Addiction & Substance Use

How can the simple act of forgetting become the impetus for a psychiatrist to develop his own series of self-administered psychotherapy computer programs? According to John Greist, M.D., it began when he forgot to ask his patients important information during the interview process. He also became aware that the very way he formed the question would lead to different responses from the patient, depending on the person he was speaking with or their frame of mind.

Detoxification from alcohol and drugs can be safely accomplished in outpatient settings. Careful selection of appropriate patients and frequent monitoring are key elements of successful detoxification. The success of outpatients withdrawing from alcohol without serious medical complications and continuing in recovery programs is comparable to success rates of inpatients when there is careful selection of patients, a good triage process and good nursing and medical assessments.

In 1962, fewer than 4 million Americans had ever tried illegal drugs. By 1983, that number had risen to 80 million. Drug use peaked in 1985 and dropped until 1992. Since then, use has been increasing steadily, particularly among teenagers. This increase is partially a result of a trend back toward glorification of drug experimentation and legalization, and also because there's a general resurgence of smoking. Whether it's marijuana, tobacco, opiates or cocaine, it's still smoking.

Because alcohol- and drug-dependent patients tend to develop high rates of symptoms usually associated with common psychiatric syndromes, practitioners often fail to diagnose substance dependence and instead jump to treat more familiar disorders. The risk that such circumstances will occur is understandable given statistics that two of every three alcohol- or drug-dependent individuals meet the criteria for psychiatric disorders and one of every three such individuals meets the criteria for anxiety or depressive disorders.

To understand our fascination with drugs in the first place, we need to ask some basic questions, such as "Why do we like to take poison in small quantities?" The truthful answer is always some variation of "To feel better." How does this come about, and why do we have so much trouble with it?

Despite the public's growing acceptance of addiction as a biopsychosocial disease from which recovery is possible, an ideological chasm persists between psychiatry AA.

Is the rising use of psychotropic medication to treat anxiety and mood disorders incompatible with the psychoanalytic approach? As a psychopharmacologist and psychoanalyst who frequently provides consultation to analysts regarding medication for their patients, Steven P. Roose, M.D., has studied this question and presented his findings and opinions in various scientific papers, books and meetings.

The guidance answers the most commonly asked questions about how ADA affects persons with psychiatric disabilities, said EEOC chairman Gilbert F. Casellas. "It provides practical instruction to employers and persons with psychiatric disabilities on their respective rights and responsibilities."

Although recent news portrays general violence as on the decline, the Centers for Disease Control still rank health care providers only one notch below convenience store clerks and taxi drivers at risk for homicide. Mental health personnel are exposed to these ultimate threats in emergency rooms, on home visits, walking through lonely hospital corridors or hotel corridors during conventions, as well as on the street and at home.

This two-year study of 341 patients is the largest controlled trial conducted in a population with moderately severe Alzheimer's. The primary end points, assessed quarterly, were the onset of severe dementia (clinical dementia rating of 3); death; institutionalization; and loss of ability to perform at least two of three basic daily activities (eating, grooming and toileting).

A scandal-rocked Medical College of Georgia has announced tightened compliance controls for clinical studies in the wake of a 172-count indictment that charged two former professors with diverting more than $10 million in research funds. Richard L. Borison, M.D., the former chair of MCG's department of psychiatry and health behavior, and Bruce I. Diamond, Ph.D., once a professor in the department, were jailed in February.

Causal Explanations that Suggest How to Change

Orally active compounds called neuroimmunophilins were demonstrated to protect and to stimulate the regeneration of brain cells in animal models with Parkinson's disease, according to a study published in the March 4 issue of the Proceedings of the National Academy of Sciences.

During this first century of Western psychotherapy, arguments among and between the schools of psychotherapy have dominated discourse. The psychotherapy of the next century is likely to place theory and associated techniques in their appropriate, practical places in the psychotherapy outcome puzzle.

The power of Superman's spell endures mightily, and the values of truth and justice he communicated through comics, and then television and movies continue to pass undiminished from generation to generation.

Panic disorder is a prevalent, debilitating illness associated with high utilization of multiple medical services, poor quality of life and a high incidence of suicide. Short-term efficacy of time-limited cognitive-behavioral and medication treatments has been demonstrated in many studies. Evidence for long-term efficacy of these treatments, however, is sparse and less convincing.

