In The News—2010 Archive

On November 16, 2010 in Houston, Texas Dr. Covert attended a scientific presentation by Ontario, Canada based psychiatrist Dr. Michael K.S. Cheng, noted expert and lecturer who has written an article in Psychiatric Clinics of North America on the therapeutic alliance between psychiatrists and their patients. This alliance refers to their collaborative partnership, agreement on goals, the tasks which each have and their bond of trust and mutual acceptance. Dr. Cheng described various interviewing styles and techniques which he has used to overcome reluctance and to keep the doctor-patient interview solution-focused. Dr. Covert enjoyed discussing these issues with Dr. Cheng, as each employ the same patient-friendly and productive therapeutic practices.

The second half of the meeting was conducted by noted psychiatrist, author and psychopharmacologist, Dr. R.J. Baldassarini, who presented the latest information on the diagnosis-specific selection of atypical neuroleptics in the treatment of major emotional disorders, including bipolar disorder and schizophrenia, focusing on side effects, adverse events and metabolic consequences of each choice.

Posted on 12-22-2010 | Permalink

Researchers at Harvard Medical School have reported that conventional magnetic resonance imaging or MRI machines detected 94 percent of individuals with a high-functioning form of autism. This disorder is diagnosed in one in 110 children in the U.S., afflicting four times the number of boys as girls.

Earlier detection may allow earlier intervention to assist in the development of language skills, improved social functioning and resolution of emotional problems in the future. The MRIs were tuned to pick up microscopic features of the brain's wiring – a technique known as "diffusion tensor imaging." MRI machines are widely available around the world.

Dr. Covert has successfully diagnosed and treated individuals with various degrees of autism and is encouraged by this scientific development.

Posted on 12-8-2010 | Permalink

Army General Raymond Odierno, commander of joint forces in Iraq, estimates that 30% of all troops suffer from PTSD. Other military officials say it’s virtually impossible for anyone to emerge unscathed in some way from combat. What is more monolithic than the murderous methods of our adversaries is the incompetent, hostile reception our injured vets and families experience later. Tragic and indefensible.

Posted on 11-19-2010 | Permalink

According to recent CDC&P figures, estimates of the incidence of ADHD have jumped to 9.5%. Nearly 1 in 10 U.S. children has ADHD, based on diagnoses given to parents. It’s hard for some kids to pay attention and to control impulsive behavior. About 2/3 of ADHD kids are on medication.

Call us for a comprehensive evaluation and treatment.

Posted on 11-18-2010 | Permalink

Due to a sharp increase in marijuana as well as surges in ecstasy and methamphetamine use, the Director of National Drug Control recently announced a 9% overall increase in substance abuse. This trend appeared to be linked to changing attitudes regarding the perception of the harm caused by these drugs and the political trend to legalize “medical marijuana” in some states. Marijuana use rose by 8% and remained the most commonly abused drug.

Posted on 11-3-2010 | Permalink

Social media, such as YouTube, Twitter, Facebook, MySpace and blogs are inappropriate for doctor-patient communication because they are too informal and lack the atmosphere of professionalism. They promote casual conversation and blur the boundary between personal and professional relationships.

Accordingly, Dr. Covert does not use the social media to dispense medical advice, respond to clinical questions from patients nor otherwise practice medicine on these sites.

Patients should presume that anything said or posted is in the public domain. These types of media do not use HIPAA-compliant secure networks. Also, remember that anything typed or emailed creates a permanent, indelible record.

Posted on 11-1-2010 | Permalink

Dr. Covert's office policy is that neither he nor his staff communicate with patients by email about any issues related to their psychiatric treatment. The reason is that exchanging emails would circumvent the normal psychotherapeutic process and create the expectation that we would continually monitor for emailed patient messages.

However, we do maintain a 24-hour answering service so that patients can leave messages with a real person who will relay those messages to Dr. Covert and his staff who will respond.

We are available and willing to communicate.

Denial of Mental Illness, or anosognosia, is a physiological syndrome that makes a person unable to understand that they are sick and dysfunctional and that their judgment is impaired.

a) About 50% of people with schizophrenia and bipolar disorder do not believe they are ill

b) About 20% ofU.S. women will have a major depressive episode in their lifetime, and 13% of U.S. men

c) Major depression may present itself as a depressed mood and loss of interest for 2 weeks or more, plus 4 of these symptoms:

(1) Sleep problems-insomnia or day sleeping

(2) Low energy

(3) Significant weight loss or gain

(4) Loss of appetite

(5) Difficulty concentrating

(6) Feelings of worthlessness and hopelessness

(7) Thoughts of death or suicide

(8) Decreased interest in socializing

(9) Morbid or illogical and irrational or delusional thinking

(10) Hearing voices

(11) Odd and peculiar out-of-control behavior, including grandiosity, recklessness, overspending or gambling

d) Anosognosia is an impairment of the frontal lobe of the brain which controls self-awareness, which results in an inability to perceive that person's dysfunctional state.

Solutions to Overcoming the Denial and your loved one's refusal to accept evaluation and treatment:

a) Be kind

b) Share your own problems, but be firm

c) Don't attempt reasoning with an unreasonable person when you can see it doesn't work

d) Make anappointment now with Dr. Covert, with your spouse, to discuss the affect this is having on your family and possible solutions, including involuntary hospitalization

e) Educate yourself beforehand on the provisions of the Texas Mental Health Code and the Probate Code elements of a comprehensive guardianship, for both medical and financial affairs

f) Seek referral from your psychiatrist to an attorney board certified in guardianship matters to discuss your legal options and take action

g) Resolve to stop being held hostage to a mentally disordered family member

Dr. Covert does not believe in sacrificial parenting nor in denial as a means of dealing with your child's or other family member's cognitive, emotional and behavioral dysfunction.

He will support your attempts to reassert appropriate and reasonable parental or family authority in your family member's best interests.

On 9/21/10, Dr. Covert participated in ADHD Live!, Expert Discussions on ADHD in Houston, Texas, for physicians who diagnose and treat ADHD.

The nationally recognized experts on the panel included:

1. Stephen Stahl, M.D., Ph.D, University of California Adjunct Professor of Psychiatry
2. Melvin Oates, M.D., Assistant Professor of Clinical Psychiatry, NYU Child Study Center
3. Theresa Cerulli, M.D., Harvard Medical School

The take home messages were:

A. Clinical Pointers:

1. Clinicians should use DSM-IV criteria, and
2. establish treatment alliance with parents and teachers, and
3. facilitate behavioral modification techniques with rewards and consequences for undesirable behavior across multiple settings by establishing a token economy, and
4. consider both stimulant and non-stimulant options to address inattentiveness, hyperactivity and impulsivity, and
5. understand that patients never outgrow the neurotransmitter imbalances of ADHD, but patients may learn to compensate for ADHD symptoms which are still present and can still affect their lives.

B. There are multiple on-line informational resources available to patients and families, including:

1. addresources.org
2. chadd.org
3. help4adhd.org
4. add.org

C. 9.8 million adults suffer from ADHD

Dr. Covert and his staff are ready to help you evaluate your family’s ADHD issues and to competently address them.