Authors
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Pandora Replies to Dr FrancesIn his recent David Letterman–like Top 19 list of DSM5 issues, Allen Frances1 targeted a proposed revision of the DSM-IV diagnosis of Pedophilia, and 2 proposed new diagnoses: Hypersexual Disorder (HD) and Paraphilic Coercive Disorder. He protests the inclusion of pubescent teenagers in the definition of the proposed revision of Pedophilia (including the renaming of it as Pedohebephilic Disorder) and criticizes the quality of writing of these criteria.1 As the chair of the DSM5 Work Group responsible for those draft criteria, I need to address his poorly reasoned claims.
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Antonio Damasio’s Descartes’ Error: Emotion, Reason, and the Human BrainDescartes’ Error1 can be read in 2 ways. To start, it works as an engagingly written, accurate piece of science journalism (which is something that we need more of; it’s hard to imagine running a democracy without it).
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Cultural Aspects of the Pharmacological Treatment of Depression: Factors Affecting Minority and YouthThe cultural and demographic profile of the United States is undergoing a rapid transformation. In many areas of the country, there is no longer an ethnic majority but a multiplicity of racial and cultural groups.
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Broadening Your Practice: Opportunities in Executive and Organizational ConsultationSeveral case examples of how psychiatrists can be a valuable asset in a workplace environment are given. What are the similarities and differences between this situation and clinical practice?
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A Look at the 988 Soft LaunchA practical guide to understanding the new behavioral health emergency number and creating effective messaging for patients, families, and colleagues.
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Algorithms Assisted By InformaticsSeveral international algorithm projects are underway, some of which have been in use for years. What are the roadblocks for their successful implementation?
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The World of Personality Disorders in 6 Clinical ReportsHere's what's new in personality disorders: DBT treatment, DSM-5 criteria, borderline personality disorder, narcissistic personalities, and mentalization-based treatments.
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The Ethical Policies and Involvement in Enhanced Interrogations of US Psychologists After 9/11The article “Mental Health Professionals in the ‘Enhanced’ Interrogation Room” on the cover of this issue provides an invaluable service. It documents psychologists’ and physicians’ involvement in enhanced interrogation programs.
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This Is the Water: The Social Determinants of Mental Health and the Future of PsychiatryHere's why we need more effective training, practice, and advocacy regarding the social determinants of mental health.
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Raising the Bar on Geriatric Mental Health Competency TrainingThe authors make the case for national education mandates from accreditation organizations and congressional support to require enhanced education of all clinicians who care for older adults.
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Electroencephalography in NeuropsychiatryThe recent evolution of neuropsychiatry/behavioral neurology as a subspecialty represents a paradigmatic shift regarding the responsibility of psychiatrists in diagnosing and managing behavioral disorders with concomitant and demonstrable brain pathology such as dementia or head injury. This authors define the clinical usefulness of electroencephalography in evaluating neuropsychiatric disorders.
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Are Migraines and Bipolar Disorder Related?Migraine is characterized by episodes of headache with qualities such as unilateral location, throbbing pain and aggravation by routine physical activity. Additional symptoms include nausea, photophobia and phonophobia. Some patients have aura symptoms, usually visual, before the headache phase (Davidoff, 1995). Prodromal and accompanying symptoms of migraine attacks often are psychiatric in nature, such as depression, elation, irritability, anxiety, overactivity, difficulty thinking, anorexia or increased appetite. In some patients, an organic mental syndrome can be part of a migraine attack (Davidoff, 1995). In other patients, an acute psychotic condition is the dominating clinical feature. This presentation, with paranoid delusions, hallucinations and anxiety, has been described in families with hemiplegic migraine (Spranger et al., 1999). Migraine is, therefore, an important differential diagnosis in relation to episodic phenomena with a mixture of somatic and psychiatric symptoms. In addition, psychosocial stress is the most common precipitating factor for a migraine attack (Davidoff, 1995).
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Board Certification: Two PerspectivesTwo perspectives regarding the American Board of Psychiatry and Neurology’s (ABPN) Maintenance of Certification (MOC) program.
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Developmental Disabilities From Childhood to Adulthood:What Works for Psychiatrists in Community and Institutional Settings
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Marijuana Use, Withdrawal, and Craving in AdolescentsMarijuana is the most commonly used illicit drug in the United States and worldwide. Initiation of use typically occurs during adolescence. The most recent epidemiological data indicate that in the United States, 42% of high school seniors have tried marijuana, 18% have used it in the past 30 days, and 5% use it daily.
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Neuropsychiatric Abnormalities: A New Vista From Studies on Fundamental Properties of Neural CommunicationPostmortem studies indicate that neural circuit abnormalities in schizophrenia could be reflected in gamma-band synchrony. We review findings of recent studies that demonstrate abnormal synchrony in the gamma band of the EEG in chronic schizophrenia patients, and point to links between gamma oscillations and some of the core symptoms of schizophrenia.
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Lifetime Psychiatric Comorbidity of Illicit Drug Use DisordersWhat is comorbidity? Psychiatric comorbidity refers to the occurrence of 2 or more mental or substance use disorders within a certain period. Research shows that comorbidity of substance use and other psychiatric disorders is common and often worsens the prognosis for each disorder.
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Cannabis Legalization: What Psychiatrists Need to KnowWhat's the latest update on cannabis legislation and its clinical utility?
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Treating Sex Offenders in a State HospitalAs a psychiatrist working in a state hospital, this author defends the long-term commitment of sexual offenders to institutions and offers insights on factors determining prognosis.
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What All Psychiatrists Need to Know About AddictionsBecause at least 10% of the US population suffers from a substance use disorder in any given year, the American Academy of Addiction Psychiatry has expanded its longstanding Board Review Course in Addictions to a more inclusive “Addictions and Their Treatment” course.
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Psychiatric Medications for ChildrenToo often news headlines exert a major influence on our patients-and nothing in child psychiatry grabs headlines like the alleged overprescription of medicines. Physicians sidestep the debate, assuring their patients and themselves that each prescription is written only after careful consideration of risks and bene-fits.
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The Ethic of Humility and the Ethics of PsychiatryA few decades ago, ethics was widely understood in the professions to be a synonym for etiquette; it described the consideration that members of a profession showed to each other. More recently, it has come to refer to the rules governing the relationship between a professional and a client or patient.
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Functional GI Disorders: A Psychiatric PerspectiveEvidence showing the effectiveness of psychopharmacologic and psychotherapeutic management of functional gastrointestinal disorders over standard medical treatment is increasing.
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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.
