Psychiatric Times Vol 21 No 8

Budget Cuts Continue to Threaten State Medicaid Programs

August 01, 2004

With states set to lose their one-time fiscal relief in June, mental health care services are bound to be hard-hit, particularly for Medicare. What services are the most likely to be cut and how will this affect Medicare beneficiaries?

Treating Eating Disorders: the Pitfalls and Perplexities

August 01, 2004

Patients with anorexia nervosa often attempt to deceive health care professionals because they do not want treatment for their disorder. Thus, physicians must maintain a high index of suspicion for signs and symptoms of AN due to its potentially fatal complications.

New Knowledge and New Conceptions

July 01, 2004

Our evolving understanding of borderline personality disorder and its treatment includes the surprising evidence that this disorder has more significant genetic determinants and many patients have a far better prognosis than had previously been thought. Treatment approaches have also become less intensive and more diverse and specific. This is a disorder that, despite the considerable gains, remains one of psychiatry's most vexsome problems and one of society's major health care priorities.

Psychodynamic Psychotherapy for Personality Disorders

July 01, 2004

There has been a significant shift from the view that personality disorder is untreatable; we do have treatments that have at least some efficacy and one of these is psychoanalytic psychotherapy. Evidence from randomized trials has shown that it is effective in treating borderline personality disorder, and follow-up studies confirm that the gains are robust.

Borderline Personality Disorder: An Overview

July 01, 2004

Borderline personality disorder is a complex, disabling disorder. The chairperson for the American Psychiatric Association workgroup for the evidence-based practice guideline on its treatment gives an overview of this disorder's etiologies, neurobiology, longitudinal course and recommended treatments. Future directions for both treatments and research are also discussed.

Beyond 'Handholding': Supportive Therapy for Patients With BPD and Self-Injurious Behavior

July 01, 2004

Can supportive therapy be modified to successfully treat patients with borderline personality disorder? By using a previously developed model, NIMH-funded researchers have found supportive therapy helpful in engaging patients in treatment, developing a therapeutic alliance and achieving treatment goals. Their outcome data may provide a new treatment approach for this difficult-to-treat population.

DHEA Lessens Depressive Symptoms, NIMH Study Shows

July 01, 2004

In many preliminary studies, including one presented at the recent 2nd World Congress on Women's Mental Health, the naturally occurring steroid dehydroepiandrosterone has been shown to be an effective treatment for mild-to-moderate midlife depression. Questions remain, however, as to its mechanism of action, the risk of side effects and its interactions with medications.

Assessing Suicide Risk in Patients With Borderline Personality Disorder

July 01, 2004

Patients with borderline personality disorder are at a much higher risk for suicide attempts than patients with almost any other mental illness. Here, a case report and examples are presented to help clinicians assess, diagnose and treat patients with BPD who have attempted or are threatening suicide.