Addiction & Substance Use

Are a history of complicated pneumonia and possible obstructive sleep apnea part of the DSM-IV exclusionary criteria for potential participants in anesthesia-assisted opioid withdrawal? How many alcoholic drinks a week does it take for a woman to be considered an at-risk drinker? These and more in this week's quiz.

The DSM-5 Work Group that first suggested the inclusion of “Psychosis Risk Syndrome” has halfway come to its senses. It has dropped this stigmatizing name in a last ditch repackaging effort to salvage the proposal.

A 3-year study involving over 3,000 patients used motivational interviewing to counsel adolescents about staying away from potentially violent and alcohol-related situations. It was found that these brief sessions “reduced by half the chances that teenagers would experience peer violence or problems due to drinking.”

Patients on average spent between 1 and 8 hours per day preoccupied with negative thoughts about their perceived [mal]odor.

Are psychiatrists agents of the police or doctors who care for the sick? Thomas Szasz raised this question 50 years ago in his iconic “The Myth of Mental Illness.” Psychiatry has changed in the ensuing decades, but Szasz’ question is still relevant. Why?

A Federal appeals court has supported an earlier ruling by a lower court that established the unconstitutionality of gassing disruptive mentally ill inmates in their cells.

Although Charles O’Brien, MD, who heads the substance-related disorders work group, is a vigorous proponent of the notion of addiction as a disease, nothing about the proposed DSM-5 substance-related disorders section supports the idea that the syndrome is best understood as a chronic brain disease.

Olfactory reference syndrome (ORS) may be more common than generally recognized, according to Dr. Katharine Phillips-a leading expert on this disorder.

With this creative and engaging eBook, the author challenges young people to resist “zombification by the zombie masters”-or, becoming addicted (“zombified”) by the individuals and systems (“zombie masters”) that sell and deal drugs and benefit from the misfortune of others.

With the transition of patients with mental illness from the beds of psychiatric institutions into the community the need for knowledgeable mental health professionals continues to grow. Correctional psychiatry has evolved in recent years and presents special challenges for clinicians, which this handbook deftly addresses. Contributing authors with various backgrounds provide a broad range of expertise.

A small percentage of educators use their position of power to sexually exploit their students. While it is assumed that men are often responsible for this type of behavior, in recent years, a number of high-profile cases of female educator sexual misconduct have been covered by the media.

Two recent studies by Harvard psychologists deliver promising data from 2 tests that may help clinicians predict suicidal behavior. The markers in these new tests involve a patient’s attention to suicide-related stimuli and the measure of association with death or suicide.

The discipline of evolutionary psychology views modern human behaviors as products of natural selection that acted on the psychological traits of our ancestors. A subdiscipline, evolutionary psychiatry, tries to find evolutionary explanations for mental disorders.

The goal of palliative care is to prevent and relieve suffering and to improve quality of life for people facing a serious, complex illness.

Opioid Dependence and XR Naltrexone

Psychiatric Times bids a very fond farewell to our long-time board member Jeffrey L. Cummings, MD, who was the originator of the Psychiatric Times “Brain and Behavior” column, which he penned for several years.

A brief report recently published in Science confirms the key role of dopamine (DA) in impulsive behavior. The researchers found that impulse control directly correlated with the amount of DA released in the striatum.

Recent findings indicate that social interaction is a key to living longer. Theoretical models have suggested that social relationships influence health through stress reduction and by more direct protective effects that promote healthy behavior.

Researchers who have spent their careers studying schizophrenia and mood disorders might be forgiven a bit of “biomarker envy.” At long last, it seems that the neurologists and neuropsychiatrists have developed some fairly sensitive and specific “lab tests” for Alzheimer’s Disease (AD).

Is there a link between heartbreak and addiction? A recent study shows that the same areas of the brain were affected as those associated with addiction, reward, craving, and depression.

Decreasing the Clinician’s Risk

Keys to diagnosis, assessment, and management.

Business 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.

As many as 80% of patients who use herbal preparations and other natural products regard these therapies as the primary treatment of their ADHD symptoms.

Fads 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.

From 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.

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.

When 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.”

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]

A 17-year study found that children raised in lesbian-mother families appear to grow up to be well adjusted and have fewer psychological problems than do children reared in more traditional families.