News

Despite the increasing number of elderly nursing home patients with dementia or Alzheimer's disease, there are problems providing appropriate care. Two of the major difficulties are lack of Medicare reimbursement and poor staff training. How can we better care for these elderly patients?

Dr. Kildare

Years ago, when I still believedDr. Kildare could cure my father,I stayed awake past my bedtimeto learn to be a doctor.

It has been well established that there is a high incidence of depression in conjunction with Alzheimer's disease and other forms of dementia. What are the best assessment and diagnostic methods, and which treatments will produce the best results?

The relationship between depression and epilepsy is bidirectional as not only are patients with epilepsy at higher risk of developing depression but patients with depression have a three- to sevenfold higher risk of developing epilepsy. Several studies have found that the presence of depression in patients with intractable epilepsy was a stronger predictor of poor quality of life than the frequency and severity of seizures. The principles of managing depression in epilepsy are reviewed in this article.

Allegations of complicity by Chinese psychiatrists in abuse and persecution of members of the Falun Gong continues to trouble the World Psychiatric Association. Are the steps being taken to learn the truth enough? Dr. Stone provides a look at the events that have unfolded to date.

Over the past quarter-century, new treatments for depression have emerged that are as effective as original pharmacotherapies but have fewer side effects. Yet, full remission and access to care remain out of reach for so many people. In this introduction to our Depressive Disorders Special Report, Dr. Golden encourages readers to see the glass as half-full.

An Illinois draft plan to screen children and pregnant women for mental illness has stirred controversy and raised questions about some elements of the President's New Freedom Commission on Mental Health report. Some critics fear the Illinois case sets a worrying precedent for mental health care throughout the United States.

Message in a Bottle

Whoever you are, I am writing to make contact, to get my message to someone who will understand. It is Friday, 7 p.m. and I've just finished my fifth phone call to a managed care automaton in 800-Land, my patient on a gurney in the ER with an IV in his arm, and they've finally agreed to pay for one hospital day.

Underdiagnosis of sexual dysfunction occurs frequently, even though more than two out of five adult women and one out of five adult men experience it in their lifetime. To increase recognition and care of sexual dysfunction, multidisciplinary teams of medical experts recently published diagnostic algorithms and treatment guidelines that include comprehensive psychosocial assessments, sexual histories, and discussions of selected psychotherapies and pharmacotherapies.

Psychiatrists and other mental health activists have been working in various countries around the globe to bring an end to unjust psychiatric incarceration for political beliefs and to improve living conditions for those patients in psychiatric hospitals. The former Soviet Union, China and India are all current targets of focus for this human rights movement. What are human rights organizations doing and how can psychiatrists help?

Homosexual identities can be described as closeted, homosexually self aware, gay/ lesbian and non-gay identified. This classification privileges the role of self-definition. In coming out, gay people integrate, as best as they can, dissociated aspects of the self. As gay people must decide on a daily basis whether to reveal and to whom they will reveal, coming out is a process that never ends.

A greater understanding of how the brain works, including the effect of environment on it development, has led to advances in diagnosing and treating psychopathology. The latest findings will be presented at an international meeting, along with a discussion of how much work is to be done and the great need for qualified child psychiatrists, especially in developing countries.

Although light therapy is an old treatment, new therapeutic uses are being researched. What is the optimal time and strength of light treatment to best help patients with depressive disorders?

According to the World Health Organization, five of the 10 leading causes of disabilities worldwide are psychiatric conditions. More than 450 million people worldwide suffer from mental and brain disorders, and nearly 1 million people commit suicide each year. Because of this, many health care organizations and governments are forging partnerships to combat the daunting talk of providing quality health care around the globe.

Despite the image presented in films, books and television, prostitution places women and children at high risk for PTSD and other comorbid disorders. What experiences lead to this life?

As society and the definition of family in the West changes, fathers in the 21st century face emotional and psychological obstacles to a healthy parent-child relationship. This article examines professional interventions and other resources that can help prepare fathers to be effective parents.

A cross-cultural comparison of suicide in old age, including a discussion of recent epidemiological trends in suicide rates. The authors also discuss the impact of social and cultural variables on the detection of depression and the formulation of suicide prevention strategies.

Both the mental health and justice communities have been troubled by the increased number of mentally ill individuals in the prison populations. Legislation awaiting passage in the U.S. Congress would fund collaborative programs between these two fields that would try to alleviate this growing problem.

With the increase in child and adolescent patients comes an increase in challenging cases. Dr. Schowalter introduces this Child and Adolescent Psychiatry Special Report and provides perspective on articles discussing approaches to initiating care with a teen-ager, collaborating with pediatricians and other clinical topics.

Beginning a therapeutic relationship with an adolescent patient requires an understanding of the family dynamics and the patient's experience of their unique stage of life. In this rapidly evolving population, a thoughtful approach is essential to prevent many of the pitfalls in treating adolescents.

What are the current policy barriers to effective addiction treatment, and how can they be overcome? Attendees at the American Society of Addiction Medicine's Annual Meeting heard about new and innovative ways of helping patients suffering from substance abuse.