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Cobenfy: The Tip of the Spear of A New Class of AntipsychoticsCobenfy: Only the first in a new upcoming class of antipsychotics.
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Neurological Complications of Perinatal AsphyxiaThe degree of asphyxia is best ascertained by measuring the amount of fetal acidosis determined by umbilical arterial blood. An umbilical arterial pH of less than 7.0 is seen in about 0.3% of deliveries.1 It indicates a severity of acidosis that places the fetus at risk for permanent neurological damage because of asphyxia. However, the outcome of infants with umbilical cord pH of less than 7.0 who required neonatal intensive care is relatively good. Eighty-one percent can be expected have a normal examination at discharge.
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Management of Mild Traumatic Brain InjuryA considerable overlap exists between TBI and disorders in cognition, behavior, and personality, which can provide even greater clinical challenges. More than 70% of the cases of TBI are mild, which makes this subgroup of particular clinical interest.
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Clinical Assessment of Dysexecutive SyndromesDysexecutive syndromes result from damage to the anterior regions of the brain and present as a combination of disinhibition, disorganization, or apathy.
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Let’s Talk About CognitionCognitive problems have historically been the last to be recognized and treated in the clinical setting.
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The Molecular Biology of Weight Loss: An Unexpected Linkage Between 2 MoleculesThis article outline a previously undescribed mechanism for understanding the molecular relationships between the hypothalamus and high-fat diets. Do they also hint at the creation of a fat pill?
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The Edifice of ScienceFor much of our 155-year history, the United States has been the global leader in research, including in its provision of funding for education and training in science, to the great advantage of itself and the wider world.
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Posttraumatic Stress Disorder in VeteransThere have been nearly 1.5 million military deployments to the southwest Asian combat zone since the start of the Afghanistan operation and Iraq war in 2001 and 2003, respectively. There have been many casualties, some of which have been highly profiled, such as service members being killed in action, losing limbs, or suffering blast injuries to their brain.
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Assessing Violence Risk in Psychiatric Inpatients: Useful ToolsPsychiatrists who work in inpatient units are faced with daily decisions about predicting which patients will be violent, both in the hospital and after discharge. These decisions are often made using unstructured clinical judgment based on the clinician's experience and knowledge of the literature. How long such judgment stays the standard of care remains to be seen, because psychiatric researchers have produced a number of assessment and management tools to improve the accuracy and use of violence risk assessment. This article briefly outlines 3 tools: the Brøset Violence Checklist (BVC), the Classification of Violence Risk (COVR), and the Historical Clinical Risk-20 (HCR-20).
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No Legal Exit: The Fort Hood ShooterArmy psychiatrist MAJ Nidal Hasan sought to get out of the service, but the Army, which had poured hundreds of thousands of dollars into his military and medical training, offered him no legal exit.
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Turning a Negative Into a Positive: Ways to Avoid and Overcome Negative ReviewsThe Internet has transformed the way we get information. It is no surprise that finding health information online is a common activity.
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Psychiatric Malpractice: Basic Issues in Evolving ContextsThis article focuses on 4 issues in psychiatric malpractice: prescribing, liability for suicide, informed consent, and duty to protect under the Tarasoff v Regents of the University of California ruling. Malpractice is a civil wrong actionable by law. There are 2 goals of malpractice suits: the first is to make an injured plaintiff whole by an award of money, and the second is to inform the profession how courts will decide similar cases in the future.
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Elder Abuse and Neglect: Appearances Can Be DeceptiveThe number of persons affected by elder mistreatment and self-neglect is growing-with consequent increases in morbidity and premature mortality.
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Cognitive Issues in Schizophrenia Remain a ChallengeHow does John Kane, MD, address issues of cognition in schizophrenia?
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Marketing Off-Label Uses: Shady Practices Within a Gray MarketFor pharmaceutical companies, off-label use of a drug represents a substantial “gray market,” to which the company is unable to sell their product directly, yet may be a significant revenue stream. Some drugs have been used more for off-label purposes than for originally approved indications.1
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No, Psychiatry Has Not Lost Its “Mind”: Here, Psychotherapy Training ThrivesAfter reading Dr Daniel Carlat’s heartfelt piece in the April 19, 2010, New York Times Magazine (“Mind Over Meds”), I was struck by several things. The first was Dr Carlat’s eloquence regarding the dilemmas of psychiatric practice. Second was how his experience may represent a generation of psychiatrists who were trained during an era of drug discovery wrapped in the exciting promise of “Biological Psychiatry.”
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Alcoholism Research and Neuroimaging: Implications for TreatmentAdvances in basic molecular research of alcoholism await translation into important new clinical insights.
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Neurobiology of PTSDThis is the last installment in a 3-part series discussing the behavioral, cellular, and molecular characteristics of posttraumatic stress disorder (PTSD). In Part 1, I described some basic clinical observations of PTSD and the challenges these observations pose to researchers attempting to understand underlying biological substrates.1 Part 2 examined progress on addressing these challenges at the level of the tissue and cell.2 In Part 3, I will discuss efforts to understand PTSD at the level of DNA, including potential genetic underpinnings and heritable risk factors.
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TV Violence and Brainmapping in ChildrenResearch conducted over the past 30 years leads to the conclusion that televised violence does influence viewers' attitudes, values and behavior.
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Atypical Depression in the 21st Century: Diagnostic and Treatment IssuesIdentification of atypical features is important in the treatment of depression for both treatment selection and prognosis, especially when initial measures prove ineffective. The concept of atypical depression has evolved over many years, and now it appears timely for a further revision.
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Consent in Psychiatric Emergencies: What Clinicians Need to KnowIt is important to recognize and document the abilities and deficits of a patient in order to determine capacity.
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Antidepressants for Bipolar DisorderWhat is the effectiveness (if any) of antidepressants in bipolar depression? What is the risk of manic switching? How effective are antidepressants in preventing relapse of bipolar depression? Insights here.
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Opposition to Medical Aid in Dying: Deserving Serious ConsiderationFurther arguments opposing MAID.
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The Internet as Practice ExtenderIn the early 1960s, the Internet was born out of the idea of a "Galactic Network." By the late 1980s, technology had advanced to allow for computer-based exchange of scientific information between academic and research institutes. From these humble beginnings, the Internet has experienced explosive growth in the last five years, evolving into a powerful global information resource and new media format unto itself. Psychiatrists can now reap the full benefit of this fast-paced evolution to extend the reach of their medical practice.
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Sweet Tea and Mental Health TransformationAcross our nation, mental health care funding and resources are either slashed to the bone or nonexistent. Yet, at the same time, there is a unique opportunity available right now for any and all who want to tackle reform.
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Traumatic Stress in Children and AdolescentsEight Steps to TreatmentTraumatic experiences are common in childhood and adolescence and can have significant psychological effects on the child’s emotional well-being and overall development. Outcomes can be affected positively or negatively depending on responses and interventions.
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Deep Brain Stimulation Surgery for OCD: On Safety, Efficacy-and Financial IncentivesOn Safety, Efficacy-and Financial Incentives
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Integrating Mental Health Apps Into Care With Your Patients: What You Need to KnowHere’s everything you need to know to about how to integrate apps into your clinical practice.
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Addressing the Interface Between Pediatrics and PsychiatryThere has been much thought and discussion about the relationship between pediatrics and psychiatry, but research on the integration of the two leaves much to the imagination.
