May 2008: This Month's Highlights -- 59 (5): 475 -- Psychiatr Serv

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src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/rarrow.gif"></b></p></td> <td bgcolor="#FCC44F" width="98%"><p><font size="+2"> <b><font color="#"> Special Section: Interpretingthe CATIE Findings </font></td></tr></tbody></table> <table align="right" cellpadding="1" cellspacing="1" border="0"> <tr><td> </td></tr> <tr><td> <table bgcolor="#f3ede2" border="1" bordercolor="#f3ede2" cellpadding="5"> <tr> <th align="left"><font face="Verdana, Arial, Helvetica, sans-serif" size="-1"> <a href="#top"><img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/uarrow.gif">TOP<br></a> <img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/dot.gif"><font color="464c53">Special Section: Interpretingthe...</font><br> <a href="#SEC2"><img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/darrow.gif">Aligning Science and Recovery...<br></a> <a href="#SEC3"><img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/darrow.gif">Mental Health Services in...<br></a> </font></th></tr></table> </td></tr></table>  <br> In September 2005 the initial report of findings from the Clinical<sup> </sup>Antipsychotic Trials of Intervention Effectiveness (CATIE) indicated<sup> </sup>that costly second-generation antipsychotics were no more effective<sup> </sup>than a first-generation agent. Advocacy groups despaired that<sup> </sup>these findings would buttress attempts to limit access to the<sup> </sup>newer agents, and much debate has since ensued about how best<sup> </sup>to interpret these findings in everyday practice. A special<sup> </sup>section of nine articles in this month's issue offers clinicians<sup> </sup>and other stakeholders some much-needed neutral commentary—free<sup> </sup>of the "thinly veiled industry spin" that has characterized<sup> </sup>much of the debate about the CATIE findings, according to Marvin<sup> </sup>S. Swartz, M.D., who served as guest editor of the special section.<sup> </sup>The first article provides an overview of the CATIE design and<sup> </sup>main outcomes (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=500&view=short">page 500</a>). The second article reports results<sup> </sup>of an analysis of national data to determine trends over ten<sup> </sup>years in first- and second-generation antipsychotic use and<sup> </sup>changes in user characteristics (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=507&view=short">page 507</a>). The third article<sup> </sup>discusses the intersection of the science of cost-effectiveness<sup> </sup>with policy and political decision making in regard to CATIE<sup> </sup>and suggests methods to better align formularies with evidence<sup> </sup>from cost-effectiveness studies (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=515&view=short">page 515</a>). The fourth article,<sup> </sup>a commentary, urges caution on use of CATIE as the cornerstone<sup> </sup>of new formulary policies (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=521&view=short">page 521</a>). The fifth article examines<sup> </sup>take-home lessons from CATIE, underscoring the importance of<sup> </sup>approaches to prescribing that optimize individual benefit-risk<sup> </sup>profiles (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=523&view=short">page 523</a>). The authors of the sixth article discuss<sup> </sup>CATIE implications from the perspective of mental health services<sup> </sup>researchers, eschewing interpretations that would support "fail-first"<sup> </sup>formulary policies (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=526&view=short">page 526</a>). In the seventh article, a clinical<sup> </sup>researcher from the United Kingdom welcomes the eroding distinction<sup> </sup>between first- and second-class agents and the end of the preferred<sup> </sup>status of the newer drugs (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=530&view=short">page 530</a>). The final two articles<sup> </sup>summarize perspectives of two other stakeholder groups—state<sup> </sup>mental health policy makers (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=534&view=short">page 534</a>) and patient advocacy<sup> </sup>groups (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=537&view=short">page 537</a>). As Dr. Swartz notes in his introduction to<sup> </sup>the special section (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=497&view=short">page 497</a>) the most enduring lesson from<sup> </sup>CATIE "is the need to critically and dispassionately evaluate<sup> </sup>unbiased empirical data and use the best tools available to<sup> </sup>drive evidence-based policy and practice." In addition, during<sup> </sup>the past six months when the special section was in review,<sup> </sup>the journal accepted three reports on trends in antipsychotic<sup> </sup>use in the era of second-generation agents—one from the<sup> </sup>United States (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=540&view=short">page 540</a>), one from Canada (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=547&view=short">page 547</a>), and one<sup> </sup>from the Netherlands (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=554&view=short">page 554</a>)—reflecting the ongoing<sup> </sup>and international focus on this important issue.<sup> </sup><p> <a name="SEC2"></a> <br clear="right"><table border="0" cellpadding="0" cellspacing="0" width="100%"> <tbody><tr valign="middle"> <td height="22" width="2%" align="left"><p><b><img width="10" height="21" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/rarrow.gif"></b></p></td> <td bgcolor="#FCC44F" width="98%"><p><font size="+2"> <b><font color="#"> Aligning Science and Recovery in Schizophrenia </font></td></tr></tbody></table> <table align="right" cellpadding="1" cellspacing="1" border="0"> <tr><td> </td></tr> <tr><td> <table bgcolor="#f3ede2" border="1" bordercolor="#f3ede2" cellpadding="5"> <tr> <th align="left"><font face="Verdana, Arial, Helvetica, sans-serif" size="-1"> <a href="#top"><img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/uarrow.gif">TOP<br></a> <a href="#SEC1"><img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/uarrow.gif">Special Section: Interpretingthe...