This book draws together the entire spectrum of the relevant psychosocial dimensions and data necessary to adequately assist in the evaluation and treatment of patients who may be candidates for bariatric surgery.
Psychiatric Times presents exclusive coverage of the American Psychiatric Association Conference. Here we will report the latest news, resources, and updates from the 2013 APA Conference, the 166th Annual Meeting of the American Psychiatric Association, May 18-22, 2013, in San Francisco, CA. Read More
Test your diagnostic skills and knowledge by quickly identifying and assessing various mental health disorders. The Psychiatric Times Diagnostic Champions' Challenge is meant to educate and entertain. Test your clinical acumen in this activity that is sure to make you think.… Read More
Approval of the nation's first physician-assisted suicide law last November has proved the adage "be careful what you wish for." In the aftermath of the Oregon initiative that once again endorsed the state's Death with Dignity Act, physicians and government officials throughout the country are now scrambling to make sense of the law and figure out ways to assure that compliance doesn't lead to liability, both criminal and civil.
Scientific, social or legal redefinition is only slowly reflected in changed practitioners and practices. It is not surprising that surveys continue to report high levels of ignorance and prejudice encountered by homosexuals in their contacts with health care providers. This also contributes to a negative feedback loop in which many homosexuals are reluctant to utilize, inform or confront their care providers, impairing collaboration in treatment.
In 1997, the National Library of Medicine (NLM) helped initiate a new era in American medicine when it made MEDLINE, its comprehensive online bibliography of published medical information, accessible to the public through the World Wide Web. That event may prove to be a symbolic watershed of 20th century American medicine. It will impact every aspect of medicine, from the manner in which physicians are educated to the way they run their daily practices.
Many of the factors purported to influence accessing mental health services by men and ethnic minorities are systemic in nature, ingrained within our culture, and consequently, difficult to change (e.g., gender differences in attitudes toward help-seeking, ethnic differences in the use of alternative healing resources). However efforts have been made within the mental health system to make services more acceptable to men and minority group members who choose to, or are able to, access the system.
The stakes in the debate over recovered memories therapy ratcheted upward in October with the indictment of five health care professionals, including two psychiatrists, in Houston. Charged in a 60-count indictment-believed to be the first of its kind in the United States-the former staff members of the now defunct dissociative disorders unit at the Spring Shadows Glen Psychiatric Hospital are accused of perpetrating a "scheme to defraud by allegedly falsely diagnosing patients with multiple personality disorder caused by their alleged participation in a secret satanic cult."
As a consultant and educator for various stakeholders in the delivery of managed mental health services, I see confusion, skepticism and demoralization in the mental health professions about the direction health care is taking. Many doubt their ability to achieve the objective of the managed care mantra: Better care at less cost. To the clinician delivering care, it feels as if there is no stable ground to stand on, or, in the words of a 1960s female R & B group: "Nowhere to run to baby, nowhere to hide." Our profession seems to be either frozen in fear or disorganized in struggle, not grounded and coordinated in response to the changes that are upon us.
Nelson Kull, executive director of Pathways, sees an additional benefit to consumer employment: it provides patients with a first-hand look inside the system, and this can help defuse the sometimes antagonistic relationship between consumers and caregivers. "Some people criticize doctors and pharmaceutical companies for making a lot of money," says Kull, "but they gave me back my life. I once told meeting [attendees] that yes, psychiatry and medical care cost a lot, but your car costs a lot. I can't drive my car without my medications, so which comes first?"
There is an increasing body of data that suggests there may be relationship between certain forms of childhood-onset OCD and previous Group A beta-hemolytic streptococcal infections. They seem to have early-onset OCD, tic disorder, Sydenham's chorea and family history of tics. Sydenham's chorea, a major manifestation of rheumatic fever and a disorder generally limited to prepubertal children, is thought to be disease of basal ganglia, and the basal ganglia is thought to be involved in both Sydenham's chorea and OCD. Children with Sydenham's chorea frequently present with OCD symptoms.
Peter Penna, Pharm. D. spoke on the future of drug formularies and how he sees them changing. Formularies in managed care evolved out of formularies in hospitals and have been around since drugs became relatively commonly used in patient settings, Penna explained. "Today, formularies are widely used by hospitals, managed care organizations, pharmacy benefit management companies, home health agencies and nursing home services."
Comments from your peers on our website and across our social media sites:
DSM-5: If You Don't Like the Effects, Look at the Causes •“‘Post-modern’” outlook on psychiatric diagnosis often leads to cynicism and nihilism—as if to say, ‘Nobody really knows anything about anything, and we shouldn’t trust anybody!’ Actually, there is a good deal of secure and well-founded scientific knowledge in psychiatry. ” Add your response...
Migraine and Psychiatric Comorbidity •“Sleep-related bruxism is high among those with fibromyalgia, anxiety, and migraines—but it is often overlooked as a dental problem. A long-acting benzodiazepine at night can make a big difference in patients with migraines who clinch or grind their teeth.” Add your response...
Can a Suicide Scale Predict the Unpredictable? •“The multifaceted nature of suicide requires both formal tools indicated in this article, as well as an awareness of changes in the patient (eg, outlook, behavior, attitude)—these and other factors may indicate suicide risk.” Add your response...
When it comes to aging, is there anything to look forward to from a neurocognitive perspective? What can we do to protect our brains from cognitive and functional decline? In this podcast, geriatric psychiatrist Helen Lavretksy outlines strategies to stimluate and revitalize an aging brain.
ADHD can persist into adulthood and have a significant impact on a person's relationships, careers, and even safety. The ASRS (Adult ADHD Self-Report Scale) is a checklist of 18 questions about symptoms that are based on the diagnostic criteria of DSM-IV. The patient answers the questions and a positive score suggests the need for a thorough clinical evaluation with a healthcare professional.
The Bipolar Spectrum Diagnostic Scale (BSDS) was developed by Ronald Pies, MD and was later refined and tested by S. Nassir Ghaemi, MD, MPH and colleagues. The BSDS arose from Pies’s experience as a psychopharmacology consultant, where he was frequently called on to manage cases of “treatment-resistant depression.” In Pies’s experience, most of these cases eventually proved to be undiagnosed bipolar spectrum disorder.