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. 31, No. 4, April

Abuse Liability of Oxycodone Nil at Acute Doses. (18 Non-Drug-Abusing Volunteers)
LAS VEGAS -- After exposure to various dose levels of oxycodone over 6 hours, patients had liking and wanting ratings no different from placebo 24 hours later, according to results from a study designed to characterize the drug abuse liability of oxycodone...
Acute Mental Health System Needs More Study. (President's New Freedom Commission)
ARLINGTON, VA.--The U.S. system for acute mental health care is in such disrepair that a national working group should be formed to study this poorly examined problem, subcommittee members said at a meeting of the President's New Freedom Commission...
Alcohol Abuse among the Elderly Is Serious Problem: Comorbid Disorders Such as Depression Are More Common in Older Alcoholics. (Big Impact on Cognitive Function)
HONOLULU -- Problem drinking among the elderly is prevalent and has a significant impact on cognitive function and quality of life, speakers said at the annual meeting of the American Association for Geriatric Psychiatry. Of 408 patients evaluated...
Are the Parents Depressed? (Guest Editorial)
We all know that children develop within the context of families. That's why I believe that physicians treating children must address questions about major family stresses, violence in the home, discord, and parental health--especially depression....
As Americans Age, Health System Will Change. (Demographic, Epidemiologic Transition)
The aging U.S. and world populations are expected to bring many challenges to health care, including more chronic and degenerative diseases and higher costs, according to an analysis by the Centers for Disease Control and Prevention. The proportion...
Benzodiazepines Are Best for Alcohol Withdrawal. (Match Drug, Dose to Patient)
TUCSON, ARIZ. -- Benzodiazepines are the best choice for the treatment of alcohol withdrawal. However, care should be taken in matching the drug and dose to the individual patient, Dr. Michael B. Scott said at a psychopharmacology conference sponsored...
Blood Pressure Boost Can Help Ischemic Stroke Patients. (Departure from Standard Care)
DENVER -- Temporarily inducing blood pressure elevations in patients with acute or subacute ischemic strokes resulted in reperfusion of ischemic brain tissue--and significantly improved function--in a small prospective, randomized trial. The best...
Careful Monitoring of Children on Atypicals Is Critical. (Fasting Glucose, Lipids Every 3 Months)
SAN FRANCISCO -- Olanzapine and risperidone use in children and adolescents is associated with significantly more weight gain than quetiapine, according to preliminary results from a prospective study. The findings suggest that clinical monitoring...
Cognitive Changes Not Inevitable after CABG. (First Prospective Study)
SAN DIEGO -- Cognitive changes after coronary artery bypass grafting are transient and reversible at 3 months and at 1 year after surgery, Ola Selnes, Ph.D., reported at the annual meeting of the Society of Thoracic Surgeons. The findings run counter...
Consider Escitalopram First for Severe Major Depression. (Most Selective SSRI to Date)
CHICAGO -- Esciralopram, a recently approved antidepressant that contains the stereoisomer responsible for citalopram's serotonin reuptake inhibition, was more effective than the older drug in severe depression, Dr. Jack M. Gorman reported in a poster...
Delusions of Psychiatrists. (Guest Editorial)
Forensic psychiatrists regularly practice a deception that I wish to bring to your attention. My awareness of this deception began a few years ago, when a 10-year-old boy was found with his throat cut in the city of Oceanside, Calif. It was a...
Dialectical Behavior Therapy Promising for Binge Eating. (Encouraging Early Data)
COLORADO SPRINGS -- The hottest development in the treatment of binge eating disorder is dialectical behavior therapy. "It looks really, really promising," according to Susan M. Cooper, Ph.D., who said that the first few published clinical trials...
Don't Fear Benzodiazepines for Sleep Problems. (Benadryl Called Ineffective)
CHICAGO -- Physicians need to take their patients' sleep complaints more seriously and be careful about underprescribing medications such as benzodiazepines, Dr. Mark W Mahowald said at a clinical symposium sponsored by the American College of Rheumatology....
