July 2nd 2025
Roger S. McIntyre, MD, FRCPC, shares the backstory and pharmacology of incretins to better understand the role of GLP-1 RAs in psychiatry.
Southern California Psychiatry Conference
July 11-12, 2025
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SimulatED™: Diagnosing and Treating Alzheimer’s Disease in the Modern Era
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SimulatED™: Understanding the Role of Genetic Testing in Patient Selection for Anti-Amyloid Therapy
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Expert Illustrations & Commentaries™: New Targets for Treatment in Cognitive Impairment in Schizophrenia – The Role of NMDA Receptors and Co-agonists
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BURST CME™ Part I: Understanding the Impact of Huntington’s Disease
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Burst CME™ Part II: The Evolving Treatment Landscape for Huntington Disease
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Clinical ShowCase: Developing a Personalized Treatment Plan for a Patient with Huntington’s Disease Associated Chorea
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Community Practice Connections™: Optimizing the Management of Tardive Dyskinesia—Addressing the Complexity of Care With Targeted Treatment
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PER Psych Summit: Integrating Shared Decision-Making Into Management Plans for Patients With Schizophrenia
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Southern Florida Psychiatry Conference
November 21-22, 2025
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Real Psychiatry 2026
January 23-24, 2026
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Managing Negative Symptoms of Schizophrenia: Can Prescription Digital Therapeutics Make an Impact?
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Optimizing Care for Patients With Tardive Dyskinesia
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Stabilize and Thrive: Prioritizing Patient Success Through Novel Therapeutic Management in Schizophrenia
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Paraphilias: Clinical and Forensic Considerations
April 15th 2007Paraphilias are defined by DSM-IV-TR as sexual disorders characterized by "recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving (1) nonhuman objects, (2) the suffering or humiliation of oneself or one's partner, or (3) children or other nonconsenting persons that occur over a period of 6 months" (Criterion A), which "cause clinically significant distress or impairment in social, occupational, or other important areas of functioning" (Criterion B). DSM-IV-TR describes 8 specific disorders of this type (exhibitionism, fetishism, frotteurism, pedophilia, sexual masochism, sexual sadism, voyeurism, and transvestic fetishism) along with a ninth residual category, paraphilia not otherwise specified (NOS).
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Comorbidity of Bipolar and Panic Disorders and Its Consequences
March 1st 2007Panic disorder occurs in about 1 in 5 individuals who have bipolar disorder. Anxiety amplifies the distress caused by depression and mania, but pharmacological approaches are tricky and under-studied. Frequent comorbidity and evidence of a possible genetic relationship of bipolar and panic disorders are suggestive of a causal relationship between the 2. Thus, it may be fruitful to look more closely at evidence for common biological abnormalities in both disorders to find a pathophysiological mechanism that links mania, depression, and panic attacks. Mood episodes and panic attacks can both be modeled as the result of deficits in amygdala-mediated emotional conditioning. From this model, some insight may be gained for potentially helpful treatment strategies for the 2 disorders when they occur together.
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WHIPLASHED: A Mnemonic for Recognizing Bipolar Depression
March 1st 2007The construct of bipolar spectrum disorder remains a work in progress. Its precise boundaries are still a matter of considerable debate. Some psychiatrists are convinced that it is widely overdiagnosed. It is possible that depending on the clinician and the clinical setting both views are correct.
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Issues and Challenges in the Diagnosis and Treatment of Mentally Ill Hispanic Patients
December 1st 2006Despite the accepted validity of Hispanic as a distinct demographic and cultural category, we have only fragmentary evidence and scarce guidelines regarding the treatment of mentally ill Hispanic Americans. This article provides a brief review of the topics with the most clinical relevance to diagnosis and treatment of mental disorders in Hispanic Americans.
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Is the DSM the Bible of Psychiatry?
December 1st 2006A discussion of the intellectual, social, and historical similarities and differences between sacred texts and the DSM would require a full-length book, but we will concentrate here on 5 main aspects: controversy, communication, interpretation, change, and power.
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Does the Biopsychosocial Model Help or Hinder Our Efforts to Understand and Teach Psychiatry?
December 1st 2006In this essay, I approach the question about the BPSM from the perspective of a teacher of psychiatry, medical school dean responsible for (among other matters) student career advising, and clinician. In those capacities, my duties include fostering an understanding of psychiatric disorders among medical students and residents, instilling confidence in and respect for the discipline of psychiatry among students as well as nonpsychiatric colleagues, and explaining psychiatric diagnosis and treatment to patients and their families.
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Depression in Patients With Alzheimer Dementia
November 1st 2006Alzheimer dementia (AD) represents a profound global health concern. By the year 2050, the prevalence of AD in the United States is expected to reach 15 million. At present, there are 4.5 million cases in the United States, which equals an estimated cost of $100 billion each year in medical and family expenses.
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Treatment-Resistant Anxiety Disorders: Neurotrophic Perspectives
October 31st 2006Anxiety 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.
