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July 2006 News and Blog Posts (38)

Obesity Linked to Depression, or Vice Versa

(PSYCHIATRIC TIMES) - SEATTLE, July 5 - Depression and obesity are often partners in pathology, according to investigators here.



Obese persons have a 20% elevated risk of depression compared with those of normal weight, reported Gregory E. Simon, M.D., M.P.H., of the Group Health Cooperative here, and colleagues in the July issue of Archives of General Psychiatry.



For white, college-educated obese individuals, the additional depression risk reaches as high 44%, said… Continue

Added by psychiatryRounds Psychiatry News on July 5, 2006 at 1:30am — No Comments

News Brief: Continuous Psychosis Not Common in Long-Term Schizophrenia Study

(PSYCHIATRIC TIMES) - In a 20-year longitudinal study, it was found that after acute hospitalization, continuous psychosis was diagnosed in only 30% of patients with schizophrenia; 20% of patients showed no signs of reoccurrence of psychosis after the acute phase. The study, presented by Martin Harrow, PhD, Thomas Jobe, MD, and Linda Grossman, PhD, of the University of Illinois in Chicago, observed a group of 187 patients, following up with them 7 times over the 20-year period using… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 11:00pm — No Comments

Pharmacology of Personality Disorders

(PSYCHIATRIC TIMES) - If psychopharmacology sometimes feels like walking a fine line between undertreatment and overtreatment or between letting patients suffer and turning to medications as an "easy fix," then the psychopharmacology of personality disorders can feel like walking a tightrope without a net.



Unfortunately, the published literature is helpful only up to a point. There are not many peer-reviewed randomized controlled trials, given the prevalence and debilitating nature… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 9:00pm — No Comments

Understanding the Usefulness of Psychosocial Interventions for Personality Disorders

(PSYCHIATRIC TIMES) - Recent research has supported the use of psychosocial interventions for persons with various personality disorders. However, few empirically supported therapies (ie, treatments that outperform control conditions in at least 2 randomized controlled trials by independent research groups1) currently exist.



This article examines recent research on psychosocial treatments for persons with personality disorders, particularly focusing on randomized controlled trials… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 9:00pm — No Comments

Exploring the Link Between Conduct Disorder in Adolescence and Personality Disorders in Adulthood

(PSYCHIATRIC TIMES) - Substantial progress has been made in the last several decades in research providing evidence for the relationship between mental disorders in childhood and adulthood.1-4 As a consequence, child psychiatrists today have much better data on the longterm outcomes of childhood disorders, while adult psychiatrists now pay much greater attention to the developmental origins of the conditions they treat. A number of possible psychopathologic mediation mechanisms are currently… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 9:00pm — No Comments

Family Involvement in Cognitive-Behavioral Therapy for Children’s Anxiety Disorders

(PSYCHIATRIC TIMES) - Cognitive-behavioral therapy (CBT) for children with anxiety disorders may be especially effective when the family is included in treatment.1-3 Family CBT (FCBT) has consistently yielded a high proportion of treatment responders (more than 70%) and in some studies has outperformed CBT programs with little family involvement.3 This article presents the rationale supporting FCBT, provides a case study illustrating FCBT techniques, and summarizes the findings of a recent… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 6:00am — No Comments

Asthma and COPD Complicated by Anxiety and Depression: Implications for Care

(PSYCHIATRIC TIMES) - Be alert for signs of anxiety and depression in patients with asthma and chronic obstructive pulmonary disease (COPD). A number of studies have found an increased prevalence of these psychological disorders in patients with chronic respiratory diseases. Although the relationship is not completely understood, it is clear that anxiety and depression can adversely affect the course of asthma and COPD. Highlighted here are some of the findings recently reported in the… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 5:30am — No Comments

Managing Suicidality in Patients With Borderline Personality Disorder

(PSYCHIATRIC TIMES) - Suicidality is a defining feature of borderline personality disorder (BPD). It is also the feature that creates the most anxiety among those who treat patients with this disorder. It is rare to find patients with BPD who have never shown any suicidal behavior. As described in criterion 5 in DSM-IV-TR,1 these patients are characterized by "recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior." Suicidal ideas and threats are ubiquitous, and most… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 4:30am — No Comments

Psychodynamic Treatments

(PSYCHIATRIC TIMES) - Personality disorders are characterized by pervasive and stable patterns of cognition, affect regulation, impulse control, and interpersonal functioning that are maladaptive and inflexible. The majority of patients who present for treatment of personality disorders fall in the "cluster B" group. In particular, patients with borderline personality disorder (BPD), as well as patients with borderline personality features in conjunction with other pathologic character traits,… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 4:30am — No Comments

Avoidant Personality Disorder: Boundaries of a Diagnosis

(PSYCHIATRIC TIMES) - Avoidant personality disorder (APD) is characterized by a general tendency to fear and avoid social interactions—even interactions with persons who are well known to the individual. In addition to deserving our clinical and research attention in its own right, APD highlights some of the key controversies with our current classification system. These debates include the "horizontal" boundaries between different Axis I and Axis II conditions as well as the "vertical"… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 4:30am — No Comments

Bipolar Disorder: Particle or Wave? DSM Categories or Spectrum Dimensions?

