May 2nd 2024
How can psychiatric clinicians improve outcomes for this unique patient population?
The Expanding Role of Fluid Biomarkers in the Diagnosis and Management of Patients With Alzheimer Disease
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Clinical Consultations™: Considerations for Customizing Care Plans for Patients with Parkinson Disease Psychosis
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Expert Illustrations & Commentaries™: Visualizing New Therapeutic Targets in Schizophrenia
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Advances In™ Schizophrenia: Expanding the Therapeutic Landscape
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Southern California Psychiatry Conference
September 13-14, 2024
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Updates on New and Emerging Therapies to Improve Outcomes for Patients With Major Depressive Disorder
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5th Annual International Congress on the Future of Neurology®
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2023 Annual Psychiatric Times™ World CME Conference
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Clinical Consultations™: Managing Depressive Episodes in Patients with Bipolar Disorder Type II
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Patient, Provider, and Caregiver Connection™: Exploring Unmet Needs In Postpartum Depression – Making the Case for Early Detection and Novel Treatments
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Medical Crossfire®: Understanding the Advances in Bipolar Disease Treatment—A Comprehensive Look at Treatment Selection Strategies
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'REEL’ Time Patient Counseling: The Diagnostic and Treatment Journey for Patients With Bipolar Disorder Type II – From Primary to Specialty Care
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More Than ‘Blue’ After Birth: Managing Diagnosis and Treatment of Post-Partum Depression
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Patient, Provider & Caregiver Connection™: Reducing the Burden of Parkinson Disease Psychosis with Personalized Management Plans
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Mental Health Parity Law Under Attack
July 7th 2010Business groups and leading behavioral managed care companies have mounted a multifront attack on the new mental health parity law. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) went into effect on January 1, 2010, for employer plans starting after that date. However, companies have been awaiting a delayed final rule interpreting the terms of the MHPAEA.
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Normality Is an Endangered Species: Psychiatric Fads and Overdiagnosis
July 6th 2010Fads in psychiatric diagnosis come and go and have been with us as long as there has been psychiatry. The fads meet a deeply felt need to explain, or at least to label, what would otherwise be unexplainable human suffering and deviance.
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Alcohol and Drugs Boost Creativity? Think Again
June 29th 2010From 19th century French impressionists to current-day “rockers,” it has always been a loosely held belief that creative genius encompasses (even embraces) substance use. But a recent study found that substance use impedes artistic creativity.
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As early as the 1970s, researchers and practitioners became increasingly aware of the necessity for services that would address the varied needs and treatment implications for consumers with the co-occurring disorders of substance abuse and mental illness. High percentages of consumers in substance abuse treatment centers were identified with mental illness disorders, and consumers admitted to psychiatric facilities often were identified as having additional substance use disorders.
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A Psychiatry of Tomorrow: DSM-5 and Beyond
June 25th 2010When I was an undergraduate studying molecular biology in the early 1990s when the Human Genome Project had just begun, my required coursework included several lectures on the ethical implications of sequencing, understanding, and ultimately being able to manipulate the “code of life.”
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I don’t believe in witches or ghosts or things that go bump in the night. I’ve always thought that the Salem witch trials were a result of mass hysteria (on the part of the persecutors) rather than a phenomenon of dark forces at work. And seeing Arthur Miller’s The Crucible a few years ago, only confirmed my suspicions. So I was gratified to see Dr Quintanilla’s poster at this year’s meeting of the American Psychiatric Association. As a physician and researcher, she factually explains the fallacy of witchcraft. Looking at historical documents dating back to the 15th century, Dr Quintanilla was able to match the symptoms of people condemned as witches with associated neurological and psychiatric disorders, such as epilepsy and hysteria. [Editor’s Note: Natalie Timoshin]
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DSM-5 in the Digital Age-Part 1
June 15th 2010Many have challenged the claim of the APA/DSM-5 Task Force that the current process is the most “open process in the history of the manual.” Few have actually provided an argument or evidence of why this might, or might not, be so. What has changed dramatically in the DSM process since DSM-IV in 1994, and even DSM-IV-TR in 2000, is the rise of Internet culture and the “blogosphere.” What does this have to do with DSM-5?
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Elegant Knockdowns, DISC1, and Schizophrenia
June 3rd 2010When I was a grad student-back in the Jurassic Era of molecular manipulations-my lab mates and I were all transfixed by the notion of a new technology: knockout animals (KOAs). This was because of its promise to solve a vexing problem.
