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. 34, No. 7, July

AMA Takes 'Bold Shift' on Health Insurance Stance: Delegates Back Individual Accountability
CHICAGO -- Individual health insurance mandates, direct-to-consumer advertising, and store-based health clinics topped the list of issues addressed at the annual meeting of the American Medical Association's House of Delegates. AMA delegates voted...
Antidepressant Benefit May Be Apparent Sooner
TORONTO -- Most clinical recommendations advise that patients who start an antidepressant be given 4-6 weeks to see whether they respond and have improvement. But an analysis of more than 5,000 patients treated in clinical trials with a variety...
Antidepressants Appear to Bolster Executive Function after Stroke
SAN DIEGO -- Treatment with antidepressants improved executive function in patients who had a recent stroke, results from a 2-year study of 47 patients demonstrated. The finding suggests that "modulation of the monoaminergic neurotransmission by...
Antidepressant Use, Diabetes Link Is Found
WASHINGTON -- Frequent antidepressant use may be associated with the development of type 2 diabetes, according to a posthoc sub-analysis of patients in the randomized Diabetes Prevention Program trial. This subanalysis is the first reported instance...
Autonomy, Family, and the Right to Die
Debates about assisted suicide, euthanasia, and the right to die are now commonplace worldwide, so it's no surprise that feature films have begun to address these thorny issues. Perhaps the best to date is the Spanish film, "The Sea Inside," a richly...
Benefits of Multivitamins Unclear, Panel Finds: Members Call for Legislation That Would Expand the FDA's Role in Addressing Oversight of Multivitamins
BETHESDA, MD. -- Evidence of the effectiveness and safety of multivitamin and mineral supplements to prevent chronic diseases is too sparse and ambiguous to recommend for or against their use, according to a panel of experts at a conference on multivitamin...
Biases, Mimicking Disorders Confound Child Abuse Dx
OLD GREENWICH, CONN. -- Child abuse remains one of the most misdiagnosed problems in all of pediatrics, Dr. Cindy Christian said at a meeting of the Eastern Society for Pediatric Research. On one hand, a lack of awareness of their own social biases,...
Buprenorphine Switch Improves Detox
SAN DIEGO -- The switch from the use of intramuscular buprenorphine to sublingual buprenorphine probably has improved the completion rate of short-term, inpatient opiate detoxification, according to the experience at the Center for Chemical Dependence...
Bupropion Wins Approval for SAD
Extended-release bupropion is the first drug to be approved by the Food and Drug Administration for patients with seasonal affective disorder. The FDA approved the antidepressant last month for preventing major depressive episodes in patients with...
Caregiver Stress May Predict Skin and Allergic Disorders in Children
NEW YORK -- Compelling research supports the link between psychological stress and specific skin and allergic disorders, Dr. Rosalind J. Wright said at a dermatology symposium sponsored by Cornell University. "There is huge biological plausibility...
CATIE Support of Atypical Antipsychotics Debated
TORONTO -- The trial that was supposed to provide definitive guidance on which atypical antipsychotic or antipsychotics work best in schizophrenia apparently has not. The months after the publication of the first-phase results from the Clinical...
Chronic Tics Did Not Worsen for Patients on Levodopa
LA JOLLA, CALIF. -- Children and adults with chronic tic disorders who were treated with levodopa did not experience a worsening of tics, Dr. Mollie Gordon reported during a poster session at the annual meeting of the American Neuropsychiatric Association....
Clinton and Obama Pitch Patient Safety Approach to Liability Crisis
Two Democratic senators are aiming to move patient safety to the center of the medical liability debate. Sen. Hillary Rodham Clinton (D-N.Y.) and Sen. Barack Obama (D-Ill.) have introduced legislation that would provide grant funding for physicians,...
Cognition Impaired in 30% with ALS: A Small Study of Patients with Classic Amyotrophic Lateral Sclerosis Found Cognitive Impairment in 30% of the Patients and Dementia in 23%
Cognitive impairment was found in 30% of patients with amyotrophic lateral sclerosis in a study designed to assess the prevalence of cognitive involvement in what used to be considered a disease restricted to the motor system, according to Dr. Gregory...
