News

The recent evolution of neuropsychiatry/behavioral neurology as a subspecialty represents a paradigmatic shift regarding the responsibility of psychiatrists in diagnosing and managing behavioral disorders with concomitant and demonstrable brain pathology such as dementia or head injury. This authors define the clinical usefulness of electroencephalography in evaluating neuropsychiatric disorders.

The FDA advisories warning of increased suicide risk among children and adolescents beginning antidepressant therapy have alarmed the health care community--but it may actually be a disservice to withhold these medications from those who need them.

As many as 90% of Americans are exposed to at least one traumatic event in the course of their lives. Many more are exposed to more than one traumatic event. Short- and long-term sequelae of traumatic exposure vary greatly and range from complete recovery, to severe and debilitating PTSD.

Signals

Noninvasive ventilation (NIV) has been shown to ameliorate respiratory impairment, which, as the disease worsens, is often responsible for death in patients with amyotrophic lateral sclerosis (ALS). Its use, however, is uncommon, and its overall value in improving quality of life and survival has been debated. Findings of a randomized controlled study by a team from the University of Newcastle upon Tyne, UK, may shift clinicians' attitudes about the intervention.

About 25% of patients seen in epilepsy clinics and monitoring units who do not respond to antiepileptic drugs (AEDs) have received a misdiagnosis.1-3 The eventual diagnosis for most of these patients will be psychogenic nonepileptic seizure (PNES)1,4-a somatoform conversion disorder. It is treatable, but diagnosis, delivery of the diagnosis, and management present significant challenges. A major barrier to care has been the stigma associated with the label "psychogenic."

Measuring amyloid-beta (Abeta) protein levels in cerebrospinal fluid (CSF) and using positron emission tomography (PET) to image amyloid in the brain might become the best diagnostic test for presymptomatic Alzheimer disease (AD), according to a study published online in December 2005 and appearing in the March issue of Annals of Neurology.

The most comprehensive evidence-based recommendations for preventing a second stroke have been released by the American Heart Association and the American Stroke Association's Stroke Council.1 In contrast with previous clinical practice guidelines, the new guidelines tie transient ischemic attack (TIA) with stroke, said Ralph Sacco, MD, chair of the American Stroke Association's Secondary Stroke Prevention Guidelines Committee.

When Medicare enrollees became entitled to the first-ever outpatient prescription drug benefit in January, the program was introduced with great fanfare and with the mission of Medicare Part D programs to make drugs more affordable for the elderly and disabled. The Medicare drug benefit issue, however, has been mired in controversy since Congress took it up years ago.

Mental Notes

When a stroke occurs, transportation to the emergency department (ED) by ambulance will get a patient care faster-a factor that so often makes a difference about whether tissue plasminogen activator will be administered-according to poster studies presented at the International Stroke Conference in February in Kissimmee, FL.

Dementia is characterized as a progressive and chronic decline in cognitive function, not limited to memory impairment, which significantly interferes with baseline daily functioning and frequently involves behavioral disturbances. It is known that behavioral problems in dementia negatively affect patients and caregivers. These disturbances lead to institutionalization, increased costs and caregiver burden, and a poorer prognosis.

The focus of this Special Report on anxiety disorders is not accidental. Anxiety disorders are, probably next to substance abuse, the most common mental disorders in the general population, and definitely the most common mental disorders among children and adolescents.

Aware that mental illness generally begins early in life and that four teenagers commit suicide every day, several organizations and agencies are stepping up efforts to expand voluntary mental health screening and suicide prevention initiatives for youth--but they are doing so in the face of stigma and vocal opposition.

Anxiety disorders are the most common mental conditions in the general population, including in children and adolescents. Young people can present with a pattern of anxiety symptoms somewhat different from that typically seen in adults. One of the most common aspects of this difference is that children (especially younger ones) may not report overt worries or fears, but instead manifest pronounced physical symptoms.