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Atlanta Medical Psychology The clinical practice of Dr. David B. Adams is located in The Medical Quarters in the northside of Atlanta at the junction of Scottish Rite, Northside and Saint Joseph's Hospitals. Dr. Adams consults to occupational medicine, surgeons, nurse case managers, insurers and employers regarding the psychological impact of work-related injury and the role of psychological factors in short- and long-term disability.      Also See: Past Factoids Volume One Past Factoids Volume Two Past Factoids Volume Three Past Factoids Volume Four Past Factoids Volume Five Past Factoids Volume Six Past Factoids Volume Seven Past Factoids Volume Eight

• A simple test that measures response to a sudden loud noise can distinguish between early- and late-onset schizophrenia and could ultimately lead to radical changes in treatment, researchers from the University of London, in the UK, report. Prepulse inhibition (PPI) of the startle response, takes just over 20 minutes and measures the brain's ability to filter information. Asthmatics with increased symptoms of depression report lower health-related quality-of-life scores than do similar asthmatics with fewer depressive symptoms, according to findings published in the May issue of the Journal of General Internal Medicine. 2000;15:301-310.

• A study in women who survived the Northridge, California, earthquake while they were in their first trimester of pregnancy, suggests that stress during the first 3 months of pregnancy may increase the risk of preterm birth. 

• Contrary to popular belief, having more children born into a family does not necessarily result in lower-IQ children, according to new research published in the June issue of American Psychologist. If family size does not directly affect children's IQ, what does? Parents' IQ is an important causal source of the relationship between family size and children's IQ, because low-IQ parents have been having relatively larger families in the United States than high-IQ parents. 

• What makes a father take an active role in caregiving activities? A new study published in the June issue of the Journal of Family Psychology, shows that fathers were more involved in caregiving when they worked fewer hours than other fathers, when mothers worked more hours than other mothers, and when mothers reported greater marital intimacy. Fathers were also more active in caregiving when they had high self-esteem and other positive psychological adjustment characteristics and when children were boys.

• They suffer from recurrent headaches, joint stiffness, nausea, anxiety, and depression. Their symptoms have been the focus of numerous studies over the last decade, including one recent report of brain-cell damage similar to that seen in early stages of Parkinson's disease. Yet, for Gulf War veterans, there is still no researcher that can pinpoint a truly unique set of symptoms that can identify Gulf War syndrome.

• A drug commonly prescribed for both depression and smoking cessation may offer treatment for hypoactive sexual desire disorder. None of the women were depressed, but all were experiencing difficulty with orgasm or arousal. The theory is that bupropion works on brain dopamine receptors, the pleasure-reward chemical in the brain.  One of the big problems with the new generation anti-depressants, especially the SSRIs, is that, as wonderful as they are, they may cause sexual dysfunction in the long run. It's been estimated that some of these drugs can delay orgasm or climax up to nine times.

• Patients with Munchausen syndrome, who purposely harm themselves to gain medical attention, may present to the emergency department with serious, confusing, and life-threatening signs and symptoms. Like somatoform disorders and malingering, Munchausen syndrome patients often present dramatically and embellish their symptoms to create a sense of urgency. The patient often resists attempts at obtaining a detailed history or physical examination and may become uneasy or aggressive when he doesn't get what he is seeking.

• Adolescent brains really are different from adult brains, which may explain the impulsiveness and aggression exhibited by many teens, Deborah Yurgelun-Todd, PhD, said at a meeting on adolescent self-destructive behavior sponsored by Cambridge Hospital. Compared with the adults, the teenagers' brains appeared to have less functional activity in the frontal cortex, considered part of the executive system that organizes and modulates behavior. Conversely, teenagers demonstrated greater activity than adults in the amygdala, part of the limbic system that is responsible for associating external sensory stimuli with emotional valences.

• Psychological forms of intimate partner violence (IPV) can have long-term health consequences that mirror those of physical battery, according to a study published in a recent issue of Archives of Family Medicine. Psychological IPV was associated with a number of adverse health outcomes, including: a disability preventing work, arthritis, chronic pain, migraine and other frequent headaches, sexually transmitted infections, chronic pelvic pain, stomach ulcers, spastic colon, and frequent indigestion, diarrhea, or constipation.

