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The Arms of Ivy Welcome HerWith the help of psychotherapy, something from the deep unconscious helped cure her depression, forge her character, and guide her to a sense of peace.
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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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Treatment-Resistant Schizophrenia: Making the DeterminationSeveral confounding factors need to be taken into account before labeling a patient as treatment-resistant. What options are available for treating a patient with schizophrenia who has been diagnosed as such?
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An Introduction to Psychotherapy IntegrationThere are three types of integration practiced by psychotherapists: Common Factors, Assimilative Integration and Theoretical Integration. How do they differ from each other, and how does psychotherapy integration differ from an eclectic approach to therapy?
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Adaptation and Implementation of the Integrated Dual Diagnosis Treatment Model Into a Psychiatric Inpatient Facility: A 12-Year PerspectiveAs early as the 1970s, researchers and practitioners became increasingly aware of the necessity for services that would address the varied needs and treatment implications for consumers with the co-occurring disorders of substance abuse and mental illness. High percentages of consumers in substance abuse treatment centers were identified with mental illness disorders, and consumers admitted to psychiatric facilities often were identified as having additional substance use disorders.
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Pseudobulbar Affect Versus Depression: Issues in Diagnosis and TreatmentThe most challenging aspect of pseudobulbar affect is differentiating it from depression. Episodes of uncontrollable, sudden, and even inappropriate emotions may point to neurologic or psychiatric conditions.
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Rika the RiveterMy wife, Rika, has completed six years of excruciating residency, passed the board exam the first time that she took it and is completing a similarly demanding medical toxicology fellowship now. She is raising our two beautiful children, works in a dangerous, hostile, challenging inner city ER, teaches, does research, refuses to hire a housekeeper yet keeps the house running like clockwork and puts up with me and all my crap.
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Sixty-Five Years After World War II: A Family SecretThe Holocaust is well known and has been well researched. The purpose of this study was to evaluate persons 65 years after the Holocaust who remained in Poland and discovered the “secret” of their Jewish ancestry, despite not being raised as Jews.
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MDMA and EcstasyAlthough there are numerous media accounts of the detrimental effects of the drug Ecstasy, there may also be some clinical uses in the treatment of PTSD. The U.S. Food and Drug Administration has approved the first-ever clinical trial of MDMA since it was banned in 1988. An expert in the field discusses what psychiatrists need to know about the popular "rave" drug and the compound's use as a therapeutic tool.
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The Huntington's Disease Society of America: Dedicated to Education and CareHuntington disease (HD) is a devastating hereditary, degenerative brain disorder for which there is, at present, no effective treatment or cure. More than a quarter of a million Americans have HD or are at risk for the disease because of potential genetic transmission. The disease slowly diminishes the affected person's ability to walk, think, talk, and reason. As it progresses, concentration and short-term memory diminish and involuntary movements of the head, trunk, and limbs increase.
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ECT and Ketamine/Esketamine: Guiding Clinical PracticeECT: a gold-standard treatment for major depressive disorder. Ketamine/esketamine: a newer therapeutic option. This ACNP 2023 Annual Meeting session took a deeper look.
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Psychotropic Drugs: Brain and Plasma Pharmacokinetics and the Therapeutic WindowAdministering drug dosages that are clinically effective while causing minimal side effects is a challenge for physicians. The latest data on antipsychotics, antidepressants, and other psychotropic drugs in relation to brain occupancy and plasma levels are reviewed here.
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10 Things to Know About Narcissistic Personality DisorderLack of empathy is a commonly known feature of narcissistic personality disorder. Relationships are typically shallow and difficult to maintain. What are some other features of NPD? More in this case presentation.
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“Switching” of Mood From Depression to Mania With AntidepressantsMood switching is not uncommon and it is much more prevalent in depressed juveniles than in depressed adults, and there is a large apparent excess of antidepressant-associated switching over reported spontaneous diagnostic changes to bipolar disorder. Details here.
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The Freedom in Accepting Our LimitsA psychiatrist realizes he is completely powerless against his patient's opiate addiction.
