Patients with a serious mental illness (SMI), such as schizophrenia or bipolar disorder, may underreport co-occurring medical conditions. Dr Amy Kilbourne and colleagues performed a cross-sectional analysis of 35,857 patients from the Department of Veterans Affairs (VA) National Registry to determine whether SMI patients were less likely to report a co-occurring medical condition. Results were published in the August 2006 issue of The Journal of Nervous and Mental Disease.
The Centers for Medicare and Medicaid Services (CMS) wants to again cut its payment to hospitals and community mental health centers (CMHCs) for outpatient psychiatric care in 2007. The benefit on which the CMS is focusing is called partial hospitalization; it is paid to a facility for treatment of a patient recovering from an acute psychiatric episode. Physicians must certify that in the absence of treatment in the partial hospitalization program (PHP), a patient would require inpatient psychiatric care. Typically, patients in a PHP spend 4 to 8 hours a day, 4 days a week, receiving intensive outpatient psychiatric care.
A 50% improvement in function was seen in patients treated with botulinum toxin type A (BTX-A, Botox) for the reduction of spasticity in the wrist, finger, or arm after stroke.
Predicting extent of neurologic recovery is crucial. The most accurate and standardized method is clinical neurologic examination using the International Standards for Neurological Classification of Spinal Cord Injury.
On March 13 at this year's meeting of the American College of Cardiology (ACC) in Atlanta, investigators from the United Kingdom unveiled the results of the Migraine Intervention with STARflex Technology (MIST) trial. The MIST trial is the first controlled study to examine the effect of patent foramen ovale (PFO) closure on migraine headache.
Characterized by a triad of symptoms including inflammation, demyelination, and gliosis, multiple sclerosis (MS) affects approximately 1.1 million persons worldwide.1 The disorder is accompanied by neurologic symptoms that include disturbances of sensation, coordination, and vision along with changes in sexual function, bladder and bowel function, gait, and endurance.
To evaluate the degree to which newer antipsychotic agents are implicated in parkinsonism and whether drug-induced parkinsonism (DIP) is being adequately recognized, Christine D. Esper, MD, clinical instructor in neurology, and Stewart A. Factor, DO, professor of neurology at Emory University in Atlanta, performed a retrospective review of 354 consecutive patients in whom parkinsonian symptoms were newly diagnosed at a movement disorders clinic in 2004-2005
Because we are an open-access journal, anyone performing a Web search can stumble upon articles that have appeared in Applied Neurology. Thus, we've begun to receive provocative letters from persons who have sought treatment for Lyme disease.
They can't reproduce, but mature neurons can grow. Indeed, for more than a century, neurologists have been able to restore at least partial function to severed peripheral nerve networks through neuronal transplantation. But the CNS has proved more recalcitrant: there, scar tissue and a complex molecular brew stymie the efforts of damaged axons to sprout new fibers and restore old connections.
Lack of adherence to therapeutic regimens for Parkinson disease (PD) is a serious problem that not only greatly impacts health care utilization resources but also throws a monkey wrench in clinicians' attempts to ameliorate disease progression and maintain patients' function and quality of life (QOL).
MTV isn't just broadcasting music videos and reruns of The Real World anymore. In November, its sister network aimed at college campuses-mtvU-began a new campaign called "Half of Us," which provides information and support to students attending colleges across the country.
The study found that both young men and young women with psychiatric disorders were at greatest risk for being involved in abusive relationships. In addition, after controlling for a history of disorder at age 18 and for lifetime conduct disorder, findings from the study imply a connection between being in a clinically abusive relationship (defined as resulting in injury and/or official intervention) and a woman's risk at age 26 of major depressive episodes, marijuana dependence, and posttraumatic stress disorder.
Progesterone may reduce the risk of disability and death in persons who have sustained moderate traumatic brain injury (TBI). The first double-blind placebo-controlled safety trial of the agent in humans showed that progesterone was safe, being associated with no more adverse effects than placebo.
ultrasonography,brain damage
The need for effective management of SCI-related pain may be apparent, but it's far less clear which of a multitude of therapeutic options if any will ultimately provide pain relief in a patient with SCI.
