November 2013  << Back  

  Can't open the PDF? Click here for help.



We are all affected by the 2013 government shutdown

Donald W. Black, MD


I am a victim of the partial government shutdown. Like you, I thought the shutdown affected others—such as the 800,000 government workers who were furloughed—not me. I serve on a National Institutes of Health study section (review panel) that was to meet in Washington, DC, on October 3 to 4. The study section will need to meet in person or by telephone at some point, but this will become a nightmare for the administrator who will need to find a time when 30 busy people can meet.

Seriously, the shutdown began as a cynical attempt by a small group of legislators determined to delay implementation of the Affordable Care Act (ACA). It later morphed into a harangue over the debt ceiling, but the goals of the “lemming” branch of the Republican Party were never clearly articulated. One concern appeared to be that if “Obamacare” was implemented people might actually like the ACA and there would be little support for defunding or rescinding it later. According to polls, most provisions are popular when the act is deconstructed (individuals cannot be denied coverage for preexisting conditions, no limits on hospital coverage, allowing young adults to remain on the parents insurance until age 26, etc.), but people tend to have an otherwise irrational response to the question, “Do you support Obamacare?” The popularity ratings are much higher if they are asked if they support the ACA. Incredible times we live in.

Now, after venting on those issues, let me describe a few of the interesting articles found in this issue of Annals. One of the more unusual articles we’ve published is by Gabriela M. Ferreira, MD, and colleagues who write about 3 patients with misophonic disorder. I was not familiar with the term, but certainly have had patients (and colleagues) with the symptoms: hatred of certain types of sounds. Sometime I wonder if I have the disorder because I have become less tolerant of noise—as I suspect many of you have as well—as I have grown older. In a contribution from South Africa, Sonja C. Pasche, MPsych, and colleagues (including Annals Editorial Board members Jon E. Grant, JD, MD, MPH, and Dan J. Stein, FRCPC, PhD) show that manualized cognitive-behavioral therapy can be successfully implemented as a treatment for pathological gambling in a middle-income country. Interestingly, the treatment has been implemented country-wide in a public-private sector initiative, and has been shown to be as effective as in wealthier societies.

I hope you have penciled in our next Current Psychiatry/AACP CME meeting on March 27 to 29, 2014 in Chicago at the Hilton Chicago. This program will feature Anita H. Clayton, MD, Marlene P. Freeman, MD, Jon E. Grant, JD, MD, MPH, George Grossberg, MD, James W. Jefferson, MD, Raphael Leo, MD, Henry A. Nasrallah, MD, Thomas Roth, PhD, and myself. Topics include DSM-5, treating pregnant women who have psychiatric disorders, treating obsessive-compulsive and related disorders, schizophrenia and medical comorbidity, and more. Please visit our website to see the entire program: