Borderline Personality Disorder: An Overview
August 25th 2006DSM-IV-TR emphasizes that patients with borderline personality disorder (BPD) show a "instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts," and any five out of nine listed criteria must be present for the diagnosis to be made.
Therapy for Sexual Impulsivity: The Paraphilias and Paraphilia-Related Disorders
August 25th 2006Paraphilias as defined by DSM-IV, are sexual impulse disorders characterized by intensely arousing, recurrent sexual fantasies, urges and behaviors (of at least six months' duration) that are considered deviant with respect to cultural norms and that produce clinically significant distress or impairment in social, occupational or other important areas of psychosocial functioning. The common paraphilias described include exhibitionism (exposure of genitals to a stranger), pedophilia (sexual activity with a prepubescent child, generally 13 years of age or younger), voyeurism (observing others' sexual activities), fetishism (use of inert objects, such as female undergarments), transvestic fetishism (cross-dressing), sexual sadism (inflicting suffering or humiliation), sexual masochism (being humiliated, beaten, bound or made to suffer) and frotteurism (touching, rubbing against a nonconsenting person).
10-Point Clock Test Screens for Cognitive Impairment in Clinic and Hospital Settings
August 25th 2006The obvious sometimes bears repeating: Sick people have trouble thinking. They may be suffering from a delirium, a dementia or a more subtle disturbance of cognition caused by fever, drugs, infection, inflammation, trauma, hypoxemia, metabolic derangement, hypotension, tumor, intracranial pathology, pain and so forth.
A Patient with Dissociative Identity Disorder 'Switches' in the Emergency Room
August 25th 2006Many highly regarded clinicians have built careers working with patients they believe to have dissociative identity disorder (DID). Other distinguished practitioners consider DID to be a bogus diagnostic tag.
Borderline Personality Disorder: Splitting Countertransference
August 25th 2006Splitting, archetypally imbedded in a patient's psychic structure, acts as a powerful unconscious force to protect against the ego's perception of dangerous anxiety and intense affects. Rather than providing real protection, splitting leads to destructive behavior and turmoil in patients' lives.
Fostering “Buy-In”: Step One in Bipolar Spectrum Treatment
August 1st 2006A look at how to use the spectrum concept to promote understanding and acceptance of bipolar II and soft bipolar diagnoses. In this article, you will find 5 tools for fostering what has been called “concordance” or, more simply, “buy-in.”
Bipolar Disorder: Diagnostic Challenges and Treatment Strategies
August 1st 2006The past few years have seen substantial progress in recognizing and treating several of the subtypes of bipolar disorder. This Special Report addresses the diagnostic challenges and the different strategies for managing these subtypes.
Interventions to Improve Adherence to Antipsychotic Medications
August 1st 2006New ways to address medication adherence problems in patients with schizophrenia offer the hope of better treatment outcomes. Two new and promising approaches for individuals with schizophrenia are the use of environmental supports and cognitive adaptation training and cognitive-behavioral therapy.
The Clinical Challenge of Comorbid Bipolar Disorder and Substance Use Disorder
August 1st 2006Bipolar disorder I and II have the highest association with substance use disorder, compared with any other major psychiatric disorder. Treatment requires an integrated approach that includes specific psychotherapy as well as the use of medication.