December 2005: This Month's Highlights

A Focus on Affective Disorders

This issue includes seven articles related to affective disorders, including several on bipolar disorder and several on racial and ethnic disparities in treatment for bipolar and other affective disorders. Jin H. Joo, M.D., and colleagues present their findings on the adequacy of depression treatment by primary care physicians and patient characteristics associated with receipt of inadequate care (page 1524). Mark A. Frye, M.D., and coauthors discuss patterns of diagnosis, consultation, and treatment among persons screening positive for bipolar disorder in a large U.S.-population-based study that used the Mood Disorder Questionnaire (page 1529). Joseph F. Goldberg, M.D., and coauthors discuss their study of pharmacotherapy for suicidal ideation among the first 1,000 participants in the Systemic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) (page 1534). In a related study, James M. Martinez, M.D., and associates examined predictors of serious adverse events in the same STEP-BD sample (page 1541). Amy M. Kilbourne, Ph.D., M.P.H., and associates look at whether African-American veterans are less likely to receive guideline-concordant care for bipolar disorder relative to whites (page 1549). Carl I. Cohen, M.D., and coauthors present data on racial differences in the prevalence of depression and associated factors in a sample of elderly persons (page 1556). Finally, Isabel T. Lagomasino, M.D., M.S.H.S., and associates discuss the impact of patient characteristics and source of care on disparities in the use and quality of depression treatment among 1,175 white and Latino managed primary care patients (page 1517).

Racial and Ethnic Disparities

Continuing the theme of racial and ethnic disparities, an Open Forum piece by Sylvia Atdjian, M.D., and William A. Vega, Ph.D., looks at some implications of documented disparities in health status and treatment outcomes among members of racial and ethnic minority groups—disparities that have been reported by the Institute of Medicine, the Surgeon General, and the President's New Freedom Commission on Mental Health, among others (page 1600). These authors make some recommendations for addressing such disparities, urging an energetic research agenda in the area of minority mental health. In an accompanying commentary, Pedro Ruiz, M.D., and Annelle Primm, M.D., M.P.H., describe the American Psychiatric Association's (APA's) efforts to eliminate racial and ethnic disparities in mental health care, including programs undertaken by APA's office of minority and ethnic affairs. They note that although much has been accomplished in eliminating disparities, "much more still needs to be achieved" (page 1603).

Assessment Instruments

Various assessment instruments are also covered in this issue. Jo Anne Sirey, Ph.D., and her coauthors describe the development, administration, and reliability of the Cornell Services Index, an instrument for measuring service use (page 1564). Donald Addington, M.B.B.S., and colleagues present their study of the feasibility of identifying performance measures for early psychosis treatment services and obtaining consensus for such measures through the Delphi group consensus method (page 1570). In a related commentary, Audrey Burnam, Ph.D., describes her organization's use of the Delphi method, which is different from that described by Addington's group (page 1583). Ian R. H. Falloon, M.D., D.Sc., and coauthors describe the development and worldwide testing of the Clinical Strategies Implementation Scale (CSI), an instrument designed to help providers measure the extent to which evidence-based strategies have been implemented in the treatment of schizophrenia spectrum disorders (page 1584). Their article inspired two commentaries—one by Gary R. Bond, Ph.D. (page 1591) and one by Sandra G. Resnick, Ph.D. (page 1592).

ADHD Among Adults

Adults with attention-deficit hyperactivity disorder (ADHD) are another special group addressed in this issue of the journal. Jennifer A. Hinnenthal, M.P.H., and her coauthors present a comparison of health service use and costs between adults with ADHD and those with depression, diabetes, or seasonal allergies in a large managed care sample (page 1593). In a brief report, Joseph Biederman, M.D., and associates describe their evaluation of a simulated workplace experience for nonmedicated adults with ADHD compared with adults who did not have ADHD (page 1617). Finally, in the Datapoints column, Linda M. Robison, M.S.P.H., and her coauthors look at trends in both ADHD and the use of stimulants among adults over the period 1995 to 2002 (page 1497).

Briefly Noted …

• The special holiday book review section returns, with an array of novels that may be of particular interest to mental health professionals (page 1626).