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PsychiatryRounds Psychiatry News's Blog – December 2006 Archive (29)

Depression in the Elderly: Could You Be Missing the Signs?

(PSYCHIATRIC TIMES) - Q:What is the best screening tool for assessing depression in elderly patients?



AThe Geriatric Depression Scale is the most widely validated screening tool. The questionnaire has been reduced to a single question that is as sensitive and as specific as the 15-item shortened form of the original 30-item scale. The question is: “How often do you feel sad or depressed?” This is certainly something that is easy to ask in the course of a general physical examination… Continue

Added by psychiatryRounds Psychiatry News on December 31, 2006 at 11:00pm — No Comments

ALZHEIMER’S DISEASE: A PHYSICIAN’S GUIDE TO PRACTICAL MANAGEMENT

(PSYCHIATRIC TIMES) - Richter RW, Richter BZ (eds) Totowa, NJ, Humana Press, 2004, 494 pages, $99.50 hardcover Ronald Reagan’s decade-long struggle with Alzheimer’s disease (AD)—which sadly ended this past June—did much to raise national awareness of this devastating illness. Despite increased awareness, AD remains underdiagnosed and undertreated. The aim of this comprehensive yet comprehensible text is to help clinicians provide optimal care for patients with AD and support for their… Continue

Added by psychiatryRounds Psychiatry News on December 31, 2006 at 11:00pm — No Comments

Behavioral Symptoms in Alzheimer Dementia: A Guide to Evaluation and Management

(PSYCHIATRIC TIMES) - The patient is a retired executive who resides at home with his wife; his daughter lives next door. Until now, the family had been able to provide the support and supervision necessary to allow the patient to remain at home. He has had brief periods of behavioral problems but these were self-limited. Recently, he has begun to demonstrate increased agitation and aggressive behavior. His relationship with his wife was described as "verbally volatile." In the past 2 to 4… Continue

Added by psychiatryRounds Psychiatry News on December 31, 2006 at 11:00pm — No Comments

Strategies to Lower the Risk of Stroke-Related Dementia

(PSYCHIATRIC TIMES) - What is the risk of dementia in patients who have had an ischemic stroke? And which therapies are most effective in reducing this risk? —— MD Population-based epidemiologic studies show that the risk of dementia is 4 to 6 times higher in patients who have had a stroke than in those who have not.1 In hospitalized cohorts, dementia develops in a quarter to a third of patients 3 months after a stroke,2 and up to 60% have impairment in at least 1 cognitive domain. Compared… Continue

Added by psychiatryRounds Psychiatry News on December 31, 2006 at 11:00pm — No Comments

“Old-Time” Doc Image Makes for Easier Elder Exams

(PSYCHIATRIC TIMES) - Elderly patients with Alzheimer disease or dementia frequently refuse to be examined or have a physical. Try approaching such patients with a smile and the “classic” physician’s white coat with all the trappings—including a stethoscope.

For full article, please visit:
http://www.psychiatrictimes.com/alzheimer-dementia/article/10162/38509

Added by psychiatryRounds Psychiatry News on December 31, 2006 at 11:00pm — No Comments

Primary Care Practitioners and Psychotherapy: Time to Talk

(PSYCHIATRIC TIMES) - As someone who has been involved in health care education for 40 years and who was a counselor in a private mental health practice for 24 years, I appreciated Dr Joseph Lieberman’s article on the role of the primary care physician (PCP) in the treatment of mental illness (CONSULTANT supplement, April 15, 2003, page 24). Psychology and nutrition have historically been something of a veneer on the overall education of both physicians and physician assistants. Dr Lieberman is… Continue

Added by psychiatryRounds Psychiatry News on December 31, 2006 at 10:00pm — No Comments

Is a Rare Cognitive Side Effect Worth Keeping in Mind?

(PSYCHIATRIC TIMES) - I have read that mental confusion and paranoia may be potential side effects of certain angiotensin-converting enzyme (ACE) inhibitors. What is the likely mechanism of these effects?

