With a prevalence of approximately 10% for North American women, vulvar vestibulitis can have enormous quality of life implications for patients and their partners. When gynecologists and other medical specialists have difficulty finding an organic cause for the chronic pain associated with this disorder, patients find themselves referred to the mental health care professional, who must determine the diagnosis and course of treatment
Literature invites readers to see the world from another viewpoint, which can, in turn, lead to an increased capacity for empathy. In working with difficult-to-treat children, Alexandra Helper, MD, has found that the use of literature that focuses on alternative viewpoints helps such patients develop empathy and improve their functioning in the "real world."
Becoming more creative and improvising have certain dynamics that can be used by therapists in fostering a more healing process. Playfulness, imagination, dialogue, skill-building, narrative, inspiration and integration can all be employed in clinical settings. These tools create an environment where spontaneity can arise, anxiety is reduced, and patients are more receptive to their own intuition.
Poetry of the Times
Proponents of mental health care parity have reintroduced the legislation that died in the U.S. House of Representatives last year. While the idea of parity has broad bipartisan support, the debate continues over how much it will cost, who will foot the bill, and how it should best be administered. In a time of war and tight budgets, will the bill get the attention it deserves?
What does the state of psychiatry look like? Surveys have been conducted and data have been broken down into compensation levels, specialties, service costs and insurance coverage. Finally enough data exist to give an overall view of where most psychiatrists stand today in the medical workforce.
Substance abuse and addiction are among the most challenging health problems facing our society. Breakthrough discoveries in science continue to refine our understanding of drug abuse and addiction and are yielding new opportunities to translate basic research findings into tangible treatment products. Read about the progress being made by the National Institute on Drug Abuse, the world's largest supporter of research on the health aspects of addiction.
There are many factors that contribute to patients with schizophrenia not taking their medication, including side effects and lack of education. What can clinicians do to help their patients adhere to treatment? Should clinicians be spending more time educating their patients? How will long-acting medications affect adherence issues?
Although there is no pharmacological agent that has been approved by the U.S. Food and Drug Administration for the treatment of autism, new studies are showing promise in not only discovering the cause of autism, but pharmacological treatments as well.
The idea that drug response could be based on a patient's genetic background first surfaced over 100 years ago. Since then, technology has advanced to the point where prescribing medications based on a patient's genetic makeup no longer seems like science fiction. This article looks at the latest research on the pharmacogenetics of psychotropic medications and shows how far we still have to go.
Increasing variations in mechanisms of action of atypical antipsychotics, side-effect profiles, and efficacy among the atypicals enable clinicians to tailor treatments to individual response, side-effect history, and current medical conditions.
With all the various types of medications as well as different formulations that can be used to treat ADHD in adolescents, choosing the right one can be a difficult task. This analysis of the options will help make that choice easier.
In this introduction to our Trauma Special Report, Dr. Novac places the articles in historical perspective and reminds the reader of the importance of understanding trauma within today's global constructs and impending war.
As the U.S. Department of Homeland Security raises security levels, Americans frantically take extraordinary precautions to prepare themselves for disaster. How is the public affected by the media and what can mental health care professionals and the government do to help minimize this anxiety?
Inpatient care for the wealthy has arrived--fluffy bath robes, in-room Jacuzzis, a concierge at your beck and call. Do the luxuries of these "resorts" negate the care that is being provided, or can patients have the best of both worlds?
Poetry of the Times
In the wake of the deaths of seven astronauts aboard the Space Shuttle Columbia, many critics have called for an end to manned space flights. Psychiatrists, however, point to the intangible benefits--including the societal values and desired psychological traits that are modeled by astronauts.
What is secondary traumatization? The authors discuss current research and implications for this controversial and emerging field of study.
The majority of people experience acute stress symptoms following trauma, but the development of posttraumatic stress disorder is the exception rather than the rule. Some investigators hypothesize that PTSD develops following increased nervous system response to trauma. Why only a minority of individuals experience this response, what their risk factors are and when should they be treated is the subject of ongoing research.
Parents who have witnessed traumatic events may pass dysfunctional life views on to their children. How much more vulnerable are these second-generation victims to PTSD and other psychiatric disorders?
The DSM may be flawed, but it is the best available system for organizing and diagnosing mental disorders, and it remains a model for other medical specialties.
Decades of labor have been poured into the formulation of the DSM and its descendants. Is this system of classification still useful and relevant to clinical practice? Should psychiatrists continue to revise it or get rid of it altogether?
The field of schizophrenia recently has seen remarkable progress in the understanding and treatment of this disabling condition. Dr. Buckley provides highlights of this special report.
Poetry of the Times
While housing problems for the mentally ill are usually associated with patients receiving public care, private patients also face obstacles over obtaining and keeping adequate housing. What are the issues, and what can agencies do to ensure all patients, regardless of socioeconomic status, have adequate housing?
With the seemingly impending war with Iraq, Dr. Stone revisits the Marxist-based film The Battle of Algiers and is surprised to find Islamic fundamentalism prominently featured throughout. Looking back, he finds nothing in the director's or writer's notes, or in critics' writings on the film, to indicate they were aware of its presence-the film was viewed through the context of the time. Are we still making this deadly error in dealing with Muslim nations?
Schizophrenia is a devastating psychiatric disorder that affects 1% of the population worldwide. Patients often suffer their first psychotic outbreak in their late teens or early 20s. Despite advances in neuroleptic drugs, many patients' symptoms remain refractory to treatment, with recurrent episodes of auditory and visual hallucinations, bizarre delusions, depression, and social withdrawal that can last an entire lifetime.
The World Trade Center attack changed the face of the United States and of psychiatry. Men and women of the cloth and of the clinic came together to care for the stricken masses. Yet, members of the clergy do not always refer congregants who exhibit duress to the psychiatrist, nor do psychiatrists refer patients to the clergy. What keeps these two fields apart? What is best for your patient?
Although late-onset psychosis is not as common as the early-onset variety, it can still pose difficulties in diagnosing and treating patients. How are patients with late-onset psychosis different from those who have early-onset, and what sorts of issues should clinicians be aware of?
The atypical antipsychotics have become the treatment of choice for patients with psychotic and other behavioral disorders. However, case reports, retrospective studies and epidemiological data suggest that these medications may be associated with new-onset type 2 diabetes and diabetic ketoacidosis.