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Posttraumatic Stress Disorder: Neurobiology, Psychology, and Public HealthIn recent years, we have learned a great deal about posttraumatic stress disorder (PTSD) and its public health implications. From 9/11 to Katrina and the present Iraq war, PTSD has been in the forefront of health concerns and public policy.
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Club Drugs and Their TreatmentThe most common club drugs or party drugs are MDMA, ketamine and GHB. How dangerous is continued use of these substances? Can they cause real damage to the brain?
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Update from the American Society of Addiction Medicine: New CriteriaHere, a psychiatrist certified by the American Board of Addiction Medicine discusses new treatment criteria for addiction.
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Melatonin: The Dark Side of the HormoneOur own melatonin plays an important role in regulating our sleep-wake cycle. Recent evidence raises questions about whether we should be taking extra doses to try to improve our sleep.
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How to Decide Whether Depressions Are Bipolar DepressionsAlthough diagnostic criteria for a depressive episode are the same for unipolar major depression and bipolar depression, these episodes differ in their natural history.
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The Elderly DriverOf concern is the safety of our roadways as the effects of aging take their toll upon drivers nationwide. Are there accurate ways to test the cognition and response ability of elderly drivers?
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Sleep Disturbances After Traumatic Brain InjurySleep-related problems are among the most disabling consequences of TBI, with multiple influences: impairment of neuronal plasticity, metabolomic alterations, loss of vascular homeostasis, and disruption of the blood-brain barrier. The authors take a close look.
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A New Screening Measure for Detecting 'Hidden' Domestic ViolenceOrgan donation from brain-dead patients has become a psychiatric issue in Japanese transplant medicine. Brain death is recognized as human death only in the context of organ transplantation in Japan. Since many Japanese physicians deny that brain death constitutes the death of an individual, there is no solid, general consensus in Japan about what constitutes brain death.
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Issues in Psycho-Oncology: What Clinicians Need to KnowAn overview of select topics in clinical psycho-oncology, including assessment and management of delirium and brain lesions, mood and anxiety disorders, medication adverse effects, and existential death anxiety.
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The Prevalence of Schizophrenia in the USMight a lower prevalence suggest that it is less a problem?
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Brain Stimulation Therapies for Treatment-Resistant DepressionEvidence for Use of Neurostimulating Techniques
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Psychoneuroimmunology and HIV Disease ProgressionAmong psychiatrists who treat patients with HIV/AIDS, the question of how psychosocial distress effects the progression of HIV disease is likely to arise. Even for healthy individuals, we are only beginning to clarify the complex pathways by which thoughts and emotions impact immune function. Due to the bidirectionality of the communications of the brain and the immune system, this is a complicated scenario. The fact that HIV alters the function of the immune system during the course of its progression creates greater confounds to the understanding of these systems. We will address the rationale that progression from HIV infection to AIDS may be modulated by psychosocial factors, discuss possible reasons for conflicting findings and posit some clinically relevant recommendations drawn from research findings.
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Update on Mood Disorders: Implications for PracticeHow generalizable are the results of depression treatment studies? Which factors predict readmission and length of stay in inpatients with mood disorders?
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Road Rage: Are Our Patients Driving Angry?Road rage is well known in popular culture and to many people it is a common and dangerous experience. Alcohol problems, illicit drug use and general psychiatric distress are associated with road rage perpetration. Road rage incidents may also result in psychiatric distress. Although treatment for road rage has received little research attention, encouraging results have been reported from specialized programs.
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Introduction: The Art of PsychopharmacologyThis Special Report presents an important set of articles that considers controversial issues relevant to the practice of psychiatry. These articles demonstrate that what we do as practitioners is often based on incomplete evidence and/or reliance on experience and the art of psychopharmacology. There are considerable limitations to “evidence-based medicine” as applied to the issues considered and also to what can be said officially about “off-label” uses of medications. All that said, these articles represent a very interesting set of perspectives on important and, to date, unresolved problems for which our science falls quite short of giving us definitive answers.
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Racial Profiling in Psychiatry: Does It Help Patients?Should psychiatrists follow these leads and use a patient's race or ethnicity to guide treatment decisions? In this article, I will describe the evidence that supports racial profiling in psychiatry and will explore some of the relevant concerns.
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CounterpointThe psychologists appear to believe that large numbers of untreated mentally ill would get better if their psychologists could prescribe medication for them, thereby making up for a resource-poor and underfunded mental health system. There is no lack of prescribers. Psychiatrists know that the biggest problem for the mentally ill isn't a lack of medication, it is the dearth of supportive services available to augment, among other treatments, the taking of medication. So why are psychologists fleeing the duties they have long been mandated to provide? The answer is simple: Money.
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College Students Under StressEmerging adults in the midst of a tremendous emotional growth spurt and a leap of neurocognitive maturation often need guidance articulating what bothers them.
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Is ECT Appropriate in Old-Old Patients?More patients are reaching the old-old demographic-those age 75 and above-with psychiatric conditions such as treatment-resistant depression. Research has shown that with some careful screening and precautions, ECT is a safe, effective treatment option for these patients.
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Climate Change: No Personal Beliefs Should Increase Children’s AnxietyOne reader believes psychiatrists and mental health clinicians should approach climate change with skepticism.
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Exploring Group TherapiesGroups are important throughout the course of a patient's therapy, especially for patients who have substance use disorders. Group therapy's clinical and cost benefit is evaluated for its efficacy in preventing and treating substance abuse.
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What the Future HoldsThis is both an exciting and challenging time to be a child and adolescent psychiatrist. New findings are changing our knowledge of childhood psychopathology. This Special Report discusses current developments in diagnosis, treatments, and problems for children and adolescents.
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Group Therapy and Cancer Survival-- Where Does the Evidence Lie in 2007?One of the most hotly debated questions within oncology over the past decade has been whether the promotion of psychological wellness can extend survival for patients with advanced cancer. The converse--that psychiatric disorder shortens survival--seems true, with mechanisms of poor self-care and reduced adherence to anticancer treatments resultant from depressive or psychotic disorders explaining this outcome.
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Cognitive Side Effects of Antiepileptic Drugs in ChildrenAntiepilepsy drug use in children presents special challenges because, unlike adults, treatment-emergent neuropsychological deficits occur against the backdrop of cognitive and psychosocial development, with treatment decisions having lifelong implications.
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The Changing Face of Substance Misuse in Older AdultsAddictive disorders are among the leading causes of disability worldwide; however, misuse of and addiction to alcohol and illicit substances is often not appreciated as relevant to the care of older adults.
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PTSD Has Unreliable Diagnostic CriteriaCurrently the Veterans Administration (VA) is the world’s largest recipient of per patient funding for PTSD. The VA treats 200,000 veterans with this diagnosis annually at a cost of $4 billion. But research calls into question the very existence of the “PTSD” syndrome, and its diagnostic formulation remains invalid. We do not minimize the suffering of those who experience trauma or the need for comfort and restitution. We seek only to reexamine research evidence, to clarify the impact of culture on diagnosis, to reevaluate the consequences of trauma, and to ensure optimal allocation of resources.
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Suicide Prevention in Diverse Populations: A Systems and Readiness Approach for Emergency SettingsIn the US, suicide is a leading cause of death, ranking third among youths aged 15 to 24. Rates of suicide attempts and death are highest among US Pacific Island indigenous youths. Emergency departments play a key role in suicide prevention, especially in this and other minority populations.
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Delayed Sleep Wake Phase Disorder in Adolescents: Chronotherapy and Best PracticesHere: suggested strategies for assessment and management of this circadian sleep disorder commonly seen in adolescents.
