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10 Salient Points About Migraine and Psychiatric ComorbidityWhere do migraines and psychiatric disorders intersect? Learn more.
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Are Assessment and Treatment Influenced by Ethnicity and Gender?Results from three statewide studies of the clinical practices for assessing and treating children and adolescents with a primary diagnosis of conduct disorder, ADHD or bipolar I disorder demonstrate gender and ethnic differences only for those diagnosed with conduct disorder. The implications of these findings and their similarities to the literature on adults with psychiatric disorders are discussed.
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Nutritional Treatments: The Next Frontier in PsychiatryHere’s how nutrients can ameliorate psychiatric conditions.
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Understanding Child MaltreatmentWithout normative attachment, children can move into their middle years without the tools to succeed in peer relationships, school, and extracurricular activities, opening the door to perils in adolescence.
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Psychiatric Evaluation of Children and Adolescents: It Takes TimePsychiatrists know that it takes longer to interview children and adolescents than adults. Child and adolescent psychiatrists are universally struck by how comparatively easy it is to interview an adult patient, whereas general psychiatrists face the evaluation of a child or adolescent with apprehension.
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A Love of GroupsI am a Registered Nurse of 37 years who has worked in hospice care and psychiatric emergency; I’ve worked as a med/surgical manager and (now) as an inpatient psychiatric nurse. Throughout it all, I most enjoy seeing a patient realize he/she is getting well; I also enjoy conducting small teaching groups to help the patient know how to stay well.
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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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The Psychiatric Dimensions of NarcolepsyNarcolepsy, cataplexy: symptoms are broad and associated with a range of medical and psychiatric comorbidities. Here: diagnostic and treatment strategies and a look at the BOND study.
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Incorporating Well-Being Into Child and Adolescent PsychiatryA well-being centered approach expands assessment and treatment for the child’s strengths and opportunities for positive experiences with the family.
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Diagnosis and Treatment of Delirium in 2006Delirium must be diagnosed accurately, prevented, and treated because of its pervasiveness and the associated risks of morbidity and mortality.
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GREAT EXPECTATIONS A Warm Welcome to 21st Century PsychiatryIn the last third of the 20th century, psychiatry boldly shook off a 120-year-long philosophical funk and rushed to catch up in the thrilling march of medicine. The biopsychosocial model that once sounded trendy now seems to be an indispensable approach. The pioneers of psychopharmacology who once labored at the margins have now been joined by thousands of bright young doctors who treat patients with depression, psychosis and impulsive aggression and realize that a troubled soul is often expressing the cries of a troubled brain. This issue of Psychiatric Times celebrates the stirring giant that is 21st-century neuropsychiatry--a discipline that derives its immense power and scope from the glad embrace of the twin Enlightenment ideals of humanism and the scientific method.
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Lhermitte-Duclos Disease or Neoplasm?A 5-month-old girl was brought to her local emergency department because she displayed increasing fussiness and back arching for 3 days. She vomited once and was febrile on the day of presentation. Meningitis was suspected. A lumbar puncture was performed. It revealed a cerebrospinal fluid (CSF) protein level of 120 mg/dL and a CSF white blood cell count of 10/µL, with 50% polymorphonuclear cells. Antibiotics were empirically administered, and the infant was transferred to a tertiary care facility for further treatment.
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Addiction Resource Guide: An Internet Publishing AdventureA psychiatrist took his expertise in addiction medicine and coupled it with his desire to start a business. An addiction treatment facility clearinghouse, this Internet venture provides consumers with the opportunity to compare and contrast different treatment centers to find the one best suited to their needs.
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POTUS, Politics, & Neuropsychiatric Assessment: What Do We Need to Know and When Do We Need to Know It?Where do we draw the line on level of impairment for our presidential candidates?
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Addiction Is a ChoiceMany activities that are not themselves diseases can cause diseases, and a foolish, self-destructive activity is not necessarily a disease. When we find a parallel between physiological processes and mental or personality processes, we can mistakenly assume the physiological process is what is really going on, and the mental process is just a passive result of the physical process.