Despite the proliferation of competing psychoanalytic theories in the past three decades, for most analysts the recognition and interpretation of resistance (as well as transference) remains at the core of psychoanalytic technique. While resistance has been defined as encompassing all of a patient's defensive efforts to avoid self-knowledge (Moore and Fine), operationally it means those behaviors that help the patient ward off disturbing feelings such as anxiety, anger, disgust, depression, envy, jealousy, guilt and shame.

Adolescents are among the most difficult populations with whom to work therapeutically. Giovacchini (1985) wrote that they possess a "propensity for creating problems within the treatment setting [including]...their reticence about becoming engaged or their inclination to express themselves through action rather than words and feelings."

The state of North Carolina has relatively liberal policies regarding petitions for involuntary commitment. If such documents bear words like "dangerous" or "mentally ill," even in the most nebulous sense imaginable, the police will surely locate the relevant individuals and dutifully bring them to the emergency department. This generosity of interpretation produces some sticky situations for the lucky ED resident of the day.

In recent years, psychiatry and psychoanalysis have been drifting apart. As has been stated, psychiatry is losing its mind as it concentrates on chemistry and biology. This is a pity, because it is always good to have a mind.

When Natalie Rogers was very young, she would enter the living room of her home where her parents, renowned psychotherapist Carl Rogers and artist Helen Elliott Rogers, sat reading. She'd turn on some music, look over at them and say, "Please don't watch me." Then she would begin to dance, describing this blissful experience as "the music flowing through me." Little did she know these impromptu rituals would set the stage for her own important work that would expand on the humanistic principles of her father, yet encompass elements of the creative process itself.

Psychotherapy is as old as civilization. Literally soul therapy, the term is a misnomer, since soul is a mystical notion and what is meant is the whole person. The misnomer also survives in the name psychiatry, literally soul medicine. Yet nobody is crusading against psychiatry and psychotherapy because soul is unscientific. What is important is that psychotherapy and psychiatry are job descriptions that refer to what we actually do when as providers or recipients of the service called psychotherapy, we use words to convey meaningful messages to each other, or to evoke desirable acts from each other.

In 1885, Georges Gilles de la Tourette, M.D., described in the Achives of Neurology  a neuropsychiatric disorder characterized by chronic motor and vocal tics that begin in childhood. During the next century, researchers demonstrated that the disorder, which came to be called Tourette's syndrome (TS), is probably inherited as a dominant gene that expresses with widely varying symptoms, even within monozygotic twin pairs.

Mood disorders and their impact on women and their families was the topic of a half-day conference held at New York City's Algonquin Hotel;, former haunt of the famous-and depressed- writer Dorothy Parker, who made at least one suicide attempt there in the early 1900s.

The past decade witnessed major strides in our understanding and treatment of affective disorders in adults, children and adolescents. One of the baffling problems in child and adolescent psychiatry was the question of psychiatric illness spanning a lifetime. The existence of depressive disorders in prepubertal children has been generally recognized and acknowledged since the 1960s; however, only in the last decade did evidence become available that supports the notion that depression in different ages represents the same entity, albeit manifesting different clinical symptoms in each developmental period (Cytryn and others 1986).

With the exploding growth of the Internet, more and more people are going on-line. Mental health professionals are finding discussion groups filled with like-minded researchers and practitioners in every aspect of the field. Laypeople are discovering the value and enrichment that mutual self-help support groups and educational materials lend to their treatment. It is important, if not invaluable, to become familiar with this new world of opportunity and to learn about what's currently available and what's coming in future years.

An explanation of the cycle of abusive dynamics as it exists in abusive relationships, in commonsense language.

Many of the advantages of the MAOIs are seen with selective serotonin reuptake inhibitors, which have become the drugs of choice in the treatment of panic disorder.

As psychiatry is swept along by the evolutionary winds of change, will you be poised and trained for success? This question was posed to psychiatrists by Joel Yager, M.D., at the recent annual meeting of the American Psychiatric Association, at which he received the Seymour D. Vestermark Award.

Attention-deficit/hyperactivity disorder (ADHD) has received an extraordinary amount of attention in the popular media over the past eight months. Stories concerning the disorder, and especially its treatment with stimulant medication, have appeared in many major newspapers, news magazines and television news, entertainment and talk show programs.