Intrigued by preliminary research indicating that omega-3 polyunsaturated fatty acids found in fish, fish oil and flaxseed may ameliorate symptoms in bipolar disorder (BD), schizophrenia and other psychiatric disorders, investigators have launched a series of double-blind trials evaluating fatty acids as adjunctive treatment. This article will discuss studies on bipolar disorder.
The methodology of clinical trials was as much of interest as the trial results for investigators gathered at the 39th annual NCDEU (New Clinical Drug Evaluation Unit) Program meeting. This meeting was conducted in June by the National Institute of Mental Health in Boca Raton, Fla.
With the stroke of a pen, California's governor, Gray Davis, approved legislation in September that will soon bring insurance coverage to 25 million individuals suffering from severe mental illnesses. Part of a major overhaul of the state's health insurance laws, when the parity bill becomes effective in July 2000, it will require that insurance companies provide co-payments, deductibles and lifetime benefits equivalent to those for other illnesses, along with reimbursements for partial hospital stays and outpatient and inpatient services.
A national company has chosen final candidates for a new group of regional manager positions. Even though the firm likes its choices, it wants an outside opinion to assess those candidates' leadership and management skills and make suggestions for their executive development.
The recovered memory debate has been the most acrimonious, vicious and hurtful internal controversy in the history of modern psychiatry. From its very beginning in the late 1980s, it has been more an "ad hominem" war, appealing to feelings and prejudices, rather than a matter of reasoned professional disagreement.
In the early 1960s, the Internet was born out of the idea of a "Galactic Network." By the late 1980s, technology had advanced to allow for computer-based exchange of scientific information between academic and research institutes. From these humble beginnings, the Internet has experienced explosive growth in the last five years, evolving into a powerful global information resource and new media format unto itself. Psychiatrists can now reap the full benefit of this fast-paced evolution to extend the reach of their medical practice.
The methodology of clinical trials was as much of interest as the trial results for investigators gathered at the 39th annual NCDEU (New Clinical Drug Evaluation Unit) Program meeting. This meeting was conducted in June by the National Institute of Mental Health in Boca Raton, Fla.
When Colorado psychiatrist Ann Seig, M.D., wrestled with erotic transference and countertransference issues, she didn't have to struggle alone. Seig's feeling of "stark terror" signaled "a need to talk to someone" about this troublesome case. She brought her concerns to her peer consultation group, where colleagues helped her discern how issues in her private life were contributing to the countertransference.
The pace of psychiatric hospital closings has slowed, and specialty psychiatric hospitals are diversifying their services to include a range of behavioral health treatment settings, according to data recently released by the National Association of Psychiatric Health Systems (NAPHS).
For a couple of years, I have been a member of the American Society of Clinical Psychopharmacology (ASCP). I guess many of us carry this need to belong from our adolescent years. It always felt good for me to be a part of a professional group, sharing the same interests, united by special education and knowledge. How wrong of me!
The fiscal year (FY) 1999 budget for National Institutes of Health funding totals more than $15 billion. This figure reflects an increase of 15% over the FY 1998 budget and is $320 million less than President Clinton's requested budget for FY 2000 (Varmus, 1999). The Foundation Center reports the funding from U.S. grant-making foundations in 1998 as $15.4 billion from independent foundations, $2.37 billion from corporate foundations and $1.48 billion from community foundations (Foundation Center, 1999). Additional funds are available from the National Science Foundation (NSF), which has a $3.95 billion budget request for FY 2000, up almost 6% from FY 1999 (NSF, 1999). With all of this available funding, how can medical clinicians and researchers increase their chances of obtaining a medical grant?
The debate over the accuracy of memories of childhood sex abuse that are recovered decades later, usually during the course of therapy, has led to the polarization of psychiatrists and other mental health professionals. There are those who claim that -recovered memories are, in the main, accurate, and there are others who believe that most, if not all, recovered memories are false.
By the time I interviewed Robyn in the emergency room, her panic attack had all but passed. But this 21-year-old woman was still shaken and tearful. This was her first panic attack, and she did not know what hit her. She thought she was having a heart attack. She had a tight feeling in her chest, she was hyperventilating. Her fingers and feet were numb and tingling. She experienced what she called a "closing in feeling." Robyn thought she was going to die.
Three reports on olanzapine (Zyprexa) as a possible treatment for bipolar affective disorder, presented at a National Institute of Mental Health-sponsored meeting in June, reflected pursuit of this indication-despite the initial "nonapprovable" letter from the U.S. Food and Drug Administration that was issued October 1998.
