May 3rd 2024
Which is the best recommendation for the treatment of alcohol use disorder?
Gender Differences, Gamma Phase Synchrony and Schizophrenia
April 24th 2006The authors discuss gender differences found in patients with schizophrenia. Their group is the first to explore the possibility that gender differences in schizophrenia are mediated by differences in integrative network activity, reflected in a synchronous phase of high frequency (40 Hz) gamma activity.
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Clinical Service Delivery and Benefits in General Medical Care of Psychosomatic Illness
April 1st 2006The renaming of consultation-liaison psychiatry as psychosomaticmedicine, a new formal subspecialtyof psychiatry, may require someadjustment in our understanding ofthese terms. Both consultation-liaisonpsychiatry and psychosomatic medicinehave focused on treatment and researchof illnesses with mind-body interactions.Despite considerable overlap,consultation-liaison psychiatry hastraditionally been associated with treatmentand clinical research of comorbidmental disorders of the medicallyill, while psychosomatic medicine hasbeen associated with research into thephysiologic mechanisms underlyingmind-body interactions and classicalpsychosomatic diseases such as hypertension,asthma, and ulcerative colitis.
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Diffusion of Medical Innovation
April 1st 2006In the late 18th century, a French surgeon named Pouteau performed 120 successive lithotomies with an extraordinarily low mortality rate. His secret was the use of innovations used widely today. Why weren't his methods more widely adopted by other physicians in his time?
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Neuropsychiatric Aspects of Traumatic Brain Injury
April 1st 2006Each year, more than 2 million individuals in the United States sustain a traumatic brain injury. Increased vigilance for previously undiagnosed or incidental TBIs in general mental health populations may lead to more effective clinical management.
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Treatment Challenges in Schizophrenia: A Multifaceted Approach to Relapse Prevention
April 1st 2006While an antipsychotic medication is the first step of treatment for schizophrenia, it is increasingly recognized that comprehensive care requires the integration of adjunctive therapies and attention to long-term treatment goals.
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Gone to Pot: The Association Between Cannabis and Psychosis
April 1st 2006Cannabis, or marijuana, has been consumed by humans for centuriesand remains one of the most widely and commonly used illicitsubstances. The authors review the evidence supporting and refutingthe association between cannabis exposure and psychotic disorders.
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Electroencephalography in Neuropsychiatry
April 1st 2006The recent evolution of neuropsychiatry/behavioral neurology as a subspecialty represents a paradigmatic shift regarding the responsibility of psychiatrists in diagnosing and managing behavioral disorders with concomitant and demonstrable brain pathology such as dementia or head injury. This authors define the clinical usefulness of electroencephalography in evaluating neuropsychiatric disorders.
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Breast Cancer: What Psychiatrists Need to Know
April 1st 2006Many of our female patients are more worried about breast cancer than heart disease. Because psychiatrists will almost certainly care for patients who have a history of breast cancer, Dr Riba reviews some of the major issues to consider.
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Treating Aggression in Patients With Dementia
March 31st 2006Dementia is characterized as a progressive and chronic decline in cognitive function, not limited to memory impairment, which significantly interferes with baseline daily functioning and frequently involves behavioral disturbances. It is known that behavioral problems in dementia negatively affect patients and caregivers. These disturbances lead to institutionalization, increased costs and caregiver burden, and a poorer prognosis.
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Are We Protecting the Vulnerable? Conservators and Guardianship Provisions Under Attack
March 1st 2006Guardianship laws--the provisions aimed at ensuring that elderly and incompetent individuals receive the necessities of life (including medical care and financial protection)--are drawing fire around the country amid charges of abuse, fraud and civil rights violations.
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Battling a National Killer: TeenScreen Aims To Prevent Teen Suicide
March 1st 2006Aware that mental illness generally begins early in life and that four teenagers commit suicide every day, several organizations and agencies are stepping up efforts to expand voluntary mental health screening and suicide prevention initiatives for youth--but they are doing so in the face of stigma and vocal opposition.
