Clinical Psychiatry News articles from September 2005

Clinical Psychiatry News archives from September 2005

PTSD Algorithm hits cyberspace.(News)(posttraumatic stress disorder)
September 1, 2005... An interactive, online treatment algorithm provides a decision tree complete with graded supporting evidence and special clinical considerations for patients with posttraumatic stress disorder. The new tool is a product of the International...

Median compensatory Jury awards leveled off in malpractice cases.(VITAL SIGNS)
September 1, 2005... Median Compensatory Jury Awards Leveled Off in Malpractice Cases Note: Based on a nationwide database of more than 213,000 plaintiff and defense verdicts, and settlements resulting from personal injury claims. Source: Jury Verdict...

Groups join forces in fight for Mental Health Reform: momentum on parity bill is a top priority.(News)
September 1, 2005... WASHINGTON -- A coalition of national mental health organizations--including the American Psychiatric Association and the National Alliance for the Mentally Ill--has launched a campaign aimed at implementing some of the goals set 2 years ago by...

Psychiatrists, others seek guidance on interrogations.(News)
September 1, 2005... WASHINGTON -- The American Psychiatric Association is in the process of hammering out a position on the role that mental health professionals should play in the interrogation of detainees at Guantanamo Bay and other prison sites around the...

Patient safety law presents challenges.(quality management)
September 1, 2005... WASHINGTON -- The patient safety system signed into law this summer by President Bush will likely take many months to implement. But, after operating so long in an environment of liability fear, doctors may take even longer to trust it,...

FDA panel blocks urine test for Alzheimer's: test detects neural thread protein, but it's unclear whether that is a valid biomarker of the disease.(News)
September 1, 2005... GAITHERSBURG, MD. -- A simple, nonnvasive urine test aimed at helping physicians determine whether a patient has Alzheimer's disease is unlikely to become widely available in the near future. According to the manufacturer, what is under...

Able Laboratories recalls all drugs.(generic prescription drugs)(Brief Article)
September 1, 2005... Able Laboratories Inc. is recalling all of its manufactured drugs because of serious concerns that the drugs were not produced according to quality assurance standards. Most of the recalled products are generic prescription drugs,...

FDA approves two monitoring changes for clozapine patients.(Food and Drug Administration)
September 1, 2005... ROCKVILLE, MD. -- The Food and Drug Administration has approved two major changes to the schedule for monitoring people on clozapine for agranulocytosis: the addition of absolute neutrophil count tests to regular monitoring and a reduction in...

Groups are seeking parity for psychiatric patients in the ED.(Emergency Medical Treatment and Active Labor Act of 1985)
September 1, 2005... WASHINGTON -- Psychiatric organizations called for greater parity in treating emergency psychiatric conditions before a technical advisory group on the Emergency Medical Treatment and Labor Act. Many issues have not been thoroughly...

Use of SSRIs linked with birth defects.(News)
September 1, 2005... ST. PETE BEACH, FLA. -- Maternal use of selective serotonin reuptake inhibitors during pregnancy may be associated with an increased risk of certain birth defects, Sura Alwan reported at the annual meeting of the Teratology Society. Data...

Unipolar, bipolar, and psychotic depression.(treatment selection and patient outcome, differential diagnosis)
September 1, 2005... To optimize treatment selection and patient outcome, differential diagnosis of psychotic depression, bipolar depression, and treatment-resistant depression is critical. Distinguishing features of each depression subtype should assist the...

Treatment of sleep-related symptoms.(insomnia)
September 1, 2005... According to the chairman of the National Commission on Sleep Disorder Research (1993), "what we are dealing with here are two gigantic problems for our society-an epidemic of undiagnosed and untreated sleep disorders; and pervasive sleep...

Therapy cuts risk of repeat attempted suicide in half.(News)
September 1, 2005... Cognitive therapy was effective in preventing repeat attempted suicide in a randomized controlled trial that spanned 18 months, reported Gregory K. Brown, Ph.D., of the University of Pennsylvania, Philadelphia, and his associates. Compared...

Doctor pay under Medicare to fall 4.3% in 2006.(Department of Health and Human Services. Centers for Medicare and Medicaid )
September 1, 2005... Physicians face a 4.3% cut to Medicare reimbursements next year unless Congress takes action to change the sustainable growth rate formula. The reduction was announced in a proposed rule that would update payment rates and revise payment...

