In addition to improving patients' emotional well-being, aggressive treatment of psychiatric illnesses such as depression can substantially increase patients' cognitive functioning and even decrease mortality. A growing number of psychiatrists and other medical doctors are joining forces to create integrated care settings where the diagnosis and treatment of mental disorders occurs alongside that of physical illness.
Can brain scans show a difference between drug therapy and psychotherapy? A researcher at University of California at Los Angeles uses positron emission tomography to observe the difference in brain changes between these two types of treatment for major depression.
Since adolescent patients often retreat into fantasy worlds of their own making, they can be difficult to treat. Psychotherapists can create a common fantasy world for successful group therapy with the use of popular fiction books, television series and movies.
After the recent decade of the brain and in the present era of evidence-based practice, psychoanalytic treatment of personality disorder is being challenged.
Is consent necessary for medical records to be utilized for treatment, payment and health care operations? The medical records privacy rule demands it. Will prepayment and postpayment audits by insurance companies be cut back? The Medicare Education and Regulatory Fairness Act of 2001 is an attempt to solve this and other issues.
With so many Americans lacking appropriate health care insurance and so much of the large insurance companies' premiums going to overhead and profit, it makes sense to move forward with a single payer system. The author discusses some of the basic features of a proposed system.
Poetic License - Poetry of the Times
Carveout programs for behavioral health care are becoming more common. Who do they benefit3/4the patient, the doctor or the insurance company?
Stephen R. Shuchter, M.D., professor of clinical psychiatry and associate director of residency training at University of California, San Diego, spends his "down" time performing as Elvis and other rock 'n' roll legends. In these efforts, he expresses his creativity and brings delight to those he entertains. Lessons from each "career" have helped his success in the other.
Stemming from evolutionary man and his simple, primitive act of help in exchange for help and Darwinian theory, Paul Genova, M.D., discusses the role reciprocal altruism plays in the "helping profession" of psychiatry.
Is there a difference between bifrontal, bitemporal and right unilateral? In addition to talking about other research into optimal strength and electrode placement, Max Fink, M.D., outlines some of his own ongoing research.
This is the second part of an article series discussing the high risk of suicide attempts in patients with schizophrenia. Herbert Y. Meltzer, M.D., continues the discussion with treatment options and efficacy.
Evidence is accumulating that untreated depression can impede comorbid medical treatment and increase mortality. The author reports on the latest research and treatment recommendations for depression that accompanies cardiovascular disease, stroke and Parkinson's disease.
Nonverbal cues speak just as loudly as words. How can video be used to capture these subtle cues and help patients make progress in therapy?
If You Ask Me My Name - Poetry of the Times
It was supposed to only take 100 days, but that was eight years ago. When President Bill Clinton took office in January 1993, an air of expectancy permeated Washington, D.C.'s stuffy corridors, and for a moment it seemed as if the world's most developed nation would finally have a national health care policy.
Dr. Usdin steps down from his role of Psychiatric Times' book review editor after 11 years of service.
There are two goals in the acute treatment setting (e.g., emergency department): initiation of treatment and reducing the symptoms of agitation and aggression that frequently accompany an acute psychotic breakdown. Treatment options and considerations are reviewed.
The FDA approved two new intramuscular, immediate-release formulations of atypical antipsychotics. Both olanzapine (Zyprexa IM) and ziprasidone (Geodon IM) were recommended as safe and effective for the treatment of agitation in patients with schizophrenia.
The SSRIs have become the most widely prescribed antidepressants in the United States. With this increased use has come more information on adverse events associated with their use, such as sexual dysfunction. However, movement disturbances associated with SSRI use can adversely impact treatment. This article explains the pathology of movement disorders and describes confounding variables such as other medications, pre-existing neurological insults and the nature of case reviews. Those at risk include the elderly, patients taking neuroleptics and those exposed to high levels of SSRIs.
A groundbreaking program at UCLA goes into inner-city schools to help students work through trauma. By learning how to deal with the trauma itself and reminders of the trauma, students are able to improve their academic and social performance.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, and it may manifest as mood disturbances in those affected. How can this medical condition be treated in women who have bipolar disorder?
In examining the demographics of a state Medicaid population, we found that members of ethnic minorities, rural residents, women, and patients aged 45 years and older were more likely to receive first-generation antipsychotic medications than the newer, second-generation agents, which have a more favorable side-effect profile.
Patients with schizophrenia have a high risk of committing suicide. Between 25% and 50% attempt suicide at least once, resulting in approximately 3,600 successful attempts each year in the United States. What are the risk factors for suicide one should look for in treating patients with schizophrenia? Herbert Y. Meltzer, M.D., discusses the issue and offers warning signs.
In spite of the enormous success of antidepressants, there are surprisingly few that are available in other than oral form. There is now substantial evidence that intravenous administration is well tolerated and may accelerate onset of therapeutic effect. With the possibility of transdermal delivery3/4a noninvasive and painless route of administration requiring no technical support3/4parenteral antidepressants may become more acceptable in this country and warrant further clinical investigation.
Dietary supplementation of SAM-e--naturally produced and physiologically necessary compound for living cells--is being investigated for its use as a viable treatment for depression.
After a significant delay, the U.S. Congress passed the Victims of Trafficking and Violence Prevention Act of 2000 to provide support and services to victims of domestic violence. Meanwhile, the findings in the Family Violence Prevention Fund's State by State Report Card on Health Care Laws and Domestic Violence shows state legislation has proved disappointing. Which states do the most in assisting physicians and other health care providers to aid victims of domestic violence?
According to a recent article in the Journal of Women's Health and Gender-Based Medicine (2000;9[4]:405-411), more psychiatrists than physicians in other specialties see themselves as the best source of information for victims of domestic abuse.
Psychiatrists can play a vital role in determining whether or not a patient will be a good candidate for an organ transplant. Using a case vignette, Dr. Garton explains how she helps a transplant team make the best possible decision.