Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success  British Medical Journal article - "Studies were assessed for statistically and clinically significant improvement in clinical practice and for the presence of 15 decision support system features whose importance had been repeatedly suggested in the literature. ... Several features were closely correlated with decision support systems' ability to improve patient care significantly. Clinicians and other stakeholders should implement clinical decision support systems that incorporate these features whenever feasible and appropriate." Also available in Adobe Acrobat format.  
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FY 2006: A funding squeeze A "Public Policy Update" in the April APA Monitor - "President George W. Bush sent Congress a $2.57 trillion federal budget for fiscal year (FY) 2006 in February that calls for the deepest domestic reductions proposed since the 1980s. The president's budget eliminates 99 programs (a reduction of $8.8 billion) and substantially reduces 55 others (a reduction of $6.5 billion) for a total decrease of $15.3 billion. Many of these cuts were proposed in previous budgets and then rejected by Congress. However, 68 of the 154 programs were not targeted by this administration in earlier budgets. They represent mostly education, health and social services programs that the administration has determined to be ineffective or inessential. The Department of Education bears the largest burden for the budget reductions..."  
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A new kind of war Article in the April APA Monitor - "In her work with U.S. veterans, psychologist Kaye Baron, PhD, may be seeing the opening salvos of a new war--one for mental health. The private practitioner in Colorado Springs, Colo., near the Fort Carson Army Base, serves a lot of military families affected by U.S. operations in Iraq and Afghanistan. She is also a contract psychologist for a local government agency for which she has evaluated more than 75 military personnel who have returned from Iraq showing depression and irritability and reliving intense emotional trauma--some of the classic signs of post-traumatic stress disorder (PTSD). ... Baron's contacts through her evaluations and work with military families are among the first of what at least one study says could be many more military personnel returning from Iraq suffering--or who will later suffer--from PTSD. While the majority of troops show resilience from the stresses of war, some do or will need help with PTSD symptoms."  
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Study shows new antipsychotic drug prevents brain loss in schizophrenia Columbia University College of Physicians and Surgeons press release at EurekAlert - "A new brain imaging study of recently diagnosed schizophrenia patients has found, for the first time, that the loss of gray matter typically experienced by patients can be prevented by one of the new atypical antipsychotic drugs, olanzapine, but not by haloperidol, an older, conventional drug. The study, published in today's Archives of General Psychiatry, also confirmed previous studies that show patients who experience less brain loss do better clinically..."  
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Injectable drug, combined with counseling, shows promise in treating alcohol dependence University of Pennsylvania Medical Center press release at EurekAlert - "Alcohol dependence is a major public health problem, ranking as the fourth leading cause of disability worldwide, according to the World Health Organization's Global Burden of Disease project. In the United States, it is believed to contribute to more than 100,000 preventable deaths a year. Now, researchers from the University of Pennsylvania School of Medicine, in conjunction with 23 other sites nationwide, have found that long-acting injections of the drug naltrexone, when added to counseling, significantly reduced heavy drinking in patients being treated for alcohol dependence. Study results show that the median number of heavy-drinking days was reduced from 19 days in the month prior to the study to three days per month over the six months of treatment. The results will be published in the April 6 issue of the Journal of the American Medical Association." Please note that the JAMA abstract is available at no cost; full text of the study is available for a fee.  
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Metabolic Side Effects of Antipsychotics are Known, but Rarely Monitored Medical College of Georgia news story - "Psychiatrists are doing a “modest” job of monitoring for weight gain, diabetes and other metabolic problems that may result from use of the newer antipsychotics for schizophrenia, researchers say. Nearly all of the 258 members of the American Psychiatric Association in Georgia, Ohio and Iowa responding to a survey said they considered metabolic side effects serious or very serious, say researchers from the Medical College of Georgia, University of Iowa and Northcoast Behavioral Healthcare in Ohio. However monitoring for these problems – including getting baseline data on personal and family health history as well as baseline and regular checks of height and body weight, waist circumference, blood pressure, fasting blood glucose and lipid levels – largely goes undone, researchers say of findings being presented during the 10th International Congress on Schizophrenia Research April 2-6 in Savannah, Ga." See also Disturbances of Glucose and Lipid Metabolism During Treatment With New Generation Antipsychotics in Current Opinion in Psychiatry at Medscape. [Viewing Medscape resources requires registration, which is free].  
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SSRI antidepressants involve dopamine as well as serotonin signaling Cell Press press release at EurekAlert - "Researchers have discovered that antidepressant drugs such as Prozac not only affect levels of the neurotransmitter serotonin in the brain, but also "hijack" dopamine signaling as well--causing it to launch serotonin signals. Their findings offer new insight into how Prozac and other "selective serotonin uptake inhibitors" (SSRIs) work and how they might cause problems in patients taking them. SSRIs perform their antidepressant function by increasing the concentration of serotonin in the signaling junctions, called synapses, between neurons. This increase alleviates the deficiency of serotonin that causes depression." See also 'Promiscuous' area of brain could explain role of antidepressants, a Baylor College of Medicine press release at the same source - "According to results published in today's issue of the journal Neuron, a study in mice proposes that dopamine and serotonin neurotransmitter systems in the brain occasionally get their signals crossed, causing delays in stabilizing mood."  
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APA Raises Privacy Concerns on Mental Health Records APA press release - "Patient privacy of mental health records was the focus yesterday during a hearing in Chicago, Illinois on the proposed National Health Information Network, which is an element of the Health Information Technology initiative put forth by President Bush in April 2004. The hearing was held by the Subcommittee on Privacy and Confidentiality of the National Committee on Vital and Health Statistics whose charge it is to make recommendations to the Secretary of Health and Human Services as to what privacy protections are necessary to implement an effective electronic health record. Testifying on behalf of the American Psychological Association, Russ Newman, Ph.D., J.D., executive director for professional practice, raised concerns regarding the need to maintain an extraordinarily high level of privacy where mental health records are concerned."  
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Brain Chemistry Anomalies Found in Bipolar Disorder Medinews story reprinted at PsycPORT - "Individuals with bipolar disorder have an average of 30% more of a vital class of signal-sending brain cells, according to new data. This discovery strengthens the hypothesis that the disorder has inescapable genetic and biologic origins, and may clarify why it runs in families. This finding is the first neurochemical difference to be discovered between asymptomatic bipolar and nonbipolar individuals. To put it simply, these patients brains are wired differently, in a way that we might expect to predispose them to bouts of mania and depression, noted Jon-Kar Zubieta, M.D., Ph.D., assistant professor of psychiatry and radiology at the University of Michigan Health System..."  
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Study: Foster Kids Face Mental Illnesses in Adulthood New York Times story reprinted at PsycPORT - "Children placed in foster care have much higher rates of mental illness when they reach adulthood, according to a new study released Wednesday. The study, based on a sampling of former foster care children in Washington state and Oregon, found that 54.4 percent had one or more mental health disorders in adulthood, as compared with 22 percent in the general population. ... The study underscores that foster children enter adulthood with 'tremendous trauma . . . and are much less prepared (for adulthood) than their peers' in the general population, she said at a news conference here to release the report. Researchers said they were particularly alarmed about the incidents of post-traumatic stress disorder in former foster care children -- 25.2 percent had the ailment as compared with 4 percent in the general population. Foster care alumni experience post traumatic stress at twice the rate of U.S. war veterans, the study said." See also the February NSDUH report, Substance Use and Need for Treatment among Youths Who Have Been in Foster Care (Adobe Acrobat format).  
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