In 1885, Georges Gilles de la Tourette, M.D., described in the Achives of Neurology a neuropsychiatric disorder characterized by chronic motor and vocal tics that begin in childhood. During the next century, researchers demonstrated that the disorder, which came to be called Tourette's syndrome (TS), is probably inherited as a dominant gene that expresses with widely varying symptoms, even within monozygotic twin pairs.
Mood disorders and their impact on women and their families was the topic of a half-day conference held at New York City's Algonquin Hotel;, former haunt of the famous-and depressed- writer Dorothy Parker, who made at least one suicide attempt there in the early 1900s.
"The Internet is like being in another world- you can pretend to be everything you ever wanted to be. There are no rules and no sense of time. In one hour you can tell each other all about yourselves. It's so interactive- question and answer and so quickly. No limits." Exhilaration was the expression of a 49-year-old divorced male gynecologist with the password "lady's doc."
The past decade witnessed major strides in our understanding and treatment of affective disorders in adults, children and adolescents. One of the baffling problems in child and adolescent psychiatry was the question of psychiatric illness spanning a lifetime. The existence of depressive disorders in prepubertal children has been generally recognized and acknowledged since the 1960s; however, only in the last decade did evidence become available that supports the notion that depression in different ages represents the same entity, albeit manifesting different clinical symptoms in each developmental period (Cytryn and others 1986).
In what well may be a first in the managed behavioral health care industry, the New Jersey Psychological Association (NJPA) and seven psychologists filed a lawsuit against MCC Behavioral Care Inc. contesting the firm's utilization of "without cause" termination contract provisions. The case may break new ground in the way managed care companies interact with providers, and may question whether managed care companies can deselect providers despite the potential harm to patients.
September 1996, Vol. XIII, Issue 9Reflecting today's surging interest in computers and what they can do for mental health professionals, it was standing room only at many of the 19 computer-related presentations offered at the American Psychiatric Association's 149th annual meeting, more than triple the number included at last year's convention.
With the exploding growth of the Internet, more and more people are going on-line. Mental health professionals are finding discussion groups filled with like-minded researchers and practitioners in every aspect of the field. Laypeople are discovering the value and enrichment that mutual self-help support groups and educational materials lend to their treatment. It is important, if not invaluable, to become familiar with this new world of opportunity and to learn about what's currently available and what's coming in future years.
Piano Music - Poetry of the Times
The development of computerized speech dictation has been a long-standing goal of mental health professionals who spend an extraordinary amount of time and money on dictating patient records.
An explanation of the cycle of abusive dynamics as it exists in abusive relationships, in commonsense language.
Many of the advantages of the MAOIs are seen with selective serotonin reuptake inhibitors, which have become the drugs of choice in the treatment of panic disorder.
As psychiatry is swept along by the evolutionary winds of change, will you be poised and trained for success? This question was posed to psychiatrists by Joel Yager, M.D., at the recent annual meeting of the American Psychiatric Association, at which he received the Seymour D. Vestermark Award.
Rural psychiatry is on the threshold of an immense transformation. Across the country, each state, faced with mandates to cut budgets and conserve health care spending, is in the complex process of negotiating the changing world of health care reimbursement and the redistribution of ever-shrinking funds. Since the majority of rural psychiatric care is delivered at community mental health centers, which rely heavily on state and federal government funding and initiatives, rural psychiatrists are likely to find themselves battling bureaucratic waves that challenge their resourcefulness and ardor.
Attention-deficit/hyperactivity disorder (ADHD) has received an extraordinary amount of attention in the popular media over the past eight months. Stories concerning the disorder, and especially its treatment with stimulant medication, have appeared in many major newspapers, news magazines and television news, entertainment and talk show programs.
Historically, cult refers to a system of worship and more specifically to an innovative religious system, as opposed to a sect, which is a breakaway group from an established religion. During the past 30 years, however, cult has taken on a pejorative connotation arising from disasters such as Jonestown and Waco, and hundreds of media reports of individuals and families devastated by involvement in cults.