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Psychiatric Price of Steroid Abuse
February 1st 2006Anabolic steroids have gone from an appropriate treatment for men with hypogonadism to an agent abused by athletes, bodybuilders, adolescents, and young adults. Use of steroids at levels 10 to 100 times those of therapeutic dosages can cause psychiatric symptoms, such as aggression, mania, depression, and psychosis. Steroid abusers often "stack" several steroids or "pyramid" agents through a 4- to 12-week cycle. Presenting complaints of steroid abusers include muscle spasms, dizziness, frequent urination, and menstrual abnormalities. Signs may include high blood pressure, needle marks, icteric eyes, muscle hypertrophy, and edema; testicular atrophy and gynecomastia in men; and hirsutism and atrophied breasts in women. Mood changes can occur within a week of first use, and body changes may occur after acute behavioral disturbances.
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PSYCHIATRIC SYMPTOMS SIGNAL AUTOIMMUNE DISORDERS
February 1st 2006Psychiatric symptoms are not uncommon in patients with autoimmune disorders, such as multiple sclerosis (MS), systemic lupus erythematosus (SLE), Sjögren syndrome, temporal arteritis, sarcoidosis, scleroderma, Hashimoto thyroiditis, and myasthenia gravis. The CNS is frequently involved with many of these disorders. The lifetime risk of depression in patients with MS is 50.3%, with demyelination, inflammation, and neuroendocrine response implicated. In patients with MS of 10 years' duration, 56% may show cognitive decline. Included in the diagnostic criteria for SLE are seizures and psychosis, including visual hallucinations and paranoia. Cognitive impairment can occur in 79% of patients with SLE. Cognitive dysfunction is also seen in patients with Sjögren syndrome.
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STAR*D Preliminary Findings Provide Clearer Picture of Major Depressive Disorder
February 1st 2006Funded by the National Institute of Mental Health, the STAR*D project is one of the largest depression treatment studies ever conducted, with more than 4,000 participants. Results from the second phase of the study will be published over the next year. In this issue PT readers will find a preliminary review of data drawn from the first 1,500 enrollees.
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From Bench to Bedside: The Future of Neuroimaging Tools in Diagnosis and Treatment
February 1st 2006Schizophrenia poses a challenge for diagnosis and treatment at least in part because it remains a syndromal diagnosis without clearly understood neuropathological bases or treatments with clearly understood mechanisms of action. Neuroimaging research promises to advance understanding of the unique pathological processes that contribute to this syndrome, and to foster both better appreciation of how current treatments work, and how future treatments should be developed.
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Monoaminergic Treatment of Schizophrenia
February 1st 2006Although several clinical studies suggest that cognitive impairments in schizophrenia are associated with reduced stimulation of dopamine receptors in the prefrontal cortex, mounting evidence suggests that other monoaminergic neurotransmitter systems may also be involved. We provide an overview of neurotransmitters that hold promise as therapeutic interventions for the cognitive deficit in schizophrenia.
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Prevention and Early Interventions
February 1st 2006It was not too long ago that the management of schizophrenia focused primarily on symptom relief in inpatient and outpatient settings. Over the past two decades, there has been a paradigm shift in our approach in the overall management of schizophrenia, toward preventive and early interventions. What are some of these management techniques, and how well do they work?
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Teacher of the Year Addresses Psychiatric Education, Schizophrenia Treatment
February 1st 2006Long recognized by peers and students alike for his teaching excellence, Henry Nasrallah, MD, was named Teacher of the Year at the 18th annual U.S. Psychiatric & Mental Health Congress. In an interview with PT, Nasrallah talks about his passion for the field of psychiatry and his clinical research in schizophrenia.
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Evaluating for Alcohol and Substance Abuse
February 1st 2006Alcohol and substance use disorders take a tremendous toll on society as a whole and also require significant emergency department (ED) resources. Alcohol use and abuse in the United States accounts for over 100,000 deaths each year1 and costs more than $185 billion annually.2 A study of the effects of alcohol-related disease and injuries found that the number of patients who presented with these conditions increased by 18% from 1992 to 2000.3
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Psychological debriefing was developed as a way to intervene with large numbers of trauma survivors in circumstances in which individual evaluation and treatment are not possible, such as after mass trauma, terrorist attacks, or disasters. The most commonly used model of debriefing is Critical Incident Stress Debriefing (CISD), a structured protocol developed by Mitchell.1 CISD has been used quite frequently with rescuers, first responders, and law enforcement personnel. After the terrorist attacks in the United States on September 11, 2001, CISD was widely applied to groups of persons who were affected by the attacks.
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