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. 3, March

Abortion for Gender Selection in India Appears Rampant
Over the past 2 decades, as many as 10 million abortions of female fetuses in India can be attributed to gender selection, especially when the fetus would have been the second or third child born to a couple who has yet to have a male child, Dr. Prabhat...
Addressing Homelessness and Substance Abuse
Of the estimated 3 million people in the United States who are homeless during the course of a year, about 30% are chronic substance abusers, according to the U.S. Conference of Mayors. Most experts agree that the actual numbers are probably much...
ADHD Drug Dosage Cut by Behavioral Therapy: The Low Level of Side Effects Produced by Lower Doses Could Put Behavior Modification in the Spotlight
WASHINGTON -- Behavior modification can reduce the level of medication needed in school-aged children with attention-deficit hyperactivity disorder, William E. Pelham Jr., Ph.D., said at the annual meeting of the Association for Behavioral and Cognitive...
Alcohol-Interactive Medicines Tend Not to Deter Drinking
ORLANDO -- Elderly people tend to quit drinking alcohol as their health declines, but their medications play little role in this decision, according to a new study. "We found no increased likelihood of drinking cessation among people taking alcohol-interactive...
Alcohol Intervention Helps Hepatitis C Patients
SANTA ANA PUEBLO, N.M. -- A hepatitis C virus clinic in Minnesota helped alcoholic patients become eligible for antiviral therapy by integrating alcohol screening and a behavioral intervention into medical care. Nearly half (47%) of 47 new patients...
Allele Worsens Symptoms in High-Risk Patients
The presence of a specific allele of a schizophrenia susceptibility gene is associated with an increase in the deterioration of neuropsychiatric symptoms and cognitive function in patients who are at very high risk for schizophrenialike disorders,...
Anxiety Disorders Are Linked to Many Medical Conditions
SEATTLE -- Anxiety disorders are associated with a wide range of physical health problems, even after adjustment for other common mental disorders such as depression, Dr. Jitender Sareen said in a poster presentation at the annual conference of the...
Biofeedback Heart Rate Control Aids Depression in Older Adults
ORLANDO -- The use of biofeedback to control heart rate variability could be useful in the treatment of older patients with depression, just as it has been beneficial for patients with asthma, chronic obstructive pulmonary disease, and various cancers....
Brief Questionnaire Identifies MI Anxiety, Need for Anxiolytics
DALLAS -- A quick, six-question survey can diagnose anxiety in patients who've had a myocardial infarction and identify those who need treatment with an anxiolytic. "The Brief Symptom Inventory [BSI] is performed similarly to the State Anxiety Instrument...
British Physicians Warned of New Risks with Atomoxetine
British physicians are being warned by their country's medical authorities about new risks associated with atomoxetine in the treatment of attention-deficit hyperactivity disorder. The new risks of seizures and abnormal heart rhythm (QT interval...
Call for Black Box on ADHD Drugs Deemed Premature: Panel Cited Adverse Cardiovascular Events
GAITHERSBURG, MD. -- The best way to inform physicians and the public about potential cardiovascular risks of drugs used to treat attention-deficit hyperactivity disorder is to conduct a clinical trial rather than add a black box warning to the labels...
Cancer Pain Needs Vary among African Americans
WASHINGTON -- African American cancer patients are heterogeneous in their need for pain medication, Salimah Meghani, Ph.D., said at a meeting sponsored by the Department of Health and Human Services and the Office of Minority Health. Dr. Meghani...
CATIE Results Favor Olanzapine
COLORADO SPRINGS -- For clinicians, the challenge to prevent the progression of schizophrenia with early, aggressive treatment is now much easier because of the results of a recent study comparing various antipsychotics, Dr. John De Quardo said at...
Coenzyme Q10 for Migraine Prophylaxis
History and Rationale for Use Coenzyme Q10 is a naturally occurring hydrophobic substance that is involved in electron transfer across the mitochondrial membrane from the NADH dehydrogenase complex and the succinate-Q reductase complex to cytochrome...
Coexisting Rhinitis Is Common in Sleep Apnea
KEYSTONE, COLO. -- All patients with obstructive sleep apnea should be evaluated and treated for rhinitis, an extremely common coexisting condition, Dr. Robert Ballard said at a meeting sponsored by the National Jewish Medical and Research Center....
Cognitive-Behavioral Therapy Eases Fear of Falling, Activity Avoidance
ORLANDO -- Cognitive-behavioral therapy can significantly reduce seniors' fear of falling and the avoidance of activity that accompanies it, according to the preliminary results of a Dutch study. CBT may also improve depression and quality of life;...
