety of therapeutic options, Dr. Hope K. Haefner said at a conference on vulvovaginal diseases sponsored by the American Society...
One of First Prevalence Studies Finds More MCI in Men
CHICAGO -- Men have more mild cognitive impairment than women do, yet there is no gender difference in the prevalence of dementia, according to the results of one of the first studies to measure mild cognitive impairment prospectively in a population-based...
Options Expanding for Bipolar Disorder
VIENNA -- A growing list of innovative therapies with novel mechanisms of action in bipolar disorder is available for tough-to-treat cases, Dr. Benedikt L. Amann said at the annual congress of the European College of Neuropsy-chopharmacology. All...
Parenting Is Crux of the Cure in Defiant Disorder
MIAMI BEACH -- It is important to confront parents about their parenting style when conveying a diagnosis of oppositional defiant disorder, a developmental pediatrics specialist advises. It is difficult to address a parenting issue, particularly...
Partner Violence Takes Toll on Women's Health
Intimate partner violence against women not only inflicts obvious injury but also contributes to the overall burden of disease through its association with mental, gynecologic, and gastrointestinal disorders, according to an observational study of...
Physician Groups Back Medical Home Coalition: The Joint Principles for a Medical Home Are Supported by Other Organizations, Including Large Corporations
WASHINGTON -- A who's who list of physician organizations, advocacy groups, pharmaceutical manufacturers, and employers is throwing its weight behind the idea that the medical home model can cure much of what ails the health care system. At a recent...
Polysomnography Study: Migraine Linked to Disturbed Sleep in Children
CHICAGO -- Sleep apnea was observed in more than half of children with migraine in a study presented at the annual meeting of the American Academy of Neurology. Polysomnography revealed sleep apnea in 56% of children with migraine, compared with...
Postpartum Depression May Be Misdiagnosed Bipolar Disorder
PITTSBURGH -- Misdiagnosis of bipolar disorder in the postpartum period may be quite common, Dr. Verinder Sharma and his associates said in a poster presentation at the Seventh International Conference on Bipolar Disorder. Among 56 women who were...
Prolapse Surgery May Improve Body Image and Depressive Symptoms
HOLLYWOOD, FLA, -- Reconstructive surgery for pelvic organ prolapse not only improves physical distress but can significantly improve a woman's body image and depressive symptoms, according to results of a prospective, case-control study. "Body...
Psychiatric Diagnoses Common in Chronic Idiopathic Urticaria
Nearly half of all patients with chronic idiopathic urticaria have Axis I psychiatric diagnoses and 45% have Axis II diagnoses, a new study shows. Obsessive-compulsive disorder (OCD) and major depression were the most common Axis I diagnoses among...
Racial Health Disparities in Elderly Teased Out
SAN FRANCISCO -- Several analyses of data from a longitudinal study of 3,075 elderly African American and white patients have helped identify some of the causes of health disparities between races in older adults, sometimes with surprising results....
Screen ADHD Patients First, Heart Group Says
The new recommendation calling for electrocardiogram screening for children with attention-deficit/hyperactivity disorder before initiating pharmacologic treatment is not based on data, according to an expert in child and adolescent psychiatry. ...
Senate Bill Seeks to Encourage Care for Elderly
Sen. Barbara Boxer (D-Calif.) has introduced legislation aimed at addressing the potential crisis in providing care for elderly Americans. The bill, introduced in March, seeks to offer a combination of educational-loan forgiveness and career-advancement...
Skin-Related Anxiety Affects Exercise Intent
Social anxiety stemming from acne or other skin conditions might keep people from exercising, say results of a survey of 50 adults selected from an acne support group. Exercise is important for overall health and skin health, but data from previous...
Smoking Cessation Intervention for Inpatients Pays Off
CHICAGO -- An intensive smoking cessation intervention that starts while patients are hospitalized for an acute cardiac event is not merely highly cost effective, it is actually cost saving, Robyn Kondrack, Pharm.D., reported at the annual meeting...
Smoking May Increase Risk of Developing Neuropathic Pain
ORLANDO -- In a community sample of 205 adults with chronic pain of any type, neuropathic pain was documented in almost two-thirds of those who smoked, compared with one-third of those who did not smoke, Dr. Todd G. Call reported at the annual meeting...