Comorbidities Are Common in Autistic Children
SAN FRANCISCO -- Data from a large national survey document very high levels of comorbidity among children with autism, James G. Gurney, Ph.D., reported at the annual meeting of the Pediatric Academic Societies. Compared with children aged 3-17...
Coping with the Loss of a Spouse
Dr. Marco Coppola was just 33 years old when he lost his wife, Dr. Margaret J. Karnes, to breast cancer on May 4, 1997. The couple had been married almost 7 years. "I used to think that it would be easier for me to have gone through a divorce, because...
Data Show That DBT Reduces Suicidal Behavior
SEATTLE -- Dialectical behavior therapy possesses far and away the strongest evidence base of any treatment aimed at reducing suicidal behavior, Marsha M. Linehan, Ph.D., said at the annual conference of the American Association of Suicidology. ...
Defensive Medicine Consumes 10% of Premium Dollars
WASHINGTON -- The costs of malpractice insurance and defensive medicine account for about 10 cents of every dollar spent on health care premiums, several speakers said at a press briefing sponsored by America's Health Insurance Plans. Medical liability...
Dementia, Depression Common in Assisted Living
SAN JUAN, P.R. -- Dementia and depression appear to be quite common among residents in assisted living facilities, based on two analyses of facilities in Maryland that were presented at the annual meeting of the American Association for Geriatric Psychiatry....
Donepezil Makes Difference in Severe Alzheimer's
CHICAGO -- Patients with severe Alzheimer's disease showed improved cognition and function when treated with donepezil in a 24-week, placebo-controlled trial, Dr. Sandra Black and her associates reported in a poster at the annual meeting of the American...
Don't Withhold Opioids from Recovering Addicts
SAN DIEGO -- Pain patients with a history of substance abuse who are otherwise appropriate candidates for opioid medications should receive the same consideration from their physicians as patients without the disease of addiction, Dr. Howard A. Heit...
Drug Companies' Influence in Psychiatry Pervasive, Experts Say
TORONTO -- Psychiatrists should be very concerned about the influence pharmaceutical companies wield in their field, and in medicine as a whole, two psychiatrists said in presentations at the annual meeting of the American Psychiatric Association....
Experts Finding Objections to No-Suicide Patient Contracts
SEATTLE -- Experts on suicide are increasingly turning thumbs-down on the use of no-suicide contracts, David A. Jobes, Ph.D., said at the annual conference of the American Association of Suicidology. These widely used contracts, also called no-harm...
Experts Still Railing against Buprenorphine Limits: American Society of Addiction Medicine Says Law Makes No Sense and 'Constitutes Rationing of Care.'
SAN DIEGO -- Despite the recent potential easing of the federal limit on the number of opiate-addicted patients a physician can treat, substance abuse experts continue to see a pressing need for more buprenorphine slots. At a recent meeting of the...
Extended-Release Naltrexone Shows Rapid Onset: Pharmacokinetic Data Show That Peak Plasma Concentration Is Reached on Day 3 after Injection
SAN DIEGO -- The new long-acting, injectable formulation of naltrexone takes effect rapidly and probably does not need to be combined with an oral dose to prevent alcohol-dependent patients from early hazardous drinking, according to a company presentation...
Family Stress High in ADHD
The results of a large national survey indicate that families of children with attention-deficit hyperactivity disorder show very high levels of stress, compared with families of children with other special health care needs, according to a poster...
For Older Women, Prenatal Alcohol Use Affects Children's Growth
SANTA BARBARA, CALIF. -- The children of older mothers who drank during pregnancy were shorter and had smaller head circumferences at the ages of 7 and 14 years than other children at those ages, it was reported at the annual meeting of the Research...
Herbal, Nutritional Therapies Can Play Supportive Role in Practice
TUCSON, ARIZ. -- Complementary herbal and nutritional therapies can play an important role in an integrated psychiatric practice, Dr. Iris R. Bell said at a psychopharmacology conference sponsored by the University of Arizona. Disputes remain about...
History May Offer Clues in Neuropsychiatric Lupus
GLASGOW -- When acute nonspecific symptoms might represent neuropsychiatric lupus, it is necessary to carefully review a patient's past medical history, because the presenting symptoms of systemic lupus erythematosus are manifold, may mimic other disorders,...