Combo TX Surpasses Fluoxetine or Therapy Alone, TADS Results Show
TORONTO -- Fluoxetine combined with cognitive-behavioral therapy was more effective in improving functioning, global health, and quality of life in depressed adolescents than was either treatment alone, Dr. Benedetto Vitiello said at the joint annual...
Compliance Programs Proof of Good Faith: Fully Document Policies and Procedures for Federal Reimbursement, Physician Groups Are Advised
LAS VEGAS -- Proper documentation is key to an effective corporate compliance program and can serve as evidence of a good-faith program to investigators, one compliance expert said at a meeting on reimbursement sponsored by the American College of...
Data Limited on Pharmacotherapy for Autism
NEW YORK -- The body of data for using newer pharmacotherapeutic agents to treat autistic symptoms is struggling to keep up with the use of such drugs in practice, Lawrence Scahill, Ph.D., said at a psychopharmacology update sponsored by the American...
Data Scant on TX for Young Opioid Abusers
BETHESDA, MD. -- Very little published evidence exists to back treatments for adolescents with opioid abuse or dependence. In addition, those adolescents appear to have characteristics that differ from those abusing or dependent on marijuana or...
Defect Rate Drops with Reduced Use of Valproate in Australia
WASHINGTON -- Decreased use of valproate to manage epilepsy during pregnancy in Australia has produced a corresponding drop in fetal malformations associated with the drug, Dr. Frank Vajda said at the joint annual meeting of the American Epilepsy Society...
Depression Linked to Increased Risk of Cardiac Arrest
People with clinical depression are at nearly twice the risk for cardiac arrest as those who are not depressed, independently of their other cardiovascular risk factors, said Dr. J.P. Empana of Hopital Paul Brousse, Villejuif, France, and associates....
Depression, Low 'Will to Live' Increase Mortality
ORLANDO -- Elderly patients who answer unenthusiastically when asked how long they would like to live may have a dramatically increased risk of dying within 2 years if this attitude is combined with even minor or subthreshold depression, according...
Depression's Annual Toll Put at $83 Billion
WASHINGTON -- The direct and indirect costs of depression total $83 billion a year in the United States, and a lack of access to care will cause that figure to keep rising, a new report by the Depression and Bipolar Support Alliance contends. Though...
Dexmethylphenidate Improves Chemo Fatigue in Breast Cancer
SAN ANTONIO -- Dexmethylphenidate at up to 50 mg/day proved safe and effective for the treatment of the often-profound chemotherapy-related fatigue of breast cancer patients in a phase II clinical trial, Dr. Stewart B. Fleishman reported at a breast...
'Doctor, We Have a Problem'
"Houston, we have a problem." With those five words, the Apollo 13 astronauts alerted ground control about an unexpected crisis that could escalate to a catastrophe unless a solution was found. The epidemic of obesity presents a similar crisis...
Donepezil for Alzheimer's Dementia
The Problem You are working with the family of a patient who has been diagnosed with probable Alzheimer's disease. The family asks about possible medications. The Question Can treatment with Aricept (donepezil) improve the patient's well-being?...
Down with Obsessionalism
As a practicing psychiatrist, I became an unwilling conscript of the information age during the 1980s, as health maintenance organizations began to enter U.S. medicine. What had taken a few minutes of paperwork in the 1960s and 1970s gradually became...
Drug Combination Fails to Benefit Clozapine-Refractory Schizophrenia
The addition of risperidone to clozapine failed to improve psychotic symptoms in patients with severe schizophrenia who had a poor response to treatment with clozapine alone, reported Dr. William G. Honer, University of British Columbia, Vancouver,...
Dual Diagnosis? Treat Substance Abuse First
SCOTTSDALE, ARIZ. -- Treating dual diagnosis patients--those with concurrent psychiatric and substance abuse disorders--requires a readiness to use a medication for the substance abuse, perhaps first and foremost, Dr. John W. Tsuang said at the annual...
Early Days of Parenthood Invoke 'Affiliative' Neural System
NEW YORK -- The first days of parenthood are a time of emotional and neurobiologic upheaval that many describe in terms of personal or spiritual transformation. The sentiment, "Once you hold the baby, you are a different person," is frequently expressed...
Eszopiclone Improves Sleep Disruptions Caused by Hot Flashes
SAN DIEGO -- Perimenopausal women who took eszopiclone for 1 month experienced significant improvements in sleep problems brought on by hot flashes, results from a randomized trial have found. The drug had no apparent effect on the number or severity...
