May 11th 2024
Here are highlights from the week in Psychiatric Times.
Clinical Consultations™: Considerations for Customizing Care Plans for Patients with Parkinson Disease Psychosis
View More
Expert Illustrations & Commentaries™: Visualizing New Therapeutic Targets in Schizophrenia
View More
Advances In™ Schizophrenia: Expanding the Therapeutic Landscape
View More
Southern California Psychiatry Conference
September 13-14, 2024
Register Now!
Updates on New and Emerging Therapies to Improve Outcomes for Patients With Major Depressive Disorder
View More
5th Annual International Congress on the Future of Neurology®
View More
2023 Annual Psychiatric Times™ World CME Conference
View More
Clinical Consultations™: Managing Depressive Episodes in Patients with Bipolar Disorder Type II
View More
Patient, Provider, and Caregiver Connection™: Exploring Unmet Needs In Postpartum Depression – Making the Case for Early Detection and Novel Treatments
View More
Medical Crossfire®: Understanding the Advances in Bipolar Disease Treatment—A Comprehensive Look at Treatment Selection Strategies
View More
'REEL’ Time Patient Counseling: The Diagnostic and Treatment Journey for Patients With Bipolar Disorder Type II – From Primary to Specialty Care
View More
Real Psychiatry 2025
January 2025 - Exact Date TBA
View More
More Than ‘Blue’ After Birth: Managing Diagnosis and Treatment of Post-Partum Depression
View More
Patient, Provider & Caregiver Connection™: Reducing the Burden of Parkinson Disease Psychosis with Personalized Management Plans
View More
The Impact of Appearance on Coping With Life
October 13th 2009In planning a media workshop to present Glenn Gers’ independent film disFigured for the May 2009 American Psychiatric Association meeting in San Francisco, my co-presenters and I devoted special attention to the diagnosis and treatment of anorexia nervosa. (The content was originally prepared by Katherine Halmi, MD, and was presented at the workshop by James Mitchell, MD, when Dr Halmi was unable to attend.) The film deals with the problems of body image represented by opposite ends of the spectrum of eating disorders-obesity and anorexia.
Read More
Continuation Treatment and Relapse Prevention in Pediatric Depression
October 11th 2009The prevalence of depression in children and adolescents ranges from 2% to 8% in the general population, which indicates that depression in this population is a major public health concern.1-3 This is especially apparent when rates of depression are compared with other serious medical conditions in childhood, such as diabetes, which has a prevalence of 0.18%.4 The burden of depressive illness-including significant functional impairment in interpersonal relationships, school, and work-on the developing child has been well documented. Affected youths are frequently involved in the juvenile justice system.5-8 Furthermore, adolescents with depression are at increased risk for substance abuse, recurrent depression in adulthood, and attempted or completed suicide.3,9-15
Read More
Sexual “Conversion”? American Psychological Association Says Not Through Psychotherapy
October 10th 2009In August, the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation released a report based on its systematic review of research on the effectiveness of sexual orientation change efforts.1
Read More
Anxiety Disorders in Children and Adolescents
October 8th 2009Anxiety disorders are one of the most common psychiatric disorders in children and adolescents, but they often go undetected or untreated. Identification and effective treatment of childhood anxiety disorders can decrease the negative impact of these disorders on academic and social functioning in youth and their persistence into adulthood.
Read More
APA and Health Care Reform: How Far the Thinking Has Come on Mental Health Issues
October 7th 2009As the nation’s uninsured population climbs to 46.3 million and Congress grapples with health care reform, the American Psychiatric Association (APA) has intensified its efforts to advocate for a public health insurance option, insurance market reforms, changes in Medicare’s physician payment system, and preservation of parity for mental health.
Read More
Veteran in an Acute Dissociative State
October 6th 2009A 24-year-old veteran of Operation Iraqi Freedom (OIF) presents to the ED mid-morning on a weekday. While the veteran is waiting to be triaged, other patients alert staff that he appears to be talking to himself and pacing around the waiting room. A nurse tries to escort the veteran to an ED examination room. Multiple attempts by the ED staff and hospital police-several of whom are themselves OIF veterans-are unsuccessful in calming the patient or persuading him to enter a room.
Read More
From War to Home: Psychiatric Emergencies of Returning Veterans
October 3rd 2009Since the time of Homer, warriors have returned from battle with wounds both physical and psychological, and healers from priests to physicians have tried to relieve the pain of injured bodies and tormented minds.1 The soldier’s heartache of the American Civil War and the shell shock of World War I both describe the human toll of combat that since Vietnam has been clinically recognized as posttraumatic stress disorder (PTSD).2 The veterans of Operation Iraqi Freedom (OIF) and of Operation Enduring Freedom (OEF) share with their brothers and sisters in arms the high cost of war. As of August 2009, there have been 4333 confirmed deaths of US service men and women and 31,156 wounded in Iraq. As of this writing, 796 US soldiers have died in the fighting in Afghanistan.3
Read More
Functional MRI, Round 3: Six Items to Keep in Mind
October 2nd 2009This is the third and final installment in a series on biophysical mechanisms of functional magnetic resonance imaging (fMRI) technologies. My overarching goal has been to explain why great care must be exercised when interpreting data derived from these magnets. The inspiration for the series came as I was reading a magazine article while waiting for a plane to take off-my reaction to what I read may have resulted in a bit of trauma to the seat pocket in front of me.
