Dear Colleagues:
Welcome to the October issue of Psychiatry 2010.
In this month’s Trend Watch, the authors examine retail pharmacy prescriptions for branded and generic attention deficit hyperactivity disorder treatments, atypical antipsychotics, selective serotonin reuptake inhibitors, and serotonin and norepinephrine reuptake inhibitors and analyze the average out-of-pocket costs incurred by patients who are covered by commercial third-party prescription plans (i.e., as opposed to patients covered by Medicaid or patients with no prescription coverage). They found that, overall, patient out-of-pocket costs in commercial third-party plans are lower for generic prescriptions than they are for brand prescriptions by at least $19.02.
Next, in this month’s The Interface, Sansone and Sansone examine the existing literature on selective serotonin reuptake inhibitors and find that exposure to these medications has been occasionally associated with both behavioral apathy and emotional blunting. The authors describe these syndromes and explore the research regarding epidemiology, etiology, and treatment strategies.
Following this, Kool and Lawver revisit for our readers a unique form of psychiatric treatment that is geared toward young children—play therapy. The authors describe the theoretical underpinnings of play therapy, discuss some practical considerations for the clinician, and summarize the current state of research in regard to play therapy. The authors present the practicing psychiatrist with a road map for referring a patient to play therapy or initiating it in appropriate cases.
Next, Narang et al review the literature and summarize safety concerns regarding the use of first- and second-generation antipsychotic medications and discuss when it is appropriate to consider using such medication in elderly patients with dementia. In addition to a careful medical work-up of the patient prior to prescribing an antipsychotic, the authors also describe the ongoing and individualized clinical, electrocardiographic, and pharmaceutical monitoring that must occur during an antipsychotic medication trial in the older patient.
Following this, Testa and West provide an excellent review of the psychiatric practice of civil commitment in the United States. In addition to providing an overview of the history of involuntary psychiatric hospitalization in the United States, the authors also discuss the ethical conflict that the practice of involuntary hospitalization presents for providers, the evolution of the United States commitment standards, and the implications that the changes in commitment criteria has had on patients and society. An overview of outpatient commitment is also provided.
Next, we are pleased to include another installment of our Forensic Files column. This month, Yanofski provides a brief history of prisoners’ rights with a focus on mental health treatment. He discusses the most common method of lawsuit, “1983 claims,” as well as relevant landmark cases.
And finally, we wrap the issue up with two great columns. In this month’s Update on Alzheimer’s, Howe reviews the core findings on the genes that contribute to the early-onset (familial) and late-onset forms of Alzheimer’s disease as well as related findings on how a psychiatrist might best approach the discussion of genetic testing with his or her patients. And in Meymandi at Large, Dr. Meymandi reviews for us Carl Jung’s fascinating compendium of writings and artwork, Liber Novus, or The Red Book.
Sincerely,
Amir Kalali, MD
Editor, Psychiatry 2010
