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. 3, March

Acne May Be Sign of Body Dysmorphic Disorder
LOS ANGELES -- Significant numbers of patients with acne have debilitating symptoms normally associated with body dysmorphic disorder, Dr. Whitney P. Bowe said at the annual meeting of the Society for Investigational Dermatology In her screening...
Admissions for Stroke Declining
BOSTON -- Hospitalization for stroke has declined since the mid-1990s, reversing the trend observed in the previous 10 years, according to findings from two studies relying on different databases and presented in separate posters by Dr. Jing Fang and...
Advisory on Varenicline Warns of Depression
The Food and Drug Administration is evaluating postmarketing adverse event reports of serious neuropsychiatric symptoms--including agitation, depressed mood, and suicidal ideation and behavior--in people taking the smoking-cessation drug varenicline,...
Aetna, AMA Clash over Medicare Payments
Aetna Inc. said in January that it is working with the American Medical Association and state medical societies to resolve issues involving nonparticipating physicians after the AMA complained that the insurer was paying those physicians just 125%...
A Florida Woman Was Charged Recently with Child Neglect after Leaving Her Four Teenage Sons to Fend for Themselves. How Can Psychiatry Support Such Families?
Mothers all over America are asking courts and child protective agencies to take custody of their children because they believe the kids are out of control and are going to get into trouble. These are mostly single parents, and many mothers are teenagers...
Agency Seeks Comment on Proposed Safety Rule
Draft federal regulations more than 2 years in the making aim to give hospital networks, physician groups, and similar organizations the ability to help doctors reduce medical errors and improve the quality of care they provide to patients. The...
Antihypertension Diet Lowers Risk of CHD, Stroke
Women who followed the Dietary Approaches to Stop Hypertension diet had significant risk reductions of coronary heart disease and stroke, results from a cohort of participants in the ongoing Nurses Health Study showed. Previous studies have shown...
Asthma Guidelines Cover Treatment in Pregnancy: Gynecologists' Group Calls Step Therapy with Medications Safer Than Symptoms, Exacerbations
The ultimate goal of asthma therapy in pregnancy is to maintain adequate oxygenation of the fetus by preventing hypoxia in the mother, and that requires step therapy medical management with the lowest possible doses of medication, according to new...
Autism Is Not an Epidemic
Clinicians who treat children with pervasive developmental disorders are likely to be asked by parents to explain the rising prevalence of autism and the possible environmental causes. Let me offer a brief background and a few facts that may help to...
Breast Ca Leads Drop in U.S., U.K. Mortality
SAN ANTONIO -- Total cancer mortality among middle-aged women in the United States and United Kingdom has declined markedly since 1990--and an unprecedented drop in breast cancer mortality is the biggest reason why, Sir Richard Peto, Ph.D., said at...
Bush Proposes Medicare, Medicaid Cuts for 2009
In the final budget proposal of his presidency, President Bush is proposing substantial cuts to hospitals, skilled nursing facilities, and graduate medical education. Leaders in the Democratic-controlled Congress instantly declared the proposal...
Carbamazepine Label Gets Warning for Asian Patients
Patients of Asian ancestry are at significantly increased risk for fatal skin reactions when treated with carbamazepine and should first undergo genetic testing to assess their risk before initiating therapy, according to an alert issued by the Food...
CBT for Insomnia May Reduce Osteoarthritis Pain
SAN FRANCISCO -- Cognitive-behavioral therapy for comorbid insomnia in patients with osteoarthritis not only improved sleep but also reduced self-reported pain in a randomized, controlled pilot study of 51 patients, reported Michael V. Vitiello, Ph.D....
Chronic Pain Worse among Emergency Department Patients
CHICAGO -- Emergency department patients with a history of chronic pain rate their pain as more severe than acute pain patients do, based on a prospective, observational study conducted in 20 emergency departments, said Dr. Martha L. Neighbor at the...