— Robert Graham, DO, MPH

Mount Pleasant, Mich For the last few decades, ACE inhibitors have been commonly used to treat hypertension and congestive heart failure. These agents were originally isolated from peptides in snake venom. The first member of the class, captopril, became… Continue

Added by psychiatryRounds Psychiatry News on December 31, 2006 at 9:00pm — No Comments

Clinical Handbook of Insomnia

(PSYCHIATRIC TIMES) - Totowa, NJ, Humana Press, 2004, 191 pages, $89.50 hardcover More than one third of American adults experience persistent insomnia, the second most common complaint—after pain—in the primary care setting. However, insomnia has often been ignored, trivialized, or summarily (often erroneously) attributed to underlying or preexisting psychological problems. This handbook is the first clinically oriented text dedicated to the evaluation and treatment of insomnia.



For… Continue

Added by psychiatryRounds Psychiatry News on December 31, 2006 at 6:00am — No Comments

Identifying Bulimia and Other Eating Disorders: Recommendations From the AAP

(PSYCHIATRIC TIMES) - Eating disorders among adolescents and children are a growing problem in the United States; the number of cases has steadily increased over the last 50 years. Up to 5% of female adolescents have bulimia nervosa, and an estimated 0.5% have anorexia nervosa.1 To better identify eating disorders, the American Academy of Pediatrics advocates the routine use of screening questions for all preteen and adolescent patients (Table).



For full article, please… Continue

Added by psychiatryRounds Psychiatry News on December 31, 2006 at 4:00am — No Comments

Woman With Jaundice,Anorexia, and Abdominal Pain

(PSYCHIATRIC TIMES) - A 52-year-old woman is hospitalized because she has had jaundice, anorexia, and occasional nausea and vomiting for about 2 weeks. She has also had moderate pain in the epigastrium and right upper quadrant, but it has not been severe enough to require analgesics. She denies hematemesis and hematochezia. HISTORY

Until now, the patient has been healthy; she takes no medications. However, she drinks about half a bottle of whiskey per day and likely consumes more on… Continue

Added by psychiatryRounds Psychiatry News on December 31, 2006 at 4:00am — No Comments

Young Woman With Cardiac Complications of Anorexia Nervosa

(PSYCHIATRIC TIMES) - A 23-year-old woman has had 2 episodes of syncope during the past month. Her mother witnessed 1 episode in which the patient collapsed and lost consciousness for a few minutes. She experienced tonic-clonic seizure activity but no subsequent confusion. Her mother is also concerned about her daughter's amenorrhea and obsessive preoccupation with weight and appearance. The mother reports purging behavior, which the patient denies. On further questioning, the patient states… Continue

Added by psychiatryRounds Psychiatry News on December 31, 2006 at 4:00am — No Comments

Invega (paliperidone), Son of Risperdal (risperidone), Wins FDA Okay for Schizophrenia

(PSYCHIATRIC TIMES) - MedPage Today Action Points



ROCKVILLE, Md., Dec. 20 -- The FDA today approved Invega (paliperidone) for treatment of acute schizophrenia.



Although the drug contains an active substance never before approved by the FDA, that substance is an active metabolite of an old drug, the atypical antipsychotic Risperdal (risperidone), which is marketed for treating schizophrenia.



The effectiveness of Invega in the acute treatment of schizophrenia was… Continue

Added by psychiatryRounds Psychiatry News on December 20, 2006 at 11:00pm — No Comments

Changes in Gray Matter Density Signal Schizophrenia Risk

(PSYCHIATRIC TIMES) - MedPage Today Action Points



o Understand that this study suggests that reduction over time in the density of gray matter in the inferior temporal gyrus signals a high likelihood that a person with a family history of schizophrenia will go on to develop the disease.



EDINBURGH, Scotland, Dec. 7 -- For a person at high risk for schizophrenia, a reduction in gray matter in the temporal lobes over time suggests a high likelihood that psychosis will… Continue

Added by psychiatryRounds Psychiatry News on December 7, 2006 at 11:00pm — No Comments

Changes in Gray Matter Density Signal Schizophrenia Risk

(PSYCHIATRIC TIMES) - EDINBURGH, Scotland, Dec. 7 -- For a person at high risk for schizophrenia, a reduction in gray matter in the temporal lobes over time suggests a high likelihood that psychosis will develop, reported investigators here.



