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. 33, No. 3, March

Abnormal Brain Anatomy Found with ADHD: Diffusion Tensor Imaging Shows Abnormalities in Pathways between the Frontal Lobe, Cerebellum
CHICAGO -- Children with attention-deficit hyperactivity disorder have anatomical brain abnormalities that can be seen with a novel technique called diffusion tensor imaging. "Our hope is, in the future, to be able to diagnose ADHD with this technique,"...
Addressing Depression in the Workplace
Bonuses, stock options, expense-paid vacations--companies shell out a lot of money on incentives aimed at improving employee performance and increasing productivity. Yet many overlook one benefit that could increase return on investment by an order...
Anger Common in Disruptive Physicians
ARLINGTON, VA. -- Can a surgeon who brings a gun to the operating room be trusted not to use it? That's an extreme example of the kinds of questions that psychiatrists must address when doctors are referred to them for evaluations. Disruptive physicians...
Aripiprazole in Bipolar Mania
The Problem You have a patient who has been diagnosed with bipolar I disorder. He has cycled into a severe manic episode with psychotic features. The patient refuses treatment with typical mood stabilizers such as lithium, valproate, or carbamazepine....
Biphasics Not Good Mix for Menstrual Migraines: Low-Dose, Monophasic Contraceptives Seem to Benefit Migraine Sufferers More
SCOTTSDALE, ARIZ. -- Fluctuating hormones are believed to be the key culprit behind menstrual migraines, so low-dose monophasic oral contraceptives are generally the best alternative to help such patients, Christine Lay, M.D., said at a symposium sponsored...
Calcium Channel Antagonists in Pain: Blockade of Voltage-Sensitive Calcium Channels Provides Novel Agents for Pain Management
Issue Three FDA-approved agents for pain management work by blocking calcium channels--ziconotide, gabapentin, and pregabalin. How do they work, and for whom do they work? Actions Learn the mechanism of action of these novel analgesics. Benefits...
Case of Treatable Autoimmunity Initially Diagnosed as Dementia
BUDAPEST, HUNGARY -- Autoimmune striatal dysfunction may be the underlying cause of dementia-like presentations, in rare cases. This was the case for a 48-year-old woman, who presented with a 1-year history of progressive difficulties with attention...
CBT Improves Itch-Scratch Cycle in Dermatitis
FLORENCE, ITALY -- A brief series of cognitive-behavioral training sessions had a highly significant impact on scratching and profoundly improved the ability of patients with atopic dermatitis to cope with the itching that accompanies the disease,...
Chromosomal Deletion More Common in Prison Population
SCOTTSDALE, ARIZ. -- A genetic abnormality known as 22q11 deletion syndrome appears to occur more commonly among incarcerated inmates than might be expected, Victoria Harris, M.D., said at the annual meeting of the American Academy of Psychiatry and...
Clomipramine May Help Men with Premature Ejaculation
SANTA FE, N.M. -- Men with premature ejaculation appear to have weaker erections and abnormal heart-rate responses in addition to their shortened ejaculatory latency, according to a study presented by Wendi L. Tai at the annual meeting of the Society...
CMS Panel Backs Coverage for Lifestyle Programs
BALTIMORE -- There might not have been thunderous applause at last month's meeting of the Medicare Coverage Advisory Committee, but the quiet approval was quite enough for Dean Ornish, M.D. The committee, which advises Medicare on coverage issues,...
Combo TX Proves Best for Obese Binge Eaters
LAS VEGAS -- Adding a weight-loss medication to cognitive-behavioral therapy for binge-eating disorder produced a higher remission rate and greater weight loss than cognitive-behavioral therapy alone in a randomized, double-blind, placebo-controlled...
Computerized Survey Adapts to Patients' Skills
SAN FRANCISCO -- The digital divide in your waiting room can be crossed, and technology can compensate for low literacy levels in some patients, said David F. Lobach, M.D. A randomized, controlled, crossover study of 567 patients found that patients...
Consumer-Driven Health Plans Have Yet to Gain Momentum
WASHINGTON -- Consumer-driven health care plans have yet to catch on with most patients. These high-deductible spending accounts were designed to empower patients to make informed choices about their health care and provide them with more options...
