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Stroke: While Current Treatment Is Limited, New Options Are on the HorizonCurrent therapy for acute ischemic stroke remains limited to intravenous recombinant tissue plasminogen activator (tPA) administered within 3 hours of symptom onset, but despite strong evidence supporting its effectiveness,1-5 only 2% to 4% of all stroke patients currently receive tPA.
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Co-occurring Substance Use and Eating DisordersWhat does existing research say about the connection between substance use disorders and eating disorders?
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Treating Comorbid Anxiety Disorders in Patients With Schizophrenia: A New PathwayIdentifying comorbid anxiety disorders as potential treatment targets may contribute to more positive outcomes for patients with schizophrenia. Details here.
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New Insights in Premature EjaculationEjaculatio praecox, or premature (rapid, early) ejaculation (PE), is a prevalent male sexual complaint. It may be part of the normal ejaculation variability in men, but it may also be the symptom of an ejaculatory dysfunction.
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Alcohol and Drug Abuse Intervention in the Emergency DepartmentIf done properly, the assessment of alcohol and substance use disorders in the emergency department (ED) or psychiatric emergency service can be the first step toward recovery.
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Headache and Psychiatric ComorbidityMigraine affects approximately 12% of the population, and a high percentage of these patients have comorbid psychiatric disorders. Knowing more about the interaction between headache and psychiatric factors can assist in evaluating and treating these patients.
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Borderline Personality Disorder: Splitting CountertransferenceSplitting, archetypally imbedded in a patient's psychic structure, acts as a powerful unconscious force to protect against the ego's perception of dangerous anxiety and intense affects. Rather than providing real protection, splitting leads to destructive behavior and turmoil in patients' lives.
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Clinical Care of the Suicidal College Student: When and How to Involve ParentsTwenty years ago, it was rare for college students to mention suicidal thoughts, and even more rare to involve parents in their care. Today, students are more likely to describe suicidal ideation, necessitating a more thorough safety assessment with potential outreach to parents.
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Common Augmentation Strategies for Depression: Findings Show Lack of EvidenceIt is estimated that at least half of persons who begin antidepressant treatment will not respond to monotherapy.
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Serving the Underserved: Who Needs Mental Health Care?Experts address specific concerns when treating the immigrant sector and describe supervised mental health services for uninsured, largely undocumented patients.
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Epilepsy and Seizures: Neuropsychiatric ImplicationsPsychiatric comorbidity in epilepsy represents not only a matter of intellectual interest but also an important variable that affects prognosis in terms of morbidity and mortality.
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Atypical Antipsychotics for Treatment of Schizophrenia Spectrum DisordersThe number of prescriptions for antipsychotic treatment of teenagers has increased sharply in office-based medical practice. Adolescents with psychotic symptoms frequently present for clinical evaluation, and early-onset schizophrenia spectrum disorders (onset of psychotic symptoms before the age of 18 years) represent an important consideration in the differential diagnosis in these youths
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Treatment of Insomnia in Anxiety DisordersHow often do insomnia and anxiety disorders coexist? And how best to treat patients with comorbid insomnia and anxiety? Answers here..
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Can Your Older Patient Drive Safely?Medical professionals may be reluctant to initiate a discussion about driving with older patients in anticipation of a negative impact on the physician-patient relationship.
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Mini Quiz: New Patient ConsultA 19-year-old new patient comes to you wanting to discontinue all his childhood psychiatric medications. What is the best next step?
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Media Advocacy Promotes Freedom to Speak OutNelson Kull, executive director of Pathways, sees an additional benefit to consumer employment: it provides patients with a first-hand look inside the system, and this can help defuse the sometimes antagonistic relationship between consumers and caregivers. "Some people criticize doctors and pharmaceutical companies for making a lot of money," says Kull, "but they gave me back my life. I once told meeting [attendees] that yes, psychiatry and medical care cost a lot, but your car costs a lot. I can't drive my car without my medications, so which comes first?"
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Parents as Part of the Therapeutic Process in a Child and Adolescent ReferralWhile some mental health services for adolescents allow self-referral, many require parental involvement. There is increasing evidence that working with the family and the child is important if only to increase compliance with medication and to tackle any comorbid difficulties.
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Sudden Onset of Tics, Tantrums, Hyperactivity, and Emotional Lability: Update on PANS and PANDASIn the neuropsychiatric disorders PANS and PANDAS, we observe childhood illness with relationships between psychiatric symptoms, infection, and inflammation. Here are keys to early identification and treatment.
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Introduction: Risk Factors, Pharmacological Interventions, and Sequelae of Suicidal BehaviorThe articles in this Special Report address suicidal behavior in the context of the role of sexual identity, the effects of antidepressants and lithium on suicidal behavior, and clinicians’ reactions in the aftermath of suicide.
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Thinking About Mental Illness: 6 Steps for Medical School FacultyRegardless of the systems in place at medical schools, psychiatrists and psychiatry residents play an important role in molding medical students' attitudes toward mental illness.
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Somatoform and Related Disorders: An UpdatePotentially over-inclusive DSM-5 diagnostic categories for somatic disorders can result in a confusing overlap of criteria. These authors sort through the challenges of the differential diagnosis-and map out a well-structured treatment plan.
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PatientsLikeMe: Crowdsourced Patient Health Data as a Clinical Tool in PsychiatryPatients want to know what to expect with a given treatment, how their experiences compare with those of others, or whether they are alone in coping with their conditions. Who best to answer these questions than others like them?
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Depression-Related Disparities Among Older, Low-Acculturated US LatinosOlder Latinos with depression report higher levels of impairment and are more persistently ill than non-Hispanic white older adults, yet they have lower rates of guideline-concordant treatment. Cognitive and problem-solving psychosocial modalities are emerging as key treatment considerations for older Latinos.
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Small Biotech Companies Target CNS DisordersThe concept of a barrier between the blood and the brain arose in the late 19th century when the German bacteriologist Paul Ehrlich observed that certain dyes administered intravenously to small animals stained all of the organs except the brain. Ehrlich interpreted this to mean that the brain had a lower affinity for the dye than the other tissues. In subsequent experiments, one of Ehrlich's students injected a blue dye directly into the cerebrospinal fluid of rabbits and dogs. The dye readily stained the entire brain, but did not enter the bloodstream to stain the other internal organs.
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Mini Quiz: Neurobiology of Borderline Personality DisorderWhat do functional magnetic resonance neuroimaging findings reveal about the neurobiology of borderline personality disorder? Take the quiz and learn more.
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5 Ways to Transform Health BehaviorsProper technique, practiced over time, can transform an appointment from "medication management" to a serious change in behavior, as evidenced by the 5 examples featured in this article.
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Psychocutaneous DisordersPsychological problems are often manifest in the skin. In fact, it is estimated that between 20% and 30% of all skin disorders have some psychological component. Many patients who have psychocutaneous disorders-which are often direct evidence of or secondary to psychological abberations-drift from one physician to another, trying to find one savvy enough to cure their “skin condition.” Furthermore, although they have sought many medical opinions already, patients afflicted with psychocutaneous disorders almost always present as “an emergency.” While pharmacological intervention may benefit such patients, traditional mental health interventions are almost always required if the aberrant behavior is to cease.
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Orthorexia Nervosa: Disease That Masquerades as HealthIn the case of orthorexic thinking, clinicians, patients, and their loved ones are bombarded by the same cultural tropes about our bodies and their relationship with the environment in which we live.
