Clinical Psychiatry News articles from July 2008

Clinical Psychiatry News archives from July 2008

TORDIA results offer guidance.(News)
July 1, 2008... PHOENIX--The only prospective, rando, controlled comparison of treatment for resistant depression in adolescents is yielding new insights about efficacy and suicidality through several post hoc analyses. The selective serotonin reuptake...

Physician suicide rates suggest lack of treatment: greater awareness of depression needed.
July 1, 2008... Each day in the United States, roughly one doctor dies by suicide. Studies over the past 4 decades have confirmed that physicians--especialy women physicians--die. by suicide more frequently than people in other professions or those in the...

Pioglitazone cuts risk of progression to diabetes.(Clinical report)
July 1, 2008... SAN FRANCISCO- people with impaired glucose tolerance were 81% less likely to develop type 2 diabetes over a 3-year period if treated with pioglitazone, according to a prospective, randomized, double-blind, placebocontrolled study of 602...

Duloxetine becomes the second drug approved for treatment of fibromyalgia.
July 1, 2008... The antidepressant duloxetine has been approved by the Food and Drug Administration for the treatment of fibromyalgia. The approval, announced in mid-June, makes duloxetine the second drug okayed by the agency for this syndrome. A year ago,...

Second-generation antidepressants differ mainly in safety.(News)
July 1, 2008... PHOENIX -- Second-generation antidepressants do not differ significantly from one another in efficacy or effectiveness, a study funded by the federal Agency for Healthcare Research and Quality shows. Some differences were found, however, in...

Students' risky behavior improving over time.(News)
July 1, 2008... Fewer high school students are engaging in certain high-risk health behaviors today, compared with their counterparts in the early 1990s, according to data from the 2007 national Youth Risk Behavior Survey. Large numbers of adolescents are...

All antipsychotics to get warnings about elderly.(NEWS FROM THE FDA)
July 1, 2008... Labeling for conventional antisychotics will now contain warnings about an increased risk of death among elderly users with dementia-related psychosis, according to new requirements issued by the Food and Drug Administration. The labeling...

Generic versions of ropinirole OK'd for restless legs syndrome.(NEWS FROM THE FDA)
July 1, 2008... The Food and Drug Administration has approved several generic formulations of ropinirole for the treatment of restless legs syndrome but not for Parkinson's disease, the other approved indication for the drug. Generic ropinirole...

Agency launches Sentinel surveillance system.(NEWS FROM THE FDA)
July 1, 2008... The Food and Drug Administration has developed a new national electronic surveillance system that will allow it to search and analyze claims data and other clinical databases for possible post-market adverse events for drugs and medical...

FDA, European regulators back opioid-induced constipation therapy.(NEWS FROM THE FDA)
July 1, 2008... Wyeth and Progenics Pharmaceuticals Inc. have received a positive recommendation from European regulators and U.S. approval for Relistor, an opioid-induced constipation therapy. The European Medicines Agency's Committee for Medicinal...

Screening for diabetes fails to lower mortality.(NEWS FROM THE FDA)(Clinical report)
July 1, 2008... SAN FRANCISCO -- A population-based screening program for type 2 diabetes does not decrease all-cause, cardiovascular, or cancer-related mortality over a 5-year period, according to a large randomized controlled trial presented at the annual...

Mediterranean diet protects against diabetes in some.(NEWS FROM THE FDA)
July 1, 2008... A Mediterranean diet high in vegetables, fruits, and cereal grains and low in meat can significantly reduce the risk of diabetes in initially healthy people, according to a large Spanish cohort study published online May 30 in BMJ. In a...

More drugs for type 2 expected on market soon.(NEWS FROM THE FDA)
July 1, 2008... PHILADELPHIA -- The number of incretins available to treat type 2 diabetes is set to expand in the near future, said Dr. Marie E. Mc Donnell, director of inpatient diabetes at Boston Medical Center. Liraglutide, a once weekly formulation of...

Physicians face 5.4% cut in Medicare payments.(NEWS FROM THE FDA)
July 1, 2008... Barring action by Congress, physicians will face a 5.4% cut in Medicare payments on Jan. 1, 2009. Officials at the Centers for Medicare and Medicaid Services projected the 2009 fee cut based on a statutory formula that uses the controversial...

