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The DSM-5 looms, prompting mental health professionals, clients, and caretakers to look ahead with a mixture of eagerness, dread, and bewilderment. As we look at the state of things now and project forward toward possibilities for the future, it pays to also look back into the past.

The subject of physician participation in interrogations (either military or law enforcement related) continues to surface as an issue of debate. Why? Allow me to state what I believe undergirds most debates on this issue: terror. No, not terrorism per se, but terror of death.

The board of trustees at the APA has established a new code of conduct in the form of a Conflict of Interest Committee at the board level. This committee will manage potential conflicts of interest and formalize already existing procedures.

Many have challenged the claim of the APA/DSM-5 Task Force that the current process is the most “open process in the history of the manual.” Few have actually provided an argument or evidence of why this might, or might not, be so. What has changed dramatically in the DSM process since DSM-IV in 1994, and even DSM-IV-TR in 2000, is the rise of Internet culture and the “blogosphere.” What does this have to do with DSM-5?

Dr Medina is a developmental molecular biologist and private consultant, with research interests in the genetics of psychiatric disorders. For more about Dr Medina, visit www.brainrules.net.



Richard M. Berlin, MD, is Senior Affiliate in Psychiatry at the University of Massachusetts Medical School. His second collection of poems, Secret Wounds, which won the 2010 John Ciardi Poetry Prize, is published by BkMk Press.

A recent essay by Michael W. Kahn, MD, explores whether psychiatrists are going too far in denying patients’ requests for drugs. When first year psychiatry residents were asked how they would react to a request from a patient for narcotic painkillers or antianxiety medications, the general consensus was that they would do no harm by playing it safe and would not provide the requested drug.

In a report by Pew Research Centers, Internet & American Life Project, 61% of patients are going online for information about their health. In 2000, that figure was 46%.

At the end of life, psychiatrists are often asked to assess a patient’s capacity to refuse treatment, but the role of the psychiatrist in this situation is much broader.

A quarter of a century ago, E. Mansell Pattison provided the invocation for the opening of the 1985 annual meeting of the American Psychiatric Association. It was called “A Prayer for Psychiatrists” and was so well received, that it was reprinted in [Pastoral Psychology (1987;35:187-188,), a now defunct journal. Dr Pattison, both a psychiatrist and a minister, died shortly thereafter, in 1989.

Ethical Questions at the Intersection of Neurotechnology and Psychiatry

Avoiding Confidentiality Conflicts


Given a choice between talk therapy and taking an antidepressant, most Americans would choose the pill. And--if given a choice among the various types of antidepressants--most would prefer an SSRI.


As an officer of the APA, I was one of the prime movers of the limitations on, and vetting of, potential participants in the preparation of the DSM5.


Digital technology has transformed the way people live, work, and play. We are now able to instantly communicate with anyone, anywhere, anytime; however, an overload of technology can be counterproductive.

Empathy is the ability to put yourself in someone else’s shoes and understand what they are feeling. This is something that psychiatrists try to do in our everyday work. Those of us who have worked in medical schools have struggled with the question of whether or not this is something that can be taught.




Today when the ground was no longer...

As if psychiatrists didn’t have enough to worry about with regard to complying with upcoming Medicare e-Prescribing dictates, there is now a second layer of complication . . . the interim final rule from the DEA, which prescribes requirements for physicians who want to use electronic prescribing for controlled substances.

Dramatology approaches human encounters, events, and scenes as dramatic enactments of characters in conflict and crisis.

As a psychiatrist who has lymphoma, I have developed a deep understanding of the ways in which our training can help us help patients who find themselves forced to deal with the complicated emotional aspects that accompany various forms of cancer. I hope these insights will be useful to psychiatrists as they wrestle with the problems that plague their patients who are coping with cancer.

The risk of breast cancer recurrence related to some SSRI antidepressants interacting with and reducing the effectiveness of tamoxifen was quantified in 2 epidemiological studies published in February.
