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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

• In men, measures of aggressive behavior are positively associated increased cellular immunity. The finding is based on data from a study conducted by the Centers for Disease Control and Prevention in the mid-1980s involving 4415 men who served in the US army. Aggression included such items as illegal behavior, fighting, school truancy, and property damage. The investigators observed significant relationships between aggressive behavior and the number of CD4 and B cells. These relationships remained after adjusting for age, health risk behavior, and health conditions. Testosterone accounted for only a small portion of the variance in the aggression-immunity relationship.Psychosom Med 2000;62:583-590.

• "When compared with pre-pregnancy frequency... 71% [of women] reported a reduction in sexual activity during pregnancy," the authors write. The reduction in frequency increased as the pregnancy progressed. Vaginal intercourse showed a progressive decline, whereas the frequency of other types of sexual behavior remained unchanged throughout the pregnancy, the authors note. About 20% of study participants reported feeling pressured to have intercourse.  58% of the women reported a decrease in sexual desire and that 49% worried at some point that intercourse would harm the fetus. Br J Obstet Gynaecol 2000;107:964-968.
• The usual alcoholic has a family and a job; only about 5 percent live on "skid row." Ninety percent of people drink alcohol, 40 to 50 percent of men have temporary alcohol-induced problems, and 10 to 20 percent of men and 3 to 10 percent of women develop pervasive and persistent alcohol-related problems (alcohol dependence or abuse--alcoholism). Even light drinking may adversely interact with other medications; temporary heavier drinking can exacerbate most medical illnesses; and alcoholism can masquerade as many different medical disorders and psychiatric syndromes. 
• In patients with mild cognitive impairment, olfactory identification deficits with subjective unawareness of such deficits appears to predict the development of Alzheimer's disease.Research results suggest that low olfaction plus lack of awareness may identify a different subset of individuals likely to develop Alzheimer's disease within 2 years than those predicted based on demographic and other clinical factors. Low olfaction plus lack of awareness still remained a significant predictor of Alzheimer's disease. Lack of awareness of an olfactory deficit could be considered a type of anosognosia. Knowing that these people are at risk for Alzheimer's disease could result in earlier intervention. Am J Psychiatry 2000;157:1399-1405.
• Finnish scientists have begun clinical trials to investigate whether or not andropause, otherwise known as the male menopause, actually exists. Andropause is a newly recognized syndrome, and even still disputed by many experts. Andropause is the decrease of androgen production. It is also termed PADAM, or partial androgen deficiency of the aging male. "The syndrome is related to a variety of symptoms, most frequently including erectile dysfunction and/or decreased libido, depression and decreased muscular power," Dr. Huhtaniemi said. The Finnish trial, to be followed by a Scottish trial, aims to determine whether there is biological evidence that a male menopause exists and is not merely a psychological condition similar to a mid-life crisis, or a physiological sign of aging.
• By looking at Nazi Holocaust survivors, their offspring, and the presence of posttraumatic stress disorder (PTSD), researchers in New York City have found biological evidence of the intergenerational transmission of stress vulnerability. Stress vulnerability is marked by low cortisol excretion and results from increased activity in the hypothalamic- pituitary-adrenal axis, according to a report in the August issue of the American Journal of Psychiatry.  PTSD may exert effects on the family because of the obvious distress of the afflicted parent, witnessing such symptoms as the parent's distractibility, frequent references to and distress at reminders of the Holocaust. Am J Psychiatry 2000;157:1252-1259. 
• The diagnosis of a terminal illness initially precipitates a vulnerability and isolation that belie description as contemplation of one's impending death transcends the mundane activities of daily living. Mortality is suddenly confronted, and the concept of hope wanes as the unattainable goal of extended life vanishes. And while denial may temporarily intervene and preclude reality, the fact that life is ending becomes hard to deny as the disease advances. But a paradoxical question arises:  hope is frequently defined as the expectancy of good in the future, how can a future defined in hours, days, weeks, and months provide hope? [West J Med 173(2):117-118, 2000.
• Patients with rheumatoid arthritis  who cope with pain by decreasing their level of activity fare worse in terms of psychological distress and disease impact. This study seems to underscore the importance of behavioral coping for subsequent psychological distress and disease impact in rheumatoid arthritis. J Behav Med 2000;23:377-391.
