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Medical school graduation usually involves the Hippocratic Oath, in which physicians vow not to intentionally harm their patients. Keeping patients safe is another basic principle of patient care. Physicians are charged with ensuring that their patients are in a safe environment and minimizing risks to their patients by carefully selecting treatment options. In emergency psychiatric settings, patient safety is critical, especially when the patient is a danger to himself or herself or to others.

All physicians need to be aware of the medicolegal aspects of practicing medicine, but because emergency psychiatrists must sometimes treat patients against their will or act as consultants to determine capacity, they must be especially vigilant when dealing with the overlap between law and medicine.

Assessing a patient's capacity to make a decision about accepting or refusing a medical intervention should be performed quickly but systematically. Physicians from the department of psychiatry at the Mayo Clinic in Rochester, Minn, present a 3-dimensional model for evaluating capacity. This model includes the risk of the proposed treatment (high vs low), the benefit level of the treatment (high vs low), and the patient's decision about the treatment (accept vs refuse).

Psychiatric advance directives (PADs) allow persons to authorize proxy decision makers and document advance instructions or preferences about future mental health treatment in the event of a crisis. The intent of PAD legislation is to enhance treatment autonomy for persons with severe mental illnesses (such as schizophrenia, bipolar disorder, and major depression) who anticipate periods of decisional incapacity associated with illness relapse.

Trichotillomania (hair-pulling) was once thought to be rare, but recent estimates indicate that it affects 2% of people.

Dance Lesson - Poetry of the Times

The National Alliance for Research in Schizophrenia and Depression awarded the 2000 Nola Maddox Falcone Prize. A brief description of each recipient's contributions to research with affective disorders is given.

The authors discuss gender differences found in patients with schizophrenia. Their group is the first to explore the possibility that gender differences in schizophrenia are mediated by differences in integrative network activity, reflected in a synchronous phase of high frequency (40 Hz) gamma activity.

What does the new set of U.S. Public Health Service guidelines for treating tobacco dependence say? Should everyone, regardless of mental health status, receive treatment?

The authors argue that adopting a single payer system would be like jumping out of the fire and into the frying pan. They look at three perspectives-the doctor's, the patient's and the health care policy-maker's.

The online contents of the April 2006 issue of Psychiatric Times.

A startled Malay woman with latah mocks the photographer.Source: Simons RC (1983)

multiple sclerosis, MS, Tysabri, natalizumab, progressive multifocal leukoencephalopathy, PML

Memory, Perimenopause

ADHD, epilepsy, depression

spinal cord injuries, SCI, neural network, axon stretch, stroke, neurorehabilitation, biomarkers, cystatin C, ALS, amyloid lateral sclerosis, MS, multiple sclerosis

Insurance, Medicare, Pay-for-performance, P4P

brain tumor, neuroma, tumorigenesis, cell phone use

Spinal cord injury, Oxidative stress, Acrolein, Hydralazine

stroke, stenting, stent deployment, Wingspan Stent System

Until recently, direct-to-consumer advertisements for selective serotonin reuptake inhibitors (SSRIs) touted their ability to correct a chemical imbalance, most memorably through the cartoon "ovoid creature" that thanked a drug for improving its mood. Over the past few years, consumer groups and patients have implored the FDA to require more accurate wording in ads. This has resulted in the appearance in ads of such qualifiers as "helps to restore," "appears to work," "may be related to," and "presumed to be linked."

Selective serotonin reuptake inhibitors, SSRIs, Suicidality, Depression, Major depressive disorder, Neonatal abstinence syndrome

Although Alzheimer disease (AD) is a global problem, it is good to analyze the impact of AD on a local level. Tim Lynch, PhD, an economics consultant and adjunct professor of health care finance at Florida State University, has done just that in a report released in March by the Cure Alzheimer's Now Coalition.

Anxiety and depression are the most often cited problems related to a cancer diagnosis, because receiving this diagnosis is often very frightening. Feeling sad, worrying relentlessly, and being unable to experience pleasure often lead people to feel that they may be on the path to losing their minds. However, in the past few years a more subtle phenomenon has been identified related to cognitive deficits allegedly associated with chemotherapy treatment, sometimes called chemobrain.

The fiscal 2007 budget that PresidentBush proposed in early February keepsa tight lid on most domestic spendingprograms, including those at the Centersfor Mental Health Services (CMHS)and the National Institute of MentalHealth (NIMH). Budgets for both willactually decrease for the second yearin a row unless Congress steps in.

The renaming of consultation-liaison psychiatry as psychosomaticmedicine, a new formal subspecialtyof psychiatry, may require someadjustment in our understanding ofthese terms. Both consultation-liaisonpsychiatry and psychosomatic medicinehave focused on treatment and researchof illnesses with mind-body interactions.Despite considerable overlap,consultation-liaison psychiatry hastraditionally been associated with treatmentand clinical research of comorbidmental disorders of the medicallyill, while psychosomatic medicine hasbeen associated with research into thephysiologic mechanisms underlyingmind-body interactions and classicalpsychosomatic diseases such as hypertension,asthma, and ulcerative colitis.

Physicians who use electroconvulsivetherapy (ECT) need tobe vigilant for unstable medicalconditions before and during the courseof treatment. This brief review is intendedto highlight some basic principlesand specific concerns that maybe encountered in the use of ECT inpatients who have comorbid medicalillness.

Practitioners understand the wholeness and unity of their patients. Instead of being considered isolated organ systems or enzyme cycles, patients are understood as coherent entities composed of coordinated and interrelated processes and systems. This fundamental understanding guidesinvestigative and clinical care approaches in psychosomatic medicine.

The fiscal 2007 budget that PresidentBush proposed in early February keepsa tight lid on most domestic spendingprograms, including those at the Centersfor Mental Health Services (CMHS)and the National Institute of MentalHealth (NIMH). Budgets for both willactually decrease for the second yearin a row unless Congress steps in.

This book is recommended not only for therapists but also for patients in therapy and others seeking enjoyable, fascinating reading and insight into their own marital relationships.