Monday, November 29, 2004

Schizophrenia Treatment Should Focus On Recovery, Not Just Symptoms
Psychiatric News story - "Psychiatry has overemphasized pharmacotherapy of symptoms and underutilized proven psychosocial treatments, while paying little attention to the substantial medical complications confronting patients with schizophrenia, says one expert. Functional outcome, not merely symptom relief, should be the clinical focus in the treatment of schizophrenia, said Stephen Marder, M.D., in an address titled 'Recovery in Schizophrenia' at last month's Institute on Psychiatric Services in Atlanta. Marder called for a new focus by psychiatrists on the physical health of patients with schizophrenia and incorporation of the broad range of proven psychosocial treatments. He also called for a new research agenda aimed at developing drugs to treat cognitive deficits—the feature of schizophrenia most strongly associated with functional outcome..."  
  

Technical Report on Psychiatric Polypharmacy
A report (in Adobe Acrobat format) from the Medical Directors Council of the National Association of State Mental Health Program Directors, brought to our attention by Open Minds - "The purpose of these reports is to provide information and assistance to state mental health directors on emerging clinical and service system issues. The technical report topics are identified by the NASMHPD Medical Directors Council in conjunction with NASMHPD leadership. Reports in the series are developed by members of NASMHPD divisions, NASMHPD affiliates, and outside experts."  
  

Prospective Payment System for Inpatient Psychiatric Facilities - Final Rule
Centers for Medicaid and Medicare Services document,in Adobe Acrobat format, brought to our attention by Open Minds - " This final rule establishes a prospective payment system for Medicare payment of inpatient hospital services furnished in psychiatric hospitals and psychiatric units of acute care hospitals and critical access hospitals. It implements section 124 of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA). The prospective payment system described in this final rule will replace the reasonable cost-based payment system under which psychiatric hospitals and psychiatric units are paid under Medicare."  
  

Editorials, Opinion Pieces Address FDA Regulation Practices
A nice roundup in the Kaiser Daily Health Policy Report of more than a dozen editorials and opinion columns on the FDA's prescription drug monitoring system, with excerpts and links.  
  

Research suggests scan may detect bipolar disorder
Duluth News Tribune story reprinted at PsycPORT - "Bipolar disorder is a serious mental illness affecting about 2.3 million Americans, yet it can be difficult for doctors to diagnose. That may soon change, thanks to groundbreaking research at the Mayo Clinic in Rochester, Minn. Using a high-powered magnetic resonance scanner, researchers have found that patients with bipolar disorder produce significantly different brain scans than patients without the disorder. ... Researchers hope the specialized scanning can help identify 'metabolic markers of the disease'."  
  

Contracts Keep Drug Research Out of Reach
Feautre business story in the New York Times - "Last December, medical school researchers went to a professional meeting in Puerto Rico with a sense of urgency. Federal drug regulators were reviewing unpublished data from their studies on the use of antidepressants in children and adolescents to see if the drugs increased suicide risks. The group included many of the researchers whose published positive findings had helped persuade doctors to prescribe antidepressants like Paxil, Zoloft and Prozac to young patients. Now, faced with growing safety questions, the researchers had been trying for months to gather all the test data about those and similar drugs to see if they had missed a pattern not apparent in any single trial. But they could get only pieces of that information..." [Viewing New York Times resources requires registration, which is free].  
  

Plans underway to improve state mental-health programming (California)
Story in the California Aggie - "With the passing of Proposition 63 on Nov. 2, state residents will begin to see a positively transformed mental health system over the coming months. The initiative, funded through a 1 percent tax on state residents' income that exceeds $1 million, will bring hundreds of millions of dollars into the system earmarked for improving the care of mentally ill children, adults and seniors. State and county workers intend to fully utilize the opportunities that this money will provide, while looking at long-term goals for California's mental health consumers."