August 2012  << Back  

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Slowing down to reflect on our work and the future of health care

Donald Black, MD


For most of us, work never stops. There are patients to see, meetings to attend, and problems to solve. Yet, we all need time to relax and contemplate our lives, and summer vacation is the time for that. Life slows down and work sometimes takes a back seat as we spend time with family and friends relaxing around the house, at the beach, or in the mountains. This is a time away from meetings, and a time to think, take stock, and plan for the future. The US Supreme Court upheld the Affordable Care Act (also known as “Obamacare”), and from the sidelines I am anxiously watching the next steps. Will individual states stonewall or fall into line? Will individuals gain access to affordable insurance? Who will take care of these newly insured people? Will people seek earlier preventive care, and have less need for urgent care? How will these benefits impact our psychiatric patients? Only time will tell.

Let me give you a sneak peek at the next annual meeting of the American Academy of Clinical Psychiatrists held in collaboration with Current Psychiatry to be held April 4-6, 2013, at the Swissôtel in Chicago, IL. The meeting’s focus is on providing high quality information by noted speakers on topics of interest to our audience—many topics, in fact, suggested by audience members. New to the meeting in 2013 will be a track on substance use disorders and their clinical management. The hotel is great and well-located in the heart of the Chicago Loop. I encourage you to put this on your calendar now.

This issue of Annals of Clinical Psychiatry begins with an intriguing article from Antonio Leandro Nascimento, MD, and colleagues on body dysmorphic and eating disorders in women who are ballet dancers. Although the connection between ballet dancing and eating disorders is well known, this report shows there may be more to the story. Mark Zimmerman, MD, and colleagues jump into the DSM-5 fray with an article discussing the “problem” of multiple Axis II disorders. I don’t want to give away their conclusions, but suffice it to say the DSM-5 Personality Disorders Work Group has argued consistently that comorbidity is a problem to be solved.

Other contributors include my University of Iowa colleague Michelle T. Weckmann, MS, MD, along with her coauthors, who provide new data on risk factors for delirium in persons receiving hematopoietic stem cell transplantation. This procedure is becoming more common and the number of patients developing delirium post-transplantation likely will increase. Christian R. Dolder, PharmD, and colleagues have authored a helpful review of mirtazapine’s effects on sleep. Certainly, many of us prescribe this medication to our patients for sleep, making this communication important and timely. Chandan Das, BS, and colleagues provide a comprehensive review of the impact of second-generation antipsychotics on weight gain in schizophrenia patients. Weight management strategies are critical for these patients because it is clear that these drugs’ metabolic effects are the Achilles’ heel of antipsychotic treatment. Finally, we offer 2 thought- provoking case reports. Gerald A. Maguire, MD, DFAPA, and Aislinn A. Bird, MD, MPH, successfully describe using gabapentin to treat acquired neurogenic stuttering, and Domenico De Berardis, MD, PhD, and collaborators used the melatonergic agonist agomelatine to treat a woman with posttraumatic stress disorder.

Enjoy the remainder of your summer!

Donald W. Black, MD