Mike Hennessy Sr

The beauty of a new year is the blank slate it presents. We close the book on the previous year, hopefully wiser from lessons learned, and charge forward expectantly. After last year, such a gift is particularly appreciated.

 is poised to jump into 2021 with great excitement. 

, our editor in chief, explores the psychiatric treatments in the pipeline. Some of these agents leverage innovative psychopharmacology, and all offer the hope of improved outcomes for patients.

, a long-time contributor, now joins us as the Psychopharmacology Section Editor. Dr Preskorn is a professor in the Department of Psychiatry and Behavioral Sciences at the University of Kansas School of Medicine in Wichita. Also familiar to readers, 

, chairman of the Department of Psychiatry & Behavioral Sciences at Cleveland Clinic Akron General in Akron, and chief of the Section for Geriatric Psychiatry at Cleveland Clinic, is now serving as our Geriatric Psychiatry Section Editor. As part of our commitment to diversity, Advisory Board member 

, is our new Diversity and Inclusion Section Editor. Dr Clark is a clinical assistant professor at the University of South Carolina School of Medicine Greenville, and the medical director and division chief for Adult Inpatient and Consult-Liaison Services for the Department of Psychiatry and Behavioral Medicine at Prisma Health. We also welcome 

 chair of psychiatry and neurobehavioral sciences and the David C. Wilson Professor of Psychiaty and Neurobehavioral Sciences at the University of Virgina School of Medicine, as our Women’s Issues Section Edior. 

 medical director of the Division of Neuropsychiatry at Dent Neurologic Institute and medical director of addiction services at BryLin Hospital, in Buffalo, New York, will serve as our Neuropsychiatry Section Editor. In our continued effort to address collaboration, we are pleased to have 

as Nurse Practitioner Liaison. Ms Robinson is a psychiatric-mental health nurse practitioner in Portsmouth, New Hampshire, and a clinical assistant professor in the Department of Nursing at the University of New Hampshire College of Health and Human Services in Durham.

This year we are excited to highlight contributions from our partner organizations and associations. In this issue, 

 and colleagues from the Committee on Work & Organizations of the 

 share their thoughts on job loss. Previous

 articles have elucidated the direct neuropsychiatric implications of coronavirus disease 2019 (COVID-19). In this piece, these authors discuss how COVID-19 affects employment and how psychiatrists can assist their patients who are struggling with job loss.

There is much reason for optimism as we step into 2021: potential new treatments, a COVID-19 vaccine, and renewed hope and enthusiasm. Through it all, 

 is committed to keeping you up-to-date with the latest information and providing you with the resources you need to help your patients. If you have suggestions or requests to better assist you and your colleagues, let us know by emailing 

Mike Hennessy Sr
Chairman and Founder, MJH Life Sciences

Articles

As we close the door to the past, the promise of tomorrow is yet to come.

New Beginnings, New Promises

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair.” – Charles Dickens, 

The year 2020 will go down in the history books as a period of unusual and challenging times. Nevertheless, as H. Steven Moffic, MD, and our editor in chief, 

, point out in their respective articles in this issue, it was a year of opportunities, growth, bravery, and renewed commitment.

, Special Report chair, notes that despite much progress in treating the core symptoms of serious mental illness, cognitive issues sometimes get overlooked. Addressing these lingering problems improves patients’ quality of life, he adds. After all, everyone is trying to make sense of the world, even (or especially) in the year 2020. To better support you and your patients, Hartej Gill; 

, explore ways to assess and address the cognitive deficits that often accompany psychiatric illnesses.

Throughout this troubled year, we have learned so much that will allow us to improve ourselves and our world, as well as patients with psychiatric disorders. To that end, 

, shares lessons gleaned from the pandemic in hopes of helping her colleagues better assist patients as the pandemic evolves. Similarly, the Schizophrenia in the News feature offers a reminder that moving the research agenda forward has remained a priority, with a better understanding of psychiatric illnesses and novel agents to treat psychiatric disorders in the works.

Dickens’ sentiments seem to ring true, but perhaps he understood only part of it. It is not that the glass is half empty or even that it is 

. Instead, the glass is vast—and that requires us to work harder to find ways to keep it filled. At 

, our goal is to keep filling your cup of knowledge with a plethora of important, interesting, and useful clinical information to best enlighten you as you care for your patients.

With that, we wish you and yours a joyous holiday season and hopes for a happy, healthy, and fulfilling 2021! ❒

Throughout this troubled year, we have learned much that will allow us to make the world a better place. 

A Dickens of a Year

November is the start of the holiday season, with Thanksgiving’s merriment arriving at the end of the month. It is the time of year we usually gather with friends and family and enjoy a bounty of food, comradery, and laughter. There is no question that this year’s feasts and festivities will be different, but the opportunity to reflect and give thanks should still be at the forefront of our minds.

