The patient, a young gay man who once lived for a time in Salt Lake City, describes his pursuers: Mormons who know where he is and are trying to kill him. As the clinic visit goes on, I see the doubt in his eyes when I explain my medication increase, and ask about it. He admits he can't be sure; his voices are saying that I'm a Mormon too. Only, with much persuasion and oversight will he comply with my prescription, because he trusts his case manager more than anyone else in the world.
Supreme Court Decision Raises New Ethical Questions for PsychiatrySeptember 1st 2002
The U.S. Supreme Court's decision on Atkins v. Virginia has transformed the capital punishment landscape for the mentally retarded. This decision also marks an important step in evaluating the competency of death row inmates of any mental capacity. What could be the future outcomes of this landmark decision?
Attendees Consider New Therapies At Annual American College of Neuropsychopharmacology MeetingSeptember 1st 2002
Noting the frequent unresponsiveness of posttraumatic stress disorder (PTSD) to standard drug treatments, Stein and colleagues reported results of the first double-blind, placebo-controlled trial of an adjunct to selective serotonin reuptake inhibitors for the treatment of this disorder.
Help for Psychiatrists Who Lose a Patient to SuicideSeptember 1st 2002
Beyond the threat of malpractice suits, losing a patient to suicide can be one of the most profoundly disturbing experiences of psychiatrists' professional careers. Yet, there is sparse literature on the occurrence and scant attention given to it in residency training programs (Gitlin, 1999).
Weight-based dosing strategies have been used in psychostimulant studies for ADHD in children between the ages of 6 and 12 years. The efficacy of weight-based psychostimulant doses changes throughout early childhood and into adolescence in ways that are not in keeping with weight-based dosing practices. Future treatment and research must explore new possibilities in order to afford patients the most benefit for the least amount of effective drug intervention.
Depressive Disorders in Adolescents: Challenges in DiagnosisSeptember 1st 2002
Many adolescents experience depressive symptoms and some have episodes that go beyond transient feelings. Risk factors and predictive strategies are thwarted by the power of individual differences. Communicating with patient families; using the available innovative pharmacological, diagnostic and behavioral tools; and individualizing treatment approaches can improve outcomes.
Behavioral Issues in Pediatric EpilepsySeptember 1st 2002
Epilepsy is one of the most common chronic neurological disorders of childhood. Therapy should consist of education to reduce fears and concerns, psychotherapy to decrease triggers for seizures, and careful medication monitoring to avoid those drugs that reduce seizure threshold or have excessive interactions with antiepileptic drugs.
Catatonia in Adolescents and ChildrenSeptember 1st 2002
Catatonia is found in at least 10% of patients admitted to acute psychiatric services, so any young patient with stupor, unexplained excitement or persistent motor signs should be formally assessed for this syndrome. From among the 20 to 40 now-identified features of catatonia, its proper diagnosis must be differentiated from other mental illnesses.