Anxiety disorders are the most prevalent psychiatric disorders in the United States. Although effective treatments are available, such as the SSRIs and cognitive-behavioral therapy (CBT), it is estimated that in about 40% of patients, anxiety disorders are partially or completely resistant to first-line treatment.
Typically, delirium worsens at night ("sundowning"), with lucid intervals often present in the morning. It is important to realize that delirium may appear before any abnormal laboratory values are detected and may persist after the resolution of these abnormalities.
Emergency department (ED) visits have increased from 89 million in 1992 to more than 110 million in 2002, while the number of EDs decreased by about 15% during the same period. One suspected consequence of ED overcrowding is an increased tendency to disregard a psychiatric problem, especially if it is not the chief complaint.
Psychotropic Drug Handbook, 8th Edition
A review of the book, "Principles and Practice of Geriatric Psychiatry."
Did homophobia and other resentments have an influence on the outcome of the Academy Awards?
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.
The numbers of patients with Alzheimer disease (AD), as well as those with severe cognitive impairment caused by traumatic brain injury and stroke, are continuing to increase. This article includes some nonconventional treatment approaches for which the evidence is limited.
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.
The obvious sometimes bears repeating: Sick people have trouble thinking. They may be suffering from a delirium, a dementia or a more subtle disturbance of cognition caused by fever, drugs, infection, inflammation, trauma, hypoxemia, metabolic derangement, hypotension, tumor, intracranial pathology, pain and so forth.
Can sociodemographic and clinical variables predict outcome in cases of schizophrenia? Results from studies related to prognostic variables for schizophrenia have yielded interesting yet inconsistent results.
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.
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.
The Risk of Cerebrovascular Problems in Patients With Dementia Treated With Atypical Antipsychotics
Reexamining the Link Between Antidepressantsand Suicidality in Children and Adolescents
Diagnosing Alzheimer disease at its earliest stage can lead to effective early interventions.
Antidepressant treatment extended beyond the recommended 6 to 12 months was recently reported to be more effective than monthly psychotherapy in maintaining remission in elderly patients.
A review of nonconvention treatments for dementia and mild cognitive impairment, including dietary modification, Ginkgo Biloba, Huperzine-A, Phosphatidylserine, CDP-choline, Idebenone, and exercise.
Because hoarding occurs in a substantial portion of patients with neurodegenerative disorders, neurologists are likely to encounter patients with this problem. Until recently, they had little to offer their patients or the patients' caregivers. Compulsive hoarding can cause severe impairment and presents intriguing psychopathology, yet it has received little systematic study, and no effective treatment is currently on the market.
Delirium must be diagnosed accurately, prevented, and treated because of its pervasiveness and the associated risks of morbidity and mortality.
The 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.
Physicians who use electroconvulsivetherapy (ECT) need tobe vigilant for unstable medicalconditions before and during the courseof treatment. This brief review is intendedto highlight some basic principlesand specific concerns that maybe encountered in the use of ECT inpatients who have comorbid medicalillness.
Practitioners understand the wholeness and unity of their patients. Instead of being considered isolated organ systems or enzyme cycles, patients are understood as coherent entities composed of coordinated and interrelated processes and systems. This fundamental understanding guidesinvestigative and clinical care approaches in psychosomatic medicine.
While teen drug use continues to decline, it is the baby boomers who are suffering the greatest losses from substance abuse, and whose plight is largely overlooked by policy makers.
The cost-effectiveness of treatment for Alzheimer disease has been questioned. But until the next generation of therapeutics arrives, cholinesterase inhibitors and memantine will probably remain essential components of therapy for cognition and function.