Teens + marijuana: (still) a dangerous mix.(GUEST EDITORIAL)
July 1, 2008... As psychiatrists with expertise in addiction medicine, we applaud the recent White House report on the impact of marijuana use on adolescents. The report, released in May by the Office of National Drug Control Policy, high-lights the...

Do high deductible plans coupled with HSAs promote underinsurance? The sick and poor are left underinsured.(POINT / COUNTERPOINT)
July 1, 2008... Consumer-directed health care (CDH) is premised on the odd idea that Americans are too well insured. In policy wonks' dreams, CDH couples high-deductible insurance policies with health savings accounts (HSAs) that patients can use to pay the...

Do high deductible plans coupled with HSAs promote underinsurance? Consumer-directed care cuts bureaucracy.(POINT / COUNTERPOINT)
July 1, 2008... In fact, high-deductible plans solve the problems of "underinsurance" and "overinsurance" and lead to "just-right insurance." Most economists recognize that excessive reliance on third-party payment is the source of many of our problems in...

Health care reform: top 10 obstacles.(GUEST EDITORIAL)
July 1, 2008... I am a strong and consistent supporter of health care reform, but perhaps I have be come a bit jaded from the unsucessful efforts I've witnessed over the past 20 years. To have real reform, it is necessary to provide adequate health...

Premature recommendations.(LETTERS)(Letter to the editor)
July 1, 2008... It must be possible to be excited and uncomfortable at the same time, because I cringed when I read a recent article based on a presentation by Dr. Dana E. King of the Medical University of South Carolina, Charleston ("Moderate Drinking Cuts...

We need data on ethnic groups.(LETTERS)
July 1, 2008... Dr. Maria A. Oquendo and others identified some of the barriers that limit research among ethnic and cultural groups ("Diversity Missing From Research," May 2008, p. 1). I would like to add to this list a few more challenges to the systematic...

Let's address autism concerns.(LETTERS)(Letter to the editor)
July 1, 2008... The autism editorial by Lawrence Scahill, Ph.D., is very upsetting ("Autism Is Not an Epidemic," Guest Editorial, March 2008, p. 14). I know that editorials are supposed to be controversial, however, this article just continues the...

Correction.(Correction notice)
July 1, 2008... A headline on page 32 in the June 2008 issue of CLINICAL PSYCHIATRY NEWS should have read: "Depression Tied to Low Vitamin D, High Parathyroid Hormone Levels."

Adverse event confidentiality.(GUEST EDITORIAL)(Guest editorial)
July 1, 2008... Imagine being involved in an adverse event--one that, through no real fault of your own, caused death or serious injury to a patient. Should your future patients have a right to know of your involvement? That is the issue Florida physicians...

Fink! still at large: a recent report on suicide in the U.S. Army shows that suicidal behaviors are more common among young, unmarried soldiers. What factors might make young people more vulnerable?
July 1, 2008... When the Army released its report, newspapers across the country (and perhaps around the world) ran headlines like this: "More U.S. Soldiers Committed Suicide in 2007 Than at Any Time Since the First Gulf War." For those of us who tend to the...

Collaborative medicine deemed best for patients.
July 1, 2008... Patients with serious mental disorders will be best served when psychiatrists starting thinking like primary care physicians, and primary care physicians start thinking like psychiatrists, experts said at a forum on integrating physical and...

Integrating Psychiatric, physical care also can lead to cost savings.
July 1, 2008... Treatment at an integrated behavioral/physical health care clinic not only reduced emergency department admissions among patients with serious mental illness but also saved a health care company $32,000/patient in psychiatric care costs. ...

Solutions for wellness.(Several Resources Available for Free)
July 1, 2008... www.solutionsforwellness.com This 6-month personalized wellness program is designed to help people with serious serious mental illnesses improve their diet, exercise, stress management, and sleep habits. Patients can create personalized...

Team solutions.(Several Resources Available for Free)
July 1, 2008... www.treatmentteam.com This program sets up a collaborative approach between patients, family, friends, and clinical treatment teams. Patients can access any of 10 easy-to-understand workbooks that address disease state and healthy life...