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Management of Mild Traumatic Brain InjuryA considerable overlap exists between TBI and disorders in cognition, behavior, and personality, which can provide even greater clinical challenges. More than 70% of the cases of TBI are mild, which makes this subgroup of particular clinical interest.
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Traumatic Brain Injury in Children and AdolescentsTraumatic brain injury (TBI) in children and adolescents is a major public health problem. Psychiatrists have a crucial role in the management of young persons who have a TBI.
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Beyond AddictionThe authors of this book leave readers feeling empowered, knowing that they can be an important driver of change. It also reminds psychiatrists about some core components of the patient experience.
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Late-Life Depression, Dementias- Top Educational Priorities for AAGPLack of energy, recurrent thoughts of death and difficulty with concentration are viewed by more than half of medical decision-makers in families as natural components of aging rather than as symptoms of clinical depression, according to a Louis Harris and Associates survey. Additionally, 93% of all adults polled said they believe depression is a normal side effect for those suffering from a medical condition.
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Childhood Adversities Associated With Risk for Suicidal BehaviorChildhood adversities associated with suicide risk include childhood maltreatment, problematic family relationships, socioeconomic hardship, and difficult relationships with peers. Acute suicide prevention strategies should focus on the treatment of contributory psychiatric disorders and on the crises that may precipitate suicidal behavior.
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Introduction: Navigating the Waters of Digital TechnologyModern communication capacities have the potential to decrease or to increase stigma and the isolation of persons with serious mental illness. Psychiatrists especially need to know how to navigate these largely uncharted waters.
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To Supplement or Not to Supplement: That Is the Bipolar Depression QuestionWith the multitude of nutritional products available to patients via the Internet and health-food stores, psychiatrists need to be prepared to respond to questions from patients about the value of these supplements.
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Family Involvement in Cognitive-Behavioral Therapy for Children’s Anxiety DisordersCognitive-behavioral therapy (CBT) for children with anxiety disorders may be especially effective when the family is included in treatment.
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Shooting for What I Want, Part 2How time flies! It has been more than a year since my last column, when I staked my claim in psychiatry. I planned to eschew the medical rat race and find my own little piece of medicine as it used to be, when doctors were doctors, nurses were nurses, and insurance salespeople were . . . salespeople. Should one read anything into the long delay between that column and this one? Absolutely! But I'll get to that.
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Evolving Issues in Correctional PsychiatryThere is no disputing that the rapidly escalating rate of incarceration during the past decade in the United States has been associated with an increasing number of imprisoned individuals with a mental illness. Research indicates that as many as 20% of inmates in jail or prison are in need of psychiatric care, frequently because of a serious mental disorder.
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Dopamine Receptors in the Human BrainDopamine plays an important role in controlling movement, emotion and cognition. Dopaminergic dysfunction has been implicated in the pathophysiology of schizophrenia, mood disorders, attention-deficit disorder, Tourette's syndrome, substance dependency, tardive dyskinesia, Parkinson's disease and other disorders.
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Can We Predict Response to Antidepressants?In this article, we use the example of major depressive disorder (MDD) to review research efforts to identify predictors of treatment response, both to antidepressant medications and to psychotherapy. We describe the promises and limitations of this research, with some emphasis on brain imaging studies, and then discuss how this work may be integrated into clinical practice in the future.
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Consumer Advertisements for Psychostimulants in the United States: A Long History of Misleading PromotionThe prescription of psychotropic medications for children continues to be a controversial area of medical practice. In the United States, academic medical centers, medical researchers, prescribers, and the FDA are all ostensibly committed to the common goal of disseminating accurate information and promoting treatment based on scientific evidence. In the United States, however, medical treatment takes place in the context of legal and pervasive direct-to-consumer advertising (DTCA). There are concerns about the potential for DTCA to affect public health negatively and to increase health care costs.
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Psychiatry on the EdgeAt a time when our field is under attack from many quarters, it is critically important to be able to discuss what it is that we do as psychiatrists in a non-defensive and intellectually rigorous manner. Help here.