Nontraumatic headaches are challenging for general practitioners (GPs) and emergency department (ED) physicians to diagnose. Studies have shown that migraine headaches in these settings are often misdiagnosed and that patients do not receive proper treatment.
More than 1 in 20 adults nationwide suffer from compulsive buying, according to a telephone survey of 2500 adults. And contrary to popular opinion, “compulsive buying appears to be almost as common in men as in women,” according to Lorrin M. Koran, MD, first author of a recently published prevalence study of compulsive buying behavior in the United States. Six percent of women and 5.5% of men in the study reported symptoms considered to be consistent with compulsive buying disorder.
Cultural psychiatry can no longer be thought to involve only unusual syndromes that occur in distant societies. The growing literature in attests to the vitality of this field.
Despite the accepted validity of Hispanic as a distinct demographic and cultural category, we have only fragmentary evidence and scarce guidelines regarding the treatment of mentally ill Hispanic Americans. This article provides a brief review of the topics with the most clinical relevance to diagnosis and treatment of mental disorders in Hispanic Americans.
Debates surrounding the psychological implications of human reproductive cloning (HRC) escalated in 1997, following the 1996 birth of Dolly, the cloned Scottish lamb. Aside from the physical risks to which cloned persons might be subjected, there was concern over psychological implications associated with family structure and relationships. Would cloned persons be deprived of autonomy and independence? Would parents impose unfair expectations on children who were their genetic replicas?
Many abusers of methamphetamine in rural areas manufacture the drug for their personal use. These "mom-and-pop cooks" produce methamphetamine in and around homes where children are also living. This article provides an overview of the mental health of children whose parents abuse methamphetamine.
In 2001, the US Surgeon General issued a report about the status of mental health with respect to racial and ethnic minority groups, which stated that ethnic and racial disparities were likely due to racism and discrimination. Empiric investigations have linked racism to poor mental health and have shown that racism is stressful and compromises the mental health of persons of color.
The world began to face the prospect of human cloning when the journal Nature published Dolly the sheep's "birth announcement" in the form of a letter authored by Wilmut and colleagues. But despite all the attention given the issue, including two presidential commissions, the psychological consequences of cloning have been little addressed.
Among the numerous challenges facing psychiatric care providers today, few experiences are as ubiquitous as treatment refusal. Tragically, it is often the case that the very patients who are most inclined to refuse treatment are the ones who are in most need of it.
Several readers have responded with comments and concerns regarding my column, "Do Physicians Use Practice Guidelines?" Since the issues these readers raised are important and concern many psychiatrists, they merit some discussion.
One of the major concerns of health professionals working in the area of psychiatry is understanding the conditions under which patients adhere to prescribed treatments. While adherence is linked to some extent to the patients' comprehension of their illness, it is also a function of their social and demographic characteristics, such as age, social milieu, or sex. Another attribute also merits our attention, however: the patient's cultural affiliation and in particular, his or her religious background.
As the United States becomes more culturally, racially, and ethnically diverse, psychiatry will be faced with the need to treat more diverse populations. This article focuses on challenges and obstacles encountered when treating black patients with mental illness.
Dr Steven King provided an interesting summary of complex regional pain syndrome (CRPS) in Psychiatric Times (Complex Regional Pain Syndrome, June 2006, page 9). We felt it would be useful to provide some additional observations on the relationship between CRPS type I and psychological causes of pain.
A discussion of the intellectual, social, and historical similarities and differences between sacred texts and the DSM would require a full-length book, but we will concentrate here on 5 main aspects: controversy, communication, interpretation, change, and power.
Analyzing data gathered in a 10-nation study of psychoses by the World Health Organization (WHO), Susser and Wanderling1 found that the incidence of nonaffective psychoses with acute onset and full recovery was about 10 times higher in premodern cultures than in modern cultures. Transient psychoses with full recovery were comparatively rare in modern cultures. Such a dramatic difference begs for explanation.