Psychiatry - October 2008 - (Page 8)

Editor’s Message Issue Highlights, October 2008 Dear Colleagues: Welcome to the October issue of Psychiatry 2008. In this month’s Trend Watch, we examine the treatment of migraine and the role of psychiatric medications. Psychiatrists treat only slightly more than one percent of migraine patients, with the majority of these patients being treated by primary care physicians or neurologists. 5HT-1 agonists represent 42 percent of migraine treatment, and pain products and antiepileptics account for an additional 34 percent of migraine therapy treatments. Psychiatric medications, such as tricyclic antidepressants, account for only 3.5 percent of medication uses. Todd Smitherman, from the University of Mississippi in Oxford, Mississippi, provides a commentary. He notes that because of the prevalence and detrimental impact of psychiatric comorbidities, all psychiatrists should screen migraine patients for depression and anxiety and also be alert for the presence of migraine in those patients who present exclusively with common psychiatric symptoms. Next, this month’s Psychotherapy Rounds focuses on use of play therapy by psychiatrists who treat children. The authors introduce this type of therapy to the readers using a casebased example of a nondirective approach with a six-year-old boy with oppositional defiant disorder. The presentation focuses on the events and interactions of a typical session with an established patient. The authors also review the literature and provide discussion on this established mode of therapy. Following this, Markowitz and Narasimhan provide the readers with a review of delirium. The authors describe how to recognize delirium and distinguish it from other disorders and illnesses. They also provide evidence-based information regarding the selection of appropriate medication to target the perceptual, behavioral, and cognitive abnormalities caused by delirium. The authors review both the typical and atypical antipsychotics with the best evidence for efficacy and safety and discuss environmental treatments to present the full armamentarium of therapeutic options available to the practicing clinician when treating delirium. Next, Bastiaens and Bastiaens examine differences between mood disorder types in children. Using standardized assessment tools, youths between 6 and 18 years old who were treated at a community mental health clinic were classified as having bipolar disorder or mood disorder not otherwise specified (NOS). The authors found that patients with bipolar disorder improved significantly more than mood disorder NOS patients, despite similar levels of care, and concluded that standardized assessments in community clinics are feasible and lead to the identification of meaningful differences between “similar” patient groups. The authors call for improvements in diagnostic practices across different psychiatric settings. Next, in this month’s Ethics in Psychiatry article, Howe moves beyond patient-informed consent and discusses the importance of physician transparency with the patient, including, among other things, fully disclosing criteria used to hospitalize a patient against his or her will. While this transparency may potentially cause the patient harm (e.g., patient may not disclose hallucinations or suicidal thoughts for fear of being hospitalized), Howe argues that transparency respects patient autonomy and increases patient trust in the psychiatrist, which ultimately may be more important. Finally, in this month’s The Interface, Sansone and Sansone examine the associations between asthma and mood and anxiety disorders and between asthma and trauma in childhood and adulthood. The authors find that there is a higher-than-expected prevalence of mood and anxiety disorders among people with asthma as well as a higher frequency of asthma among the traumatized. The authors discuss the limitations of these findings and propose a risk model. 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 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 NATIONAL SALES MANAGER Brad A. Lacey Matrix Medical Communications Edgemont, Pennsylvania CLASSIFIED SALES MANAGER Melanie A. Wolfrom 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 EDITORIAL QUERIES should be directed to Elizabeth Klumpp, Executive Editor, Matrix Medical Communications, Toll-free: (866) 325-9907; Phone: (610) 325-9905; Fax: (610) 325-9906; E-mail: eklumpp@matrixmedcom.com ADVERTISING QUERIES should be addressed to Robert Dougherty, President/Group Publisher, Matrix Medical Communications, Toll-free: (866) 325-9907; Phone: (610) 325-9905; Fax: (610) 325-9906; E-mail:rdougherty@matrixmedcom.com INDEXING—PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health Literature®), CINAHL® Plus with Full Text 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 [ O C T O B E R ]

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

Psychiatry - October 2008 Editor’s Message Editorial Advisory Board Contents Psych Rx Treatment of Migraine and the Role of Psychiatric Medications Play Therapy: A Case-based Example of a Nondirective Approach Delirium and Antipsychotics: A Systematic Review of Epidemiologyand Somatic Treatment Options Severely Mood-disordered Youth Respond Less Well to Treatment in a Community Clinic than Youth with Bipolar Disorder Beyond Informed Consent: The Ethics of Informing, Anticipating, and Warning Asthma: Wheezing, Woes, and Worries Classified Advertising Journal Watch Information for Authors

Psychiatry - October 2008

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