<br></a> <img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/dot.gif"><font color="464c53">Aligning Science and Recovery...</font><br> <a href="#SEC3"><img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/darrow.gif">Mental Health Services in...<br></a> </font></th></tr></table> </td></tr></table>  <br> The lead article, by several influential thinkers and researchers<sup> </sup>in the field of schizophrenia treatment, shows how two models<sup> </sup>of this disease—the "broken brain" model and the "recovery"<sup> </sup>model—are not as contradictory as they might seem. Jeffrey<sup> </sup>A. Lieberman, M.D., and coauthors note that the tension between<sup> </sup>neuroscientists' emphasis on brain pathologies and advocates'<sup> </sup>emphasis on recovery arises from lack of definitional clarity.<sup> </sup>They suggest defining recovery in terms of a range of improvements<sup> </sup>in specific domains, such as "recovery of cognitive functioning"<sup> </sup>or "recovery of vocational functioning," which will permit clinicians<sup> </sup>to communicate more clearly regarding research findings and<sup> </sup>treatment goals. The article examines and links new findings<sup> </sup>in neurobiology and recovery. The authors conclude that "an<sup> </sup>operational definition of recovery allows for bridging hope<sup> </sup>and recovery with important advances in the science of the brain"<sup> </sup>(<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=487&view=short">page 487</a>).<sup> </sup><p> <a name="SEC3"></a> <br clear="right"><table border="0" cellpadding="0" cellspacing="0" width="100%"> <tbody><tr valign="middle"> <td height="22" width="2%" align="left"><p><b><img width="10" height="21" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/rarrow.gif"></b></p></td> <td bgcolor="#FCC44F" width="98%"><p><font size="+2"> <b><font color="#"> Mental Health Services in Europe </font></td></tr></tbody></table> <table align="right" cellpadding="1" cellspacing="1" border="0"> <tr><td> </td></tr> <tr><td> <table bgcolor="#f3ede2" border="1" bordercolor="#f3ede2" cellpadding="5"> <tr> <th align="left"><font face="Verdana, Arial, Helvetica, sans-serif" size="-1"> <a href="#top"><img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/uarrow.gif">TOP<br></a> <a href="#SEC1"><img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/uarrow.gif">Special Section: Interpretingthe...<br></a> <a href="#SEC2"><img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/uarrow.gif">Aligning Science and Recovery...<br></a> <img width="11" height="9" border="0" hspace="5" alt=" " src="https://web.archive.org/web/20080512083607im_/http://ps.psychiatryonline.org/icons/toc/shared/dot.gif"><font color="464c53">Mental Health Services in...</font><br> </font></th></tr></table> </td></tr></table>  <br> In this issue the journal introduces a column focusing on mental<sup> </sup>health care reforms in Europe. Matt Muijen, M.D., Ph.D., who<sup> </sup>is regional adviser for mental health for the World Health Organization's<sup> </sup>Regional Office for Europe, is column editor. In his introductory<sup> </sup>installment, Dr. Muijen provides an overview of changes in services<sup> </sup>across Europe, largely driven by political commitment at national<sup> </sup>and intergovernmental levels in response to public health challenges<sup> </sup>posed by mental health problems. He emphasizes the wide diversity<sup> </sup>across Europe, which includes highly developed Western European<sup> </sup>countries and former Soviet Union republics, and the urgent<sup> </sup>need for comparable data (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=479&view=short">page 479</a>). A brief report by Stefan<sup> </sup>Priebe, Dr.Med.Habil., and colleagues presents data that appear<sup> </sup>to indicate an increase in institutional care across nine European<sup> </sup>countries (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=570&view=short">page 570</a>). In a commentary, Dr. Muijen urges caution<sup> </sup>in interpreting these data (<a href="/web/20080512083607/http://ps.psychiatryonline.org/cgi/lookup?lookupType=volpage&vol=59&fp=574&view=short">page 574</a>).<sup> </sup><p> <br clear="ALL"> <font face=""> <a name="relation_type_61"></a> <p><font size="+1"><strong>Related Articles:</strong></font><p> <dl> <dt> <strong>Focus on Mental Health Care Reforms in Europe: Mental Health Services in Europe: An Overview</strong> <dd>Matt Muijen<br> Psychiatr Serv 2008 59: 479-482. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/479">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/479">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/479">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Science and Recovery in Schizophrenia</strong> <dd>Jeffrey A. Lieberman, Robert E. Drake, Lloyd I. Sederer, Aysenil Belger, Richard Keefe, Diana Perkins, and Scott Stroup<br> Psychiatr Serv 2008 59: 487-496. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/487">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/487">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/487">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Introduction to the CATIE Special Section</strong> <dd>Marvin S. Swartz<br> Psychiatr Serv 2008 59: 497-499. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/497">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/497">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>What CATIE Found: Results From the Schizophrenia Trial</strong> <dd>Marvin S. Swartz, T. Scott Stroup, Joseph P. McEvoy, Sonia M. Davis, Robert A. Rosenheck, Richard S. E. Keefe, John K. Hsiao, and Jeffrey A. Lieberman<br> Psychiatr Serv 2008 59: 500-506. