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.
The postpartum period represents a time of increased vulnerability for women, though postpartum disorders are often under-recognized and undertreated.
The diagnosis of bipolar disorder in children remains controversial. One of the more disturbing facets of its presentation in such young patients is the presence of hypersexual behavior. How can these behaviors be differentiated from the effects of abuse and other psychiatric disorders?
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.
Given that a substantial minority of patients don't respond to monotherapy, clinicians may have to consider combined or augmentation therapy. According to the research, which drugs are most effective, and in which combinations?
Geriatric psychotherapy has begun to receive consistent and supportive attention in the psychiatric literature. Despite this growing interest in psychotherapy for older adults, studies of efficacy of either psychotherapy alone or of combined treatments for older patients are still limited in number, and more attention to the issue is needed.
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.
Evidence-based treatment has not always been a common model in the field of psychiatry. Its popularity has grown over the last five years, though, as the body of scientific evidence into mental health has grown as well.
I sit with my patient but can't tune into another painful story.
There appears to be a subgroup of children and adolescents who, despite repeated brief hospitalizations, do not improve, but along the way, these patients accumulate medications. During long-term residential treatment, however, these patients do improve and their medications are reduced.
Cognitive-behavioral therapy can be tailored for use with children who have experienced sexual abuse in order to relieve symptoms of PTSD.
There has been much thought and discussion about the relationship between pediatrics and psychiatry, but research on the integration of the two leaves much to the imagination.
Evidence is growing that trauma-focused cognitive-behavioral therapy (TF-CBT) is an effective treatment for sexually abused children, including those who have experienced multiple other traumatic events. This article reviews the research that has examined treatments for sexually abused children and suggests future research priorities in this regard.
Dirt road and forest exhale, crickets rasp,and August pours damp pink light at dusk.
With states set to lose their one-time fiscal relief in June, mental health care services are bound to be hard-hit, particularly for Medicare. What services are the most likely to be cut and how will this affect Medicare beneficiaries?
Educational Issues in Neuropsychiatry
In their introduction to the neuropsychiatry special report, Drs. Yudofsky and Hales recapitulate the evolution of neuropsychiatry over the past 150 years, offering up an answer to the question: "What is neuropsychiatry and how does it differ from the traditional specialties of neurology and psychiatry?"
The past two decades have ushered in a new era of methodological advances in tools for noninvasive imaging of the living brain. The information gleaned from advances in neuroimaging have been used to provide insights into ADHD's etiology, diagnosis and treatment.
Patients with anorexia nervosa often attempt to deceive health care professionals because they do not want treatment for their disorder. Thus, physicians must maintain a high index of suspicion for signs and symptoms of AN due to its potentially fatal complications.