Drug Pipeline Is Fat with Weight-Loss Agents. (Obesity Increasing 1 % A Year in U.S.)
Never before, perhaps, have so many novel obesity drugs been in the pipeline. One of those drugs, Axokine, recently received fast-track approval status from the Food and Drug Administration--a first for an obesity drug. The fast-track approval...
Eating Disorders Not So Obvious in Real Kids. (Catch Signs before It's Too Late)
Just flip through any teen magazine, tune into prime-time television, or drive by a fashion billboard in any U.S. city to see how society bombards children and teenagers with images of thinness, Dr. Michael S. Jellinek says. Physicians' voices on...
Educating, Communicating about Pain Increase Patient Satisfaction. (Power of Perception)
NEW ORLEANS -- When chronic pain patients felt educated by their physician about the pain, they tended to be satisfied with their care in a recent study. Those patients whose physician disagreed with the patient's assessment of the level of pain were...
Epoetin Alfa May Keep Breast Cancer Patients Sharp. (Prevents Cognitive Dysfunction)
SAN ANTONIO -- Epoetin alfa shows considerable promise for prevention of the cognitive dysfunction associated with adjuvant chemotherapy in breast cancer patients, Dr. Joyce O'Shaughnessy said at a breast cancer symposium sponsored by the San Antonio...
Escitalopram Effective, Well Tolerated Depression TX in Primary Care Setting. (Randomized Controlled Trial)
BOCA RATON, FLA. -- Escitalopram appears to be an effective antidepressant for use in the primary care setting, Dr. Alan G. Wade said in a poster session at a meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute of Mental...
Escitalopram TX Leads to Remission in GAD. (Three 8-Week Studies)
Escitalopram is effective for the treatment of generalized anxiety disorder, researchers reported at the annual meeting of the American College of Neuropsychopharmacology in San Juan, P.R. After 8 weeks, the rate of remission is similar to the remission...
Exposure Therapy a Success in Chronic PTSD. (Patients Improve in Nine Sessions)
LOS ANGELES -- Exposure therapy is one of the most successful strategies for patients with chronic posttraumatic stress disorder, Edna Foa, Ph.D., said at a meeting on posttraumatic stress disorder sponsored by the Foundation for Psychocultural Research....
Exposure to TV Violence Linked to Aggression in Adulthood. (15-Year Follow-Up)
Childhood exposure to television violence produces aggressive children who grow up to become violent adults, according to the findings of a longitudinal study, reported by L. Rowell Huesmann, Ph.D., and his associates at the University of Michigan...
FDA Probes Ephedra, Proposes Warning Label. (Risk of Heart Attack, Seizure, Stroke)
Individuals should avoid or use extreme caution before taking ephedra while the Food and Drug Administration investigates whether the substance should be placed under greater control or banned, federal officials announced. In February the FDA officially...
FDA Proposes Regulating Dietary Supplements. (Focus on Safety, Not Efficacy)
The Food and Drug Administration has addressed the growing public unease about the safety of dietary supplements by proposing industrywide "current good manufacturing practices." As the popularity of herbs and other natural remedies has skyrocketed...
Film Therapy Can Engage Patients. (Adjunctive Technique to CBT)
Now playing at selected psychiatry practices: Hollywood movies that facilitate therapy. Viewing and discussing commercial films--known variously as movie, reel, cinema, or film therapy--is not a distinct modality but an adjunct to supportive, dynamic,...
Fink! Still at Large. (Self-Disclosure)
In "Antwone Fisher," a movie about a young sailor with an uncontrollable temper who ultimately transforms his life despite an abusive childhood, the Navy psychiatrist shares with his patient some intensely personal issues. At what point is personal...
Forced Medication Case Reaches Supreme Court. (Spotlight on Newer Antipsychotics)
The question of whether mentally ill criminal defendants can be forcibly medicated reached the U.S. Supreme Court last month for the first time in more than 10 years--and for the first time since atypical antipsychotic drugs have been in wide use....
