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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

• Simple psychological interventions are effective in reducing the severity and duration of depression in adults identified through a community survey, according to results of a multinational trial reported in the British Medical Journal. This study indicates that people with depression do have genuine choices in terms of the help that they get. Drug therapy is important, but a lot of patients are not terribly keen on that for reasons that I respect. But there are clear, definable psychological interventions that do help people get better from depression more quickly than they would otherwise do.BMJ 2000;321:1-6.
• The communication from the immune system to the brain is mediated by cytokines, which are peptides that orchestrate the immune response with a wide range of other biologic activities. During immune stimulation, cytokines such as interleukins and interferons are produced both in the periphery and in the brain, where they can affect neural, neuroendocrine, and behavioral functions through specific receptors. Many interactions occur between the immune, neural, and psychological systems. These interactions include communication pathways from the brain to the immune system, particularly the hypothalamic- pituitary-adrenal (HPA) axis and the autonomic nervous system, that mediate the influence of psychological variables, such as stress and emotions, on immunity and resistance to disease. In addition, when the body is confronted by pathogens, the immune system serves as a sensory organ, alerting the brain to the presence of infection- induced immune activation. 
• Humor appreciation appears to be based in the lower frontal lobes of the brain, a location associated with social and emotional judgment and planning, according to imaging research. That might explain why people who have suffered strokes involving the lower frontal lobes of the brain may have alterations of personality which include loss of their sense of humor. A small part of the frontal lobes appears critical to our ability to recognize a joke. Although the purpose of humor and laughter is still largely unknown despite 2,000 years of speculation, having a sense of humor is a key part of our personalities and it can play a powerful role in balancing negative emotions, such as fear. Researchers found when the people laughed, activity was seen in the anterior supplemental motor area (SMA), a location near the top of the brain normally associated with planning movement and the initiation of speech.  
• Physicians are not immune to psychosocial problems but may face unique impediments to attending to them. Self-care among physicians is not a topic generally included as a part of professional training, nor is it a topic that readily receives consideration in professional practice. The stresses of professional practice can exact a great toll, however, and self-neglect can lead to tragic consequences. In some areas, particularly suicide rates, physicians have increased vulnerability, and in other areas problems may be unrecognized (depression, substance abuse, marital problems, and other stress-related concerns). Female physicians show some particular areas of risk. In this paper, we raise questions about how and why physicians may be particularly vulnerable, review the available literature about the extent and nature of such problems in physicians, discuss possible factors related to the development of these problems in physicians, and suggest a variety of solutions to improve physician self-care. [South Med J 93(10):966-972, 2000. © 2000 Southern Medical Association]  
• According to results of a US national probability sample of twin and nontwin sibling pairs, genetic factors appear to provide an important influence on sexual orientation. Clearly genes are playing some role by interacting with a range of environmental factors. It is not clear if the results are due to a large effect of one gene or to a cumulative effect of dozens of genes.It is hopeful that results will provide a somewhat reliable piece of data in a field that has been awash with speculation and a lot of emotion. Am J Psychiatry 2000;157:1843-1846.
• In a study of nearly 2000 Americans, researchers found that 1 in 10 (10.2%) reported levels of stress, anxiety, and sadness high enough to have a regular negative impact on their quality of life even though they did not meet the criteria for clinical depression.This frequent low mood group — 10% of those surveyed — find their quality of life is quite stressful on a regular basis. People with frequent low mood are not using all the methods for coping available to them. The top stressors are hard to avoid: other people's behavior and relationships. The subpopulation, suffering from what some experts call frequent low mood, report that most behavioral coping strategies are ineffective; more than 75% of this group also noted that they don't take medications or mood-enhancing dietary supplements to help.
