News

Another day without timeto write: patients call in crisis,apple trees need stakes,cord wood waits to be stacked,and rows of pink-topped turnipsremain buried in half-frozen earth.

Although several studies indicate that psychotherapy (alone or in combination with medications) can help psychiatric patients reach recovery faster and stay well longer, a declining number of office-based psychiatrists are providing psychotherapy to their patients.

Scientists from the University of Michigan are beginning a phase 1 clinical trial for the treatment of cancerrelated pain that uses a novel gene transfer vector-an agent used to carry genes into cells-injected into the skin to deliver a pain-relieving gene to the nervous system.

Perhaps you read the editorial commentary in the August issue of Psychiatric Times in which our editor-in-chief, Ronald Pies, MD, wrote about ongoing congressional hearings into potential conflicts of interest (COIs) among prominent psychiatrists?

Our returning military veterans remind us dramatically of the importance to consider traumatic brain injury (TBI) as a potential comorbid illness in cases of posttraumatic stress disorder (PTSD). The common causes of comorbid TBI and PTSD are assault and battery to the head, head trauma (personal or work-related injuries), civilian or military explosions, inflicted head trauma in children, motor vehicle accidents, and suicide attempts by jumping. Prevalence figures for comorbid TBI and PTSD historically have been lacking

Late-Life Depression

Late-life depression is both underrecognized and undertreated. The impact of medical comorbidity may mask depressive symptoms.

In last month’s column (“Painting Neural Circuitry With a Viral Brush,” Psychiatric Times, October 2008, page 16), I used Michelangelo’s famous fresco, “Hand of God Giving Life to Adam” on the ceiling of the Sistine Chapel as a metaphor to introduce a series of technologies that have allowed researchers to map the complex interactions of neural connections in continuously functioning neural tissues.

Too often news headlines exert a major influence on our patients-and nothing in child psychiatry grabs headlines like the alleged overprescription of medicines. Physicians sidestep the debate, assuring their patients and themselves that each prescription is written only after careful consideration of risks and bene-fits.

Reports of 1 in 5 military service members returning from Iraq or Afghanistan with posttraumatic stress disorder (PTSD) and/or depression and rising suicide rates have led researchers and military leaders to warn civilian psychiatric care providers of a “gathering storm”1 headed their way.

In “SSRI Prescribing Rates and Adolescent Suicide: Is the Black Box Hurting or Helping?” (Psychiatric Times, October 2007, page 33) Gibbons and associates primarily use data from their American Journal of Psychiatry article that appeared in September 2007, in a not very veiled attempt to influence doctors and the FDA to roll back the “black-box” warning on the prescription of SSRIs for adolescents.

In the Valley of Elah is an improvised explosive device that writer-director Paul Haggis has set to go off in the hearts and minds of Americans who still support the war in Iraq. Haggis, who earned an Oscar (Best Picture and Screenplay) for Crash, has aimed his second film at the hardworking, churchgoing, flag-flying, decent Americans who cannot imagine that the country they love would engage in an unjust war.

Medication adherence, especially in children and adolescents, is a complex problem that is poorly understood and underresearched, yet it is a clear barrier to effective treatment and is frequently encountered in everyday clinical practice.

In an earlier column (Psychiatric Times, “The Road Less Traveled,” September 2002, page 14), I emphasized what can be learned from interviewing nonclinical subjects.

Over the past decade, NSAIDs have been on a roller-coaster ride almost as wild as that now being experienced by this country’s housing and financial markets. The selective COX-2 inhibitors-first celecoxib (Celebrex) and then rofecoxib (Vioxx) and valdecoxib (Bextra)-promised to revolutionize the treatment of pain.

Recent research has raised concerns about the adequacy of psychiatric diagnostic evaluations conducted in routine clinical practice, particularly the detection of disorders that are comorbid to the principal diagnosis.

When most people think of bullying, they envision the schoolyard thug verbally or physically threatening hapless victims on the playground or on the school bus. The past few years, however, have witnessed a new type of bullying-cyber bullying-also known as electronic bullying or online social cruelty.