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Are the Media and the Public Still Missing the Clues?It is our responsibility as psychiatrists to educate the media and the public in general.
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The Diagnosis of Psychogenic Nonepileptic SeizuresAbout 25% of patients seen in epilepsy clinics and monitoring units who do not respond to antiepileptic drugs (AEDs) have received a misdiagnosis.1-3 The eventual diagnosis for most of these patients will be psychogenic nonepileptic seizure (PNES)1,4-a somatoform conversion disorder. It is treatable, but diagnosis, delivery of the diagnosis, and management present significant challenges. A major barrier to care has been the stigma associated with the label "psychogenic."
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Treatment-Resistant SchizophreniaStrategies for Recognizing Schizophrenia and Treating to Remission
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Utilization of MRS to Identify Neurochemical Abnormalities in Patients With Bipolar DisorderThe number of magnetic resonance spectroscopy studies that assess the levels of different neurochemicals in bipolar disorder has increased considerably in recent years. Abnormalities were reported mainly in the brain regions implicated in the pathophysiology of BD: the dorsolateral prefrontal cortex, cingulated gyrus, hippocampus and basal ganglia. Although these findings are not diagnostic, future research in this area may help to elucidate the pathophysiology of BD and monitor treatment effects.
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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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Ethical Issues: The Patient’s Capacity to Make Medical DecisionsThis article provides a practical framework that can guide consultation-liaison psychiatrists through solving problems of capacity and informed consent.
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Psychiatric Comorbidity in Emergency Department PatientsEmergency medicine provides care to a vast number of patients each year. In 2005, 115.3 million people visited emergency departments (EDs).
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Commentary: A Telling MomentWhat Z has done is momentarily lift the veil that conceals...another veil. Thrilling because he is doing in public what I do in private. Stripping the professional illusion that psychiatrists are invisible machers, not just real friends and enemies, creditors and debtors, parents and partners, but detached angels. An illusion fostered by a xenophobic profession carefully cultivating the illusion of transcendental social levitation.
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Malingering as a Maladaptive Pattern of Survival During the PandemicMalingering is a common challenge for emergency department clinicians, particularly during the pandemic. Here are 3 cases of COVID-19–induced malingering.
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The Impact of Appearance on Coping With LifeIn planning a media workshop to present Glenn Gers’ independent film disFigured for the May 2009 American Psychiatric Association meeting in San Francisco, my co-presenters and I devoted special attention to the diagnosis and treatment of anorexia nervosa. (The content was originally prepared by Katherine Halmi, MD, and was presented at the workshop by James Mitchell, MD, when Dr Halmi was unable to attend.) The film deals with the problems of body image represented by opposite ends of the spectrum of eating disorders-obesity and anorexia.
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Treating Cognition and Function in Patients With Alzheimer DiseaseThe cost-effectiveness of treatment for Alzheimer disease has been questioned. But until the next generation of therapeutics arrives, cholinesterase inhibitors and memantine will probably remain essential components of therapy for cognition and function.
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Beyond Emotional Labor: Exploring How Trauma Becomes an Occupational Hazard for CliniciansWe are all familiar with the heavy emotional labor loads that are part and parcel of clinical life. But what about the toll of exposure to verbal abuse and hostility in the workplace? Is there another labor that clinicians must contend with?
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Postpartum Anxiety or Depression? Diagnosis and Treatment in Nursing MothersWomen with postpartum depression frequently experience intrusive, obsessive ruminations that are part of a depressive episode. Many women with postpartum depression have significant anxiety, and many reach the level of meeting criteria for full-blown anxiety disorders. An anxiety disorder may also precede and contribute to the development of a depressive episode.
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Treatment Implications for Comorbid Diabetes Mellitus and DepressionDiabetes mellitus and depression symptoms are associated with with decreased self-care and less adherence to exercise, medications, smoking cessation, and eating a healthy diet.
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Clinical Implications of Substance Use on Suicidality Among YouthsBoth the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry have identified substance abuse as a top risk factor for suicide in youths.
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Introduction: Comorbidity, Cognition, and PharmacotherapiesIn this Special Report, Helen M. Pettinati, PhD, and William D. Dundon, PhD, discuss prevalence, assessment, clinical features, and treatment issues with respect to individuals with co-occurring major depression and alcohol dependence.
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Preventive Interventions for Children of DivorceStudies have shown that children of divorced parents may suffer more mental health problems, particularly conduct disorders. What programs might be effective in helping these children deal with the stress of their parents' divorce? Are there effective programs to teach parents better coping skills?
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ArachnophobiaCould social media offer a new approach for clinicians working with patients experiencing some phobias?
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Suicide Assessment Part 2: Uncovering Suicidal Intent Using the CASE ApproachThe CASE Approach is built to uncover pieces of a puzzle that enhance the likelihood of an accurate clinical formulation of risk.
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Drug Therapies for the Neurobehavioral Sequelae of Traumatic Brain InjuryTraumatic brain injury (TBI) is one of the most common causes of morbidity and mortality, especially in young adults. Recognition and early accurate diagnosis of neurobehavioral TBI sequelae are important in reducing the severity of postinjury symptoms. Sequelae of TBI include cognitive impairments, personality changes, aggression, impulsivity, apathy, anxiety, depression, mania, and psychosis.
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PTSD: Treatment Efficacy and Future DirectionsPosttraumatic stress disorder (PTSD) is a severe and often chronic anxiety disorder that can develop following exposure to an event involving actual or perceived threat to the life or physical integrity of oneself or another person. Epidemiological studies such as the National Comorbidity Survey1 estimate that more than half the population of the United States has experienced one or more traumatic events and that 8% of the population has met criteria for lifetime PTSD. Thus, trauma and PTSD are significant mental health problems.
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Substance Use Disorders in Patients With Anxiety DisordersIn this article, we attempt to leverage state-of-the-art research findings to provide empirically informed perspectives and practices related to these issues.
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Depression or Major Loss, or Both?Why do Drs Pies, Wakefield, and Horwitz feel that “blue” feelings after a major loss (such as death of a spouse) or, for that matter, any loss have to be either “grief” or “major depression”?
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Tips for Managing Multiple Medication UseAn expert shares 7 principles for clinicians to consider when prescribing multiple medications for a patient.
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Light Treatment for Nonseasonal DepressionDaniel F. Kripke, M.D. has studied the relationship between biological rhythms and depression since the early 1970s. He states that seasonal responses in many mammals are controlled by the photoperiod. Therefore, it seemed that depression might be analogous to winter responses and that light might be an effective treatment.
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The Part-time PuzzleEmbracing part-time and work-at-home schedules to help fit the right medical practice employee pieces into place.
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Regional Cerebral Metabolism and Treatment in Autism Spectrum DisordersAlthough there is no pharmacological agent that has been approved by the U.S. Food and Drug Administration for the treatment of autism, new studies are showing promise in not only discovering the cause of autism, but pharmacological treatments as well.
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Clinical Handbook of Psychiatry and the Law, 4th EditionA forensic book with a superb format, clinical wisdom, and eminent readability.