Dad's Mental Health Tempers Ill Mom's Effect
SAN FRANCISCO -- Good mental health in a father can buffer the impact of a mentally ill mother on a child, Robert S. Kahn, M.D., said at the annual meeting of the Pediatric Academic Societies. In a study of 822 children aged 3-12 years who were...
Deficits Not Seen in Preeclamptic Women on Magnesium
VIENNA -- Preeclamptic women on magnesium sulfate treatment do not appear to be at increased risk for cognitive deficits, Judith Hibbard, M.D., reported at the 14th World Congress of the International Society for the Study of Hypertension in Pregnancy....
Depression Screen May Avert 'Diabetes Burnout'
QUEBEC CITY -- Diabetes patients and their physicians are at high risk for burnout, but they can sidestep some of that risk by ruling out depression, William Polonsky, Ph.D., said at the joint annual meeting of the Canadian Diabetes Association and...
Depression Shows a Different Face with Epilepsy
BRECKENRIDGE, COLO. -- Depression has an atypical presentation in people with epilepsy, but recognizing and treating depression can significantly improve quality of life for patients carrying the dual diagnoses, Lauren C. Frey, M.D., said at a conference...
Disparities among Women Vary by Ethnic Group
WASHINGTON -- More programs need to be developed to address the specific health needs of minority women, Elena Cohen said at the annual meeting of the American Public Health Association. "Racial minorities are projected to make up almost half the...
Dissociative Disorder Seems Common in BPD Patients
NEW ORLEANS -- Dissociative disorder appears to be a common comorbidity in patients with borderline personality disorder, and their coexistence may play a role in patients' reporting of childhood trauma, Vedat Sar, M.D., said at the annual conference...
Doctors Are Top Source for Medicare Drug Info
WASHINGTON -- Older patients are choosing their physician over the phone or electronic resources to help them understand the complexities of the new prescription drug law. Many beneficiaries don't understand what the new law does, and many are not...
Dropoff Seen in Prescribing of Antidepressants: Surprisingly, Psychiatrists Writing Fewer
Arecently reported 10% decline in the percentage of children and adolescents taking antidepressants last year is alarming but not surprising, given all the controversy and publicity leading up to the Food and Drug Administration's black box requirement...
Ease Patients' Fear of Painkiller Addiction through Education
SAN FRANCISCO -- Talking to elderly patients with chronic pain about the differences between addiction, dependence, and tolerance of drugs may help them overcome some fears about using opioids, Kathryn Healey Keller, Pharm.D., said at a joint conference...
Educating Staff Key to Curbing Use of Restraints
The use of physical and chemical restraints remains a thorny issue, despite great strides that are being made to improve, reduce, and eliminate the practice. An investigative series by the Harford Courant in 1998 prompted a federal investigation...
Elderly Bipolar Patients Need Careful Treatment
CAMBRIDGE, MASS. -- A broad differential diagnosis and careful drug selection are essential to successfully treating bipolar illness in geriatric patients, M. Cornelia Cremens, M.D., said at a meeting on bipolar disorder sponsored by Harvard Medical...
Emotional Abuse May Raise Risk of Mental Illness
SCOTTSDALE, ARIZ. -- People who are emotionally and physically abused by their intimate partners develop more mental illness and substance abuse problems than those who are only physically abused, Susan Ditter, M.D., said at the annual meeting of the...
Expert Cites Genetics as Key Component in BPD
ATLANTA -- Borderline personality disorder is a condition with a greater genetic component and better prognosis than many psychiatrists have led themselves to believe. The complex disorder, often perceived as highly stable and unremitting, divides...
FDA Panel Votes No on Sex Dysfunction Patch: Safety Concerns Prompt Unanimous Vote against Indication for Treating Female Sexual Dysfunction
GAITHERSBURG, MD. -- A federal advisory panel unanimously recommended against approval of a testosterone patch for treating hypoactive sexual desire in surgically menopausal women on estrogen therapy, calling for more long-term safety studies and the...
FDA's New Drug Safety Board under Scrutiny: Critics Say Board May Lack Independence and Authority, and May Not Have Sufficient Resources
Many questions surround the authority of a new drug safety board that would oversee the management of drug safety and provide emerging information to physicians and patients about the benefits and risks of medicines on the market. Such a board is...
First-Trimester Stress May Prompt Early Delivery
RANCHO MIRAGE, CALIF. -- Mothers who experience high levels of stress during early pregnancy appear to convey distress signals to their fetuses, prompting their fetuses to eventually produce high levels of hormones that speed delivery. The phenomenon...