Classifying Stalkers Aids Counseling of Victims
MIAMI BEACH -- Risk assessment and management of stalking should begin with classifying the offender into one of five general types based on behavior, according to two presentations at the annual meeting of the American Academy of Psychiatry and the...
Combined Treatment Eases Migraine Activity: Three-Part Therapy Produced at Least 50% Reduction in Episodes, Migraine Days in 80% of Patients
WASHINGTON -- The combination of optimized acute medication, preventive medication, and behavioral therapy significantly reduced migraine activity, according to study results presented at the annual meeting of the American Pain Society. In a study...
Communication Difficulties Cited by Users of Ketamine
CORONADO, CALIF. -- The top three perceived benefits of ketamine use are decreased stress levels, dissociation from daily life, and connectedness with other people, results from a Canadian survey suggest. Meanwhile, the top three perceived adverse...
CRT May Make Heart Patients 'Sharper'
DENVER -- Cardiac resynchronization therapy not only reduces mortality and improves quality of life in heart failure patients, it also appears to enhance their cognitive function to a clinically meaningful degree, Neha K. Dixit reported at the annual...
Detecting Deception on the Part of Patients
The tragic death of actor Heath Ledger from an apparent overdose of drugs known to be dangerous in combination raises the question of how he obtained them. Details are still unfolding, and there is much that we might never know. We must be careful...
Drug's Efficacy for Treating Depression 'Exciting'
VIENNA -- Mecamylamine, an old, rarely prescribed, truly obscure antihypertensive agent, may be favorably reincarnated as an antidepressant with a completely novel mechanism of action--and vastly greater potential use. The drug displayed favorable...
Emerging Face of COPD More Youthful, Female
SAN DIEGO -- Chronic obstructive pulmonary disease, once thought of as a disease of elderly white men, is increasingly a disease of women of all ethnicities. Ranking as the fourth leading cause of death in the United States, COPD is the only leading...
Euthanasia Requests Offer Therapeutic Window
TAMPA -- A patient's request for a hastened death--either an explicit request or a hint--should be considered a clinical emergency that offers an important therapeutic opportunity. "When you're in the office and somebody asks, 'Doctor, will you...
Evidence Backs Vitamin D as Longevity Booster
SNOWMASS, COLO. -- Mounting evidence strongly suggests routine vitamin D supplementation reduces all-cause mortality. "We may finally have a vitamin that translates into greater longevity," declared Dr. Robert A. Vogel, professor of medicine at...
Evidence Base Lacking for Medicare Coverage Decisions
Data reviewed by the Centers for Medicaid and Medicare Services to inform Medicare treatment coverage decisions reflect populations that are significantly different from the Medicare beneficiary population, a recent analysis has shown. In 1998,...
FDA Deems Olanzapine Depot 'Not Approvable'
The Food and Drug Administration has issued a "not approvable" letter for a depot formulation of olanzapine. The agency said in a letter that it is seeking to better understand the risk and underlying cause of excessive sedation events that have...
For Gene Carriers, Age 60 Is Key
Age 60 seems to be the defining year for many homozygous carriers of the apolipoprotein [epsilon]4 gene--the time when age-related changes in cognition focus more on memory and begin a steeper decline into mild cognitive impairment and, eventually...
For Veterans, Depression Is Deadlier Than PTSD
Current depressive symptoms in veterans with a prior history of depression might be more of a concern as a risk factor for all-cause mortality than would a history of posttraumatic stress disorder, according to a study of more than 35,000 veterans....
Getting the NAC of a Novel Schizophrenia TX
VIENNA -- N-acetylcysteine, an inexpensive supplement widely available over the counter in health food stores, proved safe and effective as adjunctive therapy for chronic schizophrenia in a 6-month, double-blind, placebo-controlled trial, Dr. Michael...
Gus Van Sant's Compassion for Troubled Kids
There is a world-class skateboard park tucked beneath the east end of the Burnside Bridge in Portland, Ore., that was built clandestinely by skateboarders and subsequently legalized by the city as the Burnside Skatepark. I've been there more than once...
