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There are occasions in which one's best psychotherapeutic efforts are not effective or help only modestly. If the effort has taken place for a relatively long period, the therapist has several options. One is to ask a colleague for consultation. A second is to reexamine one's understanding of the patient's dilemma.

In our presentation at the 2006 annual meeting of the American Academy of Child and Adolescent Psychiatry, we suggested that child psychiatrists who come across a child with the profile of the following hypothetical case should consider whether the child may have deficits that are not currently covered by DSM-IV nosology: either a nonverbal learning disability (NVLD) or a sensory processing disorder (SPD).

An item in the Boston Globe recently caught my eye. Apparently, a man who was fired by a large corporation for visiting an adult "chat room" while at work is suing the company. The man is claiming he is an "Internet addict" who "deserves treatment and sympathy rather than dismissal." Another item reported recently concerned a lawyer who argued that her client was not responsible for a rampage that he had committed because he "had been obsessed with comic book superheroes as a kid."

Epidemiological studies report a lifetime prevalence rate of 24.9% for (any) anxiety disorder. Feelings of anxiety can also be related to normal fear of pain, loneliness, ridicule, illness, injury, grief, or death. In both these types of situations, anxiety can be difficult to deal with. Consequently, benzodiazepines, which offer almost immediate symptomatic relief for anxiety, can be quite appealing to many persons.

This May, the FDA called for a black box warning on antidepressants to indicate that patients aged 18 to 24 years are at heightened risk for treatment-emergent suicidality. But a member of the FDA advisory committee that recommended that warning has issued his own warning, saying that the "real killer in this story is untreated depression and the possible risk from antidepressant treatment is dwarfed by that from the disease."

Initial symptoms include personality changes and the gradual appearance of small involuntary movements. These move- ments progress to frank chorea, ballism, and dystonia. Later in the disease course, a bradykinetic parkinsonian phenotype manifests. It is characterized by rigidity, severe dystonia, and contractures. Falls are common. Dysphagia is common as well and is progressive, becoming severe and often contributing to death from aspiration pneumonia.

Thus, a young woman describes her ex-boyfriend who had Tourette syndrome (TS), the impact of which caused their breakup. TS affects approximately 1 in 100 Americans and is marked by a fluctuating course of multiple motor and phonic tics, which can have devastating social, physical, and psychological consequences for the patient.

For 2 decades Maggie McPhersun's physicians had attributed her fatigue, episodes of choking, and periodic imbalance and numbness to chronic fatigue or depression. But the 51-year-old registered nurse and artist from Brunswick, Maine, knew that something was very wrong. When an MRI finally revealed multiple sclerosis (MS) lesions, the first thing McPhersun felt was relief. She finally had a sensible explanation for her symptoms.

Civilian cases of traumatic brain injury (TBI) account for more than 50,000 deaths annually and represent about 50% of deaths attributed to physical injury. These injuries are a significant medical and socioeconomic burden and represent one of the leading public health problems in the United States. However, thanks to injury prevention and changes in hospital admission practices, a decline of almost 50% in civilian hospitalizations for TBI has been observed since 1980, with many patients now treated on an outpatient basis.

Alejandro Gonzales's Babel is a meditation on the barriers to communication in a world divided by class, culture, and language. Although his vision is dark, he never surrenders to cynicism. His Babel, unlike the Bible story, holds out the promise of a universal language of the human heart. Psychiatrists know this language as empathy--the wordless connection that is the art form of every caring profession.

Mounting evidence shows that patients with bipolar disorder benefit significantly when their families are involved in treatment. Despite the challenges entailed, clinicians can successfully implement a family-focused approach if they’re willing, flexible and patient.

Democratic control of Congress may result in the dislodging of a long-stuck bill authorizing an unspecified amount of additional federal funding for research into postpartum depression. But in hearings in a House subcommittee recently, Republicans voiced an intention to add postabortion depression to the bill's focus.

Twenty years after the initial meeting of the International Congress for Schizophrenia Research (ICSR), this year's biennial ICSR remained true to its mission to serve as a venue for active researchers. ICSR hosted investigators in neuroscience, cognitive neuroscience, basic and clinical psychopharmacology, psychosocial interventions, and genetics.