Gentle Persuasion Can Get Obese Diabetics Moving
DETROIT -- Many studies have shown that lifestyle interventions can improve the health of patients with obesity and diabetes, but the challenge lies in bridging the gap between research and reality, Rosalind Peters, Ph.D., R.N., said at a meeting sponsored...
Group Calls for 'Uncompromising' Diabetes Care
WASHINGTON -- Diabetes must be managed with an "uncompromising insistence to treat to target," according to new guidelines issued by the American College of Endocrinology and the American Association of Clinical Endocrinologists. The document is...
Health Care Disparities Called 'Medical Error'
WASHINGTON -- Health care disparities among ethnic groups should be considered a form of medical error, James Gavin, M.D., said at a consensus conference on patient safety and medical system errors in diabetes and endocrinology. "When we see disparities,...
Helping Elderly Drug Abusers
The Department of Health and Human Services predicts that the number of seniors with substance abuse problems will rise by 150% by 2020. Because many of these patients are resistant to therapy, treating them can prove challenging. What strategies have...
History and Physical Critical in Secondary Headache Diagnosis
LAS VEGAS -- Even in a neurologist's office, every headache patient merits a general history and a physical examination, which may be the best tools with which to differentiate secondary from primary headaches, John G. Edmeads, M.D., said at a symposium...
Hypnotherapy for Irritable Bowel Syndrome
Rationale for Use Irritable bowel syndrome (IBS) is estimated to afflict about 10%-20% of the U.S. population. In its most severe form, IBS has an impact on quality of life that rivals that of congestive heart failure or recent stroke. Treatment...
In HIV TX Adherence, Almost Isn't Good Enough
Being almost compliant with antiretroviral therapy was associated with a sharp increase in the risk that HIV-infected patients would develop resistance to one or more of the drugs, P. Richard Harrigan, Ph.D., reported at an American Medical Association...
IOM: CAM Should Use Conventional Standards
WASHINGTON -- Complementary and alternative therapies should be held to the same standards as conventional treatments, according to a new report from the Institute of Medicine. "Complementary and alternative medicine [CAM] use is widespread and...
Late-Life Anxiety Requires Modified Approach: Lower Profile for Drug Interactions Makes Citalopram, Escitalopram, and Sertraline Attractive
Anxiety seems to be as prevalent in older as in younger adults--data are inconsistent on this point--but may look different in each group. "The DSM criteria were developed for anxiety disorders in younger patients and don't always identify them in...
Long-Acting Investigational ADHD Treatment Promising in Children
CHICAGO -- A long-acting formulation of dexmethylphenidate is safe and effective in children and adolescents with attention-deficit hyperactivity disorder, according to data presented at the annual meeting of the Society for Developmental and Behavioral...
Low Fatty Acid Levels, Dementia Associated in Large Study
WASHINGTON -- Higher intake of n-3 fatty acids may have a protective effect against cognitive impairment, according to data presented at the annual meeting of the Gerontological Society of America. In a study of almost 1,000 people aged 65 and older,...
Making Exercise Part of Your Routine
Brooke Jackson, M.D., describes herself as a "late bloomer" to the notion of exercising on a regular basis. Her turning point came in 1997, when she moved to Houston for her Mohs fellowship at Baylor College of Medicine. One day she spotted a newspaper...
Marital Disagreements More Unpleasant for Older Couples
SANTA FE, N.M. -- Older married couples disagree less intensely than their middle-aged counterparts, and they experience disagreement as physiologically more unpleasant, Gilad Hirschberger, Ph.D., said in a poster presented at the annual meeting of...
Medicare Poised to Help Seniors Quit Smoking
Medicare is investigating ways to help its beneficiaries quit smoking. The Centers for Medicare and Medicaid Services proposed to extend smoking cessation coverage to beneficiaries who smoke and have been diagnosed with a smoking-related disease--or...
Migraineurs Often Delay Headache Medication
VANCOUVER, B.C. -- At least half of migraine patients who are given a prescription for a medication to abort their attacks wait too long to take their medication, making it less likely to be effective, Roger K. Cady, M.D., reported at the annual meeting...
Minority Recruiting Efforts Are Paying off at Massachusetts General
SAN DIEGO -- Expanding the staff and scope of its Multicultural Affairs Office over the last 4 years helped increase the numbers of African American, Native American, and Hispanic medical residents who opted to train at Boston's Massachusetts General...