• A virtual reality program that simulates the experience of take-offs, landings, normal flying and turbulence helps patients overcome their fear of flying. Fifteen people who had a phobia related to flying used the virtual reality program for 6 weeks. After eight sessions, all 15 patients reported significant reductions in their anxiety about flying. Six months after they received the treatment, 14 of the 15 participants in both the virtual reality group and the traditional exposure group had taken flights.
• Depressive disorders are leading causes of morbidity and mortality in young people. The prevalence of major depressive disorders is estimated to be approximately 2% in children and 4 to 8% in adolescents. Children may present with nonspecific physical complaints (stomach ache, headache) or because of negative irritable mood leading to oppositional behaviors and refusal to do school work or attend school. In adolescents, the presenting problem may be suicidal thoughts or behaviors or antisocial behavior, including substance abuse.
• Stress-free or happy situations do not always result in lower levels of cortisol, according to research findings presented at the annual meeting of the American Psychological Association. Scientists have believed that cortisol levels rise in stressful situations and fall as stress dissipates. The most important finding of the new study, she said, is that the health effects of "positive interactions" should be studied as closely as those of "negative" interactions. 
• Young children who have been sexually abused are significantly more likely than non-abused children to develop behavioral, educational and chronic health problems over time, according to findings published in the August issue of the Archives of Disease in Childhood. 60% of sexually abused children developed a wide variety of adverse behaviors over the 8-year follow-up compared with 16% of classmate controls.  Chronic health problems were also generally more common in the abuse group. Arch Dis Child 2000;83:132-134.
• Some individuals may fake illness or crisis in Internet support groups to gain attention. "Healthcare professionals need to be aware of the range of medical information and communication formats on the Internet, since it may influence the questions asked and decisions made by their patients." South Med J 2000;93:669-672.
• About 10% of the population is lesbian, gay, bisexual, or transgender^. These people face health care risks that are often not addressed because of lack of knowledge of the patient's sexual orientation, ignorance of specific health care issues, or because the patient feels that the health care professional is homophobic. The goals of this article are to educate health care professionals on specific health care issues faced by this community. As many as two thirds of physicians never ask patients about their sexual orientation.
• The orbital frontal cortex plays a crucial role in constraining impulsive outbursts, while the anterior cingulate cortex recruits other brain regions in the response to conflict. The amygdala is involved in the production of a fear response and other negative emotions. The inability of the 2 brain regions to effectively counteract the response of the amygdala may help explain how threatening situations can become explosive in some people. 
• Thousands of people are currently taking SAMe (S-adenosylmethionine), a nutritional supplement available over-the-counter, for its purported antidepressant effects. But does it work? A recent review of the literature, published in Harvard Review of Psychiatry, has concluded that although SAMe appears to be active, its effects are modest, and much of the evidence supporting its use to date is limited methodologically.
• Children and adolescents in Alabama, Florida, Mississippi and Texas deal with stressful family situations linked to behavioral and emotional problems. Massachusetts, Michigan, Minnesota, New Jersey and Wisconsin each consistently had lower percentages of children in families facing such risks, compared with the national average.
• Men who abuse alcohol and other drugs are 10% more likely to be born in the fall than at any other time, according to research presented in Denver last month at the 23rd annual meeting of the Research Society on Alcoholism and published in the June issue of Alcoholism: Clinical and Experimental Research. Considering more than 40,000 people were studied, that percentage is very small, yet the researchers think they may be on to something.
• Just 7.8% of the more than $1 trillion spent on healthcare in the US in 1997 was spent on mental health and substance abuse treatment, down from 8.8% of total healthcare expenditures the decade before. Expenditures are lower than in 1987, even though mental illnesses and substance abuse are five of the ten leading causes of global disability. Studies have shown that the cost of parity for mental illness would increase overall insurance premiums by 3.4% annually, while equal coverage for substance abuse treatment would add 0.2% to premiums.
• Annual disability costs for people with mental disorders in the US have doubled in the past decade and now run about $23 billion per year. Patients with panic disorder and schizophrenics are most likely to receive mental disability payments. Those with panic disorder were 5.2 times and persons with schizophrenia were 4.5 times as likely to begin receiving benefits compared with people without those disorders. Psychiatr Serv 2000;51:908-913.