Diabetes and antipsychotic medications toolkit.(Several Resources Available for Free)
July 1, 2008... Soon to be released by the American Diabetes Association, the kit will include a letter from the American Diabetes Association Program Planning Committee; CD-ROMs that include an archived Web cast and professional and patient education tools;...

Depression affects what mothers feed infants.(Aduit psychiatry)
July 1, 2008... HONOLULU -- Depressed Hispanic mothers are more likely than are nonde-pressed Hispanic mothers to supplement breast-feeding with water and flavored teas as early as 4-6 weeks and to be giving their babies soda, chips, and syrup-flavored cow's...

Cases show virulence of online pornography.(Aduit psychiatry)
July 1, 2008... WASHINGTON -- The ubiquity of online pornography and easy access make it problematic for people who otherwise might not be susceptible to the lure of pornography. For mental health professionals, the challenge is to clarify which...

Gabapentin withdrawal.(EVIDENCE - BASED PSYCHIATRIC MEDICINE)
July 1, 2008... The Problem Many of the patients at your long-term psychiatric treatment center (also known as a state prison) receive treatment with gabapentin for chronic pain or seizure disorders. Some inmates may well be using their gabapentin...

Clarity offered on ECGs, ADHD medications.(Child/Adolescent psychiatry)
July 1, 2008... The American Academy of Pediatrics and the American Heart Association have issued a joint statement clarifyingstate ment clarifying recent recommendations made by the AHA on evaluating and treating children and adolescents with...

ADHD unaffected by 8-week course of St. John's wort.(Child/Adolescent psychiatry)
July 1, 2008... An 8-week course of St. John's wort did not improve attention-deficit/hyperactivity disorder symptoms in what researchers described as the first-ever randomized clinical trial of the herbal remedy in children and adolescents, according to a...

Shorter wear times for Daytrana patches effective.(Child/Adolescent psychiatry)
July 1, 2008... Children with attention-deficit/hyperactivity disorder who wore Daytrana methylphenidate transdermal patches for stretches of 4 or 6 hours experienced improvements in their ADHD symptoms, results from a multicenter controlled trial of 117 young...

Disordered eating linked to suicidal ideation.(Child/Adolescent psychiatry)
July 1, 2008... BOSTON -- Disordered eating is an important risk factor for suicidal ideation in adolescents and appears to contribute an additional amount of variance above and beyond traditional risk factors, a study has shown. The findings suggest that...

Impact of apnea on cognition highly variable.(Child/Adolescent psychiatry)
July 1, 2008... FORT LAUDERDALE, FLA. -- Some children with sleep-disordered breathing experience significant cognitive deficits, but not all do, and identification of those at risk remains a clinical challenge, according to a sleep medicine expert. The...

Extremely preterm birth linked to later autism.(Child/Adolescent psychiatry)
July 1, 2008... HONOLULU -- Children born at less than 26 weeks' gestation are significantly more likely to have symptoms indicative of autism spectrum disorders at school age than are their classmates, according to a study of 219 children born extremely...

Identifying endophenotypes can help guide treatment of autism.(Child/Adolescent psychiatry)(Disease/Disorder overview)
July 1, 2008... BALTIMORE -- Identifying shared endophenotypes might help clinicians characterize neurobehavioral syndromes and plan treatment, said a specialist in neurobehavioral development. An endophenotype is a subset of features of a syndrome that...

Tarenflurbil slows decline in early AD.(Geriatric Psychiatry)
July 1, 2008... A drug that inhibits the formation of neurotoxic amyloid-[[beta].sub.42] peptides slowed functional decline in patients with mild Alzheimer's disease by 46%, Dr. Gordon K. Wilcock and his colleagues have reported. Patients who took the...

Progression from MCI to dementia affected by gender.(Geriatric Psychiatry)
July 1, 2008... Risk factors for mild cognitive impairment and progression from mild cognitive impairment to dementia are not the same for men and women, findings from a population-based study of 6,892 adults aged 65 years and older show. Identifying the...

