Clinical Psychiatry News RSS feed: Current Issue. To order this journal, and for more information, go to http://www.imng.com/ Clinical Psychiatry News is an independent newspaper that provides the practicing psychiatrist with timely and relevant news and commentary about clinical developments in the field and about the impact of health care policy on the specialty and the physician's practice.http://www.clinicalpsychiatrynews.com/?rss=yesElsevier Inc.en © 2010 Elsevier Inc. All rights reserved. Clinical Psychiatry News0270-6644388August 2010 © 2010 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.clinicalpsychiatrynews.com/article/PIIS0270664410702952/abstract?rss=yes Major Finding: Compared with people who have acute major depression, people with dysthymic disorder were more likely to receive Social Security disability (14% vs. 5%) and Medicaid insurance (20% vs. 13%), and were less likely to report full-time employment (36% vs. 44%).Dysthymic Disorder Causes More Disability Than Major DepressionDAMIAN McNAMARA10.1016/S0270-6644(10)70295-2Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4News12http://www.clinicalpsychiatrynews.com/article/PIIS0270664410702964/abstract?rss=yesEDINBURGH — Age greater than 60 years is a major risk factor for onset of a nonorganic, nonaffective psychosis that's surprisingly common yet largely unappreciated outside the relatively small world of geriatric psychiatry.Late-Life Psychosis Mimics SchizophreniaBRUCE JANCIN10.1016/S0270-6644(10)70296-4Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4News11http://www.clinicalpsychiatrynews.com/article/PIIS0270664410702976/abstract?rss=yesMore men than women report nonmedical prescription opioid use, according to the results of a nationally representative survey of 55,279 individuals published online in Addictive Behaviors.Men More Likely Than Women To Misuse Prescription OpioidsROBERT FINN10.1016/S0270-6644(10)70297-6Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4News22http://www.clinicalpsychiatrynews.com/article/PIIS0270664410702988/abstract?rss=yesVital Signs: Antipsychotics Were the Top Therapeutic Class in 200910.1016/S0270-6644(10)70298-8Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4News22http://www.clinicalpsychiatrynews.com/article/PIIS027066441070299X/abstract?rss=yesMedicare's decision to eliminate consultation codes has resulted in a loss of revenue for many physicians and forced some to cut back on appointments with Medicare beneficiaries, according to a survey commissioned by the American Medical Association and several other medical specialty societies.Specialists Hit Hard by Loss Of Consultation BillingMARY ELLEN SCHNEIDER10.1016/S0270-6644(10)70299-XClinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4News66http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703003/abstract?rss=yesPhysicians once again find themselves staring at significantly lower Medicare fees for next year, based yet again on the Medicare Sustainable Growth Rate formula. Under a stop-gap law passed in June, doctors are receiving a 2.2% increase in Medicare payments—but only through Nov. 30. In the absence of congressional action, that increase will be rolled back and the prior pay cut of approximately 21% will go into effect for the month of December.Psychiatrists Rankled by Short-Term Fix to Fee ScheduleNASEEM S. MILLER10.1016/S0270-6644(10)70300-3Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4News66http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703015/abstract?rss=yesThe federal government's decision to cut some of the red tape for veterans with posttraumatic stress disorder will make it easier for them to seek benefits and treatment, mental health experts say.VA's New Stance on PTSD Viewed as Huge Step ForwardMARY ELLEN SCHNEIDER10.1016/S0270-6644(10)70301-5Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4News66http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703027/abstract?rss=yes DR. CHIEN is a psychiatrist at Community Mental Health Council Inc. in Chicago. Previously, he was an American Psychiatric Association public psychiatry fellow and served as a member of the Council of Social Issues and Public Psychiatry.Reform Gives Boost to Public Health PsychiatryPETER CHIEN10.1016/S0270-6644(10)70302-7Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Commentary1111http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703039/abstract?rss=yes DR. JEFFERSON is director of Healthcare Technology Systems Inc., Madison, Wis., and clinical professor of psychiatry at the University of Wisconsin, Madison. He is board certified in psychiatry and internal medicine.Brush Strokes in ‘Unhinged’ a Bit Too BroadJAMES W. JEFFERSON10.1016/S0270-6644(10)70303-9Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Book Review1212http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703040/abstract?rss=yes “Everything in excess is opposed to nature.” — Hippocrates DR. LAMBA is chief resident at St. Elizabeth's Medical Center, Boston.Time to Move Away From ‘a Pill for Every Ill’GURPRIT S. LAMBA10.1016/S0270-6644(10)70304-0Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Commentary1212http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703052/abstract?rss=yes DR. SKOLNIK is associate director of the family medicine residency program at Abington (Pa.) Memorial Hospital and professor of family and community medicine at Temple University, Philadelphia. Dr. Notte is in private practice in Chalfont, Pa. They are partners in EHR Practice Consultants, helping practices move to EHR systems. Contact them at