Friday, June 18, 2004

Exploring Drug Interactions in Psychiatry
Special Report in Psychiatric Times - "Psychopharmacologic management has become increasingly complex, and physicians run the risk of precipitating drug-drug interactions when certain drugs interact via the cytochrome P450 system. In addition, the P-glycoprotein transporter may play a role in certain drug-drug interactions. While physicians currently rely on Web sites and textbooks to avoid potentially morbid and lethal interactions, electronic medical records may play a crucial role in the future."  
  

Pharmacotherapy for Patients With Eating Disorders
Special Report in Psychiatric Times - "Anorexia nervosa, bulimia nervosa and binge-eating disorder remain challenging disorders for the practicing psychiatrist. While psychopharmacological agents play an important role in the overall treatment of eating disorders, current empirical evidence does not support their sole use. A recipe consisting of evidence-based psychopharmacological agents together with evidence-based psychotherapeutic approaches is usually required for a successful outcome."  
  

Health Care Access For Low-Income People: Significant Safety Net Gaps Remain
An Issue Brief from the Center for Studying Health System Change - "Despite signs that low-income and uninsured people's access to primary health care services has improved, serious gaps in care exist, especially for specialty physician, mental health and dental care, according to the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. Key factors contributing to these gaps in the safety net include declining private physician and dentist involvement, changes in funding and facilities, and more people in need. Community leaders have developed a variety of innovative strategies to add specialty, mental health and dental services but could benefit from more support from state and federal policy makers."  
  

Patterns of Mental Health Service Utilization and Substance Use Among Adults, 2000 and 2001
SAMHSA OAS report - "This report presents estimates of the prevalence of mental health treatment among adults and describes the types of treatment received and the characteristics of persons receiving treatment based on data from the 2000 and 2001 National Household Survey on Drug Abuse (NHSDA). The NHSDA, which was renamed the National Survey on Drug Use and Health (NSDUH) in 2002, is a nationally representative survey of the civilian, noninstitutionalized population aged 12 or older and is conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA). Summary results from the 2002 NSDUH were released in September 2003 (Office of Applied Studies [OAS], 2003). The more extensive analysis of the 2000–2001 data presented in this report is not comparable with the analysis of data from the 2002 survey because of methodological improvements made in the survey in 2002 that affected prevalence estimates."  
  

Evidence-Based Medicine in Psychiatry -- A New Perspective
An Expert Interview With Ranga Krishnanpublished in May in Medscape Psychiatry & Mental Health - "Evidence-based medicine is becoming an important framework in psychiatry to help the clinician understand and use the current research in the field. Robert Kennedy, Medscape Psychiatry & Mental Health editor, discussed applying evidence-based medicine to psychiatry with Ranga Krishnan, MB, ChB, Professor and Chair, Department of Psychiatry, Duke University Medical Center, Durham, North Carolina." [Viewing Medscape resources requires registration, which is free].  
  

Faxing Patients' Protected Health Information
An "Ask the Experts about HIPAA Compliance" article at Medscape - "There is controversy about what is an acceptable transmission of patient information by fax under HIPAA's medical privacy rule. If an insurance company requests a copy of a claim by fax, is this compliant? If another person in our organization is performing audits and requests a copy of patient information (chart, claims, encounters, etc.), can this be sent by fax?" [Viewing Medscape resources requires registration, which is free].  
  

Gaining prescriptive knowledge
APA Monitor article - "Psychopharmacology training programs meet a need for many practitioners-- and, indirectly, for consumers..."  
  

Charting a course for improved public health
Article in the June APA Monitor - "National Institutes of Health (NIH) Director Elias A. Zerhouni, MD, has set his sights on increasing the pace of medical progress. So, with help from a team of 300 scientists, industry leaders, government officials and the public, he has mapped out a path of scientific discovery with the goal of giving scientists in the public sphere new tools for doing molecular-level research and translating discoveries into clinical applications. The plan, first introduced in 2003 and known as the NIH Roadmap, provides an outline of 28 cross-institutional projects. Its details are still being fleshed out, but through it, Zerhouni seeks to bring together scientists from different disciplines to tackle obesity and other such knotty public health problems that result from multiple interacting factors, including behavioral ones..."  
  

Schizophrenia: The Quest for a Minimum Sense of Identity to Ward Off Delusional Disorder
Canadian Journal of Psychiatry article - "Language lies at the confluence of the biological, physiological, psychological, and social processes underlying human behaviour. Recently, some developments in the cognitive and linguistic sciences have contributed to better understanding language in either normal subjects or subjects with language communication disorders, such as some people with psychosis. Improvements in data analysis techniques and artificial intelligence technology have led to the development of advanced methods for investigating language, mainly regarding the structure of speech. In the context of psychosis, the term schizophrenia is used to designate a group of disorders with several common features involving a wide range of behavioural differences; it is not a single pathological entity with a well-defined series of symptoms. Language, which is unique to each individual, can reflect how patients cope with their disease. The aim of this preliminary study was to describe and analyze the main characteristics and patterns of discourse from people with the disorganized type of schizophrenia who exhibited prominent negative symptoms."  
  

Prevalence Studies of Substance-Related Disorders: A Systematic Review of the Literature
Article in the Canadian Journal of Psychiatry - "This is the third in a series of papers that present systematic reviews of the prevalence and incidence of psychiatric disorders drawn from studies published between the years January 1, 1980, and December 31, 2000. The series discusses the implications of these epidemiologic findings for mental health policy and practice."  
  

The Impact of Recent Changes in Health Care Coverage for Low-Income People: A First Look at the Research Following Changes in Oregon's Medicaid Program
An issue paper, in Adobe Acrobat format, from the Kaiser Commission on Medicaid and the Uninsured - "Oregon recently restructured its Medicaid program through a Section 1115 waiver and other program changes, largely in response to particularly difficult state budget problems. This report summarizes key findings on the impact of Oregon's changes, based on work conducted by a research collaborative within the state. The experience in Oregon may be instructive, as other states have implemented or are considering implementing similar changes."  
  

Mental health center prognosis improves (Pennsylvania)
Public Opinion story - "Things are almost back to normal at Cumberland Valley Mental Health Center, 533 S. Main St., after the center postponed a round of payroll checks on April 30. ... The center provides mental health services to more than 3% of the people in Franklin County. The center manages medications for 750 of the 4,500 people who use the center annually. The center got into cash-flow problems because of problems with the state system reimbursing the mental health center. A life-skills program serving 14 severely mentally challenged adults closed May 14 and will not reopen, according to Waters. A majority of the clients have been placed. Waters decided to close the adult training facility after two of the seven employees there quit when they failed to receive their paychecks on time. A third was on medical leave. The state requires the program to have a minimum staff. The uncertainty spilled over into other areas..."  
  

Jail to start mental health screening (Iowa)
Iowa City Press-Citizen story - "Members of the Johnson County Board of Supervisors voted Thursday to launch a screening process to identify jail inmates with mental illness in hopes the expense outweighs long-term costs for keeping people in the crowded jail system. ... Upon arriving at the jail, people will answer a seven-question evaluation to help identify whether they could benefit from mental health services. The goal is to reduce repeat offenses by connecting people with needed programs upon release or to possibly divert people from the jail into other programs."