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In his recent blog posting, Dr Steven Moffic proposed that only psychiatrists be allowed to certify DSM diagnoses. While I disagree, I commend Dr Moffic for raising this controversial topic, which inevitably brings up a number of basic issues challenging our profession.

It is generally held that the offspring of parents with bipolar disorder (BD) are at risk for BD. The degree of risk is an important question for both clinicians and parents. A recent study of bipolar offspring by Birmaher and colleagues1 sheds light on this issue.

Unless you have been living on a desert island for the past 2 years, you are well aware that the development of DSM-V is well under way.

Celeste, one of my patients, a woman in her mid-30s, unexpectedly had a seizure, fell, and hit her head while at work. She was rushed to a nearby emergency department (ED) where results of laboratory work, an EEG, and an MRI confirmed that she had had a seizure but did not show a cause.

A major speech on mental health from Health and Human Services (HHS) Secretary Kathleen Sebelius and the ascension of a new administrator at the Substance Abuse and Mental Health Services Administration (SAMHSA) have sparked hopes that the Obama administration is putting increased emphasis on mental health issues. Buoying those hopes further is the fact that the White House has recruited notable mental health advocates in other top positions, such as Richard G. Frank and Sherry A. Glied, authors of the book Better But Not Well: Mental Health Policy in the United States Since 1950. Glied has been nominated as assistant secretary for planning and evaluation at the HHS. Frank is her deputy for disability and mental health policy.

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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.

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).