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The Electroencephalogram in the Management of Psychiatric ConditionsThe electroencephalogram (EEG) has a limited but definitive role in understanding and managing psychiatric conditions. When the presentation is unusual, a neurological workup that includes an EEG is essential.
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Investigating Polycystic Ovary Syndrome in Women With Bipolar DisorderPolycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, and it may manifest as mood disturbances in those affected. How can this medical condition be treated in women who have bipolar disorder?
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Tchaikovsky: Music and MelancholyA virtuoso concert pianist and psychiatrist's "play" on the role of music in healing and the influence of psychological and medical factors on the creative output of the great composers in music history.
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Attending to the “Mental Suffering” of Patients With Progressive Medical IllnessPsychiatrists have found ways to bring their expert skills and knowledge to the care of medically ill patients who are nearing the final phase of life.
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Combat Veterans: Adaptation to TransitionLeaving the military is not an easy or simple process. Here is one psychiatrist's personal story.
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Burden, Belonging, and Capability: An Interpersonal View of Military SuicidesIt would be logical to attribute the surge of suicides in the military to simultaneous prolonged engagement in combat, repeated deployments, and attendant stress. But studies have failed to connect deployments to suicide risk.
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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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Clinical Pearls on the Management of Parkinson DiseaseThe ideal medication for Parkinson disease (PD) would reduce disability and halt or slow disease progression without intolerable adverse effects. Although such an agent is not yet available, current treatments offer significant symptom control for most patients. The decision about when to start therapy is highly individual; however, delaying treatment because of fear of adverse effects may not be in the patient's best interest.
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Introduction: The Integrated Approach to Addressing Comorbidities-Part 1These articles illustrate the variety and complexity of problems associated with comorbidity in psychiatric disorder.
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Hemicraniectomy for Massive Basal Ganglia Hemorrhageintracerebral hemorrhage, hemicraniectomy, stroke, neurosurgery, traumatic brain injury
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PTSD in the Emergency SettingThe following 3 cases illustrate the diagnostic challenges related to differentiating brain injury and posttraumatic stress disorder (PTSD) in patients presenting to the emergency department (ED) in the acute period following a traumatic injury. Such patients pose a dilemma for ED clinicians because of the interplay between head injury and PTSD in the clinical presentation of cognitive impairments in the aftermath of trauma.
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Psychiatric Care of Peripartum WomenThis article summarizes clinically relevant advances in the psychiatric care of women during and after pregnancy, including recent changes in how the FDA classifies pregnancy risk for medications, and best practices in perinatal psychopharmacology.
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Drug-Drug Interactions in PsychopharmacologyCoping with the issue of drug-drug interactions (DDIs) is one of the most challenging aspects of modern psychopharmacology. Psychiatrists are treating patients with medication regimens of ever-increasing complexity.
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Psychiatrists and Peacemaking: A Cultural Psychiatry PerspectiveH. Steven Moffic, MD, interviews Neil Krishan Aggarwal, MD, MBA, MA, DFAPA, on his new book and the concept of peacemaking.
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Psychiatric PowerThe state of North Carolina has relatively liberal policies regarding petitions for involuntary commitment. If such documents bear words like "dangerous" or "mentally ill," even in the most nebulous sense imaginable, the police will surely locate the relevant individuals and dutifully bring them to the emergency department. This generosity of interpretation produces some sticky situations for the lucky ED resident of the day.
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Providing Culturally Competent Care: Understanding the Context of PsychosisCulture-the way people make meaning and live their lives in particular social worlds-matters in psychosis. The authors explore how a patient's cultural background should influence the way clinicians think about treatment and care.
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Bipolar Disorder in the Elderly: Differential Diagnosis and TreatmentBipolar disorder (BD) in later life is a complex and confounding neuropsychiatric syndrome with diagnostic and therapeutic challenges.
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Will Biology Tell Us All We Need to Know About Mental Disorder?At the very heart of psychiatry, people seem totally unconcerned about making claims that, for example, philosophers have never been able to prove.
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Depression in Patients With Alzheimer DementiaAlzheimer dementia (AD) represents a profound global health concern. By the year 2050, the prevalence of AD in the United States is expected to reach 15 million. At present, there are 4.5 million cases in the United States, which equals an estimated cost of $100 billion each year in medical and family expenses.
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The Effects of Antidepressants on SleepKnowledge of how different antidepressants are likely to affect parameters of sleep can provide an important basis for selecting an appropriate antidepressant drug among the roughly 2 dozen marketed options to meet the needs of depressed patients.
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Understanding the Usefulness of Psychosocial Interventions for Personality DisordersAn examination of recent research on psychosocial treatments for personality disorders, including randomized controlled trials and empirically supported therapies as well as dialectical behavior therapy.
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The Dog That Did Not BarkSome thoughts on the pathogenesis and persistence of prevalence of schizophrenia and bipolar affective disorder in view of current discoveries.
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A Risk Stratification Approach to Alcohol DetoxificationThe challenges of identifying patients at risk for alcohol withdrawal have been found to be mitigated by the development of a Risk Stratification Questionnaire, now being adopted by the VA regionally throughout New England. More in this video.
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Psychiatric Issues in SpaceThe many potential stressors for astronauts during space missions present unique and fascinating 21st century psychiatric and psychological issues.
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A Word From Sandy HookIt has become clear over the last couple of days that Sandy Hook Elementary School and Newtown have become an area of great concern locally, nationally, and internationally. We as a world community need to go through a grieving process that includes this type of sharing, especially for parents out there.
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Atypical Antipsychotics for Children and Adolescents With Schizophrenia-Spectrum DisordersAlthough the onset of psychotic symptoms before the age of 13 years is exceedingly rare, the incidence of schizophrenia rises sharply after the onset of puberty.1 Only 1% of the population has schizophrenia and 30% of these patients experience an onset of psychotic symptoms by age 18 years.2-8 The period that precedes the onset of frank psychotic symptoms (ie, the prodromal phase) has not been well characterized in early-onset schizophrenia-spectrum disorders (EOSS), but retrospective reports have shown that symptoms include high levels of depression and anxiety, emerging cognitive and social deficits, unusual thought content, and (not infrequently) school failure.
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Tales of Overconfidence: 3 Stories to Refine PsychiatryThese 3 stories offer a lesson in humility to psychiatry.
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QTc Prolongation Associated With Psychotropics: Therapeutic ConsiderationsA focus on QTc monitoring in patients receiving psychotropics, especially when multiple medications are prescribed.
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The Link Between Immune System Dysregulation and SchizophreniaOn the wide range of symptoms in schizophrenia, including alterations of the dopaminergic and/or glutamatergic systems, abnormal neurodevelopment, and the theory of immune system imbalance.
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Heatstroke and Psychiatric PatientsA variety of commonly used psychiatric medications increase the risk of heatstroke, leaving psychiatric patients in jails and prisons at risk.
