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Adolescent PsychosisAdolescents who present with symptoms that suggest a psychotic disorder pose a number of diagnostic and treatment challenges. This article attempts to provide a practical guide to the assessment and management of adolescents with severe psychotic illness, including schizophrenia, schizophrenia-like disorders, and bipolar disorder.
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Principles and Practice of Geriatric PsychiatryA review of the book, "Principles and Practice of Geriatric Psychiatry."
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A Practical Update on Neuroimaging for Psychiatric DisordersWhich neuroimaging test for which psychiatric patient-and when? What to ask the neuroradiologist?
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Lhermitte-Duclos Disease or Neoplasm?A 5-month-old girl was brought to her local emergency department because she displayed increasing fussiness and back arching for 3 days. She vomited once and was febrile on the day of presentation. Meningitis was suspected. A lumbar puncture was performed. It revealed a cerebrospinal fluid (CSF) protein level of 120 mg/dL and a CSF white blood cell count of 10/µL, with 50% polymorphonuclear cells. Antibiotics were empirically administered, and the infant was transferred to a tertiary care facility for further treatment.
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Depression in Parkinson DiseasePrevalence of depression in PD is estimated to range from 7% to 76%. The variation is largely attributed to the diversity of the populations under study, differences in the definition of depression, and the fact that some studies used point prevalence and other studies used monthly prevalence. Also, the prevalence of depression varies with fluctuations of cognitive status and other comorbidities that are an integral part of PD.
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Sexually Violent Predator Statutes: The Clinical/Legal InterfaceSince 1990, many states have instituted sexually violent predator (SVP) or sexually dangerous person (SDP) civil commitment statutes that seek to identify the small group of extremely dangerous incarcerated sexual offenders who would present a threat to public safety if released from custody.
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A Short History of the SSRIThrough archival footage and interviews, the documentary "Prozac: Revolution in a Capsule" does a remarkable job of capturing the time when transformation ignited the collective imagination.
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Foster CareWhen you have been neglected, made to feel so unimportant, passed around from place to place as though your life doesn’t matter, any genuine caring attention you can give that young person means the world.
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Big Data for DepressionOne of the biggest challenges in treating depression is the ability to select the best treatment for a particular individual from among the many available options.
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“Photo-Therapy:” A Promising Intervention in Anorexia Nervosa?We now communicate in ways that are very different from those available just a decade ago. The iPhone, iPad, and similar devices also enable us to observe ourselves as we perform any number of activities. These and other new devices may have an application their designers never considered.
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Clinical Psychologists and Psychiatrists: Colleagues or Competitors?If history serves as a guide, psychologists are likely to obtain prescriptive authority in significant portions of the country within the next 10 years.
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Death Is No EnemyFar less attention is paid by mental health clinicians to aspects of death and dying. This Psychiatric Times Death and Dying Special Report helps fill some of that gap.
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Comorbid Medical Illnesses in Children With Psychogenic Nonepileptic SeizuresIt is not known what makes children vulnerable to the development of psychogenic nonepileptic seizures. To date, there are no research studies available on the epidemiological, medical, or genetic risk factors for childhood PNES.
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Nonconvulsive Status in Clinical Decision MakingNonconvulsive status epilepticus (NCSE), like convulsive status epilepticus, is a state of continuous or almost continuous intermittent seizure activity lasting more than 30 minutes without a return to baseline function.
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Mood Stabilizers and Novel Antipsychotics in the Treatment of Borderline Personality DisorderThis article focuses on data concerning the efficacy of mood stabilizers in the treatment of BPD.
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Religion, Spirituality, and Mental HealthUntil the early 19th century, psychiatry and religion were closely connected. Religious institutions were responsible for the care of the mentally ill. A major change occurred when Charcot1 and his pupil Freud2 associated religion with hysteria and neurosis. This created a divide between religion and mental health care, which has continued until recently. Psychiatry has a long tradition of dismissing and attacking religious experience. Religion has often been seen by mental health professionals in Western societies as irrational, outdated, and dependency forming and has been viewed to result in emotional instability.3
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Neuropsychiatric Effects of Traumatic Brain InjuryTraumatic brain injury (TBI) affects approximately 2 of every 1000 persons per year. Persons vulnerable to mental illness (eg, persons with alcohol abuse or antisocial personality disorder) are particularly at risk.
