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The subtleties of the sense of humor may reveal alterations in mental status, yet it is often overlooked when assessing patients. It is a valuable area of inquiry and may shed light on problems of social relatedness as well as highlight resilience and coping mechanisms. Dr Greenberg discusses the use of the sense of humor in assessing well-being and how to use the sense of humor therapeutically.

On November 21, 2011, John Oldham, MD, president of the American Psychiatric Association (APA), wrote a response letter to Don W. Locke, EdD, president of the American Counseling Association, who had some concerns with proposed revisions for DSM-5.

Some months ago, I received a stern admonition from my family doctor. My fasting blood sugar of 99 mg/dL was “right on the border”, he said, and I had better work on bringing it down. “But,” I protested, “when I was in medical school (in the 70s), the normal FBS range went up to 110 mg/dL!” "Well,” he replied a bit huffily, “they changed the criteria!”

Diminishing libido is a symptom of depression, but antidepressants do not always restore sexual interest. Loss of desire may be the cause of depression, not its consequence. Dr Levine explains the nature of sexual desire and its relationship to arousal including the various biogenic, psychogenic, interpersonal, and cultural factors that contribute to problems associated with sexual desire.

Perinatal anxiety disorders are common and pose risks to women and their offspring. Here, Laura Miller, MD, speaks briefly on panic disorder, PTSD, and OCD during pregnancy and post-partum, and she offers strategies for crafting effective treatment plans.

Mood and cognitive disorders are major public health problems, and care for patients with such conditions is of growing importance as the population ages. Here, geriatric psychiatrist Jeffrey Lyness, MD, of the University of Rochester School of Medicine and Dentistry in New York offers teaching points about the evaluation of depression in older persons.

Terrence Malick’s The Tree of Life is not easy entertainment, but for psychiatrists who might welcome an encounter with a brilliant, uncompromising mind, The Tree of Life is enthralling.

Until recently, most people believed that hoarders were eccentric people who died surrounded by a lifetime collection of stuff. Hoarding in families was cloistered in a vault of family secrets or passed off as an individual peculiarity.

Michael Blumenfield, MD is the Sidney E. Frank Distinguished Professor Emeritus of Psychiatry and Behavioral Sciences at New York Medical College; a past speaker of the Assembly of the American Psychiatric Association; and President-Elect of the American Academy of Psychoanalysis and Dynamic Psychiatry. He writes a blog, www.PsychiatryTalk.com, and contributes to the Psychiatric Times blog, “Couch in Crisis.” He is in private practice in Woodland Hills, Calif.

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