• The Minnesota Multiphasic Personality Inventory (MMPI) is a reliable tool for identifying the risk of depression before and during interferon (IFN) therapy in patients with chronic viral liver disease, according to a report from Italian researchers. The MMPI is reliable and sensitive enough to screen patients who are at risk of depression while undergoing IFN therapy. Eur J Gastroenterol Hepatol 2000;12:505-509.

• The blood pressure of patients with anorexia nervosa does not show circadian variation, but the rhythm is restored after re-feeding, researchers report in the April issue of the Journal of Pediatrics. The researchers found that the circadian blood pressure rhythm of anorexic patients was absent at baseline and that night/day blood pressure ratio in systolic and diastolic was significantly elevated in patients with anorexia compared with control subjects.  After re-feeding, the ratio decreased to levels similar to those in the control group. J Pediatr 2000;136:524-527. 

• Teens and young adults with histories of alcohol use disorders (AUDs) had smaller hippocampi on MRI than normal controls, according to a report in the June issue of the American Journal of Psychiatry. The changes were greatest in those who began drinking at an earlier age and those who drank for longer periods.

• Cognitive-behavioral therapy induces recovery substantially more rapidly than interpersonal psychotherapy in patients with bulimia nervosa. Patients who underwent cognitive-behavioral therapy were also significantly more likely to achieve eating attitudes and behaviors in line with community norms than were patients treated with interpersonal psychotherapy. Those treated with cognitive-behavioral therapy demonstrate either maintenance or slight relapse during the follow-up period, while those treated with interpersonal psychotherapy demonstrate an overall tendency toward continued improvement. Arch Gen Psychiatry 2000;57:459-466. 

• Patients with inflammatory bowel disease (IBD) who experience depression or anxiety are at an increased risk of relapsing. Consequently, physicians who treat these patients, especially those with Crohn's disease, should include psychosocial and behavioral therapy in their clinical management. It may be useful for patients with IBD to receive integrated care in which the psychological care works with the gastroenterologists.

• The major predictors of general and violent recidivism among the prison population are comparable for mentally disordered and non-disordered offenders, according to the International Conference of Paroling Authorities. Criminal history, antisocial personality, substance abuse and family dysfunction are the top predictors for violence and recidivism. The number of prior convictions and age of the onset of criminal behavior are important indicators of future behavior.

• High hostility levels in young adults are associated with an increased risk of coronary artery calcification. Results are reported in the May 17th issue of The Journal of the American Medical Association. JAMA 2000;283:2546-2551.  

• Adolescents who are exposed to violence, abuse alcohol or drugs and have only one parent are at increased risk of killing someone. Adolescents with violence in the family, child abuse, gang membership, and alcohol and drug use are at twice the risk of killing someone compared with teenagers without these risk factors.  When those factors are combined with access to weapons, previous arrests, learning problems, and truancy, the teen is four times more likely to become a killer than other youths.

• Almost half of all Americans have a relative or close friend who has attempted suicide, according to data from a new survey, but the attempt is often not discussed. Less than half of people who attempt suicide but are unsuccessful receive any treatment or therapy to address the reasons for the attempt. About one third of all clinically depressed patients attempt suicide, and half of them succeed over their lifetime. 

• Past research suggesting a possible relationship between streptococcal infections and tic disorders or obsessive-compulsive disorders (OCD) may have missed an interesting association between these infections and attention-deficit/hyperactivity disorders (ADHD), according to a study published in a recent issue of Archives of General Psychiatry.

• Results of a survey conducted by Harvard Medical School found that while almost half of respondents who had one of three common mental illnesses (depression, generalized anxiety disorder, panic disorder) received some mental health care over the past year, only 14% received care that met treatment standards, according to a report in the May issue of the Journal of General Internal Medicine.

• Results from the initial phase of one the largest randomized trials to date on chronic major depression indicate that a significantly larger proportion of patients respond to a combination of medication and psychotherapy than to either treatment modality alone. The findings appear in the May 18 issue of The New England Journal of Medicine.

• Mental disorders are more widespread, beginning as early as the teens, according to the results of an international study. Most are not treated at all, and nearly half do not seek treatment. The WHO International Consortium determined that 48% of the subjects from the United States experienced at least one disorder in their lifetime.

• Hypoxia (lack of oxygen to the fetus)-associated obstetric complications more than double an infant's risk of early-onset schizophrenia. Am J Psychiatry 2000;157:801-807.

