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5 Key Issues About Comorbidity in Geriatric Bipolar DisorderClinicians need to consider and manage multiple medical and cognitive comorbidities when working with the elderly population. This slideshow provides an overview of key points relevant to geriatric bipolar disorder as it relates to comorbidity.
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Diabetic Polyneuropathy: Definitive DiagnosisDiabetic polyneuropathy (DPN) has a major impact on quality of life and can contribute to significant morbidity and mortality. In the United Kingdom, the prevalence of distal symmetrical polyneuropathy, as seen in specialty care, is about 28.5%, and prevalence increases with age.
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DSM-5: What It Will Mean to Your PracticeUndoubtedly there will be problems with some of the additions to DSM-5, with some of the combinations, with some of the new nomenclature, and with some of the new criteria sets. But practitioners will find most of DSM-5 to be well considered and well written. It is unfortunate, however, that much of its nomenclature is out of sync with the rest of medicine.
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Combined Pharmacotherapies and Behavioral Interventions for Alcohol DependenceThe COMBINE study was only one trial designed by academics to maximize internal scientific validity. It excluded individuals with other significant psychiatric and medical illnesses (more often the rule than the exception in some clinical settings)-individuals deemed too severely ill or who needed hospitalization.
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Recognizing and Treating Depression in Asian AmericansCompared with other ethnic groups, Asian Americans underuse mental health services, resulting in delayed treatment and higher attrition rates. A report by the surgeon general states that the underutilization is because of the shortage of bilingual services, the low percentage of health care insurance coverage, and the Asian American tradition of using mental health treatment only as a last resort.
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Re-Examining Seasonal Affective DisorderMany patients, particularly those living in colder climates, can suffer from seasonal affective disorder (SAD). What causes SAD and what are the treatment options for these patients?
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What Is the Role of Vitamin D in Depression?Vitamin D has been hailed as the “sunshine” vitamin with many therapeutic attributes. The authors explore the association between vitamin D deficiency and increased risk of depression.
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The Goldwater Rule Is Still RelevantCOUTERPOINT: A small number of psychiatrists have been critical of our profession’s restraint regarding public comments by psychiatrists about the mental health of the 45th President.
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Phase 2 HIPAA Audits: Strategies for CliniciansThe next phase of HIPAA compliance audits has arrived. Clinicians who are HIPAA-covered entities-or business associates-would be well served to prepare now.
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Weighing the Benefits of Genetic Information in Clinical PsychiatryHave you considered using pharmacogenomic testing in your practice?
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Substance Abuse in Women: Does Gender Matter?There has been a growing awareness in recent years of the importance of gender in medical treatment and research. While much past research in addiction focused on men, there is now recognition that biologic and psychosocial differences between men and women influence the prevalence, presentation, comorbidity, and treatment of substance use disorders.
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Keys to Success in ADHD TreatmentClinicians who treat children with ADHD face a challenging conundrum. Although our understanding of ADHD and its evidence-based treatments has increased significantly in recent years, the number of successful treatment outcomes has not.
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Road Rage: Are Our Patients Driving Angry?Road rage is well known in popular culture and to many people it is a common and dangerous experience. Alcohol problems, illicit drug use and general psychiatric distress are associated with road rage perpetration. Road rage incidents may also result in psychiatric distress. Although treatment for road rage has received little research attention, encouraging results have been reported from specialized programs.
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Envy-The Forgotten Narcissistic IssueOf the 7 "deadly" sins that are committed by humans, envy is primarily directed toward the destruction of an external object. Over the centuries, this unfortunate emotion has been the subject of inquiry by many disciplines (philosophy, religion, sociology, fiction, and so on).
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Eastern Religions, Spirituality, and Psychiatry: An Expansive Perspective on Mental Health and IllnessHow do Eastern religions, spirituality, and cultural psychiatry shape our understanding of mental health?
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Repetitive Self-Injurious Behavior: The Emerging Potential of Psychotropic InterventionRepetitive self-injury can be one of the more difficult conditions to treat. What is the biochemical basis for self-injury and how can psychiatrists treat this condition?
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The Columbia Mall ShootingIn periodic entries in his journal, the Columbia Mall shooter acknowledged having a “general hatred toward others.” He had insight into his deteriorating condition, as he felt himself slipping away from rationality and health.
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Malpractice and Liability in PsychiatryWhat do you do if you get sued? This new book provides a guide, with a comprehensive view of malpractice and liability issues across psychiatry.
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Neuropsychiatric Masquerades: Diagnosis and TreatmentA focus on the differential of CNS disorders that present with neuropsychiatric symptoms, their presentations, and guidelines for treatment.
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Intimate Portrait: Richard M. Berlin, MDA brief psychological portrait of this psychiatrist/poet.
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Missing White Woman Syndrome: Psychiatrists and Societal BiasPsychiatry has a lot to learn from the case of Gabby Petito.
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Book ReviewUntil recently, there has been a relative paucity in the selection of comprehensive child psychiatry textbooks for clinicians. Child and Adolescent Psychiatry: The Essentials finds a place in this special niche by providing comprehensive yet practical information that can be used in a variety of settings.
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Depression Following TBI Can It Be Prevented?The chronic and relapsing course of TBI-associated depression poses a challenge to the management of afflicted patients.
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Discussions About Public Figures: Clinician, Commentator, or Educator?As psychiatrists, we have a potentially unique-and powerful-influence in the discussion of public figures. But what professional and ethical obligations should we follow in this role?
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JewellJewell’s answer taught me that successful diagnosis and treatment of an illness weren’t everything. They were not the most important things.
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Ethical Issues in Forensic Psychiatry With Children and AdolescentsForensic examinations involving children and adolescents are particularly difficult, due to the vulnerability of this patient population. What ethical guidelines should be followed and what sorts of pitfalls should clinicians attempt to avoid?
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The Casebook of a Residential Care PsychiatristThe Casebook of a Residential Care Psychiatrist is knowledgeable, humorous, compassionate, and historical, with a strong plea that the mental health community become more involved in the rehabilitation of patients in RCFs.
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APA and Pharma-Funded CME Part WaysFollowing the recommendations of a working group set up to examine the American Psychiatric Association’s (APA) relationship with the pharmaceutical industry, the Board of Trustees has voted to phase out industry-sponsored educational programs and industry-supplied meals at annual meetings and educational symposia.
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EEG Monitoring in ECT: A Guide to Treatment EfficacyFor over 50 years we clinicians have administered electroconvulsive therapy with little to guide us in deciding whether or not a particular induced seizure is an effective treatment. At first we thought that piloerection or pupillary dilatation predicted the efficacy of a seizure, but these signs were difficult to assess and were never subjected to controlled experiments.
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Comorbid Depression and ADHD in Children and AdolescentsADHD, the most common diagnosis in child psychiatry, appears to be more challenging to diagnose and treat when there is a comorbid depressive disorder.