High Prevalence of Pain Found in Children with HIV
TORONTO -- Children with HIV infection reported experiencing more pain--and for longer durations--than did their uninfected counterparts in a large, prospective, multicenter observational study. The study included 576 children, aged 6-18 years,...
HIV-Infected Children Facing New Challenges
BOSTON -- The increased survival among HIV-infected children seen with effective prevention of perinatal transmission and the widespread adoption of highly-active antiretroviral therapy has been accompanied by the emergence of a new generation of clinical,...
Inadequate Vitamin D May Set the Stage for Heart Disease
Vitamin D deficiency may increase the risk of cardiovascular disease in adults, especially in people who also have hypertension, based on data from the Framingham Offspring Study. More studies are needed to show whether correcting vitamin D deficiency...
Initiative Could Transform Alzheimer's Research
A $60 million, 6-year study is being launched to find and validate biologic and imaging markers that could be used as objective measures of therapeutic response in Alzheimer's disease. The results of the Alzheimer's Disease Neuroimaging Initiative...
Insurance Fraud Scheme Investigated in N.Y.: Head of State Task Force Alleges 'Ingenix Is Nothing More Than a Conduit for Rigged Information.'
Following a 6-month initial investigation, New York Attorney General Andrew Cuomo announced plans to file suit against UnitedHealth Group and four of its subsidiaries for allegedly systematically underpaying consumers for their out-of-network medical...
IOM Panel Revisits Issue of Resident Work Hours
WASHINGTON -- Five years after the establishment of across-specialty rules to limit resident work hours, the issue of trainee schedules in teaching hospitals is again under the microscope as a continuing threat to patient safety--and this time an Institute...
Is Power the Ultimate Addiction?
As I look at the global political landscape, I am struck by a pervasive theme. High-ranking officials and politicians often resist giving up power--and are willing to do practically anything to hold on to it. Of course, this is far from a new phenomenon....
Lifestyle Modification Urged for 'Diabesity'
SAN DIEGO -- "Diabesity," as Dr. David Heber calls type 2 diabetes, is a lifestyle disease, not a diagnosis that necessarily requires heavy lifting of the prescription pad. Too many physicians begin and end the conversation by saying, "You have...
Longevity after Dementia Onset Is Estimated
Dementia patients live a median of 4.5 years following the estimated onset of the condition, with male, older, and disabled patients having a significantly shorter survival time, according to a population study published online in BMJ. The large...
Many Overweight Blacks, Hispanics Underestimate Risks
HONOLULU -- Many overweight black and Hispanic adults' estimates of their own obesity-related health problems are more optimistic than are practice-based statistical findings, according to research that was presented at the annual meeting of the National...
Mental Impairments Found among MS Patients Who Use Cannabis
Multiple sclerosis patients who smoke marijuana were more likely to have a history of a mental illness and also performed worse on a test of their mental processing speed and working memory, according to results of a community-based study. The data...
Men with Military Sexual Trauma Often Resist Disclosure
BALTIMORE -- Male veterans who have a history of military sexual trauma often fail to disclose their condition until well into treatment for posttraumatic stress disorder and have many motivations for covering up their problem, according to speakers...
Midlife Migraine Predicts Brain Infarcts Later in Life
WASHINGTON -- Migraines in midlife with accompanying visual aura predict later-life brain infarcts, according to a poster presentation at the annual meeting of the American Neurological Association. Furthermore, the relationship between migraine...
Mood Disorder Symptoms Prevalent in Epilepsy
PHILADELPHIA -- Symptoms of bipolar disorder are prevalent among patients with epilepsy, and are highly associated with depressive symptoms in these patients, an analysis of 54 epilepsy patients at a tertiary care center shows. Patients with epilepsy...
