Mike Hennessy Sr

Usually, summer is about vacations, new adventures and excursions, and time off to explore, learn, and recharge. This year, our summers were a bit different—in fact, they were like no other in recent history. Traditional travel was not an option, but there was still much to learn. New data poured in about the coronavirus disease-2019 (COVID-19). And, as regions began to re-open, we learned what happens when you do so too quickly or without enough caution.

, tackled new challenges associated with the COVID-19 virus. In this issue, he describes the neuropsychiatric sequelae seen on the consultation-liaison service in his hospital. Lessons learned from our frontline C-L psychiatrists will be helpful in the days, weeks, and months to come. Some have been hard lessons, but they can be enlightening and empowering as the next sets of patients arrive at their doorsteps.

We have also learned the importance of tempering enthusiasm with the patience of doing what’s right not just for ourselves, but also for our community. A case in point is the coming school year. The debate over opening in-person versus online must weigh the benefits of protecting children and school officials from the virus against the mental and psychiatric challenges associated with quarantining. Unfortunately, nobody has a one-size-fits-all answer.

, sheds light on the debate, including what we know about the risks to children, what the expert organizations have to say, and the emotional impact of the pandemic and isolation. He also shares resources and guidance to work toward the best outcomes possible, regardless of how we move ahead, especially for children with preexisting psychiatric disorders. The hard-earned lessons of emergency online schooling in the spring and our new knowledge about the impact of the virus on younger patients will enable society and psychiatry to prepare and react better than before.

Although it has been a tough and unusual summer, perhaps it is best to focus on gratitude for what we have learned and what we can do with that information. Knowledge, after all, is power, and so we hope this issue of 

 will inspire you to continue to be successful, safe, and serve your patients well. ❒

Articles

It has been a tough and unusual summer, but perhaps it is best to focus on gratitude for what we have learned and what we can do with that information. 

What I Learned During My Summer Vacation 

It is hard to believe it is already August. Soon children will return to school, in 1 form or another; the days will grow shorter and colder, and the leaves will change color. To some it marks the end of summer, and to others it marks the beginning of the autumn holidays and cozier days. It depends on how you look at it.

Several of this month’s contributors share these sentiments, reminding us that both the half-full and half-empty views can serve as important wake-up calls. In our 

, the authors celebrate advances in cancer care, but they also recognize we can do more to help patients. For instance, Wendy G. Lichtenthal, PhD, and colleagues explore how meaning-centered psychotherapy (MCP) can serve as a buffer against the depression and hopelessness reported by patients with metastatic disease. According to the authors, this brief, structured, manualized intervention enhances patients’ sense of meaning and purpose by reflecting on what matters most to them and facilitating reconnection, even during the most challenging of times. Similarly, Lawrence E. Kaplan, DO, sheds light on the lingering neuropsychiatric sequalae, either due to the specific cancer or adverse effects of treatment. With improved screening and awareness, interdisciplinary approaches and interventions can address these issues to improve patients’ lives.

Similarly, in the front cover article discussing racism, 7 psychiatrists come together to challenge the status quo. We can—and should—do better, they say. Not only do the authors identify areas that need to be addressed, but they provide measures to help us ensure we are indeed moving forward.

Also in this issue, leaders in psychiatry discuss the need to push the envelope to do more for patients. Jerald Kay, MD, and Joel Yager, MD, lament the 

 often seen in psychiatric literature. After diagnosing the problem, they share potential cures, identify future steps to remedy the situation, and challenge the field to do better.

, agrees with many of those sentiments, he reminds us of the 

. From pharmacogenomics to neuroimaging and brain circuitry, ever-evolving research propels psychiatry into new areas to improve patient care and outcomes. His “glass half full” assessment reminds us that while progress has been made, we need to continue pushing for more.

