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Violence and Survival: Denial and the Ultimate ThreatAlthough recent news portrays general violence as on the decline, the Centers for Disease Control still rank health care providers only one notch below convenience store clerks and taxi drivers at risk for homicide. Mental health personnel are exposed to these ultimate threats in emergency rooms, on home visits, walking through lonely hospital corridors or hotel corridors during conventions, as well as on the street and at home.
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Diagnosing and Treating ADHD in AdultsIn the past several years, there has been an increasing awareness of the syndromal persistence of ADHD into adulthood. Once considered only a childhood disorder, ADHD has become increasingly recognized as a valid psychiatric disorder in adults.
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Tips for Treating Comorbid Depression and AnxietyComorbid depressive and anxiety disorders are commonly seen in both primary care and the specialty setting. Such comorbidity can present as major depression with subsyndromal anxiety symptoms or unipolar/bipolar depression with an anxiety disorder.
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10 Tips for Embracing a HIPAA-Compliant CloudUsing the cloud in a savvy way can make your work easier and keep your patients happy-as long as you deploy it in a secure way. Here are 10 tips for embracing the cloud in your psychiatric practice.
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Anxiety Disorders: Aortic Aneurysm in the Differential?Worsening anxiety is a common symptom that may result in psychiatric consultation or evaluation in an emergency setting. Aneurysms are rarely considered in the medical differential for anxiety disorders, and the available literature and research regarding this possible connection are very limited. Overlooking this diagnosis, however, can have disastrous consequences. Here we present 2 case reports as well as a review of the literature regarding a possible relationship between aortic and thoracic aneurysms and psychiatric symptoms.
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Art Therapy in a Patient With Bipolar Disorder: Pictures Speak More Than a Thousand WordsHere: the case of a woman with bipolar disorder who was admitted for aggressive behavior and nonadherence to medications. Art therapy and pharmacotherapy played a pivotal role in her recovery.
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Depression and Diet in Elderly Community-Dwelling Mexican and European AmericansDepression and Diet in Elderly Community-Dwelling Mexican and European Americans
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A First-Episode Psychosis Treatment Program: “The Disease Doesn’t Define Me”The Psychiatric Transition Program at the Naval Medical Center in San Diego is a specialized first-episode psychosis program that provides coordinated specialty care to active-duty service members with serious mental illness.
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Gone to Pot: The Association Between Cannabis and PsychosisCannabis, or marijuana, has been consumed by humans for centuriesand remains one of the most widely and commonly used illicitsubstances. The authors review the evidence supporting and refutingthe association between cannabis exposure and psychotic disorders.
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PTSD in Survivors of Rwanda's 1994 WarIn May 1997, a young Rwandan girl came to a clinic in Kigali reporting nausea and the feeling of insects crawling on her face. She complained of the strong smell of feces and grew increasingly agitated and fearful, describing vivid images of people trying to kill her at that moment. For months she had vomited at the sight of avocados, and for three years she had been unable to tolerate the sight of rice.
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Comorbidity of Dysthymic Disorders in Children and AdolescentsComorbidity of Dysthymic Disorders in Children and Adolescents by Atilla Turgay, M.D. Many patients with dysthymic disorders also have associated comorbid disorders. A detailed history will provide insight into the comorbidity profile, cross-sectionally and developmentally. Dysthymic disorder should be addressed clinically, as it may cause long-term chronic unhappiness and poor quality of life for the patient.
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Alzheimer Dementia and Sleep Disorders: Issues in Diagnosis and TreatmentSleep disorders represent a significant problem in patients with Alzheimer disease. Here: assessment strategies and a review of drug and non-drug interventions.
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The Role of Melatonin in the Circadian Rhythm Sleep-Wake CycleMelatonin has a role in psychiatric illness and the treatment of circadian rhythm sleep disorders, insomnia, and comorbid depressive disorders.
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Despite Hospital/Physician Integration, Readmissions Remain HighIs all the time, effort and money (not to mention the stress) really going to positively influence patient well-being?
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Syncope: Workup, Differentials, and TreatmentSyncope is responsible for 1% to 6% ofhospital admissions and up to 3% of visitsto the emergency department (ED). Thissudden, brief loss of consciousness resultsfrom a decrease in or cessation of cerebralblood flow and is followed by spontaneousrecovery. The causes range from benignto life-threatening.
