WEEKLY / December 17, 2014, VOL. 4, NO. 54   Send Feedback l View Online
Psychiatric News Update
The Voice of the American Psychiatric Association and the Psychiatric Community
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If It Ain't Broke: Reflections on Long-Term Pharmacotherapy in Geriatric Depression

David Steffens, M.D.There are many ways for older adults to get into a major depression, and they usually involve some kind of loss, but if you have targetable depression symptoms, medications have an important role in treating depression and preventing relapse over the long haul. Read more.

David Steffens, M.D., is professor and chair of psychiatry at the University of Connecticut and co-editor of The American Psychiatric Publishing Textbook of Geriatric Psychiatry, Fourth Edition. APA members may purchase the book at a discount here.


Ensure Your Patients Get the MH Benefits to Which They Are Entitled

Law posterAPA has created a poster explaining the 10 key elements of the mental health parity law and the steps to take when a violation is suspected. The poster appeared in the December 5 issue of Psychiatric News and is available for downloading here.

You can display the poster in your waiting room or office, share it with community leaders and employers, and provide handouts to patients.

Patients gained important rights in 2008 with the passage of the Mental Health Parity and Addiction Equity Act (MHPAEA). This law made it clear that insurers cannot discriminate against patients with a mental illness, including a substance use disorder. But the law is only as strong as its enforcement, and action needs to be taken when patients are denied their rights. Learn more about the MHPAEA and find resources related to the law here.

To read APA President Paul Summergrad, M.D.'s column on this subject in Psychiatric News, titled "Parity Enforcement: A Top Priority," click here.

Have You Reviewed Your Sunshine Act Data for 2013? Act Now!

SunshinePhysicians have until December 31 to initiate disputes about 2013 data reported on them under the Physician Payment Sunshine Act. After January 1, they are still able to initiate disputes concerning these data, but it may take the Centers for Medicare and Medicaid Services six to 12 months before updating the public database.

The Physician Payment Sunshine Act requires manufacturers of drugs, medical devices, and biologicals that participate in U.S. federal health care programs (e.g., Medicare, Medicaid) to report certain payments and items of value above $10 given to physicians and teaching hospitals. Only medical residents are excluded. The initial round of reported information from 2013 was made public on September 30. To review and dispute data, physicians must be registered on the Open Payments Systems. Those who are already registered are encouraged to review data reported about them; those who are not registered should visit APA's dedicated webpage and follow the step-by-step instructions to register today.

VA Psychiatrists: Going to the Annual Meeting?

Annual meeting logoVA psychiatrists who are attending APA's 2015 annual meeting are reminded that the deadline to submit a travel request to their respective government agencies for approval to attend the meeting is January 15, 2015. Also, see item below about travel to Canada.

Early-Bird Registration Fees Now Available for 2015 Annual Meeting!

Annual Meeting to Be Held May 16 to 20 in Toronto

TorontoTake advantage of the lowest registration rates by registering now for APA's 2015 annual meeting, which is being held in Toronto from May 16 to 20. You also have an opportunity to secure a space in the courses you most want to attend and reserve a room at your first-choice hotel. To access the annual meeting website, click here. More information is available by calling the APA Meetings and Conventions Department at (703) 907-7822 or by e-mailing apa@psych.org.

Note about travel to and from Canada: There are several travel considerations of which annual meeting attendees should be aware, as the rules governing entering and exiting Canada have been made more stringent since APA last met there. Click here to find out more.

Deadline for IPS Abstract Submissions Extended

NYCThe deadline for submissions of abstracts for APA's 2015 Institute on Psychiatric Services has been extended until midnight tonight. Be sure to complete your submission and be part of the educational experience at next year's IPS. The IPS will be held in New York City from October 8 to 11.

Register for Free Webinar on Treatment Options for Opioid Use

WebinarRegistration is now open for the free webinar "Treatment Options for Opioid Use Disorder: A Role for Agonists vs. Antagonists." This webinar will review and describe past trends, consider the advantages and limitations of the three primary treatment options for opioid use disorder, discuss the three FDA-approved medication treatments, and much more. Registration and CME provided at no cost, and certificates of participation are available. Register here.

New Online PTSD Course Now Available

PTSDAPA has posted a new eFocus clinical vignette, "Case Study: Peace of Mind Gone in 60 Seconds." The course, whose subject matter is posttraumatic stress disorder, provides an opportunity for you to share your opinion and see how others approach the same case. Given your knowledge of the topic and the points made in the vignette, which treatment approach would you choose? For additional information and a full listing of APA online courses, click here and scroll down to the course title.