With everything going on in the world, this lesson has become abundantly clear—our attitudes will help us ride the ups and downs and the slings and arrows that present themselves and propel us to better times. And, we hope, this issue of 

will provide you with the tools and knowledge to achieve successes for you and your patients. ❒

With everything going on in the world, this lesson has become abundantly clear—our attitudes will help us ride the ups and downs and the slings and arrows that present themselves and propel us to better times.

The Glass Is Half Full

FROM THE CHAIRMAN OF MJH LIFE SCIENCES, parent company of 

Our country’s founders embarked on a dream. They did not know what would happen, and they did not agree on how our new world should work. Nonetheless, they recognized a need for change.

Here we are at the birthday of our country, recognizing we are still a work in progress, and we still have some changes we need to make to live up to the ideals of the United States of America and our founding fathers. How do we do it? We do it one step at time, always keeping in mind those precious ideals, believing we can reach them.

Same is true in medicine and psychiatry. Awais Aftab, MD, starts us on this voyage in his discussion with Anne Harrington, DPhil. A critical historian, Harrington walks the fine line of “poking holes in the narrative without legitimizing the antipsychiatry story” in her efforts to push for positive changes. Her work helps to reinforce the notion that psychiatry may be a work in progress as well as the importance to regularly question and reevaluate the progress.

 pulls together great minds to consider how psychiatry and health care might morph to better meet the needs of patients. Erin Smith, William Ellsworth, Charles F. Reynolds III, MD, Michael Berk, MD, PhD, Harris A. Eyre, MBBS, PhD, and Helen Lavretsky, MD, MS, discuss the steps that should be considered, including recognizing the current challenges coupled with the pandemic’s impact. By leveraging experts from different fields—even those beyond medicine—convergence psychiatry may very well be the answer. Only time will tell how this work-in-progress unfolds.

In the clinical world, psychiatry looks for new ways to improve care. Jon E. Grant, JD, MD, MPH, and Samuel R. Chamberlain, MD, PhD, 

explore the neurobiology of obsessive-compulsive disorder

 and what it might mean for improving outcomes. Also in this issue, David N. Osser, MD, 

 to ask the tough questions and to re-evaluate old standby treatment strategies. He leverages data from recent studies to determine what role valproic acid should really play in treating bipolar disorder.

As we all take one step at a time to reach our ideals, our goal is that, one page at a time, 

 continues to provide you with the timely commentary and clinical guidance you need to reach the ideals you want in your practice.

Our country’s founders embarked on a dream. They did not know what would happen, and they did not agree on how our new world should work. Same is true in medicine and psychiatry. More in this introduction to the July issue.

A Work in Progress

June means summer is here. When we were young, the very word 

instilled excitement. It was a time of freedom—from school, homework, and strict schedules; freedom from cold weather, early dark evenings, and being stuck inside. And it meant freedom to wander and freedom to take family vacations.

Hopefully, June 2020 will bring us a new sense of freedom, as we make progress in the fight against COVID and the possibility of returning to a more normal life. Already, states and regions are starting to open up, and there is a promise of beach visits, intimate barbecues, and even (virtual) ballgames. Although we need to be cautious as we dip our feet back into the waters of the world, the teases of summer freedom are there.

Although the shadows that the pandemic casts on this summer will mean things will be different, different is not necessarily bad. The pandemic has helped us find silver linings. For example, the necessity of telepsychiatry use has increased its acceptance and this, in turn, is making psychiatric care more accessible to patients. Similarly, since there are ways in which this technology can enhance patient care, it could become an important tool alongside in-office care as the country reopens. If you are interested in learning more, I invite you to read about the tools and tricks that were discussed in 

 during COVID-19 and beyond; if you were unable to join us for the webinar, you can read the highlights on 

The pandemic has also placed a spotlight on psychiatric care, as the country begins to better understand the importance of mental health in addition to physical health. This new dialogue may lead to advancement in 

, which is sorely needed in this country. Our cover story reviews the progress that we have made since the passing of the 2008 Mental Health Parity and Addiction Equity Act and the challenges that remain.