More Data Needed on Health Care
WASHINGTON -- Consumer-driven health care may be the "next big thing" in health insurance, but it won't go anywhere until more data on plans, providers, and outcomes become available, George Halvorson said at a health care congress sponsored by the...
New Data Mixed on Risk, Use of SSRIs in Adults
Three new studies published in the British Medical Journal on the use of popular antidepressants and suicide risk in adults reach conflicting conclusions. One study reviewed data from 702 randomized controlled clinical trials (87,650 patients) that...
New SAMHSA Guidelines Stress Importance of Dual TX
WASHINGTON -- The Substance Abuse and Mental Health Services Administration is now telling mental health professionals to expect to see substance use with other mental health disorders and to treat both problems at the same time. The release of...
New Study Finds Different Results on Efficacy of St. John's Wort for Depression
EXETER, ENGLAND -- A proprietary formulation of St. John's wort was equivalent in efficacy to paroxetine for moderate to severe depression in a prospective, randomized, multicenter study, Stephan Klement, M.D., reported at a symposium on alternative...
New Tool Improves Teen Recidivism Prediction: Once Validated, Instrument Could Be a Valuable Aid in the Allocation of Limited Treatment Resources
DENVER -- The assessment of recidivism risk among teenage sexual offenders is poised for a major step forward in terms of precision and credibility as a result of a new actuarial tool. The Juvenile Sexual Offense Recidivism Risk Assessment Tool...
Nurse-Patient Interaction Helps Reduce Opioid Dependence
WASHINGTON -- A team approach to managing opioid dependence with buprenorphine kept 32 of 37 patients (86%) on buprenorphine therapy at 4 months' follow-up, Daniel Alford, M.D., reported in a poster presented at the annual conference of the Association...
Obese Men Spend Nearly $700 per Year More on Medicine
NEW ORLEANS -- Obese men spend nearly four times more on prescription drugs than do those who are of normal weight, Thomas G. Allison, Ph.D., said at the annual scientific sessions of the American Heart Association. Overweight men fall midway between...
Patients Taking Nuclear Meds Can Set off Radiation Detectors
CHICAGO -- Patients given radiopharmaceuticals for diagnostic or therapeutic nuclear medicine procedures can trigger radiation detectors up to 3 months after the procedure, Lionel S. Zuckier, M.D., said at the annual meeting of the Radiological Society...
Perspective
The key to successful workplace mental health interventions lies with leadership. The leadership has to understand that illnesses like depression cause employees to take time off from work and to be less productive when at work. The result is a...
Plan Crafted to Accredit Neurology Subspecialties: Behavioral Neurology, Neuropsychiatry Standards Are Expected to Be Available Early This Year
A new organization is moving forward with plans to provide accreditation and certification services for neurology subspecialties. The United Council for Neurologic Subspecialties (UCNS) is currently working on accreditation and certification standards...
PPAC Offers Plan for Physician Reimbursement
WASHINGTON -- Physicians should be reimbursed retroactively for any payment miscalculations that occurred under Medicare's new system to reimburse for in-office infusions, the Practicing Physicians Advisory Council recommended. The "average sales...
Protecting the Atypical Antipsychotic-Medicated Patient: Consider All Angles before Evaluating Risk/benefit Equation
Antipsychotics have always had their problems. Conventional antipsychotics could potentially cripple patients with tardive dyskinesia, causing those individuals to become shadows of their former selves, and now, atypical antipsychotics are under fire...
Psychological Distress Lifts Atrial Fib Risk
NEW ORLEANS -- Anxiety and other forms of psychological distress constitute a potent independent risk factor for development of new-onset atrial fibrillation in patients with chronic stable coronary artery disease, Charles M. Blatt, M.D., reported...
Psychosocial Factors Predict Low Back Pain Events
CHICAGO -- A patient's psychological state appears more predictive than physical abnormalities of outcomes from persistent benign low back pain following herniated disk surgery, according to the conclusions of a prospective, longitudinal study. ...
Response, Addiction to Cocaine Hinge on Gender
NEW YORK -- Men and women respond very differently to cocaine, and these differences have important clinical implications, Scott Lukas, Ph.D., reported at the annual conference of the Association for Research in Nervous and Mental Disease. Men tend...
