AMERICAN PSYCHIATRIC ASSOCIATION MARCH 1998 TIPSHEET
EMBARGOED: MARCH 1, 1998
Melissa Saunders Katz
(202) 682-6142 / [email protected]
www.psych.org
Journal articles abstracted in this tipsheet are available in their
entirety by calling APAFastFAX at 1-888-267-5400 and selecting the
appropriate document number (numbers listed below).
In the March issue of the American Journal of Psychiatry:
(Note: All Items Embargoed until March 1, 1998)
FOR PSYCHIATRY, PRACTICES ARE CHANGING
Data from the 1996 National Survey of Psychiatric Practice demonstrate
changes in psychiatric practice during the past several years, according to
analyses published in the March issue of the American Journal of Psychiatry
. This study noted important demographic changes in psychiatrists, for
example, an increase in the number of female psychiatrists. The most
common principal diagnosis of patients were mood disorders, followed by
anxiety disorders, and schizophrenia and other psychotic disorders. This
periodic survey also serves as a vehicle for tracking changes in
psychiatrist payment and patient financial mechanisms. The 1996 survey
found that 29% of patients received care through some form of managed care
system and 42% through a non-managed public or private system. In
addition, data indicated that the primary payment mechanism for
psychiatrists? patient care services was fee-for-service, accounting for
52.5% of psychiatrists? income from direct patient care.
[?Characterizing Psychiatry With Findings From the 1996 National Survey of
Psychiatric Practice,? Deborah A. Zarin, M.D. and Harold Alan Pincus, M.D.,
et. al. p. 397] APAFastFAX#6948
HMOS CAN SUPPORT MORE PSYCHIATRIC STAFF
Researchers studying the ratio of full-time psychiatrists to members in
HMOs found that the overall number of psychiatrists per 100,000 members is
less than half the amount recommended by the Graduate Medical Education
National Advisory Committee. According to this study in the March issue of
the American Journal of Psychiatry, while the psychiatrist-to-patient ratio
previously required by the fee-for-service environment is too high a
standard for HMOs, the managed care setting could support a greater number
of psychiatrists than previously thought.
[?Psychiatrist and Nonphysician Mental Health Provider Staffing Levels in
Health Maintenance Organizations,? Thomas H. Dial, Ph.D., et. al., p. 405]
APAFastFAX#6949
RESEARCHERS CAUTION AGAINST INFLEXIBLE THERAPY?BOUNDARIES?
This paper examines the fine line between a therapist crossing a boundary,
a method which could lead to productive work in therapy, and boundary
violations, which are harmful to the patient and exploit the patient?s
vulnerable position. According to this review of clinical vignettes in the
March issue of the American Journal of Psychiatry, context is critical when
determining whether a boundary transgression in therapy represents a
breakthrough or a violation.
[?Misuses and Misunderstandings of Boundary Theory in Clinical and
Regulatory Settings,? Thomas G. Gutheil, M.D., et. al., p. 409] APAFast
FAX#6950
In the March issue of Psychiatric Services:
(Note: All Items Embargoed until March 1, 1998)
RECOGNIZING WARNING SIGNS CAN IMPROVE TREATMENT
Clinicians at the Tulsa Institute of Behavioral Sciences found that
patients with severe mental illness who failed to recognize early warning
signs had poorer treatment outcomes and more hospitalizations. According to
this study in the March issues of Psychiatric Services, only half of
patients who failed to recognize warning signs receive help. Improving
recognition of warning signs may result in more effective treatment and
lower costs.
[?Recognition of Warning Signs: A Consideration for Cost-Effective
Treatment of Severe Mental Illness,? Jill Novacek, Ph.D., et. al., p.376.]
APAFastFAX#6954. Please direct all media inquiries to Jill Novacek, Ph.D.,
at 918-586-4220; fax, 918-586-4204
VA MEDICAL CENTERS PROVIDE AN IDEAL ENVIRONMENT FOR STUDIES
A 1992 congressional mandate ordering the VA to provide treatment to
veterans traumatized by sexual assaults during active military duty has
provided an excellent opportunity to compare the effectiveness of different
treatment approaches, according to a research group in the Veterans Affairs
health care system published in the March issue of Psychiatric Services.
[?A Survey of Sexual Trauma Treatment Provided by VA Medical Centers,? Lori
L. Davis, M.D., et. al., p.382] APAFastFAX#6951
CLOZAPINE EFFECTIVE TREATMENT FOR VETERANS WITH PSYCHOSIS
Researchers found that clozapine is an important therapeutic agent for
older adults with treatment-refractory psychosis, especially for those
between the ages of 55 and 64, who had a better response than those over
65. According to this study in the March issue of Psychiatric Services,
nearly half of the 329 veterans receiving clozapine showed improvement.
[?Clozapine Therapy for Older Veterans,? F. Ramirez, M.D., et. al., p. 340]
APAFastFAX#6952
NATIVE AMERICAN VETERANS AT HIGHER RISK FOR HOMELESSNESS
Native Americans are overrepresented by about 19 percent in the homeless
veteran population, according to a study in the March issue of Psychiatric
Services. Native Americans had more current alcohol use and more previous
hospitalizations for alcohol dependence than other ethnic groups of
homeless veterans.
[?Substance Use and Psychiatric Problems of Homeless Native American
Veterans,? Wesley J. Kasprow, Ph.D., M.P.H., p. 345] APAFastFAX#6953
The text of this tipsheet (APAFastFAX #6152) and other materials for media
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The American Psychiatric Association is a national medical specialty
society, founded in 1844, whose 42,000 physician members specialize in the
diagnosis and treatment of mental and emotional illnesses and substance use
disorders. APA objectives include the advancement and improvement of care
for persons with mental illnesses through nationwide public information,
education, and awareness programs and materials.
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