Schizophrenia/Psychosis

Dr David Osser has chosen as one of the Top Papers of the Year a meta-analysis on second generation antipsychotics and the effects of these agents on patients with schizophrenia.

In a question-and-answer discussion with Dr Phillip Resnick, clinicians gained valuable insights into the legalities of psychiatry and how best to treat patients and protect the public (and themselves).

As I was driving to work on February 10, 2010, I listened to the National Public Radio host Melissa Block talking about how children labeled “bipolar” may get a new diagnosis. I was shocked that the chair of one of the DSM5 work groups, David Shaffer, MD, would discuss a controversial diagnostic topic with the media.

The DSM does and must involve both science and pragmatism. It must use the science that is available, but it must also make countless judgment calls that are not grounded in solid empirical evidence-and surely it makes sense to consider practical consequences in doing the latter.

In this autobiographic work, Darryl Cunningham explains mental illness in a succinct and novel way. It is already proving to be of use to both health professionals and mental health service clients. Published in the UK this year, its US release is scheduled for February 2011.

I do not believe that a nation as rich as ours (albeit with most wealth concentrated among the upper income levels) can shirk its moral responsibilities in the matter of providing basic health care for all its citizens.

There is evidence that the combination of medication and psychotherapy improves outcomes for many psychiatric illnesses. Among the several forms of psychotherapy that might be considered, cognitive-behavioral therapy (CBT) is the most extensively studied.

Our study suggests that most delusional patients, even those with high positive symptom scores, may have at least 1 RFD that precedes a clinical intervention specifically directed toward encouraging doubt. These preexisting “islands of doubt” may offer a useful foothold to begin the CBT process.

It is well known that black people, compared to white people, are much more likely to be diagnosed as suffering from ‘schizophrenia’ if they are seen at psychiatric units in the UK or USA. .

Autism is demanding increased attention by professional and lay audiences; prevalence seems to be increasing. There are differing opinions about whether the increase is due to greater recognition and reporting, diagnostic expansion and substitution, or increasing acceptability.

Designers of descriptive diagnostic criteria for mental disorders face some of the same problems as fishermen. Fishermen, like nosologists, want to capture not just any fish but a particular kind. Fishermen deal with this problem in various ways.

Of the more than 250 million prescriptions written for psychiatric drugs in 2009 in this country, Xanax is the by far most popular. Nearly 50 million prescriptions were written for this benzodiazepine or its generic form last year.

Do you know the comorbidity rates for OCD in the schizophrenia population? Does early onset schizophrenia have any effect on disease severity? These questions and more from this week's quiz.

Are psychiatrists agents of the police or doctors who care for the sick? Thomas Szasz raised this question 50 years ago in his iconic “The Myth of Mental Illness.” Psychiatry has changed in the ensuing decades, but Szasz’ question is still relevant. Why?

This book aims to demonstrate how, regrettably, over the last twenty years or so, typically American conceptions of mental illness have been exported successfully to the rest of the world. According to Watters, the often enthusiastic international reception of DSM-III and IV has homogenized human suffering all over the world.

The furor surrounding the recently proposed Alzheimer's Guidelines was provoked by their premature attempt to introduce early diagnosis, well before accurate tools are available. The same laudable, but currently clearly unrealistic ambition has propelled two of the worst suggestions for new diagnoses in DSM-5: Psychosis Risk and Mild Neurocognitive.

The discipline of evolutionary psychology views modern human behaviors as products of natural selection that acted on the psychological traits of our ancestors. A subdiscipline, evolutionary psychiatry, tries to find evolutionary explanations for mental disorders.

An Overview of Antipsychotic Use in Older Adults

Who should care about aging? This question is particularly germane in mental health. The articles in this Special Report remind us of the importance of understanding and focusing on the stresses, problems, and treatment-related issues in this population.

Consider the predicament of Mrs M, a 38-year-old premenopausal mother of two. Mrs M tells her primary care physician, “I just don’t have a strong desire for sex. It’s been about 10 years now, and I hardly ever have sexual thoughts or fantasies.

Houston, we have a problem. There is a critical shortage of psychiatrists. And the problem is not in Houston alone-it includes the entire state of Texas, and every other state in the union (Mid-town Manhattan, Boston’s Beacon Hill, and Sacramento Street in San Francisco might be exceptions).

Is the mortality from smoking-related diseases higher in patients with schizophrenia? What decade did the concept of the quality of life with antipsychotics come into being? These questions and more in this week's quiz.

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).

The basic problem is that the body is extremely complicated and most diseases don't arise from anything resembling simple genetic causes. We are the miraculous result of an exquisitely wrought DNA engineering that has to get trillions and trillions of steps just right. But any super-complicated system will have its occasional chaotic glitch.

I offer all of this as a way of describing how I became involved in intensive psychotherapeutic efforts with several adolescents who I then continued to see, often for many years following their inpatient experiences.