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Working With Traumatized PatientsThere are feasible and replicable ways for caring adults to help heal themselves as well as the next generation through mass application of reflection and altruistic caring for the remaining offspring, whether in Sichuan, Gaza, New Orleans, or Haiti.
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Lithium Therapy, Bipolar Disorder- and NeurocognitionFunctional mood stability can be attained with lithium therapy, but guidelines on how to get there have become increasingly sophisticated.
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Prevalence and Consequences of Metabolic Syndrome in Bipolar DisorderMedications used in the treatment of bipolar disorder are commonly associated with weight gain. Antipsychotic drugs have been implicated in new-onset diabetes.
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How to Fix the Broken Mental Health System: Ten Crucial ChangesThe Foundation for Excellence in Mental Health Care suggests a total redesign of the mental health system from the federal level down to the local level. Three overarching themes are articulated.
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The Relationship Between Anxiety Disorders and Sexual DysfunctionIn this article, we examine the relationship between anxiety disorders and SDs, using DSM-IV-TR categories, although we are conscious of the limits of this approach. In doing so, we will consider not only the dichotomy between normal and pathological functioning but also the issue of sexual satisfaction as part of wellness.
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The Concept of Recovery in Major DepressionIn clinical medicine, the term recovery connotes the act of regaining or returning to a normal or usual state of health. However, there is lack of consensus about the use of this term (which may indicate both a process and a state), as well as of the related word remission, which indicates a temporary abatement of symptoms. Such ambiguities also affect the concepts of relapse (the return of a disease after its apparent cessation) and recurrence (the return of symptoms after a remission).
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Culture and Urban Mental HealthMostly because of increased speed and decreased costs of communication and transportation, cities are growing increasingly diverse in their population. Consequently, cultural factors have taken center stage in the understanding of urban mental health. This article will focus on the main approaches to urban mental health and briefly summarize the 3 lines of research in this area. It will then discuss the main themes of a vast body of literature on the cultural aspects of urban mental health.
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“Switching” of Mood From Depression to Mania With AntidepressantsMood switching is not uncommon and it is much more prevalent in depressed juveniles than in depressed adults, and there is a large apparent excess of antidepressant-associated switching over reported spontaneous diagnostic changes to bipolar disorder. Details here.
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Clergy and Psychiatrists: Opportunities for Expert DialogueThe World Trade Center attack changed the face of the United States and of psychiatry. Men and women of the cloth and of the clinic came together to care for the stricken masses. Yet, members of the clergy do not always refer congregants who exhibit duress to the psychiatrist, nor do psychiatrists refer patients to the clergy. What keeps these two fields apart? What is best for your patient?
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Deconstructing the “Med Check”A graduating resident recently told me that a psychiatric group attempting to recruit him informed him that he would have 10 minutes for medication appointments and 30 minutes for new patient evaluations. He was horrified. (So was I.)
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A Landmark Report on Addiction by Our Nation’s DoctorVivek Murthy, MD presented for the first time a report by a Surgeon General focused solely on addiction and its consequences.
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Infographic: What Happens to Depressed Adolescents?The high rate of recurrence of depressive symptoms and ongoing psychosocial challenges point to the need for a longer-term view of the management of adolescents with depressive disorders.
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Are Women at Greater Risk for PTSD than Men?Differences between the sexes regarding the prevalence, psychopathology and natural history of psychiatric disorders have become the focus of an increasingly large number of epidemiological, biological and psychological studies. A fundamental understanding of sex differences may lead to a better understanding of the underlying mechanisms of diseases, as well as their expression and risks.
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APA Guidelines for DSM-5 UsersSurprisingly, the American Psychiatric Association (APA) has never established formal guidelines that address what qualifications are required for one to use DSM.
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DisFigured: The Making of a MovieI wrote, directed, coedited, and financed DisFigured because it’s a movie I wanted to see. I’m not a woman and I don’t have an eating disorder, but the issues of appearance, control, isolation, and our complicated relationships with our bodies seem universal to me. They are also sadly underexplored or horribly twisted in almost every form of media. I am particularly aware of this because my wife Jenn is beautiful, graceful, stylish and-according to popular culture-fat.
