May Issue Highlights

| May 19, 2010 | 0 Comments

Dear Colleagues:

Welcome to the May issue of Psychiatry 2010. We start this issue with our regular monthly column, “Trend Watch.” This month, the authors investigate the range of treatments prescribed for fibromyalgia. The data suggest that the majority of those treated, 82 percent, receive only one pharmaceutical—a surprising fact, according to Roland M. Staud, MD, Professor of Medicine, at the University of Florida in Gainesville, who provides the expert commentary on the data. Dr. Staud finds that half of all patients treated with any one of the medications listed in the data seem to experience only a 30-percent reduction of symptoms, suggesting that many patients with FM will require additional therapies. Are many FM patients undertreated?

Next, Howe tackles some difficult ethical questions in his article, “Core Ethical Questions: What Do You Do When Your Obligations as a Psychiatrist Conflict with Ethics?” In this commentary, Howe discusses, among other things, the pros and cons of warning patients that the information the patients confide in their psychiatrists may be shared with third parties (e.g., in forensic settings) or may be used to involuntarily hospitalize them. Dr. Howe also discusses situations where a psychiatrist might give moral weight to his or her own interests when making patient-treatment decisions.

Following this, Aiken and Orr investigate the safety of rechallenge with lamotrigine after an initial rash in patients with refractory bipolar depression. They find that rechallenge is a viable option after a benign rash on lamotrigine, can be undertaken with more caution after rashes with 1 to 2 signs of potential seriousness, and should be studied further when following rashes with three or more signs of seriousness.

Next, Sansone et al examine three caretaking variables (i.e., the number of different caretakers in childhood, whether caretakers were the biological parents or not, and the perceived quality of caretaking) and their relationship to self-reported sleep quality in patients of the authors’ clinic over the past month. Only one of the childhood caretaking variables demonstrated a relationship with quality of sleep in adulthood—the perceived quality of caretaking. The authors discuss the potential implications of this finding.

Following this, in their final installment of the cranial nerve series, Gillig and Sanders review the final four cranial nerves IX through XII. The article reviews several syndromes related to these cranial nerves that might be seen in psychiatry.

Next, in this month’s installment of “The Interface,” the authors examine the possible association between stalking behavior and borderline personality disorder. Data suggest that in less forensically focused samples of stalkers, rates of borderline personality are likely to be substantially higher, but confirmatory data are lacking. The authors describe and discuss the data they researched.

We wrap up the issue with another insightful piece from Dr. Assad Meymandi. In this month’s Meymandi at Large, Dr. Meymandi comments on the philosopher, Baruch Spinoza. We also present another installment of “Risk Management.” This month’s topic is curbside consultations–Are you at risk for malpractice when you perform them? We hope you find the answer helpful.

Amir Kalali, MD
Editor, Psychiatry 2010

Category: Editor's Message: Issue Highlights, Past Articles

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