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PsychiatryRounds Psychiatry News's Blog – April 2009 Archive (13)

Essential Tremor Increases Risk of Dementia

(PSYCHIATRIC TIMES) - Elderly persons with essential tremor (ET) are almost twice as likely to have dementia as those without ET, according to a new study from Elan Louis, MD, professor of neurology, and colleagues at Columbia University in New York. “There has been a sense that there are cognitive abnormalities in essential tremor, and patients frequently complain of memory problems, but the question is whether we are looking at something greater, namely dementia,” he said.

Mild… Continue

Added by psychiatryRounds Psychiatry News on April 29, 2009 at 3:00am — No Comments

Large Mayo Clinic Study Finds Sleep Disorders Common in the Elderly

(PSYCHIATRIC TIMES) - Sleep disorders are common in persons older than 70 years, according to a large community-based study of age-related diseases and cognitive functioning.¹ The most common disorder, sleep-related leg cramps, occurred in 32% of the study participants, according to investigator Jennifer Molano, MD, a behavioral neurology fellow at the Mayo Clinic in Rochester, Minnesota.

Of 892 people aged 70 to 89 assessed for sleep disturbances as part of the Mayo Clinic’s Study… Continue

Added by psychiatryRounds Psychiatry News on April 29, 2009 at 1:00am — No Comments

From Chaos to Consilience

(PSYCHIATRIC TIMES) - Chaos—definition [from]: A state of extreme disorder or confusion.

Consilience—definition [from Wikipedia]: Literally a jumping together of knowledge by the linking of facts and fact-based theory across disciplines to create a common groundwork for explanation.

Lecturing around the country has left us with the powerful impression that both psychiatrists and primary care physicians are hungry for new ways to think about and treat… Continue

Added by psychiatryRounds Psychiatry News on April 24, 2009 at 9:30pm — No Comments

Depression Responds to Collaborative Care

(PSYCHIATRIC TIMES) - Persons with chronic pain who participated in a collaborative care program with primary care physicians and psychologists showed improvement in depression, pain severity, and pain-related disability compared with those who received treatment by primary care physicians only, according to a study published in the March 25 issue of the Journal of the American Medical Association.

Steven K. Dobscha, MD, of the Portland Veterans Affairs Medical Center, Ore, and… Continue

Added by psychiatryRounds Psychiatry News on April 16, 2009 at 9:30pm — No Comments

Cormorbidity: Diagnosing Comorbid Psychiatric Conditions

(PSYCHIATRIC TIMES) - Autism spectrum disorders (ASDs) are a group of 5 neuro developmental conditions (autism, Asperger syndrome, pervasive developmental disorder not otherwise specified [PDD-NOS], Rett syndrome, and disintegrative childhood disorder).1 Once thought to be rare, the incidence of these disorders is now estimated to be 1 in 150 children in the general population.2 Furthermore, the number of recognized cases has increased markedly in recent years.

Many factors have… Continue

Added by psychiatryRounds Psychiatry News on April 16, 2009 at 3:30am — No Comments

Comorbidity: Psychiatric Comorbidity in Persons With Dementia

(PSYCHIATRIC TIMES) - The assessment and treatment of psychiatric symptoms in persons with cognitive dysfunction are becoming increasingly important. Prevalence estimates of dementia in the United States range from 5% in those aged 71 to 79 years to 25% to 50% in those 90 or older. Up to 90% of patients with dementia have psychiatric comorbidities.1,2

Physicians who treat patients with dementia must remember that dementia is not merely a problem with memory. The presence of one or… Continue

Added by psychiatryRounds Psychiatry News on April 16, 2009 at 3:00am — No Comments

Comorbidity: Schizophrenia With Obsessive-Compulsive Disorder

(PSYCHIATRIC TIMES) - The co-occurrence of obsessive-compulsive symptoms (OCS) and psychotic illness has been a challenge for clinicians and investigators for more than a century.1 Over the past decade, interest in this area has burgeoned because of recognition of higher-than-chance comorbidity rates of schizophrenia and obsessive-compulsive disorder (OCD), and observations of appearance or exacerbation of OCS during treatment of schizophrenia with atypical antipsychotics.2-6 Emerging… Continue