More Adolescents Acquiring HIV through Risk Behaviors
BOSTON -- The adolescent HIV-1 epidemic as reflected in a multisite cohort of U.S. youth is changing from one of vertically transmitted infection to one where infection is acquired through risk behaviors, posing new challenges for providers and the...
More Data Needed on Physicians in Recovery
CORONADO, CALIF. -- Of 104 physicians in New York state who were admitted to substance abuse treatment programs between 2003 and 2004 and were monitored for a mean of 41 months by the state's Committee for Physicians' Health, only 9 (9%) were discharged...
Motivation as Important as Education in Type 2 Diabetes
ST. LOUIS -- Teaching type 2 diabetes patients about how to take care of themselves isn't enough; they need to be motivated to follow through, according to results of a survey of 3,867 patients. Yet discussions with patients remain primarily educational...
Multisystemic Therapy Helps Sex Offenders, Saves Money
SAN FRANCISCO -- Several recent studies show that multisystemic therapy helped decrease behavioral problems and criminal activity among adolescent sexual offenders, Charles M. Borduin, Ph.D., said at the annual meeting of the American Psychological...
Networking Sites More Benign Than Thought
Use of social networking Web sites poses no greater risk of sexual solicitation and harassment of children than do other online behaviors, according to the results of an e-mail survey of 1,588 preteens and teens. "Our findings suggest that online...
Obesity Linked to Postpartum Depression Risk
DALLAS -- Obese women may be at increased risk for postpartum depression, new research suggests. In a prospective analysis of 1,282 women who gave birth to singleton infants at term, nearly 30% of women with a prepregnancy body mass index of 30...
Oral Contraceptives May Worsen Low Androgen in Anorexia
TORONTO -- Physicians commonly prescribe oral contraceptives for women with anorexia nervosa, but research presented at the annual meeting of the Endocrine Society suggests that androgen levels are already low in these women and are further reduced...
Panic Disorder Patients Need Us
After feeling chest tightness, shortness of breath, and dizziness, the patient got herself to an emergency department. While waiting to be seen, she experienced profuse sweating that was accompanied by shaking, tingling, and a sense of impending doom....
Perspective
Telemedicine is particularly well suited to psychiatry. It allows you to see and talk to your patient, which is what we do. The absence of the other senses is mostly a nonissue, with the exception of some neurological testing--which occasionally is...
Preliminary Study Finds 34% of Detox Inpatients Using Opioids
CORONADO, CALIF. -- About one-third of inpatients on a detoxification unit were currently taking prescription opioid medication, most commonly Lortab and hydrocodone, results from a small pilot study showed. In an investigation of prescription opioid...
Protocol Works for Narcotic Bowel Syndrome
SALT LAKE CITY -- Narcotic bowel syndrome is a problem that physicians have been sweeping under the rug, and it may be growing in frequency, Dr. Douglas A. Drossman said at the annual meeting of the North American Society for Pediatric Gastroenterology,...
Psoriasis Comes with Social Support, Self-Esteem Issues
TORONTO -- Consider asking young women with psoriasis about self-esteem and their social support to ensure an optimal quality of life, Renita Ahluwalia said at the annual conference of the Canadian Dermatology Association. "We need to address social...
Psych Beds in General Hospitals Needed
Almost half of all psychiatric admissions to a 24-hour facility in the United States are made to a psychiatric unit in a general hospital. The number of psychiatric beds in general hospitals probably peaked in 1998, at 54,434 beds. Since then, however,...
Psychosocial Care Set as Standard in Cancer Treatment: IOM's Report Reflects 'Attitudinal Shift.'
WASHINGTON -- An Institute of Medicine report says providing appropriate psychosocial services to all cancer patients and their families should become a new standard of care, Dr. Jimmie C. Holland said at the annual Community Oncology conference. ...
PTSD Common in Soldiers with Mild Brain Injury
Mild traumatic brain injury occurring among soldiers deployed in Iraq is strongly associated with posttraumatic stress disorder and physical health problems 3-4 months after the soldiers return home, according to survey findings. Results from a...
