The U.S. Supreme Court's decision on Atkins v. Virginia has transformed the capital punishment landscape for the mentally retarded. This decision also marks an important step in evaluating the competency of death row inmates of any mental capacity. What could be the future outcomes of this landmark decision?
Noting the frequent unresponsiveness of posttraumatic stress disorder (PTSD) to standard drug treatments, Stein and colleagues reported results of the first double-blind, placebo-controlled trial of an adjunct to selective serotonin reuptake inhibitors for the treatment of this disorder.
Weight-based dosing strategies have been used in psychostimulant studies for ADHD in children between the ages of 6 and 12 years. The efficacy of weight-based psychostimulant doses changes throughout early childhood and into adolescence in ways that are not in keeping with weight-based dosing practices. Future treatment and research must explore new possibilities in order to afford patients the most benefit for the least amount of effective drug intervention.
Epilepsy is one of the most common chronic neurological disorders of childhood. Therapy should consist of education to reduce fears and concerns, psychotherapy to decrease triggers for seizures, and careful medication monitoring to avoid those drugs that reduce seizure threshold or have excessive interactions with antiepileptic drugs.
Although ADHD can be effectively treated and can lead to significant dysfunction if left untreated, negative public perceptions still abound. Proper diagnosis, exploration of comorbid disorders and collaboration with other health care professionals may be the answer to ensuring positive outcomes for children afflicted with this disorder.
Serotonin, the prefrontal cortex, and the amygdala interact with one another in the emergence of impulsive aggression. Which pharmacological and psychosocial treatments prove most effective?
After numerous hospitalizations, electroconvulsive therapy and a battery of drug trials, a college senior remained suicidal. Looking for advice on her patient, a psychiatrist brought the case to a team meeting, only to be told by a senior colleague, "You can't save them all."
Psychiatrists, neurologists, primary care physicians, physician assistants, psychologists, psychiatric nurses, social workers and other mental health care professionals. Continuing education credit is available for most specialties. To determine if this article meets the requirements of your specialty, please contact your state licensing board.
As a psychiatrist working in a state hospital, this author defends the long-term commitment of sexual offenders to institutions and offers insights on factors determining prognosis.
What effects will the verdict from the murder case against Andrea Yates have on the public's view of the insanity defense?
It is amazing how a psychiatric practice changes over the years including the switch to managed care from fee-for-service, larger caseloads, new medications and new treatment options. Despite all the changes, both for better and for worse, one psychiatrist is enjoying his practice as much today as ever before.
Advances in basic behavior and neuroscience research have been stunning, but until quite recently, efforts to encourage the clinical application of new knowledge have not kept pace. To aid in applying new knowledge to important public health issues, the National Institutes of Health has placed emphasis on "translational research," which aims to provide a bridge between basic research and clinical care. Particularly promising areas of study are highlighted.
How has the emphasis on economics and mental health care affected the quality of care? Has it improved under managed care? Implementing prevention strategies and improved quality, although initially costly, may save money in the long term.
New medications for the treatment of various addictions are currently under investigation. However, there are still substantial barriers, on the part of health and social policies and the patients themselves, to patients receiving these new treatments. Many of these issues were explored at the 2001 American Society of Addiction Medicine's State of the Art in Addiction Medicine conference.
Several confounding factors need to be taken into account before labeling a patient as treatment-resistant. What options are available for treating a patient with schizophrenia who has been diagnosed as such?
There is a range of meaning that underlies patients' violent acts against themselves. The usefulness of so-called "safety contracts" to actually predict suicidal behavior is questioned.
While the public perceives that many criminals escape punishment by pleading insanity, the truth is that very few people are ever found not guilty by reason of insanity. Society has to decide whether they want to lock up everyone who does any bad thing or excuse the behavior of people who are not capable of controlling their own behavior.
Although it may be tempting to say that almost any rewarding activity can become addicting, new research appears to indicate that, at least in the case of Internet use, that may not be the case. In fact, "Internet addiction" may actually be a sign for other psychiatric disorders.
Psychiatrists can help employers better understand the effects of personality disorders on employment litigation. This article looks at some of the consequences that personality disorders may have on employees' work conduct and the role of these disorders in settling employment legal claims.
Public perceptions are that the insanity defense occurs far more commonly than records indicate. In fact, the insanity defense is used in less than 1% of criminal proceedings and is successful in approximately one-quarter of those cases. Furthermore, defendants who are found insane spend as much, or more, time in state custody than their criminally convicted counterparts.
Anxiety disorders are highly prevalent and potentially debilitating psychiatric conditions. Is heredity linked to anxiety disorders? The importance of early identification and management of children at risk for anxiety disorders is emphasized.
Social anxiety disorder, the third most common mental disorder, is often underdiagnosed and undertreated. A leading expert on SAD provides an overview, including highlights of the barriers to diagnosis, a differential diagnostic approach and treatment options for social anxiety disorder.
A recently published meta-analysis questions if efficacy data garnered from clinical trials is relevant to everyday clinical practice. The authors ponder if enough patients are being included, if they are being followed long enough afterward, and whether exclusion criteria are too broad?
As the field of addiction psychiatry continues to evolve, researchers and clinicians are looking at old problems with new vision.
Will insurance coverage for mental health care ever equal that of physical health care? Until the federal government takes a stand, many states are implementing new laws or revising old ones to help level the grounds. However, with the states' options ranging from full parity to mandated offering and the option to base coverage on type of mental illness, equal mental health care coverage is still left on shaky grounds.