As we ponder our summer freedoms, this month’s 

 explores freeing pre-conceived notions of care to think creatively about psychosis. For example, Patrick D. McGorry, MD, PhD, explains how a staging philosophy adds utility and sophistication to treatment selection, involving timing, sequence, intensity, and therapeutic variety. Patricia E. Deegan, PhD, challenges psychiatry to redefine the term 

as well as the tools used in achieving this treatment goal. Leveraging her experiences as a clinician as well as a patient, Dr Deegan provides insights into effectively engaging and empowering patients by incorporating goals and preferences that are important to them.

As always, this issue is packed with practical clinical articles and timely commentary to keep you connected to the field and to help you care for your patients. And, you are 

 to read more online at psychiatrictimes.com.

Hopefully, the season will bring us a new sense of freedom, as we make progress in the fight against COVID and the possibility of returning to a more normal life. 

Here Comes Summer

 looks at preventing premature mortality, one of medicine’s noble goals. The US has made progress in this endeavor via education and awareness addressing chronic health issues like heart disease, cancer, and cigarette use. Unfortunately, we still have a long way to go in preventing premature mortality, as psychiatrists can sadly attest. Suicide continues to be among the top 10 causes of death in this country, and the opioid epidemic has put the spotlight on the addiction woes that cripple the country.

Patients with psychiatric illness face additional challenges resulting in unique morbidity and mortality issues. Studies have estimated shorter life expectancy-by as many as 20 years-for patients with mental illness. The literature on premature mortality originally focused on patients with schizophrenia, but data now support increased mortality associated with attention-deficit hyperactivity disorder, obsessive-compulsive disorder, personality disorders, and mood and anxiety disorders. Accidents, lifestyles, socioeconomic, and limited access to care impact lifespan, despite advances in diagnosis and treatment for psychiatic disorders. The articles in this Special Report provide a glimpse into what can else be done to reduce premature mortality.

It is no coincidence that this Special Report falls in the midst of our fight against the coronavirus. As medical health care professionals fight the 

head-on in hospital rooms across the country, psychiatry continues to be the voice of reason and calm. In the last issue, 

explored resiliency. In this issue, we take a closer look at the enemy and our responses. Editor Emeritus Ron Pies, MD, eloquently 

the virus’s psychological assault and provides tips for healing the soul during this unprecedented time. Meanwhile, Greg Eghigian, PhD, ponders lessons learned-and not learned-from last century’s flu pandemic. And, as the government begins to consider reopening the country, Sheldon Preskorn, MD, 

how we can prepare to ensure the safest return to normalcy possible.

As we consider the most vulnerable, this issue of 

 discusses other matters that affect your patients. From understanding recovery in depression to special issues for patients with substance use disorders undergoing 

, you are sure to find practical tips and useful information to help you help your patients.

Mike Hennessy Sr
	Chairman and Founder, MJH Life Sciences

The Chairman and Founder of Psychiatric Times' parent company introduces the May issue.

Opening Up

As I write this, the world is dealing with an unprecedented crisis. 

 is not only affecting us in terms of our health, but it is also having a huge impact on the global economy and our everyday lives. Psychiatry is in a unique position to help the world navigate these times.

Psychiatry’s focus on recovery and resilience allows for a positive approach to challenges. Psychiatrists have been on the forefront of dealing with disasters and learning from them, so they can not only help their patients but society as a whole. Along those lines, Phebe Tucker, MD, shares a 

 on resilience in her article commemorating the Oklahoma City bombing.

 in our history-the Holocaust. His reflections and commentary remind us that the right attitude sprinkled with hope can make a huge difference in our survival during the most horrific times. I concur that resilience, not panic, is key in this time of pandemic.

