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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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Introduction: Risk Factors, Pharmacological Interventions, and Sequelae of Suicidal BehaviorThe articles in this Special Report address suicidal behavior in the context of the role of sexual identity, the effects of antidepressants and lithium on suicidal behavior, and clinicians’ reactions in the aftermath of suicide.
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Thinking About Mental Illness: 6 Steps for Medical School FacultyRegardless of the systems in place at medical schools, psychiatrists and psychiatry residents play an important role in molding medical students' attitudes toward mental illness.
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Somatoform and Related Disorders: An UpdatePotentially over-inclusive DSM-5 diagnostic categories for somatic disorders can result in a confusing overlap of criteria. These authors sort through the challenges of the differential diagnosis-and map out a well-structured treatment plan.
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PatientsLikeMe: Crowdsourced Patient Health Data as a Clinical Tool in PsychiatryPatients want to know what to expect with a given treatment, how their experiences compare with those of others, or whether they are alone in coping with their conditions. Who best to answer these questions than others like them?
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Depression-Related Disparities Among Older, Low-Acculturated US LatinosOlder Latinos with depression report higher levels of impairment and are more persistently ill than non-Hispanic white older adults, yet they have lower rates of guideline-concordant treatment. Cognitive and problem-solving psychosocial modalities are emerging as key treatment considerations for older Latinos.
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Small Biotech Companies Target CNS DisordersThe concept of a barrier between the blood and the brain arose in the late 19th century when the German bacteriologist Paul Ehrlich observed that certain dyes administered intravenously to small animals stained all of the organs except the brain. Ehrlich interpreted this to mean that the brain had a lower affinity for the dye than the other tissues. In subsequent experiments, one of Ehrlich's students injected a blue dye directly into the cerebrospinal fluid of rabbits and dogs. The dye readily stained the entire brain, but did not enter the bloodstream to stain the other internal organs.
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Mini Quiz: Neurobiology of Borderline Personality DisorderWhat do functional magnetic resonance neuroimaging findings reveal about the neurobiology of borderline personality disorder? Take the quiz and learn more.
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5 Ways to Transform Health BehaviorsProper technique, practiced over time, can transform an appointment from "medication management" to a serious change in behavior, as evidenced by the 5 examples featured in this article.
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Psychocutaneous DisordersPsychological problems are often manifest in the skin. In fact, it is estimated that between 20% and 30% of all skin disorders have some psychological component. Many patients who have psychocutaneous disorders-which are often direct evidence of or secondary to psychological abberations-drift from one physician to another, trying to find one savvy enough to cure their “skin condition.” Furthermore, although they have sought many medical opinions already, patients afflicted with psychocutaneous disorders almost always present as “an emergency.” While pharmacological intervention may benefit such patients, traditional mental health interventions are almost always required if the aberrant behavior is to cease.
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Orthorexia Nervosa: Disease That Masquerades as HealthIn the case of orthorexic thinking, clinicians, patients, and their loved ones are bombarded by the same cultural tropes about our bodies and their relationship with the environment in which we live.
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Medical Marijuana: Regulations Surrounding Its UseDisparate means of accessing marijuana complicates the evaluation of the quality, purity, and potency of cannabis.
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Firearms and Mental IllnessWhile violence is often portrayed in the media as related to persons with mental illnesses, there are limited research data to support this idea. This article reviews laws and obligations for mental health professionals.
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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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The HEADS-ED: Review of a Mental Health Screening Tool for Pediatric PatientsA new screening tool based on the previously developed mnemonic designed to assist physicians with obtaining a psychosocial history from adolescents as part of a routine visit was developed by researchers at the Children’s Hospital of Eastern Ontario.
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Rapid Cycling in Bipolar Disorder: Diagnostic Issues and Treatment OptionsA discussion of the many difficulties in treating patients with the rapid-cycling subtype of bipolar disorder, along with a history of the condition and the author’s treatment approach.
