New Algorithms for the Management of Treatment-Resistant Bipolar Depression
November 10th 2009Current guidelines for the management of bipolar depression are outdated because they are based on the definition and treatment of unipolar depression, according to Eduard Vieta, MD, PhD, director of the bipolar disorders program at the University Clinic Hospital of Barcelona, Spain. Dr Vieta led a study to create new definitions and algorithms for the management of treatment-resistant bipolar I and bipolar II depression.
Placebos: Is It All in Your Spine?
November 9th 2009Researchers have found evidence that the placebo effect is not all “in your mind.” This study, recently published in Science, suggests that the spinal column-specifically, the dorsal horn-may be involved in blocking pain after placebo has been administered. Eippert and colleagues1 examined pain reactions in 13 young, healthy men (21 to 30 years old) after applying 2 types of cream on their forearms. The participants were told that one cream was a highly effective analgesic (“lidocaine”) and the other was a control cream. In reality, both creams were identical and pharmacologically inactive; the one labeled lidocaine was used to measure the placebo response.
Advocates Call for Treating Tobacco Dependence in Psychiatric Patients
November 7th 2009Smoking cessation services should be integrated into substance use disorder treatment programs, according to David Kalman, MD, Department of Psychiatry, University of Massachusetts, and colleagues, in their recent review of tobacco dependency among patients who sought treatment for alcoholism.1
The Role of Antidepressants for the Treatment of Bipolar Depression
November 4th 2009Although rapid-cycling bipolar disorder has been linked to the use of antidepressants, these treatments may still have a role in the management of patients with bipolar depression, said Stephen V. Sobel, MD, clinical instructor at the University of California, San Diego School of Medicine, in a presentation at the U.S. Psychiatric and Mental Health Congress in Las Vegas.
rTMS May Be Effective in Patients With Treatment-Resistant Bipolar Depression
November 4th 2009Repetitive transcranial magnetic stimulation (rTMS) may be an effective therapy for treatment-resistant bipolar depression, according to the results of a recent pilot study led by Guohua Xia, MD, PhD, assistant clinical professor of psychiatry at the University of California, Davis.
Strategies to Avoid a Malpractice Suit When a Patient Commits Suicide
November 4th 2009A few simple steps can enhance your assessment of a patient’s suicide risk-and thereby reduce your own risk for liability if the patient does commit suicide. Phillip J. Resnick, MD, professor of psychiatry and director of forensic psychiatry at Case Western Reserve University in Cleveland, described those measures in a lecture today at the US Psychiatric Congress in Las Vegas.
Living the Questions: Cases in Psychiatric Ethics
November 3rd 2009Information transmission, such as blogs, RSS feeds, and podcasts, have emerged as common forms of communication. The exponential growth of medical knowledge and the increasingly rapid pace of scientific discovery have made it nearly impossible for the print medium to keep abreast of new developments.
What “Meaningful Use” of Electronic Health Records May Mean to Psychiatrists
November 2nd 2009With billions of dollars for electronic health record (EHR) technology purchases hanging in the balance, psychiatrists need to be paying attention to the Department of Health and Human Services (HHS) deliberations on the definition of “meaningful use.”
Advice to DSM-V: Integrate with ICD-11
November 1st 2009I have elsewhere summarized the problems caused by the excessive and misdirected ambitions of the DSM-V effort.1 My purpose here is to suggest a different, more useful and attainable ambition for DSM-V-namely trying to integrate DSM-V and ICD-11 into one system. If successfully achieved, this would be by far the biggest accomplishment possible in this round of revision.
The Cellular and Molecular Substrates of Anorexia Nervosa, Part 1
November 1st 2009Appetite regulation is made up of complex interlocking, incentive-driven motivational hormonal and neuronal circuitries . . . that can be pulled in many directions, especially where food is cheap and readily available.
The Ethical Policies and Involvement in Enhanced Interrogations of US Psychologists After 9/11
October 31st 2009The article “Mental Health Professionals in the ‘Enhanced’ Interrogation Room” on the cover of this issue provides an invaluable service. It documents psychologists’ and physicians’ involvement in enhanced interrogation programs.
Rape and the Heart of Darkness at Richmond High
October 29th 2009The press reported it in various ways-either as a “brutal gang rape” or, more forensically, as a “2½-hour assault” on the Richmond High School campus. Anyway you look at it, the horrendous attack on a 15-year old girl raises troubling questions for theologians, criminologists, and, of course, psychiatrists.
Chronic Pain and Mood Disorders-Identifying and Understanding Shared Neurophysiological Mechanisms
October 29th 2009The editors of Psychiatric Times interview Vladimir Maletic, MD, PA, clinical professor of neuropsychiatry and behavioral science at the University of South Carolina School of Medicine, Columbia; founding member of the Integrative Neurobiology Educational Alliance; and member of the U.S. Psychiatric and Mental Health Congress 2009 advisory board.
Doctor: Are You “Drugging” or “Medicating” Your Patients?
October 29th 2009You have read the blogs and seen the placards a dozen times: doctors prescribe too many “drugs” for too many patients. Psychiatrists, in particular, are popular targets of politically motivated language that seeks to conflate the words “medication” and “drug”-thereby tapping into the public’s understandable fears concerning “drug abuse” and its need to carry out a “War on Drugs.”
Twitter and YouTube: Unexpected Consequences of the Self-Esteem Movement?
October 28th 2009To Americans over 30, YouTube, Facebook, MySpace and Twitter are buzzwords that lack much meaning. But to those born between 1982 and 2001-often referred to as “millennials” or “Generation Y”-they are a part of everyday life. For the uninitiated, these Web sites are used for social networking and communication. They are also places where individuals can post pictures and news about themselves and express their opinions on everything from music to movies to politics. Some sites, such as YouTube, allow individuals to post videos of themselves, often creating enough “buzz” to drive hundreds and even thousands of viewers; in some instances, these videos create instant media stars-such as the Obama imitator, Iman Crosson.
Mental Health Professionals in the “Enhanced” Interrogation Room
October 28th 2009On Monday, August 24, 2009, in response to a Freedom of Information Act lawsuit, the Central Intelligence Agency (CIA) released a “Top Secret,” highly redacted May 7, 2004, report, Counterterrorism Detention and Interrogation Activities (September 2001 – October 2003).1 The report’s opening pages concede that the activity it divulges “diverges sharply from previous Agency policy and rules that govern interrogation.”
On Narcissism, the Internet, and Social Networking Sites
October 27th 2009I read with interest the posts of Dr John Grohol, PsyD regarding my commentary, "Twitter and YouTube: Unanticipated Consequences of the Self-Esteem Movement.” I had hoped it would bring attention to this topic and am glad that this has opened up an important dialogue. However, the author has missed the point.
Readers React to “Abortion Trauma Syndrome”
October 27th 2009Respecting the article “Abortion Trauma Syndrome” by Arline Kaplan, I would note the irony of the claim that this syndrome is “conceived by anti-abortion activists to advance their cause,” given the obvious pro-abortion attitude of everyone associated with Kaplan’s article.
The Impact of Appearance on Coping With Life
October 13th 2009In planning a media workshop to present Glenn Gers’ independent film disFigured for the May 2009 American Psychiatric Association meeting in San Francisco, my co-presenters and I devoted special attention to the diagnosis and treatment of anorexia nervosa. (The content was originally prepared by Katherine Halmi, MD, and was presented at the workshop by James Mitchell, MD, when Dr Halmi was unable to attend.) The film deals with the problems of body image represented by opposite ends of the spectrum of eating disorders-obesity and anorexia.