Girls Acting Too Old, Too Fast. (Guest Editorial)
Young girls in this country are losing their childhoods by mimicking the appearance and social behavior of older teens. You must make an effort to spot the telltale signs and warn both patients and parents of the potentially dangerous emotional...
Government Puts $100 Million into Disease Prevention. (Effort to Reform Risky Behaviors)
ST. LOUIS -- Obesity, diabetes, and tobacco-related illnesses are killing hundreds of thousands of Americans at a cost of hundreds of billions of dollars every year, and it's time to focus on prevention rather than treatment, Secretary of Health and...
HIPAA Drives Encrypted E-Mail. (Privacy, Security Requirements)
COLORADO SPRINGS -- Physicians using regular e-mail to communicate with patients are strongly advised to switch to a secure messaging service that will meet new HIPAA requirements, said Dr. C.T. Lin, senior medical director of informatics at the University...
Informed Consent and Physician Outreach Can Help Prevent, Mitigate Legal Action. (Risk Management)
NEW YORK -- Treating the feelings of the patient and his or her family with respect isn't just good psychiatry--it's a key to malpractice liability prevention, Dr. Thomas G. Gutheil said at a conference on psychopharmacology sponsored by New York University....
Lack of Response Psychopharmacology in Dual-Diagnosis Patients? Try Higher Doses. (Mental Illness, Substance Abuse)
COLORADO SPRINGS -- A major reason for lack of response to psychiatric medications in patients with comorbid mental illness and substance abuse is that dual-diagnosis patients often require higher dosing than those with psychiatric disorders only,...
Language Disorders Can Damage Development. (Children Adolescents)
BOSTON -- Developmental language disorders can wreak havoc on the social development of children and adolescents. Deficits in the comprehension, production, and/or use of language can lead to self-regulatory problems, self-perception issues, chronic...
Let's Talk about Sex. (Guest Editorial)
Now more than ever, it's important for physicians to have a broad perspective on the subject of sexual health. Today's consumers are much more sophisticated. They are inundated with information about what should be considered normal, healthy, or...
Letters
High-Flying Ambition I'm an 18-year-old college student in Colorado, and my dad is a psychiatrist in Colorado Springs. He gave me this article to read, and I wanted to let you know that I enjoyed it ("High-Achieving Women," Fink! Still at Large,...
MDs Wary over IOM's Health Care Reform Plan. (Demonstrated Projects)
Physicians are expressing concerns about an Institute of Medicine report that proposes several broad-based health care reforms via a series of nationwide demonstration projects. Health and Human Services Secretary Tommy G. Thompson commissioned...
Medicare Cuts Could Take Toll on Practices. (Surveys Suggest Widespread Impact)
WASHINGTON -- The ongoing drop in Medicare reimbursement has forced physicians like Dr. Michele O'Fallon to dip into their own pockets to keep their practices afloat. After she found herself unable to pay her bills, Dr. O'Fallon used her retirement...
Medicare Gaps Often Hurt Women More Than Men. (Long-Term Care Coverage)
WASHINGTON -- Much attention has been paid to the problems caused by the lack of a prescription drug benefit in the Medicare program--a shortfall that affects many beneficiaries. But there are many other gaps that hurt women more than men, several...
Modest Behavior Changes Could Reverse Obesity Trend. (Message Counters Prevailing Pessimism)
The constant expansion of the national waistline seems inexorable, but turning around the trend could be relatively simple. All that's needed is 15 minutes of walking a day--or just fewer bites of oversized portions, according to James O. Hill,...
Music Therapy, Guided Imagery Lower Pain, Anxiety. (Women Post-Op)
NEW ORLEANS -- Brief music therapy sessions with guided imagery were useful for reducing postoperative pain, anxiety, and medication use during the postoperative period in a recent study of women undergoing major gynecologic surgery. In 81 patients...
