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Top Paper of the Year-Integrative Management of ADHD: What the Evidence SuggestsMore than half of parents who have children with ADHD treat their child’s symptoms with vitamins, dietary changes, and expressive therapies-but only a small minority tell their doctor. More in this podcast.
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Top Research Findings That Can Change Clinical PracticeFour studies sprang from the TORDIA trial on treatment-resistant depression in children and adolescents and showed that several factors influence treatment efficacy following treatment resistance.
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APA Guidelines for DSM-5 UsersSurprisingly, the American Psychiatric Association (APA) has never established formal guidelines that address what qualifications are required for one to use DSM.
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Issues in Psychodynamic PsychiatryPsychiatry must remain a profession defined by an organizing model of the mind, rather than by specific treatment techniques. Psychodynamic psychiatry offers such a model, and it is applicable to all psychiatric patients.
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The Neurobiology of Treatment-Resistant DepressionTreatment-resistant unipolar major depression appears to be the rule rather than the exception. This view is supported by data from the STAR*D program, a multilevel treatment trial for major depression.
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The First Session With an AdolescentBeginning a therapeutic relationship with an adolescent patient requires an understanding of the family dynamics and the patient's experience of their unique stage of life. In this rapidly evolving population, a thoughtful approach is essential to prevent many of the pitfalls in treating adolescents.
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Secondary Trauma Issues for PsychiatristsThe characteristics that bring people into the caring professions are, ironically, the very factors that make them vulnerable to vicarious trauma and job burnout. It is our responsibility to ensure that these adverse outcomes are minimized among those who have chosen such a career.
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Environmental Toxicants and Autism Spectrum DisorderOn the association between symptoms of autism spectrum disorder with environmental toxin exposure.
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Posttraumatic Growth: A New Perspective on PsychotraumatologyLittle attention has been paid in the professional literature to a phenomenon that non-professionals have recognized since ancient times: Trauma can lead to personal growth. This article focuses on how traumatic events set processes in motion that produces new perspectives on the self, relationships and philosophy of life. Implications for clinical work with trauma survivors are discussed.
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Effects of Culture on Recovery From Transient PsychosisAnalyzing data gathered in a 10-nation study of psychoses by the World Health Organization (WHO), Susser and Wanderling1 found that the incidence of nonaffective psychoses with acute onset and full recovery was about 10 times higher in premodern cultures than in modern cultures. Transient psychoses with full recovery were comparatively rare in modern cultures. Such a dramatic difference begs for explanation.
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The Body Bears the Burden: Trauma, Dissociation, and Disease, 2nd edTraumatology has become an increasingly multidisciplinary field. Originally the province of psychiatry and clinical psychology, the field has now been enriched by the contributions of epidemiologists, neuroscientists, anthropologists, and historians.
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The Empire of AlcoholThe frayed dignity of the patient described in this poem, his intelligence matched by the inexplicable intransigence of his alcoholism, moved this VA psychiatrist to describe the clinical encounter, apropos for April, Alcohol Awareness Month.
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The Suicidal Patient: Risk Assessment, Management, and DocumentationSuicide is a serious public health problem that ranks as the 11th leading cause of death in the United States. Within the 15- to 24-year-old age group, it is the third leading cause of death.1 Many suicide victims have had contact with the mental health system before they died, and almost one fifth had been psychiatrically hospitalized in the year before completing suicide. A recent review found that psychiatric illness is a major contributing factor to suicide, and more than 90% of suicide victims have a DSM-IV diagnosis.
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Psychosocial Assessment and Treatment of Bariatric PatientsThis book draws together the entire spectrum of the relevant psychosocial dimensions and data necessary to adequately assist in the evaluation and treatment of patients who may be candidates for bariatric surgery.
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Diagnostic Utility of the Subjective Peripheral Neuropathy Screen in HIV-Infected PatientsHIV/AIDS, peripheral neuropathy, sensory neuropathies, subjective peripheral neuropathy screen
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Treating Complex Trauma SurvivorsThis CME outlines distinguishing features of PTSD, complex trauma, and the dissociative subtype of PTSD (DPTSD), with an explanation of the distinctive neurobiological subtype of DPTSD.
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The Moon Is on Wellbutrin"The moon used to be on Zoloft, before trying Prozac, before adding Klonopin to her lunar chemistry."
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Top Papers That Can Change Your PracticeThe psychiatric literature is overwhelming. So these authors have culled 25 "top" articles based on their relevance to clinical practice. Here's a quick synopsis of 8 top articles.
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Mini Quiz: Informed ConsentWho wrote the legal opinion that is considered to be the birth of the informed consent doctrine?
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Speak, MemoryIn the 1980s, thousands of patients insisted they were recovering childhood memories of physical and sexual abuse during Satanic cult rituals. Here: a look back at the moral panic.
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DSM-V: Mind Made Up?I read with great interest and considerable apprehension Dr. Frances’ assessment of the DSM-V developmental process ("A Warning Sign on the Road to DSM-V," Psychiatric Times, July 2009).
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Herbal Treatment of Major Depression: Scientific Basis and Practical UseMany patients can benefit from herbs with gentler action, fewer adverse effects, and some health benefits beyond their antidepressant effects.
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Detecting Sexual AbuseFew circumstances confront the psychiatrist with more complex, painful, and potentially problematic clinical dilemmas and challenges than the treatment of the incest victim. Here are some factors that may lead to memory of a trauma becoming inaccessible or withheld by a patient.
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Methamphetamine Abuse: Consequences and TreatmentMethamphetamine (MA) abuse is not a new problem in the United States, but the current epidemic is more widespread and presents with more pernicious consequences than in the past. MA, frequently called "speed," "crystal," "crank," "ice," or "tina," is a potent psychostimulant that can be swallowed in pill form or administered via intranasal, intravenous, or smoking route.
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Complex Partial Seizures Present Diagnostic ChallengeTemporal lobe epilepsy (TLE), now more commonly called complexpartial seizure disorder so as to include seizures that originatein the frontal foci, straddles the borderland between psychiatryand neurology.
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The Rise of Consciousness and the Development of Emotional LifeThis volume is written from an emerging edge of basic science and will reward a clinical readership.
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Cognitive Impairment in Patients With Bipolar DisorderIt is widely accepted that patients with schizophrenia have some degree of cognitive deficiency and that cognitive deficits are an inherent part of the disorder. Historically, there has been less focus on cognitive deficits in patients with bipolar disorder; however, numerous studies of cognition in patients with bipolar disorder, including several comprehensive meta-analyses of bipolar patients who were euthymic at the time of testing, have recently been undertaken.1-4 Each of these analyses found that cognitive impairment persists during periods of remission, mainly in domains that include attention and processing speed, memory, and executive functioning.4
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Private Practice Changes: A Personal PerspectiveIt is amazing how a psychiatric practice changes over the years including the switch to managed care from fee-for-service, larger caseloads, new medications and new treatment options. Despite all the changes, both for better and for worse, one psychiatrist is enjoying his practice as much today as ever before.
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Study Faults Selective Publication of Antidepressant TrialsMedical journals have a unique image in the US health care system. Because most of them adhere to a strict system of critical peer review, they are often seen as unimpeachable sources of accurate information about the safety and efficacy of new medications.
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How to Protect Patient InformationProtecting patient information is an essential part of maintaining patient trust.
