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A Review of Changes in DSM-5 Sleep-Wake DisordersDSM-5 sleep-wake disorders are now more in sync with other medical disorders and sleep disorders classificatory systems. Here's what's changed.
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Portable Pulse Oximeter Use During Patient RestraintPortable pulse oximeters are inexpensive ($150 to $600), are noninvasive, and can measure a patient's oxygen saturation in 5 to 10 seconds.
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Beyond 'Handholding': Supportive Therapy for Patients With BPD and Self-Injurious BehaviorCan supportive therapy be modified to successfully treat patients with borderline personality disorder? By using a previously developed model, NIMH-funded researchers have found supportive therapy helpful in engaging patients in treatment, developing a therapeutic alliance and achieving treatment goals. Their outcome data may provide a new treatment approach for this difficult-to-treat population.
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Fumbling ThroughThis is the story of Peter. I feel chosen to have gotten to know him and to have the memory of what such an experience has carved into me.
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Promoting Resiliency After First-Episode PsychosisSimple but powerful strategies for drawing on patients’ existing character strengths and long-term goals.
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Intellectual Disability and Psychiatric Comorbidity: Challenges and Clinical IssuesIntellectual disability affects an individual’s functioning in everyday life. The risk for a psychiatric disorder is greater in persons with ID than in those with intelligence in the normal range. Here: the latest information on ID.
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Behavioral and Pharmacologic Treatment of Aggression in Children With AutismThis article will provide an overview of treatment modalities, with emphasis on the future direction of interventions targeting aggression in children with autism.
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Benefits of Early Pharmacological Treatment in Alzheimer DiseaseSuccessful intervention for Alzheimer disease requires an early and timely diagnosis. Caregivers of persons with AD often state that an average of 2 years passes from the onset of symptoms to a formal diagnosis.
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Video Games: Recreation or Addiction?Many people like to spend at least part of their free time playing video games. However, for some, what starts as innocent recreation becomes an addiction and, at times, tragedy ensues.
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Depression in Dementia: Diagnosis and TreatmentIt has been well established that there is a high incidence of depression in conjunction with Alzheimer's disease and other forms of dementia. What are the best assessment and diagnostic methods, and which treatments will produce the best results?
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Referral Strategies for Patients With Co-Occurring Substance Use and Psychiatric DisordersThis article provides an overview of research concerning referral strategies for patients with substance use disorder and co-occurring disorders in the emergency department.
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Forced Medication and Competency to Stand Trial: Clinical, Legal, and Ethical IssuesThe authors examine legal and ethical challenges for the psychiatrist when a defendant who is incompetent to stand trial declines to take prescribed psychotropic medication.
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Edema Associated With Infarct . . . Or Something Else?A sharp decrease in visual acuity affecting both eyes developed in a 35-year-old man 3 days after elective abdominal surgery. Six months earlier, acute B cell-type lymphoblastic leukemia was diagnosed in the patient for which he received bone marrow transplantation (BMT). Following BMT, graft-versus-host disease developed in the patient. It was treated with cyclosporine, mycophenolate mofetil (CellCept), sirolimus (Rapamune), and prednisone.
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Cognitive Impairment in Patients With Bipolar DisorderIt is widely accepted that patients with schizophrenia have some degree of cognitive deficiency and that cognitive deficits are an inherent part of the disorder. Historically, there has been less focus on cognitive deficits in patients with bipolar disorder; however, numerous studies of cognition in patients with bipolar disorder, including several comprehensive meta-analyses of bipolar patients who were euthymic at the time of testing, have recently been undertaken.1-4 Each of these analyses found that cognitive impairment persists during periods of remission, mainly in domains that include attention and processing speed, memory, and executive functioning.4
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Brain Insulin Resistance in Alzheimer Disease and Its Potential Treatment With a Mediterranean Diet and GLP-1 AnaloguesThis article explains the rationale and evidence for 2 novel treatments of Alzheimer disease: a reformulated Mediterranean diet and an antidiabetic agent, liraglutide, marketed as Victoza.
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A Critical Consideration of the Most Recent Guidelines for Bipolar DepressionThis article reviews the most recent (after 2010) published guidelines on bipolar depression.
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Youth-Led Suicide Prevention in an Indigenous Rural CommunitySuicide is a pervasive public health issue for adolescents in Hawaii. In response, a youth leadership model was initiated to empower young leaders in suicide prevention through evidence-based training, relationship building, and community awareness.
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Strategies for Assessing and Treating Comorbid Panic and Generalized Anxiety DisorderThe 2 most common anxiety disorders are generalized anxiety disorder (GAD) and panic disorder. Approximately 5.7% of people in community samples will meet diagnostic criteria for GAD in their lifetime; the rate is about 4.7% for panic disorder (with or without agoraphobia).1 GAD-which is characterized by excessive and uncontrollable worry about a variety of topics (along with associated features such as trouble sleeping and impaired concentration)-is often chronic and is associated with significant costs to the individual and to society.
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Development of a Transdiagnostic Unified Psychosocial Treatment for Emotional DisordersResearch emerging from the field of emotion science suggests that individuals who have anxiety and mood disorders tend to experience negative affect more frequently and more intensely than do healthy individuals, and they tend to view these experiences as more aversive, representing a common diathesis across anxiety and mood disorders.1-5 Deficits in the ability to regulate emotional experiences, resulting from unsuccessful efforts to avoid or dampen the intensity of uncomfortable emotions, have also been found across the emotional disorders and are a key target for therapeutic change.
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New Risks to Confidentiality in the Modern EraWhile this article highlights some of the modern-era risks to confidentiality that psychiatrists may experience, it does not constitute an exhaustive list of issues to consider and is not a substitute for legal advice.
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Mini Quiz: Alcohol and SleepWhich sleep parameters are increased in alcohol use disorders? Take the quiz and learn more.
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A “Real” PsychiatristAs the end of this psychiatrist's intern year approached, a chief resident told her that second year is the year “you really become a psychiatrist.”
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Hypothyroidism: An Important Diagnostic Consideration for the PsychiatristHypothyroidism is a common clinical disorder that psychiatrists frequently encounter. However, symptoms of thyroid dysfunction are often vague and nonspecific, which can lead to delayed or missed diagnosis.
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The Role of Psychiatrists in Countering Violent ExtremismThere is no predictive tool that is likely to have validity for rare outcomes such as terrorist attacks. More here.
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The Use of Omega-3 Fatty Acids in Treatment of DepressionThis review provides an overview of the efficacy, safety, and mechanisms of action in the treatment of depression.
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Handbook of Correctional Mental Health, Second EditionWith the transition of patients with mental illness from the beds of psychiatric institutions into the community the need for knowledgeable mental health professionals continues to grow. Correctional psychiatry has evolved in recent years and presents special challenges for clinicians, which this handbook deftly addresses. Contributing authors with various backgrounds provide a broad range of expertise.
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Obstructive Sleep Apnea and Depression: Issues for PsychiatristsWhat are the effects of sleep apnea on depression--and depression on sleep apnea? Insights here.
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What's New in Pediatric Lower Respiratory Tract Infections?Lower respiratory tract infections are among the most frequent causes for office visits and hospitalizations of otherwise healthy young US children. Here, an overview of current guidance on diagnosis and management.
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Older Drivers RevisitedThe United States is facing accelerated growth in the number of older citizens due to the aging baby boomer generation. It is expected that this emerging cohort will have more licensed drivers who will drive longer distances more frequently and later into life than preceding generations. What are the risks from elderly drivers and how can we help them drive safely?