And so, we continue to march forward, meeting our daily challenges despite this new crisis. Your patients continue to need care, perhaps now more than ever, and Psychiatric Times is here to support you in that endeavor.

 on the growing use and normalization of medical marijuana in patients with bipolar disorder. Did you know that 25% to 30% of patients with Parkinson disease have psychotic symptoms? Rajesh R. Tampi, MD, and Deena J. Tampi, RN, discuss the underlying pathophysiology, assessment, and management of these symptoms. Stephen A. Wyatt, DO, delves into world of benzodiazepines, exploring their mechanism of action and how to make treatment decisions. Although there has been some controversy and concern regarding this class of medications, they can be helpful if used cautiously and appropriately.

 on Sleep Disorders and some of our regular features to support you in your practice. And, don’t forget to check out our special coverage of COVID-19 online at 

.
	We hope you and yours remain safe, well, and resilient during these challenging times!

Mike Hennessy Sr
	Chairman and Founder, MJH Life Sciences, parent company of 

Psychiatry is in a unique position to help the world navigate these unprecidented times. MJH Life Sciences' founder and CEO introduces the newest issue of Psychiatric Times.

Let’s Talk About Resilience

You know the old saying, “The more things change, the more they stay the same.” In many ways we have made great strides, and our lives are most likely easier and better than the lives of our grandparents and previous generations. But, it seems like we are still fighting the same battles.

Take, for instance, COVID-19. We have seen frightening epidemics in the last 100 years-HIV, Ebola, smallpox, Spanish flu, etc. Outbreaks are not uncommon, yet we continue to struggle with appropriate reactions to new threats. It does not take long for fear, panic, and distrust to settle in or for bad information to spread. That is why 

 invited Drs Nidal Moukaddam and Asim Shah to 

 on this new virus, the pandemic, and its potential impact. Our goal is to arm you with the information you need to better educate and help your patients.

Are we faring better in the field of addiction medicine? In our Psychiatry 20/20 series, 

 looks back at society’s approaches to addiction and comes away with mixed results. Thankfully, the US government is no longer interested in arresting and jailing psychiatrists and other addiction specialists while these clinicians help opioid-dependent patients. And, the pharmacological options to address addiction are also greatly improved. Yet, Dr Kosten is quick to point out that we are still battling an opioid epidemic, and only time will tell if we have learned the lessons of the past.

Fortunately, there are some areas where there has been progress. To address medication adherence, for instance, we now have psychotropic medications with improved adverse effect and efficacy profiles as well as new delivery methods. Along those lines, this month’s continuing medical education article discusses the pros and cons of long-acting injectable antipsychotics in helping to not only improve adherence but also outcomes.

So, while we may continue with similar struggles, it seems like we are taking steps in the right direction. And, cover-to-cover, 

 will continue to provide you with timely clinical information and discussions so you, too, can make and see progress!

We’ve Come a Long Way . . . Or Have We?


	
	Communicators and clinicians-the words we utter have great meaning and carry great weight. On the cover, for instance, Dr Steven Moffic discusses the tragic state of affairs in 

as the wildfires wreak havoc on that country. In that same article, he talks about physician burnout, which can happen when emotional, mental, and physical exhaustion extinguish the fire or passion that is so predominant at the beginning of one’s career. And later in the issue, Dr John Miller alludes to feeding the flames of knowledge in our ongoing quest for 

. Depending on the context, fire can have either negative or positive connotations.

In clinical care, the choice of words and when to use them also has immense impact. In this issue, Dr George Mecouch 

the conversations he had with a patient with depression, psychosis, and delusions. While psychopharmacological strategies helped, the words they shared were instrumental in her recovery and healing. Similarly, Dr David Osser notes how expert words can have an impact on patient choices: once hearing study results on the beneficial effects of 

, otherwise ambivalent patients become more open to integrating lithium into their care.

