Addiction & Substance Use

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.

The side effect of persons with psychiatric illness like bipolar disorder going off medication can be destructive. This patient had been in trouble with the local police, who saw her as a troublemaker and a menace.

DSM-5 better captures the essence of narcissistic personality disorder (NPD) than previous versions did. The hypervigilant NPD subtype is the least understood but seen the most often in patients.

After scoring high on the Panic Disorder Severity Scale, this patient sought panic-focused psychodynamic therapy.

A bill banning mental health providers from engaging in sexual orientation change efforts with patients passed the California Senate just weeks after prominent psychiatrist Robert Spitzer, MD, apologized to the gay community for his 2003 study.

Sleep-disordered breathing is common in patients with mood and anxiety disorders. This article explores the implication for practicing psychiatrists whose patients have sleep disorders.

Propranolol therapy at a relatively low dose can cause anger and rage behaviors to subside in some patients. This case describes a man with Down syndrome who, after an accident, sustained minor brain trauma. Subsequently, he regressed to a rage state he had experienced when he was younger.

The California Supreme Court’s decision in the Tarasoff case over 30 years ago has become a standard part of mental health practice. This case influenced the legal requirements governing therapists’ duty to protect third parties in nearly every state in the US.

Psychiatry is a profession that deeply needs honest workers who are willing to seek a knowing ignorance, to be dissatisfied, and to refuse to conform-doing so in the interest of the truth and of the profession, seeing both as inseparable.

Evidence suggests that cannabis is associated with an increased risk of psychosis when it is used frequently. Marijuana doesn't count, does it?

How can clinicians reliably identify comorbid drug and alcohol use disorders in patients with anxiety disorders?