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Assessment and Diagnosis of Posttraumatic Stress DisorderThis article, based on a comprehensive review by Weathers and associates, provides a selective and brief summary of trauma and PTSD assessments in adults.
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Can Atypical Antipsychotics Reduce Suicide Risk in Patients With Schizophrenia?Suicide is a devastating, tragically frequent outcome for persons with varying psychiatric conditions, including schizophrenia. An estimated 5% to 10% of persons with schizophrenia commit suicide and 20% to 50% attempt suicide during their lifetime.1,2 Patients with schizophrenia have more than an 8-fold increased risk of completing suicide (based on the standardized mortality ratio) than the general population.3
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Cultural Variables in PsychiatryIn modern practice, psychiatrists will invariably have patients who come from different ethnic or cultural backgrounds. Practitioners will need to consider socioeconomic status, diet, use of herbal medications and immigration status, as well as patients' own self-perception of ethnicity, in assessing patients and planning treatment.
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HIV and Psychiatric IllnessMost estimates suggest that there are just over a million persons living with HIV/AIDS in the United States. According to CDC data, between 2001 and 2005, an average of 37,127 new cases of HIV infection, HIV infection and later AIDS, and concurrent HIV infection and AIDS were diagnosed each year.
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Comorbid Depression and ADHD in Children and AdolescentsADHD, the most common diagnosis in child psychiatry, appears to be more challenging to diagnose and treat when there is a comorbid depressive disorder.
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Life Lessons Learned From AddictionsA reminder that success in life requires paying attention to the basics, starting with showing up and hanging in there.
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New Directions in PsychiatryIn order to make positive changes in the field of psychiatry, it is important to appreciate and understand the current challenges and significant limitations of the present approach to psychiatric therapy.
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Neuropsychiatric Aspects of Traumatic Brain InjuryEach year, more than 2 million individuals in the United States sustain a traumatic brain injury. Increased vigilance for previously undiagnosed or incidental TBIs in general mental health populations may lead to more effective clinical management.
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Treatment for Cocaine DependenceDr Edward Nunes discusses the latest evidence from research studies on stimulant and cocaine dependence in this podcast.
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Cognitive Therapy: What Is Its Role in Depression Treatment?Although cognitive therapy (CT) is the best-studied form of psychotherapy, its effectivenes compared with antidepressant medication remains controversial. Over the years, there has been some variability in the results of randomized controlled trials and other types of clinical trials, as well as meta-analyses.
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Improving the Mental Health System by Addressing Core ProblemsWhat psychiatry needs is a new approach to “psychiatric theory.” Here are a few practical suggestions.
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The Maintenance of Certification Exam as FetishIn the opinion of this psychiatrist, the point of the MOC test isn’t to measure competence, but to convey the impression that competence was measured. The point of the test is to say that a test was given-and nothing else. More in this commentary.
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Physician, Heal ThyselfOsama Bin Laden is dead. 9/11 lives on. The sudden annihilation of the man responsible for that cruel and ultimately defining act brought me joy, and rekindled a sense of pride in our country and its capabilities.
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From Our ReadersThe totalitarian system as we know it today may also be called 'managerial capitalism' since the decisions dictated by technical and economic considerations are no longer hampered by the rights of ownership and title holders. Yet it should be emphasized, speaking of 'managers,' that the true technical directors have nowhere acquired the disposing power of technocrats; the real power rests mainly with economic and business managers. This was written by H. Bruggers in 1941 in his "Stages of Totalitarian Economy," in the publication Living Marxism.
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Anxiety and Depression in a Psychiatrically Informed Pain Medicine PracticePatients with chronic pain and head injury frequently have comorbid anxiety and depressive disorders, with depressive disorders appearing to be more predominant. A number of studies show that depressive spectrum illness develops in 40% to 80% of patients with chronic pain; in a majority of these cases, the mood disorder is caused by chronic pain.
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Neuronal Plasticity and Mood DisordersRecent evidence suggests that reorganization of neuronal connectivity might play an important role in the pathophysiology of mood disorders and in both pharmacological and psychological treatments of depression. This evidence suggests a new framework for the etiology of mood disorders that focuses more on the problems in neuronal connectivity, plasticity and information processing in the brain than on abnormalities in chemical neurotransmission. Although this framework is still controversial and far from being complete, improved familiarity with the concepts of neuronal development and activity-dependent plasticity among mental health professionals would be useful.
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Psychiatry and ArtFreud famously quipped: "The creative writer cannot evade the psychiatrist nor the psychiatrist the creative writer."
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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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Identifying and Treating Common Psychiatric Conditions Comorbid with Myalgic Encephalomyelitis and/or FibromyalgiaThis article reviews the diagnostic criteria for both myalgic encephalomyelitis and fibromyalgia and describes how to differentiate them from depressive and anxiety disorders, the psychiatric conditions with which they are most often confused.
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Does Marijuana Withdrawal Syndrome Exist?The question of whether a clinically significant marijuana (cannabis) withdrawal syndrome exists remains controversial. In spite of the mounting clinical and preclinical evidence suggesting that such a syndrome exists, the DSM-IV does not include marijuana withdrawal as a diagnostic category.
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Introduction: Impulsivity-A Transdiagnostic TraitThe topics selected for this special issue highlight the broad relevance of this symptom domain to clinical practice in psychiatry and beyond.
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The Federal Government Ignores the Treatment Needs of Americans With Serious Mental IllnessFor too long the treatment needs of the seriously mentally ill have been ignored by SAMSHA, and this needs to change, says this psychiatrist.
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Integrating Psychosocial Treatment for PTSD and Severe Mental IllnessPatients with severe mental illness (SMI), such as schizophrenia, bipolar disorder, and major depression, are more likely to have experienced trauma in childhood, adolescence, and throughout their adult lives than the general population. This high exposure to traumatic events such as physical and sexual abuse and assault takes a heavy toll.
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Treatment of Insomnia in Anxiety DisordersHow often do insomnia and anxiety disorders coexist? And how best to treat patients with comorbid insomnia and anxiety? Answers here..
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A Look at the Ethical, Legal, and Clinical Issues Associated With Information TechnologyNew technologies pose challenges in the need to maintain boundaries and confidentiality. The same boundaries and ethical standards that existed in the 20th century must be thoughtfully applied with all new and developing technologies of the 21st century.
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Introduction: Mental Health Correlates of TraumaOver half of the population is exposed to at least one lifetime traumatic event, yet relatively few of those exposed have lasting psychiatric sequelae. As psychiatrists, we attend to the needs of those who suffer.
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Outside the Pill Box: The Systems-Based Practice of PsychiatryMeet "Gary," whose case provides an introduction to the value of systems-based practice.
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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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Recognizing and Addressing Domestic Violence: Issues for PsychiatristsA cultural shift has occurred and intimate partner violence (IPV) is no longer defined as a family affair, but one that has lasting effects on the individual, the family, and the community.
