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New Evidence Suggests Media Violence Effects May Be MinimalNew research over the past decade has suggested that links between media violence and child aggression are less clear than previously thought. How has our understanding of media violence effects changed?
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Medical Marijuana and Mental Health: Cannabis Use in Psychiatric PracticeHere's why psychiatrists and other mental health professionals need to understand the relationship between cannabis and mental disorders.
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Shared Decision Making in the Treatment of PsychosisPsychiatrists vary in their eagerness to share therapeutic decisions with patients: some believe that adherence is paramount and paternalism is often necessary to prevent loss of insight with consequent impaired judgment and functional decline. These authors argue in favor of a radically more collaborative style.
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Interventions for Perpetrators of Intimate Partner ViolenceSubstantial progress has been made in the development of etiologic models of intimate partner violence and interventions for individuals who assault their intimate partners. These authors provide details.
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Adolescent Marijuana Use and Vulnerability for Neuropsychiatric DisordersAn overview of some of the recent scientific data examining the relationship between adolescent marijuana use and later onset of neuropsychiatric disorders.
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8 Core Principles When Treating Addiction in AdolescentsThe main goal in treating addiction is to help the patient achieve and improve functioning. When that patient is also an adolescent, there are special considerations. Here's a quick primer.
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Your Child in the Balance: An Insider's Guide for Parents to the Psychiatric Medicine DilemmaYour Child in the Balance provides parents with a unique and insightful look into the role of psychotropic medications in the treatment of children and adolescents. Dr Kalikow does a stellar job of systematically and comprehensively addressing this complex and provocative topic in this guide for parents from the perspective of a practicing child and adolescent psychiatrist.
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Behavioral and Pharmacologic Treatment of Aggression in Children With AutismThis article will provide an overview of treatment modalities, with emphasis on the future direction of interventions targeting aggression in children with autism.
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Psychobiological Aspects of Antisocial Personality Disorder, Psychopathy, and ViolenceThe key focus is on understanding violent offending (eg, reactive, proactive, firearm violence) tied to antisocial personality disorder and psychopathy using a psychobiological lens.
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Ethics, Psychiatry, and End-of-Life IssuesAt the end of life, psychiatrists are often asked to assess a patient’s capacity to refuse treatment, but the role of the psychiatrist in this situation is much broader.
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Understanding and Managing Adolescent Disruptive BehaviorThe words attributed to Socrates resonate with the perspectives of many contemporary parents and clinicians.1 The endurance of the concern suggests something fundamental about the psychopathology of deviant, disruptive behavior of youth. Yet clinicians struggle to understand its origins, to help parents control their children, and to help the children control themselves. Clinically, this manifests in failed pharmacological treatments, incompleted courses of individual therapy, problems in engaging families in treatment, and controversies over which therapy is most effective.
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Levodopa-Induced Dyskinesia: Medical and Surgical ManagementIn the 1960s, the treatment of Parkinson disease (PD) was revolutionized by the introduction of levodopa. Soon after its discovery, however, it was observed that continuous treatment was complicated by the emergence of choreoathetoid movements and off episodes.
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Outlook for Federal Mental Health Policy in the 115th CongressWill the new Administration disrupt mental health coverage in this country?
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Introduction: Serving Those Who ServeThis Special Report aims to address those symptoms and syndromes most commonly seen by clinicians who treat service members. The 5 articles of the Special Report cover the most challenging aspects of their care, and the authors hope to expand the reader’s understanding of the recent conflicts’ tragic consequences.
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The Clinical Management of Amyotrophic Lateral SclerosisAmyotrophic lateral sclerosis (ALS) is a progressive, debilitating, fatal disease that involves degeneration of upper and lower motor neurons. Patients often initially present with limb or bulbar weakness, atrophy, and spasticity, followed by progressive loss of ambulation and, ultimately, respiratory failure, which is the most common cause of death.
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Practice Management: Managing Risks When Practicing in Three-Party Care SettingsFollowing trends in medicine, psychiatry is faced with limited resources and third-party administration of resource allocation. This has affected psychiatric practice in many ways and altered the doc-tor-patient relationship. Trends toward resource-sensitive, third-party–related psychiatric practice may be accelerated by the current social concerns regarding the economy. Thus, an awareness of social context and the growing recognition that autonomy-enhancing alternatives to paternalistic care are fundamental to improve both the effectiveness and accessibility of care in limited-resource environments are each becoming vital for an informed clinical and risk-management practice perspective.1
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Positivism and Heart Health: Issues for PsychiatristsPsychiatrists are uniquely suited to help patients with and without heart disease feel more positive and hopeful. This, in turn, can have substantial effects not just on mental health, but on health behaviors and physical health outcomes as well.
