Special Reports

The diagnosis and management of unipolar depression remain challenging. The articles in this Special Report remind us of the wide knowledge base that is needed in the management of the depressed patient and of the multiple conceptual levels that must be integrated in the care of our patients.

Despite its many challenges, rural psychiatry can be particularly rewarding because it allows an opportunity to provide much-needed care and the ability to be at the forefront of helping to close gaps in health care disparities.The privilege of being a true community resource and the ability to improve overall community mental health give meaningful purpose to the work of a rural psychiatrist.

Even as psychiatry advances and develops new clinical techniques and as behavioral health systems seek the means to be able to serve all people needing care, disparities in service persist. The articles in this Special Report examine the demographically hard-to-reach populations-the socially marginalized who require special outreach techniques.

Obesity is one of the most common physical health problems in individuals with psychiatric conditions and contributes to excess medical morbidity and mortality. Several classes of psychotropic medications, particularly atypical antipsychotics, cause weight gain. While these issues pose challenges to optimal health, the good news is that there are solutions and emerging strategies.

Assessments of partial culpability of adolescents are difficult in individual cases; however, the courts are moving away from mandatory sentencing to individual determinations, even for the most heinous crimes.