Initial Psych Screenings Key at Nursing Homes
SAN JUAN, P.R. -- Consulting psychiatrists can help improve the lives of nursing home residents by establishing psychiatric diagnoses, coordinating medications, and educating staff, Dr. Olivera Bogunovic said at the annual meeting of the American Association...
Insomnia Appears to Be a Risk Factor for Anxiety and Other Psychiatric Disorders
MIAMI -- People with anxiety often present with insomnia, but evidence suggests that untreated insomnia might precipitate anxiety disorders, according to a presentation at the annual conference of the Anxiety Disorders Association of America. "We...
Keep an Open Mind about CAM for Parkinson's
WASHINGTON -- Many patients with Parkinson's disease turn to complementary and alternative medicine therapies for the relief of symptoms. Keeping an open mind can help these patients get nontraditional treatments that actually may help them and at...
Lithium: The Unsung Antisuicidal Agent
SEATTLE -- Lithium is vastly underappreciated as a suicidality-reducing agent, Dr. Mark W. Viner asserted at the annual conference of the American Association of Suicidology. Lithium is supported by far and away the strongest evidence of efficacy...
Long-Term Interventions Can Reduce Repeat Suicide Attempts
SEATTLE -- Promising examples of how long-term continuity of care for suicide attempters can reduce future suicidal behavior range from comprehensive, multidisciplinary networks for follow-up care to a simple series of mailed postcards, Annette L....
Mother's Depression Affects Child's Mental State
When a mother's depression remits, her child's clinical state also improves, and children of mothers who remain depressed are likely to deteriorate, reported Myrna M. Weissman, Ph.D., and her associates in the pediatric portion of the Sequenced Treatment...
MRI Captures Differences in Pain Perception: Statistically Significant Differences in Brain Activity Found beyond the Thalamus but Not within It
BETHESDA, MD. -- Pain perception, far from being the simple one-directional process first proposed by Descartes in 1664, appears to be modulated by several psychological, genetic, and other factors specific to the individual experiencing it, several...
New Revenues Needed for Universal Care, Panel Says
Affordable health care coverage should be public policy established in law with a set of core benefits available to all Americans by 2012, the Citizens' Health Care Working Group said in its interim recommendations. Benefits would be defined by an...
Obesity Appears to Be a Stronger Asthma Risk Factor in Women
KEYSTONE, COLO. -- Obesity appears to be modestly associated with subsequent development of asthma, particularly in women, Dr. David A. Beuther reported at a meeting sponsored by the National Jewish Medical and Research Center. His metaanalysis...
Optimism Tied to Lower CVD Mortality in White Men
Older white men who have an optimistic nature have about half the risk of dying from cardiovascular causes as their less optimistic peers, according to Dr. Erik J. Giltay of the Institute of Mental Health, Delft, the Netherlands, and his associates....
Pain Specialists: Urged to Resist Profiteering
SAN DIEGO -- Challenges such as declining reimbursements and limitations on payor approval of prescribed therapies are creating fertile ground for conflict of interest and profiteering by physicians, Dr. Jerome Schofferman said at the annual meeting...
Pathology Is Rule for Youth Offenders
MIAMI BEACH -- Data on the prevalence of mental and substance-related disorders among youth in juvenile justice systems--such as those who are on probation, involved in juvenile/family court, on detention, or in juvenile correctional facilities or...
Patient Registries May Offer Cheaper Alternative to EHRs
PHILADELPHIA -- A costly electronic health record system is not necessary to engage in quality improvement and participate in the growing number of pay-for-performance programs, Dr. Rodney Hornbake said at the annual meeting of the American College...
Paxil Fails to Improve Children's MDD
Paroxetine was no more effective than a placebo in reducing the symptoms of major depressive disorder in a population that, for the first time, included patients younger than 12 years, reported Dr. Graham J. Emslie of the University of Texas, Dallas,...
Perimenopause Complicates Treatment
The perimenopause, or menopausal transition, is a difficult time often marked by physical discomfort, insomnia, and dysphoria. It is a time of heightened psychiatric risk as well. An increase in the risk of depression and depressive symptoms has...
Perspective
As the principal investigator of a sexual risk reduction intervention funded by the National Institute of Mental Health for 10- to 13-year-olds in Durban, South Africa, I have experienced firsthand a lesson from Stephen Covey's "The Seven Habits of...