Don't Wait to Report Your CME

CMEDo you need to report your CME to your employer, state medical board, or the ABPN by December 31? If so, don't wait until the last minute—dozens of CME activities are available at www.apaeducation.org, and many are free for APA members, including Performance in Practice modules and eFocus self-assessment vignettes. Catch up on MOC requirements, learn about DSM-5, and brush up on changes in CPT coding. If you have questions about CME or need assistance logging into your account, please contact educme@psych.org as soon as possible so that you can spend New Year's Eve celebrating!

Interested in Complementary/Alternative Medicine and Mental Health?

Henry Emmons, M.D.APA's Caucus on Complementary and Alternative Medicine invites you to participate in monthly conference calls on integrative mental health. This month's call, "Restoring Resilience for Young Adults," will be held Thursday, December 18, at noon ET. The host is Henry Emmons, M.D., a psychiatrist who integrates mind-body and natural therapies, mindfulness, and Buddhist teachings into his clinical work. He is the developer of the Resilience Training Program, used at the Penny George Institute for Health and Healing. For U.S. access, call (712) 432-0900; for access in Canada, call (559) 546-1400. Use passcode 736325#. For more information about APA's Caucus on Complementary and Alternative Medicine, contact Lila Massoumi, M.D., at apacaiminfo@gmail.com.

Take a Moment to Remember Deceased Colleagues

CandleAPA honors members whose deaths were reported from July 1, 2014, to September 30, 2014. Read more.


Special Offer for Secure Office Payments

Credit cardAPA's member benefit for payment processing is provided by TransFirst. With more than 19 years of experience, TransFirst offers PCI-compliant point-of-sale and terminal products; wired, wireless, mobile, and Internet-based payment solutions; 24/7, U.S.-based merchant support; security and data-protection technologies; and pricing structures for businesses of every size. If you act before December 31, you can also save on TransFirst's online payment gateway, Transaction Express. Call (800) 613-0148 for details and be sure to mention promo code APA1214EN. Call this number for a free savings analysis or visit TransFirst's website for more information.

Legal Information and Consultation Available to APA Members

Enroll Early! Members who enroll by January 1, 2015, may deduct $25 from their fee.

GavelAs one of your member benefits, APA has an agreement with Anne Marie "Nancy" Wheeler, J.D., to offer confidential triage consultation on practice-related issues to APA members at a preferred rate. She will also provide names of local counsel when your issue requires representation or an opinion based on your state's law. All plan options include a quarterly enewsletter that covers legal issues related to the practice of psychiatry and includes an FAQ section. (This plan is not available to members residing in North Carolina.) For more information, click here.


New Jersey Lawmakers, Insurer Expanding Coordinated Care Programs

Jeffrey Brenner, M.D.A series of small programs that provide intensive, coordinated health care to some of New Jersey's sickest residents is drawing the attention of statewide policymakers, as well as one of the state's largest health insurers, according to a report on the website NJSpotlight. According to the report, UnitedHealthcare is expanding on the work it has been doing with one of these groups—the Camden Coalition of Healthcare Providers—into a model of care delivery that it is rolling out across the state. In this model, a nurse is assigned to meet with patients and coordinate and monitor their care. To read the report, click here.

The Camden Coalition is led by Jeffrey Brenner, M.D., who spoke at APA's 2013 Institute on Psychiatric Services. For information about Brenner, see the Psychiatric News article "primary care physician describes health care 'hot spotting'."

Harvard Business Review: Collaborative Care Models Gaining Ground

FragmentedPioneers in integrated care are proving that it works, according to an article in the Harvard Business Review titled "The Antidote to Fragmented Care." The article provides a broad overview of how integrated/collaborative care models across the country are transforming the delivery of general health and mental health care. Among those models, the Review notes that the integration of behavioral health and chronic-disease expertise where indicated for patients with asthma, diabetes, and cardiovascular disease has also resulted in lower costs and less utilization of emergency services at Group Health in Washington and Intermountain Health in Utah. Read more.

Publications From American Psychiatric Publishing

Psychiatric News
Moving to an Integrated Medical and Psychiatric Payment Platform

MedicareIntegrated care, sometimes called collaborative care, is everywhere and becoming more common at a fast pace. But maybe you still have some more fundamental questions: what is it? why is it important? and perhaps most important, how do I get started?

Psychiatric News has the tool for you—an online primer about integrated care with frequently asked questions and commentary from APA President Paul Summergrad, M.D., and other APA leaders who have been pioneers in integrated care. Click here to access the primer.

