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Delirium: Emergency Evaluation and TreatmentDelirium is a disorder that lies at the interface of psychiatry and medicine. It is an acute organic syndrome caused by an underlying medical condition and is defined clinically by disturbances in cognitive function, attention, and level of consciousness.1 Delirium is considered a syndrome because of the constellation of signs and symptoms associated with the disorder, coupled with a wide variety of potential etiologies.
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A Clinician’s Guide to Statistics and Epidemiology in Mental Health: Measuring Truth and UncertaintyIs A Clinician’s Guide to Statistics and Epidemiology in Mental Health what we have been waiting for? Yes and no. It contains solid descriptions of concepts such as the P value and confidence intervals, and it has extensive discussions of the history of modern statistical methods. Perhaps its greatest strength involves critiques of the interpretations of several studies that have mistakenly become cornerstones of clinical lore.
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The Four Categories of Elder Abuse: Evaluation ApproachesThis article reviews the different categories of elder abuse, emphasizing the role and requirements for psychiatrists, with a focus on financial elder abuse.
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Clinical Service Delivery and Benefits in General Medical Care of Psychosomatic IllnessThe renaming of consultation-liaison psychiatry as psychosomaticmedicine, a new formal subspecialtyof psychiatry, may require someadjustment in our understanding ofthese terms. Both consultation-liaisonpsychiatry and psychosomatic medicinehave focused on treatment and researchof illnesses with mind-body interactions.Despite considerable overlap,consultation-liaison psychiatry hastraditionally been associated with treatmentand clinical research of comorbidmental disorders of the medicallyill, while psychosomatic medicine hasbeen associated with research into thephysiologic mechanisms underlyingmind-body interactions and classicalpsychosomatic diseases such as hypertension,asthma, and ulcerative colitis.
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Learning How to Actively Listen: In Conversation With Stephen McLeod-Bryant, MDThe president of Black Psychiatrists of America shares his thoughts on making a difference for Black communities, the removal of the REMS for clozapine, and more.
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Informed Consent and Civil Commitment in Emergency PsychiatryMedical school graduation usually involves taking the Hippocratic oath, in which physicians vow not to intentionally harm their patients. Keeping patients safe is another basic principle of patient care. Physicians are charged with ensuring that their patients are in a safe environment and minimizing risks to their patients by carefully selecting treatment options.
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The Rise of Cranial ElectrotherapyCranial electrotherapy devices, soon to be only home-use device approved to treat depression, can be an essential adjunctive treatment to standard modalities of care for soldiers and veterans, says this psychiatrist.
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Evaluating Capacity to Make a WillPsychological Autopsy and Assessment of Testamentary CapacityIt is an ancient practice to state instructions for distributing one’s property after death. In Genesis 48, Jacob verbally bequeaths his property to Joseph, Joseph’s siblings, and Joseph’s 2 sons. Wills existed in ancient Greece and Rome, with restrictions.
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10 Factors Leading to Pain Complaints in the Absence of a Medical DiagnosisWith most chronic pain conditions, the exact pathology is uncertain. In such cases, psychiatrists may be called to assess for illness beyond medical diagnosis.
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The Former Secret Life of an Elvis ImpersonatorStephen R. Shuchter, M.D., professor of clinical psychiatry and associate director of residency training at University of California, San Diego, spends his "down" time performing as Elvis and other rock 'n' roll legends. In these efforts, he expresses his creativity and brings delight to those he entertains. Lessons from each "career" have helped his success in the other.
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Dopamine Receptors in the Human BrainDopamine plays an important role in controlling movement, emotion and cognition. Dopaminergic dysfunction has been implicated in the pathophysiology of schizophrenia, mood disorders, attention-deficit disorder, Tourette's syndrome, substance dependency, tardive dyskinesia, Parkinson's disease and other disorders.
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Nonverbal Learning Disabilities and Sensory Processing DisordersIn our presentation at the 2006 annual meeting of the American Academy of Child and Adolescent Psychiatry, we suggested that child psychiatrists who come across a child with the profile of the following hypothetical case should consider whether the child may have deficits that are not currently covered by DSM-IV nosology: either a nonverbal learning disability (NVLD) or a sensory processing disorder (SPD).
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Exploring the Link Between Environmental Noise and Psychiatric DisorderNoise, or unwanted sound, is a pollutant and an environmental stressor. The frequency of noise events seems to have increased in recent years while the amount of the day without noise has lessened.
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Novel Drug Delivery Systems in ADHD and Take-Home MessagesDrs Stephen Faraone, Theresa Cerulli, Craig Chepke, and Andrew J. Cutler discuss novel drug delivery systems and provide take-home messages when treating an adult with ADHD.
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Panic Disorder: Keys to Evidence-Based Effective TreatmentKeys to the management of panic disorder include appropriate use of psychotropic medication and psychotherapy predicated on an understanding of the disorder's biopsychosocial underpinnings. Here, Stephen V. Sobel, MD, focuses on treatment options.
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The Limits of AdvocacyMigrant children were being endangered, with potentially devastating effects on their mental health and development, and we requested policy changes.
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A Psychiatrist Investigates Poet Allen Ginsberg’s Journeys into MadnessThe story of the legendary Beat poet’s involvement with madness and mental illness has never really been told—until now.
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Assessing and Enhancing the Effectiveness of AntidepressantsWith over 2 dozen FDA-approved antidepressants on the market, it is reasonable to ask: which antidepressants are most effective?
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What’s New in Depression?The Chair of the Scientific Program Committee of APA 2016 offers an overview of the latest on depression.
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Introduction: The Scope of PsychiatryHere's where psychiatry extends beyond a medical setting into collaborative, innovative, and integrated models of care..
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Child & Adolescent Psychiatry: An Overview of the Complex ChallengesWe need to have a framework to make certain that our interventions are balanced, safe, and a function of the existing evidence.
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Fibromyalgia: What It Is and How to Treat ItThis CME covers the ins and outs of fibromyalgia, and everything a mental health professional needs to know when dealing with it.
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Mixed States in Their Manifold Forms: Part 3In Part 3 of this 3-part series, Dr Dilsaver discusses dichotomization versus a continuum model and concerns that bipolar disorders are over-diagnosed.
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Which Came First: Fatigue or Depression?5 key questions to ask as part of a comprehensive differential assessment of fatigue and depression.
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Recurrent Brief Mixed DepressionThis case study of a 21-year-old woman-referred by a relative because of long-standing severe interpersonal, academic, and occupational impairment-illustrates the importance of screening patients with brief episodes of depression for mixed features.
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Introduction: The Conventional Wisdom About Mood DisordersWhat is the future of psychiatric assessment and treatment of mood disorders? The articles in this Special Report explore some important aspects and issues.
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Ethics and Dual Agency in Forensic PsychiatryDual agency often presents a confusing situation for the clinician who must simultaneously serve two separate roles in a legal case, such as a treatment role and a forensic role (Berger, 1997). The two roles have different purposes, procedures, relationships with the patient or evaluee, and different ethical principles.
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Stigma Continues in HollywoodStereotypical portrayals of people with mental illness are as old as Hollywood itself. What are some of the clinical implications of the continued stigmatization of the mentally ill in television and film?
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Psychiatric Polypharmacy: The Good, the Bad, and the UglyA great deal of data exists about the dangers of polypharmacy. Persons with psychiatric disorders experience increased risk for adverse drug interactions because of the great frequency with which multiple medications are used.
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Predicting Outcome in SchizophreniaCan sociodemographic and clinical variables predict outcome in cases of schizophrenia? Results from studies related to prognostic variables for schizophrenia have yielded interesting yet inconsistent results.