Report Cites Diet, Exercise as Keys in Prevention of Cancer
WASHINGTON -- A comprehensive evidence-based report issued by an international expert panel provides an unprecedented analysis supporting the preventability of cancer by way of diet, exercise, and avoidance of obesity. Developed over a 5-year period...
Rheumatoid Arthritis Doubles Heart Failure Risk
SNOWMASS, COLO. -- Heart failure is a major contributor to the excess mortality in patients with rheumatoid arthritis, Dr. Sherine E. Gabriel said at a symposium sponsored by the American College of Rheumatology. Rheumatoid arthritis patients have...
Risk of Colorectal Adenoma Is Up in Smokers
Cigarette smoking does appear to be linked to a higher risk of colorectal adenoma, to a large enough degree that perhaps smoking history should be considered in guidelines for colonoscopy screening, Edoardo Botteri and colleagues reported. The smoking-associated...
Sexually Transmitted Disease Rates Still on Rise
Rates of chlamydia, gonorrhea, and syphilis increased in the United States during the past year and continued recent upward trends, according to a report from the Centers for Disease Control and Prevention. "Young women, racial and ethnic populations,...
Sleep Medicine Strives to Unite Multiple Disciplines
MINNEAPOLIS -- The need to unite sleep specialists from multiple academic departments challenges the field of sleep medicine, Dr. Ronald D. Chervin said at the annual meeting of the Associated Professional Sleep Societies. "Because sleep is relevant...
Smokers of Cigarettes and Marijuana Fare Worse
Among teenagers and young adults who smoke marijuana, the minority who are not cigarette smokers have fewer problems personally, socially, and academically than do the majority who also smoke cigarettes, according to Swiss investigators. The researchers...
Social Anxiety Disorder Strongly Associated with Risk of Depression
VIENNA -- Social anxiety disorder, regardless of age of onset, is consistently associated with strongly increased risk for subsequent depression, according to 10-year results of the large prospective Early Developmental Stages of Psychopathology Study....
SSRIs Tied to Upper GI Bleeding
A new analysis of data from observational studies and case reports has confirmed that the use of selective serotonin reuptake inhibitors is associated with an increased risk of upper gastrointestinal hemorrhage, particularly in patients also taking...
Statewide Studies Aiming to Prevent Abusive Head Trauma
SAN DIEGO -- Two federally funded studies are underway to test the effectiveness of abusive head trauma prevention efforts in Pennsylvania and in North Carolina. The studies, which received funding from the Centers for Disease Control and Prevention...
Statin Use May Improve Poststroke Mortality
Patients who discontinue their use of statins within the first year after a stroke may have a significantly increased risk of death, even in the absence of diagnosed heart disease, according to findings from a single-center observational study. ...
Study Links Idiopathic Cough to Iron Deficiency in Women
CHICAGO -- A small but provocative Italian study suggests that women complaining of chronic idiopathic cough should be evaluated for iron deficiency. Researchers at the University of Turin (Italy) observed that cough and signs and symptoms of pharyngolaryngitis...
Suicidality Alert on Antiepileptic Labels Likely to Be Broadened
WASHINGTON -- Findings of an increased suicidality risk in patients given antiepileptics likely will lead to broad class labeling changes, the Food and Drug Administration said in an alert issued to health care professionals. The agency, which issued...
Suicide Rates among Young Men in U.K. Show Decline
An observational study on suicide trends among young people in the United Kingdom suggests that suicide rates among young men in England and Wales have dropped markedly over the past decade. In the study, published by BMJ, Lucy Biddle, research...
Support Reduces Depression Risk in New Mothers
MONTREAL -- Mother-to-mother support can significantly reduce the development of postpartum depression in women who are at high risk for the condition, Cindy-Lee Dennis, Ph.D., said at the annual conference of the Canadian Psychiatric Association....