Added by psychiatryRounds Psychiatry News on April 15, 2009 at 5:00am — No Comments

Antipsychotic Combination Strategies in Bipolar Disorder:

Optimal management of bipolar disorder (BD) includes the careful selection and regular ingestion of appropriate medication to stabilize mood. Unfortunately, between 40% and 50% of patients with BD in routine clinical settings take breaks or forget to take their medication or even discontinue the drug altogether.1-3 Treatment nonadherence is associated with mood relapse, hospitalization, and suicide.4,5

Adequate adherence can be defined as the taking of the minimum amount of… Continue

Added by psychiatryRounds Psychiatry News on April 14, 2009 at 3:00am — No Comments

What Should Count as a Mental Disorder in DSM-V?

(PSYCHIATRIC TIMES) - What exactly is a “mental disorder”? For that matter, what criteria should determine whether any condition is a “disease” or a “disorder”? Is “disease” something like an oak tree—a physical object you can bump into or put your arms around? Or are terms like “disease” and “disorder” merely abstract, value-laden constructs, akin to “injustice” and “immorality”? Are categories of disease and disorder fundamentally different in psychiatry than in other medical specialties?… Continue

Added by psychiatryRounds Psychiatry News on April 14, 2009 at 3:00am — No Comments

FDA Approves Pioneering Treatment for Obsessive- Compulsive Disorder

(PSYCHIATRIC TIMES) - Psychiatrists will have to take the lead in ensuring that deep-brain stimulation (DBS)—approved by the FDA in February for the first time for use in obsessive-compulsive disorder (OCD)—is used appropriately.

Medtronic Inc’s Reclaim DBS therapy was approved under a humanitarian device exemption, which means that the system will be used on a relatively small number of adults (no more than 4000 and probably considerably fewer) with recalcitrant OCD.

The… Continue

Added by psychiatryRounds Psychiatry News on April 8, 2009 at 9:00pm — No Comments

When to Avoid Antidepressants in Bipolar Patients

(PSYCHIATRIC TIMES) - Patients with bipolar depression who exhibit even minimal manic symptoms are at heightened risk for switching into mania if they receive antidepressant medication, according to a new report from the Bipolar Collaborative Network.1

This finding from the multinational sites of the former Stanley Foundation Bipolar Network emerged in a post hoc analysis of 176 patients who participated in a 10-week controlled trial of adjunctive antidepressant medication for… Continue

Added by psychiatryRounds Psychiatry News on April 8, 2009 at 3:00am — No Comments

Volumetric MRI produces early warning on Alzheimer's disease EXAM CAN EVALUATE MILD COGNITIVE IMPAIRMENT, EARLY-STAGE DISEASE

(PSYCHIATRIC TIMES) – MRI measures of regional brain atrophy, taken at the University of California, San Diego, have established the basis for a new way to diagnose Alzheimer's disease.

Radiology professors Andres Dale, Ph.D., and Dr. Carl Hoh, neurologist Dr. James Brewer, and radiology resident Dr. David Karow saw that volumetric MRI potentially fulfilled the need for a less expensive and less invasive test for early diagnosis of the disease and for drug research and… Continue

Added by psychiatryRounds Psychiatry News on April 1, 2009 at 8:30pm — No Comments

Anxiety Disorders: Guidelines for Effective Primary Care, Part 2, Treatment

(PSYCHIATRIC TIMES) - Most uncomplicated anxiety disorders can be treated in the primary care setting. Following the initial treatment, patients require ongoing care, which combines psychosocial and psychopharmacological therapies. Treatment of anxiety disorders can lead to improved interpersonal, social, and vocational functioning.

In the second part of this 2-part series, I describe the various treatments, with emphasis on those that are typically used in the primary care setting.… Continue

Added by psychiatryRounds Psychiatry News on April 1, 2009 at 3:00am — No Comments

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