(PSYCHIATRIC TIMES) - Psychiatric diagnosis is currently based on a system of categories, much like the Linnaean classification in biology. However, a seemingly opposite diagnostic system is emerging, usually dubbed the “dimensional view,” in which related psychiatric conditions such as major depressive disorder (MDD) and bipolar disorder (BD) are seen as end points of a spectrum.



With this expansion of the concept of BD to include intermediate forms (ie, manifestations between… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 4:30am — No Comments

Bipolar Disorder: Particle or Wave? DSM Categories or Spectrum Dimensions?

(PSYCHIATRIC TIMES) - Psychiatric diagnosis is currently based on a system of categories, much like the Linnaean classification in biology. However, a seemingly opposite diagnostic system is emerging, usually dubbed the “dimensional view,” in which related psychiatric conditions such as major depressive disorder (MDD) and bipolar disorder (BD) are seen as end points of a spectrum.



With this expansion of the concept of BD to include intermediate forms (ie, manifestations between… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 4:30am — No Comments

Mood Stabilizers and Novel Antipsychotics in the Treatment of Borderline Personality Disorder

(PSYCHIATRIC TIMES) - Borderline personality disorder (BPD) is characterized by a pervasive pattern of instability of interpersonal relationships, self-image, and affect, in addition to marked impulsivity.1 Although psychotherapy plays a significant role in the treatment of borderline patients by focusing on maladaptive personality traits and patterns of interpersonal relationships, 2,3 pharmacotherapy is indicated by the American Psychiatric Association guidelines to manage vulnerability… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 4:30am — No Comments

Photoclinic: Fragile X Syndrome

(PSYCHIATRIC TIMES) - During a routine physical examination, a 3-year-old boy was noted to have speech delay and hyperactive behavior. The child was born at term to a 25-year-old mother with epilepsy, which was managed with phenytoin. His birth weight was 3.5 kg (7.8 lb); he had no neonatal problems or features of fetal Dilantin syndrome. However, he had undergone bilateral hydrocele and inguinal hernia repair and tube placement for recurrent ear infections. His half sister (from his mother's… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 3:30am — No Comments

More Treatments Needed for Childhood Depression Karen Dineen Wagner, MD, PhD

(PSYCHIATRIC TIMES) - Concern has been raised recently about the efficacy and safety of antidepressants for treatment of depression in children. Some clinicians, therefore, have suggested that psychotherapy be started before medication treatment of depression in children. How effective is psychotherapy for the treatment of depression in children and adolescents?



Weisz and associates1 recently conducted a meta-analysis to assess the effects of psychotherapy for the treatment of… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 1:30am — No Comments

Children Improve as Mothers’ Depression Remits

(PSYCHIATRIC TIMES) - The conventional wisdom that a child benefits from improvement in the mother’s mental health has been confirmed and quantified in a prospective evaluation of the relationship between a child’s clinical state and remission of the mother’s depression.



The maternal-child investigation reported in the Journal of the American Medical Association by Myrna Weissman, PhD, and colleagues is an ancillary study of the NIMH-sponsored STAR*D (Sequenced Treatment Alternatives… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 1:30am — No Comments

Brain Metabolic Correlates of Depression and Recovery

(PSYCHIATRIC TIMES) - Depression is increasingly considered to have a biologic basis. The effectiveness of antidepressant medication suggested this decades ago, but now neuroimaging, neuropathology, and neurochemical studies can delineate brain pathology. The hippocampus (a bilateral subcortical temporal lobe structure) is one area of the brain where patients with major depression may experience loss of volume if their depression is prolonged and untreated. Antidepressant medication seems to… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 1:30am — No Comments

The Risk of Cerebrovascular Problems in Patients With Dementia Treated With Atypical Antipsychotics

(PSYCHIATRIC TIMES) - Educational Objectives:



After reading this article, you will be familiar with:



* Concerns associated with the use of antipsychotics in patients with dementia

* Amount of risk for cerebrovascular adverse events (CVAEs) associated with various antipsychotics

* Mechanisms that may be involved in increasing the risk of CVAEs in patients with dementia



Who will benefit from reading this article?



Psychiatrists, primary care… Continue

Added by psychiatryRounds Psychiatry News on July 1, 2006 at 1:30am — No Comments

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