Patients with schizophrenia have a high risk of committing suicide. Between 25% and 50% attempt suicide at least once, resulting in approximately 3,600 successful attempts each year in the United States. What are the risk factors for suicide one should look for in treating patients with schizophrenia? Herbert Y. Meltzer, M.D., discusses the issue and offers warning signs.
In spite of the enormous success of antidepressants, there are surprisingly few that are available in other than oral form. There is now substantial evidence that intravenous administration is well tolerated and may accelerate onset of therapeutic effect. With the possibility of transdermal delivery3/4a noninvasive and painless route of administration requiring no technical support3/4parenteral antidepressants may become more acceptable in this country and warrant further clinical investigation.
Dietary supplementation of SAM-e--naturally produced and physiologically necessary compound for living cells--is being investigated for its use as a viable treatment for depression.
After a significant delay, the U.S. Congress passed the Victims of Trafficking and Violence Prevention Act of 2000 to provide support and services to victims of domestic violence. Meanwhile, the findings in the Family Violence Prevention Fund's State by State Report Card on Health Care Laws and Domestic Violence shows state legislation has proved disappointing. Which states do the most in assisting physicians and other health care providers to aid victims of domestic violence?
According to a recent article in the Journal of Women's Health and Gender-Based Medicine (2000;9[4]:405-411), more psychiatrists than physicians in other specialties see themselves as the best source of information for victims of domestic abuse.
Psychiatrists can play a vital role in determining whether or not a patient will be a good candidate for an organ transplant. Using a case vignette, Dr. Garton explains how she helps a transplant team make the best possible decision.
Dorrance Publishing; Pittsburgh, 2000 142 pages $13
(Additional information regarding violence and trauma can be found in the Special Report section of the April 2001 issue of Psychiatric Times-Ed.)
Missed Diagnosis
People are different, according to conventional wisdom - the saying generally used in explaining varying opinions, attitudes or ways of thinking. Why then is it not a given that people are different in basic brain functions such as learning and intelligence?
Samantha Meltzer-Brody, M.D., et al. provided data suggesting that fluoxetine (Prozac) exerts a broad-spectrum effect in reducing all symptom clusters in a sample of 53 patients with posttraumatic stress disorder (PTSD). Their results indicated that fluoxetine was most effective in treating the individual symptoms of intrusive recollections and having a sense of failure.
The Most Common Time - Poetry of the Times
A further look at TMS, including synopses of presentations from the 3rd Annual Meeting of the International Society of Transcranial Stimulation.
The 89-year-old woman had undergone hip replacement surgery two days before, had tubes in her arms and couldn't walk. But she blithely announced to her daughter that she was leaving the hospital immediately and started to get out of bed. Astounded, the daughter sought out her mother's physician and asked, "What's going on?"
The author examines how temperature and length of day can affect mood and behavior, both in a general population and a group of inpatients. In both groups, there were two peaks of violent behavior, one in May-June and one in October-November, which correspond with the equinoxes. Is it possible to track violent behavior in various geographical areas depending upon weather and length of day?
In response to encouraging results from a small pilot study of vagus nerve stimulation (VNS) for treatment-resistant depression, researchers are now expanding the study to approximately 200 patients in 20 sites across the United States.
In this overview of research into the biopsychosocial changes caused by traumatic events, Dr. Novac discusses psychopathology, brain development and the effect a traumatic event can have on the victim's family-even long after the event occurred.
"Stalking" is defined as repeated and persistent unwanted communications and/or approaches that produce fear in the victim. The stalker may use such means as telephone calls, letters, e-mail, graffiti and placing notices in the media. A stalker may approach or follow the victim, or keep their residence under surveillance.
Methods for detecting possible abuse and how to help victims (even if they are unable to help themselves or leave their abuser).
Most studies have found clear gender differences in the prevalence of depressive disorders. Typically, studies report that women have a prevalence rate for depression up to twice that of men (Bebbington, 1996; Nolen-Hoeksema, 1987).
Obstetrics Ward, County Hospital - Poetry of the Times
California's recent passage of Proposition 36 mandates treatment instead of incarceration for illegal drug offenses. Proponents believe the measure will save the state millions of dollars in the long run and will be more effective in curbing drug abuse than the war on drugs. Critics argue it is hamstrung, cannot achieve its goals and will only negatively impact successful drug court programs.
The National Alliance for Research in Schizophrenia and Depression awarded the 2000 Nola Maddox Falcone Prize. A brief description of each recipient's contributions to research with affective disorders is given.
Evaluations of new drugs, new dosage formulations and new applications for currently approved drugs were a substantial portion of the scientific program at the 40th annual NCDEU meeting, which is sponsored by the National Institute of Mental Health.
(The following are highlights of new research presented at the 2000 American Psychiatric Association Annual Meeting. Additional highlights can be found in "APA Meeting Highlights New Research," in the February issue of Psychiatric Times, p23-Ed.)
There is a history of gender bias in medical education and practice. Research has shown that this bias extends to the psychiatric field as well. Through material presented to medical trainees-in classes, textbooks, research reviews and the like-subsequent thoughts and actions may be negatively biased against women. A review of the ways in which biases are conveyed is explored, as well as suggestions for reducing, eliminating and preventing these biases in medical education.
Men's Reactions to Female Sexual Coercion
Because there is intense pressure by managed care to shorten the hospital stay for patients with anorexia nervosa, there is a need for partial-hospitalization treatment programs. Since patients gain an average of 0.5 lbs/week to 1.5 lbs/week in these less-monitored programs, as opposed to 2 lbs/week to 3 lbs/week in the inpatient behavioral specialty programs, Angela S. Guarda, M.D., and colleagues (Symposium 21B) described components that would improve the partial treatment program.
How Bourbon Says Goodbye - Poetry of the Times
Two studies of patients who switched from Clozaril to generic clozapine are being evaluated by the U.S. Food and Drug Administration to determine whether the rating of the generic drug as bioequivalent (AB) to the brand-reference drug should be reconsidered and whether additional bioavailability assessment should be undertaken.
