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Ms. L, Delirious ManiaTo this day, I fiercely debate whether I would want to remember such an experience if it had happened to me. How tortured would I feel?
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Why Do Psychiatrists Select or Switch an Antipsychotic?The increase in diagnostic and therapeutic options has made the selection of the best medical strategy more complex. Physicians are often forced to work and make decisions under time pressure, which complicates matters.
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Psychiatric Consultant's Role Continues to Grow at Life Insurance CompanyI find expertise is best defined by the attending psychiatrist. I usually ask them whose opinion they respect in the community, whether that person is acceptable to them to do the evaluation and if their conclusions about disability would be acceptable. If the attendings have no one in mind, I have developed a network of excellent forensic psychiatrists around the country from which I can draw. In this case, I make a suggestion, and ask the attending if the particular provider is acceptable.
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Q&A: Addiction MedicineIn this podcast, Dr Michael Miller, Director of the American Board of Addiction Medicine, discusses addiction medicine, including the new ASAM, patient placement criteria, and DSM-5 changes.
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An Army of ChildrenI am a civilian psychiatrist who recently finished 20 months of work as a contractor for the US Army. Going into the job, I expected the degree of combat-related stress I saw in our troops. I was not prepared, however, for the scope of the impact our 2 long wars have had on military children.
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5 Classic Hallucinogens Studied in the Treatment of AddictionsThis slideshow provides information about the compounds, clinically relevant attributes, approximate dose, and data under study.
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Helping Children Hospitalized for RagesRages are part of a syndrome of severe mood dysregulation, which is defined by markedly increased and frequent reactivity to negative emotional stimuli.
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Exploring OCD Subtypes and Treatment ResistanceObsessive-compulsive disorder (OCD) is a heterogeneous disorder with a variety of phenotypic expressions. Delineation of clinically distinct subtypes of the disorder may be valuable in predicting treatment response and resistance.
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Behavioral Comorbidities in Rheumatoid ArthritisWhile tremendous therapeutic advancements have been made, patients with rheumatoid arthritis (RA) have a myriad of comorbidities, including fatigue, depression, and sleep disturbances. Data on the comorbidity of psychiatric disorders with arthritis are also striking: according to the NIMH Catchment Area program, the lifetime prevalence of psychiatric disorders among patients with RA is 63%.
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Black Boxes, Xboxes, and Other Current ConcernsThe articles in this Special Report, although far from comprehensive, address an intriguing sample of the many key topics in child and adolescent psychiatry today.
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10 Hallmarks of a Great PsychiatristA great psychiatrist knows the disease, the person with the disease, and the way the two interact. Here are tips from a clinician who has devoted his career to treating psychiatric disorders.
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Measuring Up on Mental Health?Tracking and measuring the nation’s health is no easy undertaking. How are we doing?
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Reactivation of PTSD Symptoms Resulting From Sandy Hook Media ExposureCombat veterans who have suffered a moral injury in the past may be predisposed to a recurrence of the painful memories associated with previous trauma after exposure to similar traumatic events with moral overtones.
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Multi-Modal Integrated Treatment for Youth With Bipolar DisorderBipolar disorder in children is particularly difficult to treat. A treatment algorithm combining pharmacology with psychotherapy in order to get optimal results is presented.
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Eating Disorders in SchizophreniaEating disorders in patients with schizophrenia have been underappreciated and poorly studied. Profiling characteristic phenotypic patterns will help clarify the distinctions among eating behaviors that are part of the spectrum of schizophrenia, those that represent distinct coexistent entities, and those that represent overlapping comorbidity.
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Management of Acute Ischemic Stroke: Reviewing the OptionsDespite the significant progress in stroke prevention and treatment over the past 10 years, stroke remains the third leading cause of death in the United States.1 Approximately 700,000 strokes occur every year; the majority are ischemic.1 In 1996, the FDA approved the use of intravenous tissue-type plasminogen activator (t-PA).
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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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Stalkers and Their Victims"Stalking" is defined as repeated and persistent unwanted communications and/or approaches that produce fear in the victim. The stalker may use such means as telephone calls, letters, e-mail, graffiti and placing notices in the media. A stalker may approach or follow the victim, or keep their residence under surveillance.
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Serving the Underserved: Who Needs Mental Health Care?Experts address specific concerns when treating the immigrant sector and describe supervised mental health services for uninsured, largely undocumented patients.
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Cyberbullying: Who Hurts, and WhyThe research on electronic aggression among college students indicates that it is highly prevalent, with over 93% of college students reporting some negative effects due to electronic victimization.
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6 Challenges for Mental Health Providers Using ICD-10The transition to ICD-10 poses unique challenges for mental health providers. Here are 6 documentation and coding issues they need to understand.
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Malingering in the Clinical SettingPsychiatry is the go-to specialty for determining whether a patient in need of inpatient hospitalization or has an alternative motivation?
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A Simple Concept With Complex ImplicationsComorbidity: The concept is simple enough, but in practice, comorbidity drives complexity and presents the specters of diagnostic ambiguity and therapeutic unpredictability.
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Clinical Issues and Challenges in Treating Undocumented ImmigrantsDespite the need for mental health support, undocumented immigrants underutilize mental health services. Many endure traumatic experiences while emigrating that put them at psychological risk and once in the US, undocumented immigrants face multiple psychosocial stressors.
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Psychiatric Informatics: Exploring Myths and BarriersMyth #1; I don't need computers in my work. Myth # 2: If I wait, things will stabilize and the prices will come down. Myth # 3: I'm too old to begin thinking about computers. Myth # 4: It's easier for men to understand computers than women.
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A Psychiatrist's Primer on Sleep ApneaSleep apnea, a medical disorder with significant health and behavioraleffects, is of particular interest to psychiatrists for its capacityto mimic or exacerbate symptoms of psychiatric disturbances suchas depression, anxiety and panic disorder.
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Defining Intellectual Disability: The Case of Hall Versus FloridaIn March, the Supreme Court will need to set a national standard for the definition of intellectual disability. In doing so they will inevitably have to address a number of complications that arise when clinical constructs, such as intellectual disability, are used in the courtroom.
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Living Stories: Spiritual Awakenings in RecoveryDeAndra's story: I came into the rooms and realized after a while that I had the attitudes and behaviors of an addict way before I ever picked up a drug. I remember growing up and being at my family's parties, [where] my aunts and uncles would give me and my brothers beer. There are pictures in our photo albums of us, all under 6 or 7, with cans of beer in our hands. At an early age I learned to manipulate to get what I wanted.
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Psychiatric Epigenetics: A Key to the Molecular Basis of and Therapy for Psychiatric DisordersThe major challenges for epigenetic therapies are target specificity of the drugs-an issue that is also true for most of the currently used drugs in medicine, especially in psychiatry.
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Addressing Psychosomatic Illness in the Elderly: Integrated CareThe need to integrate psychiatric treatment with somatic care puts psychosomatic medicine in a unique position to focus on older patients who would not otherwise seek specialized treatment.