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Pathology and Management of Treatment Resistance in Bipolar Disorder
October 30th 2006The problem of treatment resistance in bipolar disorder begins with its definition. Characterizing the phases of bipolar disorder as manic, mixed, hypomanic, or depressed does not do justice to the reality for many persons with this disorder.
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Better Tools Needed to Measure Treatment Outcome
October 1st 2006The need for better tools, as well as better use of existing tools, to measure treatment response in clinical trials was a principle focus of the 46th annual NIMH-sponsored NCDEU (New Clinical Drug Evaluation Unit) meeting, held June 12-15 in Boca Raton, Fla. Improved clinical research techniques are needed to better separate treatment effect from placebo response, to distinguish between active comparators, and to facilitate development of novel treatments, according to several presenters at the conference.
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Cortisol and Seasonal Changes in Mood and Behavior
October 1st 2006The degree to which season changes affect mood, energy, sleep, appetite, food preference, or desire to socialize with others has been called "seasonality." Identification of a seasonal pattern can only be made if both the patient and physician actively look for it.
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Borderline Personality Disorder: An Overview
August 25th 2006DSM-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.
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Therapy for Sexual Impulsivity: The Paraphilias and Paraphilia-Related Disorders
August 25th 2006Paraphilias as defined by DSM-IV, are sexual impulse disorders characterized by intensely arousing, recurrent sexual fantasies, urges and behaviors (of at least six months' duration) that are considered deviant with respect to cultural norms and that produce clinically significant distress or impairment in social, occupational or other important areas of psychosocial functioning. The common paraphilias described include exhibitionism (exposure of genitals to a stranger), pedophilia (sexual activity with a prepubescent child, generally 13 years of age or younger), voyeurism (observing others' sexual activities), fetishism (use of inert objects, such as female undergarments), transvestic fetishism (cross-dressing), sexual sadism (inflicting suffering or humiliation), sexual masochism (being humiliated, beaten, bound or made to suffer) and frotteurism (touching, rubbing against a nonconsenting person).
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The Clinical Challenge of Comorbid Bipolar Disorder and Substance Use Disorder
August 1st 2006Bipolar 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.
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Bipolar Disorder: Particle or Wave? DSM Categories or Spectrum Dimensions?
July 1st 2006With 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.
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National Survey Shows High Prevalence of Impulse Control Disorders
November 2nd 2005Published a decade ago, the original National Comorbidity Survey focused largely on anxiety and depression. In an exclusive interview, the survey's designer, Ronald C. Kessler, Ph.D., talks with Psychiatric Times about the just-published replication study, which found that the combined lifetime prevalence of impulse control disorders is higher than that for either mood or substance use disorders.
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Critical Issues in Perinatal Psychiatric Emergency Care
November 1st 2005Over the past decade, there has been increasing attention to the identification and management of mood and anxiety disorders related to childbearing. Emergen- cy physicians, including psychiatrists, primary care providers, obstetricians, gynecologists, and pediatricians, encounter women who are struggling with mental health issues in the context of reproductive events, such as pregnancy, pregnancy loss, and the postpartum adjustment period. In some cases, the reproductive event may precipitate a mental health crisis. In others, it may exacerbate an underlying mental health condition that, in turn, may need to be managed differently because of issues related to pregnancy or breast-feeding.
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Neuronal Plasticity and Mood Disorders
October 1st 2005Recent evidence suggests that reorganization of neuronal connectivity might play an important role in the pathophysiology of mood disorders and in both pharmacological and psychological treatments of depression. This evidence suggests a new framework for the etiology of mood disorders that focuses more on the problems in neuronal connectivity, plasticity and information processing in the brain than on abnormalities in chemical neurotransmission. Although this framework is still controversial and far from being complete, improved familiarity with the concepts of neuronal development and activity-dependent plasticity among mental health professionals would be useful.
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Comorbidity of Dysthymic Disorders in Children and Adolescents
September 1st 2005Comorbidity of Dysthymic Disorders in Children and Adolescents by Atilla Turgay, M.D. Many patients with dysthymic disorders also have associated comorbid disorders. A detailed history will provide insight into the comorbidity profile, cross-sectionally and developmentally. Dysthymic disorder should be addressed clinically, as it may cause long-term chronic unhappiness and poor quality of life for the patient.
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The Emerging Role of GABAergic Mechanisms in Mood Disorders
September 1st 2005The Emerging Role of GABAergic Mechanisms in Mood Disorders by Po W. Wang, M.D., and Terence A. Ketter, M.D. Gamma-aminobutyric acid is a major inhibitory neurotransmitter widely distributed in the mammalian central nervous system. Animal models of depression have pointed toward the importance of the GABA system in the pathophysiology of mood disorders. Thus, elucidating the GABAergic effects of benzodiazepines, mood stabilizers, antidepressants, and new anticonvulsants and antipsychotics may expand our understanding of mood disorder pathophysiology and potentially generate new targets for treatment.
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