Brain-focused regime improves gait better than physical therapy.(Geriatric Psychiatry)(Brief article)
July 1, 2008... WASHINGTON -- An exercise program designed to overcome neural deficits improved elders' walking more than physical therapy that focused on lower-body muscles did, results of a randomized, controlled trial of the two approaches show. ...

Exams differentiate delirium from dementia.(Geriatric Psychiatry)
July 1, 2008... SAN FRANCISCO -- Two brief mental state exams can reliably differentiate delirium from dementia in the elderly emergency department patient. Because delirium usually is caused by an organic illness, confusional symptoms may disappear once...

Study: gambling common among disabled.(Addiction Psychiatry)
July 1, 2008... WASHINGTON -- people with intellectual disabilities do exhibit pathological gambling behavior, and gambling in general is common in this population, a study of 79 people in the Las Vegas area shows. Two of the study participants (2.5%) met...

New treatment options can help smokers quit.(Addiction Psychiatry)
July 1, 2008... Many new and effective treatment strategies are available that clinicians can employ to help patients quit tobacco use, according to an updated Clinical Practice Guideline released recently by the U.S. Public Health Service. Use of...

Reduced hippocampus volume tied to cannabis use.(Addiction Psychiatry)
July 1, 2008... Heavy cannabis users show marked reduction in hippocampus volume on high-resolution 3-T MRI imaging, investigators have reported. The volume reductions appear to correlate with the degree of exposure to the drug, according to Murat Yucel,...

Naltrexone tx inhibits pleasures from drinking.(Addiction Psychiatry)
July 1, 2008... TORONTO -- Long-term treatment with extended-release naltrexone selectively inhibited the hedonic response associated with drinking alcohol while sparing the experience of pleasure associated with other activities such as reading and listening...

Drug therapy for Alcohol dependence.(PRACTICAL PSYCHOPHARMACOLOGY)
July 1, 2008... Alcohol dependence is among the most common psychiatric disorders: A recent National Epidemiologic Survey on Alcohol and Related Conditions found a 12-month prevalence of 3.8% (Arch. Gen. Psychiatry 2007;64:830-42). In individuals with comorbid...

Smoking associated with cognitive decline in middle age.(PRACTICAL PSYCHOPHARMACOLOGY)
July 1, 2008... Smoking is associated with a decline in reasoning ability and with memory deficit as early as in middle age, according to a study of more than 5,000 people. People who quit smoking before they reach middle age, however, show little of this...

Perspective.
July 1, 2008... The fact that the foster care system is failing to provide sufficient protective factors for children is offensive. At some point, the science will become so clear that not to do certain things for foster children will be considered unethical....

Foster care: casey program is a good model.(PREVENTION IN ACTION)
July 1, 2008... The foster care system in the United States was designed to provide a short-term safe haven for abused or neglected children--a temporary way station of sorts for kids in crisis en route to a more stable, supportive living situation. But for...

DBS may prove beneficial in early Parkinson's.(Neuropsychiatric Medicine)
July 1, 2008... Data from new studies suggest that patients with Parkinson's disease might benefit from deep brain stimulation surgery much earlier in their disease course, offering tantalizing hints that early surgery could actually delay progression by...

Cost separates old migraine drugs from new.(Pain Medicine)
July 1, 2008... WASHINGTON -- Newer drugs aren't any better for migraine prophylaxis than are older treatments and might be worse choices for older treatments and might be worse choices for many patients when cost is a factor. "There's no proof of...

Methylnaltrexone relieves opioid-induced constipation.(Pain Medicine)
July 1, 2008... A single dose of methylnaltrexone relieved opioid-induced constipation three times more often than did placebo in a phase III clinical trial of 133 terminally ill patients, investigators have reported. The treatment did not interfere with...

Ongoing trial compares anorexia therapies.(Psychosomatic Medicine)
July 1, 2008... SEATTLE -- The relative efficacy of three treatments for anorexia nervosa appears to shift with long-term follow-up according to the results of an ongoing' analysis of data from a randomized, controlled trial. The treatment that was the...

Use of Zolpidem appears safe during pregnancy.(Psychosomatic Medicine)
July 1, 2008... WASHINGTON -- Even though the sleeping aid Zolpidem does cross the placenta, use of the drug during pregnancy does not appear to significantly affect outcomes, a study of 45 women shows. The study, presented as a poster at the annual...

