Addiction & Substance Use

Rape is always a heinous, ugly, violent, and cruel crime. But the violence and cruelty that are part of all rapes should not be confused with the specifically motivated violence and cruelty that distinguish sexual sadism...

Anyone working in the mental health field will recognize that in patients with extreme irritability, explosive behavior, or quick mood changes, bipolar disorder (BD) is often unquestionably diagnosed.

Deliberate self-harm (DSH) is a behavior in which a person commits an act with the purpose of physically harming himself or herself with or without a real intent of suicide.

DSM-IV, published in 1994, did not include a cannabis withdrawal disorder diagnosis. DSM-IV-TR clearly stated the reason for the omission: “Symptoms of possible cannabis withdrawal . . . have been described in association with the use of very high doses, but their clinical significance is uncertain.”1

Antidrug vaccines represent an exciting area of development in the pharmacological treatment of chemical dependency. In addition to the clinical trials being conducted on vaccines for cocaine and nicotine dependence, preclinical development of vaccines for methamphetamine and heroin is ongoing.

The focus of this Special Report is on some future-oriented aspects of psychopharmacology. First, it is an eclectic set of articles that cover treating resistant depression, using currently illegal drugs to treat psychiatric problems, and finally the potential of using vaccines to treat substance use disorders.

The NIMH Research Domain Criteria (RDoC) project raises many questions about DSM-5 and future DSMs.

ECT is making something of a comeback because it remains a paragon of efficacy amidst other relatively disappointing treatments.

Digital technology is a valuable tool, but if it dazzles us with its speed and control, there is the risk that we may forget the old way of connecting.

As experts in neurobiology, we can conduct and critically evaluate research to identify the short- and long-term risks and benefits of neuroenhancers for patients without recognized clinical indications.

Dr Weissman discusses psychiatric residency recruitment by looking at the forces that affect a student’s selection of a psychiatric career rather than at what the influences have been during the past 5 years.

This article reviews methods to rehabilitate cognition in schizophrenia and suggests strategies for instituting a cognitive remediation program.

The New York Times of February 14 carries the disturbing news of an alarming increase in deaths from accidental overdose among our active duty military personnel and our war veterans.

Apart from the lack of evidence supporting their use, is there any reason not to use patient opioid agreements and urine drug testings?

I recently shared a research article on “no-suicide contracts” with a colleague who is very knowledgeable about suicide. That article concluded--as virtually all the previous literature had-that use of suicide prevention contracts (SPC) remains a questionable clinical practice intervention.

In a recent Psychiatric Times blog, Allen Frances engaged a debate with Andrew Hinderliter over the question of change in the diagnostic categories of DSM-5.

On January 24, Dr Ronald Pies posted a thoughtful piece titled “Who Can Forgive Jared Loughner?” which advocates the importance of relinquishing hatred in cases like the ones in Tucson and transforming “our revulsion and rage into something higher and nobler.”

Major mood disorders have been associated with increased suicidal behavior. This is especially true in patients with a mixed, manic-depressive, or dysphoric-agitated state.

Expansion of age-appropriate developmental psycho-therapeutic services must become a top public health priority to make these treatments more widely available to young children and to capture the potential greater benefit of the earliest possible intervention for mental disorders.

Pushing the edge of our understanding into the murky world of association cortex only means that future experiments will be trickier to interpret.

Is violent behavior a proxy indicator for the relationship between severity of substance abuse and suicide risk? What has the strongest influence in promoting doubt about a delusion in a patient with schizophrenia? These questions and more.

I would like to start off this blog with two stories that happened many years ago.

Emerging research suggests that some individuals with particular types of substance use and abuse may be more likely to engage in suicidal behaviors. For example, those who use opiates, cocaine, or sedatives may have a noticeably higher risk of suicide than those who use other drugs.

What goes on in the minds of those who attempt suicide? Here: a psychologist who explores the myths that surround suicide notes "We need to get it in our heads that suicide is not easy, painless, cowardly, selfish, vengeful, self-masterful, nor rash."

Erroneous conclusions, and medical harm, can come from accepting any hypothesis uncritically, and growing evidence indicates that treatments based on disorder hypotheses for depression do cause harm.