News

Recent evidence suggests that reorganization of neuronal connectivity might play an important role in the pathophysiology of mood disorders and in both pharmacological and psychological treatments of depression. This evidence suggests a new framework for the etiology of mood disorders that focuses more on the problems in neuronal connectivity, plasticity and information processing in the brain than on abnormalities in chemical neurotransmission. Although this framework is still controversial and far from being complete, improved familiarity with the concepts of neuronal development and activity-dependent plasticity among mental health professionals would be useful.

A pioneer in alcohol addiction studies reviews his past accomplishments and looks toward the future.

Selective serotonin reuptake inhibitors have been shown effective in the treatment of depression with psychosis. This efficacy appears to correlate with the SSRIs’ level of affinity at the sigma-1 receptors in the brain. What role does the sigma-1 receptor play in psychotic depression? Based on this role, are there implications for other treatments?

By 2020, depression will be the second leading cause of death and disability worldwide. As the importance of depression as a public health problem has been reinforced, research efforts have followed different paths. Read about some of the latest developments.

When a family member is diagnosed with depression the whole family is affected. Additional family and marital stresses imposed on the patient with depression can add to the severity of depression and affect long-term remission rates. In order to ensure the best possible success in treatment, the therapist should integrate the family into the patient’s treatment.

Poetry of the Times: The Grave on Perry's Peak

The Centers for Medicare & Medicaid Services has been quietly working on new ways to gather health care data. What are some of these pilot programs and how might they affect payment and health care services?

Internet, Web sites, Practice management

Although public officials expressed surprise and outrage at the behavior of the some of the victims of Hurricane Katrina, research and history has shown that both altruism and violence are common after a disaster of this magnitude. Why is human behavior not a part of disaster preparedness planning?

New Clinical Drug Evaluation Unit presented new clinical data at their 45th annual meeting in Boca Raton, Fla. In the first of two articles, suicide studies, the effectiveness of antidepressants and the efficacy of drug combination therapy are explored.

Advances in technology allow more options for treating patients, tracking medications and preventing errors. What are some of these emerging technologies, and what are their benefits and their drawbacks?

The incidence of polypharmacy is on the rise, and with the increase comes a greater risk of drug-drug reactions. One survey estimated that patients seeing a psychiatrist may be six times more likely to receive multiple psychotropic medicines compared to patients seen by a primary care physician. This article provides an overview of the extent of polypharmacy, the factors driving the phenomenon and issues clinicians should consider when treating patients who are already taking medicines for other illnesses.

Migraine, Headache, Epilepsy, Vagus nerve stimulation, VNS, Stroke, Insomnia

multiple sclerosis, neutralizing antibodies, interferon beta, Avonex, Betaseron, Betaferon, Copaxone, Novantrone

Malformed, reactive astrocytes (blue) interacting with neurons (orange/red) in a human subject whose temporal lobe ultimately was removed because the epilepsy did not respond to pharmacotherapy. Reactive astrocytes are responsible for inappropriate glutamate release, which in turn triggers epileptiform seizures. Image courtesy of Maiken Nedergaard, MD.

translational research, brain tumor

complementary medicine, alternative medicine, acupuncture, and integrative medicine

The more severe the stroke, the greater the liklihood of poststroke epilepse.

This review will familiarize physicians with the embryology, types, and incidence of various interatrial communications; summarize and highlight the potential association of interatrial communications with stroke, platypnea-orthodeoxia syndrome, neurologic decompression sickness in divers, and migraine headaches; discuss various therapeutic modalities available for closure of interatrial communications; and outline future directions in this rapidly evolving field.

Comorbidity of Dysthymic Disorders in Children and Adolescents by Atilla Turgay, M.D. Many patients with dysthymic disorders also have associated comorbid disorders. A detailed history will provide insight into the comorbidity profile, cross-sectionally and developmentally. Dysthymic disorder should be addressed clinically, as it may cause long-term chronic unhappiness and poor quality of life for the patient.

Through the Times With Max Fink, M.D. by Arline Kaplan Long viewed as a pre-eminent researcher and advocate for electroconvulsive therapy, Max Fink, M.D., reflects on more than five decades of groundbreaking research.

Evidence-Based Therapies in Child and Adolescent Psychiatry by Jon McClellan, M.D. Given the lack of large, randomized controlled studies of psychiatric medications that involve children and adolescents, it can be difficult to establish evidence-based therapies that are effective for this population. However, there are studies that have shown the effectiveness of various medications, as well as for various psychotherapy techniques.

Poetry by Richard M. Berlin, M.D. - "Fungo"

Updates Show Progress in TMS for Depression and Schizophrenia by Arline Kaplan In research presented at the 2005 APA annual meeting, transcranial magnetic stimulation is showing efficacy in treating depression and schizophrenia in the research setting. The question of how to translate those findings to a real-world setting still remains.

Childhood Reactions to Terrorism-Induced Trauma by Wanda P. Fremont, M.D. The unpredictable, indefinite threat of terrorist events, the profound effect on adults and communities, and the effect of extensive terrorist-related media coverage can contribute to a continuous state of stress and anxiety in children. Current treatment strategies are discussed as well as direction for further research.

diabetic neuropathy

A team of neuroscientists from Purdue University and Nagoya University in Nagoya, Japan, has identified acrolein as a key neurotoxin in the neurodegenerative process that follows traumatic spinal cord injury. Acrolein, a toxic industrial by-product, naturally occurs in the body in negligible quantities as free radical molecules. However, it can quickly accrue to toxic levels in response to trauma, stress, or exposure to environmental carcinogens. Carriage

Alzheimer disease,folate,radiology

diabetic peripheral neuropathy, neuropathy

restless legs syndrome, Parkinson disease, ADHD