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The Neurobiological Development of AddictionSelf-administration of drugs of abuse often causes changes in the brain that potentiate the development or intensification of addiction. However, an addictive disorder does not develop in every person who uses alcohol or abuses an illicit drug. Whether exposure to a substance of abuse leads to addiction depends on the antecedent properties of the brain.
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Prescription Digital Therapeutics and the Hunger for New TreatmentsHere's why the next step in mental health treatment is digital.
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Out of Her Mind: How We Are Failing Women’s Mental Health and What Must ChangeDoes the psychiatric approach to treating women need to change? How does feminist thought consider psychiatric treatment? Linda Gask, Msc, PhD, shares her thoughts in "Out of Her Mind".
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Lessons Learned From the International Society for Bipolar Disorders Task Force on SuicideWhat is the actual risk of suicide attempts or suicide death in people with bipolar disorder? How does a BD diagnosis affect short-term and long-term suicide risk? How should a BD diagnosis help guide us toward the most effective suicide prevention strategies?
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Keys to Success in ADHD TreatmentClinicians who treat children with ADHD face a challenging conundrum. Although our understanding of ADHD and its evidence-based treatments has increased significantly in recent years, the number of successful treatment outcomes has not.
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Treatment-Resistant Depression: An Alternative Approach to ManagementIn this podcast, B. Andrew Farah, MD, looks at shortcomings of current therapy that make treatment-resistant depression so common, offers insights into the genetic underpinnings of TRD, and focuses on a new treatment paradigm.
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Eating Disorders: Research and Future DirectionsWhat do we know about eating disorders and what are the next steps in treatments and research? More in this podcast.
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Interatrial Communications, Stroke, and Migraine HeadacheThis review will familiarize physicians with the embryology, types, and incidence of various interatrial communications; summarize and highlight the potential association of interatrial communications with stroke, platypnea-orthodeoxia syndrome, neurologic decompression sickness in divers, and migraine headaches; discuss various therapeutic modalities available for closure of interatrial communications; and outline future directions in this rapidly evolving field.
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Reducing Risk Associated With Seclusion and RestraintThis article briefly reviews the federal standards regarding S/R and methods of reducing the risk associated with their use. CMS standards that went into effect February 6, 2007, will be emphasized; however, some of these standards vary from JCAHO standards.
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Hypersexuality in Children With Mania: Differential Diagnosis and Clinical PresentationThe diagnosis of bipolar disorder in children remains controversial. One of the more disturbing facets of its presentation in such young patients is the presence of hypersexual behavior. How can these behaviors be differentiated from the effects of abuse and other psychiatric disorders?
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The Book of Ethics: Expert Guidance for Professionals Who Treat AddictionFewer than a handful of books have been published on the ethical dimensions and challenges in treating and helping persons living with an addiction. Therefore, this book is a welcome contribution to the literature almost from the start. The contributors in this 9-chapter text range from community- and hospital-based professionals to behavioral program directors to ethics center directors and researchers to psychology, neurology, and psychiatry professors and fellows. The book aims to provide general advice on central issues encountered routinely by those experienced in addiction services and research. Contrary to the book’s rather biblical and authoritative title, the editors “offer this work modestly,” given the relative newness of focused ethical analysis in addiction treatment and care.
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The Medication Check as Psychotherapeutic OpportunityThis article explores the use of functional analytic psychotherapy (FAP)-a behavioral, evidenced-based approach to psychotherapy that can add psychotherapeutic benefit to your existing brief approaches during medication checks.
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Panic-Focused Psychodynamic PsychotherapyBoth cognitive-behavioral and pharmacological treatments for panic disorder have been found to be effective over the short term. Not all patients, however, can tolerate or fully respond to these approaches, and the effectiveness of these interventions over the long term remains unclear.
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Special Issues in Menopause and Major Depressive DisorderA risk to benefit ratio of treatment must be established to determine the optimal treatment for perimenopausal depression. Untreated depression during the perimenopause exacerbates heart disease, diabetes, and osteoporosis. Details about management options here.
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My Patient Lost Their Job…Now What?Unemployment is associated with an array of social and psychological complexities, directly affecting patients' self-esteem and perceptions of self-worth. When a patient loses their job, the psychiatrist has 4 tasks.
