For various reasons, up to half of patients stop taking their prescribed antidepressant within three months. Side effects are often the biggest obstacle in maintaining treatment adherence. How can clinicians help patients deal with the sexual dysfunction and weight gain that often accompany psychotropic treatment?
Stephen R. Shuchter, M.D., professor of clinical psychiatry and associate director of residency training at University of California, San Diego, spends his "down" time performing as Elvis and other rock 'n' roll legends. In these efforts, he expresses his creativity and brings delight to those he entertains. Lessons from each "career" have helped his success in the other.
The SSRIs have become the most widely prescribed antidepressants in the United States. With this increased use has come more information on adverse events associated with their use, such as sexual dysfunction. However, movement disturbances associated with SSRI use can adversely impact treatment. This article explains the pathology of movement disorders and describes confounding variables such as other medications, pre-existing neurological insults and the nature of case reviews. Those at risk include the elderly, patients taking neuroleptics and those exposed to high levels of SSRIs.
Men's Reactions to Female Sexual Coercion
This is the second of two articles regarding herbal medicines as discussed at the American Psychiatric Association's annual meeting in Toronto. Potential benefits and risks of kava, St. John's wort and hoasca were considered at the recent American Psychiatric Association's symposium on herbal medicine.
The diagnostic criteria for sexual addiction are derived from the behaviorally nonspecific criteria for addictive disorder that were presented in Part 1 (Goodman, 1998b), by replacing "behavior" with "sexual behavior".
In Kansas v. Hendricks, the Supreme Court upheld by a narrow 5-4 margin a Kansas law that permits the civil commitment of individuals who, due to a "mental abnormality" or "personality disorder," are likely to engage in "predatory acts of sexual violence." Justice Clarence Thomas said the Kansas statute "comports with due process requirements and neither runs afoul of double jeopardy principles nor constitutes an exercise in impermissible ex post facto lawmaking."
Despite the proliferation of competing psychoanalytic theories in the past three decades, for most analysts the recognition and interpretation of resistance (as well as transference) remains at the core of psychoanalytic technique. While resistance has been defined as encompassing all of a patient's defensive efforts to avoid self-knowledge (Moore and Fine), operationally it means those behaviors that help the patient ward off disturbing feelings such as anxiety, anger, disgust, depression, envy, jealousy, guilt and shame.
Paraphilias 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.