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No, Psychiatry Has Not Lost Its “Mind”: Here, Psychotherapy Training Thrives
June 3rd 2010After reading Dr Daniel Carlat’s heartfelt piece in the April 19, 2010, New York Times Magazine (“Mind Over Meds”), I was struck by several things. The first was Dr Carlat’s eloquence regarding the dilemmas of psychiatric practice. Second was how his experience may represent a generation of psychiatrists who were trained during an era of drug discovery wrapped in the exciting promise of “Biological Psychiatry.”
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The Political Diagnosis: Psychiatry in the Service of the Law
May 13th 2010Perhaps one of the positive things to come out of the Kansas v Hendricks wave of sexually violent predator (SVP) commitment laws during the past decade is that our knowledge base on sex offenders has grown tremendously.
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DSM5 on Substance-Related Disorders
May 13th 2010Included in this list of disorders is the recommendation that the category include substance use disorders and non-substance addictions such as gambling and Internet addiction. The category has tentatively been retitiled "Addiction and Related Disorders."
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DSM5 Suggests Opening The Door To Behavioral Addictions
April 23rd 2010The recently posted first draft of DSM-5 has suggested a whole new category of mental disorders called the "Behavioral Addictions." The category would begin life in DSM-5 nested alongside the substance addictions and it would start with just one disorder (gambling).
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DSM5 Temper Dysregulation-Good Intentions, Bad Solution
April 22nd 2010Sometimes you spot a serious problem and figure out a very well-intended solution, only to discover eventually that your solution created as much trouble as the original problem. The workers on DSM5 have spotted an enormously worrying problem-the wild overdiagnosis of childhood bipolar disorder (BD) which has led to a massive increase in the use of antipsychotic and mood stabilizing medications in children and teenagers.
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Psychiatric Diagnosis Gone Wild: The "Epidemic" Of Childhood Bipolar Disorder
April 8th 2010Mark Twain observed that "the past may not repeat itself, but it sure does rhyme." An unfortunate rhyme in psychiatric history is the recurrence of fad diagnoses. Childhood Bipolar Disorder is the most dangerous current bubble, with a remarkable forty-fold inflation in just one decade.
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ADHD and Comorbid Substance Use Disorder
April 7th 2010Epidemiological studies show that, 4% to 5% of the general population have severe ADHD. Of this number, half have a comorbid substance use disorder. The aim of this article is to help physicians understand and manage this challenging combination of comorbidities.
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Are FDA Warnings on Antipsychotics Heeded?
April 7th 2010The impact of FDA alerts and label warnings was examined in 2 recently published studies of antipsychotic drug use. In one study, researchers gauged physician response to the 2005 warning of increased mortality with antipsychotic use in elderly patients with dementia, and in the other study, researchers determined whether recommended safeguards were implemented following the 2003 advisories on adverse metabolic effects of second-generation antipsychotics.
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My parents lived in 2 different worlds together. One, the outside world, was where they sparkled. Their business was so successful, and they were urbane, sophisticated, and very smooth. At home, the inside world was very different. They were competitive with each other, more critical than affectionate; there was none of the togetherness they presented to the outside world.
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Overly sensitive, aversive reactions to stress seem to run in families. The literature abounds with reports of relatives in these populations predisposed to depression, anxiety, and even suicide. Some family members present with glucocorticoid levels notched abnormally high, and in curiously deregulated concentrations. Behaviorally, they seem to exist at a permanent state of high alert.
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Psychologist Prescribing Privileges: Bias and Risk Assessment
April 5th 2010Oregon’s legislature has passed the bill: should the governor sign it? Most opinions on this issue are strong, and many have reached the point of invective. Even such a cool mind as Ronald Pies' has weighed in with an emotionally charged editorial.1 To speak in favor when so many are opposed seems only to invite more affective discharge. On the other hand, editorial views thus far may be moving us toward extremes on an issue that is highly complex. Perhaps a dialectic approach -– what value can we find in an opposing view? -- would be wise at this point. In that spirit, here are 4 considerations that I hope will be useful.
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In his recent David Letterman–like Top 19 list of DSM5 issues, Allen Frances1 targeted a proposed revision of the DSM-IV diagnosis of Pedophilia, and 2 proposed new diagnoses: Hypersexual Disorder (HD) and Paraphilic Coercive Disorder. He protests the inclusion of pubescent teenagers in the definition of the proposed revision of Pedophilia (including the renaming of it as Pedohebephilic Disorder) and criticizes the quality of writing of these criteria.1 As the chair of the DSM5 Work Group responsible for those draft criteria, I need to address his poorly reasoned claims.
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