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Personalized Medicine and Psychiatry: Dream or Reality?This article explores the current state of knowledge regarding personalized medicine in psychiatry and discusses how the tools might be used to help psychiatrists understand the components of their patients’ unique endophenotypic profiles.
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Improving Understanding of Veteran Suicide Relative to VHA Service UseThe authors summarize findings from the first study to compare suicide risk for veterans who do and those who do not use VA services.
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Psychotherapy Strategies and the Chronically Suicidal PatientThe benefits of psychotherapy in treating the chronically suicidal patient, as well as strategies that can help the potential suicide patient imagine and reflect others' reactions to this most final of acts, was the subject of a conference by Glen O. Gabbard, M.D., at the 11th Annual U.S. Psychiatric & Mental Health Congress. Gabbard is the Bessie Callaway Distinguished Professor of Psychoanalysis and Education at the Karl Menninger School of Psychiatry and Mental Health Sciences.
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Pharmacotherapy, Epilepsy, and Comorbidities: Causes for ConcernMany persons with epilepsy have comorbid conditions that are treated with concomitant medications. However, patients for whom first-generation antiepileptic drugs (AEDs) are prescribed have been shown to be at high risk for drug interactions with medications that involve the cytochrome P-450 pathway, specifically antipsychotics, contraceptives, tricyclic antidepressants (TCAs), calcium channel blockers, and warfarin.
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Understanding the Neurobiological Basis of Drug Abuse: Comorbidity in SchizophreniaIt is clear that the prognosis for schizophrenia is much better when patients achieve drug abstinence, including in the domains of depression, quality of life, and community integration.
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Functional GI Disorders and PsychiatryThis article provides background information on the FGIDs for psychiatrists and a review of recent research on the biopsychosocial mechanisms that contribute to the illness experience.
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Characteristics of Sleep Disorders in WomenThis brief review addresses what is currently known about sleep problems in women. The main focus is on sleep issues that are particularly relevant to reproductive stages in a woman’s life cycle and therefore potentially linked to reproductive and/or hormonal factors.
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Assessment and Management of Sleep Disorders in ChildrenSleep disorders are very common and are often underrecognized and underreported in children. If left untreated, these disorders can cause serious developmental and physiologic problems.
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Assessing and Treating Sleep Disturbances in Patients With Alzheimer's DiseasePatients with Alzheimer's disease may suffer the same age- and disease-related changes to sleep as their age-matched peers. However, as the dementia progresses, even more severe disturbances develop, with impairments in both nighttime sleep continuity and daytime alertness. This article focuses on long-term, holistic approaches to treatment, including environmental and behavioral interventions to augment sleep medications.
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Underdiagnosing and Overdiagnosing Psychiatric ComorbiditiesDiagnostic assessment of psychiatric disorders and their comorbidities is a challenge for many clinicians. In emergency settings, there is no time to conduct lengthy interviews, and collateralinformation is often unavailable.
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The Intersection of Mental Health and Successful AgingOne consequence of the "graying" of the world's population is that psychiatrists, along with all health care professionals, will increasingly be providing services to older adults. In the United States, the first set of people belonging to the baby boom generation turned 60 in 2005, and the number of people older than 60 will soonoutnumber children for the first time in recorded history.
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Repetitive Self-Injurious Behavior: The Emerging Potential of Psychotropic InterventionRepetitive self-injury can be one of the more difficult conditions to treat. What is the biochemical basis for self-injury and how can psychiatrists treat this condition?
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Frontiers in Imaging Markers for EpileptogenesisContributing to the problem is the relative unreliability of EEG tracings recorded from patients during the interictal period. Although these tracings can reveal certain abnormalities that are characteristic of epilepsy, such as spikes, they tend to be relatively nonspecific. Interictal spikes, for instance, occur inconsistently; they are present in some persons who do not have epilepsy and absent in others who do.
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Lessons Learned in Residency: Working 5 to 9A resident describes her experience in dealing with a potentially agitated patient.
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Benefits of Early Pharmacological Treatment in Alzheimer DiseaseSuccessful intervention for Alzheimer disease requires an early and timely diagnosis. Caregivers of persons with AD often state that an average of 2 years passes from the onset of symptoms to a formal diagnosis.
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Clinical Tests Can Assess Chemotherapy-Induced NeuropathyAn estimated 1,368,000 new cases of invasive cancer were diagnosed and 563,700 cancer-related deaths occurred in the United States in 2004
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Elder Abuse and Ageism During COVID-19The pandemic hit everyone hard, but what implications and consequences has it had for the older generations?
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The Link Between Immune System Dysregulation and SchizophreniaOn the wide range of symptoms in schizophrenia, including alterations of the dopaminergic and/or glutamatergic systems, abnormal neurodevelopment, and the theory of immune system imbalance.
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Antipsychotics for Behavioral Disturbance in Dementia? A Clinical ConundrumAlthough the adverse-effect profile of older, conventional (typical) antipsychotics has discouraged many clinicians from using them, they remain widely used in elderly patients with dementia.
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New Research Examines Genetics Behind ADHDAttention-deficit/hyperactivity disorder (ADHD) is one of the most widely diagnosed disorders: an estimated 8% to 12% of children are affected worldwide. Although many studies about treatment options have been published, the genetic components that underlie the disorder are still being discovered. A special issue of the American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics, highlights recent research and includes results from the first genome-wide study of patients with ADHD. Genome-wide studies have successfully identified variants associated with obesity and such diseases as age-related macular degeneration, diabetes, and prostate cancer.
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The Case of Factitious Disorder Versus MalingeringPatients who exaggerate, feign, or induce physical illness are a great challenge to their physicians. Trained to trust their patients’ self-reports, even competent and conscientious physicians can fall victim to these deceptions.
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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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Common Augmentation Strategies for Depression: Findings Show Lack of EvidenceIt is estimated that at least half of persons who begin antidepressant treatment will not respond to monotherapy.
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Suicide Among Service MembersThe suicide rate in the US military has steadily climbed over the past 5 to 7 years despite aggressive efforts by the military and the mental health community to counter this trend.
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Should Emergency Medicine Physicians Screen for Psychiatric Disorders?Emergency department (ED) visits have increased from 89 million in 1992 to more than 110 million in 2002, while the number of EDs decreased by about 15% during the same period. One suspected consequence of ED overcrowding is an increased tendency to disregard a psychiatric problem, especially if it is not the chief complaint.
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Mini Quiz: Depression and CancerWhat is the estimated prevalence of psychiatric disorders in ambulatory patients with cancer? Find out in this quiz.
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USPSYCH: Concurrent Treatment Works for Comorbid ADHD and Substance AbuseSAN FRANCISCO -- Given the high prevalence of substance abuse in patients with attention deficit hyperactivity disorder (ADHD), psychiatrists need to consider comorbidity in assessment of both conditions.
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Talking to Families About Mental Illness: What Clinicians Need to KnowTalking to Families About Mental Illness aims to help primary care providers who want to offer family psychoeducation. This book targets non-psychiatrists who diagnose and treat mental illnesses.