• Depression is associated with an increased incidence of coronary heart disease (CHD) in men and women and with increased CHD mortality in men, according to a report in the May 8th issue of the Archives of Internal Medicine. Previous research has linked depression to reduced short- and long-term survival in patients with CHD and to increased CHD incidence and mortality in men, the authors note. Little is known, however, about the association between depression and CHD risk in women. Arch Intern Med 2000;160:1261-1268.

• In a large study of community-dwelling older women with physical disabilities, the risk of severe depression was doubled in those with a metabolically significant vitamin B₁₂ deficiency, according to a report in the May issue of the American Journal of Psychiatry.

• Panic disorder effects 3-4% of Americans (~75% of them women). It is treated most effectively by a combination of antidepressants such as Paxil, Zoloft, Prozac, Celexa or Luvox along with cognitive-behavioral psychotherapy to teach the patient how to manage anxiety and correct anxiety-provoking thoughts.
• Primary care physicians miss telltale signs that would suggest a diagnosis of alcohol abuse, according to a new survey of doctors and their patients. The findings show that this lost opportunity occurs an incredible 94% of the time.
• Psychological intervention may increase conception rates in women receiving fertility treatments, according to a study in the April issue of Fertility and Sterility. Harvard researchers report that in this study cognitive-behavioral training and group therapy had a significant impact on pregnancy rates.
• In 1997, there were 2.3 million marriages. Sixty percent of Americans were married at that time, 23% had never married, 9% were divorced, and 7% were widowed. Fifteen percent of Americans are single parents, 45% rely upon dual income and only 20% maintain the traditional breadwinner/homemaker roles. Fifty-three percent of couples have no children. The average is 1.84 children per family. Sixty-eight percent live with mom and dad; twenty-four percent live with their mother; 4% live with their father. Six percent of families have incomes above $100k and sixteen percent have incomes below $10k. Eleven percent of males had been sterilized as compared to 28% of females. Seven percent of women are homosexual, and thirteen percent of males. Of the 1.3 million prostitutes in the U.S., 500 thousand were under the age of 18, and 100 thousand of all prostitutes had been arrested. Thirty-eight percent of girls under sixteen years of age were sexually active; 20% become pregnant.
• The psychoactive drug nefazodone (SerzoneŽ) lessens depression and improves sleep in Vietnam combat veterans with post-traumatic stress disorder; reduction in anxiety, severity of depression, intrusive recollections, avoidance and hyperarousal. J Clin Psychiatry 2000;61:203-208.   
• Psychological complaints are rarely considered "health" problems by many Americans who tend to see them as an expression of constitutional weakness. Thus, Americans are more prone to accept that depression, for example, is entirely a biological problem and, thus, the responsibility is to be medicated, not to seek solutions.
• Patients with irritable bowel syndrome were found to benefit from behavioral therapy in addition to standard medical treatment, researchers in Germany report. Patients also felt more in control of their health. Am J Gastroenterol 2000;95:981-994.
• Depression arising from the death of spouse lasts longer in those in their 70s and older than was once believed. Twelve percent of those studied were depressed two years after the loss.
• While the incidence of depression is greater in women than in men, many believe that part (perhaps not all) of that difference is explained in the reluctance of men to admit to psychological symptoms.
• A person may feign (falsify) physical symptoms for two reasons: a. to receive financial gain or b. to maintain themselves in a role of a patient where others care for them, and they feel life is less demanding.
• Health risk, illness and premature death are often linked to maladaptive health behaviors including diet, exercise and chemical intake including nicotine, alcohol and caffeine. In turn, health behaviors are most often associated with poor understanding or irrational beliefs about those behaviors. Many, for example, believe that smoking is essential to "calm me down" or that "a drink helps me sleep."
• Preoccupation with imagined or exaggerated physical complaints (somatization) varies between cultures dependent upon what that culture feels is appropriate expression of distress and dependent upon the nature of health care in that culture.
• While 1 of 5 Adult Americans may have symptoms that indicate the need for psychological care, eighty-percent may avoid seeking consultation due to poor understanding of psychological care and/or embarrassment/fear of their own symptoms.
• Approximately 14% of noninstitutionalized adults between ages of 15-54 report Alcohol Dependence at some time in their lives. It is among the most prevalent of mental disorders in the U.S. General Population.
• Ten to 15% of adults in the U.S. have some degree of work disability due to back pain alone.