Psychiatric Times Through the Years: The Last 5 Years in May Covers

During the 40th anniversary of Psychiatric Times, we are taking a look back at our covers over the last 5 years.

2020

In December 2019, Congress awarded the National Institute of Mental Health (NIMH) an additional $98 million as part of the National Institutes of Health budget resolution, which represented a 35% increase since 2015, one of the largest increases in the history of the NIMH. Yet, during the 5 years from 2015 through 2019, NIMH funded a total of 2 new drug treatment trials for schizophrenia and bipolar disorder, in contrast with the 5-year period from 2006 through 2010, when NIMH funded 48 such trials. Seemingly, the NIMH had almost entirely given up its role of evaluating drugs for the treatment of 2 disorders, despite their prevalence. In our May 2020 cover, E. Fuller Torrey, MD, and Robert H. Yolken, MD, explored the reasoning behind this lack of research and expressed opinions on how they thought the NIMH funds should be spent. Read more.

Psychiatric Times, vol. 37 no. 5

May is National Foster Care Month, and to honor this, Jeanette M. Scheid, MD, PhD, shed light on issues in the foster care system for our May cover 2. On any given day, there are more than 400,000 children in foster care in the US. Providing psychiatric services to children and adolescents in foster care require collaboration not only with the clinical team, but also the child welfare team, including parents, foster parents, and the social worker. In order to provide the best possible care, psychiatrists must receive complete prior mental health records, including those prior to foster care placement; This need must be communicated to the team. As Scheid demonstrates, children in foster care present with extra challenges and unique situations, but with thoughtful assessments and coordination, they can have positive outcomes. Psychiatrists are in the unique position to provide comprehensive clinical care and policy leadership supporting all children’s health and well-being. Read more.

2021

Psychiatric Times, vol. 38 no. 5

In 2021, methamphetamine became one of the most abused illicit drugs in the United States. The continued escalation of methamphetamine use, alone or with opioids, presents providers with complex medical challenges and difficult consequences for patients, families, and the legal and health care systems. The opioid epidemic in the United States is well established, but an increasing number of individuals abuse both opioids and methamphetamine. The CDC reported that 70,630 fatalities was associated with drug overdoses in 2019, including all drugs. That year, the second-highest number of fatalities were associated with stimulant drugs, largely methamphetamine. Michael W. Jann, PharmD, FCP, explored this problem in our 2021 May cover 1. Read more.

For our 2021 May cover 2, we asked explored an ethical conundrum brought on by COVID-19: How would we, as a society, determine who gets the first vaccines? Prioritization was determined by the Centers for Disease Control and Prevention (CDC), the National Academy of Sciences, and Johns Hopkins University’s Center for Health Security. Unfortunately, a review of these frameworks revealed a relative exclusion of patients with serious mental illness (SMI) and the practitioners who treat them. This raised further questions: How is it that, yet again, patients with SMI and substance use disorders have been marginalized, in this instance from vaccine allocation protocols? What were the clinical and ethical imperatives to ensure there is equity in access? How could mental health professionals promote a true community of immunity? Our Ethics Section Editor, Cynthia M.A. Geppert, MD, PhD, MA, MPH, MSBE, DPS, MSJ, contemplated this issue. Read more.

2022

Psychiatric Times, vol. 39 no. 5

“Physiologically speaking, what is a thought?” Paul Minot, MD, asserts that brains deserve the respect that we give to computers, and explores what he calls a neurodigital hypothesis. It is estimated that 1 gram of DNA could possibly store up to 455 billion gigabytes of information, and that the entirety of humanity’s data could thus be stored in 1 room. Novel applications of DNA like this demonstrate the capacity of nucleic acids to store and process digital data—but they do not prove that they are being utilized in this manner by living organisms. However, in May 2018, eNeuro published the results of a UCLA study headed by David Glanzman that succeeded in using RNA to transfer learned behavior from 1 animal to another. Investigators proposed that memories are instead stored in the nuclei of neurons, elevating RNA’s prospective role. Explore the research in our 2022 May cover 1. Read more.

On February 24, 2022, after the monthslong buildup of Russian troops on the Ukrainian border, the Russian invasion began. In our 2022 May cover 2, Peter Kowalski, MD, shared his experiences from the frontlines in Ukraine. Kowalski believes that a psychiatrist can do a lot in a disaster, not just by providing counseling and medications, but also bringing hope to others. Read more.

2023

Psychiatric Times, vol. 40 no. 5

The spread of social contagion: Social media platforms such as TikTok and Snapchat take advantage of adolescents’ innate need to interact, and this became especially apparent in the wake of COVID-19 and forced isolation. Reliance on social media and technology exacerbated preexisting issues. As we know, distressed youth typically go online for information and help. Many learn about psychiatric disorders via popular social media posts, although the veracity of such videos is generally poor. One review of 500 mental health advice videos on TikTok found 84% to be inaccurate. Clinicians can and should help all patients pursue healthy ways to address unmet psychological needs, including these patients influenced by social media, shared Paul Weigle, MD, in our 2023 May cover 1. Read more.

On November 29, 2022, Mayor Eric Adams announced that New York City would step up efforts to involuntarily hospitalize homeless persons with severe mental illness even if they did not represent a threat of violence. Several politicians, organizations, and advocates voiced their opinion on this decision; however, psychiatrists were notably excluded from the conversation. Involuntary treatment, shared Daniel Morehead, MD, is common in all medical care and is not unique to psychiatry. In his opinion, psychiatrists should educate the public on involuntary commitment, not tell it what to do, as he explains in our 2023 May cover 2. Read more.

2024

Psychiatric Times, vol. 41 no. 5

Despite advances in psychotropic agents, treatment-resistant psychotic symptoms remain prevalent in schizophrenia spectrum disorders. Deep brain stimulation (DBS) could be an attractive option in terms of effectiveness. DBS is underutilized, and ethical issues—as well as knowledge, cost, and acceptability issues—represent barriers to its usability. Authors Omar Shalaby, and Hazem Shahin, MD, explore these barriers and provide a case example of how to best utilize DBS in our 2024 May cover 1. Read more.

An underappreciated aspect of borderline personality disorder (BPD) is the patient’s characteristic methods of communication. Because the symptoms of BPD manifest most noticeably in the context of human relationship, and because the disorder is most effectively treated via the human relationship known as psychotherapy, an understanding of these patterns is of importance, shared Mark L. Ruffalo, MSW, DPsa, in our 2024 May cover 2. He defined the double bind, which is a dilemma in communication in which 2 or more messages are relayed simultaneously, or in close proximity, and 1 message contradicts the other(s). Here's a classic example: Person A makes a contract within their own mind between them and person B. Person A expects person B to do something for them without actually telling them about it. When person B does not do what person A expects them to do, person A turns around and says, “See, you do not care about me.” Because no one is a mind reader, person A has entered person B into a game person B does not know they are playing. Double binds leave the recipient of such communications in a proverbial lose-lose situation; patients with BPD often engage in this manner. Read more.