Richard Balon, MD

More than half of parents who have children with ADHD treat their child’s symptoms with vitamins, dietary changes, and expressive therapies-but only a small minority tell their doctor. More in this podcast.

This 3-part manual on sexual disorders is edited by 2 psychiatrists who have been engaged for more than 20 years in clinical treatment of patients with sexual problems.

This 3-part manual on sexual disorders is edited by 2 psychiatrists who have been engaged for more than 20 years in the clinical treatment of patients with sexual problems. Drs Balon and Segraves bring their rich experience to this field. Patients who have sexual disorders need extra time to present their questions of doubt, confusion, misunderstanding, and perhaps guilt and shame. They also need clarification and understanding-and possible answers and reassurance.

Everyone would probably agree that the practice of clinical psychiatry has changed profoundly over the second half of the past century. One of the most remarkable changes has been the rapid development and expansion of clinical psychopharmacology, which has become, like it or not, a dominant part of the clinical practice of most psychiatrists. Available treatments for mental disorders changed and our armamentarium broadened. We have numerous medications for psychiatric disorders. We even use medications for disorders traditionally considered only amenable to and suitable for psychotherapy.

Sexual dysfunctions as distinct syndromes were first identified in DSM-III in 1980. At that time, sets of criteria were specified for inhibited sexual desire, inhibited sexual excitement, inhibited female orgasm, inhibited male orgasm, premature ejaculation, dyspareunia, and functional vaginismus.

The focus of this Special Report on anxiety disorders is not accidental. Anxiety disorders are, probably next to substance abuse, the most common mental disorders in the general population, and definitely the most common mental disorders among children and adolescents.

The discipline of psychopharmacology has expanded enormously during the last several decades. As this Special Report illustrates, while the treatment of mental illness with medication has definitely advanced, it is neither quick nor easy. Instead, it has become more complex and complicated.

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?