Neuropsychiatry

In this column, we explore how the judicious use of neural stem cells (NSCs) has led to a research Holy Grail: the creation of research-ready, patient-specific neurons.

If ketamine is able to turn off a patient’s depression, even for one day, you have accomplished something important, whether or not you can maintain it. This is because you have at least given the patient hope . . . that in itself is very significant from a therapeutic perspective.

Dr Weissman discusses psychiatric residency recruitment by looking at the forces that affect a student’s selection of a psychiatric career rather than at what the influences have been during the past 5 years.

Dr McIntyre discusses bipolar disorder and several studies in medical comorbidity in general and more specifically neurological comorbidity.

Daily meditation over a consistent period of time changes gray matter density in parts of the brain associated with memory, sense of self, empathy, and stress. But more research is needed.

The doctor’s role is to go beyond the obvious and to detect subtle determinants. Good diagnosticians have been trained to look beneath the loud symptom and consider underlying factors.

The neuroanatomical linkage that emerges from a normal part of business experience-the reaction to success and also to failure (especially if that failure happens to someone else)-is the focus of this column.

Psychiatric Times bids a very fond farewell to our long-time board member Jeffrey L. Cummings, MD, who was the originator of the Psychiatric Times “Brain and Behavior” column, which he penned for several years.

Researchers who have spent their careers studying schizophrenia and mood disorders might be forgiven a bit of “biomarker envy.” At long last, it seems that the neurologists and neuropsychiatrists have developed some fairly sensitive and specific “lab tests” for Alzheimer’s Disease (AD).

Ethical Questions at the Intersection of Neurotechnology and Psychiatry

Digital technology has transformed the way people live, work, and play. We are now able to instantly communicate with anyone, anywhere, anytime; however, an overload of technology can be counterproductive.

Transcranial magnetic stimulation (TMS) is noninvasive focused brain stimulation that uses pulsed magnetic fields. The underlying mechanism depends on the principle of electromagnetic induction, the process (discovered by Faraday in 1839) by which electrical energy is converted into a magnetic field and vice versa.1

Bioethicists often debate whether the rapid pace of medical science truly generates new ethical questions or whether what appear to be novel dilemmas are really ancient conflicts presented in modern terms and contexts.1 The valuable essays in this Special Report offer support for each position and, more important, provide clinical wisdom for mental health professionals struggling with ethical issues both profound and prosaic in a variety of practice settings.

My “most important achievement to date” is that I’m capable of even the simplest forms of basic cognition. I can remember, perceive, speak, feel, think, solve, and-sometimes-pay attention.

The recently posted first draft of DSM-5 has suggested a whole new category of mental disorders called the "Behavioral Addictions." The category would begin life in DSM-5 nested alongside the substance addictions and it would start with just one disorder (gambling).

There are limited data on clinical and biological predictors of antipsychotic drug response. The ability to identify those patients who will respond well to psychotropic drug treatment or who will be at a higher risk for adverse effects could help clinicians avoid lengthy ineffective drug trials and limit patients’ exposure to those effects. Moreover, better predictability of treatment response early in the course of a patient’s illness can result in enhanced medication adherence, a significant predictor of relapse prevention.

Available treatments are so robust that nearly one-third of patients with major depression will achieve full clinical remission with monotherapy.

Traumatic brain injury (TBI) affects approximately 2 of every 1000 persons per year. Persons vulnerable to mental illness (eg, persons with alcohol abuse or antisocial personality disorder) are particularly at risk.

Given the potential for a significant role in recognition of neurologically complex disorders, psychiatrists should become familiar with diagnostic criteria and appropriate therapeutic option.

Parkinson disease (PD) is the second most common neurodegenerative illness in the United States, affecting more than 1 million persons. Disease onset is usually after age 50. In persons older than 70 years, the prevalence is 1.5% to 2.5%.1 While the primary pathology involves degeneration of dopaminergic neurons in the substantia nigra, circuits important in emotion and cognition-such as the serotonergic, adrenergic, cholinergic, and frontal dopaminergic pathways-are also variably disrupted.

The issues being debated here have important long-term implications for psychiatry, and we are pleased to present these revised versions of 2 principal presentations.

Another lifetime ago-just after leaving residency-I took a job as a psychiatric consultant at a large, university mental health center. Had I known the poisoned politics of the place, I would have headed for someplace safe-like, say, Afghanistan.

This article reviews the differences between dementia types and future directions.

Practical approaches to integrating 3 aspects of a suicide assessment have been well delineated for adults and adolescents.

Of the screening tools available to help identify early symptoms of Alzheimer’s disease, which is best?

Repetitive transcranial magnetic stimulation (rTMS) may be an effective therapy for treatment-resistant bipolar depression, according to the results of a recent pilot study led by Guohua Xia, MD, PhD, assistant clinical professor of psychiatry at the University of California, Davis.

Information transmission, such as blogs, RSS feeds, and podcasts, have emerged as common forms of communication. The exponential growth of medical knowledge and the increasingly rapid pace of scientific discovery have made it nearly impossible for the print medium to keep abreast of new developments.

The editors of Psychiatric Times interview Vladimir Maletic, MD, PA, clinical professor of neuropsychiatry and behavioral science at the University of South Carolina School of Medicine, Columbia; founding member of the Integrative Neurobiology Educational Alliance; and member of the U.S. Psychiatric and Mental Health Congress 2009 advisory board.

Transcranial magnetic stimulation produced improvements in key areas of cognition and in short-term verbal memory in patients with major depressive disorder, and no adverse cognitive effects were shown. The results of this research were presented by Mark Demitrack, MD, vice president and chief medical officer of Neuronetics, Inc, and colleagues at the annual meeting of the American Psychiatric Association in May.

Whether you credit the idea to Niels Bohr or Yogi Berra, it is true that predictions are very difficult to make, especially about the future. It is a daunting task, yet obviously an intriguing one, to try to imagine what our field will be like in 10 years or more.