Moving beyond 'unarticulated suffering'.(LETTERS)(Letter to the Editor)
September 1, 2005... I applaud the attention that Dr. Robert T. London paid to the underserved field of psychooncology and the recognition that psychiatrists, working in tandem with hematologists/oncologists, can improve the quality of life of cancer patients and...

BPD revisited.(LETTERS)(Letter to the Editor)
September 1, 2005... Dr. Paul J. Fink's very important column raises a fundamental issue: Is DSM-IV selection of the label "borderline personality disorder" harmful for these patients? ("BPD: Should the Patient Be Told?" Fink! Still at Large, July 2005, p. 11.) ...

Fostering the treatment alliance.(LETTERS)(Letter to the Editor)
September 1, 2005... The pathology of borderline personality disorder consists of an expectation of rejection and a tendency to react explosively to a perception of such rejection. Usually, I have found that sharing of that formulation with the patient is very...

Feds shouldn't have health care role.(LETTERS)(Letter to the Editor)
September 1, 2005... Predictably, neither of the commentators in the health savings accounts debate made an effort to correctly diagnose the problem; they just want to treat symptoms, an approach that we physicians should know is not optimal ("Will health savings...

Correction.(Correction Notice)
September 1, 2005... In "Treating Panic Disorder and Agoraphobia," (The Psychiatrist's Toolbox, August 2005, p. 22), a statement about the way in which transference cures were viewed in analytic therapy years ago should have said, "Cases in which patients recovered...

Health disparities: not just a clinical issue.(high rates of childhood obesity)
September 1, 2005... Imagine having your child exercise in the bathroom because fellow renters are sleeping in all the other rooms in your apartment, and it's too dangerous to send him outside. This was the lament of a mother in a community where we have a...

Should experts with potential conflicts of interest be allowed to serve on FDA advisory panels?(PRO & CON)
September 1, 2005... YES What is the best thing for patients? That is the key question. Patients are best served when the experts who have the most knowledge about a medicine or disease advise officials at the Food and Drug Administration. These...

Let's make health plans competitive.(medical care quality)(Editorial)
September 1, 2005... Today's health care plans primarily compete on price. In large part, that's because many employers seek to offer the lowest-cost health plans to their employees, which forces the health plans to offer the lowest possible rates. Many physicians...

Pain relievers.(GUEST EDITORIAL)(Cartoon)
September 1, 2005... "Congratulations on completing your residency.... I see you've chosen sleep as your specialty...."

Health IT support saves lives.(electronic health records)(Editorial)
September 1, 2005... Physician adoption of electronic health records is woefully inadequate, and current Stark and antikickback laws are part of the problem. Congress should pass reforms that create new exceptions to these statutes so that hospital systems and...

Alexithymia requires persistence, empathy.(psychotherapy)
September 1, 2005... Alexithymia is known as a patient characteristic that can have a negative outcome on psychotherapy (Compr. Psychiatry 2005;46:206-13). But many of our patients have difficulty understanding and describing their emotions, and as a result, their...

Hunting for good therapy.(psychotherapy)
September 1, 2005... Here's a trivia question for you: Who's the only actor to ever receive an Oscar for playing a psychotherapist? If you said Robin Williams, you're right. He was awarded Best Supporting Actor honors in 1998 for his role in "Good Will Hunting" as...

Beating dog phobias.(psychotherapy)
September 1, 2005... You have a patient who is planning to visit a good friend. The patient is looking forward to the visit but with a sense of dread--for reasons that have nothing to do with the friendship. Why the ambivalence? It's the friend's dog, which is...

Aripiprazole wins out in comparison with olanzapine.(control of schizophrenia symptoms)
September 1, 2005... BOCA RATON, FLA. -- Aripiprazole and olanzapine provided similar control of schizophrenia symptoms, but aripiprazole patients gained less weight and had a better metabolic profile than olanzapine patients in a 52-week, open-label study. ...

Olanzapine vs. risperidone in schizophrenia.(leading antipsychotic drugs comparison)
September 1, 2005... The Question Olanzapine and risperidone are the leading antipsychotic drugs ("Vital Signs: Zyprexa Sales Led Antipsychotic Market in 2004," July 2005, p. 1), but which one is better for the treatment of schizophrenia? The Analysis ...

