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Treatment for Cannabis Use Disorders: A Case ReportIt is vital that psychiatrists are able to identify and characterize cannabis use disorders; provide education; and offer effective, evidence-based treatments. This article provides a brief overview of each of these topics.
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Psychotherapy and Combined Therapy for Depressive Disorders in Later LifeGeriatric psychotherapy has begun to receive consistent and supportive attention in the psychiatric literature. Despite this growing interest in psychotherapy for older adults, studies of efficacy of either psychotherapy alone or of combined treatments for older patients are still limited in number, and more attention to the issue is needed.
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Marketing Off-Label Uses: Shady Practices Within a Gray MarketFor pharmaceutical companies, off-label use of a drug represents a substantial “gray market,” to which the company is unable to sell their product directly, yet may be a significant revenue stream. Some drugs have been used more for off-label purposes than for originally approved indications.1
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Clinical Manual of Geriatric PsychopharmacologyTo assist in meeting the daunting challenge of medication management, the Clinical Manual of Geriatric Psychopharmacology is a valuable, up-to-date resource for any clinician who prescribes for elderly patients.
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Never-Ending Winter: Chronic DepressionMood disorders are among the most prevalent forms of mental illness. Serious depression is especially common; based on a face-to-face survey conducted from December 2001 to December 2002, the past-year prevalence rate of clinically significant major depressive disorder (MDD) was estimated to be 6.6%, affecting at least 13.1 to 14.2 million Americans.
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Borderline Personality Disorder: New Reasons for HopeBorderline Personality Disorder: New Reasons for Hope is one in a series being published by Johns Hopkins University Press on major 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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Treatment-Resistant Depression: The Role of Gene FactorsMajor depressive disorder (MDD) affects a large proportion of the world's population, but much still needs to be done to categorically improve the lives of people with this condition.
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Bipolar II Disorder: Current Issues in Diagnosis and ManagementThree issues of current concern in bipolar II disorder include: diagnostic criteria for hypomania, diagnosis of mixed depression, and management of mixed depression.
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International Psychopharmacology ResearchA longitudinal study of the nicotine patch for smoking abstinence and a look at new drugs to lower blood pressure in patients with cerebrovascular disease are among the various research studies from Europe, Australia and Asia highlighted in this column.
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Bringing New Medications to the Treatment of AddictionSubstance abuse and addiction are among the most challenging health problems facing our society. Breakthrough discoveries in science continue to refine our understanding of drug abuse and addiction and are yielding new opportunities to translate basic research findings into tangible treatment products. Read about the progress being made by the National Institute on Drug Abuse, the world's largest supporter of research on the health aspects of addiction.
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Tools for Assessing Generalized Anxiety DisorderGeneralized anxiety disorder (GAD) is a chronic, impairing and highly comorbid psychiatric condition. A small but sufficient group of empirically supported instruments to assess the severity of GAD are now available.
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Headache in Children and Psychiatric ProblemsHeadache is a frequent somatic complaint in childhood and adolescence, and its prevalence has increased over the last few decades. The presence of a comorbid psychiatric disorder tends to worsen the course of headache by increasing attack frequency and severity, making the headaches less responsive to treatment, and increasing the risk of chronification. Identification and treatment of comorbid psychiatric conditions is, therefore, important for the proper management of headache, especially in children and adolescents.
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Headache and Psychiatric ComorbidityMigraine affects approximately 12% of the population, and a high percentage of these patients have comorbid psychiatric disorders. Knowing more about the interaction between headache and psychiatric factors can assist in evaluating and treating these patients.
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Introduction: Neuropsychiatry Is ThrivingNeuropsychiatry is thriving, and the articles in this Special Report demonstrate its breadth and depth while providing the opportunity to characterize and delimit its scope.
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Mini Quiz: Obligation to Report AbuseWhen did the US Supreme Court confirm the authority of states to intervene in family relationships to protect children? Find out in this quiz.
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Current Clinical Practice in Asperger DisorderHans Asperger considered the disorder a personality factor rather than a developmental issue. How things have changed.
