Cultural Psychiatry

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There are no books written by, or even about, locum tenens psychiatrists. Why is that? Why is their story-the story of psychiatrists who "hold a place," participate a bit, and then move on-not shared? Is there nothing in their experience worth sharing?

Recent years have witnessed exciting developments in understanding and treating addictions. For example, it seems that almost weekly we get new insights into the neurobiology underlying vulnerability to addiction. Similarly, there have never been more medications available to treat the spectrum of addictive disorders, especially alcohol, nicotine, and opioid dependence. In addition, studies continue to underscore the crucial role of psychosocial treatments in recovery from addiction.

Among clinicians and researchers in geriatric psychiatry, interest in late-life bipolar disorder is growing, fueled not only by the increasing size of this clinical population but also by the recent discovery that mood stabilizers such as lithium may influence the pathogenesis of Alzheimer disease.

When offered a gift by a patient or a patient's family, a psychiatrist faces a significant practical challenge to negotiate "the poles of rule-bound rigor and individually tailored flexibility," the McLean Hospital Ethics Committee wrote in a recent article.

All of us have heard the phrase "between a rock and a hard place," and many of us have been in the situation that the idiom describes. However, few of us (other than English professors) likely know the origin of the saying and even fewer of us know how it applies to clinical psychiatry. Delving into these seemingly unrelated queries will be the subject of this month's column.

In this article, we discuss recent advances in drug transporters and nutrient-transporter interactions that can impact drug bioavailability in the systemic circulation and the brain. We also present emerging research strategies that may facilitate the discovery and clinical development of predictive diagnostic tests to identify patients at risk for treatment resistance.

About 60% of users of illegal prescription drugs receive them free from friends or relatives, H. Westley Clark, MD, JD, director, Center for Substance Abuse Treatment (CSAT), of the federal Substance Abuse and Mental Health Services Administration (SAMHSA), told attendees at the American Society of Addiction Medicine 38th Annual Medical-Scientific Conference

This commentary arises from my concern about the superficiality that characterizes the process of diagnosing attention-deficit/hyperactivity disorder (ADHD) in children--usually followed by the prescription of one of the most powerful drugs on earth, methylphenidate.

A Forbidden Hope

This is a film for psychiatrists who are concerned about women's issues and for anyone else who struggles to reconcile an enlightened humanism with the constraints of religious tradition.

Anxiety is a ubiquitous, natural affective state that is essential for evolutionary survival. Nearly as common, however, are experiences of anxiety that exceed social, psychological, or physiological needs, leading to functional impairment. Indeed, primary anxiety disorders, including panic disorder, social phobia, and generalized anxiety disorder (GAD), represent the most common category of mental illness in the United States. Secondary, or reactive, anxiety is also widespread and can arise not only from numerous medical causes but also from the psychological process of coping with illness.

A major participant in outreach efforts to Latino populations is the New Jersey Mental Health Institute, Inc (NJMHI), which recently launched the National Resource Center for Hispanic Mental Health.

In 2001, the US Surgeon General issued a report about the status of mental health with respect to racial and ethnic minority groups, which stated that ethnic and racial disparities were likely due to racism and discrimination. Empiric investigations have linked racism to poor mental health and have shown that racism is stressful and compromises the mental health of persons of color.