• There is a dramatic increase in the population-adjusted rate of diagnosis of anxiety, in total and by subcategory, over the timeframe 1990 through 1997. The majority of patients were female, aged between 40 and 59 years, and White.The annualized mean number of office visits documenting a diagnosis of anxiety increased from 5,739,390 in 1990-1991 to 8,429,413 in 1996-1997.. The majority of patients were female, aged between 40 and 59 years, and White. On average, 44.4% of patients were prescribed an anti-anxiety medication. The proportion of patients with a concomitant diagnosis of depression increased from 7.1 to 12.8%.  The proportion of patients prescribed both an anti-anxiety medication and an antidepressant increased from 7.4 to 13.8%. 
• Three historical cycles of legalized gambling have occurred in the South. Currently, every southern state has legalized some form of gaming. Adult past-year prevalence rates of problem gambling in southern states are within the national range. Higher prevalence rates occur in states with casinos and multiple forms of legalized gambling. States with lotteries have higher prevalence rates of adolescent problem gambling. Problem gambling can cause stress-induced physical diseases and psychiatric symptoms in gamblers and their families. Treatment approaches include inpatient treatment centers, self-help fellowship groups, and cognitive-behavioral and addiction-based psychotherapies. [South Med J 93(9):850-858, 2000. © 2000 Southern Medical Association] 
• The claustrum is the region of the brain most strongly linked with visual sexual stimulation in men, French scientists report.The claustrum was not the only area of the brain demonstrated to be involved in sexual arousal, but further study of this area of the temporal lobe could improve understanding of human sexual response. Activity of the claustrum was directly linked with the intensity of the sexual arousal. Other areas of the brain also reacted to the stimuli but the activity of the claustrum was most closely associated with the self-reported level of arousal reported in the journal Human Brain Mapping.
• Menopause, per se, has less effect on sexual function than conventional wisdom would seem to suggest. A recent study showed that "menopausal status was related to some aspects of sexual functioning, but not others." Overall, menopause was less important than health, marital status, mental health, or smoking when it came to a woman's sexual function. The report is published in the September/October issue of Menopause. Sexual satisfaction levels were higher in women who judged their health status as "better than most women their age." Lower estrogen levels were related to pain either during or after intercourse, but did not affect sexual drive or interest. Menopause 2000;7:297-309
• While patients with dysthymic disorder generally present with mild-to-moderate symptoms, findings from a longitudinal naturalistic study indicates that the long-term course of the disorder is actually quite "severe. Another important finding was that an estimated 73.7% of the patients with dysthymic disorder who reported never experiencing a major depressive episode in the initial evaluation developed a first lifetime major depressive episode within 5 years of follow-up," the SUNY team says in the June issue of the American Journal of Psychiatry. This means that 94.2% of the patients in the cohort as a whole had experienced at least one major depressive episode by the 5-year follow-up. Am J Psychiatry 2000;157:931-938. 
• Parentally bereaved children and adolescents appear to experience more posttraumatic stress disorder (PTSD) symptoms than do children who have survived tornadoes, researchers report in the September issue of the Journal of the American Academy of Child and Adolescent Psychiatry. The bereaved children reported significantly more PTSD symptoms than did those in the other groups. In addition, bereaved girls, younger children and children whose surviving parent scored high on PTSD measures appeared to be at greater risk of PTSD symptoms. In conclusion, the researchers suggest that clinicians working with bereaved children "be more cognizant of the potential risk for PTSD symptoms." J Am Acad Child Adolesc Psychiatry 2000;39:1112-1119. 
• Certain psychosocial factors can play a significant role in the development of erectile dysfunction (ED) in men, despite the recent focus on medical causes of this condition. While depression and anger did not appear to significantly affect the risk of ED during follow-up, "the trait of dominance independently contributed to the risk of ED," the NERI team writes in the September 15th issue of the American Journal of Epidemiology. The investigators speculate that the link between ED and a "submissive" personality may lie in the ability to cope with stress. Poor coping can lead to adverse neurocardiovascular changes that may play an etiologic role in the development of ED. Another factor that may play a role is the well-known link between dominance and testosterone levels. Am J Epidemiol 2000;152:533-541.