info@ehrpc.com.Meaningful Use Criteria: What's Missing?CHRISTOPHER NOTTE, NEIL SKOLNIK10.1016/S0270-6644(10)70305-2Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Commentary1313http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703064/abstract?rss=yes DR. HOWARD is assistant professor of pediatrics at the Johns Hopkins University School of Medicine, Baltimore, and creator of CHADIS, the Child Health and Development Interactive System (www.CHADIS.com). She can be reached at cpnews@elsevier.com.The Other Face of ADHD: Inattentive TypeBARBARA J. HOWARD10.1016/S0270-6644(10)70306-4Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Commentary1313http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703076/abstract?rss=yes DR. FINK is a psychiatrist and consultant in Bala Cynwyd, Pa., and professor of psychiatry at Temple University in Philadelphia. Dysthymic disorder is one of those diagnoses in the DSM-IV that seems to be characterized by ambiguity. I think that many psychiatrists like me do not use this category very often because we see it as a fall-back diagnosis. For example, if you don't think that the patient has a serious depression, you might call it dysthymic disorder.A recent study shows that dysthymic disorder leads to more disability than major depressive disorder. How should we think about dysthymic disorder?PAUL J. FINK10.1016/S0270-6644(10)70307-6Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Fink! Still at Large1414http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703088/abstract?rss=yesEDINBURGH — British psychiatrists are scratching their heads over two fresh sets of sharply conflicting guidelines on the use of medications in borderline personality disorder.Dueling Borderline Guidelines Spark Debate in U.K.BRUCE JANCIN10.1016/S0270-6644(10)70308-8Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Adult Psychiatry1515http://www.clinicalpsychiatrynews.com/article/PIIS027066441070309X/abstract?rss=yesMale veterans with posttraumatic stress disorder appear to be nearly twice as likely to develop dementia as those who do not have PTSD, a study has shown. The reason for this association is not yet known, nor is it clear whether treatment of PTSD reduces dementia risk. Until more is understood about this newly identified link, it is critical that all patients with PTSD, especially those of advanced age, be followed to screen for cognitive impairment, said Dr. Kristine Yaffe of the University of California, San Francisco, and her associates.PTSD Tied to a Doubling of Veterans' Risk for DementiaMARY ANN MOON10.1016/S0270-6644(10)70309-XClinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Adult Psychiatry1515http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703106/abstract?rss=yesEDINBURGH — The link between psychosis and violence is considerably stronger in women than men, a review of the available evidence suggests. “I think there is quite good evidence that psychosis seems to confer a disproportionate risk of violence in women as compared to men. Psychosis is a very important risk factor for violence among women—more so than in men,” Dr. Pamela J. Taylor said at the meeting.Psychosis Is a Major Risk Factor for Violence by WomenBRUCE JANCIN10.1016/S0270-6644(10)70310-6Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Adult Psychiatry1616http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703118/abstract?rss=yesInstead of fading as time passes, mental health problems, including posttraumatic stress disorder and depression, actually increase late in the year after combat veterans return from serving in Iraq, a study has shown.PTSD, Depression Worsen During Year After CombatMARY ANN MOON10.1016/S0270-6644(10)70311-8Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Adult Psychiatry1616http://www.clinicalpsychiatrynews.com/article/PIIS027066441070312X/abstract?rss=yesEDINBURGH — Why should being male so markedly increase the likelihood of ending up with a diagnosis of an autism spectrum condition? One explanation gaining increased traction as a result of multiple converging lines of evidence is the fetal testosterone theory of autism, Simon Baron-Cohen, Ph.D., said in the annual Blake Marsh Lecture at the meeting‥Fetal Testosterone Theory of Autism Gathering SteamBRUCE JANCIN10.1016/S0270-6644(10)70312-XClinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Child/Adolescent Psychiatry1717http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703131/abstract?rss=yes Major Finding: Child psychiatrists report that insomnia is a major problem for 28% of the patients they see in a typical month. In a typical month, 96% of respondents recommended a prescription medication, and 88% recommended an over-the-counter medication.Insomnia Diagnosed Almost 30% of Time by Child PsychsROBERT FINN10.1016/S0270-6644(10)70313-1Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Child/Adolescent Psychiatry1717http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703143/abstract?rss=yesCHICAGO — Whether the activity involves putting brush to paper or assembling images into a collage, expression through the visual arts can powerfully improve the quality of life for people with dementia and terminal illness.Art Therapy Benefits Hospice, Dementia PatientsSUSAN BIRK10.1016/S0270-6644(10)70314-3Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Geriatric Psychiatry1818http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703155/abstract?rss=yes Major Finding: Asking patients to recite the days of the week backward correlated better with a standard dementia screen (3.88 on a scale of 0-5) than did a