Psychiatry 2008 - September 2008 - (Page 8)

Editor’s Message Issue Highlights, September 2008 Dear Colleagues: Welcome to the the September issue of Psychiatry 2008. We start with Trend Watch. In this month’s installment, we examine the role of benzodiazepines in the treatment of anxiety by both psychiatrists and primary care physicians. Total benzodiazepine use remains slightly greater in primary care than psychiatry (51% vs. 42%). Next, Shah, et al., provide a review on use of deep brain stimulation for treatment of obsessive compulsive disorder (OCD) and major depressive disorder. The authors review the etiology of OCD and MDD and discuss the role that distinct neuronal circuits have on OCD and MDD symptoms. The authors review several neurosurgical interventions that have been used in OCD and MDD and focus on neuromodulation, or deep brain stimulation. In this month’s Psychotherapy Rounds, Kaminer, et al., present the case of a 15-year-old boy who was referred to the authors’ clinic after being arrested for drug dealing. The patient was willing to discuss a treatment option in order to avoid legal consequences and have his pending charges dropped; however, he was not motivated to abstain from drug use. The authors review the literature on substance use disorder (SUD) and unipolar depression and provide guidelines for a combined pharmacological and psychosocial intervention based on this clinical case example. Next, Saxena, et al., present a case report of a patient with paranoid schizophrenia who was treated with risperidone long-acting injection given in the deltoid muscle instead of the US Food and Drug Administration (FDA)approved gluteal muscle injection site. Use of this agent in the deltoid muscle facilitated healing of the numerous, painful, lumpy nodules associated with prior trials of conventional long-acting injections. In addition, the patient’s psychiatric outcome was improved relative to what had been observed with the previous agents. This method of injection is something to consider for those patients who will not tolerate injections at any other site. In this month’s The Interface, Sansone and Sansone discuss studies that relate to alcohol and substance misuse and medical treatment nonadherence. Despite illness type, population characteristics, or adherence measures, studies are fairly consistent—alcohol and substance misuse reduce patient adherence with medical treatment. Perhaps not a surprise, but an important reminder to clinicians is to consider every patient’s current or past use, misuse, or abuse of alcohol or drugs when prescribing treatment. Finally, Dr. Feifel shares with the readers his successful implementation of more aggressive, biologically based interventions in his psychiatric ward for inpatients. Dr. Feifel states, “…it is worthwhile for those in our field, particularly the growing group of psychiatric hospitalists and administrators, to seek to expand the role of psychiatric inpatient care and stake out a place for it at the leading edge, rather than the trailing edge of psychiatric care.” Sincerely, Business Staff EDITOR Amir H. Kalali, MD Vice President, Global Therapeutic Group Leader CNS, Quintiles Inc.; Professor of Psychiatry, University of California, San Diego, California FOUNDING EDITOR Wade H. Berrettini, MD, PhD Karl E. Rickels Professor of Psychiatry, Director, Center for Neurobiology and Behavior, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania PRESIDENT/GROUP PUBLISHER Robert L. Dougherty Matrix Medical Communications Edgemont, Pennsylvania PARTNER Patrick D. Scullin Matrix Medical Communications Edgemont, Pennsylvania VICE PRESIDENT, BUSINESS DEVELOPMENT Joseph J. Morris Matrix Medical Communications Edgemont, Pennsylvania VICE PRESIDENT, EXECUTIVE EDITOR Elizabeth A. Klumpp Matrix Medical Communications Edgemont, Pennsylvania ASSOCIATE EDITOR Colleen M. Hutchinson Matrix Medical Communications Edgemont, Pennsylvania ASSOCIATE EDITOR Kimberly B. Chesky Matrix Medical Communications Edgemont, Pennsylvania NATIONAL SALES MANAGER Brad A. Lacey Matrix Medical Communications Edgemont, Pennsylvania EDITORIAL CORRESPONDENCE should be directed to Executive Editor, Psychiatry 2008, Matrix Medical Communications, 4975 West Chester Pike, PO Box 445, Edgemont, PA 19028-0445. Tollfree: (866) 325-9907; Phone: (610) 325-9905; Fax: (610) 3259906; E-mail: eklumpp@matrixmedcom.com INDEXING— PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health Literature®), CINAHL® Plus with Full Text ADVERTISING QUERIES should be addressed to Robert Dougherty, President/Group Publisher, Psychiatry 2008, Matrix Medical Communications, 4975 West Chester Pike, PO Box 445, Edgemont, PA 19028-0445. Toll-free: (866) 325-9907; Phone: (610) 325-9905; Fax: (610) 325-9906; E-mail: rdougherty@matrixmedcom.com 4975 West Chester Pike PO Box 445 Edgemont, PA 19028-0445 Copyright © 2008 Matrix Medical Communications. All rights reserved. Opinions expressed by authors, contributors, and advertisers are their own and not necessarily those of Matrix Medical Communications, the editorial staff, or any member of the editorial advisory board. Matrix Medical Communications is not responsible for accuracy of dosages given in the articles printed herein. The appearance of advertisements in this journal is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality, or safety. Matrix Medical Communications disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the articles or advertisements. Reprints are available. Contact Matrix Medical Communications for information. Psychiatry 2008 (ISSN 1550-5952) is published 12 times yearly by Matrix Medical Communications and printed by Publishers Press, Shepherdsville, Kentucky. Printed in the United States of America. Amir Kalali, MD Editor, Psychiatry 2008 8 Psychiatry 2008 [ S E P T E M B E R ]

Table of Contents Feed for the Digital Edition of Psychiatry 2008 - September 2008

Psychiatry 2008 - September 2008 Editor’s Message Editorial Advisory Board Contents Psych Rx Letters to the Editor Use of Benzodiazepines in the Treatment of Anxiety Functional Neurosurgery in the Treatment of Severe Obsessive Compulsive Disorder and Major Depression: Overview of Disease Circuits and Therapeutic Targeting for the Clinician Treatment of Comorbid Adolescent Cannabis Use and Major Depressive Disorder Risperidone Long-acting Injections: Successful Alternative Deltoid Muscle Injections for Refractory Schizophrenia Alcohol/Substance Misuse and Treatment Nonadherence: Fatal Attraction Transforming the Psychiatric Inpatient Unit from Short-term Pseudo-asylum Care to State-of-the-art Treatment Setting Journal Watch Classified Advertising Information for Authors

Psychiatry 2008 - September 2008

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