Psychiatric Times Vol 23 No 4

Neuropsychiatry: A Renaissance

April 01, 2006

The 5 papers in this Special Report on neuropsychiatry provide compelling evidence for the renaissance of neuropsychiatry as a clinical discipline. Wehave every reason to hope that this will lead to a better understanding of the complex interactions between brain and behavior and will reduce the artificial distinction between neurology and psychiatry.

RVUs-Whose Value Is It, Anyway?

April 01, 2006

There is no shortage of evidence for the notion that society places a low value on the treatment of mental illness. Have psychiatrists bought into the attitude that mental health is less valuable than physical health?

DTC Ads Linked to Rise in Drug ‘Scripts for Teens

April 01, 2006

Prescriptions for psychotropic drugs for adolescents increased by 250% between 1994 and 2001. Researchers note that this trend coincides with the 6-fold increase in direct-to-consumer drug advertising.

Child and Adolescent Psychiatry: Update on the Antidepressant Controversy

April 01, 2006

A black box warning about increased suicidality in pediatric patients is now required for all antidepressant medications. This column reviews a number of studies on this topic that were published after the FDA advisory was issued.

Exploring Phantom Limb Pain

April 01, 2006

First described more than 500 years ago, phantom limb pain affects as many as 50% to 80% of patients who undergo amputation. Although it is easy to recognize and diagnose, its cause remains unclear, it can be difficult to manage successfully, and health care professionals often do not address it.

Diffusion of Medical Innovation

April 01, 2006

In the late 18th century, a French surgeon named Pouteau performed 120 successive lithotomies with an extraordinarily low mortality rate. His secret was the use of innovations used widely today. Why weren't his methods more widely adopted by other physicians in his time?

Neuropsychiatric Aspects of Traumatic Brain Injury

April 01, 2006

Each year, more than 2 million individuals in the United States sustain a traumatic brain injury. Increased vigilance for previously undiagnosed or incidental TBIs in general mental health populations may lead to more effective clinical management.

Treatment Challenges in Schizophrenia: A Multifaceted Approach to Relapse Prevention

April 01, 2006

While an antipsychotic medication is the first step of treatment for schizophrenia, it is increasingly recognized that comprehensive care requires the integration of adjunctive therapies and attention to long-term treatment goals.

Gone to Pot: The Association Between Cannabis and Psychosis

April 01, 2006

Cannabis, or marijuana, has been consumed by humans for centuriesand remains one of the most widely and commonly used illicitsubstances. The authors review the evidence supporting and refutingthe association between cannabis exposure and psychotic disorders.

Electroencephalography in Neuropsychiatry

April 01, 2006

The recent evolution of neuropsychiatry/behavioral neurology as a subspecialty represents a paradigmatic shift regarding the responsibility of psychiatrists in diagnosing and managing behavioral disorders with concomitant and demonstrable brain pathology such as dementia or head injury. This authors define the clinical usefulness of electroencephalography in evaluating neuropsychiatric disorders.

Treating Cognition and Function in Patients With Alzheimer Disease

April 01, 2006

The cost-effectiveness of treatment for Alzheimer disease has been questioned. But until the next generation of therapeutics arrives, cholinesterase inhibitors and memantine will probably remain essential components of therapy for cognition and function.

Neuropsychiatric Dimensions of Movement Disorders in Sleep

April 01, 2006

Sleep-associated movement disorders are common in the general population. When patients complain of sleep disturbance, psychiatrists should consider,and question for, features of nocturnal movement disorder.

Antidepressants: Youth Suicide Warnings Increasingly Questioned

April 01, 2006

The FDA advisories warning of increased suicide risk among children and adolescents beginning antidepressant therapy have alarmed the health care community--but it may actually be a disservice to withhold these medications from those who need them.

What Role Does Serotonin Play in PTSD?

April 01, 2006

As many as 90% of Americans are exposed to at least one traumatic event in the course of their lives. Many more are exposed to more than one traumatic event. Short- and long-term sequelae of traumatic exposure vary greatly and range from complete recovery, to severe and debilitating PTSD.

Breast Cancer: What Psychiatrists Need to Know

April 01, 2006

Many of our female patients are more worried about breast cancer than heart disease. Because psychiatrists will almost certainly care for patients who have a history of breast cancer, Dr Riba reviews some of the major issues to consider.

Stalkers and Their Victims

April 01, 2001

"Stalking" is defined as repeated and persistent unwanted communications and/or approaches that produce fear in the victim. The stalker may use such means as telephone calls, letters, e-mail, graffiti and placing notices in the media. A stalker may approach or follow the victim, or keep their residence under surveillance.

Single Payer? Yes, But. . .

April 24, 2006

The authors argue that adopting a single payer system would be like jumping out of the fire and into the frying pan. They look at three perspectives-the doctor's, the patient's and the health care policy-maker's.