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From Bench to Bedside: The Future of Neuroimaging Tools in Diagnosis and TreatmentSchizophrenia poses a challenge for diagnosis and treatment at least in part because it remains a syndromal diagnosis without clearly understood neuropathological bases or treatments with clearly understood mechanisms of action. Neuroimaging research promises to advance understanding of the unique pathological processes that contribute to this syndrome, and to foster both better appreciation of how current treatments work, and how future treatments should be developed.
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Psychoanalysis and Couple TherapyMeeting the mental health needs of the millions of immigrants from diverse cultural backgrounds and homelands who now live in the United States may require more than a thorough knowledge of psychiatry or psychology, according to a number of cultural psychiatric practitioners.
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Choosing Appropriate TechniquesThe use of supportive psychotherapy, where the clinician acts as a watchful parent, may be of some use to certain patients as opposed to traditional psychoanalysis. This paper gives some examples of cases in which supportive psychotherapy may be more effective.
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Psychodynamic Treatment of Panic DisorderPanic disorder is a prevalent, debilitating illness associated with high utilization of multiple medical services, poor quality of life and a high incidence of suicide. Short-term efficacy of time-limited cognitive-behavioral and medication treatments has been demonstrated in many studies. Evidence for long-term efficacy of these treatments, however, is sparse and less convincing.
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Integrating Psychotherapy and Psychopharmacology in the Treatment of Major Depressive DisorderAlthough multiple interventions exist for major depressive disorder (MDD), only partial response is achieved in many patients and recurrence is common. Combining medication and psychotherapy may enable more effective treatment of MDD.
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Breast Cancer: What Psychiatrists Need to KnowTo support patients with breast cancer, psychiatrists should be aware of possible medication interactions, psychiatric or neurologic adverse effects of treatment, and signs of disease progression--issues that are the focus here.
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Hypochondriasis: A Fresh Outlook on TreatmentThis is the fourth in a series of five articles regarding obsessive-compulsive spectrum disorders. The first three articles ran in the March 1997, June 1997 and January 1998 issues of Psychiatric Times. The first article gave an overview of spectrum disorders, the second discussed obsessive-compulsive disorder and the third examined body dysmorphic disorder.
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Novel Methods to Predict Outcome Using NeuroimagingThe capacity of cognitive neuroscience to inform clinical practice has stimulated both excitement and controversy.
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Treating Aggression in Patients With DementiaDementia is characterized as a progressive and chronic decline in cognitive function, not limited to memory impairment, which significantly interferes with baseline daily functioning and frequently involves behavioral disturbances. It is known that behavioral problems in dementia negatively affect patients and caregivers. These disturbances lead to institutionalization, increased costs and caregiver burden, and a poorer prognosis.
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Religious Understanding as Cultural Competence: Issues for CliniciansImproving religious competence among clinicians is vital if everyday psychiatric care is to become truly person-centered.
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Does the Biopsychosocial Model Help or Hinder Our Efforts to Understand and Teach Psychiatry?In this essay, I approach the question about the BPSM from the perspective of a teacher of psychiatry, medical school dean responsible for (among other matters) student career advising, and clinician. In those capacities, my duties include fostering an understanding of psychiatric disorders among medical students and residents, instilling confidence in and respect for the discipline of psychiatry among students as well as nonpsychiatric colleagues, and explaining psychiatric diagnosis and treatment to patients and their families.
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Atypical Antipsychotic Augmentation in the Treatment of DepressionDespite the clinician's goal of treating the depressed patient to the point of remission, this state is generally achieved in only 15% to 30% of patients. Another 10% to 30% of patients respond poorly to antidepressant treatment, while 30% to 40% have a remitting and relapsing course.1 Patients without a major depressive disorder are likely to be treated successfully by primary care physicians and/or other mental health professionals, which leaves psychiatrists to treat patients who have forms of depression that are less responsive to treatment.
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Practice Patterns for ADHD and Other Disorders CollideRecent data show that widespread discrepancy exists between clinical guidelines and practice patterns for ADHD, dementia, and bipolar disorders.