Schizophrenia-bipolar I theory gains traction.(continuity theory)
September 1, 2005... NEW YORK -- From their first classification by Emil Kraepelin late in the 19th century, bipolar I disorder and schizophrenia have been considered distinct disease entities. But in recent years, clinicians and researchers have increasingly...

Clozapine underused for black patients with psychosis.(Adult Psychiatry)
September 1, 2005... BOCA RATON, FLA. -- Clozapine is underused as a treatment for schizophrenia in African Americans, compared with white patients, despite similar baseline psychopathology and symptom improvements between the two populations after 6 months,...

Study backs previous findings on famine, schizophrenia.(Adult Psychiatry)
September 1, 2005... A study of schizophrenia after the Chinese Famine of 1959-1961 demonstrates that prenatal exposure to severe nutritional deficiency may increase the risk of later developing the psychiatric disorder, investigators have reported. The new...

Antidepressant combos show synergistic benefit.(cmbination drug therapy)
September 1, 2005... BOCA RATON, FLA. -- A combination of antidepressants with complementary effects on serotonin and norepinephrine provides earlier symptom relief than does monotherapy, according to preliminary results of a study. As a result, it appears...

Comorbid insomnia-depression may respond to cotherapy.(Adult Psychiatry)
September 1, 2005... DENVER -- Coadministration of eszopiclone (Lunesta) and fluoxetine (Prozac) for newly diagnosed major depressive disorder with coexistent insomnia was associated with significantly larger and quicker improvements in both disorders than...

Personality disorder risks.(comorbidity of anxiety and depression)(Brief Article)
September 1, 2005... Comorbid anxiety disorders in patients with major depressive disorder are associated with a greater risk of personality disorders, especially a personality disorder in cluster A or C. reported Amy Farabaugh, Ph.D., and her associates at Harvard...

Spotting preclinical Alzheimer's.(diagnosis)(Brief Article)
September 1, 2005... A metaanalysis has confirmed that multiple cognitive impairments are evident several years before the diagnosis of Alzheimer's disease, reported Lars Back-man, of the Karolinska Institute in Stockholm and his associates. The investigators...

Impact of statins on cognition.(association between statins and cognition)(Brief Article)
September 1, 2005... Statins do not appear to decrease the risk of Alzheimer's disease, vascular dementia, or mixed dementia in patients aged 65 years or older. A secondary analysis of the Cardiovascular Health Study found no protective cognitive effects of...

Combo could help smokers.(methoxsalen's interaction with cytochromes)(Brief Article)
September 1, 2005... Methoxsalen's interaction with a protein that breaks down nicotine may aid researchers in developing more potent drugs to help reduce smoking and tobacco carcinogenesis, reported Jason K. Yano, Ph.D., and his associates at the Scripps Research...

Combo Rx may speed unipolar remission.(Adult Psychiatry)
September 1, 2005... BOCA RATON, FLA. -- A combination of escitalopram and bupropion might produce early remission in as many as one-third of patients with unipolar depression, according to a pilot study presented at a meeting of the New Clinical Drug Evaluation...

Quick scale tracks mood changes in primary care.(Adult Psychiatry)
September 1, 2005... BOCA RATON, FLA. -- An abbreviated Hamilton Depression Rating Scale can quickly assess depression severity and monitor patient response to treatment in a primary care setting, according to a multicenter study. Complete remission of symptoms...

Halt to exercise = depression?(research)
September 1, 2005... VANCOUVER, B.C. -- Regular exercisers who are forced to stop may experience depressive symptoms, Ali A. Berlin reported at the annual meeting of the American Psychosomatic Society. The findings of a study of 40 regular exercisers do not...

The art of Michelle Cohen.(art nouveau movement)
September 1, 2005... A love of art and a desire to teach young children have shaped the life of artist Michelle Cohen. A diagnosis of depression and schizoaffective disorder have dampened neither her enthusiasm for art nor her love of color. She was strongly...

Compulsive tanning may mean body dysmorphia.(body dysmorphic disorder)
September 1, 2005... ATLANTA -- A high proportion of individuals with body dysmorphic disorder are compulsive tanners, so "clinicians should be aware that compulsive tanning may be a clue to the presence of the psychological illness," Michelle Conroy, M.D., said at...

