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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.
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Part 2: Who Is the Optimal Candidate for Focused Ultrasound Treatment?Who would be the optimal candidate to receive focused ultrasound to treat obsessive-compulsive disorder?
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New Approaches to Juvenile Delinquency: Psychopathology, Development, and NeuroscienceNew findings in epidemiology, developmental psychiatry, and neuroscience offer the opportunity for a new perspective on the problems of juvenile delinquency and bring to bear the insights of modern psychiatry in the treatment and successful rehabilitation of juvenile offenders.
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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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Augmentation Strategies in MDD TherapyFor many patients with depression, full symptom remission remains elusive despite multiple trials of antidepressants. This article focuses on psychopharmacological and related interventions.
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New Insights Into the Effects of Alcohol on the BrainWhat are the latest findings on acute and chronic effects of alcohol on the human brain?
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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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Dynamic Psychotherapy for Cancer Patients and Their PartnersThe estimated number of patients with cancer in this country is 10.5 million. Close to a million and a half are new cases, and it is estimated that 560,000 people die of cancer each year.1 There is clearly a large group of cancer patients and their families at high risk for serious psychiatric illness. In this article, I focus on the advantages of a psychodynamic approach and address how this approach is helpful in the liaison function and psychotherapy of cancer patients and their partners.
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Clinical Considerations in Renal Failure, Depression, and DeliriumRenal failure is not an uncommon disorder either in the general public or in patients with psychiatric disorders, but accompanying depression, anxiety, and loss must be attended to during such an illness.
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Botulinum Toxin for Depression? Emotional ProprioceptionIf larger trials confirm the strong antidepressant effects observed so far, botulinum toxin may become a standard therapeutic addition to the psychiatric armamentarium.
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Stroke Complications: Hiding in Plain Sight?Despite the enormous progress made in stroke diagnosis and treatment in recent years, patients continue to experience stroke-related deficits that clinicians-even those working on stroke rehabilitation units-do not always recognize or record. In a recent study of 53 patients who underwent screening tests within 10 days of admission to a stroke unit, every impaired patient had at least 1 undocumented cognitive or sensory deficit. The authors suggested that without formal testing with standardized assessments, much stroke-related impairment goes unrecognized and perhaps untreated.
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The Neurochemistry of Pediatric Major Depressive DisorderMajor depressive disorder (MDD) in pediatric populations represents a significant public health concern. Rates of MDD rise dramatically in adolescence, with an estimated lifetime prevalence of 15% in adolescents aged 15 to 18.
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Rehabilitative Management of Complications of Spinal Cord InjuryPredicting extent of neurologic recovery is crucial. The most accurate and standardized method is clinical neurologic examination using the International Standards for Neurological Classification of Spinal Cord Injury.
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Are Migraines and Bipolar Disorder Related?Migraine is characterized by episodes of headache with qualities such as unilateral location, throbbing pain and aggravation by routine physical activity. Additional symptoms include nausea, photophobia and phonophobia. Some patients have aura symptoms, usually visual, before the headache phase (Davidoff, 1995). Prodromal and accompanying symptoms of migraine attacks often are psychiatric in nature, such as depression, elation, irritability, anxiety, overactivity, difficulty thinking, anorexia or increased appetite. In some patients, an organic mental syndrome can be part of a migraine attack (Davidoff, 1995). In other patients, an acute psychotic condition is the dominating clinical feature. This presentation, with paranoid delusions, hallucinations and anxiety, has been described in families with hemiplegic migraine (Spranger et al., 1999). Migraine is, therefore, an important differential diagnosis in relation to episodic phenomena with a mixture of somatic and psychiatric symptoms. In addition, psychosocial stress is the most common precipitating factor for a migraine attack (Davidoff, 1995).
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Mental Health Services in a Single Payer SystemWith so many Americans lacking appropriate health care insurance and so much of the large insurance companies' premiums going to overhead and profit, it makes sense to move forward with a single payer system. The author discusses some of the basic features of a proposed system.
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Differential Diagnosis of Psychotic Symptoms: Medical “Mimics”The number of medical diseases that can present with psychotic symptoms (ie, delusions, hallucinations) is legion. A thorough differential diagnosis of possible medical and toxic causes of psychosis is necessary to avoid the mistaken attribution of psychosis to a psychiatric disorder.
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Understanding Comorbid Depression and AnxietyComorbidity of psychiatric syndromes is quite common-in a 12-month period, almost 50% of adults in the United States with any psychiatric disorder had 2 or more disorders.
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Euthanasia in Animals and Humans: Distinctions to ConsiderHere’s why the euthanasia of animals as an argument for physician-assisted suicide is invalid…
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Substance Abuse in Aging and Elderly AdultsAs we are faced with a growing population of older adults, a better understanding of the issues that they confront is crucial.
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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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Diabetes-Related Risk Factors and Cognitive AgingFocus on Obesity, Insulin Resistance, and the Metabolic Syndrome
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Mini Quiz: Psychogenic Non-Epileptic SeizuresWhich psychiatric disorder has the highest rate of co-occurrence with patients suffering from PNES? Take the quiz and learn more.
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Reporting Under Fire: Understanding Psychopathology of War JournalistsThe dozens of journalists killed while covering the current war in Iraq gives currency to the dangers encountered by those who bring us the news from the world's conflict zones. Despite the risks inherent in their profession, it is only recently that the psychological health of war reporters has been captured in a systematic and empirical manner.
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How Catastrophe Can Change PersonalityThis article explores why Enduring Personality Change After Catastrophic Experience (EPCACE) is a clinically useful diagnosis.
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Introduction: The Connection Between Medical Illness and Psychiatric DisordersThis Special Report focuses on the psychiatric and medical interface of some common medical problems.
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Issues in Treating Anxiety Disorders in PregnancyAnxiety disorders are a frequent occurrence in pregnancy. While some worries and anxiety are experienced by more than 50% of pregnant women, a full-blown anxiety disorder involves risk to both mother and fetus and increases the risk of postpartum depression.
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How Does Your Practice Compare? A How-To Guide to Practice BenchmarkingEveryone is talking about the decline in reimbursements and the increase in overhead costs. While most practices are faltering, some are quite successful--that is, they are economically thriving. So what makes the difference?
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The Crisis of Present-Day Psychiatry: Regaining the PersonalPresent-day psychiatry has fallen into crisis because of the severe limitations of its conception of the person and, as a result, its conception of the patient. It objectifies the patient in a number of ways. Because of this reductionism, psychiatry fails to distinguish between healthy and pathological features of human life. It fails to consider adequately the psychological and social factors that cause and maintain each patient's problems.
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New Agents of AbuseUnderstanding Prescription Drug Misuse by AdolescentsA large percentage of youths use and abuse psychoactive substances. According to the 2007 Monitoring the Future (MTF) survey, the percentage of US adolescents who used illicit drugs or drank alcohol continued a decade-long drop, revealing that 19% of 8th graders, more than 36% of 10th graders, and 47% of all 12th graders have taken an illicit drug (other than alcohol) during their lifetime.1 According to the National Survey on Drug Use and Health, the rate was 3.3% for misuse or nonmedical use of prescription drugs.2 The misuse of prescription drugs among adolescents was second only to marijuana use. In fact, prescription drugs increasingly have become a part of the repertoire of drug-using adolescents.
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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.
