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American Psychiatric Association, May 14-18, 2011

Last Updated: May 23, 2011.

The 164th Annual Meeting of the American Psychiatric Association

The annual meeting of the American Psychiatric Association was held from May 14 to 18 in Honolulu and attracted over 8,000 participants from around the world. The conference highlighted recent advances in the prevention, detection, and treatment of psychiatric conditions, with presentations focusing on mental illnesses, including substance use disorders.

In one study, Adam Lau, M.D., of the Zucker Hillside Hospital in Glen Oaks, N.Y., and colleagues found that delirium was relatively common after cardiac surgery among older patients.

The investigators evaluated 50 patients following cardiac bypass and/or valvular surgery and found an overall incidence of delirium of 20 percent, with a significant increase in incidence with age. The incidence of delirium was 38 percent among patients over 70 years of age and 43 percent among those around 80 years of age. The investigators also found that no patients under 70 years of age experienced delirium post-surgery.

"Post-operative delirium following cardiac surgery appears to be a significant event. There is a rationale in targeting patients for delirium screening and/or prospective studies based on their age," the authors write.

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In another study, William Yates, M.D., of the University of Oklahoma in Tulsa, and colleagues showed that, if the United States follows a similar pattern to that which occurred after the economic crisis in Japan, then they will likely experience a significant increase in suicides.

The investigators evaluated suicide trends in Japan by age, gender, and year in relation to a series of economic variables. They compared economic trends by year between Japan and the United States to estimate the timing of a potential economic effect on suicide rates in the United States. The investigators found that, if U.S. rates of increased suicide approximate those in Japan, the United States would see a yearly increase of suicide deaths estimated at 14,610.

"U.S. clinicians and public health officials need to be alert to the potential for the United States to experience a significant increase in suicides if the United States follows the pattern of Japan," the authors write. "A recent increase in suicides in U.S. 'baby boomers' may be a harbinger of the onset of this pattern."

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Eleni Maneta, M.D., of the Harvard Longwood Psychiatry Residency Training Program in Boston, and colleagues found that women with histories of childhood physical abuse were at a higher risk for becoming aggressive in intimate relationships as well as becoming the victims of aggression by their partners.

"We also found that a potential mechanism explaining this link may be a passive-aggressive/brooding expression of anger rather than a more open way of expressing anger. The relationships we examined are not cause-effect relationships and have to be looked at in light of limitations such as small sample size, only heterosexual couples," Maneta said.

The investigators evaluated reports from individuals in 109 couples on histories of physical abuse in childhood and physical aggression toward adult partners during the previous year as well as their typical modes of anger expression.

"The implications for clinical practice would be to examine ways in which anger is being experienced and expressed in couples with intimate partner violence and to look at the childhood histories of both the partners and to focus treatment on the couple dynamics rather than on the individuals separately," Maneta said.

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Investigators at the Naval Medical Center in San Diego showed that recreational use of synthetic cannabis may lead to psychosis that can last for days or months. The investigators evaluated 10 patients hospitalized for psychosis apparently induced by the use of synthetic cannabis and found that it was associated with ongoing psychotic symptoms, including auditory and visual hallucinations, paranoid delusions, odd or flat affect, thought blocking, disorganized speech, thoughts of suicide, insomnia, slowed reaction times, agitation, and anxiety. While psychotic symptoms generally resolved between five and eight days after admission, some cases continued three months or longer.

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Caris Fitzgerald, M.D., and Erick Messias, M.D., Ph.D., of the University of Arkansas for Medical Sciences in Little Rock, found that, compared to watching television, gaming and Internet activity negatively impacted self-reported teen sleep duration, while physical activity improved sleep duration. The investigators used data from the 2009 Youth Risk Behavioral Survey.

"Overall, our study found that, in a nationally representative sample of teens, self-reported sleep duration was negatively associated with media use and positively associated with physical activity. In contrast to previous studies, no correlation was seen with television use," Fitzgerald said. "I caution that our finding on television is not supported by previous studies. It is possible television may have a different type of influence on sleep than gaming or Internet use and more studies will be helpful in delineating the nature of the impact of different types of media on sleep."

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Another study, presented by Shabnam Balali-Edin, M.D., of Boise, Idaho, found that enrolling primary care patients in a low-intensive, peer-led therapy group made them less vulnerable to suicide.

"Focusing on protective factors can be more effective towards managing suicidal ideation. I am proposing a more cognitive behavioral therapy approach that is systematic and peer-lead. It focuses more on preventing suicidal ideation and/or gestures," Balali-Edin said. "This is a treatment which can offer prevention of regression to suicidal ideation and/or gestures. It can be reparative for groups of patients which have already made suicidal gestures and potentially prevent relapse."

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APA: Psychiatric Emergency Department Visits Up in Elderly

TUESDAY, May 17 (HealthDay News) -- Psychiatric emergency department (ED) visits have increased among elderly patients in Hawaii, and hospital length of stay (LOS) appears to be longer among elderly patients than among younger patients, according to research presented at the annual meeting of the American Psychiatric Association, held from May 14 to 18 in Honolulu.

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APA: Parental Deployment Tied to Psychiatric Hospitalization

TUESDAY, May 17 (HealthDay News) -- Children of deployed active duty military personnel have a greater risk of being hospitalized for a mental or behavioral health disorder, with the risk of hospitalization increasing with increased length of parental deployment, according to research presented at the annual meeting of the American Psychiatric Association, held from May 14 to 18 in Honolulu.

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