Indeed, nowhere is it clearer how words affect people than in psychiatry, where stigma continues to be a problem for patients, families, caregivers, and clinicians. This month’s Special Report and CME articles explore the stigma of violence and trauma and the interplay between violence and its consequences. In doing so, the articles provide practical tips for treating psychiatric disorders. Similarly, choosing when and what words to speak is important, especially when you find yourself between a rock and a hard place. Dr James L Knoll IV shares insights on the ethical, moral, and malpractice issues surrounding disclosure in his analysis of a challenge posed by Dr Eduardo Constantino.

And, with that in mind, we hope that cover-to-cover, the words you find in this issue of Psychiatric Times enlighten, entertain, and educate you as you feed the flame of lifelong learning in psychiatry!

Mike Hennessy Sr.
	Chairman and Founder, MJH Life Sciences

Chairman and Founder, MJH Life Sciences, Mike Hennessy, Sr, introduces the February issue.

The Words We Use

January is a time of reflection, fresh beginnings, and new opportunities, and a time of new year resolutions. The slate is wiped clean, and we all try to be the best version of ourselves.

. We are looking back at where we have been, and we are looking ahead to where we want to be. On our cover, Dr Allen Frances shares potential new year 

, addressing the issues in our mental health care system that he thinks can be changed for the better. And, in noting the great potential for this upcoming new decade, Editor in Chief Dr John Miller shares his 

. With some perseverance, perhaps we will be looking back 10 years from now feeling satisfied that the field has addressed some, if not all, of those items.

’ continued resolution is to provide you with clinically useful information to support you. With that in mind, Drs Pojen Deng and Anusha Yeshokumar shed some light on 

, an emerging and unique clinical entity that causes severe neuropsychiatric symptoms. In our 

, you will find strategies for integrating psychopharmacology and psychotherapy and ways to overcome challenges in pediatric bipolar disorder. You also can earn CME credit while exploring how to overcome 

 in older patients. And, you will find many more informative clinical pieces with up-to-date guidance and tips on our website at 

looks forward to being your go-to resource for clinical updates you can use and important information impacting the field in 2020 and beyond!

Mr Hennessy is Chairman and Founder, MJH Life Sciences, Parent Company of 

January is a time of reflection, fresh beginnings, and new opportunities. We are doing the same thing here at Psychiatric Times.

Here’s to Resolutions

As we come to the end of 2019, one of the emerging hot topics in psychiatry is artificial intelligence. We’ve been seeing more and more stories about initiatives for using technology, ie, mobile apps in caring for patients. In a study at the University of Colorado at Boulder researchers are looking at a speech-based mobile app that may be able to gauge a patient’s mental health status as well as, or even better than, a doctor can.

We’re also hearing more about telepsychiatry. One study from the Icahn School of Medicine at Mount Sinai in New York City is comparing in-person with telephonic evaluations of asylum seekers. The evaluations show similar efficacy, and consequently greater access to care.

On our cover, we feature the next installment of our Bipolar Telehealth series. Dr Osser discusses the use of aripiprazole in bipolar mania and depression and well at its use in preventing bipolar episodes. And, if you missed the “

Digital Psychiatry: Augmenting the Future of Mental Health Practice

” article, in the November issue, you may want to go back and read it.

This month we’re bringing you articles on another hot topic: sex and sexuality. Sex is always a provocative subject and it has proven so with the December issue. The articles in this month’s Special Report explore sexuality from the psychiatric perspective-some are diagnosis specific, eg, paraphilias, compulsive disorders; others are more wide-ranging, such as how to work with LGBTQ patients, sexting, and how to talk to patients about sex. After reading Dr Levine’s article, you’ll understand how taking a sexual history will help you understand your patient.

The CME article is just as stimulating. You’ll learn about the changes in consumption patterns of pornography since the advent of the internet. The increased use affects psychiatric and physical health as well as other aspects of functioning.

We expect 2020 to hold many more exciting stories as well as new features for 

. For instance, keep your eyes out for our upcoming 

 video series, which will provide you with additional opportunities to explore these and other hot topics.

 and MJH Life Sciences wish you Happy Holidays!

Author | Mike Hennessy Sr

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