Stress Affects Athletic Injuries, Recovery: Physicians Not Immune to 'Culture of Risk,' Which Encourages Athletes to Keep Playing despite Pain
Difficult life events and other types of stress, as well as psychological interventions, can have a marked impact on the occurrence of athletic injuries among children and adolescents, according to the authors of a review on the topic. These issues...
Study Assesses 1-Year Substance Use Remission in Native American Veterans
CORONADO, CALIF. -- One-year remission from substance abuse disorder among Native American veterans does not reduce the prevalence of mood and anxiety disorders, gambling disorders, or posttraumatic stress symptoms, results from a community survey...
Suicidality? Primary Care Docs Often Fail to Ask
SAN FRANCISCO -- In a randomized trial involving actors portraying patients with major depression, internists and family physicians usually failed to ask these patients about suicidality, even when they correctly made the depression diagnosis, Dr....
Syphilis Rate Rises Most in Gay Men, African Americans
CHICACO -- The rate of syphilis in the United States has increased for the 7th consecutive year, jumping 12% from 2006 to 2007, according to preliminary evidence released by the Centers for Disease Control and Prevention. The upsurge was driven...
Tailor Dementia Treatment to Each Patient
Cholinesterase inhibitors and memantine are not one-size-fits-all drugs that can be prescribed to every patient with dementia and should only be employed after assessing each drug's risk/benefit profile in light of an individual patient's needs, according...
To Be a Patient, to Be a Caregiver
For those of us lucky enough to have escaped sudden, devastating, and unalterable health catastrophes, or fortunate enough to have not had to shoulder the burden of unending care of persons so afflicted, three outstanding films form an edifying spectrum...
Topical NSAID Relieves Pain of Osteoarthritis: Diclofenac Treatment Rated as Very Good or Excellent by 48% of Patients, Compared with 37% for Placebo
BOSTON -- Topical administration of diclofenac sodium gel was associated with statistically significant and clinically meaningful improvements in symptoms of hand osteoarthritis in a multicenter, double-blind trial, Dr. Roy Altman reported at the annual...
Tough Decisions Surround Rx in Pregnancy: The Child Will Be Exposed to Illness or Treatment, and 'Some Decisions Are Far Worse Than Others.'
KOLOA, HAWAII -- Labeling typically doesn't support the use of psychotropic drugs in pregnant women, but the drugs might be needed during pregnancy, according to an observational study done at Emory University, Atlanta. "What I want you to recognize...
Treating Intellectually Disabled Patients
With increasing numbers of intellectually disabled individuals living in residential settings or with their families, psychiatrists in the community are becoming more involved in their care. Many are unprepared. "Most psychiatric training programs...
Two-Session Strategy Helps Trauma Patients Avoid PTSD
BALTIMORE -- Patients who receive a brief secondary prevention intervention shortly after experiencing trauma can avoid a diagnosis of posttraumatic stress disorder up to 2 years later, research presented at the annual meeting of the International...
Undocumented Adolescents: Building Hope
The guidance offices of many of this country's large urban middle schools and high schools--particularly those in economically depressed areas--are teeming with what psychiatrist Dr. Dean DeCrisce of New York University Medical Center refers to as...
Use Behavioral Strategies to Help Manage Diabetes
SAN FRANCISCO -- Here's what doesn't work when trying to help patients self-manage their diabetes: * Urging them to use more willpower. "You need to get serious about your diabetes." * Threatening them with bad outcomes. "Do you want to go blind?...
Vitamin E May Increase Survival in Alzheimer's
CHICAGO -- Vitamin E supplementation at doses of 2,000 IU/day appeared to be associated with improved survival in a retrospective case analysis of patients who had Alzheimer's disease. The results, presented at the annual meeting of the American...
Waist Size Is a Vital Sign of Hypertension Risk
COLORADO SPRINGS -- Marginally increased waist circumference is strongly associated with prevalent hypertension in normal-weight and overweight adults, according to data from a large National Institute of Neurological Disorders and Stroke--sponsored...
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