New Electrical Therapy May Relieve Low Back Pain. (Noninvasive Treatment)
ORLANDO, FLA. -- Percutaneous neuromodulation therapy appears to be an effective, noninvasive treatment for subacute radiating lower back pain, said Dr. Joanne Borg-Stein of Spaulding Rehabilitation Hospital, Wellesley, Mass. Percutaneous electrical...
New Guidelines to Shape TX for Inhalant Abuse. (Treatment Often Complicated)
WASHINGTON -- Treating patients who abuse inhalants is more complicated than treating those who abuse other drugs, a new advisory says. That's because inhalant abuse patients often abuse other drugs and "have a chaotic family life, low self-esteem,...
New Stress-Buster Drugs Block Hormone Binding. (Compounds Target Chronic Anxiety)
NEW YORK - Get ready for the stress busters. A new class of anxiety-relieving drugs--agents that interrupt core hypothalamicpituitary-adrenal (HPA) stress signals--will emerge in the next 2-3 years, predicted Dr. George Chrousos, chief of the Pediatric...
Opioids for Headache Pain Can Backfire. (Rehab Program Proves Beneficial)
NEW ORLEANS -- People who take opioids for chronic headache pain experience greater pain severity and more interference in their daily functioning than do headache sufferers who do not take opioids, according to a study presented at the annual meeting...
Patients Often Contact Therapist after Termination of Psychoanalysis. (Medication Management Common)
NEW YORK -- When psychoanalysis is over, it isn't all over. Heretical as it may seem to some purists, posttermination contact is frequent. In fact, most analysts are open to it, and many actively encourage it, Dr. Suzanne Yang reported in a poster...
Pediatric Bipolarity and ADHD: Comorbidity May Be Uncommon. (Conflicts with Harvard Numbers)
COLORADO SPRINGS -- The true rate of comorbid attention-deficit hyperactivity disorder in children with bipolarity may not be nearly as high as is often claimed, Dr. Willis Holloway said at a symposium on addictive disorders sponsored by Psychotherapy...
Peppermint Oil for Irritable Bowel Syndrome. (Alternative Medicine)
* Peppermint oil, long a popular aid for gastrointestinal symptoms, has shown benefits in some, though not all, studies evaluating its use in the treatment of irritable bowel syndrome. * Enteric-coated capsules reduce the likelihood of adverse effects...
Physician Advisory Council May Drop Medicaid Oversight. (Lack of Time, Resources)
WASHINGTON -- A federal advisory panel that addresses physician payment issues will limit or possibly eliminate Medicaid deliberations from its purview. The Practicing Physicians Advisory Council (PPAC) no longer has the time or the resources to...
Physician Fear of Controlled Substance Prescribing Overblown. (Complaints Engender Scrutiny)
New York -- Many doctors are afraid that they will get into trouble with the Drug Enforcement Administration every time they write a prescription for a controlled substance, but those fears are overblown, according to one DEA official. "We'll only...
Physicians vs. Bioterrorism. (Guest Editorial)
The proliferation of biological weapons poses a growing strategic threat, and physicians have two roles to play in the fight against these agents. First, we can work against the misuse of biological research and support the development of appropriate...
Plan Now for Looming HIPAA Security Provisions. (Must Be Implemented by 2005)
Even though the deadline for complying with new federal health security regulations is 2 years away, physicians need to start planning for it now, according to experts familiar with the regulations. "Doctors shouldn't think that the security rule...
Practical Psychopharmacology. (Atypical Antipsychotics)
Atypical antipsychotics recently have come into the mainstream of bipolar disorder treatment--and not just for acute mania. While researchers debate whether these drugs are true mood stabilizers, clinicians use them with increasing frequency and confidence...
Psychiatry Is Continuing to Make Modest Gains: Of U.S. Seniors, 4% Chose the Specialty. (Match Day 2003)
Psychiatric residency programs continued their steady climb in this year's Match Day results. The National Resident Matching Program reports that 916 graduating seniors filled 986 positions in general psychiatry in 2003. The tally includes 597 U.S....
