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Inflammation and Treatment Resistance in Major Depression: The Perfect StormNew findings provide powerful evidence that inhibition of inflammation or its downstream effects on mood may open up a host of new approaches to treatment for depression, especially for patients with treatment-resistant depression.
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Transition Issues for Patients With Eating DisordersStrategies to decrease the chances that individuals will fall through the cracks in the college years.
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Mini Quiz: Micronutrients and DepressionMicronutrient deficiencies can bring about a range of mental health complications. Take the quiz and learn more.
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Autism Spectrum Disorders and Psychiatry: Update on Diagnostic and Treatment ConsiderationsWhat are the most effective assessment practices for ASD during the developmental stages of early childhood, middle childhood, adolescence, and adulthood?
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Sudden Onset of Tics, Tantrums, Hyperactivity, and Emotional Lability: Update on PANS and PANDASIn the neuropsychiatric disorders PANS and PANDAS, we observe childhood illness with relationships between psychiatric symptoms, infection, and inflammation. Here are keys to early identification and treatment.
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Ethics and Virtues in Clinical PsychiatryCase-based dialogues illustrate some virtues required in psychiatric practice.
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Mini Quiz: Psychiatric Emergency Assessment of YouthsNearly half of children who present to emergency departments with self-harm receive no mental health assessment. What are the essential elements needed to interview children and adolescents in the context of a psychiatric emergency?
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Sexual Orientation: Neuroendocrine and Psychodynamic InfluencesIn this article we discuss psychoneuroendocrine influences on sexual orientation and the psychodynamics of internalized homophobia. Because of space limitations, we focus on homosexual orientation, although research in this area sheds light on heterosexual and bisexual orientation as well.
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Disparities and Opportunities in Mental Health Care for Women"There is an urgency for competent, thoughtful mental health care for women—not only because the differences have been ignored in the past, but because women’s mental health so often affects health and mental health outcomes for their children."
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Underdiagnosing and Overdiagnosing Psychiatric ComorbiditiesDiagnostic assessment of psychiatric disorders and their comorbidities is a challenge for many clinicians. In emergency settings, there is no time to conduct lengthy interviews, and collateralinformation is often unavailable.
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Apps for Suicide Prevention: What the Research SaysA review of smartphone tools for suicide prevention and recommendations for clinicians.
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Mental Health Disability: A Resident’s Perspective of Problems and SolutionsThe case for training residents to conduct evaluations of impairments in patients with chronic mental health issues.
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The Use of Omega-3 Fatty Acids in Treatment of DepressionThis review provides an overview of the efficacy, safety, and mechanisms of action in the treatment of depression.
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Grand Theft Childhood: The Surprising Truth About Violent Video Games and What Parents Can DoGrand Theft Childhood: The Surprising Truth About Violent Video Games and What Parents Can Do is a controversial, opinionated book that discusses the effects of computer gaming on children.
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Lac-yawn? A Jacques-ular Exchange: From our ReadersDrs differ on the advisability of reading a certain famous French psychoanalyst.
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Introduction: Expanding Your Practice and Avoiding BurnoutThe topics in this Special Report provide a broad picture of the issues psychiatrists face as they take a clear-eyed look at the opportunities and challenges in the emerging health care system.
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Treatment-Resistant Anxiety Disorders: Neurotrophic PerspectivesAnxiety disorders are the most prevalent psychiatric disorders in the United States. Although effective treatments are available, such as the SSRIs and cognitive-behavioral therapy (CBT), it is estimated that in about 40% of patients, anxiety disorders are partially or completely resistant to first-line treatment.
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Computers in the Consulting RoomComputerized information resources are being introduced into psychiatric practice settings, but some psychiatrists question whether they are really needed.
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Mini-case: Psychiatry in Pediatric Palliative CareThis case of a 14-year-old female patient with end-stage cystic fibrosis illustrates the psychiatrist's critical role in ensuring quality end-of-life care.
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Inter-Rater Reliability in Psychiatric DiagnosisDSM-5 presents psychiatry with a potential “reset button” for diagnostic reliability.
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The Mythology of Evidence-Based MedicineMedical training is awash in catch phrases and shibboleths. Some can be useful (“When you hear hoofbeats, think horses not zebras”); others, perhaps overly simplistic (“If it’s not in the chart, it didn’t happen”). A current divination clinging to medical consciousness is the concept of evidence-based medicine (EBM).
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Depressive Symptoms After LossTo improve validity, we proposed extending the current MDD bereavement exclusion-which excludes “uncomplicated” (relatively brief, lacking certain severe symptoms) depressive bereavement from diagnosis-to also exclude uncomplicated reactions to other major stressors, such as romantic breakups, job loss, and serious medical diagnoses.
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Psychiatric Issues in the Somali Refugee PopulationThis article highlights several features of medical and social importance that are somewhat unique to the Somali refugee community in the US.
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The Vote on Tutu: Fair Hearing?More details on the APA Assembly meeting in Washington discussing Desmond Tutu being designated as convocation speaker for the American Psychiatric Association’s recent annual meeting.
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The Concept-Laden PrescriptionCompared with the many recent articles addressing medications' multiple meanings for the patients who take them and the psychiatrist-therapists who prescribe them, there has persisted in the literature and in clinical practice a curious literal conception of the prescription itself. This article challenges the idea that the only medication that can be prescribed comes in the form of pills or tablets; on the contrary, ideas constitute some of the most potent "medication" known.
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Cognitive/Neuropsychological Functioning and Suicidal Behavior: A Review of Research and Implications for Clinical PracticeIn this CME, learn to identify 3 patient groups who are characterized by elevated rates of suicidal behavior and co-occurring cognitive/neuropsychological impairment.
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Psychiatric Issues in Children and Adolescents With DiabetesThe diagnosis of T1DM can be devastating to both the child and family. Because of the potential for immediate life-threatening complications of poorly controlled diabetes, family members must readjust their approach to daily living.
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The Evolutionary Calculus of DepressionThe discipline of evolutionary psychology views modern human behaviors as products of natural selection that acted on the psychological traits of our ancestors. A subdiscipline, evolutionary psychiatry, tries to find evolutionary explanations for mental disorders.
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Innovations in Treating Neuropathic Pain: Off-label Pharmaceuticals, Novel Orthotics, and Other New ApproachesManagement of diabetic peripheral neuropathy (DPN) centers on proper footcare, offloading, and various orthotic devices to prevent the development of ulcers. Management trends, however, show that off-label use of some pharmaceutical agents is common and that these agents are proving beneficial in relieving the pain that can accompany DPN in up to 35% of patients. In addition, innovations in orthotic devices and new technologies for patient monitoring are being rolled out.
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Looking BackPatients’ stories (both content and structure) contain more therapeutically useful information than merely identifying and counting symptoms.