PTSD symptoms persist in refugees for decades.(post-traumatic stress disorder, Cambodian Civil War 1970-1975)
September 1, 2005... Cambodian refugees continue to have high rates of posttraumatic stress disorder and major depression--more than 2 decades after the end of the Cambodian civil war and resettlement in the United States, said Grant N. Marshall, Ph.D., of the Rand...

Psychiatric work-up need not include extensive medical testing.(psychiatric patients)
September 1, 2005... LA QUINTA, CALIF. -- Patients brought into the emergency department with a psychiatric condition probably do not need an extensive battery of laboratory tests to clear them medically, according to a small, retrospective chart study. Of 50...

War survivors' PTSD Tx: focus on sense of control.(posttraumatic stress disorder and depression)(Brief Article)
September 1, 2005... Contrary to popular opinion, posttraumatic stress disorder and depression in war survivors appear to develop independently of a perceived lack of redress for trauma, according to the investigators of a study that was conducted in three former...

Choose nonstimulants with care in ADHD.(Child/Adolescent Psychiatry)
September 1, 2005... NEW YORK -- Options are available for children with attention-deficit hyperactivity disorder who do not respond to treatment with stimulants or are troubled by side effects, but they must be chosen and used carefully, Laurence L. Greenhill,...

ADHD stimulants: no link to propensity for later drug abuse.(attention deficit hyperactivity disorder)
September 1, 2005... YOSEMITE, CALIF. -- Will my child become a dope fiend? That's a common question Robert S. McKelvey, M.D., fields from parents of children who are prescribed a class II stimulant for attention-deficit hyperactivity disorder (ADHD). "The...

Anxiety disorders place huge burden on child's entire family.(child's illness)
September 1, 2005... ATLANTA -- A significant burden is placed on the family members of children and adolescents with anxiety disorders, regardless of the age of the child, Catherine Mancini, M.D., said in a poster presentation at the annual meeting of the American...

Female victimization and violence.(violence research)(Brief Article)
September 1, 2005... Girls who reported being the victims of violence were 2.2 times more likely to engage in violent behavior themselves, wrote Beth E. Molnar, Sc.D., and her colleagues at Harvard University (Arch. Pediatr. Adolesc. Med. 2005;159:731-9). In a...

Family teasing hits home.(overweight of teenage girls)(Brief Article)
September 1, 2005... When family members teased middle school girls about their appearance, the teasing had a significant impact on the girls' dissatisfaction with their bodies, said Helene Keery, Ph.D., of the Eating Disorders Institute at Methodist Hospital, St....

Quest for muscles and steroid use.(cross-sectional study)(Brief Article)
September 1, 2005... Both boys and girls who reported a desire to look like celebrities in magazines were significantly more likely to use products to enhance their physiques, reported Alison E. Field, Sc.D., of Harvard University, and her colleagues. In a...

Early warning signs in boys?(childhood mental disorders)(Brief Article)
September 1, 2005... Conduct disorder symptoms in 8-year-old boys were independent predictors of substance abuse, antisocial personality, and psychotic disorders in adulthood, said Andre Sourander, M.D., of Turku (Finland) University Hospital, and his associates....

ADHD and moderate mental retardation.(Attention deficit hyperactivity disorder)(Brief Article)
September 1, 2005... Risperidone was associated with a greater reduction of attention-deficit hyperactivity disorder symptoms compared with methylphenidate in children with moderate mental retardation, said Alceu Gomes Correia Filho, M.D., of the Federal University...

Zolmitriptan spray effective as migraine Tx.(Child/Adolescent Psychiatry)
September 1, 2005... PHILADELPHIA -- For the first time, the triptan, zolmitriptan nasal spray has been found to be effective in the short-term treatment of migraines in adolescents, Paul Winner, D.O., reported at the annual meeting of the American Headache...

Comorbid conduct disorder secondary to depression.(Child/Adolescent Psychiatry)
September 1, 2005... SANTA FE, N.M. -- A study of children's autonomic responses to reward and negative mood induction suggests that when conduct disorder and depression are comorbid, depression is the primary disorder. In a poster presentation at the annual...

