Psychiatric Times Vol 21 No 4

Assessing and treating patients with suicidal behavior is not an easy task. Acts of suicide cannot be predicted; the best a psychiatrist can hope for is the ability to identify a patient's risk factors and reduce them. With the publication of a new practice guideline, it is hoped that psychiatrists will be better equipped to deal with this particularly vexing challenge.

Psychological debriefing is a popular crisis intervention designed to alleviate immediate distress and prevent posttraumatic psychopathology following exposure to traumatic events. Despite a flourishing "debriefing industry," the author argues that there is no convincing evidence that it prevents posttraumatic psychopathology.

One of the spin-offs of the consensus statement is a study of the risk for metabolic disorders with antipsychotic use in children and adolescents. Here, the lead researcher discusses some of the group's initial findings.

Community awareness of traumatic events and their effects on individuals has increased in the last decade. The articles in the special report section of Psychiatric Times enhance our appreciation of the divergent research and clinical efforts being made assist those who have suffered from the consequences of trauma and its aftermath.

With proposed cuts in state budgets nationwide, social services--including mental health care--are taking a financial blow. As a result, mental health care facilities are closing and services are disappearing. What will the effect be on patient care?

For decades, personal essays on ECT highlighted pain and discomfort, a dismaying loss of memory, and an indifference of practitioners who forced the treatment on unwilling patients. The attacks on ECT by popular writers in the press and in film drowned out the voices that described its benefits. However, the public testimony has slowly changed toward a greater acceptance of ECT; it is time to hearken to the testimony of these witnesses and roll back the unethical restrictions that commit our most disadvantaged citizens to unnecessary chronic illness, prolonged hospital care and even death.

In the wake of the Columbine school shootings, it is of utmost importance for psychiatrists to be aware of the role they can play in preventing violence and bullying in our schools. What programs have been tried and how have they fared? What are the elements for a successful program?

The distress and functional impairment associated with PTSD may make it difficult for IPV victims to benefit from interventions to increase their safety and reduce their exposure to violence. Empirically supported PTSD treatments include pharmacotherapy and cognitive behavioral therapy. Incorporating these treatments into interventions to improve victims' safety and reduce exposure to violence may improve their effectiveness in protecting women from IPV.

A new consensus statement has been issued regarding the high risk of diabetes and associated disorders with use of atypical antipsychotics. Several of the major pharmaceutical companies have responded negatively to this statement.

How is it that anti-anxiety drugs can cause anxiety and insomnia, sometimes within the first day or two of treatment? These are not the soothing qualities we expect for anti-anxiety medications.

Little attention has been paid in the professional literature to a phenomenon that non-professionals have recognized since ancient times: Trauma can lead to personal growth. This article focuses on how traumatic events set processes in motion that produces new perspectives on the self, relationships and philosophy of life. Implications for clinical work with trauma survivors are discussed.

Individuals exposed to horrifying, life-threatening events are at heightened risk for posttraumatic stress disorder. Given the substantial personal and societal costs of chronic PTSD, mental health care professionals have developed early intervention methods designed to mitigate acute emotional distress and prevent the emergence of posttraumatic psychopathology.

There is a long tradition in psychiatry, reaching at least back to World War I, of studying the response of people who are faced with traumatic circumstances and devising ways to restore them to psychological health. The main focus of this work has been on the ways in which traumatic events are precursors to psychological and physical problems.

We waited for the broken and the burned.