Psychiatric Services
New York State Effort to Provide MH Consultation to Pediatricians Assessed

PSA preliminary evaluation of Project TEACH, a statewide training and consultation program for pediatric primary care providers (PCPs) on the identification and treatment of mental health conditions, indicates that the program does impact provider behavior. An intervention group of 176 PCPs who volunteered for PT training was compared with a stratified random sample of 200 PCPs who did not receive PT training. Data on prescription practices, diagnoses, and follow-up care were from New York State Medicaid files (2009-2013) for youth seen by the trained and untrained. The percentage of children prescribed psychotropic medication increased after PT training, a larger increase than in the untrained group. Fewer differences were noted in diagnoses and in medication use and follow-up care among children with depression.

The study can be accessed here.

For more about the program, see the Psychiatric News article, "n.y. child psychiatry divisions fill gap in collaborative care model."


Applications Sought for Improved 2015 Spurlock Congressional Fellowship

Jeanne SpurlockThe deadline for the APA Jeanne Spurlock Congressional Fellowship has been extended to Friday, December 19. This fellowship provides an opportunity for residents, fellows, and early career psychiatrists to represent the profession of psychiatry on Capitol Hill and work with federal policymakers to shape public policy. More information and details on how to apply for the fellowship are available here.


Participate in AJP's Journal Club

AJP CoverThe goal of the Journal Club is to facilitate the study of a major article in an APA scholarly journal and discuss it with other psychiatrists. A series of questions following a description of the article will help readers focus on its main points.

>>Risk of Switch to Mania in Bipolar Patients Taking Antidepressants
Alexander Viktorin, M.Sc., et al. (October 2014)

The risk of a manic switch was increased in depressed patients with bipolar disorder who were on antidepressant monotherapy but not in depressed bipolar patients who were treated with an antidepressant and concurrent mood stabilizer.

Discussion Questions:

1. How would you best describe confounding by indication?
2. How do incidence of manic episodes compare in patients treated with antidepressant monotherapy relative to in combination with a mood stabilizer?
3. One concern regarding antidepressant use in bipolar disorder is that it might induce a switch from depression to mania. In what group of antidepressants was this observation first noted?


• From the Experts

• General News

• Membership Gives You More Benefits

• Integrated Care: What It Means to

• Nominations Invited





>>Why Can't Teenagers Go to Sleep Earlier?

>>Psychotropic Medication and Osteoporosis

>>Psychiatrists' Pay to Rise at Veterans Health Administration

>>SSRI Data Continue to Confound Researchers

>>Novel Suicide-Prevention Treatment Targets Poor Sleep


>>Army Recruits' Mental Disorder Rates Similar to Those of Civilians'

>>Strategies Urged for Improving Mental Health of LGBT Individuals

>>Senators, Vets, Families Push VA for Better Mental Health Care

>>Civilian Clinicians Need More Specialized Training to Help Vets

>>From the President: No Room at the Inn




American Psychiatric Publishing
Book of the Week

Book of the Week

Study Guide to Personality Disorders: A Companion to the American Psychiatric Publishing Textbook of Personality Disorders, Second Edition

Philip R. Muskin, M.D.

>>description, contents, and reviews

>>order the book


Job Hunting Made Easy: Here’s Help

Job CentralFor current job opportunities from the job board at APA Job Central, click here. In addition to searching the site for available positions, APA members may post their resume, set up email job alerts, and access a "job seeker" account.


Check out the latest issues of
APA’s major periodicals.

Psychiatric Services

Psychiatric Services

PS>>Why Do Americans Stop Taking Antidepressants?
A sizable proportion of Americans surveyed reported discontinuing antidepressants on their own in a one-year period, often because of side effects and lack of improvement.

PS>>Continuity of Care Defies Easy Measurement
The challenge of measuring continuity of care is a major stumbling block in determining whether coordinating services leads to better outcomes for behavioral health patients.

PS>>1 in 5 Children Receiving Stimulants for ADHD Prescribed SGAs
Almost 1 in 5 children enrolled in Medicaid who initiated long-acting stimulants for ADHD also received second-generation antipsychotics, despite questions about whether the practice is effective.

American Journal of Psychiatry

The American Journal of Psychiatry

PS>>Association of CRP Genetic Variation and CRP Level With PTSD Symptoms
Genetic variability in the CRP gene was associated with serum CRP level and PTSD symptom severity, and elevated CRP levels were associated with exacerbated fear-related psychophysiology and PTSD symptom ratings and diagnosis.

PS>>Health Promotion Coaching for Obesity in Serious Mental Illness
Positive results from an earlier randomized trial were replicated in patients in ethnically diverse, urban community mental health organizations. Weight and cardiovascular outcomes of patients receiving a 12-month fitness club membership plus coaching were better than those for patients who received fitness club membership only, and positive outcomes were maintained.

PS>>Electronic Health Record Phenotyping of Bipolar Disorder Cases and Controls
Algorithms to identify bipolar disorder diagnoses and features in electronic medical records yielded ascertainment rates similar to those of expert in-person clinician diagnoses.



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