Authors
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Amotivation in Individuals with Schizophrenia: Exciting Research Ideas at ACNP 2023 Annual MeetingExciting research ideas are stirring at the ACNP 2023 Annual Meeting.
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Diagnosis and Assessment Issues in Eating DisordersYou must assess the presenting problem and identify the appropriate diagnostic code needed for insurance billing. But diagnosis is complicated. Help here.
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The Conceptualization and Role of Impulsivity: Bipolar Disorder and Substance AbuseImpulsive behaviors play an important role in both bipolar and substance abuse disorders. However, results of studies investigating this link are often ambiguous, in part, due to the multidimensional nature of the impulsivity construct and the fact that many studies use a single measurement technique. We describe a model of impulsivity characterized by three components: response initiation, response inhibition and consequence sensitivity. How these components differ from one another in terms of their use, behavioral theory and biological function is discussed, along with measurement techniques.
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The “Hard” and “Soft” Phenotypic Boundaries of Bipolar DisorderThere is no substitute for understanding one’s patient as an individual, and treating accordingly, keeping in mind the possibility that not all psychosis is schizophrenia and that moodiness may or may not indicate a place in the bipolar spectrum.
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Rape-Related PTSD: Issues and InterventionsRape is a crime that is defined as an unwanted sexual act that results in oral, vaginal, or anal penetration. Generally speaking, there are 2 major types of rape. Forcible rape involves unwanted sexual penetration obtained by the use of force or threat of force. Drug- or alcohol-facilitated rape occurs when the victim is passed out or highly intoxicated because of voluntary or involuntary consumption of alcohol or drugs. Rape can happen to boys and men as well as to girls and women but this article will focus primarily on women.
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Are Genius and Madness Related? Contemporary Answers to an Ancient QuestionEver since antiquity, thinkers have associated creativity with psychopathology--the classic idea of the "mad genius."
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Clinical Uses and Ethical Implications of Psychiatric Genetic CounselingThe Human Genome project has provided an abundance of genetic information, including identification of many disease-causing genes. Clinical applications, genetic counseling and the potential ethical issues raised by the availability of genetic testing are all areas of concern in gene research. Will genetic counseling in classical genetic diseases help to provide guidelines for behavioral disorders?
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Are Studies Misguiding the Choice of First-Line Treatments?A recently published meta-analysis questions if efficacy data garnered from clinical trials is relevant to everyday clinical practice. The authors ponder if enough patients are being included, if they are being followed long enough afterward, and whether exclusion criteria are too broad?
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Rural Psychiatry's Appeal Increasing as Urban Opportunities DiminishRural psychiatry is on the threshold of an immense transformation. Across the country, each state, faced with mandates to cut budgets and conserve health care spending, is in the complex process of negotiating the changing world of health care reimbursement and the redistribution of ever-shrinking funds. Since the majority of rural psychiatric care is delivered at community mental health centers, which rely heavily on state and federal government funding and initiatives, rural psychiatrists are likely to find themselves battling bureaucratic waves that challenge their resourcefulness and ardor.
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Guest Editorial: The Loss of the Right of ConsentInitially, it seemed that the privacy rule for HIPAA would protect patients' privacy, but in reality it has opened the door for insurance companies and hospitals to view private health care information. How can physicians and patients protect their privacy from further erosion?
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Dispatch From the Repressed-Memory Legal FrontDespite the fact that recent juries have discounted repressed-memory testimony as viable, the emotional cost of such cases still takes its toll. Why are such cases so controversial, and how can psychiatrists avoid their pitfalls?
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Treatment for Eating Disorders and the Path to WellnessPodcast: Experts summarize effective treatment options for patients with eating disorders and discuss common features, medical components of anorexia and bulimia, behavioral features, and psychological symptoms.
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Youth-Led Suicide Prevention in an Indigenous Rural CommunitySuicide is a pervasive public health issue for adolescents in Hawaii. In response, a youth leadership model was initiated to empower young leaders in suicide prevention through evidence-based training, relationship building, and community awareness.
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Sharing the Burden of Intercultural StressThe manner in which a clinician enters the room and approaches and engages with an intercultural patient and family can either set off or relieve “culture shock.”
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The Little Psychotherapy Book: Object Relations in PracticeThis book is recommended for therapy trainees who are interested in relational psychodynamic approaches and concerned with putting these seemingly abstract concepts into “real world” practice.
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An Early Warning Sign for ViolenceBullying and being bullied put adolescents at risk for developing violent behaviors. Depression and anxiety are two of the underlying issues related to this type of behavior. Recognizing the warning signs may help mental health care professionals prevent violence in the adolescent's life.
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Psychiatric Consultation to the Postpartum MotherThe authors examine the potential areas of concern during the postpartum period, as well as practical approaches to differential diagnosis and treatment.
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The Use of Meditation in Children With Mental Health IssuesThis review provides information to assist clinicians who are considering mindfulness meditation for their patients.
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Neurofeedback: Significance for PsychiatryThis article provides an overview of the role of neurofeedback as an intervention to target symptoms associated with psychiatric disorders.
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Intervention Helps Workers With DepressionIn the US, depression ranks fifth in the number of disability-adjusted life years lost due to illness and employment problems often persist, even if help is sought. Helping those who want and/or need to work is part of providing comprehensive, patient-centered care.
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A Wake-Up Call: Substance Abuse Among Older AdultsDespite growing awareness and dangers of opioid diversion, misuse among the aging population has skyrocketed.
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Eating Disorders Among Older AdultsIn this CME article, learn how to evaluate older adults who present with significant appetite and weight changes for the presence of an eating disorder.
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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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Update on Pediatric Pneumonia: Causes-Treatment OptionsHere we summarize the evaluation of pediatric pneumonia and offer our management recommendations-based on a literature review and on clinical experience-in the outpatient setting.
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In the Eye of the BeholderI have a neuromuscular disorder. This problem presented itself at birth, and I took much longer than other children to crawl, walk, and reach other physical developmental milestones. My sister is also affected, and although we have had extensive workups twice, the diagnosis is unclear. I had physical therapy up until my early teens, at which point I could do everything I needed to do in day-to-day life.
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Psychosocial Treatments for Trauma-Based NightmaresTwo evidence-based psychosocial treatments are available for trauma-based nightmares. The authors provide a case illustration for each method.
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Psychiatrist on the Road: Encounters in Healing and HealthcareAfter 18 years as a senior clinical psychiatrist at a New England inner-city mental health clinic, Dr Lawrence Climo was understandably surprised and saddened when he was given 2 weeks’ notice that his services were no longer needed. Financial constraints meant the clinic was replacing him with a nurse. Although his wife told him it was an opportunity, he remembers thinking that health care reform made him feel that his professional skills were “almost irrelevant or at least unmarketable.”
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A Response to Dr Allen Frances on SVP/ParaphiliasIn this guest blog, Dr Deirdre D'Orazio responds to a recent commentary by Dr Allen Frances on conducting evaluations of potential sexually violent predators.
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Comorbidity: Psychiatric Comorbidity in Persons With DementiaThe assessment and treatment of psychiatric symptoms in persons with cognitive dysfunction are becoming increasingly important. Prevalence estimates of dementia in the United States range from 5% in those aged 71 to 79 years to 25% to 50% in those 90 or older.
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Closing the Research-Practice Gap in Eating DisordersEating disorders (EDs) are associated with high medical and psychiatric comorbidity, poor quality of life, and high mortality, and mortality from anorexia nervosa (AN) is the highest of all mental disorders. Fortunately, there are a number of evidence-based psychological treatment approaches for EDs.
