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Psychiatry for Primary Care: An Update on Hoarding DisorderHow can we effectively identify hoarding disorder, the various treatment options, and the research that informs these interventions?
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Managing MCI: Sifting Through the UnknownsIn many ways, the frustration experienced bypatients struggling with mild cognitive impairment(MCI) is matched by the frustration ofclinicians facing the challenge of managing thisheterogeneous condition. The prognosis can bevariable, and no proven therapies exist.
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Are the Media and the Public Still Missing the Clues?It is our responsibility as psychiatrists to educate the media and the public in general.
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Nonvalidated Pharmacogenetic Tests, Part I: Confessions of an Embarrassed Psychiatry ProfessorI started promoting pharmacogenetic tests in the 1990s-before they were fashionable-and now, after going through the 3 phases of pharmacogenetic testing (fear, failure, and hype), I am embarrassed.
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Neuropsychiatric Masquerades: Diagnosis and TreatmentA focus on the differential of CNS disorders that present with neuropsychiatric symptoms, their presentations, and guidelines for treatment.
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Psychiatric Presentations of Autoimmune EncephalopathiesGiven the potential for a significant role in recognition of neurologically complex disorders, psychiatrists should become familiar with diagnostic criteria and appropriate therapeutic option.
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Secondary Trauma Issues for PsychiatristsThe characteristics that bring people into the caring professions are, ironically, the very factors that make them vulnerable to vicarious trauma and job burnout. It is our responsibility to ensure that these adverse outcomes are minimized among those who have chosen such a career.
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Therapist-Patient Race and Sex Matching: Predictors of Treatment DurationMany of the factors purported to influence accessing mental health services by men and ethnic minorities are systemic in nature, ingrained within our culture, and consequently, difficult to change (e.g., gender differences in attitudes toward help-seeking, ethnic differences in the use of alternative healing resources). However efforts have been made within the mental health system to make services more acceptable to men and minority group members who choose to, or are able to, access the system.
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Is There a Common Basis for All Addictions?Addicts are people who have learned how to give themselves a quick chemical fix or achieve an emotional high when they either want to or have to change how they feel, and when they want to ignore real-life problems. Most people do that, but the next morning, they feel sick or foolish. They don't do it again because it didn't work for them. What makes addicts different is that they are willing-or feel compelled-to do it again and again even though they "know" that doing so will get them into trouble.
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Medicare Revenue Enhancement and Consultation-Liaison PsychiatryConsultation-Liaison (C-L) psychiatric services are generally not profit-making enterprises. Indeed, they are hard-pressed to demonstrate that they break even. Some attention has been paid to this issue in the recent literature, and specific recommendations of a most helpful nature have been made. The C-L service at Lehigh Valley Hospital (LVH) in Allentown, Pa., is an example of recommendations that have been put in place for C-L.
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Psychotherapy Supervision (2nd ed)who remarked that the problem with most new books he reads these days is that there is “too much space between the covers.” After all, he queried rhetorically, “Do I really need more than 250 pages or so on any one subject?” Days before this conversation, I had accepted an invitation to write a review of Psychotherapy Supervision and had received the 632-page tome by mail.
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Brain Pathways: New Approaches to Structure-Function LocalizationIs it time again for greater unification of neurology and psychiatry?
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Drugs On Our Minds: Historical, Social Perspectives on 'Modifiers of Affect'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?
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Update on Bipolar Disorder, Part 2: Bipolar Depression and Cyclothymic DisorderThis article reviews DSM-5 changes to symptom criteria for bipolar disorder with a focus on treatment of bipolar depression and cyclothymic disorder.
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An Update on the Diagnosis and Treatment of Bipolar Disorder, Part 1: ManiaThis article reviews DSM-5 changes to symptom criteria for bipolar disorder. The primary focus is on the diagnosis and treatment of mania and hypomania.
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Schizophrenia and Smartphones: Separating Speculation From ScienceCan mobile technologies advance care for schizophrenia? The research literature strongly supports feasibility, although clinical data on validity, safety, and efficacy are still lacking.
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Some Concerns Regarding DiagnosisThe mental health professions are currently awaiting the American Psychiatric Association’s newest version of the Diagnostic and Statistical Manual. The need for a fifth revision underscores the lack of satisfaction within the professions with our diagnostic schema
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Neoplasm or Demyelinating Lesion?A 32-year-old left-handed woman presented with a 4-week history of progressive left hand numbness, tingling, and clumsiness. Symptoms worsened until she found it difficult to write and perform fine motor tasks. She reported having no transient neurological symptoms in the past. Her medical history was significant only for Dengue fever acquired several years ago while on a visit to Southeast Asia. She was taking no medications, and a review of systems was noncontributory.
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Assessing Malingered Voice-HearingMalingering in clinical settings is usually motivated by an attempt to obtain care or social services (eg, hospital admission, medication, disability income) and often co-occurs with real mental illness, hence the dilemma.
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Antecedents of Personality Disorders in Young AdultsPersonality disorders are characterized by the presence of inflexible and maladaptive patterns of perceiving oneself and relating to the environment that result in psychosocial impairment or subjective distress. The enduring nature of the behaviors, their impact on social functioning, the lack of clear boundaries between normality and illness, and the patient's perception of the symptoms as not being foreign make this group of conditions more difficult to conceptualize than the more typical, episodic mental disorders.
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Telepsychiatry: The Perils of Using SkypeWhat Skype does not offer is a means of communication clearly suitable for clinical services-especially in mental health and psychiatry.
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Hemicraniectomy for Massive Basal Ganglia Hemorrhageintracerebral hemorrhage, hemicraniectomy, stroke, neurosurgery, traumatic brain injury
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Psychiatric Problems in Patients Who Survive Critical Illnesses (Part 2)The psychiatric aftermath of critical illness can involve emerging from the ICU with horrifying memories (of being tortured, raped, assaulted, or imprisoned).
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What’s New in Our Understanding of SchizophreniaDuring the past 5 years, new insights into the pathophysiological processes that underlie schizophrenia have been revealed. Here's a quick update.
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The State of the Mental Health SystemThe federal government must realize that decades of allowing mental health care to go begging leaves a very weak chance of detecting or treating those who need help.
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Progress in the Treatment of Bipolar Depression: Advances and ChallengesA discussion of the pharmacologic management of bipolar depression, including emerging treatments and expert recommendations.
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Correctional Psychiatry: Challenges and RewardsPracticing psychiatry in a correctional environment differs from traditional outpatient and inpatient venues and presents unique challenges. It can be a rewarding choice of workplace.
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The OPTICS Project: An Open-Science Framework for the Analysis of Clinical Trial DataA report of initiatives that have raised awareness of and promoted data sharing and data transparency in order to advance science and improve public health and health care.