Attention-deficit/hyperactivity disorder (ADHD) in adults is a common-and, frequently undiagnosed-psychiatric disorder. This article will focus on the symptoms, associated features, diagnosis, differential diagnosis, prevalence, etiology and treatment of this illness.
Paraphilias as defined by DSM-IV, are sexual impulse disorders characterized by intensely arousing, recurrent sexual fantasies, urges and behaviors (of at least six months' duration) that are considered deviant with respect to cultural norms and that produce clinically significant distress or impairment in social, occupational or other important areas of psychosocial functioning.
Since 1980, criteria for diagnosing bipolar disorder in adults have also been used to diagnose mania in children, with some modifications to adjust for age.
At this time, both patients and professionals seem to have an unprecedented interest in circadian rhythms. We now know that the body's clock is located in the suprachiasmatic nucleus (SCN) of the hypothalamus, and that the SCN regulates the pineal gland's secretion of the hormone melatonin.
For clinicians, the assiduous and sustained resistance to change common in patients with narcissistic personality disorder (NPD) has been especially noticeable and trying. However, until recently the natural course of NPD has not received much attention in the clinical and empirical literature, and there is very little documented knowledge about the factors that might contribute to changes.
Personality disorders are characterized by the presence of inflexible and maladaptive patterns of perceiving oneself and relating to the environment that result in psychosocial impairment or subjective distress. The enduring nature of the behaviors, their impact on social functioning, the lack of clear boundaries between normality and illness, and the patient's perception of the symptoms as not being foreign make this group of conditions more difficult to conceptualize than the more typical, episodic mental disorders.
Psychopathy (renamed antisocial personality disorder) is marked by persistent violations of social norms, including lying, stealing, truancy, inconsistent work behavior and traffic arrests.
Significant research developments in the etiopathogenesis of schizophrenia have occurred during the past several years. One such advance is the "neurodevelopmental" hypothesis that events during early brain development, especially the prenatal and perinatal periods, may play an important causal role in at least some, and perhaps many, cases of schizophrenia.
Temporal lobe epilepsy (TLE), now more commonly called complexpartial seizure disorder so as to include seizures that originatein the frontal foci, straddles the borderland between psychiatryand neurology.
Brain serotonin levels as a predictor of suicide has been the subject of intense research scrutiny over the past several years, with scientists trying to find easily accessible markers so that the neurotransmitter's levels might someday be readily measured in clinical settings.
Late last year, Oregon voters approved a law that would permit doctors to prescribe lethal drugs to patients judged to be in the last six months of life. Oregonians are setting out on a path that the Dutch have traveled for the past 20 years.
Venlafaxine (Effexor) is a novel antidepressant recently released to the American market. Its entry into the antidepressant market has been much heralded. The lay press has described the drug as "Prozac with a punch," and many patients were asking for it long before it was available. As the hoopla settles down, we are learning that venlafaxine is a potentially important drug with both advantages and disadvantages over other available antidepressants, including the selective serotonin reuptake inhibitors (SSRIs).
Sleep disorders and substance abuse disorders are widespread acrossthe United States, researchers have found. According to the NationalCommission on Sleep Disorders Research, more than 80 million Americanscomplain of sleep difficulties, while Schuckit and Irwin reportedthe lifetime prevalence of alcohol abuse or dependence to be 13percent and nonalcohol drug abuse, 5.9 percent.
Insomnia, the subjective sense of having inadequate quantity orquality of sleep, may result from a variety of causes. In itschronic form, such etiologies may include psychiatric disorderssuch as depression or anxiety, medical illnesses, medications,substance abuse, circadian dysrhythmias and pathophysiologiesintrinsic to sleep such as sleep apnea or periodic movement disorder.When these conditions have been ruled out, however, there remaintwo very interesting groups that at this time are best understoodin psychophysiological terms.
Sleep apnea, a medical disorder with significant health and behavioraleffects, is of particular interest to psychiatrists for its capacityto mimic or exacerbate symptoms of psychiatric disturbances suchas depression, anxiety and panic disorder.
