Psychiatric Times Vol 27 No 2

Bottle of Pink Lemonade

February 02, 2010

Like every new resident just starting to work in an outpatient clinic, I was nervous about the patients I would inherit from the graduating resident. It did not help when the graduating resident warned me that one particular patient “could be difficult.” I comforted myself with the thought that every psychiatric patient has a “difficult life” and that is why they need our help.

Young Adult Mental Health

February 02, 2010

The young adult years (18 to 29) are a critical time of transition, and they present unique challenges in regard to mental health issues and development. Until recently, most research has focused either on children and adolescents or adults. Grant and Potenza’s Young Adult Mental Health is a comprehensive text for clinicians and researchers who work with persons in the transitional period of young adulthood.

Senate Committee on Aging Holds Hearing on Industry-Supported CME

February 03, 2010

A recent Senate hearing on conflicts of interest (COIs) in medical education and research revealed that the tri-committee health care reform bill requires public disclosure of pharmaceutical company payments to several health entities, that the removal of industry-sponsored symposia by the American Psychiatric Association (APA) cost it $1.5 million in revenues, and that the Accreditation Council for Continuing Medical Education (ACCME) is expanding its requirements and enforcement actions.

Hopeful Signs of Increased Emphasis on Mental Health Issues

February 07, 2010

A major speech on mental health from Health and Human Services (HHS) Secretary Kathleen Sebelius and the ascension of a new administrator at the Substance Abuse and Mental Health Services Administration (SAMHSA) have sparked hopes that the Obama administration is putting increased emphasis on mental health issues. Buoying those hopes further is the fact that the White House has recruited notable mental health advocates in other top positions, such as Richard G. Frank and Sherry A. Glied, authors of the book Better But Not Well: Mental Health Policy in the United States Since 1950. Glied has been nominated as assistant secretary for planning and evaluation at the HHS. Frank is her deputy for disability and mental health policy.

An Unusual Side Effect

February 07, 2010

Celeste, one of my patients, a woman in her mid-30s, unexpectedly had a seizure, fell, and hit her head while at work. She was rushed to a nearby emergency department (ED) where results of laboratory work, an EEG, and an MRI confirmed that she had had a seizure but did not show a cause.

A New PsychiatricTimes.com: What’s In It for You?

February 07, 2010

I invite you to log on and have a good look around at the topic centers filled with clinical information on more than 100 psychiatric disorders. You’ll find the latest psychiatric news, clinical guidelines, details about ongoing clinical trials (for which your patients might be eligible), and patient education information. You’ll find podcasts on topics that range from ethical dilemmas to ways to market your practice. You’ll find archival and brand-new content from Psychiatric Times, and links to our 10 most popular articles. You can earn CME credits and access a number of psychiatric clinical scales. You’ll find classified job listings and details about our upcoming virtual career fair this spring. The site is also home to SearchMedica.com-a search engine specifically designed for psychiatrists and mental health professionals. And if you are moved to post your thoughts and comments about various articles, you can register and do so easily now.

Learning to Do Psychotherapy With Psychotic Patients: In Memory of Elvin Semrad, MD

February 05, 2010

Dr Elvin Semrad was a much-loved psychiatrist and psychotherapy supervisor who had a profound influence on hundreds of psychotherapists and psychoanalysts in the Boston area. One of his unique qualities was his ability to connect empathically with even the most psychotic patients. He supervised at Boston State Hospital and then for 4 decades at the Massachusetts Mental Health Center (MMHC) in Boston, where he conveyed his strong conviction that psychotic and other seriously men-tally ill patients could benefit from long-term psychoanalytically oriented psychotherapy.

A Serious Man

February 03, 2010

A Serious Man-a film that explores their Jewish roots in Minnesota. Not roots in the genealogical or autobiographical sense but from a removed and more philosophical perspective-what does it mean to be a Jew, both as a matter of social identity and as someone who is supposed to believe in God or Hashem, the word religious Jews invoke so as not to take the name of the Lord in vain. Hashem will roll so glibly off the tongues of the Coens’ Jews, it will seem more like affectation than piety.

Medical Marijuana: The Institute of Medicine Report

January 06, 2010

The most rigorous scientific review of “medical marijuana” to date was carried out by the Institute of Medicine in 1999, under the direction of Drs John A. Benson Jr and Stanley J. Watson Jr.1 The institute’s conclusions were considerably more nuanced and qualified than those of the US Drug Enforcement Administration.2 The institute report found that:

The Good Psychiatry Does: A Brief Review

February 02, 2010

In 2 previous editorials-“The ‘McDonaldization’ of Psychiatry” and “Doctor, Are You ‘Drugging’ or Medicating Your Patients?”-I focused on some serious problems in current psychiatric practice and on various shortcomings in our treatments. In the third “panel” of this editorial triptych, I want to take note of the considerable good that psychiatric treatment may bring to those who suffer with devastating illnesses.

The Patient-Physician Bond

February 05, 2010

During my medical training in the early 1980s, I attended a Grand Rounds on health care reform. Sleep-deprived physicians-in-training are easily conditioned to snooze upright in their auditorium seats, and economics is not an interest of choice for me, but when the speaker told us that there would be no solution to rising health care costs except to fracture the bond between patient and doctor, I found myself engaging in nightmarish fantasies that in subsequent decades have come true.

Anorexia and Brain Imaging

February 05, 2010

Recent multiple brain imaging studies of patients with restricting-type anorexia nervosa (AN) reveal neurocircuit dysregulation and may help clarify the disorder’s confounding symptoms.

New Recommendations for Treatment of Schizophrenia

February 06, 2010

Newly published recommendations for pharmacological and psychosocial treatments from the Schizophrenia Patient Outcomes Research Team (PORT) are the first to address related treatments, such as smoking cessation, substance abuse, and weight loss, and they are the first update since 2003.

Boundaries and Benefits of Psychotherapy

February 06, 2010

In this essay I give my views on the boundaries of individual psychotherapy-their necessity and the process of learning them, accepting them, then gaining from and leaving the therapy process. For me, the learning process was long, and I realize now how I had to internalize a number of new concepts for the therapy to succeed. After much thought and work, therapy was beneficial and rewarding for me. I now know that because I took the process of psychotherapy seriously, it made my life more fulfilling and my relationships more meaningful. For me, psychotherapy was especially helpful in reinforcing my ability to deal with a chronic, debilitating, and life-threatening illness. It helped me make each day a gift, accept my imperfections, and live with uncertainty, frustration, and anger with more dignity and greater understanding.

Crime, the Hippocampus-and the Lingering Eye

February 05, 2010

Let’s say you’re in a crowded bar when somebody suddenly shoots at a patron. You clearly see a man carrying a firearm, but all hell breaks loose as you and everybody else scramble for the exits. In the terrifying seconds following the crime, you lose track of who discharged the firearm: it could have been 1 of 3 suspects. Afterward, the police interview you, but it is hopeless. Even bringing in the suspects for a lineup isn’t going to help you recall. There will be no “Perry Mason” moments, when the perpetrator breaks down under the weight of guilt and confesses to the crime. How can the authorities make an arrest?