Newly published recommendations for pharmacological and psychosocial treatments from the Schizophrenia Patient Outcomes Research Team (PORT) are the first to address related treatments, such as smoking cessation, substance abuse, and weight loss, and they are the first update since 2003.
Although a large body of research has documented the risk factors for and negative effects of depression in mothers, little is known about depression in expectant or new fathers.
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In this essay I give my views on the boundaries of individual psychotherapy-their necessity and the process of learning them, accepting them, then gaining from and leaving the therapy process. For me, the learning process was long, and I realize now how I had to internalize a number of new concepts for the therapy to succeed. After much thought and work, therapy was beneficial and rewarding for me. I now know that because I took the process of psychotherapy seriously, it made my life more fulfilling and my relationships more meaningful. For me, psychotherapy was especially helpful in reinforcing my ability to deal with a chronic, debilitating, and life-threatening illness. It helped me make each day a gift, accept my imperfections, and live with uncertainty, frustration, and anger with more dignity and greater understanding.
Dr Elvin Semrad was a much-loved psychiatrist and psychotherapy supervisor who had a profound influence on hundreds of psychotherapists and psychoanalysts in the Boston area. One of his unique qualities was his ability to connect empathically with even the most psychotic patients. He supervised at Boston State Hospital and then for 4 decades at the Massachusetts Mental Health Center (MMHC) in Boston, where he conveyed his strong conviction that psychotic and other seriously men-tally ill patients could benefit from long-term psychoanalytically oriented psychotherapy.
During my medical training in the early 1980s, I attended a Grand Rounds on health care reform. Sleep-deprived physicians-in-training are easily conditioned to snooze upright in their auditorium seats, and economics is not an interest of choice for me, but when the speaker told us that there would be no solution to rising health care costs except to fracture the bond between patient and doctor, I found myself engaging in nightmarish fantasies that in subsequent decades have come true.
Two new oral analgesics have recently been approved by the FDA: milnacipran (Savella) for fibromyalgia and tapentadol (Nucynta) for moderate to severe acute pain.
Let’s say you’re in a crowded bar when somebody suddenly shoots at a patron. You clearly see a man carrying a firearm, but all hell breaks loose as you and everybody else scramble for the exits. In the terrifying seconds following the crime, you lose track of who discharged the firearm: it could have been 1 of 3 suspects. Afterward, the police interview you, but it is hopeless. Even bringing in the suspects for a lineup isn’t going to help you recall. There will be no “Perry Mason” moments, when the perpetrator breaks down under the weight of guilt and confesses to the crime. How can the authorities make an arrest?
Recent multiple brain imaging studies of patients with restricting-type anorexia nervosa (AN) reveal neurocircuit dysregulation and may help clarify the disorder’s confounding symptoms.
Medical training is awash in catch phrases and shibboleths. Some can be useful (“When you hear hoofbeats, think horses not zebras”); others, perhaps overly simplistic (“If it’s not in the chart, it didn’t happen”). A current divination clinging to medical consciousness is the concept of evidence-based medicine (EBM).
“The proper use of these criteria requires specialized clinical training that provides both a body of knowledge and clinical skills.” How many of us psychiatrists recognize this statement? Or, is it like the fine print that we often gloss over in our everyday contracts and hope it doesn’t cause us trouble at some later time?
A recent Senate hearing on conflicts of interest (COIs) in medical education and research revealed that the tri-committee health care reform bill requires public disclosure of pharmaceutical company payments to several health entities, that the removal of industry-sponsored symposia by the American Psychiatric Association (APA) cost it $1.5 million in revenues, and that the Accreditation Council for Continuing Medical Education (ACCME) is expanding its requirements and enforcement actions.
A Serious Man-a film that explores their Jewish roots in Minnesota. Not roots in the genealogical or autobiographical sense but from a removed and more philosophical perspective-what does it mean to be a Jew, both as a matter of social identity and as someone who is supposed to believe in God or Hashem, the word religious Jews invoke so as not to take the name of the Lord in vain. Hashem will roll so glibly off the tongues of the Coens’ Jews, it will seem more like affectation than piety.
Years ago I wrote, “I love my patients,
The young adult years (18 to 29) are a critical time of transition, and they present unique challenges in regard to mental health issues and development. Until recently, most research has focused either on children and adolescents or adults. Grant and Potenza’s Young Adult Mental Health is a comprehensive text for clinicians and researchers who work with persons in the transitional period of young adulthood.
Like every new resident just starting to work in an outpatient clinic, I was nervous about the patients I would inherit from the graduating resident. It did not help when the graduating resident warned me that one particular patient “could be difficult.” I comforted myself with the thought that every psychiatric patient has a “difficult life” and that is why they need our help.
A pair of recent research articles has cast the public spotlight on treating schizophrenia in youths with antipsychotic medications.
In 2 previous editorials-“The ‘McDonaldization’ of Psychiatry” and “Doctor, Are You ‘Drugging’ or Medicating Your Patients?”-I focused on some serious problems in current psychiatric practice and on various shortcomings in our treatments. In the third “panel” of this editorial triptych, I want to take note of the considerable good that psychiatric treatment may bring to those who suffer with devastating illnesses.
