Addiction & Substance Use

R.I.P. Rest Inspiring Psychiatrists. I am grateful for having known you.

Is the expression “mental illness” merely a metaphor? If so, does that tell us something about the persons we identify as having a mental illness? To clinicians who deal with devastating psychiatric disorders every day-and to those afflicted with these conditions-these questions may seem like a lot of semantic nonsense.

Do not be surprised if you hear more about hybrid models of psychiatric diagnoses included in DSM-5. The categorical and dimensional model approaches are 2 sides of the same coin as you look at the same patient from 2 different angles.

In this review, we discuss the established medications as well as experimental therapeutic options that may emerge as future medications for alcohol intoxication, withdrawal, and/or long-term abstinence maintenance or harm-reduced drinking.

Editor’s note: We are pleased to introduce Being a Therapist with this issue of Psychiatric Times. We hope you will enjoy the close-up views of these therapists.

What follows is an adaptation of Dr Ellis’s response to a volunteer who took part in a live public workshop demonstration of the Rational Emotive Behavior Therapy approach.

Using a question-and-answer format, we present a brief overview of issues that arise when mental health professionals explore how to best serve this population.

A parent's heavy drinking can increase a child's risk of substance use disorder.

In spite of a chronic mental illness (schizophrenia)and a psyche that increasingly blurred the boundaries between fantasy and reality, this lawyer and professor graduated from Vanderbilt with a perfect academic record.

The primary difference between malingering and factitious disorder is the question of motivation.

Our exchanges be marked by basic respect and civility-and by a willingness to take personal responsibility for what we say and how we say it. Physicians ought to be in the vanguard of such an Internet reformation.

"Internet Addiction" may soon spread like wildfire. All the elements favoring fad generation are in place . . . the profusion of alarming books; the breathless articles in magazines and newspapers; extensive TV exposure; ubiquitous blogs; the springing up of unproven treatment programs; the availability of millions of potential patients; and an exuberant trumpeting by newly minted "thought leading" researchers and clinicians. So far, DSM-5 has provided the only restraint.

Anti-psychiatry proponents forget it is widely recognized that the DSM is a provisional diagnostic system pending progress in better understanding uniquely human disorders of our most complex organ.

My advice to residents is that you remain open to the opportunities that surround you every day as you continue your education and professional training.

The role of subtyping and bipolarity in TRD was discussed in Part 1 of this 2-part article. Here we review a number of the most common confounding factors of TRD but limit our scope to comorbidities that can be directly addressed and treated by psychiatrists.

Ongoing advances in functional brain imaging will permit studies on postulated roles of magnetic fields, biophotons, and macroscopic highly coherent quantum field effects on normal brain functioning and mental illness.

Psychotherapy is a rubric--an umbrella under which a vast array of differing interventions exist. Its diverse forms are supported by different ideologies and vocabularies.

Two recent publications provide clinically relevant information about the risk to benefit ratio of antidepressants for the treatment of MDD in youths, adults, and the elderly.

We do not need psychiatrists who fit people into categories and slots and treat them as if they are robots, according to the dictates of a recipe book called “The Diagnostic and Statistical Manual.”

As we are faced with a growing population of older adults, a better understanding of the issues that they confront is crucial.

Patients with masochistic tendencies present with self-defeating patterns and often reject help.

Apathy is our enemy. Pain, paradoxically, is our ally because it is one of the most powerful fuels we have to impel us to a different and better tomorrow.

SAMHSA is celebrating its 20th anniversary with a set of 8 new strategies to support and address the needs of patients with behavioral health disorders.

Ethics in the field of mental health is a concern for every psychiatrist, but what happens when past patients reenter a retired clinician's life in a personal setting?

The current system of payment for mental health care in the US can lead, or even incentivize, clinicians to focus on and code for Axis I disorders and their more readily reimbursed psychopharmacological treatment approaches.