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The Behavioral Neurology of White Matter: Diagnosis of Major Disordersand SyndromesMore than 100 neurologic diseases, injuries, and intoxications are known to prominently or exclusively involve the white matter of the brain.
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Forced Medication and Competency to Stand Trial: Clinical, Legal, and Ethical IssuesThe authors examine legal and ethical challenges for the psychiatrist when a defendant who is incompetent to stand trial declines to take prescribed psychotropic medication.
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Sweet Sorrow: The Relationship Between Depression and Diabetes MellitusMultiple studies show that diabetes approximately doubles the risk of comorbid depression. Furthermore, major depressive disorder is a risk factor for the subsequent development of type 2 diabetes mellitus. Treatments for depression in the setting of diabetes must be evaluated for their effects on blood glucose levels, propensity for weight gain, possible concomitant use for diabetic neuropathy and potential drug interactions.
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Interventions for Perpetrators of Intimate Partner ViolenceSubstantial progress has been made in the development of etiologic models of intimate partner violence and interventions for individuals who assault their intimate partners. These authors provide details.
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Development of a Transdiagnostic Unified Psychosocial Treatment for Emotional DisordersResearch emerging from the field of emotion science suggests that individuals who have anxiety and mood disorders tend to experience negative affect more frequently and more intensely than do healthy individuals, and they tend to view these experiences as more aversive, representing a common diathesis across anxiety and mood disorders.1-5 Deficits in the ability to regulate emotional experiences, resulting from unsuccessful efforts to avoid or dampen the intensity of uncomfortable emotions, have also been found across the emotional disorders and are a key target for therapeutic change.
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The Effects of Age on Cognitive Deficits in SchizophreniaRecent studies have shown that patients with schizophrenia experience a greater decline in cognitive abilities with age. Given the large baby boomer population, how will this influence treatment for aging patients with schizophrenia?
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Serious Delinquency and Gang MembershipYouth gangs are a recognized risk factor for adolescent violence and delinquency. This article reviews recent research on these topics, including the prevalence, characteristics and influence of youth gangs, and discusses the implications of those findings for clinical practice.
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Post-COVID Stress Disorder: Another Emerging Consequence of the Global PandemicThe pandemic has triggered an array of emotional, physical, and economic issues but in the midst of this crisis, nations have shared and learned from each other’s experiences.
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Extraordinarily OrdinaryMy “most important achievement to date” is that I’m capable of even the simplest forms of basic cognition. I can remember, perceive, speak, feel, think, solve, and-sometimes-pay attention.
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The Relevance of New Alzheimer Guidelines for Clinical PracticeThe proposed new diagnostic categories and guidelines for Alzheimer's disease include not only dementia, but also the preclinical and mild cognitive impairment (MCI) phases of AD.
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Strategies for Treating Osteoporosis and Its Neurologic ComplicationsOsteoporosis is a disorder characterized by low bone mass and microarchitectural deterioration with resulting compromised bone strength and increased risk of fracture.1 The World Health Organization defines osteoporosis based on T-scores, which reflect bone mineral density (BMD) relative to mean BMD for healthy 25-year-old same-sex populations. A T-score between 0 and 21 is considered normal density, a score between 21 and 22.5 indicates osteopenia, and a score of less than 22.5 signifies osteoporosis.2 Severe osteoporosis is defined as a T-score of less than 22.5 combined with a fragility fracture.2
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How to Write a Suicide Note: Practical Tips for Documenting the Evaluation of a Suicidal PatientProper suicide assessment is probably the most important part of a clinician's job; appropriately, heavy emphasis is placed on this in our education. Unfortunately, psychiatrists receive comparatively little practical guidance in documenting the history and physical examination (H&P) of a suicidal patient.
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ADHD, Bipolar Disorder, or Borderline Personality DisorderADHD can present with symptoms such as irritability, mood lability, low frustration tolerance and low self-esteem, making it easily confused with mood disorders and personality disorders.
