News

Neurofeedback, also called electroencephalogram (EEG) biofeedback or neurotherapy, is an adjunctive treatment used for psychiatric conditions such as attention-deficit/hyperactivity disorder, generalized anxiety disorder, posttraumatic stress disorder, phobic disorder, obsessive-compulsive disorder, bipolar disorder, depression and affective disorders, autism, and addictive disorders (Moore, 2000; Rosenfeld, 2000; Trudeau, 2000).

The question of whether a clinically significant marijuana (cannabis) withdrawal syndrome exists remains controversial. In spite of the mounting clinical and preclinical evidence suggesting that such a syndrome exists, the DSM-IV does not include marijuana withdrawal as a diagnostic category.

On Feb. 12, New Mexico's Senate passed House Bill 170, "Prescriptive Authority to Psychologists," with a 29-9 vote, and Governor Gary Johnson (R), will soon decide the bill's fate. According to Gov. Johnson's office <www.governor.state.nm.us>, the estimated date for the final decision is March 6.

Two new reports, released by the Institute of Medicine and the World Health Organization, examine the issue of mental health care in Third World countries. In those areas that have limited medical resources, how can mentally ill patients best be served?

Lay Down Sally

I've known him since my first days as a doctor,and now he wants to quit.

Whether for free or for a fee, many states are now offering public Internet access to information regarding physicians. Much of this information is benign -- specialty certification, years of practice, medical school and so on. However, some Web sites are including more controversial information such as malpractice suits and settlements. Is this going too far?

The following are case studies discussing the impact of proper evaluation of comorbid psychiatric illness and medical disorders. To read more case studies and find out how to effectively recognize and treat patients with these disorders, please see the January 2002 issue of Psychiatric Times.

E. Fuller Torrey, M.D., explores the battle for control of the state asylums in the late 1800s. Using everything from rational arguments to blatant defamation of character, William Hammond's neurologists and John Gray's psychiatrists duked it out in New York as other states watched carefully in pursuit of what might follow.

Although incomplete, the link between thyroid function, bipolar affective disorder, and lithium has been acknowledged for many years. This article provides an overview of the relationship and recent literature.

Diabetes doubles the likelihood of comorbid depression, which impairs functioning and quality of life. This mood disorder has a unique importance in diabetes because of its associations with treatment noncompliance, insulin resistance, hyperglycemia and an increased risk for diabetes complications.

Asthma is a serious health condition that can be exacerbated by emotional triggers. Furthermore, depression in these patients can affect treatment compliance, thus worsening prognosis. What role does psychiatry play in treating these patients?

The very immediacy of the recent terrorist attacks makes the diagnosis of posttraumatic stress disorder problematic since there is no distance of time or space from the event itself. How can clinicians deal with this shift to best treat patients?

Dr. Genova offers the antidote to the complexities of manualized and proceduralized psychotherapy that have arisen in imitation of procedural, technology-driven medicine. Supportive, directive and relational types of therapy and their correlation with various power structures within the doctor-patient relationship are described.

What was it like to be at "Ground Zero"? Three psychiatrists discuss their experience and the impact the attack on the World Trade Center will have on the future.

Given the recent anthrax scares, it is important for psychiatrists to be on the alert. However, this should be balanced with the realization that life must continue as normal as possible.

Since Sept. 11, health care professionals and their patients have been trying to make sense of the tragedy as well as cope with the possibility of future attacks. While the following list of books, articles, Web sites and so forth is certainly not exhaustive, it serves as a starting point of information sharing.

Over the past two decades, there has been considerable progress in understanding the functions of the prefrontal cortex of the brain and its regulation of mental activities that allow for self-control and goal-directed behaviors. These mental activities are unified under the term executive functions.

The introduction of posttraumatic stress disorder (PTSD) into psychiatric nosology has brought about a great deal of insight as well as controversy. Have complex clinical manifestations of PTSD created a need for further clarification of the disorder?

In the glossary of our book The Culture-Bound Syndromes, Charles C. Hughes, Ph.D., listed almost 200 folk illnesses that have, at one time or another, been considered culture-bound syndromes (Simons and Hughes, 1986). Many have wonderfully exotic and evocative names: Arctic hysteria, amok, brain fag, windigo.

The Human Genome project has provided an abundance of genetic information, including identification of many disease-causing genes. Clinical applications, genetic counseling and the potential ethical issues raised by the availability of genetic testing are all areas of concern in gene research. Will genetic counseling in classical genetic diseases help to provide guidelines for behavioral disorders?

Although many of the physiological functions of neurosteroids are currently unknown, evidence suggests that these endogenous molecules may play a role in the pathophysiology of psychiatric disorders and treatment strategies. Neurosteroids have been linked to SSRI action and may be relevant to antipsychotic drug effects. Do neurosteroids have neuroprotective properties or HPA axis effects?

The first magnetic resonance imaging studies in schizophrenia began to appear in the literature in 1984. These studies confirmed earlier theories and also contributed new findings such as changes in size of the hippocampus, amygdala, corpus callosum and so on in patients with schizophrenia. What other neuroimaging techniques are being used? What do recent studies show regarding the neuroanatomic abnormalities found in patients with schizophrenia?