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Psychotropic drugs are big business: in 2009, roughly 300,000,000 prescriptions were written for these agents.


My medical school clinical preceptor asked me, during my first year, what specialties (at The University of Chicago, the attitude toward general practice was well represented by the dismissive references to ‘LMDs’-local medical doctors) I was considering.

Transcranial magnetic stimulation (TMS) is noninvasive focused brain stimulation that uses pulsed magnetic fields. The underlying mechanism depends on the principle of electromagnetic induction, the process (discovered by Faraday in 1839) by which electrical energy is converted into a magnetic field and vice versa.1

The issue of self-disclosure in psychotherapy is one of complexity and some evolution.1-16 Most discussions about the practice refer to boundary questions because self-disclosure by the therapist to the patient is a boundary issue. Self-disclosure has, of course, a number of dimensions, including clinical, therapeutic, technical and-in some cases-legal or regulatory. Despite the rich and interesting clinical issues relating to self-disclosure (outlined in Gutheil and Brodsky1), the focus of this article is on the ethical aspects of self-disclosure.1,15,16 Of necessity, the discussion centers on the more exploratory forms of psychotherapy, such as dynamic therapy, rather than on behavioral therapies, co-counseling, substance abuse treatment, or pharmacological treatment.

Bioethicists often debate whether the rapid pace of medical science truly generates new ethical questions or whether what appear to be novel dilemmas are really ancient conflicts presented in modern terms and contexts.1 The valuable essays in this Special Report offer support for each position and, more important, provide clinical wisdom for mental health professionals struggling with ethical issues both profound and prosaic in a variety of practice settings.

Questions have also been raised about the extent of industry influence on the American Psychiatric Association’s diagnostic and treatment guidelines-namely, its DSM and Clinical Practice Guidelines.


In addition to their use in the management of epilepsy, anticonvulsants are indicated for management of bipolar disorder, mania, neuralgia, migraine, and neuropathic pain.



Other disorders include those not currently listed such as complex somatic symptom disorder; those proposed for reclassification such as body dysmorphic disorder; and those proposed to by subsumed under other diagnoses such as somatization disorder, pain disorder associated with psychological factors, and hypochondriasis.

Included in this list of disorders are those proposed for possible reclassification such as obsessive-compulsive disorder; those proposed for removal such as agoraphobia without a history of panic disorder; those proposed to be subsumed under other diagnoses such as panic disorder with or without agoraphobia; and those not currently listed such as substance-induced tic disorder, hoarding disorder, olfactory reference syndrome, and skin picking disorder.

I never wanted to go to New Orleans-I thought it would be hot and muggy and very crowded. But, life takes you on unexpected journeys and one day I found myself at a conference in New Orleans, and I was charmed.

I just finished reading Dr Zucker’s retort to Dr Frances’ critique of proposed categories for paraphilias in DSM5, as well as Dr Frances’ reply.

Among other things, the Work Group for this class of disorders is examining whether premenstrual dysphoric disorder should classify as a separate disorder from mood disorders or a specifier for mood disorders.

The health insurance reform bill Congress passed and President Obama signed has a number of small, psychiatric-targeted provisions, but their significance probably pales beside the first-time insuring of somewhere above 30 million Americans-some of whom will visit psychiatrists for the first time in their lives.

Hear the story of wood...

The recently posted draft of DSM5 makes a seemingly small suggestion that would profoundly affect how grief is handled by psychiatry.

My “most important achievement to date” is that I’m capable of even the simplest forms of basic cognition. I can remember, perceive, speak, feel, think, solve, and-sometimes-pay attention.

Perhaps one of the positive things to come out of the Kansas v Hendricks wave of sexually violent predator (SVP) commitment laws during the past decade is that our knowledge base on sex offenders has grown tremendously.

While the Army considers what, if any, disciplinary actions to take against those who directed the medical training of MAJ Nidal Hasan-the accused Fort Hood shooter-one psychiatrist’s legal counsel faults the military for blaming a handful of officers for a broader institutional failing.


Over the past several months, Psychiatric Times has posted numerous-and often stinging-critiques of the DSM5 process. Readers have reacted to the ongoing heated debates between Allen Frances, MD, who oversaw the development of DSM-IV, and the DSM5 Task Force with significant interest. Now you can weigh in with your own opinions, suggestions, and recommendations on our DSM5 forum, which features proposed revisions by topic.Select a topic below to add your comments.


Included in this list of disorders is the recommendation that the category include substance use disorders and non-substance addictions such as gambling and Internet addiction. The category has tentatively been retitiled "Addiction and Related Disorders."

Included in this category is the recommendation that the category be divided into 3 broad syndromes: delirium, major neurocognitive disorder, and minor neurocognitive disorder. The Work Group is also exploring removing dementia, categorizing behavioral disturbances, and selecting specific domains and measures of severity of cognitive functional impairment.

I can almost hear Albert Ellis saying “Amen” to the data I am about to share. To explain his reaction, I have to talk about war.

Nothing can replace talking with patients. This can take substantial amounts of time, but it is the only way to obtain as clear a view as possible about whether a patient is benefiting from treatment.