Addiction & Substance Use

Were you unable to attend the annual meeting of the American Psychiatric Association in May? Read the first part in a series of summaries of important new research presented there.

When treating alcohol-dependent patients, clinicians may be well advised to integrate disulfiram into the treatment plan. Who are good candidates, and who are not? How can you enlist the aid of family members and friends to ensure compliance?

With an increasing number of drugs in the pipeline, the efficacy and safety of drug trials become even more important. Who are the various entities sponsoring these trials, and what are their goals?

On May 3, U.S. Surgeon General David Satcher, M.D., launched a national plan to reduce the suicide rate in the United States. A collaborative effort by the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, the National Institutes of Health, and the Health Resources and Services Administration, the National Strategy for Suicide Prevention maps out 11 goals and provides a blueprint for action on those goals.

There are three types of integration practiced by psychotherapists: Common Factors, Assimilative Integration and Theoretical Integration. How do they differ from each other, and how does psychotherapy integration differ from an eclectic approach to therapy?

Can brain scans show a difference between drug therapy and psychotherapy? A researcher at University of California at Los Angeles uses positron emission tomography to observe the difference in brain changes between these two types of treatment for major depression.

Since adolescent patients often retreat into fantasy worlds of their own making, they can be difficult to treat. Psychotherapists can create a common fantasy world for successful group therapy with the use of popular fiction books, television series and movies.

After the recent decade of the brain and in the present era of evidence-based practice, psychoanalytic treatment of personality disorder is being challenged.

Carveout programs for behavioral health care are becoming more common. Who do they benefit3/4the patient, the doctor or the insurance company?

Stemming from evolutionary man and his simple, primitive act of help in exchange for help and Darwinian theory, Paul Genova, M.D., discusses the role reciprocal altruism plays in the "helping profession" of psychiatry.

Nonverbal cues speak just as loudly as words. How can video be used to capture these subtle cues and help patients make progress in therapy?

There are two goals in the acute treatment setting (e.g., emergency department): initiation of treatment and reducing the symptoms of agitation and aggression that frequently accompany an acute psychotic breakdown. Treatment options and considerations are reviewed.

The FDA approved two new intramuscular, immediate-release formulations of atypical antipsychotics. Both olanzapine (Zyprexa IM) and ziprasidone (Geodon IM) were recommended as safe and effective for the treatment of agitation in patients with schizophrenia.

A groundbreaking program at UCLA goes into inner-city schools to help students work through trauma. By learning how to deal with the trauma itself and reminders of the trauma, students are able to improve their academic and social performance.

Psychiatrists can play a vital role in determining whether or not a patient will be a good candidate for an organ transplant. Using a case vignette, Dr. Garton explains how she helps a transplant team make the best possible decision.

(Additional information regarding violence and trauma can be found in the Special Report section of the April 2001 issue of Psychiatric Times-Ed.)

The author examines how temperature and length of day can affect mood and behavior, both in a general population and a group of inpatients. In both groups, there were two peaks of violent behavior, one in May-June and one in October-November, which correspond with the equinoxes. Is it possible to track violent behavior in various geographical areas depending upon weather and length of day?

In this overview of research into the biopsychosocial changes caused by traumatic events, Dr. Novac discusses psychopathology, brain development and the effect a traumatic event can have on the victim's family-even long after the event occurred.

"Stalking" is defined as repeated and persistent unwanted communications and/or approaches that produce fear in the victim. The stalker may use such means as telephone calls, letters, e-mail, graffiti and placing notices in the media. A stalker may approach or follow the victim, or keep their residence under surveillance.

Most studies have found clear gender differences in the prevalence of depressive disorders. Typically, studies report that women have a prevalence rate for depression up to twice that of men (Bebbington, 1996; Nolen-Hoeksema, 1987).

California's recent passage of Proposition 36 mandates treatment instead of incarceration for illegal drug offenses. Proponents believe the measure will save the state millions of dollars in the long run and will be more effective in curbing drug abuse than the war on drugs. Critics argue it is hamstrung, cannot achieve its goals and will only negatively impact successful drug court programs.

The National Alliance for Research in Schizophrenia and Depression awarded the 2000 Nola Maddox Falcone Prize. A brief description of each recipient's contributions to research with affective disorders is given.

Men's Reactions to Female Sexual Coercion

APA Annual Meeting Highlights New Research

With more and more Americans engaging in gambling activities, odds are high that psychiatrists may see patients who have some sort of gambling problem. What can be done about this problem, and how can these patients best be treated?

Smoking is not only a comorbid condition for schizophrenia; it may also have an effect on other psychiatric conditions.

America's policy regarding illegal drugs has been accused of being a failure and being racially biased against blacks and other minorities. The author asserts that while drugs and crime exist in all parts of the society, problem-generating drug use and serious crime are indeed concentrated among the urban poor, some of whom are black. He further explores what this disproportionate drug-related suffering means when it comes to the provision of addiction treatment, law enforcement resources and other responses to the problems spawned by addiction.

This article presents addictive behavior as a chronic illness rather than an acute illness. Studies of characteristics and treatment of addiction, similar to that of other chronic illnesses, are discussed.

Results from the 1999 National Household Survey on Drug Abuse show significant increases in rates of prescription drug abuse. Other surveys show similar findings. An overview of the most commonly abused drugs and suggestions for preventing abuse are reviewed.

Although comprehensive theories of addiction recognize the etiological importance of environmental and cognitive factors, it has been widely accepted for many years that addiction is also a brain disease and that individuals differ in their susceptibility to this condition.