Addiction & Substance Use

Typically, delirium worsens at night ("sundowning"), with lucid intervals often present in the morning. It is important to realize that delirium may appear before any abnormal laboratory values are detected and may persist after the resolution of these abnormalities.

If done properly, the assessment of alcohol and substance use disorders in the emergency department (ED) or psychiatric emergency service can be the first step toward recovery.

The degree to which season changes affect mood, energy, sleep, appetite, food preference, or desire to socialize with others has been called "seasonality." Identification of a seasonal pattern can only be made if both the patient and physician actively look for it.

Most physicians make at least some use of the placebo effect to enhance treatments, whether they realize it or not. This article examines the extent of the placebo effect in patients with psychiatric illness, and reviews what is known about how placebos work.

Alcohol is the drug of choice for adolescents, with cigarettes and marijuana being second and third. Contrary to widespread belief, alcohol dependence is most common in 18- to 20-year-olds, with progressively decreasing rates of alcohol dependence in older age groups.

Depressive disorders and symptoms are common in cancer patients (up to 58% have depressive symptoms and up to 38% have major depression), worsen over the course of cancer treatment, persist long after cancer therapy, recur with the recurrence of cancer, and significantly impact quality of life.

The longitudinal course of bipolar disorder (BD) is characterized by a low rate of recovery, a high rate of recurrence, and poor interepisodic functioning. There is a need to invoke a chronic disease management model (CDMM) when treating individuals with BD.

Complaints of persistent memory loss in otherwise well-functioning individuals after recovery from a psychiatric illness through electroconvulsive therapy (ECT) are best viewed as a conversion reaction or a somatoform disorder. The Camelford experience is a model for the complaints of ECT's profound personal memory losses.

Sleep disorders are very common and are often underrecognized and underreported in children. If left untreated, these disorders can cause serious developmental and physiologic problems.

As Americans' use of personal electronic devices increases, so too, do the controversies surrounding these now seemingly indispensable tools.

Dolls and other toys, such as teddy bears, can alleviate agitation, reduce withdrawal, help overcome communication challenges, and generally improve the quality of life of patients with Alzheimer disease (AD).

Ampakines, agents that have been shown to enhance memory, appear to trigger endogenous brain-derived neurotrophic factor (BDNF), a natural mechanism in the brain that could restore neuronal viability and synaptic plasticity through increased trophic support.

An unfavorable prognosis may be in store for patients who report severely disrupted sleep patterns accompanied by rapid eye movement (REM).

Your patient has pain and numbness that extends from the shoulder to the hand. You suspect a herniated cervical disk, but the MRI scan comes back normal. What else could the culprit be?

The Terri Schiavo story that was widely publicized in early 2005 was one in which clinical issues were at best misunderstood and at worst overshadowed by political posturing and media sensationalism.

Stress Neurobiology and Corticotropin-Releasing Factor

While some mental health services for adolescents allow self-referral, many require parental involvement. There is increasing evidence that working with the family and the child is important if only to increase compliance with medication and to tackle any comorbid difficulties.

Infant, or developmental, psychiatry is a subspecialty of child and adolescent psychiatry that focuses on the promotion of mental health in infants, toddlers, preschoolers, and their families through the consultation, assessment, and treatment of clinical problems.

Current treatments for autistic spectrum disorders (ASD) are useful in some cases, but have little enduring impact. This had lead to many parents seeking nonconventional treatments that often border on quackery.

Noninvasive brain imaging methods are providing unprecedented views of the structural and functional development and aging of an individual's brain or state of brain pathology. These exciting new may provide novel information relevant to the enhancement of clinical practice.

Several forums at the May 2006 American Society of Addiction Medicine (ASAM) addressed the issue of the gap between the number of investigational addiction treatment drugs and the few actually available on the market.

Adolescents reject their parents’ icons and seek out and empower their own. Antiheroes seem deliberately provocative, assailing almost every social convention of the adult generation, and parents often fear they are leading youth astray.

New findings in epidemiology, developmental psychiatry, and neuroscience offer the opportunity for a new perspective on the problems of juvenile delinquency and bring to bear the insights of modern psychiatry in the treatment and successful rehabilitation of juvenile offenders.

The inclusion of parents in their children's treatment for eating disorder is not universally accepted. However, recent studies suggest that families should be included in treatment and that they are often a powerful resource for helping their children recover.

While social anxiety disorder (SAD) may cause observable signs of anxiety and social awkwardness in some, many others suffer silently. Cognitive-behavioral therapy can be helpful for most patients with SAD, with alternative therapies such as psychodynamic therapy and interpersonal therapy filling the gaps.

The capacity of cognitive neuroscience to inform clinical practice has stimulated both excitement and controversy.

Particularly because 25% to 50% of patients with conversion disorder eventually have a nonpsychiatric illness that explains their symptoms, it behooves us as psychiatrists to remember that we are physicians too.

The numbers of patients with Alzheimer disease (AD), as well as those with severe cognitive impairment caused by traumatic brain injury and stroke, are continuing to increase. This article includes some nonconventional treatment approaches for which the evidence is limited.

Treating Parkinson disease with dopamine receptor agonists puts patients at risk for a number of symptoms over and above classic motor disturbances.

Stalking is defined as repeated and persistent unwanted communications and/or approaches that produce fear in the victim. Stalking intrudes on the victim's privacy and evokes a fear of violence. Such fears are justified, as threats, property damage and assault occur all too frequently in association with stalking.