Psychiatric Times Vol 24 No 9

From a research perspective, it is always a joy when molecular mechanisms that were first characterized in petri dishes are confirmed inside a living animal. As molecular techniques have become more sophisticated, such dual results are increasingly commonplace. This month's column is about just such an achievement and takes its cue from a topic I considered in last month's article.

Department of Defense (DOD) medical centers, community hospitals, and clinics throughout the United States were tasked with hiring 44 "contract" psychiatrists over the summer as a response to growing concerns about inadequate mental health care for soldiers in Iraq and Afghanistan and those returning home.

There are occasions in which one's best psychotherapeutic efforts are not effective or help only modestly. If the effort has taken place for a relatively long period, the therapist has several options. One is to ask a colleague for consultation. A second is to reexamine one's understanding of the patient's dilemma.

In our presentation at the 2006 annual meeting of the American Academy of Child and Adolescent Psychiatry, we suggested that child psychiatrists who come across a child with the profile of the following hypothetical case should consider whether the child may have deficits that are not currently covered by DSM-IV nosology: either a nonverbal learning disability (NVLD) or a sensory processing disorder (SPD).

An item in the Boston Globe recently caught my eye. Apparently, a man who was fired by a large corporation for visiting an adult "chat room" while at work is suing the company. The man is claiming he is an "Internet addict" who "deserves treatment and sympathy rather than dismissal." Another item reported recently concerned a lawyer who argued that her client was not responsible for a rampage that he had committed because he "had been obsessed with comic book superheroes as a kid."

This May, the FDA called for a black box warning on antidepressants to indicate that patients aged 18 to 24 years are at heightened risk for treatment-emergent suicidality. But a member of the FDA advisory committee that recommended that warning has issued his own warning, saying that the "real killer in this story is untreated depression and the possible risk from antidepressant treatment is dwarfed by that from the disease."