Neuropsychiatry

A review of the book, "Principles and Practice of Geriatric Psychiatry."

Current treatments for autistic spectrum disorders (ASD) are useful in some cases, but have little enduring impact. This had lead to many parents seeking nonconventional treatments that often border on quackery.

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.

With an application to certify its use in depression before the FDA, transcranial magnetic stimulation (TMS) has become a hot topic in the expanding field of device-based treatment modalities.

The following 3 cases illustrate the diagnostic challenges related to differentiating brain injury and posttraumatic stress disorder (PTSD) in patients presenting to the emergency department (ED) in the acute period following a traumatic injury. Such patients pose a dilemma for ED clinicians because of the interplay between head injury and PTSD in the clinical presentation of cognitive impairments in the aftermath of trauma.

Any survivor of a traumatic event is at increased risk for the development of a stress disorder. Considering the number of persons affected by events related to the global war on terrorism and several recent large-scale natural disasters, it seems inevitable that the number of persons who will experience a stress disorder will increase. It is also probable that many of these persons will at some point seek treatment in or be brought to an emergency department (ED).

The presentation of patients to the emergency department following trauma is often complicated by the behavioral reaction to the accident that brought them there. In some cases, the mental reaction to psychological trauma is the primary presenting phenomenon. ED physicians and staff often use medication to treat the acute effects of psychological trauma. However, there is little empiric evidence to support this practice.

The prevalence and debilitating nature of some of the personality disorders has impeded the study of psychopharmacology in these conditions. However, important advances have been made in the last several years.

This article focuses on data concerning the efficacy of mood stabilizers in the treatment of BPD.

Dr Muller describes a case of a patient with a paranoid psychosis who clearly needs help, yet refuses treatment.

Antidepressants may have a protective effect on the hippocampal atrophy seen in patients with severe, untreated depression. This atrophy may be caused by an overabundance of glucocorticoids.

mild traumatic brain injury, MTBI, concussion, post-concussive syndrome

mental notes

A discussion of the current evidence base of psychosomatic medicine in the context of its public health significance and suggestions for the future development of the field.

Neurotechnology's New Wave, Part I: The Rise of the Device Market

autism, mirror neuron defect

There is a tendency to avoid psychiatric medications during pregnancy, but the high prevalence of psychiatric disorders in pregnant women means that women and their physicians must make impromptu decisions regarding the initiation or continuation of drug therapy.

The online contents of the April 2006 issue of Psychiatric Times.

spinal cord injuries, SCI, neural network, axon stretch, stroke, neurorehabilitation, biomarkers, cystatin C, ALS, amyloid lateral sclerosis, MS, multiple sclerosis

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.

The 5 papers in this Special Report on neuropsychiatry provide compelling evidence for the renaissance of neuropsychiatry as a clinical discipline. Wehave every reason to hope that this will lead to a better understanding of the complex interactions between brain and behavior and will reduce the artificial distinction between neurology and psychiatry.

First described more than 500 years ago, phantom limb pain affects as many as 50% to 80% of patients who undergo amputation. Although it is easy to recognize and diagnose, its cause remains unclear, it can be difficult to manage successfully, and health care professionals often do not address it.

Each year, more than 2 million individuals in the United States sustain a traumatic brain injury. Increased vigilance for previously undiagnosed or incidental TBIs in general mental health populations may lead to more effective clinical management.