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Trauma and Violence in Childhood: A U.S. PerspectiveThis article reviews the Adverse Childhood Experiences (ACE) Study that examined the association between multiple childhood traumas and health outcomes in adults. These findings have significant public health implications for individuals exposed to childhood trauma, and the authors present a vision for a children's mental health care and wellness infrastructure in the United States derived from the Report of the Surgeon General's Conference on Children's Mental Health.
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Cyberbullying: Who Hurts, and WhyThe research on electronic aggression among college students indicates that it is highly prevalent, with over 93% of college students reporting some negative effects due to electronic victimization.
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Frontolobular Cystic Mass and Hydrocephalus in Woman With Headache and LethargyA previously healthy 35-year-old woman was admitted to a New York City hospital after presenting to the emergency department (ED) with a 10- to 14-day history of generalized weakness, progressive frontal headache, and lethargy. She immigrated to Brooklyn, New York, from urban Haiti 9 years previously and had not returned to Haiti since. She denied any recent travel elsewhere and had no pets. An HIV antibody test, performed 4 months before ED presentation, was negative.
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Mini Quiz: Cognitive EnhancersWhich pharmacotherapeutic approach is most effective for cognitive enhancement? Test your knowledge with this quiz.
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The Influence of Diet on ADHDThere is good emerging evidence that aspects of diet can indeed affect ADHD. Clinical recommendations here.
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Culture and Suicide in Late LifeA cross-cultural comparison of suicide in old age, including a discussion of recent epidemiological trends in suicide rates. The authors also discuss the impact of social and cultural variables on the detection of depression and the formulation of suicide prevention strategies.
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The Impact of Antipsychotics on Cognitive Functioning in SchizophreniaCognitive deficits, which play a crucial role in the pathogenesis and prognosis of schizophrenia, can lead to noncompliance and poor outcomes. New treatment options need to be tested that may offer surplus effects on neurocognition.
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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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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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Suicide in Older Adults: Advances and the Role of Technology in TreatmentRecent updates in suicide prevention interventions for older adults and how a novel tablet application may provide relief to individuals at high risk of suicide.
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Through Hamlet to Narrative Medicine and Neuroscience: Literature as a Basic Science of PsychiatryPsychiatrists have often turned to literature for theory building, clinical understanding and teaching. Hamlet is a common example, beginning with Freud. Most psychiatrists, like Freud, look at content (character and motivation) when using literature. However, the process (interaction between characters) can also teach us much about the psychiatrist-patient encounter.
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Cultural Issues in the Emergency SettingThe setting of a fast-paced emergency department (ED) or psychiatric emergency service makes it especially difficult to sensitively elicit and address an individual patient's needs and concerns. When considering the myriad differences in culture that come into play between a patient and a psychiatrist or other mental health care clinician, optimal diagnosis and treatment can be even more challenging, as the cases described here illustrate. The important influence of culture cannot be stressed enough. Taking the time to understand "where the patient is coming from" can prevent an already stressful, highly emotionally charged situation from becoming even more convoluted.
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Catatonia in Autism or the Blind Men and the ElephantCurrent treatments for autistic spectrum disorders (ASD) are useful in some cases, but have little enduring impact. This had lead to many parents seeking nonconventional treatments that often border on quackery.
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Psychiatric Emergency StrategiesHere we present how to assess safely patients who become oppositional or menacing in a clinic or office.
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Can Dialogue Cure? A Couple's Therapeutic JourneyIndividuals with a past history of chronic psychiatric illness are often given poor prognoses that can limit their therapeutic horizons for further treatment. This pessimism may be misplaced as is demonstrated by the case of Jay, age 71, and Kay, age 65. The couple presented at the Loyola Sexual Dysfunction Clinic in a program consisting of 7 weekly sessions of 5 hours each with 2 trainee therapists.
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Telepsychiatry for Vulnerable and Underserved PopulationsWhen timely psychiatric care or consultation is difficult or impossible to obtain, telepsychiatry may be an acceptable, economical, and effective alternative.
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10 Salient Points About Migraine and Psychiatric ComorbidityWhere do migraines and psychiatric disorders intersect? Learn more.
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Antipsychotics and the Shrinking BrainPsychosis at any phase of the illness can be extremely distressing, disruptive, and potentially dangerous for patient and family.
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Predicting, Assessing, and Treating Self-Harm in AdolescentsThe authors differentiate between 3 types of deliberate self-harm: nonsuicidal self-injury, culturally sanctioned body modifications (tattooing or body piercing), and unintentional or accidental injury.
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Current Obstacles to Drug DevelopmentWhile pharmaceutical research in the United States provides for unparalleled high quality of treatment, many drugs already proven effective in other countries may never become available here due to a combination of obstacles.
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Pharmonitor FeedbackDr Stone’s Pharmonitor essay justly skewers drug promotion hubris disguised as a CME article.
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Narcissistic Leaders: Who Succeeds and Who FailsMost of what we read confirms the correctness of our approach and technique. Reasonably proud of our successes as clinicians, we blame the illness rather than the patient when we fail.
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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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Drug Therapies for the Neurobehavioral Sequelae of Traumatic Brain InjuryTraumatic brain injury (TBI) is one of the most common causes of morbidity and mortality, especially in young adults. Recognition and early accurate diagnosis of neurobehavioral TBI sequelae are important in reducing the severity of postinjury symptoms. Sequelae of TBI include cognitive impairments, personality changes, aggression, impulsivity, apathy, anxiety, depression, mania, and psychosis.
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Differentiating Epileptic Seizures From Other SpellsIt can be difficult to determine whether unusual, paroxysmal behavior represents a seizure or a nonepileptic event. Patients with convulsive, clonic movements may, in fact, be experiencing psychogenic events.
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Psychiatric Comorbidity Associated With Pathological GamblingGambling has become a major recreational activity in the United States. Formerly confined to a few states such as Nevada and New Jersey, legal gambling opportunities have exploded across the nation in the past 2 decades.
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Treatment Challenges in Schizophrenia: A Multifaceted Approach to Relapse PreventionWhile an antipsychotic medication is the first step of treatment for schizophrenia, it is increasingly recognized that comprehensive care requires the integration of adjunctive therapies and attention to long-term treatment goals.
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6 Things to Remember When Practicing TelemedicineWhat 6 things are important to keep telemedicine practice running smoothly?
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Psychotherapy for Treatment-Resistant Depression Is Overlooked, Underused"Evidence indicates that psychotherapy may yield greater durability of treatment gains than pharmacotherapy."