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Epileptic or Nonepileptic Seizure?A right-handed woman aged 19 years is referred for intractable clinical events. The patient's medical history is remarkable for anxiety, depression, and attention-deficit/hyperactivity disorder; migraine headache; and Lyme disease for which she received 6 months of intravenous antibiotic therapy.
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Fat, Food, and Mood: Beyond Omega-3sPotential benefits and benign safety profile of omega-3s indicate a promising intervention.
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Does Evidence-Based Medicine Discourage Richer Assessment of Psychopathology and Treatment?The paradigm for modern psychiatry is evidence-based medicine (EBM)-it represents proven treatments for defined diagnoses. But there are major problems with this position, starting with the fact that while they are superior to placebo, evidence-based treatments too often are ineffective.
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Cognitive-Behavioral Therapy for Adolescent DepressionProcesses of Cognitive ChangeThe substantial and often recurrent distress and impairment associated with major depressive disorder (MDD) in youth has prompted increased interest in the identification and dissemination of effective treatment models. Evidence supports the use of several antidepressant medications, specific psychotherapies, and, in the largest treatment study of depressed teenagers, the combination of fluoxetine and cognitive-behavioral therapy (CBT) as effective treatments.1-3 CBT is the most extensively tested psychosocial treatment for MDD in youth, with evidence from reviews and meta-analyses that supports its effectiveness in that population.3-5
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E-Cigarettes, Vaping, and Other Electronic Nicotine Products: Harm Reduction Pathways or New Avenues for Addiction?This article summarizes data on e-cigarettes, provides recommendations and resources to learn more, and emphasizes the evidence for treating tobacco (traditional cigarettes) addiction in people with mental illness.
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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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Cognitive Rehabilitation in SchizophreniaThis article reviews methods to rehabilitate cognition in schizophrenia and suggests strategies for instituting a cognitive remediation program.
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Anxiety Disorders in Children and AdolescentsAnxiety disorders are one of the most common psychiatric disorders in children and adolescents, but they often go undetected or untreated. Identification and effective treatment of childhood anxiety disorders can decrease the negative impact of these disorders on academic and social functioning in youth and their persistence into adulthood.
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Setting Up a Neurology-Based Infusion Center: Rationale and Guidelines"No longer a pipe dream," is the suggestive lead-in of a widely distributed press release issued last October touting the potential benefits of cannabinoid compounds in the treatment of Parkinson disease (PD), Lou Gehrig disease-or amyotrophic lateral sclerosis (ALS)-and a number of other debilitating conditions, as reported during last fall's 2004 annual meeting of the Society for Neuroscience. According to Daniele Piomelli, PhD, an expert in cannabinoid research and professor in the Department of Pharmacology at the University of California, Irvine, certain cannabinoid compounds can be harnessed to "provide select benefits to patients while avoiding some of the unwanted effects" associated with marijuana use. Compounds of greatest interest have been WIN 55212-2, delta(9)-tetrahydrocannabinol (THC), and anandamide.
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The Challenges and Rewards of Rural PsychiatryDespite its many challenges, rural psychiatry can be particularly rewarding because it allows an opportunity to provide much-needed care and the ability to be at the forefront of helping to close gaps in health care disparities.The privilege of being a true community resource and the ability to improve overall community mental health give meaningful purpose to the work of a rural psychiatrist.
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Working Within a Campus Health Service: A Challenge With Many RewardsPsychiatrists can provide significant support and insight to patients who are now coming to campus with a wide array of mental health challenges.
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Considering PTSD in the Treatment of Female Victims of Intimate Partner ViolenceThe distress and functional impairment associated with PTSD may make it difficult for IPV victims to benefit from interventions to increase their safety and reduce their exposure to violence. Empirically supported PTSD treatments include pharmacotherapy and cognitive behavioral therapy. Incorporating these treatments into interventions to improve victims' safety and reduce exposure to violence may improve their effectiveness in protecting women from IPV.
