Schizophrenia/Psychosis

Using Antidepressants During Pregnancy: An Update

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.

A discussion of the epidemiology, assessment, diagnostic dilemmas, and treatment of avoidant personality disorder.

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.

An examination of recent research on psychosocial treatments for personality disorders, including randomized controlled trials and empirically supported therapies as well as dialectical behavior therapy.

When assessing a sleep-related problem in a psychiatric patient, investigating all possible causes may be more helpful than assuming the complaint is a result of medication or the underlying condition.

How does the difference between objective evidence and subjective evidence relate to the practice of psychiatry?

Researchers found a high incidence of health problems such as obesity, hypertension, and diabetes in predominantly Hispanic outpatients with chronic mental disorders.

The psychiatric community has a need for diagnostic and predictive tests. Some recent techniques have just become available for clinical care.

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

In a 20-year longitudinal study, it was found that after acute hospitalization, continuous psychosis was diagnosed in only 30% of patients with schizophrenia; 20% of patients showed no signs of reoccurrence of psychosis after the acute phase.

This article examines the use of cognitive-behavioral therapy for psychosis, the evidence for its use, and the implications for practicing psychiatrists given the short-comings of pharmacologic therapy.

There is hope for patients with schizophrenia who do not respond to first-generation antipsychotic drugs: phase 2 results of the CATIE study show that second-generation antipsychotic drugs may be effective.

Eating disorders in patients with schizophrenia have been underappreciated and poorly studied. Profiling characteristic phenotypic patterns will help clarify the distinctions among eating behaviors that are part of the spectrum of schizophrenia, those that represent distinct coexistent entities, and those that represent overlapping comorbidity.

BasicNeeds is a program in developing countries that works with individuals with mental illness or epilepsy, their families, and their communities to establish accessible treatment programs, satisfy basic needs, and reduce social marginalization and stigma.

Emotional maltreatment is of two major types: emotional abuse and emotional neglect. While emotional abuse is easier to identify, emotional neglect is subtler, possibly more damaging, and poses even more challenging barriers to definition and study.

An appreciation of melancholia as the principal definable mood disorderoffers a better guide to diagnosis and treatment than does DSM-identified major depression.

The idea that schizophrenia and bipolar disorder might be caused by infection is not new. New research on infectious agents in patients with schizophrenia and bipolar disorder has implications for psychiatric clinicians.

In many situations, patients--even those who are acutely mentally ill--and physicians agree on a treatment regimen. In some cases, however, patients may disagree with the treatment after the fact or refuse treatment altogether. Although the physician's primary concerns are patient care and safety, the legalities of medicine are ever present and must be kept in mind. The following cases illustrate some of the medicolegal challenges that may arise in the emergency care setting.

Pediatric psychosomatic research shows that emotional, behavioral, and psychiatric symptoms are found more often in children and adolescents with chronic illnesses than in healthy children.

Damage can take biologic, syndromic, social, and personal form, with correlations among the various levels of damage.

The perinatal period is a high-risk time for some women to experience a new onset or exacerbation of a mood disorder that may require emergency psychiatric care.

Medical school graduation usually involves the Hippocratic Oath, in which physicians vow not to intentionally harm their patients. Keeping patients safe is another basic principle of patient care. Physicians are charged with ensuring that their patients are in a safe environment and minimizing risks to their patients by carefully selecting treatment options. In emergency psychiatric settings, patient safety is critical, especially when the patient is a danger to himself or herself or to others.

All physicians need to be aware of the medicolegal aspects of practicing medicine, but because emergency psychiatrists must sometimes treat patients against their will or act as consultants to determine capacity, they must be especially vigilant when dealing with the overlap between law and medicine.