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The Conundrum of Psychiatric ComorbiditySince the revision of DSM-III, high rates of co-occurring psychiatric disorders have been observed, particularly in cases of moderate and severe psychiatric illness. The reason lies in the design of the diagnostic system itself: DSM-IV is a descriptive, categorical system that splits psychiatric behaviors and symptoms into numerous distinct disorders, and uses few exclusionary hierarchies to eliminate multiple diagnoses.
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Improving Mental Health Care in America: An Opportunity for Comprehensive ReformThe authors outline the ingredients for the transformation of mental health care in America.
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Adverse Effects of Antipsychotics and Mood StabilizersAlthough psychotropic medications have revolutionized the treatment of many psychiatric disorders, the benefits sometimes come at a price.
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The Once-Forgotten Factor in Psychiatry: Research Findings on Religious Commitment and Mental HealthAs previously discussed, new research has made us look much more closely at the influence of religion and spirituality on overall health. Now more than 30 psychiatric residencies including Harvard, Baylor, and Georgetown provide focused training on addressing patients' religious/spiritual beliefs.
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Patients Versus Therapists: Legal Actions Over Recovered Memory TherapyThe debate over the accuracy of memories of childhood sex abuse that are recovered decades later, usually during the course of therapy, has led to the polarization of psychiatrists and other mental health professionals. There are those who claim that -recovered memories are, in the main, accurate, and there are others who believe that most, if not all, recovered memories are false.
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We Will Remember Dancing: A Message From a Child Shoah Survivor to the Young 10/7 SurvivorsDance/movement therapy has proven to be effective in treating children with trauma, making dance something that can change the way a child develops psychologically.
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Psychiatry Residents: Best of Luck!My advice to residents is that you remain open to the opportunities that surround you every day as you continue your education and professional training.
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Illicit Drug Dependence Across the Globe: Results From the Global Burden of Disease 2010 StudyHow prevalent is dependence on amphetamines, cocaine, opioids, and other illicit drugs across the world? What is the associated disease burden? Insights here.
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Protecting Yourself and Your PatientsGood risk management is part of, but also distinct from, good clinical practice. The principles of risk management evolved in the 1960s as a way to defend businesses from loss of financial assets from tort claims
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End-of-Life Care and the ElderlyEvery life ends with death. For the elderly, death is the end of a long life that has been shaped by personal history and world events, various relationships, well-set personality characteristics and, of course, happenstance. Each of these, in addition to the specific circumstances that herald death, shapes the experience of dying in old age.
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Transit: Already in HellChristian Pitzold’s haunting 2019 film, based on Anna Seghel’s masterful 1942 novel.
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How Psychotherapy Changes the BrainPsychotherapy outcomes and the mechanisms of change that are related to its effects have traditionally been investigated on the psychological and social levels, by measuring changes in symptoms, psychological abilities, personality, or social functioning.
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Understanding the Differences Between Impulsivity and CompulsivityA review of targeted treatment strategies for symptom domains when impulsivity and compulsivity become dysfunctional.
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Cobenfy as an Adjunctive Agent in Schizophrenia: Peter J. Weiden, MD, Shares Insights on the Latest FindingsPeter J. Weiden, MD, discusses the latest Cobenfy data and implications for schizophrenia treatment.
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Key Takeaways and the Future of Narcolepsy TreatmentAn expert panel concludes the discussion by reviewing factors to consider when diagnosing and treating narcolepsy.
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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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Apps for Suicide Prevention: What the Research SaysA review of smartphone tools for suicide prevention and recommendations for clinicians.
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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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The Science, Ethics, and Art of Disclosing a Dementia DiagnosisHow can you communicate the diagnosis in a way that relieves suffering and helps patients and their caregivers prepare for the future?
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Post-Acute Sequelae of COVID-19 Infection Presenting With Neuropsychiatric Symptoms: Diagnosis and ManagementIn this CME article, learn more about the common neuropsychiatric sequelae of post-acute sequelae of COVID-19, the underlying neurobiological mechanisms, and evidence-based treatments and interventions.
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Introduction: Meeting Our Personal and Professional GoalsBy building a practice model that we enjoy, it enhances our ability to “cure sometimes, treat often, and comfort always.”
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Advances and Challenges in Treating Alcohol Dependence With PharmacotherapyAlcoholism is a chronic and serious disorder with often devastating consequences. One out of three families in the United States is negatively impacted by a family member's excessive drinking and painful drinking-related problems.
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The Patient-Physician BondDuring my medical training in the early 1980s, I attended a Grand Rounds on health care reform. Sleep-deprived physicians-in-training are easily conditioned to snooze upright in their auditorium seats, and economics is not an interest of choice for me, but when the speaker told us that there would be no solution to rising health care costs except to fracture the bond between patient and doctor, I found myself engaging in nightmarish fantasies that in subsequent decades have come true.
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Risk Management for the Supervising PsychiatristThe need for expert supervision of residents and other health professionals by psychiatrists is growing as a result of the increased demand for accountability by third parties and the expanded number of clinical specialists seeking supervision in psychiatry. The Accreditation Council for Graduate Medical Education has placed professional competency of graduating residents in the national spotlight, and insurers are increasingly scrutinizing patient care provided by trainees and oversight provided by their supervisors.
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Psychedelic Medicine: New Evidence for Hallucinogenic Substances as Treatments (2 volumes)The use of psychedelic plants and drugs in psychiatric medicine has been a promise for more than half a century, suppressed by a draconian legal response to the epidemic of drug abuse in the 1960s. This 2-volume work seeks to reverse the suppression of scientific inquiry in this field by bringing together a comprehensive airing of the topic.
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The Supportive Component of PsychotherapyIn view of the fact that support is an important aspect of all models of psychotherapy, it is remarkable that beginning practitioners are not taught how to be supportive. Only limited attention has been paid to discussion of the principles underlying supportive interactions. It seems to be taken for granted that good sense, kindness, innate empathy and life experience will enable psychotherapists-and physicians in general-to meet their patients' needs for support by communicating interest, liking and understanding. Just as the literature on psychoanalysis is a source for much of what we know about the expressive component of therapy, the limited literature on supportive psychotherapy is a source for ideas pertinent to the supportive component.
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Topiramate and Heavy Drinking: Implications for Personalized MedicineVery few heavy drinkers receive treatment and fewer still are prescribed medications with demonstrated efficacy. Here, a summary of current research, key takeaways, and highlights from a study on topiramate treatment for heavy drinkers by the lead author of that study.
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Challenges and Obstacles in Treating Mentally Ill Black PatientsAs the United States becomes more culturally, racially, and ethnically diverse, psychiatry will be faced with the need to treat more diverse populations. This article focuses on challenges and obstacles encountered when treating black patients with mental illness.
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Progress and Promise: Research and Education in Psychosomatic MedicinePractitioners understand the wholeness and unity of their patients. Instead of being considered isolated organ systems or enzyme cycles, patients are understood as coherent entities composed of coordinated and interrelated processes and systems. This fundamental understanding guidesinvestigative and clinical care approaches in psychosomatic medicine.
