Psychiatric Times Vol 24 No 5

The comorbidity of anxiety disorders with bipolar disorder is a rule, not an exception, with a negative impact on both course and treatment outcome. So far, there are no guidelines or consensus for the treatment of this comorbidity.

A recent 16-week, randomized, double-blind, placebo-controlled trial found that treating children and adolescents with metformin (Glucophage, Fortamet) may help curb the weight gain and decrease the insulin sensitivity and abnormal glucose metabolism that often results from atypical antipsychotic use.

In the past few years, a great deal of information has been learned about how the brain processes ambiguous information. Data exist that allow us to view what the brain looks like when we are deliberately trying to deceive someone. In response, a number of corporations have been established that use these data--and the imaging technologies that gave them to us--to create brain-based lie detectors.

This article focuses on 4 issues in psychiatric malpractice: prescribing, liability for suicide, informed consent, and duty to protect under the Tarasoff v Regents of the University of California ruling. Malpractice is a civil wrong actionable by law. There are 2 goals of malpractice suits: the first is to make an injured plaintiff whole by an award of money, and the second is to inform the profession how courts will decide similar cases in the future.

Recent discoveries in neuroscience have ramifications for all aspects of clinical and forensic practice, including diagnosis, treatment, and testimony in civil and criminal justice cases.

Unlike a pure psychiatric disabilityevaluation, mental and emotionaldamage claims require anassessment of causation. Today, treatingpsychiatrists are increasingly asked toprovide this assessment, since mentaland emotional damages are widelyclaimed in the United States as a remedyin legal actions.

Paraphilias are defined by DSM-IV-TR as sexual disorders characterized by "recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving (1) nonhuman objects, (2) the suffering or humiliation of oneself or one's partner, or (3) children or other nonconsenting persons that occur over a period of 6 months" (Criterion A), which "cause clinically significant distress or impairment in social, occupational, or other important areas of functioning" (Criterion B). DSM-IV-TR describes 8 specific disorders of this type (exhibitionism, fetishism, frotteurism, pedophilia, sexual masochism, sexual sadism, voyeurism, and transvestic fetishism) along with a ninth residual category, paraphilia not otherwise specified (NOS).

Each year, the CDC's National Center for Health Statistics creates a report on the current health status of the US. In addition to the issues usually addressed in this report, such as information on morbidity and mortality, vaccination rates, and use of health care resources, the recently released report contained a special feature on pain.

A forensic book with a superb format, clinical wisdom, and eminent readability.

Psychiatric Reporter:Insomnia and Its Risks: Causes, Consequences and Treatment

Psychiatric Reporter: Breaking the Frontier: Update on Etiology and Treatment of Alcohol Abuse and Dependence