Addiction & Substance Use

complementary medicine, alternative medicine, acupuncture, and integrative medicine

Comorbidity of Dysthymic Disorders in Children and Adolescents by Atilla Turgay, M.D. Many patients with dysthymic disorders also have associated comorbid disorders. A detailed history will provide insight into the comorbidity profile, cross-sectionally and developmentally. Dysthymic disorder should be addressed clinically, as it may cause long-term chronic unhappiness and poor quality of life for the patient.

Updates Show Progress in TMS for Depression and Schizophrenia by Arline Kaplan In research presented at the 2005 APA annual meeting, transcranial magnetic stimulation is showing efficacy in treating depression and schizophrenia in the research setting. The question of how to translate those findings to a real-world setting still remains.

Childhood Reactions to Terrorism-Induced Trauma by Wanda P. Fremont, M.D. The unpredictable, indefinite threat of terrorist events, the profound effect on adults and communities, and the effect of extensive terrorist-related media coverage can contribute to a continuous state of stress and anxiety in children. Current treatment strategies are discussed as well as direction for further research.

restless legs syndrome, Parkinson disease, ADHD

cognitive impairment,memory,stroke,spinal cord injury,attention deficit hyperactivity disorder

Celebrity Triggers Tumult Over Psychiatric Care: Did the News Media Make Things Worse? by Michael Jonathan Grinfeld When Tom Cruise accused Brooke Shields of being irresponsible by taking antidepressants after the birth of her baby, psychiatry was momentarily thrust into the spotlight. How did journalists and scientists handle the situation, and how can they do better in the future?

The Emerging Role of GABAergic Mechanisms in Mood Disorders by Po W. Wang, M.D., and Terence A. Ketter, M.D. Gamma-aminobutyric acid is a major inhibitory neurotransmitter widely distributed in the mammalian central nervous system. Animal models of depression have pointed toward the importance of the GABA system in the pathophysiology of mood disorders. Thus, elucidating the GABAergic effects of benzodiazepines, mood stabilizers, antidepressants, and new anticonvulsants and antipsychotics may expand our understanding of mood disorder pathophysiology and potentially generate new targets for treatment.

A discussion about new depression treatments with the chairperson of Stanford University’s department of psychiatry, Alan Schatzberg, M.D.

New research into the genetic basis and possible genetic markers for attention-deficit/hyperactivity disorder may open the door for new treatments. There is a clear concordance between twins who have ADHD, as well as siblings. What can genetic mapping tell us about treating ADHD?

Delirium,Dementia

cancerpain,neuro-oncology

traumaticbraininjury,behavioralneurology,generalneurology,neuropsychiatry

Suicidal behavior is a complex and multi-factorial phenomenon for which epidemiological genetics suggests a genetic basis that may be specific and independent from those implicated in the vulnerability to the psychiatric disorders associated with SB. Recently, new molecular biology tools have been designed to identify predisposition factors to complex disorders. One of the main goals of current studies is to specify the suicidal phenotype, as well as the intermediate phenotypes associated with these genes.

Research at the Crossroads of Genetics and Psychiatry

Many physicians who work in the emergency department (ED) consider the agitated patient the bane of their existence. These patients are frequently difficult to deal with, are uncooperative, and can bring an already busy ED to its knees. Although it is easy to understand why severely agitated patients are commonly placed in restraints or seclusion, it is essential that cooler minds prevail when an agitated patient presents to the ED. The patient should be treated with dignity, respect, and understanding. Because these patients often cannot express their feelings adequately, many who work in the ED do not realize that these patients do not like the feeling of being out of control.

Restraints and seclusion have been used for many years in emergency departments (EDs) and psychiatric emergency services (PESs), but anecdotal case reports and newspaper investigations as well as clinical advances have led to restrictions in their use.

The use of restraint and seclusion remains a controversial issue, and emergency care providers must remain absolutely current on it. We can come under criticism both for using too much coercion and for not using enough. Restraint and seclusion exist at an intersection of science, government policy, and public perception. These seemingly straightforward forms of medical coercion are still, in actuality, far from straightforward.

In an attempt to reframe the either-or debate over the impact of genetics versus environment on emotional makeup, a panel convened at the American Psychoanalytic Association’s Winter 2005 Meeting in New York City. This article highlights studies presented at the meeting.

Impulsive behaviors play an important role in both bipolar and substance abuse disorders. However, results of studies investigating this link are often ambiguous, in part, due to the multidimensional nature of the impulsivity construct and the fact that many studies use a single measurement technique. We describe a model of impulsivity characterized by three components: response initiation, response inhibition and consequence sensitivity. How these components differ from one another in terms of their use, behavioral theory and biological function is discussed, along with measurement techniques.

Proposed changes in the conceptualization of compulsivity and impulsivity in the DSM-V will have important implications in the way clinicians recognize and treat these disabling conditions.

One of this year’s recipients of the National Medal of Science sits down to talk with Psychiatric Times about his research, accomplishments and music.

Marijuana is the number one illegal drug of abuse in the United States; in second place is the nonmedical use of prescription medications such as pain relievers, tranquilizers, stimulants and sedatives. The National Institute on Drug Abuse is intensifying its research in understanding mechanisms that underlie the reinforcing, addictive and toxic properties of prescription medications, and developing medications with less abuse potential.

Comparative data are emerging on the metabolic effects of the second-generation antipsychotics on adolescents and children. Data presented at national meetings is discussed. When using these medications, the risks and benefits need to be carefully weighed until more definitive information is available.

On physical examination, the patient appeared well, except for the obvious diffuse rash. Erythematous macules, papules, and patches covered his extremities, face, trunk, palms, and soles. His conjunctivae, mucous membranes, and joints were normal, as were the results of cardiac, pulmonary, abdominal, and neurologic examinations. Several anterior and posterior cervical lymph nodes (0.5 to 1 cm) were present bilaterally.