Sleep Loss Tied to Impaired Glucose Tolerance
RANCHO MIRAGE, CALIF. -- Healthy young adults who are chronic "short sleepers"--getting an average of about 5 hours of sleep a night--must secrete 30% more insulin than other adults to achieve a normal glucose curve. The finding, which points to...
Soy's Effects on Cognition, Bones Disappointing
Soy supplementation was not associated with significant improvements in cognition, bone density, or lipid profiles, compared with placebo, in more than 200 older postmenopausal women followed for 1 year, Dutch investigators reported. The findings...
Spiritualized Therapy May Lessen Symptoms in Sex Abuse Survivors
A program that integrates cognitive therapy with spiritual awareness and healing has proved beneficial to female survivors of childhood sexual abuse, significantly decreasing symptom scores in all patients in a small pilot study. The 8-week program...
Stroke Risk Rises with Dietary Fat and Sodium: In Two Studies, Ischemic Stroke Incidence Was 60% Higher in Those Consuming over 65 G of Fat Daily
NEW ORLEANS -- For the first time, physicians have evidence independently linking high dietary levels of fat and sodium to an increased risk of ischemic stroke, based on findings from an epidemiologic study in New York. Experts who heard these findings...
Suicide Causality Not Part of Black Box Warning
Revised requirements for antidepressant labels that would omit references to a causal link between the drugs and suicide in children and adolescents have drawn mixed reactions from clinicians. "I think it's good that the FDA has shied away from...
Synthetic Marine Snail Toxin Receives FDA Approval as Intrathecal Analgesic
An intrathecal formulation of a synthetic version of a toxin used by a fish-eating marine snail to catch its prey has been approved as a treatment for severe, chronic pain. The Food and Drug Administration approved ziconotide for intrathecal (IT)...
Teen Drug Use Has Changed Little since 1970s: Genetics, Environment, Nature of Drug Determine Number of New Users Who Become Dependent
NEW YORK -- The number of teenagers who experiment with recreational drugs is nearly the same as it was during its peak years in the early 1970s, reported James Anthony, Ph.D., at the annual conference of the Association for Research in Nervous and...
The Art of Meghan Caughey
Meghan Caughey is almost matter-of-fact about the place of art in her world. "I draw and paint to stay alive," she writes in her artist statement on her Web site. While an undergraduate, she was diagnosed with schizophrenia. Later, in graduate school,...
'The Lobotomist'
Walter Jackson Freeman, M.D. (1895-1972), is one of the most reviled physicians of the 20th century, but from the 1930s through the 1950s he was celebrated, showered with awards, and featured on the covers of magazines, all for his single-minded advocacy...
Treat Drug Abuse, Eating Disorder Concurrently
ATLANTA -- Eating disorders and substance abuse often go hand in hand, and treatment of patients with both is often improved when there is a focus on body reclamation, Adrienne Ressler said at a conference jointly sponsored by the National Association...
Treating Fearful Flyers
Last May, I used this space to describe techniques that have helped me to help patients beat their phobias. As I wrote in that column, 5%-10% of the population suffer from a phobia at some time in their lives (CLINICAL PSYCHIATRY NEWS, May 2004, p....
Try Higher Oxygen Flow for Cluster Headache Patients
LAS VEGAS -- The flow rate of oxygen routinely prescribed to abort cluster migraine is too low to be effective in many patients, Todd D. Rozen, M.D., said at a symposium sponsored by the American Headache Society. Since the effectiveness of inhaled...
University Opens First Center for Patient Safety: Simulation Facility Will Be Used to Provide Courses for Health Care Professionals at All Levels of Training
MIAMI -- The blades roared overhead as the Miami-Dade rescue helicopter approached the rooftop of University of Miami/Jackson Memorial Hospital shortly after dark. Through the rain, emergency medical technicians rushed a pregnant woman injured in...
Using Electronic Health Records System Not Burdensome
SAN FRANCISCO -- Adopting an electronic health records system reduced the mean length of visits at five outpatient clinics by 4 minutes per patient, a difference that was not statistically significant but that should allay physicians' fears that the...
Vets and the VA: Another Kind of War Story
"Article 99," a 1992 film directed by Howard Deutch, has renewed relevance now. It is a unique, ambitious effort to portray problems in the Veterans Affairs Healthcare System, problems receiving greater attention recently because of the unanticipated...
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