Histrionic Personality Disorder

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Diagnosis of the two main major eating disorders, anorexia nervosa and bulimia nervosa, can be difficult because of denial of symptomatology by the patients and problems with some of the diagnostic criteria. Although CBT has been the most effective, there are no treatments available that can guarantee a cure for either disorder. Medication is only a helpful adjunct to the treatment of anorexia, while many controlled studies that show antidepressant medications are effective in reducing binge/purge behavior in bulimia.

An Illinois draft plan to screen children and pregnant women for mental illness has stirred controversy and raised questions about some elements of the President's New Freedom Commission on Mental Health report. Some critics fear the Illinois case sets a worrying precedent for mental health care throughout the United States.

While the symptoms of somatoform and dissociative disorders are influenced by the patient's culture, these syndromes are heterogeneous and may have overlapping features. Although more frequently reported in non-Western cultures and thought of as exotic and culture-bound, multiple personality disorder may be a North American example of one such disorder.

The inability to create an accurate picture of self-awareness is a feature in many mental illnesses, such as schizophrenia, autism, ADHD, personality disorders and substance abuse. At a Kansas City, Mo., conference, researchers begin to establish a biological basis for self-awareness and hope to isolate the deficits in the brain that causes abnormal functioning.

Psychiatrists can help employers better understand the effects of personality disorders on employment litigation. This article looks at some of the consequences that personality disorders may have on employees' work conduct and the role of these disorders in settling employment legal claims.

Given the recent anthrax scares, it is important for psychiatrists to be on the alert. However, this should be balanced with the realization that life must continue as normal as possible.

In the glossary of our book The Culture-Bound Syndromes, Charles C. Hughes, Ph.D., listed almost 200 folk illnesses that have, at one time or another, been considered culture-bound syndromes (Simons and Hughes, 1986). Many have wonderfully exotic and evocative names: Arctic hysteria, amok, brain fag, windigo.

The threat of a bioterrorist attack is very real and should be of real concern to those in the health care field. While federal government budgets have been requested to address the mental health aftermath of such attacks, they have been repeatedly denied. Psychiatrists will be needed to help treat panic and hysteria among populationsthose who are affected, those who are not but believe they are and those who are left to pick up the pieces.

Present-day psychiatry has fallen into crisis because of the severe limitations of its conception of the person and, as a result, its conception of the patient. It objectifies the patient in a number of ways. Because of this reductionism, psychiatry fails to distinguish between healthy and pathological features of human life. It fails to consider adequately the psychological and social factors that cause and maintain each patient's problems.

In May 1997, a young Rwandan girl came to a clinic in Kigali reporting nausea and the feeling of insects crawling on her face. She complained of the strong smell of feces and grew increasingly agitated and fearful, describing vivid images of people trying to kill her at that moment. For months she had vomited at the sight of avocados, and for three years she had been unable to tolerate the sight of rice.

There is a substantial constituency for alternative medicine. Worldwide, 70% to 90% of all health care "ranges from self-care according to folk principles, to care given in an organized health care system based on an alternative tradition or practice." As many as one-third of all Americans are reported to have some belief in alternative medicine or to be actively using nonmainstream remedies.