News

While progress in identifying the specific genetic variations that help determine an individual's vulnerability to addiction has been slow, a great deal has been uncovered about delineating the role that numerous genes and their protein products play in mediating the development of addiction.

Contingency management provides tangible reinforcement to modify patients' behaviors and has been found to reduce substance abuse across a number of clinical populations and settings. What types of tangible reinforcements are most effective?

Although there are numerous media accounts of the detrimental effects of the drug Ecstasy, there may also be some clinical uses in the treatment of PTSD. The U.S. Food and Drug Administration has approved the first-ever clinical trial of MDMA since it was banned in 1988. An expert in the field discusses what psychiatrists need to know about the popular "rave" drug and the compound's use as a therapeutic tool.

Psychodynamic concepts such as the Self and the collective unconscious are helpful in understanding "our millennial event"3/4Sept. 11, 2001. Because it aims to help patients become aware of and free themselves from social contexts, psychotherapy may be more useful than ever.

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.