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The science of trans-kids

The science of trans-kids

SCOTTSDALE, ARIZ. – The treatment of preadolescents who present with gender questions is often complicated by the absence of evidence-based data on who is most likely to remain gender dysphoric into adulthood and who is not, an expert said at the annual meeting of the American College of Psychiatrists.

Avoiding a "brain attack"

Avoiding a "brain attack"

WASHINGTON – As data mount confirming the neurodegenerative effects of psychotic episodes in schizophrenia, one expert urges psychiatrists to think of psychosis as a “brain attack” which, like heart attacks, must be prevented from recurring.

Drugs of desire

Drugs of desire

MIAMI – Women distressed by a low desire for sex could have a novel pharmaceutical intervention soon.

Patient profile & antipsychotic use

Patient profile & antipsychotic use

MIAMI – Expert clinicians endorsed long-acting injectables as a preferred treatment for bipolar I disorder on the basis of patient characteristics and treatment history, rather than on an assumed level of treatment adherence, according to a small survey.

Survivor, not 'crazy'

Survivor, not 'crazy'

WASHINGTON – A view of borderline personality disorder as neurobiological in nature can help clinicians extend their patience and empathy to these notoriously difficult-to-treat patients, according to an expert.

Resilience for doctors: smooth sails

Resilience for doctors: smooth sails

SCOTTSDALE, ARIZ.-- “Changes in medicine have been so frustrating; physicians are at their wits’ end. We don’t recruit people into medicine because they have a skill set for expressing their emotions, or taking care of themselves, or dealing with conflict,” she said. “That’s okay. They can learn it.” That's according to Linda L.M. Worley, MD, staff psychiatrist in the Fayetteville, Ark., Veterans Health Care System and adjunct prof. at Vanderbilt Univ. in Nashville, Tenn.

Psychosis in bipolar depression

Psychosis in bipolar depression

MIAMI – Response rates for psychotic and nonpsychotic depression in bipolar disorder were statistically similar, regardless of treatment, an ad hoc analysis has shown.

PTSD: talk therapy is best

PTSD: talk therapy is best

MIAMI – New federal clinical practice guidelines for treating posttraumatic stress disorder move trauma-focused psychotherapy ahead of pharmacotherapy as first-line treatment.

Staging the blues

Staging the blues

WASHINGTON--Why don't we stage depression, like we do cancer? And rather than cure it, can we learn to live with it?

Psychoanalysis for all

Psychoanalysis for all

SCOTTSDALE, ARIZ. -- That grumpy grimace is not the face of today's pscyhoanalysis, even if it is the mug of the man who "invented" the notion of using your words as keys to unlock you from your prison of tortuous memory.

Inflamed brains link to depression

Inflamed brains link to depression

SCOTTSDALE, ARIZ. – Inflammation is inextricably linked to depression in a subset of patients who differ from other depressed patients in their responses to certain interventions, according to Charles L. Raison, MD.

Talk therapy for all

Talk therapy for all

SCOTTSDALE, ARIZ. – Most psychiatrists are familiar with many of the basic tenets of psychoanalysis, but they probably aren’t relying on its therapeutic powers in practice as much as they are pharmacotherapy, according to an expert.

The patient as partner in cure

The patient as partner in cure

MIAMI – Not all researchers are clinicians, but what if all clinicians were researchers? Clinical studies would yield more relevant data, resulting in better patient care, according to an expert.

Psycho-social diabetes care

Psycho-social diabetes care

Landmark guidelines addressing the psychosocial needs of persons with diabetes are being met with praise overall, but some question whether endocrinologists and others are up to the task of providing the extensive mental health services called for in the document.

Why are Hep C pills hard to get

Why are Hep C pills hard to get

BOSTON – State Medicaid programs have begun to loosen restrictions and improve transparency around access to direct-acting antiviral agents to treat hepatitis C virus infection, but inconsistencies are still the norm nationwide.

Hope for families of mentally ill

Hope for families of mentally ill

WASHINGTON – Bipartisan legislation to improve care of patients with serious mental illness is just a pen stroke from passage, now that the 21st Century Cures Act is headed for the President’s desk. While the mental health care reform provisions in the legislation (H.R. 34) will impact mental health services broadly, the bulk of the reform language comes from H.R. 2646, a bill sponsored by Rep. Tim Murphy (R-Penn.), which was intended to reverse decades of fragmented – and at times nonexisten

Our BRAIN needs big bucks

Our BRAIN needs big bucks

BETHESDA, MD – Top researchers are optimistic that billions in funding for basic neuroscience research made possible by the 21st Century Cures Act, will lead to breakthroughs in the understanding of brain function--and dysfunction. Will the discoveries help end the stigma of mental illness?

