In last month’s column (“Painting Neural Circuitry With a Viral Brush,” Psychiatric Times, October 2008, page 16), I used Michelangelo’s famous fresco, “Hand of God Giving Life to Adam” on the ceiling of the Sistine Chapel as a metaphor to introduce a series of technologies that have allowed researchers to map the complex interactions of neural connections in continuously functioning neural tissues.
The National Comorbidity Survey estimates that approximately 50% of the population in the United States is exposed to traumatic events and that the lifetime prevalence of posttraumatic stress disorder (PTSD) is approximately 7.8%.
Too often news headlines exert a major influence on our patients-and nothing in child psychiatry grabs headlines like the alleged overprescription of medicines. Physicians sidestep the debate, assuring their patients and themselves that each prescription is written only after careful consideration of risks and bene-fits.
DSM-IV-TR, our current diagnostic classification system of psychiatric disorders, follows the diagnostic paradigm first established by DSM-III in 1980.
Dissociation-a common feature of posttraumatic stress disorder (PTSD)-involves disruptions in the usually integrated functions of consciousness, memory, identity, and perception of the self and the environment.
Reports of 1 in 5 military service members returning from Iraq or Afghanistan with posttraumatic stress disorder (PTSD) and/or depression and rising suicide rates have led researchers and military leaders to warn civilian psychiatric care providers of a “gathering storm”1 headed their way.
Drs Pope and Gutheil correctly admonish psychologists who partake in detainee interrogations (Psychiatric Times, “The American Psychological Association and Detainee Interrogations: Unanswered Questions,” July 2008, page 16).
In “SSRI Prescribing Rates and Adolescent Suicide: Is the Black Box Hurting or Helping?” (Psychiatric Times, October 2007, page 33) Gibbons and associates primarily use data from their American Journal of Psychiatry article that appeared in September 2007, in a not very veiled attempt to influence doctors and the FDA to roll back the “black-box” warning on the prescription of SSRIs for adolescents.
In the Valley of Elah is an improvised explosive device that writer-director Paul Haggis has set to go off in the hearts and minds of Americans who still support the war in Iraq. Haggis, who earned an Oscar (Best Picture and Screenplay) for Crash, has aimed his second film at the hardworking, churchgoing, flag-flying, decent Americans who cannot imagine that the country they love would engage in an unjust war.
Medication adherence, especially in children and adolescents, is a complex problem that is poorly understood and underresearched, yet it is a clear barrier to effective treatment and is frequently encountered in everyday clinical practice.
Reducing complex human experiences into a psychiatric diagnosis can be a daunting task. For children with developmental disorders, this process is even more complicated and requires distilling often incomplete and frequently contradictory scientific evidence.
In an earlier column (Psychiatric Times, “The Road Less Traveled,” September 2002, page 14), I emphasized what can be learned from interviewing nonclinical subjects.
Over the past decade, NSAIDs have been on a roller-coaster ride almost as wild as that now being experienced by this country’s housing and financial markets. The selective COX-2 inhibitors-first celecoxib (Celebrex) and then rofecoxib (Vioxx) and valdecoxib (Bextra)-promised to revolutionize the treatment of pain.
Recent research has raised concerns about the adequacy of psychiatric diagnostic evaluations conducted in routine clinical practice, particularly the detection of disorders that are comorbid to the principal diagnosis.
When I was recently asked by a patient about the link between osteoporosis and SSRIs, I dimly recalled this topic’s emergence in a medical journal in 2007, its subsequent meander through several newsletters, and its gradual return to the bottom of my mental risk-assessment checklist.
Commercially available telephone sex with women has been available at all hours of the day or night for over 25 years to anyone who pays the fee.
Recently, I was involved in a discussion with several other mental health writers and editors regarding the most appropriate term to use for those we treat: patient or client. Our lack of consensus reflected that in contemporary medical and psychiatric literature.
When most people think of bullying, they envision the schoolyard thug verbally or physically threatening hapless victims on the playground or on the school bus. The past few years, however, have witnessed a new type of bullying-cyber bullying-also known as electronic bullying or online social cruelty.
Diagnostic assessment of psychiatric disorders and their comorbidities is a challenge for many clinicians. In emergency settings, there is no time to conduct lengthy interviews, and collateralinformation is often unavailable.
In the new century, the dementias will probably become 1 of the 2 or 3 dominant behavioral health problems in the United States. This article provides an overview of the major clinical features of these cognitive loss syndromes and emphasizes the perspective of the practicing psychiatrist.
Emergency medicine provides care to a vast number of patients each year. In 2005, 115.3 million people visited emergency departments (EDs).
As a licensed acupuncturist, I am often asked by both medical professionals and laypersons whether acupuncture actually “works” and whether it should really be considered part of a belief system rather than science.
We often describe neural connections in the brain as if they were a cellular version of Michelangelo’s famous painting “Hand of God Giving Life to Adam,” on the ceiling of the Sistine Chapel.
The use of antipsychotics to quiet agitated older adults with dementia has come under increasing fire. After a Canadian study demonstrated an increased risk of adverse events or death with these agents,1 the FDA expanded its earlier warning to physicians.
Neuroimaging is often used in clinical psychiatry to rule out medical and neurological conditions that can mimic psychiatric disease rather than for the diagnosis of specific psychiatric disorders.
Gambling has become a major recreational activity in the United States. Formerly confined to a few states such as Nevada and New Jersey, legal gambling opportunities have exploded across the nation in the past 2 decades.
William Bruce, a young man with symptoms of paranoid schizophrenia, was released from Maine’s state-run Riverview Psychiatric Center in April, 2006. Two months later, he killed his mother with a hatchet. Bruce subsequently was found not criminally responsible by reason of insanity and was recommitted to Riverview.
We need to have a framework to make certain that our interventions are balanced, safe, and a function of the existing evidence.
Participants in past meetings of the FDA’s Psychopharmacologic Drugs Advisory Committee (PDAC) think changes to FDA advisory committee procedures announced in August will add credibility to those committee votes.