Alhough depressive and anxiety disorders are classified as distinct groups of illnesses, studies document their frequent co-occurrence and provide evidence of a common biological substrate and a shared vulnerability.1 Comorbid depression and anxiety disorders are most frequently seen in primary care and in the general community, and the prevalence of comorbidity has been estimated to be as high as 10% to 20%.1

Social anxiety disorder (SAD), also referred to as social phobia, is a chronic and potentially disabling anxiety disorder characterized by the intense and persistent fear of being scrutinized or negatively evaluated by others. At its core, people with this disorder fear and/or avoid the scrutiny of others. Symptoms may occur only in circumscribed situations, such as a fear of speaking in formal or informal situations, or eating or drinking in front of others.

Psychotropic treatment can often prevent the relapse of psychotic and mood symptoms. However, many patients take medication intermittently or not at all; or the symptoms may be only partially responsive to medication. Therefore, there is a need for interventions that can supplement the effect of medication and improve treatment outcomes.

Brief psychotherapy is not the name of a specific model or theory of treatment. Rather, it describes an approach that attempts to make psychotherapy as efficient and practically helpful as possible within a limited time frame. The aim of brief therapy is to speed up the process of change, amplify patient involvement, and foster more focused psychotherapy sessions. Over the years, several approaches to brief psychotherapy have evolved. Some advocate a handful of sessions; others involve more than 20 sessions (eg, psychodynamic therapy).

Fibromyalgia syndrome (FM) is a chronic condition that consists of a pervasive set of unexplained physical symptoms with widespread pain (involving at least 3 of 4 body quadrants and axials) of at least 3 months duration and point tenderness at 9 bilateral locations (Figure) as the cardinal features.1 Patients with FM report a set of symptoms, functional limitations, and psychological dysfunctions, including persistent fatigue (78.2%), sleep disturbance (75.6%), feelings of stiffness (76.2%), headaches (54.3%), depression and anxiety (44.9%), and irritable bowel disorders (35.7%).1 Patients also report cognitive impairment and general malaise, “fibro fog.” This pattern of symptoms has been reported under various names (such as tension myalgia, psychogenic rheumatism, and fibro­myositis) since the early 19th century.

Suicide risk assessment is a core competency that all psychiatrists must have.¹ A competent suicide assessment identifies modifiable and treatable protective factors that inform patient treatment and safety management.² Psychiatrists, unlike other medical specialists, do not often experience patient deaths, except by suicide. Patient suicide is an occupational hazard. A clinical axiom holds that there are 2 kinds of psychiatrists: those who have had patients commit suicide—and those who will.

In 2001, depressive disorders were the third leading cause of disability in Western industrialized countries.

In the new century, the dementias will probably become 1 of the 2 or 3 dominant behavioral health problems in the United States. This article provides an overview of the major clinical features of these cognitive loss syndromes and emphasizes the perspective of the practicing psychiatrist.

Elder abuse is a concern for all practitioners who care for elderly patients or their family members. An elderly person’s fears of aging and dependence may be heightened by stories and news accounts of abuse. Medical and psychiatric care is fundamental in the identification, treatment, and mitigation of clinical effects of elder abuse, and physician documentation often provides evidence crucial for investigations of elder abuse.

According to the World Health Organization, by 2020, depression will be second only to heart disease as a cause of disability and premature death in established market economies. With unsatisfactory monoamine-based pharmacotherapy and the high comorbidity of medical illnesses in depression, the serotonin hypothesis seems to be insufficient in determining the cause of depression. Recently, ω-3 polyunsaturated fatty acids have been gaining attention as a promising alternative treatment for mood disorders, based on epidemiological evidence, preclinical trials, case-control studies, and clinical trials. This review provides an overview of the efficacy, safety, and possible mechanisms of action of ω-3 polyunsaturated fatty acids in the treatment of depression.