Imaging breakthroughs reveal early AD changes.(Geriatric Psychiatry)
September 1, 2005... WASHINGTON -- Imaging techniques designed to enable identification of preclinical Alzheimer's disease were showcased in numerous presentations at an international conference sponsored by the Alzheimer's Association. Preclinical Biochemical...

Gentle exercises can lead to improved balance.(frail elderly)
September 1, 2005... NASHVILLE, TENN. -- Practicing postural and strength exercises twice a week leads to significant increases in balance and overall activity among the frail elderly, Sue Scott said in a poster presented at the annual meeting of the American...

Late-onset bipolar patients not as ill as counterparts.(differences between early-onset and late-onset bipolar disorder)
September 1, 2005... People who first develop bipolar disorder at age 60 years or older are less ill overall than are those with the more typical pattern of early-onset bipolar disorder, said Martha Sajatovic, M.D., of the University Hospitals of Cleveland, and her...

Insomnia may blunt response to antidepressants.(elderly patients)
September 1, 2005... DENVER -- Chronic insomnia in depressed elderly patients confers roughly a ninefold increased risk of continued depression after as much as 12 months of antidepressant therapy, Wilfred Pigeon, Ph.D., reported at the annual meeting of the...

Modify depression treatment for older patients: comorbidities are common, so the initial dosage of any agent should be low and titration cautious.(PRACTICAL PSYCHOPHARMACOLOGY)
September 1, 2005... Depression among the elderly is, in most ways, no different than in younger adults. It responds to the same drugs, but patient factors, presentation, and context must be appreciated for optimal treatment. The most prominent age-linked...

Intervention improves vertigo and reduces risk of falling.(disequilibrium of aging)
September 1, 2005... BOCA RATON, FLA. -- Vestibular rehabilitation and balance retraining reduced vertigo and falls in a study of 100 community-dwelling elderly patients with disequilibrium of aging. The intervention also improved gait and overall quality of...

Watch for the hallmarks of 'pseudoaddiction'.(Addiction Psychiatry)
September 1, 2005... PALM SPRINGS, CALIF. -- Patients suffering severe, inadequately treated chronic pain can closely resemble drug addicts, posing diagnostic and management challenges for addiction and pain special-its, and primary care physicians. John...

Bupropion not as successful in poorer, less motivated smokers.(Addiction Psychiatry)
September 1, 2005... NEW ORLEANS -- Low-income smokers prescribed bupropion in primary care settings are less successful with smoking cessation than participants in controlled trials, according to a study presented at the annual conference of the Society of...

Mental illness flares for some patients in rehab.(Addiction Psychiatry)
September 1, 2005... SANTA BARBARA, CALIF. -- Psychiatric symptoms are common among people with substance abuse disorders, but in most patients those symptoms improve over the course of residential substance abuse disorder treatment. A recent Veterans Affairs...

Clinic experience gives students an attitude adjustment.(medical students)(Brief Article)
September 1, 2005... ST. PETE BEACH, FLA. -- Attending a specialized clinic for pregnant women with substance use disorders helped medical students in a recent study feel more comfortable and less judgmental when working with such patients. A total of 104...

Perspective.(Community Psychiatry)
September 1, 2005... The statistics on health disparities suggest that quite a number of youth do not get the advantage of being led to prepare for a parent's death by a professional skilled in this arena. Not addressing the relevant issues when they occur can...

Supporting kids with a terminally Ill parent.(illness)
September 1, 2005... Changes in daily rituals and routines, snippets of frightening conversations, worried glances between grown-ups, limited interaction with one or both parents, questions with no answers, answers that make no sense--children of critically ill...

FDA approves melatonin agonist for insomnia.(Neuropsychiatric Medicine)
September 1, 2005... The Food and Drug Administration has approved an insomnia drug with a unique mechanism of action and several features unique among hypnotics approved for insomnia: It is not a controlled substance and does not produce some CNS side effects...

NIH panel assesses treatments for insomnia: members conclude that more studies are needed to assess new drugs and alternative therapies.(Neuropsychiatric Medicine)
September 1, 2005... New benzodiazepine receptor agonists for chronic insomnia--zaleplon, zolpidem, and eszopiclone--have shown fewer adverse effects compared with other medications, but additional studies are needed to assess these drugs' long-term effectiveness,...