The challenge of treating facial tics.(THE PSYCHIATRIST'S TOOLBOX)(Case study)
July 1, 2008... Facial tics and tic-like movement that spreads to the shoulders, parts of the torso, or other parts of the body are difficult to treat. The patients I've treated with tic disorders had one thing in common: They knew that the tics worsened when...

Citalopram appears effective for reducing hot flashes.(Psychosomatic Medicine)
July 1, 2008... CHICAGO -- Citalopram may be an effective option for reducing hot flashes, having performed twice as well as placebo in a randomized, placebo-controlled phase III trial conducted by the North Central Cancer Treatment Group. "Hot flash...

Refractory asthma persists despite new guidelines.(Across Specialties)(Disease/Disorder overview)
July 1, 2008... TORONTO -- A substantial proportion of patients with severe refractory asthma are unable to become well controlled despite the availability of updated guidlines, even in subspecialty care, according to Dr. Amandeep S. Gill of the Medical...

Proton pump inhibitors not helpful in asthma without reflux.(Across Specialties)
July 1, 2008... TORONTO -- Treatment with a proton pump inhibitor did not improve asthma control in patients with poorly controlled asthma and minimal or no symptoms of gastroesophageal reflux, according to results from a large study presented at an...

'Estimated average glucose' unit gains favor.(Across Specialties)
July 1, 2008... SAN FRANCISCO -- Hemoglobin [A.sub.1c] levels can now be accurately expressed as estimated average glucose for most patients with type 1 and type 2 diabetes. In a multinational study presented at the annual scientific sessions of the...

Taranabant aids weight loss, improves metabolism.(Across Specialties)
July 1, 2008... GENEVA -- Overweight and obese patients achieved significant weight loss and improved metabolic parameters using taranabant, according to interim results from a 2-year study. Taranabant is a structurally distinct, highly selective...

Fructose consumption implicated in rise of gout.(Across Specialities)
July 1, 2008... LIVERPOOL, ENGLAND -- Consumption of soft drinks containing fructose may underlie the sharp increase in gout among American adults that has occurred in recent decades, Dr. Hyon K. Choi said at the annual meeting of the British Society for...

QoL, cancer outcome linked in meta-analyses.(Across Specialities)(Clinical report)
July 1, 2008... CHICAGO -- Feeling better overall translates to better survival for cancer patients, based on the results of two studies presented at the annual meeting of the American Society of Clinical Oncology and involving more than 10,000 cancer...

CAM use puts cancer patients at risk for drug interactions.(Across Specialities)
July 1, 2008... CHICAGO -- More than one-third of older patients with cancer are at risk for drug interactions because of widespread use of biologically based complementary and alternative medicine in the United States, according to population-based data...

Psychosocial assessment is key for teens in emergency departments.(Across Specialities)
July 1, 2008... SAN DIEGO -- Given that adolescents account for 10%-15% of all emergency department visits and arrive for reasons ranging from sexually transmitted infections to mental health disorders, it is important to conduct a thorough psychosocial...

Drug Testing Without Patient Consent?(Across Specialities)
July 1, 2008... It's acceptable to perform drug testing in an adolescent without the patient's consent in cases of altered mental status such as intoxication or overdose or as an adjunct in the evaluation of the victim of trauma or violence, Dr. Baren said....

Abuse recurs most often in adolescents.(Across Specialities)
July 1, 2008... HONOLULU -- Adolescents are far more likely to suffer recurrent abuse than are younger children, according to an analysis of data from 18 states within the National Child Abuse and Neglect Data System. "Age matters," Dr. Vincent J. Palusci...

BMI data for young people: plateau or pause?(Across Specialities)
July 1, 2008... The apparent leveling off in the prevalence of being overweight among U.S. children and adolescents is cause for celebration, but it might not necessarily be a trend, experts say. A study by the National Center for Health Statistics (NCHS)...

Gastric bypass improves sexual function in men.(Across Specialities)
July 1, 2008... ORLANDO -- Gastric bypass surgery leads to significant improvement in the sexual dysfunction experienced by many morbidly obese men, according to a recent study. The effects of surgical weight loss on sexual function are not well studied,...