Depression & measurement-based care

Depression & measurement-based care

WASHINGTON – Challenging patients with depression to stay engaged in their recovery while rigorously monitoring and measuring their treatment response can mean the difference between remission or resistance, according to an expert.

Psychiatry’s role rising in hospital

Psychiatry’s role rising in hospital

BALTIMORE – A team of physicians and mental health experts at Johns Hopkins Hospital is trying something new: combining mental health services with medical ones. Hospital leadership hopes the experiment will pay off in shorter lengths of stay, lower readmission rates, and better overall patient care.

Less opioids mean nothing without...

Less opioids mean nothing without...

WASHINGTON – Pressure on physicians to prescribe fewer opioids could have unintended consequences in the absence of adequate access to treatment, according to experts.

Should you trust in that drug?

Should you trust in that drug?

Doubt is being cast on the efficacy of Diclegis – the only prescription drug approved in the United States for treating nausea and vomiting in pregnancy – after researchers exposed flaws in previously unpublished data that served as the basis for the drug’s approval.

Ostracism of concern in military

Ostracism of concern in military

WASHINGTON – The role of ostracism in overall poor health outcomes in service personnel is a growing concern, according to a panel of military experts.

Suicide risks in military women

Suicide risks in military women

WASHINGTON – Women service personnel face different suicide risks from their civilian counterparts, according to a Department of Defense appointee.

Battle over mandate at NIMH

Battle over mandate at NIMH

NEW YORK Speaking with psychiatrist and neuroscientist Joshua Gordon in his office at Columbia Univ. the week before he assumed leadership of the world's largest mental health research organization, we talked about his plans for his tenure, and whether he would pick up where his controversial predecessor left off, or go in a new direction.

Can pot smoking trigger psychosis?

Can pot smoking trigger psychosis?

Evidence is strong that cannabis use after a first episode of psychosis increases the risk of relapsing psychosis, but causality is still not definite.

Psych + pri-care = future

Psych + pri-care = future

SCOTTSDALE, ARIZ. – Whether or not the Affordable Care Act (ACA) is repealed, replaced, reviled, or revered should not deter psychiatrists and primary care physicians from seeking to work together, according to a leading expert on integrating mental health care in medical practice.

ECT in elderly curbs depression

ECT in elderly curbs depression

AMSTERDAM – Despite persistent stigma, electroconvulsive therapy endures as an effective treatment for depression, particularly when applied with a patient-specific approach, according to several study results presented at the annual congress of the European College of Neuropsychopharmacology.

More suicide risk training needed

More suicide risk training needed

BETHESDA - The rise in U.S. suicide rates to the highest levels in almost 30 years is tied to many factors has prompted some experts to call for more suicide risk assessment training for mental health and substance abuse clinicians.

"Adopt federal mental health policy"

"Adopt federal mental health policy"

WASHINGTON In order for the United States to succeed in reducing the stigma associated with mental illness and substance use disorders, the Department of Health & Human Services should lead the way, according to a National Academies of Sciences report.

Talk therapy + ECT = less depression

Talk therapy + ECT = less depression

AMSTERDAM – Electroconvulsive therapy’s efficacy in rapid relief from depression is well-established, particularly in the elderly, but the best ways to improve the treatment’s overall effectiveness over time remain a puzzle.

Mental Health State of the Union

Mental Health State of the Union

WASHINGTON – Just because mental health parity laws exist, doesn’t mean they are enforced.

ALZ: 'Passing at a cocktail party'

ALZ: 'Passing at a cocktail party'

Newtown, Mass. - Steve Johanson was diagnosed with early onset Alzheimer’s disease at age 58. It wasn’t apparent at first, although there were subtle signs and symptoms that in retrospect, an alert physician might have seen. Hear Steve and his wife Judy tell their story and learn ways you can detect memory disorders in patients like Steve. Dr. Andrew Budson discusses ways you can detect memory disorders in patients like Steve Johanson.

So much to love

So much to love

BOSTON, Mass. - Boston University’s PAIRS program (Partnering in Alzheimer’s Instruction Research Study) partners medical school students from the University’s medical school with patients who have early stage Alzheimer’s disease or other cognitive impairment. Oscar Garcia, a second year medical school student from El Paso, Tex., was paired with the Johanson family of Watertown, Mass., whose patriarch, Steve Johanson, has been diagnosed with early stage Alzheimer’s. This is their story.

Successful schizophrenia care

Successful schizophrenia care

CAPITOL HILL -- The young woman on the right, Maggie, age 20, is one of the most intriguing young women with mental illness I have encountered. At 15, she was at a friend's house having a sleep over. All of a sudden...