Pharmacotherapy Urged for 'Hard-Core' Smokers
SAN DIEGO -- Physicians who have a patient who smokes need to do more than just advise them to quit. Most smokers need much more help than that, Dr. Linda Hyder Ferry said at the annual conference of the American Society of Addiction Medicine. Specifically,...
Poor Physical Function May Precede Dementia Onset
Older people with poor physical function are at higher risk for developing dementia than those with good physical function, reported Li Wang of the Veterans Affairs Puget Sound Health Care System, Seattle, and her associates. In a study of 2,288...
Post-MI Depression Severity Appears to Stabilize after 6 Months
DENVER -- Depression that occurred in adults after acute myocardial infarction decreased in severity during the first 6 months after the cardiac event, but then stabilized over the next several years, Kenneth E. Freedland, Ph.D., reported in a poster...
Power of DBT Is in the Therapy, Trial Finds
SEATTLE -- For years, skeptics have questioned whether dialectical behavior therapy demonstrates such strong efficacy for borderline personality disorder in randomized trials because of the unique strengths of the therapy or merely because of a higher...
Programs Attempt to Treat the Trauma That Underlies Addiction
COLORADO SPRINGS -- Trauma therapy should be an integral part of substance abuse recovery programs, because trauma is at the root of most addictions, Dolores J. Walker said at a symposium on addictive disorders sponsored by Psychotherapy Associates....
Proposals Debated to Address Organ Shortage
The growing gulf between patients requiring organ transplants and the number of persons willing to give them is spurring some ethicists to call for new--and sometimes radical--ways to encourage donations. The proposals range from loosening current...
Radio Psychiatry
Many of our patients put stock in call-in radio shows featuring mental health professionals who help callers talk through their problems. Is any kind of meaningful treatment possible in such forums? Do these shows have any value for patients? Psychoeducation,...
Rivastigmine Backed for Parkinson's Dementia
GAITHERSBURG, MD. -- The cholinesterase inhibitor rivastigmine is likely to be approved for a second indication: the treatment of mild to moderate dementia associated with Parkinson's disease, based on a study that found treatment was associated with...
Screen for Depression in Women Complaining of Hot Flashes
TUCSON, ARIZ. -- When a female patient presents with hot flashes, consider screening her for depression, Dr. Marlene Freeman advised at a psychopharmacology conference sponsored by the University of Arizona. The risk of depression is known to increase...
Screen for Intimate Partner Abuse in Ped Emergency Visits
CHICAGO -- Screening for intimate partner violence among parents who bring their children into the emergency department is an active form of child abuse protection, Dr. Jane F. Knapp said at a meeting sponsored by the American College of Emergency...
Seizures May Present as Subtle Cognitive Changes
SAN DIEGO -- Seizures in elderly patients may present as subtle changes or unexplained fluctuations in cognitive abilities, results from a small study demonstrated. The finding suggests that physicians "need to consider subtle or subclinical seizures...
Social Anxiety Diminishes Positive Experiences: Researchers Also Find More Suppression of Emotion among Participants with Social Anxiety
MIAMI -- Socially anxious people report fewer positive experiences and greater suppression of emotion than their nonanxious counterparts do, Todd B. Kashdan, Ph.D., reported at the annual conference of the Anxiety Disorders Association of America....
Strategies Can Improve Treatment Adherence: If Alcohol Abusers Don't Improve, They May Need to Be Reeducated about Their Medications
SCOTTSDALE, ARIZ. -- Sometimes an alcohol abuser prescribed a medication such as disulfiram, acamprosate, or naltrexone has no improvement in their drinking behavior. Sometimes the reason is that the patient has not been adherent to the medication,...
Stress Affects Clearing of Psoriasis
NEW YORK -- There is mounting evidence that stress and the way in which patients with psoriasis view themselves or perceive themselves to be seen affects the way that they respond to treatment, Dr. Christopher Griffiths said at a dermatology symposium...
Stress Can Alter Brain, Lead to Psychopathology
SAN JUAN, P.R. -- Stress can cause structural remodeling of the brain that can have short-term advantages, but if left unchecked, the changes can contribute to psychopathology, according to a presentation by a neuroendocrinologist at the annual meeting...