My First Professor - Poetry of the Times
When The New York Times decided to run a story in July about refractory depression, the article was entitled "Some Still Despair in a Prozac Nation." Even after a decade on the market, and despite the availability of a host of competing drugs, the headline exemplifies the extent to which Eli Lilly and Company's popular antidepressant remains a pop culture icon. So when the Indianapolis-based pharmaceutical manufacturer launched a 30-minute program that featured Prozac (fluoxetine) in May-it avoids using the term infomercial-the cutting edge direct-to-consumer (DTC) ad naturally raised questions and a few eyebrows as the company sought to gain even wider exposure for the drug.
Among psychiatrists who treat patients with HIV/AIDS, the question of how psychosocial distress effects the progression of HIV disease is likely to arise. Even for healthy individuals, we are only beginning to clarify the complex pathways by which thoughts and emotions impact immune function. Due to the bidirectionality of the communications of the brain and the immune system, this is a complicated scenario. The fact that HIV alters the function of the immune system during the course of its progression creates greater confounds to the understanding of these systems. We will address the rationale that progression from HIV infection to AIDS may be modulated by psychosocial factors, discuss possible reasons for conflicting findings and posit some clinically relevant recommendations drawn from research findings.
In the 1950s and 1960s, researchers found that mice and rats subjected to stressful stimuli were more likely to develop viral infections and tumors than nonstressed animals (Miller, 1998). Today, that once-pioneering research in psychoneuroimmunology (PNI) has burgeoned into sophisticated clinical studies that look at, for example, how caregiving can affect the immune system, how stress may delay wound healing and how pretreatment with an antidepressant prevents cytokine-induced depression in therapy for cancer.
As chief of the division of sleep and chronobiology in the department of psychiatry at the University of Pennsylvania School of Medicine, David F. Dinges, Ph.D., focuses on ways sleep and the endogenous circadian pacemaker interact to control wakefulness and waking neurobehavioral functions such as physiological alertness, attention, cognitive performance, fatigue, mood, neuroendocrine profiles, immune responses and health. In an interview with Psychiatric Times, Dinges discussed neurobehavioral consequences of sleep loss, factors that impair sleeping, the pervasiveness of sleepiness and new ways to manage sleepiness.
Mood-stabilizing drugs slipped into the vocabulary of psychiatrists during the last 15 years without a proper discussion of their definition. Consequently, these medications have been used in ways that have no empirical justification.
"You really have to prepare patients for group treatment and have to compose your groups and select patients for that particular group with some care."
Several incidents of serious violence, including the death of one woman, have pushed the issue of involuntary commitment of the noncompliant mentally ill higher on the priority list of the government of New York State.
Developmental traumatology research is the systemic investigation of the psychiatric and psychobiological impact of overwhelming and chronic interpersonal violence on the developing child.
Children whose parents have been diagnosed with affective disorders are far more likely to be diagnosed with a mental illness-especially affective disorder-than their peers whose parents do not have mood disorders (Beardslee, 1998; Burge and Hammen, 1991; Downey and Coyne, 1990).
As traditional unions successfully expand the ranks of organized physician employees, and as the U.S. Congress considers an antitrust exemption so that all doctors can collectively bargain, the American Medical Association decided to unionize. Doing nothing would have been tantamount to leaving the bargaining table even before the negotiations began.
The Hotseat - Poetry of the Times
America's teaching hospitals are facing an unprecedented financial crisis that could leave more than one-third of the most respected institutions operating at a loss within the next five years, according to leaders in academic medicine. In addition to reducing their traditional educational programs, teaching hospitals may have to eliminate a wide variety of community health projects, poison control centers, safety programs and indigent care programs if budget cuts imposed by third-party payers are not reversed.
Present-day psychiatry has fallen into crisis because of the severe limitations of its conception of the person and, as a result, its conception of the patient. It objectifies the patient in a number of ways. Because of this reductionism, psychiatry fails to distinguish between healthy and pathological features of human life. It fails to consider adequately the psychological and social factors that cause and maintain each patient's problems.
The most common psychiatric sequelae following trauma include major depressive disorder, somatoform pain disorder, adjustment disorder and posttraumatic stress disorder (PTSD). In law, trauma that precipitates PTSD is viewed as a tort, which stems from the root word "torquere" (to twist), as does the word torture. In a sense, plaintiffs do allege torture in personal injury cases. A tort constitutes a civil or private wrong, as opposed to a criminal wrong, and rests on the general principle that every act of a person causing damage to a legally protected interest of another obliges that person, if at fault, to repair the damage (Slovenko, 1973).
With less than five months before an irrevocable and unavoidable deadline, major questions still remain about the ability of the health care industry to cope with the so-called Y2K problem