FDA Guidance Backs Early Clinical Studies
Researchers now have a pathway for conducting early clinical testing of drugs in a small number of human subjects under new guidance from the Food and Drug Administration. Officials at the FDA finalized guidance on exploratory investigational new...
FDA Guide on Antidepressants Offers Challenges: Complying with Schedule in Agency's Medication Guide 'Almost Impossible' for First 12 Weeks
MONTREAL -- Prescribing antidepressants to children comes with its own set of challenges, Dr. Neil S. Kaye said at the annual meeting of the American Academy of Psychiatry and the Law. For one thing, it's difficult to comply with the visit schedule...
For Mentally Ill, a Rocky Rollout for Medicare Part D
The transition to the Medicare prescription drug program that began on Jan. 1 has been especially hard for patients with mental illness, physicians reported. In Alabama, for example, two patients were hospitalized after being denied their medications...
Fostering Adherence to Depression Treatment
In recent years, clinicians have come to appreciate the importance of aggressive and extended treatment to achieve full remission from depression and forestall recurrence. Nonadherence to pharmacotherapy, however, remains a barrier. "By the end...
Get It Right the First Time with High-Dose Triptan: In Patients with Acute Migraine, the Greater Chance of Improvement Offsets the Risk of Adverse Events
SCOTTSDALE, ARIZ. -- When it comes to triptan use in treatment of acute migraine, consider the maxim: Go big or stay home. A high dose of a given triptan may be associated with an elevated risk for side effects; however, it also is more likely to...
High-Carb Low-Fat Diets Don't Cause Weight Gain
Diets low in fat and high in carbohydrates from vegetables, fruits, and whole grains do not cause weight gain in postmenopausal women, reported Barbara V. Howard, Ph.D., and her associates in the Women's Health Initiative Dietary Modification Trial....
HPV Vaccine Is 100% Effective against Warts: Gardasil Was Previously Found Completely Effective in Preventing Cervical Intraepithelial Neoplasia
WASHINGTON -- A human papillomavirus vaccine developed by Merck & Co. is 100% effective in preventing genital warts in women in addition to preventing cervical cancer, Dr. John T. Schiller reported at the annual meeting of the Interscience Conference...
Improvements in Sleep Hygiene Benefit Chronic Migraine
PHILADELPHIA -- Insomnia and poor sleep habits may be the cause of the transformation from episodic to chronic migraine, Dr. Anne H. Calhoun said in a poster session at the annual meeting of the American Headache Society. This hypothesis turns on...
Inconsolable Infants Linked to Mothers' Depression: A Third of Mothers Reporting Crying Babies Who Could Not Be Consoled Also Reported Being Depressed
SAN DIEGO -- Results from the first population-based study of its kind have found that about one in three mothers of inconsolable, crying infants reported having postpartum depressive symptoms, Dr. Pamela C. High said at the annual meeting of the Society...
Initiative Helps California Hospitals Implement End-of-Life Services
A California program has helped hospitals establish palliative care services, according to a recent study evaluating the program 1 year after its completion. Given that more than half of people in the United States die in a hospital, end-of-life...
Interventions Work for Alzheimer's Caregivers
ORLANDO -- The quality of life among caregivers of Alzheimer's patients can improve significantly when interventions are tailored to their needs, according to the first randomized trial of such interventions. "Physicians are in a position to identify...
Is There a Cure for the Common Homophobe?
Homosexuality is the dominant theme of Ang Lee's acclaimed film, "Brokeback Mountain." Heath Ledger offers one of the finest performances in memory by an actor in an American film as Ennis Del Mar, one of the star-crossed male lovers in this tragic...
Is Total Sobriety Necessary?
The thinking among some addiction specialists that perhaps patients can be treated effectively in the absence of total abstinence is not only controversial but also questionable ("New Paradigm Embraced for Alcohol Treatment," CLINICAL PSYCHIATRY NEWS,...
Keep Eye out for Slowing of Growth with Stimulants in Some Patients
NEW YORK -- Significant growth slowdown during treatment with stimulants may occur in a small subset of children who require closer monitoring and referral, Dr. Harold E. Carlson said at a psychopharmacology update sponsored by the American Academy...
Manual's Breadth May Aid Diagnosis
The DSM-IV-TR and the ICD-10 are no longer the only handbooks for psychiatric diagnosis. After 2-plus years of preparation, a consortium of psychoanalytic groups has published its own guide to the full spectrum of disorders: the Psychodynamic Diagnostic...
