Addiction & Substance Use

Final guidance from the federal government is imminent about how much of a patient’s protected health information (PHI)-including psychotherapy notes-a psychiatrist must provide to a health insurer.

Patients’ stories (both content and structure) contain more therapeutically useful information than merely identifying and counting symptoms.

The neuroanatomical linkage that emerges from a normal part of business experience-the reaction to success and also to failure (especially if that failure happens to someone else)-is the focus of this column.

DEBATE In 2005, the Board of Trustees of the American Psychiatric Association (APA) prepared a Position Statement entitled Psychiatric Participation in Interrogation of Detainees

As I lie in my hospital bed, attempting to breathe through my trach tube at a normal rate, waiting for my morning medication, and hoping to hear good, or at least manageable, results from my doctors when they come to me on rounds, my mind wanders. Despite the precariousness of my situation, I can’t help but smile as I think of my now monthly psychotherapy sessions.

Dr Allen Frances pleads for the United States Supreme Court to “step up to the plate” and halt the “disturbing misuse” of the “makeshift” psychiatric diagnosis of Paraphilia NOS (nonconsent).

The DSM does and must involve both science and pragmatism. It must use the science that is available, but it must also make countless judgment calls that are not grounded in solid empirical evidence-and surely it makes sense to consider practical consequences in doing the latter.

Every year, more than 1 million children are exposed to sexual or physical abuse or neglect in the US. The research summarized here clearly demonstrates that exposure to stress before adulthood can result in persistent effects on both mental and physical health.

The characteristics that bring people into the caring professions are, ironically, the very factors that make them vulnerable to vicarious trauma and job burnout. It is our responsibility to ensure that these adverse outcomes are minimized among those who have chosen such a career.

Forensic psychiatrists expressed near-unanimous opposition to 3 controversial new sexual diagnoses after a spirited debate at a recent conference of the American Association of Psychiatry and Law (AAPL).

There is evidence that the combination of medication and psychotherapy improves outcomes for many psychiatric illnesses. Among the several forms of psychotherapy that might be considered, cognitive-behavioral therapy (CBT) is the most extensively studied.

He had returned to a familiar place, and his peers welcomed him back. The word "recidivist" comes from the French word "recidiver," meaning to "fall back." This was not the first time he had fallen back. He would surely tell you that his return was not by choice, but sometimes such things are hard to determine.

A recent study reports that patients have a greater chance of survival when given opiate substitution treatment (OST) for over 12 months. Although there has been a 2-fold increase in opiate prescriptions in the past 10 years, the mortality rate from OST has fallen, making it a viable treatment for opiate abusers.

This essay does not proffer a change in the classification of specific conditions but will sketch a new meta-concept of evaluative disorders that encompasses a number of prevalent and serious psychiatric diagnoses.

Harvard professor, Marc Hauser, PhD-whose views on the evolution of morality have been widely accepted by many psychiatrists and others-was recently found by a university investigating committee to be “solely responsible for 8 instances of scientific misconduct.”

As I came closer, I could see Mr P more clearly. He was in his own world, wearing a Walkman with earphones on. I puzzled for a brief moment over this-was this to shut out attempts to talk him down? I could also see more clearly the rivulets of blood dripping from the incisions on his wrists to the concrete ground below.

Clinicians who treat children with ADHD face a challenging conundrum. Although our understanding of ADHD and its evidence-based treatments has increased significantly in recent years, the number of successful treatment outcomes has not.

In essence, screen media constitute neurologically potent, arousing input to the developing brain. Unlike conventional toxins, their effects are mediated by sense organs. However, they have demonstrable effects on brain activity, and on behavior and function.

Autism is demanding increased attention by professional and lay audiences; prevalence seems to be increasing. There are differing opinions about whether the increase is due to greater recognition and reporting, diagnostic expansion and substitution, or increasing acceptability.

This is both an exciting and challenging time to be a child and adolescent psychiatrist. New findings are changing our knowledge of childhood psychopathology. This Special Report discusses current developments in diagnosis, treatments, and problems for children and adolescents.

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?