PTSD Underrecognized in Pregnancy, Childbirth. (Look for Signs)
NEW YORK -- Pregnancy and childbirth should be added to the risk factors for posttraumatic stress disorder and a diagnostic code for traumatic childbirth should be created, according to Dr. Diana Dell. "Every obstetrician and gynecologist has seen...
Race, Ethnicity Categories Proposed for Drug Trials. (Responses May Differ)
ROCKVILLE, MD.--A standardized approach to collecting data in people from different ethnic and racial groups in new drug trials has been recommended by the Food and Drug Administration. The proposal reflects the increased awareness that responses...
Reel Life. (Beloved)
Oprah Winfrey wanted "Beloved" to be an experience, not just entertainment. The film, like Toni Morrison's novel, was meant to answer the question: What was it like to be a slave? In answering it, Morrison makes her readers feel, perhaps for the...
Should Medicare Cover PET Scans for Alzheimer's Disease? (Pro & Con)
Dr. Gary Small YES The diagnosis of dementia in Alzheimer's disease is not straightforward. With current clinical approaches, it can often take years for a physician to feel confident enough to make a diagnosis of probable Alzheimer's disease....
Step in If a Colleague Is Impaired. (Never Confront the Person Alone)
Last year, Dr. Dana Ware was stunned when a fellow physician arrived for work clearly impaired. "If he came into the ER as a patient, you would say, 'This person is under the influence of something,'" recalls Dr. Ware, a family physician at Seneca...
Stigma Continues to Impede Acceptance of ECT. (New Research Validates Efficacy)
Recent research reinforces existing findings that electroconvulsive therapy is effective for depression. But the stigma surrounding ECT is keeping it from widespread acceptance among both physicians and patients. Images from the 28-year-old movie...
Teamwork Is Needed to Tackle Shortages in Child Psychiatry. (Primary Care Physicians Must Be Involved)
The plight of children in Maine needing psychiatric treatment is a microcosm of a nationwide problem, physicians working in Maine told this newspaper. This is a powerful call for mental health professionals and primary care physicians to work together...
Then and Now: Seeing the Evolution of Psychiatric Diagnosis. (Count on Comorbidities)
COLORADO SPRINGS -- Psychiatrists who are middle-aged or older have been on the scene long enough to recall an era of psychiatric diagnosis that their younger colleagues will find utterly foreign. "When I trained years ago, there was a premium on...
The Tribulations of Trials: How to Read the Studies. (Watch for Inconsistencies)
NEW YORK--In evaluating the relative efficacy of antidepressant medications, research studies should be a useful guide. But the unwary can be easily misled by inconsistencies in analysis and reporting, Dr. Norman Sussman said at a conference on psychopharmacology...
Tobacco-Free Chemical Dependence Treatment Facilities Advocated. (Smoking Undercuts Therapy)
COLORADO SPRINGS -- Allowing inpatients who are at chemical dependence treatment facilities to go outside to smoke is an outdated and indefensible practice--yet it is still the norm across the country Dr. Elizabeth B. Stuyt said at a symposium on addictive...
Two Novel Therapies Help Intractable Cluster Headache. (Study of 125 Patients)
DENVER -- Two last-ditch surgical approaches--percutaneous radiofrequency trigeminal rhizolysis and deep-brain electrode stimulation--proved highly effective for intractable, chronic duster headache in studies presented at the annual meeting of the...
U.S. Supreme Court Upholds Two Megan's Law Statutes. (Connecticut and Alaska Cases)
WASHINGTON -- The U.S. Supreme Court has ruled to uphold Megan's Law statutes in two key decisions. Those rulings, made last month, mark the first by the high court on Megan's Laws, which are designed to ensure that the public can obtain information...
Web Site to Help Seniors Get Drug-Cost Assistance. (Free Service)
To help older patients find out if they are eligible for prescription drug assistance, consider referring them to www.benefitscheckuprx.com. This free service, developed by the National Council on the Aging, allows seniors or caregivers to fill...
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