New Five-Step Process Is Available to Appeal Medicare Part B Denials
LAS VEGAS -- On Jan. 1, Medicare officials implemented a new five-step process for appealing Medicare Part B claims. The changes apply to Part B initial claim determinations issued and mailed on or after that date, Edward R. Gaines III, senior vice...
Non-GI Symptoms Can Point to Irritable Bowel Syndrome
MONTREAL -- Non-GI symptoms can help distinguish irritable bowel syndrome from inflammatory bowel disease, Dr. Noel B. Hershfield said at the 13th World Congress of Gastroenterology. Patients with irritable bowel syndrome (IBS) are more likely than...
Occipital Region Hardest Hit by Cerebral Amyloid Angiopathy
PORTO, PORTUGAL -- Cerebral amyloid angiopathy appears to disproportionately affect the occipital region, according to findings presented at the Fourth International Congress on Vascular Dementia. In a study involving the postmortem neuropathologic...
Opiate Dependence May or May Not Be Addiction
SCOTTSDALE, ARIZ. -- Addiction specialists do see chronic pain patients who are so dependent on opiates that they require detoxification, but the question of whether such patients are "addicted" is difficult to determine clinically, two presenters...
Palliative Care Programs Spread to 1 in 4 Hospitals
The number of palliative care programs in U.S. hospitals grew from 632 in 2000 to 1,027 in 2003, an increase of 63%, according to results from a large study. The study "demonstrates the increasing recognition by hospitals in the United States and...
Paternal Depression Relatively Common, Hurts Children
QUEBEC CITY -- Paternal depression is relatively common and can negatively affect child behavior, Shreya Dave reported at the annual meeting of the North American Primary Care Research Group. A clear link has been established between maternal depression...
Personification of Medicine Compromises Therapy: When a Patient Transfers Feelings onto a Drug, Side Effects Can Be Exacerbated and Distress Amplified
NEW YORK -- People often experience medication as if it were a person, transferring to a drug feelings aroused by the prescriber or important people in the patient's life. This process, if unappreciated, can compromise psychoanalysis and psychotherapy,...
Perspective
Al Capone once said, "You can get much farther with a kind word and a gun than you can with a gun alone." This, I suspect, partly explains why providing abstinence-contingent housing to homeless substance abusers might work better than providing...
Proper History and Physical Are Keys to Low Back Pain Dx
SAN FRANCISCO -- A careful history and physical exam, without the need for lab tests or radiography, can help identify any red flags in patients presenting with low back pain, Dr. David Borenstein said at the annual meeting of the American College...
Psychiatric Residents Lax on Informed Consent
NEW YORK -- Psychiatric residents may have learned a good deal about diagnosis and dosage, treatment options, and side effects in their training. But they are not eager to share this knowledge with patients, judging by the results of a study designed...
Putting Herbal Therapies to the Test
As interest in herbs and phytomedicines continues to grow, physicians and patients alike may wonder which of these products can be considered reliable, based on their quality and/or their clinical efficacy. At least four organizations have established...
Reasons for Failure of Chronic Daily Headache TX Numerous
SCOTTSDALE, ARIZ. -- Consider a range of explanations when a chronic daily headache patient does not improve with standard therapy, Dr. Joel R. Saper suggested at a symposium sponsored by the American Headache Society. Some top reasons include medication-overuse...
Report Casts Doubt on VNS Approval
A Senate committee report showing that a vagus nerve stimulation device was approved for treatment-resistant depression over the objections of "more than 20 [Food and Drug Administration] scientists, medical officers, and management staff" could add...
Reward-Based Behavior Common in Parkinson's
SAN DIEGO -- Obsessive or impulsive reward-based behavior was reported by nearly 6 in 10 patients with Parkinson's disease answering an anonymous survey, adding to the suspicion that dopaminergic medications may influence impulse control. Patients...
Risk of Premature Death Higher with Serious Mental Illness
SAN DIEGO -- Heart disease and suicide were the leading causes of death in a large study of patients with mental illness in Ohio. Moreover, these patients died at a mean age of 48 years, which represented 32 years of potential life lost, Dr. Brian...
Seniors in Low-Income Housing Respond Less to Antidepressants
Older adults living in low-income census tracts are significantly less likely to respond to depression treatment than are their counterparts in middle- and high-income census tracts, researchers reported. Alex Cohen, Ph.D., of Harvard Medical School,...
