New findings in epidemiology, developmental psychiatry, and neuroscience offer the opportunity for a new perspective on the problems of juvenile delinquency and bring to bear the insights of modern psychiatry in the treatment and successful rehabilitation of juvenile offenders.
Friendship with patients, particularly those with serious mental illness, may seem anathema for a psychiatric ethicist, yet there is a long and rich history of physician-patient friendship in medical ethics.
Treating Parkinson disease with dopamine receptor agonists puts patients at risk for a number of symptoms over and above classic motor disturbances.
DSM-IV-TR emphasizes that patients with borderline personality disorder (BPD) show a "instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts," and any five out of nine listed criteria must be present for the diagnosis to be made.
While dementia is marked by such cognitive deficits as disorientation, memory loss and changes in intellectual functioning, these are not the symptoms that cause the most distress to caregivers.
College students are far less likely to kill themselves than are nonstudent peers, according to a 10-year research study examining suicide rates at 12 Midwestern campuses.
What does the term “polypharmacy” actually mean? Dr Pies likens polypharmacy to fire: just as the latter may either heat your house or burn it down, polypharmacy may either help or harm the patient.
A discussion of the pharmacologic management of bipolar depression, including emerging treatments and expert recommendations.
A look at how to use the spectrum concept to promote understanding and acceptance of bipolar II and soft bipolar diagnoses. In this article, you will find 5 tools for fostering what has been called “concordance” or, more simply, “buy-in.”
Although psychosis is rare in adolescent patients with anorexia nervosa restricting type, the possibility should be explored because it may be the underlying cause of the eating disorder.
There are still many questions about how to develop useful guidelines, introduce them into clinical practice, and measure their effectiveness. What does it mean to use a guideline in practice?
The past few years have seen substantial progress in recognizing and treating several of the subtypes of bipolar disorder. This Special Report addresses the diagnostic challenges and the different strategies for managing these subtypes.
A discussion of the many difficulties in treating patients with the rapid-cycling subtype of bipolar disorder, along with a history of the condition and the author’s treatment approach.
Three issues of current concern in bipolar II disorder include: diagnostic criteria for hypomania, diagnosis of mixed depression, and management of mixed depression.
Bipolar disorder I and II have the highest association with substance use disorder, compared with any other major psychiatric disorder. Treatment requires an integrated approach that includes specific psychotherapy as well as the use of medication.
A discussion of the development of the brain and whether neurobiology of the brain can play a role in predicting risk for future bipolar disorders and substance use disorders SUDs.
Since its initial description by Kahlbaum (1828-1899) over a century ago, catatonia has been associated with psychiatric, neurologic, and medical disorders. Contemporary authors view catatonia as a syndrome of motor signs in association with disorders of mood, behavior, or thought. Some motor features are classic but infrequent (eg, echopraxia, waxy flexibility) while others are common in psychiatric patients (eg, agitation, withdrawal), becoming significant because of their duration and severity.
There are dozens of books on the market aimed at helping the general public recognize depression; there are far fewer that focus specifically on the more subtle forms of bipolar disorder. This disparity has its clinical parallel in the over-diagnosis of unipolar depression among patients who ultimately prove to have a bipolar disorder. Indeed, survey data suggest that there is typically a 7-year delay in the correct diagnosis of bipolar spectrum disorder.
The prevalence and debilitating nature of some of the personality disorders has impeded the study of psychopharmacology in these conditions. However, important advances have been made in the last several years.
Suicidality in patients with borderline personality disorder is chronic. It is important to distinguish these patients from those with classic mood disorders, who are suicidal only when acutely depressed.
This article focuses on data concerning the efficacy of mood stabilizers in the treatment of BPD.
The evidence showing a relationship between mental disorders in childhood and adulthood has increased in the last several decades.
When assessing a sleep-related problem in a psychiatric patient, investigating all possible causes may be more helpful than assuming the complaint is a result of medication or the underlying condition.
With expansion of the concept of bipolar disorder (BD), there has been concern about the potential for overdiagnosis. However, diagnostic errors in bipolar disorder are currently skewed towards underdiagnosis.
The psychiatric community has a need for diagnostic and predictive tests. Some recent techniques have just become available for clinical care.
