Top News Stories From the APA 2010 Annual Meeting: Slideshow

The American Psychiatric Association (APA) looked toward "a new psychiatry" at its 2010 annual meeting, held in New Orleans, Louisiana, May 22 - 26, 2010. Research highlights included studies on:

• More effective treatments for posttraumatic stress disorder

• Potential for shorter-term treatment of prescription opioid addiction

• Simple screening methods for major depressive disorder in college students

• Adverse metabolic effects of psychotropic drugs

• Novel agents for treating major depressive disorder

Some psychotropic medications are bad to the bone, exacerbating an already high underlying risk for osteoporosis among psychiatric patients, according to investigators in a large Canadian study. SSRIs were associated with a 40% increase in risk for low bone mineral density (BMD), and nonlithium mood stabilizers were associated with a 35% greater risk. In contrast, tricyclic antidepressants seemed to have a protective effect, with a 37% lower risk for low BMD, reported James Bolton, MD, from the University of Manitoba in Winnipeg, Canada. He and colleagues reviewed data on 7994 patients with osteoporosis and 23,298 matched control patients from the province's healthcare database.

Full news coverage: Many Psychotropic Medications May Be Bad for Bones

Virtual reality exposure with arousal control (VRE-AC) may be more effective than prolonged exposure therapy with simulation for the treatment of combat-related posttraumatic stress disorder (PTSD), according to Navy researchers.

"The participant, wearing a headset, has the experience of being in a city in Iraq. The therapist sits nearby and controls all aspects of this world, changing the sounds, the weather, and the level of violence. With some software we can even introduce smells and vibrations," explained lead investigator Robert McLay, MD, PhD, from the Naval Medical Center, San Diego, California.

Full news coverage: Virtual Reality Exposure Enhances Treatment of PTSD

"Perhaps the main value of this study is to emphasize the problem of depression in this population and provide the impetus to do something about it," Victor Schwartz, MD, university dean of students at Yeshiva University and associate professor of clinical psychiatry at Yeshiva University's Albert Einstein College of Medicine in New York City, told Medscape Psychiatry.

Full news coverage: Email Feasible, Inexpensive Way to Screen for Depression in College Students

Body image distortion in patients with anorexia nervosa can be objectively assessed with the help of a new software program. Patients self-administer the test, rating how their images of other bodies compare with their own, and manipulate images to bring them into line with self-perception of actual and ideal body sizes.

"As a clinician who has been working in this field for 2 decades, it was really striking for me to be able to see the image my patient sees and what they experience. For me this really changed my understanding of what body image distortion is really like for these patients," principal investigator Jennifer Hagman, MD, from the University of Colorado Denver, told Medscape Psychiatry.

Full news coverage: Software Program Accurately Assesses Body Image in Patients With Anorexia Nervosa

Patients with posttraumatic stress disorder (PTSD) do better when they're given a choice of therapies, according to Nora C. Feeny, PhD, from Case Western Reserve University in Cleveland, Ohio. In a trial that compared randomization to a therapy with the patient indicating their treatment preference, treatment with either a selective serotonin reuptake inhibitor (SSRI) or prolonged exposure were both effective. However, about 80% of patients given a choice responded to therapy, and 70% of them lost the PTSD diagnosis compared with only 55% for each category of patients who were assigned to a treatment.

Full news coverage: PTSD Treatment Effective When Patients Given a Say

Shorter treatment courses don't seem to work for the treatment of prescription opioid dependence, according to Roger D. Weiss, MD, an investigator with the National Drug Abuse Treatment Clinical Trials Network Prescription Opioid Addiction Treatment Study.

The study involved 653 persons with opioid dependence who underwent standard medical management with buprenorphine-nalaxone followed by a 1-month taper and 2 months of stabilization. The participants were then randomly assigned to either standard or enhanced medical management; only about 7% of participants in each group did not relapse.

In phase 2, relapsed patients were again randomly assigned to standard or enhanced medical management. After a further 3 months, only 9% of patients remained successfully treated.

Full news coverage: For Prescription Opioid Dependence, Relapses Associated With Shorter Treatment Course

The drug-development pipeline for agents to treat major depressive disorder is strong, but only a few current clinical trials are testing novel agents or new indications for existing drugs in children or adolescents, said Aarti Gupta, MBBS, a psychiatry resident at the University of Texas Health Sciences Center in Houston. Many current trials are looking at drugs with novel mechanisms of action, including triple reuptake inhibitors, selective norepinephrine reuptake inhibitors, nicotinic receptor antagonists, CRF-1 antagonists, 5HT-7 antagonists, and others. Six compounds are being evaluated for augmentation of an antidepressant, including omega-3 fatty acids, cimicoxib, saredutant, cysteamine bitartrate, D-cycloserine, and creatine monohydrate.

Full news coverage: See Pipeline Robust for Treatment of Depression, but Studies in Children Still Rare

The precise, methodic practice of tai chi chuan may improve some symptoms of attention-deficit/hyperactivity disorder (ADHD) in adolescents with mental illness, results of a small study by Peng Pang, MD, a resident in psychiatry at Maimonides Medical Center in Brooklyn, New York, suggest.

Of 19 adolescents, the 10 who were taught tai chi in 45-minute sessions twice a week for 6 weeks had significantly improved hyperactivity and ADHD index subscores compared with the 9 control participants. The effect was not sustained at 12 weeks, however, probably because the subjects did not continue tai chi at home and went back to taking ADHD medication.

Full news coverage: Tai Chi May Improve Some ADHD Symptoms

Older women with mental illness who are newly diagnosed with cancer are significantly less likely to receive chemotherapy than women with cancer who are free from mental illness, according to findings from a cohort trial from the Health and Retirement Study (HRS), reported by principal investigator Simha Ravven, MD, from Harvard Medical School, Boston, Massachusetts.

However, women with cancer and mental illness had only one third the risk of dying after a cancer diagnosis than the general population (odds ratio [OR], 0.36). In contrast, men with mental illness had a nearly 3-fold higher risk for dying after a cancer diagnosis than men without mental illness (OR, 2.91).

Full news coverage: Older Adults With Cancer, Mental Illness Less Likely to Receive Chemotherapy

Photos by Ron Zimmerman, San Antonio, Texas

For more information, see the following resources:

• News Coverage From the American Psychiatric Association (APA) 2010 Annual Meeting
• Medscape Psychiatry & Mental Health
• American Psychiatric Association

Contributor Information

Caroline Cassels
News Editor
Medscape Psychiatry
Toronto, Canada

Disclosure: Caroline Cassels has disclosed no relevant financial relationships.

Deborah Brauser
Freelance Journalist
Orlando, Florida

Disclosure: Deborah Brauser has disclosed no relevant financial relationships.

Caroline Helwick
Freelance Journalist
New Orleans, Louisiana

Disclosure: Caroline Helwick has disclosed no relevant financial relationships.

Neil Osterweil
Freelance writer
Boston, Massachusetts

Disclosure: Neil Osterweil has disclosed no relevant financial relationships.

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