Between 50% and 80% of people with mental disorders smoke cigarettes. Are the tobacco companies targeting this population, and are mental health care facilities promoting the use of tobacco? What are psychiatrists' responsibilities in the overall health of their patient?
The existing literature on the hoarding of animals by human beings has been written by officials of the Humane Society of the United States and animal shelter operators. Only one case series appears in medical or psychological literature.
Sexuality is a very important life issue for the elderly, but is often overlooked, according to Cynthia L. Ardito, Psy.D. Ardito frequently speaks on this subject to various health care provider groups in the United States and Canada.
A man named Edward Charles Allaway walked into a college library at California State University in Fullerton, Calif., and, using a .22-caliber rifle, killed seven people and wounded two others in 10 minutes. One of the few individuals who was successfully defended with a plea of insanity, Allaway was ultimately committed to a state psychiatric institution. This incident is not ripped from today's headlines, but from newspapers with a 1976 dateline.
The recovered memory debate has been the most acrimonious, vicious and hurtful internal controversy in the history of modern psychiatry. From its very beginning in the late 1980s, it has been more an "ad hominem" war, appealing to feelings and prejudices, rather than a matter of reasoned professional disagreement.
In the early 1960s, the Internet was born out of the idea of a "Galactic Network." By the late 1980s, technology had advanced to allow for computer-based exchange of scientific information between academic and research institutes. From these humble beginnings, the Internet has experienced explosive growth in the last five years, evolving into a powerful global information resource and new media format unto itself. Psychiatrists can now reap the full benefit of this fast-paced evolution to extend the reach of their medical practice.
The fiscal year (FY) 1999 budget for National Institutes of Health funding totals more than $15 billion. This figure reflects an increase of 15% over the FY 1998 budget and is $320 million less than President Clinton's requested budget for FY 2000 (Varmus, 1999). The Foundation Center reports the funding from U.S. grant-making foundations in 1998 as $15.4 billion from independent foundations, $2.37 billion from corporate foundations and $1.48 billion from community foundations (Foundation Center, 1999). Additional funds are available from the National Science Foundation (NSF), which has a $3.95 billion budget request for FY 2000, up almost 6% from FY 1999 (NSF, 1999). With all of this available funding, how can medical clinicians and researchers increase their chances of obtaining a medical grant?
By the time I interviewed Robyn in the emergency room, her panic attack had all but passed. But this 21-year-old woman was still shaken and tearful. This was her first panic attack, and she did not know what hit her. She thought she was having a heart attack. She had a tight feeling in her chest, she was hyperventilating. Her fingers and feet were numb and tingling. She experienced what she called a "closing in feeling." Robyn thought she was going to die.
Among psychiatrists who treat patients with HIV/AIDS, the question of how psychosocial distress effects the progression of HIV disease is likely to arise. Even for healthy individuals, we are only beginning to clarify the complex pathways by which thoughts and emotions impact immune function. Due to the bidirectionality of the communications of the brain and the immune system, this is a complicated scenario. The fact that HIV alters the function of the immune system during the course of its progression creates greater confounds to the understanding of these systems. We will address the rationale that progression from HIV infection to AIDS may be modulated by psychosocial factors, discuss possible reasons for conflicting findings and posit some clinically relevant recommendations drawn from research findings.
In the 1950s and 1960s, researchers found that mice and rats subjected to stressful stimuli were more likely to develop viral infections and tumors than nonstressed animals (Miller, 1998). Today, that once-pioneering research in psychoneuroimmunology (PNI) has burgeoned into sophisticated clinical studies that look at, for example, how caregiving can affect the immune system, how stress may delay wound healing and how pretreatment with an antidepressant prevents cytokine-induced depression in therapy for cancer.
As chief of the division of sleep and chronobiology in the department of psychiatry at the University of Pennsylvania School of Medicine, David F. Dinges, Ph.D., focuses on ways sleep and the endogenous circadian pacemaker interact to control wakefulness and waking neurobehavioral functions such as physiological alertness, attention, cognitive performance, fatigue, mood, neuroendocrine profiles, immune responses and health. In an interview with Psychiatric Times, Dinges discussed neurobehavioral consequences of sleep loss, factors that impair sleeping, the pervasiveness of sleepiness and new ways to manage sleepiness.
