Dear Colleagues:
Welcome to the September issue of Psychiatry 2010. We hope everyone had a restful and relaxing summer and is ready for the cooler weather and the busy months ahead.
We start this issue of the journal with Trend Watch, in which the authors explore the current state of the psychiatry drug development pipeline. Analysis suggests that overall the psychiatry pipeline is heavily skewed toward a few major indications and tends to have more programs in early development (Phase I and II) than later stages (Phase III). A review of development sponsors shows a fairly even split of programs between Top 50 Pharmaceutical companies and small to mid-sized biopharmaceutical companies.
Next, Sansone and Sansone provide us with another interesting mini-review in this month’s “The Interface.” This time, the authors examine and discuss the literature regarding hyper-reactivity in patients with borderline personality disorder. Perhaps not surprisingly, the majority of empirical studies the authors examined concluded that patients with borderline personality disorder are hyper-responsive to experimental environmental stimuli, whether the stimuli are negative, positive, or even neutral or ambiguous. Both practicing psychiatrists and primary care physicians should keep this in mind when treating patients with borderline personality disorder.
Following this, Khawaja et al assess the characteristics and correlates of sleep problems in patients with lifetime posttraumatic stress disorder and ongoing sleep disturbance not due to obstructive sleep apnea or other diagnosed sleep disorders. The authors find in their patient sample that sleep quality among patients with posttraumatic stress disorder in active treatment is worse in direct relation to more severe posttraumatic hypervigilance symptoms.
Next, Morandi et al examine the role of magnetic resonance imaging (MRI) in the evaluation of intensive care unit delirious patients. The authors present a series of cases and describe preliminary MRI findings obtained because of delirium. The authors also describe the subsequent in-hospital clinical decisions and post-discharge neurocognitive outcomes in intensive care unit survivors. The authors conclude that the MRI findings in these delirious intensive care unit patients did not alter the immediate treatment course and these patients had neuropsychological impairments at three months. The authors call for additional research to define the role of current and newer MRI techniques in assessing and managing delirious intensive care unit patients.
Following this, te Wildt et al describe a case of a man with intellectual disability who routinely swallowed numerous sharp objects and other non-food items and presented to the hospital for treatment. The authors discuss how the objects were removed, the challenging management of the patient, and the possible reasons behind his behavior, including impulse control disorder and malingering.
Finally, in this month’s installment of “Psychiatry and Neurology,” Gillig and Sanders review the role the cerebellum has in pain perception, attention deficit disorder, autism, dementia, and schizophrenia. The authors also describe practical observations and tests to assess cerebellar function in the psychiatrist’s office.
Sincerely,
Amir Kalali, MD
Editor, Psychiatry 2010
