Authors
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Diagnosis and Treatment of Late-Life DepressionClinicians will likely encounter increasing numbers of older adults with late-life depression. Advances in our understanding of the neurobiology can help inform diagnosis and prognosis.
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Neuroscience of Morality for the Mental Health Practitioner: A ReviewThe study of moral cognition now carries age-old questions and observations into the era of neuroimaging and cognitive neuroscience by the shift toward a capacity for asking, “What are the structures necessary and sufficient for moral reasoning?”
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The CircleOn the value of drawing from past experiences to establish a relationship with an elderly patient.
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Cross-National Research: Caregiver ConsequencesComparing the consequences of caregiving across countries for a person with a serious mental illness needs to take into account not only different languages, but also different cultures, quality of mental health services and standards of living. So far, one questionnaire has shown the most validity and become the exemplar in cross-national research; yet it is still not free from possible cultural bias or criticism from its creators who acknowledge that much more research needs to be done.
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Medical Comorbidities in Late-Life DepressionLate-life depression is both underrecognized and undertreated, and the impact of medical comorbidity may mask depressive symptoms. Depression further complicates the prognosis of medical illness by increasing physical disability and decreasing motivation and adherence to prescribed medications and/or exercise or rehabilitation programs
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An Elderly Woman Who Refuses TreatmentMrs E, who is 80 years old, lives in the community with the help of a 24-hour-a-day home health aide. She is forgetful and requires assistance with many activities of daily living.
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The Forensic Psychiatrist and the Code of Medical EthicsDEBATE In 2005, the Board of Trustees of the American Psychiatric Association (APA) prepared a Position Statement entitled Psychiatric Participation in Interrogation of Detainees
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Key Stressors in Transplant PsychiatryHere: A summary of indicators for stress and anxiety in patients undergoing transplantation, and why it is important for psychiatrists to be aware of these factors.
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Opioid Use Disorder: Update on Diagnosis and TreatmentWhile opioid dependence is among the most severe and lethal of addictions, it also has the most effective medication treatments. The authors provide 2 case vignettes and a step-by-step process for clinical decision making.
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Using Creativity to Explore in PsychotherapyBecoming more creative and improvising have certain dynamics that can be used by therapists in fostering a more healing process. Playfulness, imagination, dialogue, skill-building, narrative, inspiration and integration can all be employed in clinical settings. These tools create an environment where spontaneity can arise, anxiety is reduced, and patients are more receptive to their own intuition.
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Management of Mild Traumatic Brain InjuryA considerable overlap exists between TBI and disorders in cognition, behavior, and personality, which can provide even greater clinical challenges. More than 70% of the cases of TBI are mild, which makes this subgroup of particular clinical interest.
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Mindfulness of the Moment as an Antidote to Emotional Death SpiralingRemaining in the current moment is a good way to avoid toxic negative thoughts.
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Confabulation: A Bridge Between Neurology and Psychiatry?Mr A is a 73-year-old resident of a nursing home, where the irate aides describe him as “a liar and a troublemaker.” Mr A’s “stories” were regarded by the staff as deliberate mischief on his part.
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Treating Psychiatric Patients With Psoriasis: Clinical ConsiderationsPsoriasis, a chronic inflammatory, autoimmune skin disorder, is associated with both genetic and environmental factors. It has important treatment implications for patients who have psychiatric disorders.
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New Biologic Tools in PsychiatryThe psychiatric community has a need for diagnostic and predictive tests. Some recent techniques have just become available for clinical care.
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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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Coming Along With the DSM-5: Hybrid Models of Psychiatric DiagnosisDo not be surprised if you hear more about hybrid models of psychiatric diagnoses included in DSM-5. The categorical and dimensional model approaches are 2 sides of the same coin as you look at the same patient from 2 different angles.
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Prevention and Treatment of AddictionIn 2006, substance dependence or abuse was diagnosed in about 22.6 million persons in the United States.1 Addiction-related morbidity and mortality pose a major burden to society, costing our economy more than $500 billion annually: about $181 billion for illicit drugs,2 $168 billion for tobacco,3 and $185 billion for alcohol.4
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Psychiatric Issues in the Somali Refugee PopulationThis article highlights several features of medical and social importance that are somewhat unique to the Somali refugee community in the US.
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OCD in Egyptian Adolescents: The Effect of Culture and ReligionHow does the role of culture affect disease presentation? The author reviews the impact of religion, ideology and upbringing on the epidemiology of OCD in Egypt.
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Psychiatric Medicine: The Psychiatrist’s Guide to the Treatment of Common Medical IllnessesMost, if not all, psychiatrists have cared for psychiatric patients with common but sometimes complex medical illnesses.
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Multiple Medication Use in General Practice and Psychiatry: So What?The incidence of polypharmacy is on the rise, and with the increase comes a greater risk of drug-drug reactions. One survey estimated that patients seeing a psychiatrist may be six times more likely to receive multiple psychotropic medicines compared to patients seen by a primary care physician. This article provides an overview of the extent of polypharmacy, the factors driving the phenomenon and issues clinicians should consider when treating patients who are already taking medicines for other illnesses.
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A Literature Review of Videophone Use in Mental HealthIn our survey, we found videophones a surprisingly understudied and underutilized tool in spite of the fact that they are easy to use and do not require any technical support.
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Placebo Effects on Pharmacotherapy Outcomes in Major DepressionIf clinical trials data are any indication, the potential impact of placebo treatment on depression outcomes may be potent. Placebo response rates in clinical trials for depression average approximately 30%, with a top range beyond 50%-and the trend is upward.
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Neurotechnology's New Wave, Part II: Value, Acceptance, and Clinical ApplicationsNeurotechnologic devices are proving themselves in clinical medicine. Many of these devices offer several distinct advantages over traditional pharmaceutical-based therapies: their effects are reversible, they are often cheaper than pharmaceuticals, and they solve therapy adherence issues. "If a problem occurs, you can turn off the device; or if the disease evolves over time, you can dynamically adjust the device," explained Ali R. Rezai, MD, chairman of the Center for Neurological Restoration at the Cleveland Clinic.
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A New Adaptation of Integrated Psychological Treatment for Patients With SchizophreniaIntegrated psychological treatment (IPT)--which was developed by a research group in Bern, Switzerland, for patients with schizophrenia--is a distinctive and practical approach to rehabilitation.
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When Your Child Is SickOne is reminded as one reads this book of Emerson’s well-known quote, “Common sense is genius dressed in work clothes.”
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Biofeedback and AnxietyConsidered a "fringe" therapy 25 years ago, biofeedback has matured today to a modality much closer to mainstream treatment. Its value is accepted by a growing number of professionals, and it is covered by Medicare for some conditions, as well as by most health insurers.
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Psychiatric Emergencies in Bipolar and Related DisordersPart 1 of this article, discussed a general approach to treating psychiatric emergencies in patients with bipolar and related disorders, as well as the assessment and management of agitation and impulsive aggression. Part 2 focuses on psychosis, suicidality, and specific treatments relevant to patients in emergency settings who are agitated or have bipolar disorder.