• Women undergoing chemotherapy for breast cancer have significantly reduced cognitive function compared with healthy controls. The group of patients currently receiving chemotherapy had a significantly lower median cognitive function score than healthy controls, independent of age, education level and menopausal status. J Clin Oncol 2000; 18: 2695-2701
• Chronic or early-life stressors may alter neurochemistry and lead to dysthymia, according to a review published in a recent issue of Molecular Psychiatry. Dysthymic patients who develop depression may respond only partially to antidepressants, as the acute depression -- but not the underlying dysthymic state -- responds to treatment. 
• In women, chronic depression starting at an early age leads to lower educational attainment and, consequently, lower annual earnings. Compared with women with late-onset depression, women with early-onset depression were only 57% as likely to have completed a college degree and only half as likely to have received any postgraduate education, the results indicated. Such women were also more than twice as likely as their late-onset counterparts to have a history of alcohol or drug abuse. Am J Psychiatry 2000;157:940-947.
• Emotional responses appear to have an impact on intestinal reactivity in patients with irritable bowel syndrome. From these findings, the investigators gathered that rectal tone significantly predicted brain reactivity to emotional words, suggesting that changes in intestinal motor function may influence brain perception. Dig Dis Sci 2000;45:1153-1165. 
• Men with asthma are more likely to suffer psychological stress and less likely to seek medical care than are female asthmatics according to researchers reporting in the April issue of the Journal of Asthma. In addition, the asthmatic's illness and stress appeared to have a greater effect on healthy female partners than on healthy male partners. Women with asthma also appeared to be more negatively affected by a partner's stress than were men with asthma. J Asthma 2000;37:153-161.
• Insomnia is a highly prevalent complaint among the general population that can affect an individual's health, performance and quality of life. Attempts to improve sleep should begin with  modification of lifestyle factors that may affect sleep quality (sleep hygiene). A sleep history may reveal important clues as to the cause of insomnia. It should include complaints about sleep, the course of insomnia, daytime consequences, sleep pattern, patient's beliefs about the sleep problem, psychological functioning, medication and substance use, and the effects of previous treatments. 
• The lifetime risk of developing a depressive episode now approaches 15% and the World Health Organization ranks depression as the world's fourth greatest public health problem. This situation is growing even more problematic, because the age of onset of a first-episode depression is becoming progressively younger and, with early onset, comes greater risks of recurrence and chronicity. Thus, the already considerable public health burden of recurrent depression will most certainly increase in the future.
• Researchers are having a difficult time trying to help people with schizophrenia reduce their high rates of cigarette smoking, while still offering them the apparent benefits of nicotine. The sky-high smoking rate is thought to be as high as 90%. The lack of a nicotine "rush" from patches may also help explain the intervention's failure. The nasal sprays offered only about one third the nicotine dose that cigarettes provided in the first 3 minutes after a puff. 
• High-resolution single-photon emission tomography shows significant similarities — and differences — between patients with chronic fatigue syndrome (CFS) and those with major depression. The chronic fatigue syndrome patients exhibited increased perfusion in the left thalamus. Decreased perfusion in the left prefrontal cortex was found in patients with depression. From these data the researchers conclude that biological disturbance in chronic fatigue syndrome is not limited to those with comorbid depressive symptoms. Br J Psychiatry 2000;176:550-556.
• The UK Cabinet's Body Image Summit in London has called for an end to unrealistic images of women in the press that have contributed to a crisis in low self-esteem in girls in Britain. Recommendations include the call for a media-led body to promote the need for a greater diversity of images of women, and the creation of an organization for the study of eating disorders to examine the existing gaps in research. 
• Patients with restless legs syndrome (RLS) are much more likely to have a prior diagnosis of extrapyramidal disorders, musculoskeletal disorders, depression, and painful conditions such as joint and back disorders than patients without RLS, investigators reported at the 14th annual meeting of the Associated Professional Sleep Societies.
• Anxiety disorders seem to be caused by a combination of genetic and psychological risk factors, according to study results reported in the June 14th issue of the Journal of Abnormal Psychology.  Within the next few years, several different genes will be recognized as contributing to psychopathology. J Abnormal Psychol 2000;109:308-320.
• Women with high-grade cervical neoplasia were significantly more likely to report more lifetime stressful events than women with low-grade neoplasia or normal cervical cytology, according to data presented at the Society for Epidemiologic Research meeting, in Seattle, Washington.