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/500">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/500">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/500">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Who Are the New Users of Antipsychotic Medications?</strong> <dd>Marisa Elena Domino and Marvin S. Swartz<br> Psychiatr Serv 2008 59: 507-514. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/507">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/507">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/507">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Second-Generation Antipsychotics: Cost-Effectiveness, Policy Options, and Political Decision Making</strong> <dd>Robert A. Rosenheck, Douglas L. Leslie, and Jalpa A. Doshi<br> Psychiatr Serv 2008 59: 515-520. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/515">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/515">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/515">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Policy Toward Second-Generation Antipsychotic Drugs: A Cautionary Note</strong> <dd>Richard G. Frank<br> Psychiatr Serv 2008 59: 521-522. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/521">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/521">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Lessons to Take Home From CATIE</strong> <dd>William T. Carpenter and Robert W. Buchanan<br> Psychiatr Serv 2008 59: 523-525. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/523">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/523">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/523">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Implications of CATIE for Mental Health Services Researchers</strong> <dd>Nancy H. Covell, Molly T. Finnerty, and Susan M. Essock<br> Psychiatr Serv 2008 59: 526-529. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/526">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/526">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/526">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>What CATIE Did: Some Thoughts on Implications Deep and Wide</strong> <dd>David Cunningham Owens<br> Psychiatr Serv 2008 59: 530-533. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/530">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/530">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/530">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Impact of the CATIE Findings on State Mental Health Policy</strong> <dd>Joseph J. Parks, Alan Q. Radke, and Rajiv Tandon<br> Psychiatr Serv 2008 59: 534-536. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/534">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/534">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/534">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>NAMI Perspective on CATIE: Policy and Research Implications</strong> <dd>Kenneth Duckworth and Michael J. Fitzpatrick<br> Psychiatr Serv 2008 59: 537-539. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/537">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/537">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/537">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Effect of Prior Authorization of Second-Generation Antipsychotic Agents on Pharmacy Utilization and Reimbursements</strong> <dd>Michael R. Law, Dennis Ross-Degnan, and Stephen B. Soumerai<br> Psychiatr Serv 2008 59: 540-546. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/540">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/540">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/540">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Utilization and Costs of Antipsychotic Agents: A Canadian Population-Based Study, 1996–2006</strong> <dd>Silvia Alessi-Severini, Robert G. Biscontri, David M. Collins, Anita Kozyrskyj, Jitender Sareen, and Murray W. Enns<br> Psychiatr Serv 2008 59: 547-553. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/547">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/547">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/547">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Use of Antipsychotic Drugs Among Dutch Youths Between 1997 and 2005</strong> <dd>Luuk J. Kalverdijk, Hilde Tobi, Paul B. van den Berg, Janelle Buiskool, Leonie Wagenaar, Ruud B. Minderaa, and Lolkje T. W. de Jong-van den Berg<br> Psychiatr Serv 2008 59: 554-560. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/554">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/554">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/554">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Mental Health Care Institutions in Nine European Countries, 2002 to 2006</strong> <dd>Stefan Priebe, Patrick Frottier, Andrea Gaddini, Reinhold Kilian, Christoph Lauber, Rafael Martínez-Leal, Povl Munk-Jørgensen, Dermot Walsh, Durk Wiersma, and Donna Wright<br> Psychiatr Serv 2008 59: 570-573. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/abstract/ps;59/5/570">[Abstract]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/570">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/570">[PDF]</a> </nobr><p> </dl> <dl> <dt> <strong>Commentary: Interpreting Data on "Institutionalization": Not Simply Counting Beds</strong> <dd>Matt Muijen<br> Psychiatr Serv 2008 59: 574. <nobr> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/content/full/ps;59/5/574">[Full Text]</a> <a href="https://web.archive.org/web/20080512083607/http://ps.psychiatryonline.org/cgi/reprint/ps;59/5/574">[PDF]</a> </nobr><p> </dl> </font> <br clear="ALL"> <br clear="ALL"> <br clear="ALL"> <table align="left" border="0" cellpadding="4" cellspacing="4" bgcolor="#FFFFFF"> <tr> <td>  <table border="1" bordercolor="#d1d1d1" cellpadding="0" cellspacing="0" width="268" bgcolor="#FFFFFF">  <tr><td class="content_box_title_highlight" 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May 2008: This Month's Highlights -- 59 (5): 475 -- Psychiatr Serv