Surgical neovagina may not provide sexual satisfaction.(Across Specialities)(Clinical report)
July 1, 2008... NEWPORT BEACH, CALIF. -- Women with vaginal agenesis who undergo laparoscopic Davydov surgery to create a neovagina may have impaired sexual function, compared with controls, a study of six such patients found. The findings of the small...

Teens want doctors to initiate discussion of sexual issues.(Across Specialities)
July 1, 2008... NEWPORT BEACH, CALIF. -- Adolescents want their doctors to bring up the topic of sexuality, but few physicians do, a survey of 388 teenagers revealed. The majority of adolescents said they would be comfortable being asked any of 11...

Internet sex partnering could reduce STD risk.(Across Specialities)
July 1, 2008... NEW YORK -- Many researchers and clinicians view Internet use to find sexual partners as a risk factor for sexually transmitted diseases, but it may also have some protective qualities, research indicates. The risk of acquiring an STD may...

New policy stresses competence in palliative care.(Across Specialities)
July 1, 2008... Palliative care applied to all stages of illness--whether terminal or not--is an integral part of caring for patients with chronic or advanced respiratory and critical illnesses, the American Thoracic Society has said in a new clinical policy...

Law limits third-party use of genetic info.(Practice Trends)
July 1, 2008... Patients will soon be able to undergo genetic testing without fear of discrimination from either their health insurers or their employers, thanks to a new law signed by President Bush. The Genetic Information Nondiscrimination Act...

Grassley seeks paxil inquiry.(POLICY & PRACTICE)
July 1, 2008... Sen. Chuck Grassley (R-Iowa) is asking the Food and Drug Administration to investigate data it has from Glaxo-SmithKline on paroxetine (Paxil), alleging that the company may have withheld knowledge of a risk of suicide and suicidal ideation. In...

THC levels highest ever.(POLICY & PRACTICE)
July 1, 2008... The federal government says that levels of tetrahydrocannabinol (THC) in marijuana are at the highest-ever recorded amounts, and that the potency may be contributing to increasing numbers of teenagers seeking treatment for dependence. The...

DOD improves on mental health.(POLICY & PRACTICE)
July 1, 2008... The Department of Defense is making some progress on screening troops for traumatic brain injury (TBI) and on screening for mental health issues before deployment, but there are still many gaps in the system, according to a report released last...

Drug Lobby Spending Is Up 32%.(POLICY & PRACTICE)
July 1, 2008... The pharmaceutical and medical device industries had yet another banner year for spending on lobbying in 2007, according to a new report by the Washington-based Center for Public Integrity. Last year, the pharmaceutical industry alone spent at...

Consumer Reports rates hospitals.(POLICY & PRACTICE)
July 1, 2008... Consumer Reports has begun grading hospitals and plans to eventually add ratings for other health care providers. The ratings, which include nearly 3,000 hospitals, are available at www.consumerreportshealth. org. The online tool allows...

The promises and perils of proximity.(THE ETHICAL WAY)
July 1, 2008... Perhaps you have encountered a situation that is comparable to one of the following: * A relative has alcohol and other drug abuse problems and seems to resist getting appropriate treatment. * You work in a small town. The secretary at...

CMS proposes rules to curb marketing abuses.(Practice Trends)
July 1, 2008... The Centers for Medicare and Medicaid Services, seeking to curtail marketing abuses within Medicare Advantage and Medicare Part D prescription drug plans, has proposed new regulations that would prohibit such tactics as door-to-door marketing...

Feds' strategic plan boosts electronic health records.(Practice Trends)
July 1, 2008... If the feds have it their way, 40% of physician offices will be using certified electronic health records by 2012. The goal is part of a strategic plan for coordinating the federal government's health IT efforts over the next 4 years, and...

Ready or not, National Provider Identifier policy is implemented.(Practice Trends)
July 1, 2008... WASHINGTON -- Medicare has stopped accepting claims that contain outdated provider identifying numbers, even if the claims also include a National Provider Identifier--despite concerns voiced by physician groups that many are still not ready....