For clinicians, the assiduous and sustained resistance to change common in patients with narcissistic personality disorder (NPD) has been especially noticeable and trying. However, until recently the natural course of NPD has not received much attention in the clinical and empirical literature, and there is very little documented knowledge about the factors that might contribute to changes.
Personality disorders are characterized by the presence of inflexible and maladaptive patterns of perceiving oneself and relating to the environment that result in psychosocial impairment or subjective distress. The enduring nature of the behaviors, their impact on social functioning, the lack of clear boundaries between normality and illness, and the patient's perception of the symptoms as not being foreign make this group of conditions more difficult to conceptualize than the more typical, episodic mental disorders.
Psychopathy (renamed antisocial personality disorder) is marked by persistent violations of social norms, including lying, stealing, truancy, inconsistent work behavior and traffic arrests.
Significant research developments in the etiopathogenesis of schizophrenia have occurred during the past several years. One such advance is the "neurodevelopmental" hypothesis that events during early brain development, especially the prenatal and perinatal periods, may play an important causal role in at least some, and perhaps many, cases of schizophrenia.
Brain serotonin levels as a predictor of suicide has been the subject of intense research scrutiny over the past several years, with scientists trying to find easily accessible markers so that the neurotransmitter's levels might someday be readily measured in clinical settings.
Dopamine plays an important role in controlling movement, emotion and cognition. Dopaminergic dysfunction has been implicated in the pathophysiology of schizophrenia, mood disorders, attention-deficit disorder, Tourette's syndrome, substance dependency, tardive dyskinesia, Parkinson's disease and other disorders.
The gloom of winter, more often a literary theme than a medical topic, is a biological reality for an estimated 10 million Americans who suffer from seasonal affective disorder (SAD). For some, however, the depression ushered in by the dark days of winter can be treated simply and with rapid results with 30 minutes to two hours of bright-light therapy per day for a few weeks.