IBD specialists turn to psychiatry

IBD specialists turn to psychiatry

PITTSBURGH - In just 1 year, 34 out of about 5,000 patients seen at the inflammatory bowel disease center at the University of Pittsburgh Medical Center cost more than $10 million to treat. “Our health plan said, ‘You have to fix this,’” recalled Dr. Miguel Regueiro, codirector of the IBD center. So, in addition to asking the insurer for ideas, Dr. Regueiro did the most cost conscious thing he could think of: He asked for ideas from his colleague, Dr. Eva Szigethy, a psychiatrist specializing

Protecting her husband

Protecting her husband

WATERTOWN, Mass. -- I was sent to tell a story about a man with early onset Alzheimer's disease. Steve Johanson, 62, had been paired with first year medical school student, Oscar Garcia, 21, as part of an experiential learning program that has shown promise for increasing the heuristic skill sets of future physicians who will one day treat these patients.

The future of Alzheimer’s in America

The future of Alzheimer’s in America

WATERTOWN, Mass - The 4.7 million Americans with Alzheimer’s in 2015 could mushroom to 10.3 million by 2040, according to researchers at the Lewin Group, a policy and research consulting firm. Aging along with this population are the relatives and friends who likely will care for them.

Get ready for biosimilars in IBD

Get ready for biosimilars in IBD

ORLANDO – Regardless of what you think about using biosimilars, chances are you won’t be able to avoid using them if you already use biologics.

Heavy pot use tied to earlier death

Heavy pot use tied to earlier death

Heavy marijuana use by men aged 18 or 19 years is associated with a greater risk of mortality by age 60, a longitudinal study of more than 45,000 subjects shows.

The politics of food addiction: who

The politics of food addiction: who

ATLANTA – It’s too soon to disrupt current obesity treatment by declaring food addiction to be a clinical condition, according to Dr. Paul Fletcher. "If we are to employ [the term] food addiction ... it needs a firm scientific basis," said Dr. Fletcher, who is the Bernard Wolfe Professor of Health Neuroscience in the department of psychiatry at University of Cambridge (England).

Freud, math, and psychiatry's future

Freud, math, and psychiatry's future

TORONTO – Five in the afternoon, after a full day of cramming one’s brain with information from multiple sessions at an annual medical meeting, is a cruel time to offer a panel discussion linking behavioral economics, Freud, and the RDoC to future treatments for mental disorders.

Psychiatry bible for lay public

Psychiatry bible for lay public

TORONTO – The American Psychiatric Association’s consumer guide to the DSM-5, “Understanding Mental Disorders,” debuted at the organization’s annual meeting this year.

Opioid crisis partly fault pri-care

Opioid crisis partly fault pri-care

Underlying the nation’s opioid abuse epidemic is the fact that physicians are undertrained, underresourced, and using incorrect assessment tools to diagnose and treat chronic pain, according to an expert panel.

Oxytocin "no go" in schizophrenia

Oxytocin "no go" in schizophrenia

AMSTERDAM – For decades, researchers have studied whether oxytocin has the potential to have a therapeutic effect in schizophrenia. Recently, however, the lack of consistently positive findings has caused some to wonder whether the hormone’s value as a schizophrenia treatment is at a dead end.

First transgender top doc

First transgender top doc

Before her appointment earlier this year by Gov. Tom Wolf (D-Pa.) as the state’s physician general, Dr. Rachel Levine was vice chair for clinical affairs in the department of pediatrics and chief of the division of adolescent medicine and eating disorders at Penn State Hershey Children’s Hospital at the Penn State Hershey Medical Center. While on the faculty there, she decided to transition from her male birth sex to that of female.

LGBT-friendly care

LGBT-friendly care

The pivotal moment in Dr. David Jaspan’s decision to create an LGBT-friendly practice was when a first-year resident physician told him a lesbian woman had presented with advanced-stage cervical cancer to their Philadelphia-based community ob.gyn. clinic.

Feds: treatment, not jail

Feds: treatment, not jail

WASHINGTON – The Obama administration announced Aug. 17 that it will spend an additional $13.4 million fighting opioid and heroin abuse, emphasizing treatment over law enforcement.

Is PTSD being diagnosed enough?

Is PTSD being diagnosed enough?

TORONTO – The most effective ways to diagnose and treat posttraumatic stress disorder in military populations is at issue after the results of a recent study showed that a third of soldiers who previously would have qualified for the diagnosis do not under updated criteria. The matter is far from settled, however, and continues to be a matter of debate.

Politics, prejudice harms the obese

Politics, prejudice harms the obese

ATLANTA – Obesity and its comorbidities loom, threatening to become an expensive national crisis, given that its treatment costs are nearly double that of other chronic diseases, and third party payers so far have failed to invest in its prevention. "Obese individuals are about 42% more expensive than their normal weight counterparts," accounting for 9% of all medical expenditures, Eric Finkelstein, Ph.D., said.

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