Stress, Depression May Speed Breast Ca Progression: Combination May Dysregulate the Hypothalamic-Pituitary-Adrenal Axis and Lead to More Stress
SAN JUAN, P.R. -- Women who experience stressful life events, especially trauma, together with depression have a shorter time to breast cancer progression than women with no such history, Dr. David Spiegel said at the annual meeting of the American...
Suicidal Behavior Needs Long-Term Follow-Up
SEATTLE -- Suicide attempt behavior is best viewed in most instances as a chronic condition embedded in long-term psychiatric illness and lifestyle problems, Annette L. Beautrais, Ph.D., asserted in her Edwin S. Shneidman Award lecture at the annual...
Suicide Rates in Decline, but Suffocation Deaths on the Rise
SEATTLE -- Suicide rates in general have been steadily decreasing over the past 2 decades. But a new investigation conducted by the Harvard Injury Control Research Center shows that suicide via suffocation has actually increased, Catherine Barber reported...
Suicide Risks Higher after DBS among Parkinson's Patients
SAN DIEGO -- Parkinson's disease patients who have undergone subthalamic nucleus deep brain stimulation have higher rates of completed and attempted suicide than do others with the disease, Dr. Valerie Voon reported at the annual meeting of the American...
Teens' Sexual Risk Taking: Early Intervention a Must
Sexually risky behaviors on the part of adolescents is nothing new, but the age at which these behaviors begin is. In fact, new data suggest that sexual risk taking often begins in middle school. Baseline data collected in spring 2005 from 4,457...
Testosterone Doesn't Significantly Improve Cognition, Study Finds
CHICAGO -- Exogenous testosterone, taken either alone or with finasteride for 36 months, did not significantly improve cognition in a randomized, placebo-controlled trial involving healthy older men. The findings do little to settle the debate over...
The Art of Carolyn S. Gabb
Carolyn S. Gabb's "Woman in the Box" series of ceramics stems from a dream of a woman who was struggling to come out of--you guessed it--a box. "She was in a fetal position in the box," said Dr. Gabb, who holds an Ed.D. in language education. "The...
Therapy Linked to Autism Recovery
BALTIMORE -- Growing evidence suggests that a small minority of children with autistic spectrum disorder can recover from the condition to near-normal levels with only mild residual deficits, Deborah Fein, Ph.D., said at a meeting on developmental...
Treating Depression Can Curb Drinking in Alcoholic Patients
SCOTTSDALE, ARIZ. -- Most physicians who treat alcohol-dependent patients know that studies have shown that depressed patients are much less likely to quit, or reduce, their drinking. It is less well known that treating depression in these patients...
Tysabri Is Again Available-With Conditions
Tysabri, the monoclonal antibody withdrawn from the market in February last year after progressive multifocal leukoencephalopathy was diagnosed in three patients receiving the drug in clinical trials, will be made available again for patients with...
Unraveling the Mind/gut Puzzle
A few years ago, an accountant was referred to me by his internist. The accountant's chief complaint was that he had daily episodes of feeling bloated. When he wasn't bloated, he had an urge to defecate. When I saw the patient, he was so possessed...
Use of Intranasal Lidocaine May Relieve Migraine
SOUTH LAKE TAHOE, CALIF. -- The next time you see a patient with a migraine headache, you might want to try intranasal lidocaine, Dr. John Richards said at an emergency medicine conference sponsored by the University of California, Davis. "It's...
Uses of Some Opiates Limited in HIV Patients
SAN FRANCISCO -- Opiates are often the best choice when treating pain in patients with HIV, but some of the available drugs can have limitations, Dr. Robert V. Brody said at a meeting on HIV management sponsored by the University of California, San...
Wanted: Docs to Craft Pay for Performance; CMS Says Physician Input Is Needed to Make Programs Effective; AMA Trustee Stresses Quality
CHICAGO -- Physicians need to help design the pay-for-performance programs that are now being initiated by Medicare and other payers or they may not like the results, Dr. Trent Haywood said at the annual meeting of the American Association of Clinical...
'Weak' Ties Matter to Our Patients
Hurricane Katrina, the war in Iraq, and the Southeast Asian tsunami are disasters that are likely to have immense consequences--for all of us--if we do not have a plan for the recovery efforts. We cannot plan properly if we fail to understand environmental...
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