standard spelling (2.24) or counting task (0.90).Modified MMSE Screens More Accurately for DementiaDAMIAN McNAMARA10.1016/S0270-6644(10)70315-5Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Geriatric Psychiatry1818http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703167/abstract?rss=yesSelective serotonin reuptake inhibitor use may lead to an increased risk of cataract development, a study by Canadian researchers has shown. In a large nested case-control study, the researchers found that certain SSRIs correlated with an increased likelihood of cataract diagnosis and cataract surgery.Cataract Risk 15% Higher in Current SSRI UsersCALVIN GODFREY10.1016/S0270-6644(10)70316-7Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Geriatric Psychiatry1919http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703179/abstract?rss=yesFaith not only feeds the soul, it also might heal the mind. Data amassed over the past three decades on religion, spirituality, and health suggest that faith practices can be powerful mental health elixirs.A Little Faith Goes a Long Way10.1016/S0270-6644(10)70317-9Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Prevention in Action2020http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703180/abstract?rss=yesWASHINGTON — The federal government is seeking to track acute and long-term health effects in individuals working to clean up the BP oil spill in the Gulf of Mexico and is enlisting health care providers to assist, the director of the National Institute for Occupational Safety and Health (NIOSH) testified at a hearing.Feds Seek to Track Oil Spill—Related Health IssuesALICIA AULT10.1016/S0270-6644(10)70318-0Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Practice Trends2121http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703192/abstract?rss=yesThe physician search firm Merritt Hawkins & Associates says that from April 2009 to March 2010, requests for psychiatrists jumped 47% over the previous year, and 121% from 3 years ago. The Irving, Tex.–based company said that the increased demand is attributable to the recession and its accompanying rise in stress-related conditions. And as the population ages and more Afghanistan and Iraq war veterans need mental health services, the supply of psychiatrists is dwindling, said Merritt Hawkins. “The shortage of psychiatrists may be a silent one, but it is real nonetheless,” said company president Mark Smith in a statement. The company also reported that more physicians are choosing to work as hospital employees. Four years ago, 23% of physician searches were for positions in hospitals, but in the latest survey, that portion jumped to 51%.Policy & Practice: Want more health reform news? Subscribe to our podcast – search ‘Policy & Practice’ in the iTunes storeAlicia Ault10.1016/S0270-6644(10)70319-2Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Practice Trends2121http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703209/abstract?rss=yesThe line between typical and atypical (first- and second-generation) antipsychotic medications is becoming ever more blurred, with numerous investigators suggesting that the distinction is no longer valid or useful in designing clinical trials, or even in selecting the best agent to treat an individual patient.New Data Blur Typical-Atypical Drug Distinctions10.1016/S0270-6644(10)70320-9Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Practical Psychopharmacology2222http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703210/abstract?rss=yesOne of the first provisions of the Patient Protection and Affordable Care Act to take effect is the $250 rebate for Medicare beneficiaries who fall into the Part D doughnut hole.Closing the Doughnut Hole10.1016/S0270-6644(10)70321-0Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Implementing Health Reform3030http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703222/abstract?rss=yesNew federal regulations mandated by the Affordable Care Act will give patients new rights to appeal claims denials made by their health plans. The rules will allow consumers in new health plans to appeal decisions both through their insurer's internal process and to an outside, independent entity. Most health plans already provide for an internal appeals process, but not all offer an external review of plan decisions, according to the U.S. Department of Health and Human Services. The types of appeals processes often depend on individual state laws.Patients Get New Rights to Appeal Insurance DecisionsMARY ELLEN SCHNEIDER10.1016/S0270-6644(10)70322-2Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Practice Trends3030http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703234/abstract?rss=yesThe U.S. health care system ranked last, compared with several other industrialized nations, on measures of quality, efficiency, patient safety, access to care, and equity, according to a new report by the Commonwealth Fund.U.S. Health Care System Ranks Last Among Industrialized CountriesNaseem S. Miller10.1016/S0270-6644(10)70323-4Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Practice Trends3030http://www.clinicalpsychiatrynews.com/article/PIIS0270664410703246/abstract?rss=yesDENVER — Physicians might not be enamored of Medicare, but they like it a whole lot better than private insurance plans, according to a survey by the Medical Group Management Association.Survey: Medicare Preferred to Private InsurersERIK GOLDMAN10.1016/S0270-6644(10)70324-6Clinical Psychiatry News 38, 8 (2010)2010-08-01Clinical Psychiatry News2010-08-01388S0270-6644(10)X7008-4Practice Trends3131