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Bullying and SuicideChildhood and adolescent bullying-and, recently, cyberbullying-is a major public health problem with potentially devastating consequences. In any prevention effort, students need hope and to learn the skills to end the abuse, as described here.
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Rejecting the Accusation of a Violated STAR*D ProtocolThe original STAR*D authors refute claims of a violated protocol.
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Treating Psychiatric Patients With Psoriasis: Clinical ConsiderationsPsoriasis, a chronic inflammatory, autoimmune skin disorder, is associated with both genetic and environmental factors. It has important treatment implications for patients who have psychiatric disorders.
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Obesity in Patients With Psychiatric ConditionsObesity is one of the most common physical health problems in individuals with psychiatric conditions and contributes to excess medical morbidity and mortality. Several classes of psychotropic medications, particularly atypical antipsychotics, cause weight gain. While these issues pose challenges to optimal health, the good news is that there are solutions and emerging strategies.
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Sixty-Five Years After World War II: A Family SecretThe Holocaust is well known and has been well researched. The purpose of this study was to evaluate persons 65 years after the Holocaust who remained in Poland and discovered the “secret” of their Jewish ancestry, despite not being raised as Jews.
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Syncope: Workup, Differentials, and TreatmentSyncope is responsible for 1% to 6% ofhospital admissions and up to 3% of visitsto the emergency department (ED). Thissudden, brief loss of consciousness resultsfrom a decrease in or cessation of cerebralblood flow and is followed by spontaneousrecovery. The causes range from benignto life-threatening.
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Treating Insomnia in Patients With Substance Use/Abuse DisordersPatients who use or abuse alcohol and other substance are at high risk for insomnia and present unique challenges for treating this debilitating disease. The three avenues of treatment--behavioral, OTC medications and prescription medications--are reviewed and future trends are outlined.
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The Interface of Depression and DementiaDepression and dementia or Alzheimer's disease often go together. The presence of dementia may also increase the odds of depression. What can clinicians do to treat these two often comorbid conditions?
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Treatment Options in Late-Life Treatment-Resistant DepressionThis article sheds light on the strengths and weaknesses of various approaches to TRD management in adults 60 years and older.
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HypnoticsSeveral classes of hypnotic medication are available: the older barbiturates and their derivatives; benzodiazepines; chemically distinct “z-compounds”; antihistamines and antihistaminic antidepressants; and melatoninergic compounds. The use of hypnotic medications continues at a high rate. However, some switching to the shorter-acting benzodiazepines has occurred. The z-compounds-eszopiclone, zolpidem, and zaleplon-have become popular; they seem to have fewer residual effects than the benzodiazepines. Even so, care is needed in prescribing such hypnotics for the elderly.
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Anxiety in the Medical PatientAnxiety is a ubiquitous, natural affective state that is essential for evolutionary survival. Nearly as common, however, are experiences of anxiety that exceed social, psychological, or physiological needs, leading to functional impairment. Indeed, primary anxiety disorders, including panic disorder, social phobia, and generalized anxiety disorder (GAD), represent the most common category of mental illness in the United States. Secondary, or reactive, anxiety is also widespread and can arise not only from numerous medical causes but also from the psychological process of coping with illness.
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College Students Under StressEmerging adults in the midst of a tremendous emotional growth spurt and a leap of neurocognitive maturation often need guidance articulating what bothers them.
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Gender Differences and Psychiatric DisordersGender is an important variable in medicine and psychiatry. The initial interest in gender issues was stimulated by recognition that women were absent from much medical research. Now, however, the field has expanded to include more specific and sensitive attention to men and the role of gender and gender differences.
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Contraception and MisconceptionsPsychiatrists who treat women and adolescent girls may find it necessary to discuss with their patients reproductive planning and the role of contraception in setting comprehensive treatment goals. Here's why.
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Can You Trust Your Physician?Statutes in 8 states are not designed to assure informed decision-making, say these psychiatrists; instead they represent an unprecedented effort by the government to use physician communications as an instrument for discouraging pregnant women from exercising their constitutional right to make their own reproductive choices.
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The State of the Evidence on Pediatric Bipolar DisorderPediatric bipolar disorder (PBD) is a serious psychiatric illness that impairs children’s emotional, cognitive, and social development. PBD causes severe mood instability that manifests in chronic irritability, episodes of rage, tearfulness, distractibility, grandiosity or inflated self-esteem, hypersexual behavior, a decreased need for sleep, and behavioral activation coupled with poor judgment. While research in this area has accelerated during the past 15 years, there are still significant gaps in knowledge concerning the prevalence, etiology, phenomenology, assessment, and treatment for PBD.
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Biological Markers and the Future of Early Diagnosis and Treatment in SchizophreniaBiological Markers and the Future of Early Diagnosis and Treatment in Schizophrenia
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Dementia, Agitation, and Aggression: The Role of Electroconvulsive TherapyWhat role might electroconvulsive therapy play for short-term treatment of agitation and aggression in patients with dementia?
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New Findings Related to Childhood-Onset PsychopathologyInnovative approaches that advance our understanding of the mechanisms that confer risk for psychiatric illness in youths is the focus.
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Podcast: Brief Dynamic Therapy-5 Tenets to Maximize EffectivenessIn this podcast, Dr Mantosh Dewan, discusses strategies to help you and your patient get the most benefit from this form of therapy.
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Are We Over-Diagnosing ADHD Based on “Hyperactivity"?Here’s why ADHD is a diagnosis of exclusion.
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Lessons Learned From the International Society for Bipolar Disorders Task Force on SuicideWhat is the actual risk of suicide attempts or suicide death in people with bipolar disorder? How does a BD diagnosis affect short-term and long-term suicide risk? How should a BD diagnosis help guide us toward the most effective suicide prevention strategies?
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Early Evaluation and Management of Mild Traumatic Brain Injurymild traumatic brain injury, MTBI, concussion, post-concussive syndrome
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The Case of Factitious Disorder Versus MalingeringPatients who exaggerate, feign, or induce physical illness are a great challenge to their physicians. Trained to trust their patients’ self-reports, even competent and conscientious physicians can fall victim to these deceptions.
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The Age of Cannabis Has Arrived: Issues for Older AdultsCannabis use has prompted symptoms such as dizziness, sleepiness, and fatigue in older patients. Are there any benevolent effects?
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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.