Read More
Understanding Addiction as Self Medication: Finding Hope Behind the Pain
September 10th 2009Why do people get addicted? Of the countless books that have been published on this topic, this is the first that focuses on the self-medication hypothesis (SMH). Understanding Addiction as Self Medication is largely based on the experiences of the authors and other clinicians with individuals who struggle with addiction.
Read More
Electroconvulsive Therapy: A Guide for Professionals and Their Patients
September 4th 2009This book is well-written and concise. It provides an overview of ECT that is evidence-based yet understandable by the average person. The author effectively uses clinical anecdotes to provide a “face” for the science. The book is organized in a user-friendly way.
Read More
In our last installment, we discussed a familiar finding from the National Comorbidity Survey Replication (NCS-R): the peak age of onset for any mental health disorder is about 14 years. In an attempt to explain these data, we are exploring some of the known developmental changes in the teenaged brain at the level of gene, cell, and behavior.
Read More
Risk Management for the Supervising Psychiatrist
September 3rd 2009The need for expert supervision of residents and other health professionals by psychiatrists is growing as a result of the increased demand for accountability by third parties and the expanded number of clinical specialists seeking supervision in psychiatry. The Accreditation Council for Graduate Medical Education has placed professional competency of graduating residents in the national spotlight, and insurers are increasingly scrutinizing patient care provided by trainees and oversight provided by their supervisors.
Read More
Psychological problems are often manifest in the skin. In fact, it is estimated that between 20% and 30% of all skin disorders have some psychological component. Many patients who have psychocutaneous disorders-which are often direct evidence of or secondary to psychological abberations-drift from one physician to another, trying to find one savvy enough to cure their “skin condition.” Furthermore, although they have sought many medical opinions already, patients afflicted with psychocutaneous disorders almost always present as “an emergency.” While pharmacological intervention may benefit such patients, traditional mental health interventions are almost always required if the aberrant behavior is to cease.
Read More
The Neurobiological Development of Addiction
August 28th 2009Self-administration of drugs of abuse often causes changes in the brain that potentiate the development or intensification of addiction. However, an addictive disorder does not develop in every person who uses alcohol or abuses an illicit drug. Whether exposure to a substance of abuse leads to addiction depends on the antecedent properties of the brain.
Read More
Successful Treatment of Physicians With Addictions
August 28th 2009Physicians generally display better health and have lower rates of all-cause mortality than the general population. However, their education, nutrition, and lifestyle do not offer similar protection from substance abuse and dependence.
Read More
The editorial board and staff of Psychiatric Times wish to announce, with much regret, the retirement of Max Fink, MD, from our journal’s editorial board. Dr Fink-who is emeritus professor of psychiatry and neurology at the State University of New York at Stony Brook-has been a valued member of our board since 2002, and a regular contributor to the journal for many years before that.
Read More
Pathological Gambling: Update on Assessment and Treatment
August 27th 2009Surveys show that approximately 60% of the general population has gambled within the past 12 months.1 The majority of people who gamble do so socially and do not incur lasting adverse consequences or harm. Beyond this, approximately 1% to 2% of the population currently meets criteria for pathological gambling.2 This prevalence is similar to that of schizophrenia and bipolar disorder, yet pathological gambling often goes unrecognized by most health care providers.
Read More
Challenging the "Dis-ease" Model
August 27th 2009>I greatly enjoyed Dr Ron Pies’ editorial “What Should Count as a Mental Disorder in DSM-V?”1 in which he encouraged framers of DSM-V to critically examine the boundaries of mental illness and to more carefully distinguish between diseases, disorders, and syndromes. As I have noted elsewhere, current plans to integrate a “spectrum” approach into DSM-V require a careful consideration of these issues that must be defensible to critics of diagnostic expansion within psychiatry.2
Read More
Atypical Antipsychotics for Children and Adolescents With Schizophrenia-Spectrum Disorders
August 11th 2009Although the onset of psychotic symptoms before the age of 13 years is exceedingly rare, the incidence of schizophrenia rises sharply after the onset of puberty.1 Only 1% of the population has schizophrenia and 30% of these patients experience an onset of psychotic symptoms by age 18 years.2-8 The period that precedes the onset of frank psychotic symptoms (ie, the prodromal phase) has not been well characterized in early-onset schizophrenia-spectrum disorders (EOSS), but retrospective reports have shown that symptoms include high levels of depression and anxiety, emerging cognitive and social deficits, unusual thought content, and (not infrequently) school failure.
Read More
This statistic is as familiar as it is startling. According to the National Comorbidity Survey-Replication (NCS-R), the peak age of onset for any disease involving mental health is 14 years. True for bipolar disorder. True for anxiety. True for schizophrenia and substance abuse and eating disorders. The data suggest that most mental health challenges emerge during adolescence. If true, this brings to mind an important developmental question:
Read More
Inflammation, Psychosis, and the Brain
July 11th 2009When the solution to a clinical or scientific puzzle eludes us for more than a century, as with schizophrenia, we need new methods to examine the pathology. If we want to make an impact on the disease we must shift research paradigms and focus on the early detection, early intervention, and new avenues of treatment that address different symptoms of schizophrenia.
Read More
Delirium With Catatonic Features: A New Subtype?
July 10th 2009Delirium has been recognized and described since antiquity. It is a brain disturbance manifested by a syndrome of diverse neuropsychiatric symptoms. Various terms have been used for delirium, such as acute brain disorder, metabolic encephalopathy, organic brain syndrome, and ICU psychosis.
Read More