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Acetaminophen use during pregnancy and behavioral problems in childhood

Leo Sher, M.D.

A British research group examined associations between offspring behavioral problems and maternal prenatal acetaminophen use, maternal postnatal acetaminophen use, and partner’s acetaminophen use (1). Acetaminophen, also known as paracetamol, relieves pain and fever and is the active ingredient in Tylenol and a large number of over-the-counter and prescription drugs. Acetaminophen is not considered a nonsteroidal anti-inflammatory drug (NSAID) because it does not exhibit significant anti-inflammatory activity. More than half of all pregnant women in the United States and Europe use acetaminophen (2,3).

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Insanity defenses recalibrated

Jacob M. Appel, M.D., J.D.
 
The recent release of would-be Reagan assassin John Hinckley Jr. serves as a reminder that while for much of the country, the three decades starting in 1980 were the ‘Reagan Era,’ forensic psychiatry remains trapped in a ‘Hinckley Era.’  Hinckley pled not guilty by reason of insanity (NGRI) and was acquitted on all charges.  In the public backlash that ensued, the federal government and the majority of states made such defenses far more difficult (1).  Many jurisdictions shifted the burden of proof to defendants, requiring “clear and convincing evidence” that mental illness prevented legal culpability.  Others switched from NGRI to a “guilty but mentally ill” approach. Four states abolished the insanity defense entirely.
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Loneliness and paranoia

Leo Sher, M.D.

A research group in Germany studied the relationship between loneliness and paranoia (1). The authors of the study have found that loneliness affects paranoia.

Loneliness has been defined as “distressful consciousness of an inner distance to other humans and thus as a desire for satisfying and meaningful relations” (1,2). In other words, loneliness is a subjective, emotional, and cognitive assessment of an individual’s position in his/her social situation (3).

The researchers recruited 60 healthy individuals. Loneliness was experimentally manipulated using a false-feedback paradigm.
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Congratulations to Professor Masahito Fushimi!

Leo Sher, M.D.

On behalf of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force on Men’s Mental Health I would like to congratulate Professor Masahito Fushimi, a Member of the Task Force on becoming the Director and a Professor at the Akita University Health Center.

Professor Fushimi was born in Hokkaido, Japan. He lives in Akita, Japan.  Professor Fushimi received his M.D. and Ph.D. degrees from the Akita University School of Medicine in 1990 and 1997, respectively. He worked for many years as the Director of the Akita Prefectural Mental Health and Welfare Center. Professor Fushimi has studied stress-related disorders and suicidal behavior and published a lot of scholarly papers related to these issues.
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Catatonia: A much expanded diagnostic view

Kendall Bache, M.D., Kanwarjeet Brar, M.D., Steven Lippmann, M.D.

Catatonia has been a condition commonly associated with schizophrenia, but it exists in a number of other psychiatric disorders.  Diagnostic criteria for catatonia involves at least three of these twelve findings: catalepsy, waxy flexibility, posturing, mutism, negativism, mannerism, stereotypy, grimacing, stupor, agitation, echolalia, and/or echopraxia.  However, catatonia can also be a sign of medical or neurological conditions. An expanded understanding of potential etiologies speeds recognition, diagnosis, and treatment.
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More than one-third of the adults in the U.S. report sleeping less than seven hours in a 24-hour period: A CDC study

Leo Sher, M.D.

The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults aged 18–60 years should sleep at least 7 hours each night. Sleeping less than 7 hours per night is associated with increased risk for obesity, diabetes, high blood pressure, coronary heart disease, stroke, psychiatric disorders, and all-cause mortality. Insufficient sleep impairs cognitive functioning, which can increase the likelihood of motor vehicle and other accidents, medical errors, and loss of work productivity. The Centers for Disease Control and Prevention (CDC) have called inadequate sleep a public health problem.
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Do you know about flakka?

Kavitha Srinivasan, M.D., Steven Lippmann, M.D.
                                          
Alpha pyrrolidinopentiophenone (a-PVP) commonly known as “flakka” or “gravel” is fast emerging as a new and dangerous drug of abuse. Initially gaining prominence in Florida, it is now frequently abused throughout our country. It belongs to the class of synthetic cathinones, commonly marketed as bath salts, plant food, or insect repellant and to avoid scrutiny marketed with packaging labels warning “not for human consumption”. In 2014, a-PVP was classified as a Schedule I drug.

Flakka is a crystalline powder which can be inhaled directly or vaporized in e-cigarettes, consumed orally, or injected after being mixed into a solution. A potent dopamine and norepinephrine transporter inhibitor, it acts as a psychostimulant and is highly addictive.
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Cocaine dangerously contaminated with levamisole

Manasa Enja, M.D., Suneela Cherlopalle, M.D., Melanie Lippmann, M.D., Steven Lippmann, M.D.
         
Cocaine is a frequent drug of abuse and a common precipitant of health emergencies. Recently, cocaine has become an even more dangerous public health concern since being adulterated by the addition of levamisole.
 
It is hard to detect levamisole when mixed with cocaine; the addition of levamisole adds to the volume and appears to augment cocaine's stimulant effects. However, this agent often causes serious toxicity, which includes a vasculitic effect in the body, especially at the skin, bone marrow, lungs, kidneys, and vascular system. Such a drug reaction can be fatal.
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