The American Psychiatric Association has developed a sweeping vision for reforming mental health care in the midst of a fiscal crisis that it says threatens a wholesale collapse of the system. The plan calls for an investment in mental health services equal to the level of disability that mental disorders cause, an end to behavioral health carveouts and better integration between psychiatry and primary care.
An increasing amount of systemic research has galvanized opinions regarding pediatric-onset bipolar disorder (BD). Although originally thought to be a rare condition, the number of pediatric-onset BD diagnoses is rising. This article summarizes current thinking regarding pediatric BD, including work focusing on presentation, psychiatric comorbidity and recent treatment data
The use of alternative treatments--like acupuncture, homeopathy, herbs, dietary supplements--for postpartum depression is becoming widespread. Dr. Hendrick discusses the benefits and risks of these alternative treatments and research that is being done to ensure their safety for new mothers
Rather than looking at the biological basis for depression, it may be more useful to look at the patient's worldview and how that may have primed them for depression. Examining events that took place in the patient's past lead to a solution to their current depression.
I have been following the ongoing dialogue regarding the Falun Gong movement, and I have been pleased to find that Alan Stone, M.D., is the first psychiatrist to write something approaching the truth about the Falun Gong group (November 2002 Psychiatric Times, p1; April PT, p9).
Now that the HIPPA compliance deadline has passed, it seems as though Congress is no closer to reaching a solution to the issue of patient privacy. What should physician groups such as the American Psychiatric Association be doing to support patient privacy, and are they doing enough?
Erotic transference can be one of the most difficult issues to work through in psychotherapy. What is the history of the understanding of erotic transference, and what factors may play into its emergence in therapy?
Poetry of the Times
With the advent of computer technology, new forms of therapy have emerged that can help patients. How can a virtual reality environment enable patients to overcome panic disorder and agoraphobia, and what are the advantages to such forms of therapy?
One of the more difficult aspects of treating children and adolescents is the issue of aggression. An expert consensus panel convened by the Center for the Advancement of Children's Mental Health at Columbia University and the New York State Office of Mental Health has released a new set of treatment guidelines that should help physicians give the best care possible.
The use of supportive psychotherapy, where the clinician acts as a watchful parent, may be of some use to certain patients as opposed to traditional psychoanalysis. This paper gives some examples of cases in which supportive psychotherapy may be more effective.
Once the potential for violent behavior has been identified in a patient, how should it be dealt with? What steps can the clinician take to ensure the physical and legal safety of themselves and their patients? Furthermore, what are the clinician's legal and ethical responsibilities if the patient does commit a violence act?
Although the prospect of online mental health care raises obvious questions, it also offers an opportunity to make cost effective services available to many who may not otherwise have access. By understanding issues such as confidentiality, emergencies and lack of face-to-face contact, psychiatrists can determine if this area of treatment is right for them.
Poetry of the Times
Confidentiality Under Fire - Poetry of the Times
Stereotypical portrayals of people with mental illness are as old as Hollywood itself. What are some of the clinical implications of the continued stigmatization of the mentally ill in television and film?
Theater, film, literature and poetry are forms of expression that allow artists and their audiences to explore the compelling issues of their lives. By understanding which pieces "speak" to patients and physicians, the dialogue and therapy may be enhanced.
In the wake of the report issued by the Institute of Medicine detailing the number of medical errors each year, the American Psychiatric Association has issued a set of patient safety recommendations. Will these recommendations reduce the number of psychiatric patient deaths and injuries?
The inability to create an accurate picture of self-awareness is a feature in many mental illnesses, such as schizophrenia, autism, ADHD, personality disorders and substance abuse. At a Kansas City, Mo., conference, researchers begin to establish a biological basis for self-awareness and hope to isolate the deficits in the brain that causes abnormal functioning.
Using music as a form of therapy for emotionally disturbed children seems quite natural, given children's innate love of music. How can this form of creativity be used as therapy to help children better communicate feelings and emotions?
In presenting the subject of dangerousness assessments at my hospital, I told a story about my grandchildren that illustrated the fact that we all make such assessments and act on them regularly in various contexts.
With a prevalence of approximately 10% for North American women, vulvar vestibulitis can have enormous quality of life implications for patients and their partners. When gynecologists and other medical specialists have difficulty finding an organic cause for the chronic pain associated with this disorder, patients find themselves referred to the mental health care professional, who must determine the diagnosis and course of treatment
Literature invites readers to see the world from another viewpoint, which can, in turn, lead to an increased capacity for empathy. In working with difficult-to-treat children, Alexandra Helper, MD, has found that the use of literature that focuses on alternative viewpoints helps such patients develop empathy and improve their functioning in the "real world."
Becoming more creative and improvising have certain dynamics that can be used by therapists in fostering a more healing process. Playfulness, imagination, dialogue, skill-building, narrative, inspiration and integration can all be employed in clinical settings. These tools create an environment where spontaneity can arise, anxiety is reduced, and patients are more receptive to their own intuition.
Poetry of the Times
Proponents of mental health care parity have reintroduced the legislation that died in the U.S. House of Representatives last year. While the idea of parity has broad bipartisan support, the debate continues over how much it will cost, who will foot the bill, and how it should best be administered. In a time of war and tight budgets, will the bill get the attention it deserves?
What does the state of psychiatry look like? Surveys have been conducted and data have been broken down into compensation levels, specialties, service costs and insurance coverage. Finally enough data exist to give an overall view of where most psychiatrists stand today in the medical workforce.
Substance abuse and addiction are among the most challenging health problems facing our society. Breakthrough discoveries in science continue to refine our understanding of drug abuse and addiction and are yielding new opportunities to translate basic research findings into tangible treatment products. Read about the progress being made by the National Institute on Drug Abuse, the world's largest supporter of research on the health aspects of addiction.
There are many factors that contribute to patients with schizophrenia not taking their medication, including side effects and lack of education. What can clinicians do to help their patients adhere to treatment? Should clinicians be spending more time educating their patients? How will long-acting medications affect adherence issues?
Although there is no pharmacological agent that has been approved by the U.S. Food and Drug Administration for the treatment of autism, new studies are showing promise in not only discovering the cause of autism, but pharmacological treatments as well.