, does just that. Although the past 6-plus months have been challenging, he found silver linings amid the coronavirus disease 2019 (COVID-19) crisis. From teamwork and innovation to more fully appreciating the little things, his article reminds us of the magic that happens when people come together to help others. For those who have worked tirelessly to keep our health care system working, we give thanks.

Meanwhile, Carl I. Cohen, MD, and Jena Lee, MD, explore one of the mixed blessings of the COVID-19 pandemic—

 and the seemingly infinite number of virtual meetings. On the surface, “

” and the inability to see patients in-person seem like another hassle. Yet, technology has afforded us ways to communicate and connect from the safety of our homes for work and pleasure and it has allowed clinicians to “meet” with their patients without exposing the most vulnerable to undue risks. For all those virtual platforms, we give thanks.

Pain continues to be a hot topic in medicine, especially as the fight against the opioid epidemic continues. To that end, a number of articles in this issue investigate the strategies for managing pain in patients with psychiatric disorders. Steven King, MD, 

 a fascinating Special Report that examines the roles sleep and posttraumatic stress disorder play in addressing pain. Similarly, Ellen Lockard Edens, MD, MPE, and colleagues explore the vicious “catch-22” of pain and substance use, explaining how chronic pain drives substance use and how the cycle of addiction leads to greater pain interference and poorer outcomes. Although the complications and challenges are ever-present, the articles share solutions to help improve patients’ quality of life. For the increasing options and awareness, we give thanks.

To help address the need for continuing medical education, last month we held our 

Annual Psychiatric Times® World CME Conference™

. The virtual meeting was a huge success, as attendees had the opportunity to hear from leaders in the field and Psychiatric Times

 contributors and editorial board members. For those who attended and shared their positive feedback as well as for our first-class speakers and staff who ensured a meaningful meeting experience for all, we give thanks.

So, although this year has given us plenty of obstacles, frustrations, and disappointments, I cannot help but look around and think we are relatively fortunate. As we gather around our more intimate holiday table this year, I will be thankful for so much. And, among other things, I am thankful for you, dear reader, for giving Psychiatric Times

 the opportunity to provide you with the insights and information you need to best treat your patients. May you, too, continue to have a plethora of reasons to be thankful! ❒

Although this year has thrown us off, there is much to be thankful for.

Giving Thanks

Albert Einstein once said, “Intellectual growth should commence at birth and cease only at death.” Nowhere is that truer than in medicine. As research uncovers new mechanisms of action for pharmacology and etiologies of disorders, physicians must keep up with the latest and most effective ways to help their patients.

John J. Miller, MD, sets the stage with his editorial, a personal reflection on a lifetime of learning. Even after nearly 30 years of practice, he admits he has mastered only the first 5 letters of the “psychiatric alphabet.” He exhorts clinicians to join him as he seeks a deeper understanding of the psychiatric ABCs. And 

® is honored to support you in that endeavor.

Perhaps the most exciting learning happens at the frontiers of knowledge, where new discoveries are made. In this issue you will find clinical and commentary pieces that explore new research, outline novel strategies to overcome challenges, and share lessons from experiential learning. Our continuing medical education article, for example, discusses considerations surrounding medical cannabis. Although it is gaining medical acceptance and piquing patient interest, cannabis raises important medicolegal questions, and clinicians need to know what they are and how to answer.

At the same time, there is always something new to learn, even about the most familiar topics. Within these pages, we include articles that explore core clinical areas, including mood disorders, schizophrenia and psychosis, and neuropsychiatry. For example, Rajesh Tampi, MD, MS, FAPA, and colleagues take a close look at the variants of 

 (FTD). This disorder is the third most common type of dementia and the second most common among patients 65 years or younger, but it is often misdiagnosed as other psychiatric disorders. The authors provide the practical knowledge you need to better identify and manage FTD. Similarly, Kultaj Kaleka, RN, and Juliette M. Perzhinsky, MD, MSc, share insights into medication-assisted treatment, including the ethical dilemmas related to its use. They remind us that in learning the ABCs of psychiatry, it is important to reflect on the ethical implications for patients.

This month you have another exciting learning opportunity, as we proudly present the 

. This dynamic, online event will offer you practical clinical insights, from the comfort of your own home, as you learn from members of the Psychiatric Times’

 Editorial Board, regular contributors, and leaders in the field. As a bonus, attendees can earn 16.5 AMA PRA Category 1 credits. We hope to see you there!

In our continuing effort to support you and your practice, we encourage you to give us your thoughts, feedback, and ideas.You can reach the editorial staff at 

. We are partners on your educational journeys, and 

®is honored to be the publication you read cover-to-cover. ❒

The chairman of Psychiatric Times' parent company, MJH Life Sciences, introduces the October issue.

The Importance of Learning

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. ❒

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.