Schizoaffective

Are juveniles mature enough to receive the death penalty? No, according to a ruling by the U.S. Supreme Court. Medical, psychiatric, psychological and brain-imaging data all supported the decision to ban execution of juvenile death-row inmates.

Heavy smoking and caffeine intake are highly prevalent in patients with psychiatric disorders, both of which significantly impact the metabolism of a number of psychotropic medications. Hence, these factors should be routinely considered in making prescribing decisions.

Multiple studies show that diabetes approximately doubles the risk of comorbid depression. Furthermore, major depressive disorder is a risk factor for the subsequent development of type 2 diabetes mellitus. Treatments for depression in the setting of diabetes must be evaluated for their effects on blood glucose levels, propensity for weight gain, possible concomitant use for diabetic neuropathy and potential drug interactions.

What special issues do psychiatrists face when treating women, children and adolescents, and elderly people with schizophrenia? Are there recommendations for care and monitoring strategies to maintain patients on effective, long-term treatment regimens?

One of the spin-offs of the consensus statement is a study of the risk for metabolic disorders with antipsychotic use in children and adolescents. Here, the lead researcher discusses some of the group's initial findings.

Will the most effective treatments be available for your patients? Atypical antipsychotics and antidepressants that are being marketed or developed worldwide are reviewed.

It's often believed--even by mental health care professionals--that people with mental illnesses could be employed in low-level jobs. Studies and demonstration projects have shown, however, that these individuals can sustain employment in high-level positions with the proper training and support.

The chief psychiatrist of the Community-University Health Care Clinic in Minneapolis reflects on what he's learned caring for refugees from Southeast Asia and Somalia. His experiences can educate others caring for immigrants and refugees.

Increasing variations in mechanisms of action of atypical antipsychotics, side-effect profiles, and efficacy among the atypicals enable clinicians to tailor treatments to individual response, side-effect history, and current medical conditions.

Decades of labor have been poured into the formulation of the DSM and its descendants. Is this system of classification still useful and relevant to clinical practice? Should psychiatrists continue to revise it or get rid of it altogether?

While housing problems for the mentally ill are usually associated with patients receiving public care, private patients also face obstacles over obtaining and keeping adequate housing. What are the issues, and what can agencies do to ensure all patients, regardless of socioeconomic status, have adequate housing?

How does a clinician deal with those patients for whom they can ultimately do nothing but help them stay numb for the majority of their days?

Deficient omega-3 fatty acids can result in myriad pathological changes including altering the central nervous system. Their balance or imbalance changes receptor function, prostaglandin and cytokine production. Understanding the roles of these essential fatty acids is vital to remedying the fatty acid abnormalities found in a number of psychiatric disorders.

In this second article of a series, innovative research and technologies presented at the 41st Annual New Clinical Drug Evaluation Unit meeting are highlighted.

In the first of this series of articles, some of the innovative research and technologies presented at the 41st annual New Clinical Drug Evaluation Unit meeting in Phoenix in May are discussed.

This is the second part of an article series discussing the high risk of suicide attempts in patients with schizophrenia. Herbert Y. Meltzer, M.D., continues the discussion with treatment options and efficacy.

The FDA approved two new intramuscular, immediate-release formulations of atypical antipsychotics. Both olanzapine (Zyprexa IM) and ziprasidone (Geodon IM) were recommended as safe and effective for the treatment of agitation in patients with schizophrenia.

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.

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.

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.

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.

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.

Schizophrenic patients treated with olanzapine (Zyprexa) required less health care services and incurred less overall health care costs over a 28-week period than patients treated with risperidone (Risperdal). This was the result of a study presented by Eli Lilly and Company researchers at the European College of Neuropsychopharmacology meeting held in Paris from Oct. 31, 1998 to Nov. 4, 1998.

One day after Eli Lilly and Company researchers reported finding olanzapine (Zyprexa) superior to risperidone (Risperdal) on some measures in a 28-week comparative study presented to the American College of Neuropsychopharmacology (ACNP) meeting in 1996, Janssen Pharmaceutica Inc. issued a press statement critical of the methodology and results of the study. Janssen then announced it would undertake its own comparative trial. The results of this trial's initial eight-week acute treatment phase were presented at the European College of Neuro-psychopharmacology meeting held Oct. 31, 1998, through Nov. 4, 1998, in Paris. They indicate risperidone has an advantage for positive symptoms such as hallucinations and delusions, and for anxiety/depression in patients with schizophrenia and schizo-affective disorder.

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.