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Japan: Denial of Hikikomori Could Hinder Relief EffortsThe current situation in Japan has been called the worst crisis in the country since World War II. Relief effort organizations are urged to take hikikomori seriously when planning strategies to help the victims of the recent disasters in Japan.
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Suicide in Older Adults: How Do We Detect Risk and What Can We Do About It?Older adults have higher rates of suicide than younger adults in many industrialized nations.
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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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Apathy and Its Treatment in Alzheimer's Disease and Other DementiasAffecting 70% of patients with Alzheimer's disease and common in patients suffering from other dementing illnesses, apathy is associated with functional impairment and caregiver distress at all levels of disease severity. Assessment and treatment for this under-recognized syndrome are discussed.
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Two Stories We Tell Ourselves About CancerLike more and more cancer patients today, I have outlived several prognoses and am still hanging around, in a diminished life, trying to outlive the latest. Sooner or later, all of us get swept up into one or another of the collectively available cancer story lines in the culture.
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Implications for Treatment and Prognosis of Borderline and Substance Use DisordersBorderline personality disorder (BPD) and substance use disorder (SUD) often co-occur. Comorbid BPD and SUD is related to a variety of severe adverse outcomes.
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ADHD in AdultsAttention-deficit/hyperactivity disorder (ADHD) in adults is a common-and, frequently undiagnosed-psychiatric disorder. This article will focus on the symptoms, associated features, diagnosis, differential diagnosis, prevalence, etiology and treatment of this illness.
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Mini Quiz: Cultural Diversity and the Young PatientWhat are the benefits of exploring cultural issues with a young patient and family before proceeding with treatment?
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Anticonvulsant Strategies for Treating Bipolar Disorder: What Works, What Doesn'tClinical applications for the most commonly used anticonvulsants are reviewed here, along with complications and recent findings for day-to-day practice. Also: an update on findings from research on anticonvulsants used less often, but which may be potentially beneficial.
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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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Comorbid Clinical and Personality Disorders: The Risk of SuicidePersonality disorders are arguably the most challenging for psychiatrists because they are difficult to diagnose and frequently coexist with psychotic, affective, and anxiety disorders.
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Working With Transgender PersonsUsing a question-and-answer format, we present a brief overview of issues that arise when mental health professionals explore how to best serve this population.
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Structural and Functional Neuroimaging: Focusing on Mild Cognitive ImpairmentAlzheimer disease, cognitive impairment, neurologic imaging
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The Role of Cortisol and Depression: Exploring New Opportunities for TreatmentsAfter reading this article, you will be familiar with:The function of the hypothalamic-pituitary-adrenalaxis and the significance of cortisolin the etiology of depression.
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Coming Soon: The Computer-Assisted Diagnostic InterviewComputer-Assisted Diagnostic Interview (CADI) uses the computer to assist, enhance and improve Traditional Diagnostic Interview (TDI). CADI was first presented at the APA's annual meeting in 1996. CADI modifies both data collection and data processing. It occupies a place between the less-than-reliable TDI and the reliable but time-consuming structured interview like the Structured Clinical Interview for DSM (SCID).
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The Role of Estrogen in the Development of Age-Related Cognitive Impairment and DementiaDuring and after menopause, many women report impairments in cognitive functioning. Should hormones be prescribed in an effort to mitigate cognitive symptoms of menopause?
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Forensic Ethics, Interrogations, and Getting the Facts RightDEBATE When you get facts wrong, as Dr Halpern does, it is hard to end up with the right conclusions. He suggests incorrectly that my approach to forensic ethics leads to the conclusion that participation in interrogation is permissible, when exactly the opposite is true.
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Assessing Suicide Risk in Patients With Borderline Personality DisorderPatients with borderline personality disorder are at a much higher risk for suicide attempts than patients with almost any other mental illness. Here, a case report and examples are presented to help clinicians assess, diagnose and treat patients with BPD who have attempted or are threatening suicide.
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A Missed OpportunityHow accurate is this picture, and what explains the changing patterns of psychiatric practice? Gardiner Harris and The New York Times were near these important stories and missed them.
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Brain Mapping in Adolescents With Very Early Onset SchizophreniaSchizophrenia is a devastating psychiatric disorder that affects 1% of the population worldwide. Patients often suffer their first psychotic outbreak in their late teens or early 20s. Despite advances in neuroleptic drugs, many patients' symptoms remain refractory to treatment, with recurrent episodes of auditory and visual hallucinations, bizarre delusions, depression, and social withdrawal that can last an entire lifetime.
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Coyne Battles Darwin, Many Other Evolutionary Biologists-and HimselfErroneous conclusions, and medical harm, can come from accepting any hypothesis uncritically, and growing evidence indicates that treatments based on disorder hypotheses for depression do cause harm.
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Bereavement-Related DepressionThe loss of a loved one is one of the most traumatic events in a person’s life. In spite of this, most people cope with the loss with minimal morbidity. Approximately 2.5 million people die in the United States every year, and each leaves behind about 5 bereaved people.
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Bereavement-Related DepressionThe loss of a loved one is one of the most traumatic events in a person’s life. In spite of this, most people cope with the loss with minimal morbidity. Approximately 2.5 million people die in the United States every year, and each leaves behind about 5 bereaved people.
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Positive Psychology: A More Direct Route to Happiness?Like medicine in general, psychiatry and psychotherapy have long focused on relieving illness and pain. Traditional psychotherapeutic approaches have often emphasized examination and understanding of painful experiences as a route toward obtaining relief from suffering.
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Optimizing Care in a Team Setting: A Program for People With SchizophreniaA look at a multidisciplinary team -- and its focus on meaningful recovery -- for patients with schizophrenia.
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Key Stressors in Transplant PsychiatryHere: A summary of indicators for stress and anxiety in patients undergoing transplantation, and why it is important for psychiatrists to be aware of these factors.
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3 Features of Eating DisordersA special collection of current clinical work and issues surrounding eating disorders-specifically comorbidity, prevalence in men, and mortality.
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Introduction: Treatment Along the Life CycleThe diagnosis and management of unipolar depression remain challenging. The articles in this Special Report remind us of the wide knowledge base that is needed in the management of the depressed patient and of the multiple conceptual levels that must be integrated in the care of our patients.
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Cognitive Difficulties Associated With Depression What Are the Implications for Treatment?Subjective complaints of impaired concentration, memory, and attention are common in people with major depressive disorder (MDD), and research shows that a variety of structural brain abnormalities are associated with MDD.1 These findings have intensified the interest in quantitative assessment of cognitive and neuropsychological performance in patients with mood disorders. Many studies that used standardized cognitive tests have found that mild cognitive abnormalities are associated with MDD and that these abnormalities are more pronounced in persons who have MDD with melancholic or psychotic features
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Consumer Employment: Advocacy Assumes Another FaceThe goals of National Coalition for Mental Health Professionals and Consumers are to educate the public about the problems of managed mental health care and to develop alternative health delivery models. I think greater media coverage has spawned greater awareness of the difficulties with managed care and has provided legislators with vital information. Certainly sharing their stories has made many people feel less alone and isolated within a system they find frustrating and depriving. I think media advocacy has helped doctors find support for their right to stand up to these abuses and band together in greater numbers to fight for integrity and quality in mental health care delivery.