Sertraline Improved Itching from Liver Disease in Small Study
SAN FRANCISCO -- The SSRI sertraline improved pruritus from cholestatic liver disease in a small double-blind crossover study of 12 patients, Dr. Marlyn J. Mayo said at the annual meeting of the American Association for the Study of Liver Diseases....
Skin Sores Can Be Clue to Methamphetamine Use: After Problem Has Been Detected, Only Way to Cure the Dermatologic Manifestations Is to Stop the Abuse
The next time a referring physician sends a patient with a possible case of recalcitrant scabies, look carefully and ask questions. What primary care physicians think is scabies actually may be a manifestation of addiction to methamphetamine, according...
Solo Lamotrigine Not Linked to Birth Defects
WASHINGTON -- There is no evidence that lamotrigine monotherapy increases the risk of major congenital malformations in infants exposed prenatally to the drug, according to updated data from the International Lamotrigine Pregnancy Registry. However,...
SSRIs Tied to Slight Risk of Neonatal Hypertension
Use of selective serotonin reuptake inhibitors during pregnancy is associated with neonatal abstinence syndrome and a slightly increased risk of persistent pulmonary hypertension of the newborn, according to results of two recently published studies....
Statins Don't Affect Cancer Risk or Mortality, Metaanalysis Finds
Statins neither raise nor lower the risk of cancer or cancer mortality, according to a metaanalysis of 26 randomized clinical trials. Several retrospective studies have suggested that statins reduce the risk of developing cancer by as much as 50%....
Suicides in Liver Donors Suggest Need for Psychiatric Assessment
SAN FRANCISCO -- Postoperative psychiatric complications in a small percentage of liver donors included three completed or attempted suicides, Dr. James F. Trotter reported in a poster at the annual meeting of the American Association for the Study...
Surveys Show Paths to Addiction Treatment in U.S.: Only 9% of the Estimated 22.5 Million People with a Drug or Alcohol Problem Actually Received Specialty Treatment
BETHESDA, MD. -- Treatment for substance use disorders continues to be out of reach for many people who need it at a time when funding for treatment and health plan coverage of substance abuse remains stagnant, Constance M. Horgan, Sc.D., said at the...
Telephone Intervention Boosts Cancer Screening
QUEBEC CITY -- A series of telephone calls can significantly improve cancer screening rates among low-income women, a randomized controlled trial suggests. Not all practices have the resources to implement such an intervention, Dr. Allen J. Dietrich...
The Art of Jamie Winter
Artist Jamie Winter is part Native American, and her paintings are strongly influenced by her roots in Wisconsin's Ho-Chunk tribe. She was diagnosed with bipolar disorder at age 15 and immediately hospitalized for 2 years, but that didn't stop her...
The Value of Integrated Care
Psychiatrists and primary care physicians need to work together to meet the needs of psychiatric patients. In Texas, we have developed an integrated community program that has as its centerpiece just this kind of collaboration. The results are still...
The Wonders of Cognitive Restructuring
More than 20 years ago, two physicians I knew--a cardiologist and nephrologist--called my office to see if I would see a patient with hypertension that was not well controlled by medications. He was a corporate attorney, and a consultant to many Fortune...
Tips for Securing Your Financial Future
For as long as he can remember, Dr. Robert M. Doroghazi has been prudent with money. "It was difficult to come by," said Dr. Doroghazi, who was raised in Granite City, Ill., as the son of a steelworker. At age 8, he began to earn an income by...
Use of Racially Targeted Drug Therapy Questioned
WASHINGTON -- Drugs like BiDil that target a particular racial or ethnic group do not represent the best approach for looking at health disparities, Dr. Francis S. Collins said at a meeting sponsored by the Department of Health and Human Services and...
Videophones and Psychiatry
Community-based case management is now the preferred treatment approach for those psychiatric patients who suffer from severe mental illness and live in the community. Intensive case managers perform a variety of supporting roles that range from...
Weight-Loss Drug Orlistat Backed for OTC Status: An FDA Advisory Panel Has Recommended OTC Approval of the Drug, Which Reduces Fat Absorption
BETHESDA, MD. -- The advisory panel that gave near-unanimous support for making orlistat available without a prescription also voiced several concerns about its potential for interactions with cyclosporine and warfarin, its limited efficacy in mildly...
Who Should Get Long-Term Venous Prophylaxis?
NICE, FRANCE -- Now that safe and effective thrombolytic agents are available for short-term treatment of venous disease, Dr. Patrick Mismetti has two questions he would like to see answered. The first is how long to treat venous disease in high-risk...
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