Mood-stabilizing drugs slipped into the vocabulary of psychiatrists during the last 15 years without a proper discussion of their definition. Consequently, these medications have been used in ways that have no empirical justification.
Present-day psychiatry has fallen into crisis because of the severe limitations of its conception of the person and, as a result, its conception of the patient. It objectifies the patient in a number of ways. Because of this reductionism, psychiatry fails to distinguish between healthy and pathological features of human life. It fails to consider adequately the psychological and social factors that cause and maintain each patient's problems.
The most common psychiatric sequelae following trauma include major depressive disorder, somatoform pain disorder, adjustment disorder and posttraumatic stress disorder (PTSD). In law, trauma that precipitates PTSD is viewed as a tort, which stems from the root word "torquere" (to twist), as does the word torture. In a sense, plaintiffs do allege torture in personal injury cases. A tort constitutes a civil or private wrong, as opposed to a criminal wrong, and rests on the general principle that every act of a person causing damage to a legally protected interest of another obliges that person, if at fault, to repair the damage (Slovenko, 1973).
More than 430 psychiatrists, research donors and others gathered in late October for the National Alliance for Research on Schizophrenia and Depression (NARSAD)'s awards dinner in New York City. The black-tie fundraising event was held in conjunction with the organization's 10th annual scientific symposium at which 15 selected NARSAD grantees presented their ongoing research over two days of sessions devoted to basic science, schizophrenia and depression.
When do therapists legally owe a duty of care to persons other than their patients? It is an axiom that good medical care involves consideration not only of the patient but also of others. In law, the general principle is that the risk which may result from one's behavior, as reasonably perceived, determines the duty of care.
It is relatively recent that boundary issues in clinical practice have attained professional awareness, although some early concepts portended the issue. Several decades ago, for example, the term boundary violations referred almost exclusively to what we now term sexual misconduct.
Other Hormones on Behavior - Poetry of the Times
For her work in establishing the Dialectic Behavioral Therapy (DBT) model for use with chronically suicidal individuals suffering from borderline personality disorder (BPD), Marsha M. Linehan, Ph.D., is this year's recipient of the annual research award given by the New York City-based American Foundation for Suicide Prevention (AFSP).
The benefits of psychotherapy in treating the chronically suicidal patient, as well as strategies that can help the potential suicide patient imagine and reflect others' reactions to this most final of acts, was the subject of a conference by Glen O. Gabbard, M.D., at the 11th Annual U.S. Psychiatric & Mental Health Congress. Gabbard is the Bessie Callaway Distinguished Professor of Psychoanalysis and Education at the Karl Menninger School of Psychiatry and Mental Health Sciences.
Tina, a 35-year-old legal secretary, is admitted to the hospital hearing voices that demand she gouge out her own eyes as punishment for having lived a sinful life. She was seen in the local emergency room prior to admission, both for involuntary certification and treatment for corneal damage from having attempted to harm herself. She states to the admitting psychiatrist, "If thine eye offend thee, pluck it out!"
For her work in establishing the Dialectic Behavioral Therapy (DBT) model for use with chronically suicidal individuals suffering from borderline personality disorder (BPD), Marsha M. Linehan, Ph.D., is this year's recipient of the annual research award given by the New York City-based American Foundation for Suicide Prevention (AFSP). Linehan is professor of psychology and adjunct professor of psychiatry and behavioral sciences at the University of Washington.
Psychiatry residents want and need solid training in psychotherapy in order to best serve their patients and to remain competitive in the mental health marketplace, concluded a March conference sponsored by the American Psychiatric Association's Commission on Psychotherapy by Psychiatrists (COPP). The event, entitled "Integration and Specificity in Psychotherapy Education," drew 120 training directors, residents and faculty from around the country, and represented approximately 40% of U.S. residency training programs.
Until the last half of this century, there were few if any treatments that seemed consistently effective in responding to the clinical needs of individuals who were abusing or dependent upon alcohol. As a result, support or self-help groups emerged. Alcoholics Anonymous is an extraordinary example of these groups.
Only one month after the American Medical Association unveiled a major reorganization of its science and technology departments-one that included the dismantling of its department of mental health-the former director, psychiatrist Larry Goldman, M.D., was fired after he criticized the changes.
