News

There are currently several disturbing phenomena in the field of suicidology: •Many papers are describing risk assessment and suggesting the need for high-risk patients to be hospitalized. •Emergency department (ED) staff are complaining about spending much of their time trying to find beds for patients. •Programs are claiming “crisis intervention” when, in fact, they only provide triage.

A new study appears to add a new dimension to mothers’ sage advice. Researchers in Austria have found that fish oil with omega-3 polyunsaturated fatty acids reduced the risk of progression to psychotic disorder in young people who had subthreshold psychotic symptoms-with none of the adverse effects associated with drug treatment. Click here for more details.

I have been a member of our American Psychiatric Association (APA) for over 30 years. I've also been a Fellow for many years, served on the Assembly 3 different times, served on the Managed Care Committee twice, and was once asked if I would consider running for President. On the other hand, I did resign from a request to run for District Branch President because of some unexpected (and what I and some others thought was unethical) collegial conflict.

It is safe to say that few authors of mental health–related books would introduce themselves by presenting these credentials:

A major general problem in the preparation of DSM5 is that the various Work Groups have been given far too little guidance and support. This explains why: 1)most of the criteria sets are written so obscurely and inconsistently; 2) the rationales for change vary so widely in depth and quality across Work Groups,and; 3) so many suggestions that should have no chance at all have made it this far without being tossed.

The recently posted draft of DSM5 makes a seemingly small suggestion that would profoundly impact how grief is handled by psychiatry. It would allow the diagnosis of Major Depression even if the person is grieving immediately after the loss of a loved one. Many people now considered to be experiencing a variation of normal grief would instead get a mental disorder label.

Due to decreasing revenue, the APA Assembly has been forced to reduce its budget by $200,000 and and many of the APA Components have been eliminated or significantly changed.

I had lunch with Death some 12 or so years ago, as a chief resident in psychiatry. He was a bit hard to converse with. In fact, the exact opposite of how he had been when presenting grand rounds just an hour before.

Our country is in the midst of a 15-year "epidemic" of Attention Deficit Disorder (ADD). There are 6 potential causes for the skyrocketting rates of ADD-- but only 5 have been real contributors. The most obvious explanation is by far the least likely -- that the prevalence of attention deficit problems in the general population has actually increased in the last 15 years. Human nature is remarkably constant and slow to change, while diagnostic fads come and go with great rapidity. We don't have more attention deficit than ever before. . . we just label more attentional problems as mental disorder.

There are a lot of temperamental Jerome Kagan moments in my friend’s household-an observation that will require this entire column to explain. What exactly is a temperamental moment? And who exactly is Jerome Kagan?

An overview of the characteristics of auditory hallucinations in people with psychiatric illness, and a brief review of treatment options.

Traumatic brain injury (TBI) affects approximately 2 of every 1000 persons per year. Persons vulnerable to mental illness (eg, persons with alcohol abuse or antisocial personality disorder) are particularly at risk.

Six months after the deadline for a final rule, 3 federal departments published an interim final rule that leaves a number of questions open about the application of the expanded mental health parity law passed by Congress in October 2008. But the penultimate version of the implementing regulations won mostly praise from psychiatrists and psychiatric hospitals.

Given the potential for a significant role in recognition of neurologically complex disorders, psychiatrists should become familiar with diagnostic criteria and appropriate therapeutic option.

Parkinson disease (PD) is the second most common neurodegenerative illness in the United States, affecting more than 1 million persons. Disease onset is usually after age 50. In persons older than 70 years, the prevalence is 1.5% to 2.5%.1 While the primary pathology involves degeneration of dopaminergic neurons in the substantia nigra, circuits important in emotion and cognition-such as the serotonergic, adrenergic, cholinergic, and frontal dopaminergic pathways-are also variably disrupted.

New Insights Into Diagnosis, Comorbidities, and Treatment Approaches

In response to increasing public distrust and congressional concerns regarding pharmaceutical company influence on medical research and education, professional organizations have taken steps to phase out or regulate industry-sponsored educational support. A related problem is industry funding of philanthropic organizations, such as patient advocacy groups. Thus, when the office of Sen Charles Grassley (R-Iowa) recently reported that the National Alliance for the Mentally Ill received substantial pharmaceutical funding, there was concern among the membership’s psychiatric patients and their families.

Writer Jonah Lehrer caused quite a stir with his recent article in the New York Times Magazine, with the unfortunate title, “Depression’s Upside.” I have a detailed rejoinder to this misleading article posted on the Psychcentral website.

On February 12, 2009, the US Court of Federal Claims issued a trio of long-awaited decisions in its Omnibus Autism Proceeding.1 The 3 were representative cases chosen from more than 5500 pending MMR/autism cases by the Plaintiffs’ Steering Committee. Each presented the theory that the measles-mumps-rubella (MMR) vaccine in combination with thimerosal, a mercury-based ingredient contained in some diphtheria-tetanus-pertussis (DTP), diphtheria-tetanus–acellular pertussis (DTaP), hepatitis B, and Haemophilus influenzae type B (Hib) vaccines, causes autism. In nearly 700 combined pages that reviewed the scientific and epidemiological evidence, all 3 opinions determined that the plaintiffs had not demonstrated a link between these vaccines and autism.

Your mother was right-fish is good for you.

I remember as a child gathering wild greens with my Cherokee grandmothers, 2 generations of them, and hearing the lilt of spoken Cherokee. I can still see myself listening quietly in the corner of the room while others came to visit my great-grandmother, a respected traditional healer. We were poor. There is no other way to say it. My mother carried water from a well in the middle of the field, and I remember before going outside to play in the snow that we wrapped bread sacks around our feet to keep them dry. But as a child, while life was hard and even harsh at times, it felt safe and constant.

Posted on February 3, I asked the question, CAUTION! Who Should Be the DSM5 Diagnostician? I suggested that we needed to pay as much attention to who would be designated as the diagnostician as on the revised diagnostic criteria.

The issues being debated here have important long-term implications for psychiatry, and we are pleased to present these revised versions of 2 principal presentations.

Arlington, VA, March 2 (compiled from AP reports)-Officials at the American Psychiatric Association (APA) confirmed today that their national headquarters had been taken over by “very, very large English and literature teachers,” according to a spokesperson for APA President, Dr Alan Schatzberg. Schatzberg himself was unavailable for comment and was reported to be in seclusion “…brushing up his Shakespeare.”

Small physician practices are less likely than big groups to have electronic medical records-and there’s a reason that goes beyond cost. They lack the resources and the technical knowledge to implement these complex systems. The support and training that vendors offer is frequently inadequate, especially for physicians who aren’t especially computer-savvy. And the vendors freely admit that they don’t have sufficient staff to cope with the expected influx of new EHR buyers who want to show meaningful use by 2011, when the government incentives start flowing.