In a study of 65 young men and women with a family history of schizophrenia, those with changes over time in the inferior temporal gyrus had a 10-fold greater risk for developing schizophrenia than the cohort as a whole, reported Dominic E. Job,… Continue

Added by psychiatryRounds Psychiatry News on December 7, 2006 at 11:00pm — No Comments

There Is Accounting for Taste in Treatment of Depression

(PSYCHIATRIC TIMES) - MedPage Today Action Points



o Explain to patients who ask that depression, anxiety, and other mental and physical disorders can alter taste perception. This study suggests that the neurotransmitters serotonin and norepinephrine, levels of which are targeted by newer antidepressants, may be involved in taste alteration.



BRISTOL, England, Dec. 6 -- For newly diagnosed depression patients, there may be a tell-tale taste test for selecting the right… Continue

Added by psychiatryRounds Psychiatry News on December 6, 2006 at 11:00pm — No Comments

There Is Accounting for Taste in Treatment of Depression

(PSYCHIATRIC TIMES) - BRISTOL, England, Dec. 6 -- For newly diagnosed depression patients, there may be a tell-tale taste test for selecting the right antidepressant.



On the basis of their finding that serotonin and norepinephrine can alter taste thresholds, investigators here think they may have found a tasteful way to choosing the antidepressant that fits the patient.



In a study of 20 healthy adult volunteers, those who were exposed to the selective serotonin reuptake… Continue

Added by psychiatryRounds Psychiatry News on December 6, 2006 at 11:00pm — No Comments

ACNP: Hypertension Drugs May Block Alzheimer's

(PSYCHIATRIC TIMES) - MedPage Today Action Points



o Note that this study, in cell cultures and in experimental mice, suggests that some anti-hypertensive medications may reduce the risk of Alzheimer's disease in mice, even at relatively low doses.



o This report is based on an abstract presented at a meeting. These data and conclusions should be considered preliminary as they have not yet been reviewed and published in a peer-reviewed publication.



HOLLYWOOD,… Continue

Added by psychiatryRounds Psychiatry News on December 6, 2006 at 11:00pm — No Comments

ACNP: Hypertension Drugs May Block Alzheimer's

(PSYCHIATRIC TIMES) - HOLLYWOOD, Fla., Dec. 6 -- Without any fanfare or intention, the use of some drugs for high blood pressure may be silently protecting against Alzheimer's disease, suggest in vitro and animal studies presented here today.



"Conceptually, our studies suggest that people on treatment for hypertension might get a beneficial effect on beta-amyloid (accumulation in the brain)," according to Gulio Maria Pasinetti, M.D., Ph.D., of the Mount Sinai in New York. He reported… Continue

Added by psychiatryRounds Psychiatry News on December 6, 2006 at 11:00pm — No Comments

Smaller Brain Structures in Autism Linked to Social Deficits

(PSYCHIATRIC TIMES) - MADISON, Wis., Dec. 5 -- Severe social deficits in males with autism has been traced by investigators here to shrinkage of the amygdala, the component of the limbic system that governs non-verbal responses to threats.



In a small study of eye-tracking and facial recognition in teens and young men with autism, those who were slowest at distinguishing emotional expressions had amygdalae that were smaller than normal in volume, reported Richard J. Davidson. Ph.D.,… Continue

Added by psychiatryRounds Psychiatry News on December 5, 2006 at 3:30am — No Comments

Employer-Sponsored Depression Screening Seen as Saving

(PSYCHIATRIC TIMES) - MedPage Today Action Points



o Explain to patients who ask that this study using a computer model suggests that an employer-based program that includes a one-time depression screening coupled with telephone counseling and other services can benefit both employees and the companies they work for.



BETHESDA, Md., Dec. 4 -- Employers including depression screening with care management as a benefit could help improve workers' lives and the company's bottom… Continue

Added by psychiatryRounds Psychiatry News on December 4, 2006 at 11:00pm — No Comments

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