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Merging Administrative and Academic Careers in PsychiatryIn the current climate of psychiatric medicine, changes that greatly impact a psychiatrist's time, income potential and career enjoyment are constantly occurring. Is a career in psychiatric administration and academics a rewarding combination?
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Illicit Drug Dependence Across the Globe: Results From the Global Burden of Disease 2010 StudyHow prevalent is dependence on amphetamines, cocaine, opioids, and other illicit drugs across the world? What is the associated disease burden? Insights here.
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Shadows on a Wall: Phenomenology in an Acute Care SettingWe present the case of a patient for whom different attending providers had markedly different interpretations. As the case unfolds, we invite you to reflect on your diagnostic understanding of each presentation.
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A New Adaptation of Integrated Psychological Treatment for Patients With SchizophreniaIntegrated psychological treatment (IPT)--which was developed by a research group in Bern, Switzerland, for patients with schizophrenia--is a distinctive and practical approach to rehabilitation.
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Why Aren’t We All in Therapy?The looming specter of emotional and physical exhaustion in residency often takes hold well into a physician's career. So what are we doing about it?
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Are Psychiatric Disorders Inflammatory-Based Conditions?A plethora of studies support the hypothesis that inflammation plays a role in the pathophysiology of major psychiatric disorders.
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Taking Culture Into Account When Assessing a Young PatientThis list serves as a guide when treating persons of diverse cultures and backgrounds.
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Algorithm Project Takes Shape in TexasWe believe that TMAP [The Texas Medication Algorithm Project] is the first large-scale use of medication algorithms, Rush said, "certainly in a community mental health setting. A project like this may help to lay the groundwork for improved public mental health treatment here and in other states as well." Medication algorithms, according to the project directors, consist of "a series of treatment steps, each of which is defined in turn by the clinical response of the patient to the preceding step."
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An Update on Street and Club Drugs: What Clinicians Need to KnowA review of the pharmacological and symptomatic effects of various classes of designer drugs, including stimulants, hallucinogens, and sedatives.
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6 Psychotherapy Questions for Medically Ill PatientsA brief psychosocial tool that offers compassionate, tailored care using existential neuroscience, a new perspective for conducting bedside psychotherapy.
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Treating Prolonged Grief Disorder: Innovations and Future DirectionsWhat is the best treatment course for prolonged grief disorder?
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Benefits of Early Pharmacological Treatment in Alzheimer DiseaseSuccessful intervention for Alzheimer disease requires an early and timely diagnosis. Caregivers of persons with AD often state that an average of 2 years passes from the onset of symptoms to a formal diagnosis.
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Dialectical Behavior Therapy for Patients Dually Diagnosed With Borderline Personality Disorder and Substance Use DisordersWith its focus on both behavior modification and mindfulness training, dialectical behavior therapy has proven quite effective in treating patients with borderline personality disorder. This article provides a primer on a modified version of this outpatient treatment for borderline patients with substance use disorders, a comorbid condition that may affect as many as two-thirds of patients with BPD.
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Frontiers in Psychiatric ResearchThese are exciting times for genetics research: Science magazine chose our new appreciation of human genetic diversity as the scientific breakthrough of the year 2007.1 The year brought a new genetic bonanza with the announcement of the 1000 Genome Project, a plan to capture human diversity by obtaining the entire genome sequence information of 1000 individuals.
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Conventional and Integrative Approaches to Treating Anxiety in PregnancyWomen should be provided with multiple options for treatment if they decide to engage in mental health care during this critical period.
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Bullying and SuicideChildhood and adolescent bullying-and, recently, cyberbullying-is a major public health problem with potentially devastating consequences. In any prevention effort, students need hope and to learn the skills to end the abuse, as described here.
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Rejecting the Accusation of a Violated STAR*D ProtocolThe original STAR*D authors refute claims of a violated protocol.
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Treating Psychiatric Patients With Psoriasis: Clinical ConsiderationsPsoriasis, a chronic inflammatory, autoimmune skin disorder, is associated with both genetic and environmental factors. It has important treatment implications for patients who have psychiatric disorders.
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Obesity in Patients With Psychiatric ConditionsObesity is one of the most common physical health problems in individuals with psychiatric conditions and contributes to excess medical morbidity and mortality. Several classes of psychotropic medications, particularly atypical antipsychotics, cause weight gain. While these issues pose challenges to optimal health, the good news is that there are solutions and emerging strategies.
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Sixty-Five Years After World War II: A Family SecretThe Holocaust is well known and has been well researched. The purpose of this study was to evaluate persons 65 years after the Holocaust who remained in Poland and discovered the “secret” of their Jewish ancestry, despite not being raised as Jews.
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Syncope: Workup, Differentials, and TreatmentSyncope is responsible for 1% to 6% ofhospital admissions and up to 3% of visitsto the emergency department (ED). Thissudden, brief loss of consciousness resultsfrom a decrease in or cessation of cerebralblood flow and is followed by spontaneousrecovery. The causes range from benignto life-threatening.
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Treating Insomnia in Patients With Substance Use/Abuse DisordersPatients who use or abuse alcohol and other substance are at high risk for insomnia and present unique challenges for treating this debilitating disease. The three avenues of treatment--behavioral, OTC medications and prescription medications--are reviewed and future trends are outlined.
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The Interface of Depression and DementiaDepression and dementia or Alzheimer's disease often go together. The presence of dementia may also increase the odds of depression. What can clinicians do to treat these two often comorbid conditions?
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Treatment Options in Late-Life Treatment-Resistant DepressionThis article sheds light on the strengths and weaknesses of various approaches to TRD management in adults 60 years and older.
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HypnoticsSeveral classes of hypnotic medication are available: the older barbiturates and their derivatives; benzodiazepines; chemically distinct “z-compounds”; antihistamines and antihistaminic antidepressants; and melatoninergic compounds. The use of hypnotic medications continues at a high rate. However, some switching to the shorter-acting benzodiazepines has occurred. The z-compounds-eszopiclone, zolpidem, and zaleplon-have become popular; they seem to have fewer residual effects than the benzodiazepines. Even so, care is needed in prescribing such hypnotics for the elderly.
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Anxiety in the Medical PatientAnxiety is a ubiquitous, natural affective state that is essential for evolutionary survival. Nearly as common, however, are experiences of anxiety that exceed social, psychological, or physiological needs, leading to functional impairment. Indeed, primary anxiety disorders, including panic disorder, social phobia, and generalized anxiety disorder (GAD), represent the most common category of mental illness in the United States. Secondary, or reactive, anxiety is also widespread and can arise not only from numerous medical causes but also from the psychological process of coping with illness.
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College Students Under StressEmerging adults in the midst of a tremendous emotional growth spurt and a leap of neurocognitive maturation often need guidance articulating what bothers them.
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Gender Differences and Psychiatric DisordersGender is an important variable in medicine and psychiatry. The initial interest in gender issues was stimulated by recognition that women were absent from much medical research. Now, however, the field has expanded to include more specific and sensitive attention to men and the role of gender and gender differences.
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Contraception and MisconceptionsPsychiatrists who treat women and adolescent girls may find it necessary to discuss with their patients reproductive planning and the role of contraception in setting comprehensive treatment goals. Here's why.
