Friday, August 20, 2004

Structured Interview Helps Make Correct Diagnosis
Psychiatry News story - "Some surprising findings appeared when the prevalence of anxiety disorders among patients of psychiatrists in APIRE's Practice Research Network was compared with that for a community sample who had completed a structured interview. Anxiety disorders appear to be underdiagnosed and undertreated in routine psychiatric practice, according to a study reported at the 2004 AcademyHealth meeting in San Diego."  
  

Restraint Used Less After Training Program
Psychiatry News story - " A university hospital intervention involving training psychiatric patients and hospital staff in crisis-prevention techniques dramatically decreases the use of physical restraints. Recent federal regulations have mandated that psychiatric facilities use physical restraint only when patients pose a danger to themselves or others and as a last resort. Finding effective and safe alternatives to restraint or avoiding its use altogether is critical for inpatient psychiatric facilities. Researchers in the department of psychiatry at the University of Illinois at Chicago (UIC) described an effective training program in the July issue of the APA journal Psychiatric Services that led to a significant reduction in the use of restraint with adolescent and adult psychiatric inpatients..."  
  

Distinct Neural Correlates of Washing, Checking, and Hoarding Symptom Dimensions in Obsessive-Compulsive Disorder
Archives of General Psychiatry article at Medscape - " Previous studies of obsessive compulsive disorder (OCD) have indicated that there are at least 4 stable symptom dimensions: contamination/washing, aggression/checking, hoarding, and symmetry/ordering. The authors attempted to identify the neural correlates of the hand washing, checking, and hoarding groups of OCD. They took 16 patients with multisymptom OCD and 17 control subjects and exposed them to various pictures designed to stimulate the different dimensions of OCD as well as a symptom-unrelated stimulus while being scanned by a functional MRI machine. The subjects were exposed to pictures that were deemed normally disgusting to individuals as well as those depicting scenes related to contamination/washing, aggression/checking, and hoarding..." [Viewing Medscape resources requires registration, which is free].  
  

Bipolar Depression: Long-term Challenges for the Clinician
A new CME unit from Medscape - "Of the 2 poles of bipolar disorder, mania is the more dramatic, and indeed the defining, characteristic. Not surprisingly, it has been the major focus of clinical and research attention, while bipolar depression has been relatively neglected. But a growing body of evidence suggests that depression accounts for the greater burden of morbidity and mortality in bipolar disorder and is an underrecognized clinical challenge. Bipolar depression is often misdiagnosed, inappropriately treated in the acute phase, and undertreated in the maintenance phase. Fortunately, increasing interest in bipolar depression has led to an expanding pharmacopoeia, the establishment of international consensus treatment guidelines, and an improved understanding of bipolar disorder as a severe, recurrent illness requiring long-term pharmacotherapy and psychosocial support." [Viewing Medscape resources requires registration, which is free].  
  

Antidepressant Study Seen to Back Expert
New York Times story - "A top government scientist who concluded last year that most antidepressants are too dangerous for children because of a suicide risk wrote in a memo this week that a new study confirms his findings. The official, Dr. Andrew D. Mosholder, a senior epidemiologist at the Food and Drug Administration who assesses the safety of medicines, found last year that 22 studies showed that children given antidepressants were nearly twice as likely to become suicidal as those given placebos. His bosses, however, strongly disagreed with his findings, kept his recommendations secret and initiated a new analysis. In his memo, dated Monday, Dr. Mosholder said that the results of the new analysis, undertaken in part at Columbia University, matched his own. Though the two studies used different methods and different numbers, they came to similar conclusions..." [Viewing New York Times resources requires registration, which is free]. See also FDA Analysis Backs Antidepressant Concern (AP story at Yahoo) and FDA Sees Changes to Antidepressant Labels (Reuters story at Yahoo) - "The U.S. Food and Drug Administration plans to update antidepressant labels to reflect studies that suggest a link between the drugs and suicide in youths, according to documents released on Friday."   
  

Depression Traced to Overactive Brain Circuit
Kansas City InfoZine story - "A brain imaging study by the NIH's National Institute of Mental Health (NIMH) has found that an emotion-regulating brain circuit is overactive in people prone to depression — even when they are not depressed. Researchers discovered the abnormality in brains of those whose depressions relapsed when a key brain chemical messenger was experimentally reduced. Even when in remission, most subjects with a history of mood disorder experienced a temporary recurrence of symptoms when their brains were experimentally sapped of tryptophan, the chemical precursor of serotonin, the neurotransmitter that is boosted by antidepressants"