Compared with trials, warfarin is half as effective at stroke prevention in real world.(Neuropsychiatric Medicine)
September 1, 2005... NEW ORLEANS -- Real world experience with warfarin suggests that it is not as good at preventing strokes among patients with atrial fibrillation as clinical trial results suggested, especially among African Americans. A review of more than...

Restless legs underdiagnosed.(correct diagnosis)(Brief Article)
September 1, 2005... The diagnosis of restless legs syndrome is made correctly in only 6% of symptomatic patients, Richard P. Allen, Ph.D., of Johns Hopkins University, Baltimore, and colleagues have reported. Dr. Allen and his associates surveyed 15,391 adults...

With Palladone pulled, FDA looks at other opioids: agency, company agree that concomitant use of alcohol could cause 'dump' of the hydromorphone.(Pain Medicine)
September 1, 2005... Shortly after Purdue Pharma announced in July that it was taking its 24-hour opioid Palladone off the market because of a potentially fatal interaction with alcohol, the Food and Drug Administration said it was looking into the possibility that...

Drug combination for migraines deemed too risky for approval.(Pain Medicine)
September 1, 2005... ROCKVILLE, MD. -- At a meeting last month, members of the Food and Drug Administration's Peripheral and Central Nervous System Drugs Advisory Committee agreed that the risk of tardive dyskinesia associated with the metoclopramide component of a...

Pain relievers.(Pain Medicine)(Cartoon)
September 1, 2005... OBVIOUS PROBLEM

Subclinical brain lesions in migraine mimic MS.(multiple sclerosis)
September 1, 2005... PHILADELPHIA -- Migraine patients have an increased risk for subclinical brain lesions that sometimes resemble lesions found in patients with multiple sclerosis or cerebral autosomal dominant arteriopathy with subcortical infarcts and...

New treatment for endometriosis pain has bone-loss warning.(Pain Medicine)
September 1, 2005... Subcutaneous medroxyprogesterone acetate has been approved for the treatment of endometriosis-related pelvic pain. It is the first new treatment to be approved for this indication in 15 years. Depo subQ provera 104 (DMPA-SC), which contains...

Apnea in pregnancy could pose threat to fetus.(Psychosomatic Medicine)
September 1, 2005... DENVER -- Obstructive sleep apnea is far more common during pregnancy than most physicians realize and in its more severe forms can jeopardize the fetus, Meir H. Kryger, M.D., said at a satellite symposium held in conjunction with the annual...

Brief depression screen may improve cardiac outcomes.(Psychosomatic Medicine)
September 1, 2005... NEW ORLEANS -- A brief, two-question screening instrument is sensitive for identifying depression in patients with coronary heart disease, a study has shown. Because major depression is associated with adverse outcomes in this patient...

Treating patients' physical symptoms may improve depression severity.(Psychosomatic Medicine)
September 1, 2005... BOCA RATON, FLA. -- Targeting physical symptoms of depression in a primary care setting increases the likelihood of treatment response, according to a multicenter, naturalistic study. Somatic symptoms of depression are getting increased...

Avoid term 'metabolic syndrome,' groups advise: meaning, clinical usefulness of label remain unclear, U.S. and European organizations say.(American Diabetes Association and European Association for the Study of Diabetes )
September 1, 2005... Physicians should avoid labeling patients with the term "metabolic syndrome," at least until its meaning and medical usefulness can be further clarified, the American Diabetes Association and the European Association for the Study of Diabetes...

Obese cardiac patients may not link weight to heart disease.(Across Specialties)
September 1, 2005... WASHINGTON -- Obese patients with coronary disease don't always see their excess weight as being part of the problem, Francisco Lopez-Jimenez, M.D., and his associates reported in a conference on cardiovascular disease epidemiology and...

Rimonabant reduces CV risks in type 2 diabetes.(Across Specialties)
September 1, 2005... SAN DIEGO -- The investigational drug rimonabant produces highly significant cardiovascular and metabolic benefit in patients with type 2 diabetes, Andre Scheen, M.D., reported at the annual scientific sessions of the American Diabetes...

Pain relievers.(Across Specialties)(Cartoon)
September 1, 2005... "Your HMO will cover treatment for only one of your hearts."