Psychiatric Times Vol 21 No 5

New studies show that people may cycle in and out of insurance coverage. This can lead to poor health outcomes as chronic disorders, including mental illnesses, are neglected during times when insurance is lacking. Is true health care reform finally on its way?

They called him Silk for the moveshe wove intothe fabric of his game

According to a large international study, BD-II mixed depression can easily be misdiagnosed as major depressive disorder. Proper assessment and treatment of mixed depression in BD-II could have a positive impact on outcomes in bipolar disorder.

In modern practice, psychiatrists will invariably have patients who come from different ethnic or cultural backgrounds. Practitioners will need to consider socioeconomic status, diet, use of herbal medications and immigration status, as well as patients' own self-perception of ethnicity, in assessing patients and planning treatment.

A longitudinal study of the nicotine patch for smoking abstinence and a look at new drugs to lower blood pressure in patients with cerebrovascular disease are among the various research studies from Europe, Australia and Asia highlighted in this column.

Several international algorithm projects are underway, some of which have been in use for years. What are the roadblocks for their successful implementation?

A recent survey of 1,200 Australians found that many respondents did not understand how best to help people with depression.

Headache is a frequent somatic complaint in childhood and adolescence, and its prevalence has increased over the last few decades. The presence of a comorbid psychiatric disorder tends to worsen the course of headache by increasing attack frequency and severity, making the headaches less responsive to treatment, and increasing the risk of chronification. Identification and treatment of comorbid psychiatric conditions is, therefore, important for the proper management of headache, especially in children and adolescents.

Despite increased knowledge of child and adolescent mental health disorders worldwide, there is still a dearth of economic and human resources available to meet treatment needs, especially in developing countries. In this article, the impact of developed countries and the dimensions of this problem are discussed.

While the symptoms of somatoform and dissociative disorders are influenced by the patient's culture, these syndromes are heterogeneous and may have overlapping features. Although more frequently reported in non-Western cultures and thought of as exotic and culture-bound, multiple personality disorder may be a North American example of one such disorder.

How does the role of culture affect disease presentation? The author reviews the impact of religion, ideology and upbringing on the epidemiology of OCD in Egypt.

Comparing the consequences of caregiving across countries for a person with a serious mental illness needs to take into account not only different languages, but also different cultures, quality of mental health services and standards of living. So far, one questionnaire has shown the most validity and become the exemplar in cross-national research; yet it is still not free from possible cultural bias or criticism from its creators who acknowledge that much more research needs to be done.

Research presented at an international meeting in Australia found that lamotrigine may be beneficial against depressive relapse for patients either currently or recently in a manic phase.

Will the most effective treatments be available for your patients? Atypical antipsychotics and antidepressants that are being marketed or developed worldwide are reviewed.