What everyone agrees on (except the authors of DSM-III and DSM-IV), is that bereaved people meeting criteria of MDD should be diagnosed with MDD and treated accordingly. Where the confusion occurs is over how to sort out sub-MDD grief from grief with MDD … Read More
The mental health professions have been placed in the position of providing a dangerous fig leaf to cover an unfortunate correctional gap created by fixed sentencing.… Read More
Charles Moser, PhD, MD, has forwarded an interesting suggestion to solve the problem of weak diagnoses that have received a free ride through previous... More »
Revisions to the Diagnostic and StatisticalManual of Mental Disorders aim to ground diagnoses in empirical evidence, make them less stigmatizing, and incorporate assessments of patients' functioning over time. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.|Revisions to the Diagnostic and StatisticalManual of Mental Disorders aim to ground diagnoses in empirical evidence, make them less stigmatizing, and incorporate assessments of patients' functioning over ti
Archives of General Psychiatry, a monthly professional medical journal published by the American Medical Association, publishes original, peer-reviewed articles about psychiatry and related fields
Attrition in Web-Based Treatment for Problem Drinkers|Background: Web-based interventions for problem drinking are effective but characterized by high rates of attrition. There is a need to better understand attrition rates in order to improve the completion rates and the success of Web-based treatment programs. Objective: The objectives of our study were to (1) examine attrition prevalence and pretreatment predictors of attrition in a sample of open-access users of a Web-based program for problem drinkers
14 A disturbance of attention ( or inattention) is one of the core diagnostic features of delirium. ... 22 This diagnostic instrument records the presence of four core features of delirium: ( 1) attentional impairment, ( 2) confused thinking, ( 3)
It seems that the core neural regions and cognitive processes implicated in obsessive-compulsive disorder (OCD) pathophysiology may overlap with those involved in humor appreciation. However, to date, there have been no studies that have explored humor appreciation in OCD. The purpose of the present work was to investigate humor appreciation in a group of patients with OCD.|It seems that the core neural regions and cognitive processes implicated in obsessive-compulsive disorder (OCD) pathophysiology may ov
Evidence-based changes planned for Diagnostic and StatisticalManual 5th edition (DSM-5) substance use disorders (SUDs) include combining dependence and three of the abuse criteria into one disorder and adding a criterion indicating craving. Because DSM-IV did not include a category for nicotine abuse, little empirical support is available for aligning the nicotine use disorder criteria with the DSM-5 criteria for other SUDs.|Latent variable analyses, bootstrap tests and likelihood ratio tests were used to explore the unidimensionality, psychometric properties and information of the nicotine criteria.|A sample of household residents selected from the Israeli population register yielded 727 life-time cigarette smokers.|DSM-IV nicotine dependence criteria and proposed abuse and craving criteria, assessed with a structured interview.|Three abuse criteria (hazardous use, social/interpersonal problems and neglect roles) were prevalent among smokers, formed a unidimensional latent trait
Alcohol abuse leads to earlier onset of aging-related diseases, including cancer at multiple sites. Shorter telomere length (TL) in peripheral blood leucocytes (PBLs), a marker of biological aging, has been associated with alcohol-related cancer risks. Whether alcohol abusers exhibit accelerated biological aging, as reflected in PBL-TL, has never been examined. To investigated the effect of alcohol abuse on PBL-TL and its interaction with alcohol metabolic genotypes, we examined 200 drunk-driving traffic offenders diagnosed as alcohol abusers as per the Diagnostic and StatisticalManual of Mental Disorders [DSM-IV-TR] and enrolled in a probation program, and 257 social drinkers (controls). We assessed alcohol intake using self-reported drink-units/day and conventional alcohol abuse biomarkers (serum -glutamyltrasferase [GGT] and mean corpuscular volume of erythrocytes [MCV]). We used multivariable models to compute TL geometric means (GM) adjusted for age, smoking, BMI, diet, job at
The aim of this study was to examine the prevalence of impulse control disorders (ICDs) in a European psychiatric inpatient sample. Two hundred thirty four consecutive psychiatric inpatients (62% female) were examined using a module of the Structured Clinical Interview for Diagnostic and StatisticalManual of Mental Disorders fourth edition (DSM-IV) that has been developed for ICDs (SCID-ICD). In addition to intermittent explosive disorder, pyromania, kleptomania, pathological gambling, and trichotillomania, the proposed ICDs not otherwise specified were assessed, including compulsive buying, nonparaphilic compulsive sexual behavior, pathological internet use, and pathological skin picking. Based on the SCID-ICD, a lifetime ICD rate of 23.5% and a current ICD rate of 18.8% were found. The most frequent ICDs were pathological skin picking (lifetime 7.3%, current 6.8%), compulsive buying (lifetime 6.8%, current 6.0%), and intermittent explosive disorder (lifetime 5.6%, current 3.4%). In
The reliability of generalized anxiety disorder (GAD) features has been shown to be moderate, based on research utilizing the Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV), a semi-structured diagnostic interview. This may be a function of the criteria for the diagnosis of GAD, which have undergone much revision since its first inclusion in the Diagnostic and StatisticalManual of Mental Disorders. The reliability and validity of disorder feature ratings were examined in a diverse sample of patients who presented for assessment and treatment of excessive worry, generalized anxiety, or tension at an anxiety specialty clinic and who met criteria for a principal diagnosis of GAD (N=129). Internal consistency of the ratings of excessiveness of worry, uncontrollability of worry, and the associated symptom cluster was moderate to low and varied by disorder feature. Inter-rater reliability for all features of GAD and severity of the disorder varied between good and poor.
Most people with mental disorders receive treatment in primary care. The charts developed by the Dartmouth Primary Care Cooperative Research Network (COOP) and the World Organization of National Colleges, Academies, and Academic Associations of General Practitioners/Family Physicians (WONCA) have not yet been evaluated as a screen for these disorders, using a structured psychiatric interview by an expert or considering diagnoses other than depression. We evaluated the validity and feasibility of the COOP/WONCA Charts as a mental disorders screen by comparing them both with other questionnaires previously validated and with the assessment of a mental health specialist using a structured diagnostic interview.|We trained community health workers and nurse assistants working in a collaborative mental health care model to administer the COOP/WONCA Charts, the 20-item Self-Reporting Questionnaire (SRQ-20), and the World Health Organization-Five Well-Being Index (WHO-5) to 120 primary care
'What They Should Really Teach in Medical School' Julie Schopps, MD , February 6, 2012 The North Carolina-based pediatrician weighs in on why she thinks the real learning doesn't take place until students are out of the classroom.
Improve EHR Systems by Rethinking Medical Billing Daniel Essin, MA, MD, February 6, 2012 Separating billing-related data from other clinical documentation and transmitting it to a billing system is not difficult …no matter how the charting is done.