Bipolar Disorder

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.

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.

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.

Smoking is not only a comorbid condition for schizophrenia; it may also have an effect on other psychiatric conditions.

More patients are reaching the old-old demographic-those age 75 and above-with psychiatric conditions such as treatment-resistant depression. Research has shown that with some careful screening and precautions, ECT is a safe, effective treatment option for these patients.

Dementia produces significant dependency and contributes to costly long-term care; depression contributes to high rates of suicide; and both contribute to lower quality of life and higher disability among older patients. Therefore, researchers are eager to find new ways of preventing and treating these conditions. Studies currently underway include evaluating the role of health specialists in treating depressed patients, looking at bereavement and its effects on patients, and the role of estrogen, vitamin E, NSAIDs and COX-2 inhibitors in preventing and treating Alzheimer's disease.

Between 50% and 80% of people with mental disorders smoke cigarettes. Are the tobacco companies targeting this population, and are mental health care facilities promoting the use of tobacco? What are psychiatrists' responsibilities in the overall health of their patient?

Bipolar disorder (BD) in children and adolescents is severe and has significant adverse effects on academic, social and family functioning. The high rate of relapse and suicide attempts in youth with BD makes effective treatment essential.

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.

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.

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.

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.

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!

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.

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.

More than 430 psychiatrists, research donors and others gathered in late October for the National Alliance for Research on Schizophrenia and Depression (NARSAD)'s awards dinner in New York City. The black-tie fundraising event was held in conjunction with the organization's 10th annual scientific symposium at which 15 selected NARSAD grantees presented their ongoing research over two days of sessions devoted to basic science, schizophrenia and depression.

Ownership of the human genome-or, more exactly, access to the tools and databases necessary to make sense out of the millions of bits of information that make up the estimated 100,000 human genes-constitutes one of the hottest scientific debates in the public policy arena. On one hand is the Human Genome Project (HGP), a worldwide consortium of governments and their supported researchers who are mapping the 23 pairs of human chromosomes and are determining the complete nucleotide sequence, involving 3 billion base pairs of DNA.

Recent advances in the treatment of mental and addictive disorders, along with research findings in basic neuroscience, molecular genetics and molecular biology that contribute to the understanding of such disorders, were discussed at the American College of Neuropsychopharmacology's 37th annual meeting in Puerto Rico. The following are brief reports from selected presentations.

More than 80 medications are in development to treat mental illnesses, including 18 for depression, 15 for schizophrenia and 16 for anxiety disorders, according to the Pharmaceutical Researchers and Manufacturers of America (1998). Which ones will most likely come to market in the United States?

Psychogenic excoriation (also called neurotic excoriation, pathologic or compulsive skin picking, and dermatotillomania) is not yet recognized as a symptom of a distinct DSM-IV disorder.

This is the first in a series of articles summarizing research presented at the 1998 American College of Neuropsychopharmacology Annual Meeting.

Efforts are underway to persuade the Health Care Financing Administration (HCFA) to expand Medicare coverage for positron emission tomography, popularly known as PET scanning. At present, the government only reimburses charges for PET scans in connection with the diagnosis of lung cancer.

Daniel F. Kripke, M.D. has studied the relationship between biological rhythms and depression since the early 1970s. He states that seasonal responses in many mammals are controlled by the photoperiod. Therefore, it seemed that depression might be analogous to winter responses and that light might be an effective treatment.

Warning of declining resources for mental health, Nelba Chavez, Ph.D., administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA), said mental health must become a top priority in public policy, health care services and coverage, training of health care professionals and community education.

It is more cost-effective for psychiatrists to provide medication and psychotherapy to depressed patients than it is to split treatment between medical doctors and other mental health care providers

Insufficient intake of essential fatty acids (EFAs) may contribute to the pathogenesis of mental diseases, while their supplementation may relieve some symptoms, according to researchers who attended the National Institutes of Health (NIH) Workshop on Omega-3 Essential Fatty Acids and Psychiatric Disorders held in Bethesda, Md., in September 1998.

This month establishes a milestone for CME LLC Not only is it the company's 11th annual U.S. Psychiatric & Mental Health Congress, it also marks the 20th anniversary of the company's first conference. CME LLC grew out of a desire to reach and educate more people regarding psychiatric issues. One way to do this was by developing high-quality continuing education opportunities.

Atypical antipsychotic treatment for borderline personality disorder (BPD) and augmentation therapy with olanzapine (Zyprexa) or estrogen replacement therapy (ERT) for patients with mood disorders were among the research questions addressed at the American Psychiatric Association's annual meeting in Toronto. Following are some brief reports of selected presentations.

Day in and day out, psychiatrists-especially those involved with couples therapy-counsel and treat patients experiencing relationship problems with their spouses or partners. But what about the psychiatrist having a similar problem in his or her own life? Who does a doctor turn to for guidance and insight regarding such intimate matters?