Take Active Approach against Weight Gain
Weight gain is a serious concern in psychopharmacology--potentially toxic to patients' psychological and physical well-being and a barrier to effective treatment. "This is a huge issue in my practice," said Dr. Adele Tutter of the department of...
Telepsychiatry Addresses Needs of Rural Youth
Life in rural America appears to render today's children and adolescents especially vulnerable to mental health problems. An analysis of mental health risk factors and service access conducted by the South Carolina Rural Health Research Center (SCRHRC)...
The Art of Randee Savage
Randee Savage's guitar and art are both vitally important to her. But when pressed, Ms. Savage says she prefers painting because it is more in her control. "The colors and the paints are right there," she says. She started painting and taking photos...
Three Groups More Likely to Self-Medicate
NEW ORLEANS -- Men, singles, and those aged 30 years and younger are more likely than other groups in the general population to use psychoactive substances to cope with psychiatric symptoms, a large population-based study conducted in France suggests....
Triple P System of Parenting Reduces Abuse
SAN DIEGO -- Dissemination of the Triple P system of parenting interventions produced a clear impact on the prevalence of child maltreatment in South Carolina, results from a population-based study demonstrated. The study, currently under scientific...
Try CBT First for Anxiety in Children
NEW YORK -- When treating first-time, uncomplicated cases of anxiety in children and adolescents, it's usually best to start with a 6- to 12-week trial of psychosocial treatment, Dr. Moira Rynn said at a psychopharmacology update sponsored by the American...
Type 1 Diabetes Patients Face Lower Schizophrenia Risk
Patients with type 1 diabetes are at a significantly reduced risk of developing schizophrenia and related disorders, suggesting a need to study the genetic traits and environmental triggers that can lead to either condition, Finnish investigators have...
U.S. Advice Implicated in Obesity Trends
By stressing the importance of a carbohydrate-based, low-fat diet, current U.S. dietary guidelines may have unexpectedly contributed to the current obesity epidemic, investigators reported. In accordance with national recommendations, Americans...
Use Incentives to Stop Inmates' Substance Abuse
CORONADO, CALIF. -- Treatment and continuing care are two key components to a chronic care approach to effective recovery for patients with a substance abuse problem. But in a correctional setting, that basic model faces several challenges and is...
Use of CNS Medication May Reduce Cognition
SAN FRANCISCO -- Community-dwelling elderly people were more likely to show cognitive decline over a 5-year period if they took medications that act on the central nervous system, especially with higher cumulative doses or with longer use, Dr. Rollin...
Use of Statin Therapy Improves Outcomes after Carotid Interventions
HOLLYWOOD, FLA. -- Statin use has been linked with reducing stroke rates and mortality following carotid endarterectomy and may have a similar benefit in patients undergoing carotid artery stenting, Dr. Bruce A. Perler said at ISET2008. Statin treatment...
Vitamin D Deficiency
The Problem You are working in a correctional setting and start a new assignment in administrative segregation (jail within a prison). Many inmate-patients serve months to years in this setting and receive 1 hour of yard time per day. Many simply...
Vulvodynia Often Triggers Depression, Anxiety
SAN FRANCISCO -- Vulvodynia so profoundly affects quality of life that management needs to address the physical, psychological, sexual, and relationship problems caused by the pain. "Support, support, support" patients with vulvodynia by reassuring...
When Women Rule Psychiatry
Have you ever had a day when so many coincidences happened that they seemed like something more? I had a day like that recently. On the way to work one morning, I heard a story on NPR about reality television shows. The point was that interest in...
Women, Families with Children Need Sleep Education
NEW ORLEANS -- Mothers of young children aren't likely to be surprised by a recent study showing that they are more sleep deprived than are their male partners and women without children, but the findings are important because they underscore the need...
Worldwide Survey Finds Adult Obesity Rate of around 25%
The rest of the world seems to be catching up with the United States in the prevalence of heftiness and obesity, according to a survey of primary care patients in 63 countries. Analysis of data from the survey, which excluded the United States,...