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Parenteral Antidepressants: Is America Ready?In spite of the enormous success of antidepressants, there are surprisingly few that are available in other than oral form. There is now substantial evidence that intravenous administration is well tolerated and may accelerate onset of therapeutic effect. With the possibility of transdermal delivery3/4a noninvasive and painless route of administration requiring no technical support3/4parenteral antidepressants may become more acceptable in this country and warrant further clinical investigation.
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Germs and Viruses: The Other KindIs your practice’s computer infected? Perhaps, but that stack of papers on your desk might have a richer history of contamination.
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Adaptation and Implementation of the Integrated Dual Diagnosis Treatment Model Into a Psychiatric Inpatient Facility: A 12-Year PerspectiveAs early as the 1970s, researchers and practitioners became increasingly aware of the necessity for services that would address the varied needs and treatment implications for consumers with the co-occurring disorders of substance abuse and mental illness. High percentages of consumers in substance abuse treatment centers were identified with mental illness disorders, and consumers admitted to psychiatric facilities often were identified as having additional substance use disorders.
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Overview of Elder MaltreatmentAs the population ages, psychiatrists will need to take a more proactive role in preventing, diagnosing and treating elder abuse. This article looks at the definition of elder abuse and the history of reporting it, research findings on the effects of abuse on mortality, and needs for the future.
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HHS Proposed Rule Pushes ICD-10 Compliance to Oct. 1, 2014HHS Secretary Kathleen Sebelius has announced a proposed rule that would push the compliance date for ICD-10 to Oct. 1, 2014, one year past the original date.
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Psychiatrists and Mandatory Reporting of Domestic ViolenceMandatory reporting laws rarely require reporting by psychiatrists. Psychiatrists need to treat the patient, rather than act as mandated reporters, and be knowledgeable about the dynamics and consequences of domestic violence and about available community resources and advocates that can help the patient.
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Adaptation and Implementation of the Integrated Dual Diagnosis Treatment Model Into a Psychiatric Inpatient Facility: A 12-Year PerspectiveAs early as the 1970s, researchers and practitioners became increasingly aware of the necessity for services that would address the varied needs and treatment implications for consumers with the co-occurring disorders of substance abuse and mental illness. High percentages of consumers in substance abuse treatment centers were identified with mental illness disorders, and consumers admitted to psychiatric facilities often were identified as having additional substance use disorders.
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CRPS Type I and Mental IllnessDr Steven King provided an interesting summary of complex regional pain syndrome (CRPS) in Psychiatric Times (Complex Regional Pain Syndrome, June 2006, page 9). We felt it would be useful to provide some additional observations on the relationship between CRPS type I and psychological causes of pain.
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The Many Faces of Posttraumatic Stress DisorderChronic posttraumatic stress disorder (PTSD) may occur secondary to combat, terrorism, civilian assaults including physical and sexual abuse, or other traumatic experiences.
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Managing Psychosis in Patients With Alzheimer DiseaseAlzheimer disease psychosis appears to be a distinct clinical entity. This article focuses on management strategies.
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Managing Late-Life Depression With Combined Medication and PsychotherapyThere are hundreds of studies that show that pharmacotherapy is used to treat depression in adult and geriatric populations. There are far fewer studies that test the efficacy of psychotherapies and even fewer studies that focus on combined treatment for older patients.
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A New Approach: Using Virtual Reality Psychotherapy in Panic Disorder With AgoraphobiaWith the advent of computer technology, new forms of therapy have emerged that can help patients. How can a virtual reality environment enable patients to overcome panic disorder and agoraphobia, and what are the advantages to such forms of therapy?
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Comorbidity: Psychiatric Comorbidity in Persons With DementiaThe assessment and treatment of psychiatric symptoms in persons with cognitive dysfunction are becoming increasingly important. Prevalence estimates of dementia in the United States range from 5% in those aged 71 to 79 years to 25% to 50% in those 90 or older.
