Folks,

DSM-IV-TR has gotten outdated as to dementias.  So attached is a listing that includes codes of ICD-9-CM for 2010 [99.9% are already OK].  Since the potential list is very long, I began with those listed in the ICD-9-CM’s index under “dementia,” and added a few others.  If some of you have had experiences with people with dementia of other disorders I have not listed, which clinicians should usually consider, let me know.

Speaking of codes, this week’s JAMA was devoted to violence. All of the types of violence discussed could be coded using the ones we listed in the ICD-9-CM mental stress/trauma coding of the County Update of 25July2009.

From this month’s AJP, for treatment of GAD, both psychodynamic psychotherapy and CBT led to improvements in symptoms of patients with GAD. CBT had greater decreases in worry, depression, and anxious traits, and an accompanying editorial pointed out that psychodynamic therapy might do better with symptoms that are not part of the GAD DSM-IV-TR criteria set. 

Speaking of CBT, a recent article in J Neuropsychiatry Clin Neurosci addressed the question of whether CBT changed the brain, a question some of us thought Eric Kandel answer years ago.  Their conclusion, “yes,” and more specifically that it changed dysfunctions of the nervous system in anxiety disorders.

Also in J Neuropsychiatry Clin Sci, a report of post-CVA apathy in three pts whose apathy was improved with methylphenidate, beginning at 2.5 mg/AM and increasing gradually to as much as 5.0/AM and 7.5/noon – two of the pts needed less. Long-term results are not available in these three.

One of you asked about a therapist for Body Dysmorphic Disorder and two names have come to my attention:

Michael Diamond, M.D.

Friendship Psychiatric Associates Chartered

Phone: 301-657-4570

Charles Mansueto, Ph.D.

Behavior Therapy Center of Greater Washington

Phone: 301-593-4040 ext. 111

Roger