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The Role of MRI in the Diagnosis of Multiple SclerosisMultiple sclerosis (MS) is the most commoninflammatory demyelinating disease of theCNS and the most frequent cause of nontraumaticneurological disability in young andmiddle-aged adults.1 Women are twice as likelyto be affected as men, and onset typicallyoccurs between the ages of 20 and 40 years.
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Substance Abuse Screening in Patients With Anxiety DisordersHow can clinicians reliably identify comorbid drug and alcohol use disorders in patients with anxiety disorders?
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Patient Education: 11 Common Questions on Heroin AbuseA guide for helping patients understand heroin, its history, and how it impacts our communities.
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Psychiatric Symptoms Associated With Parkinson DiseaseParkinson disease (PD) is the second most common neurodegenerative illness in the United States, affecting more than 1 million persons. Disease onset is usually after age 50. In persons older than 70 years, the prevalence is 1.5% to 2.5%.1 While the primary pathology involves degeneration of dopaminergic neurons in the substantia nigra, circuits important in emotion and cognition-such as the serotonergic, adrenergic, cholinergic, and frontal dopaminergic pathways-are also variably disrupted.
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Addressing the Aftermath of Suicide: Why We Need PostventionHere: a brief review of the literature on postvention efforts; the effects on the victim’s caregivers; and a guide to resources to help manage survivors’ and caregivers’ emotions and dread.
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Addressing Postdeployment NeedsAlthough we would all like to believe otherwise, war is not over when a service member returns home. For many, returning home may be where the harder battles begin. Intensive training prepares troops for warfare, but what training do they have to readjust when they return home?
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Improving Mental Health Care in America: An Opportunity for Comprehensive ReformThe authors outline the ingredients for the transformation of mental health care in America.
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Unmasking Comorbid Pyromania and Psychosis in a Patient With AnorexiaAlthough psychosis is rare in adolescent patients with anorexia nervosa restricting type, the possibility should be explored because it may be the underlying cause of the eating disorder.
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Cognitive Rehabilitation in SchizophreniaThis article reviews methods to rehabilitate cognition in schizophrenia and suggests strategies for instituting a cognitive remediation program.
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That’s Not My Child: A Case of Capgras SyndromeThe specific cause of Capgras syndrome has been hypothesized from neuropsychological and psychodynamic views.
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Psychiatric Presentations of Autoimmune EncephalopathiesGiven the potential for a significant role in recognition of neurologically complex disorders, psychiatrists should become familiar with diagnostic criteria and appropriate therapeutic option.
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Autism: Where Do We Go From Here?In the last 5 years, there has been an absolutely profound transformation in the ability to identify genes that contribute to autism and schizophrenia.
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Depression and Anxiety in Cardiac DiseaseHere: a look at the associations between negative psychological states and CV health, physiologic and health behavior mechanisms, and ways to diagnose and treat depression and anxiety disorders.
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Clinical Pearls on the Management of Parkinson DiseaseThe ideal medication for Parkinson disease (PD) would reduce disability and halt or slow disease progression without intolerable adverse effects. Although such an agent is not yet available, current treatments offer significant symptom control for most patients. The decision about when to start therapy is highly individual; however, delaying treatment because of fear of adverse effects may not be in the patient's best interest.
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Sexual Assault Among Male VeteransLittle attention has been paid to the prevalence of sexual assault and its sequelae among military men. The past-year prevalence of sexual assault among enlisted men ranges from 0.4% to 3.7%, a figure equal to or exceeding the lifetime prevalence among civilian men in some studies. Increased awareness and understanding of male sexual assault as well as routine screening of all patients, regardless of gender, for exposure to sexual victimization will enhance their recovery.
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Frontiers in Psychiatric ResearchThese are exciting times for genetics research: Science magazine chose our new appreciation of human genetic diversity as the scientific breakthrough of the year 2007.1 The year brought a new genetic bonanza with the announcement of the 1000 Genome Project, a plan to capture human diversity by obtaining the entire genome sequence information of 1000 individuals.
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Comorbidity in Bipolar DisorderThe central tenet of clinical comorbidity, the occurrence of 2 syndromes in the same patient, presupposes that they are distinct categorical entities.
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Mini Quiz: Violence and PsychosisWhat percentage of patients hospitalized for a first episode of schizophrenia who had threatened others had displayed overt signs of illness for over a year?
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Learning to Do Psychotherapy With Psychotic Patients: In Memory of Elvin Semrad, MDDr Elvin Semrad was a much-loved psychiatrist and psychotherapy supervisor who had a profound influence on hundreds of psychotherapists and psychoanalysts in the Boston area. One of his unique qualities was his ability to connect empathically with even the most psychotic patients. He supervised at Boston State Hospital and then for 4 decades at the Massachusetts Mental Health Center (MMHC) in Boston, where he conveyed his strong conviction that psychotic and other seriously men-tally ill patients could benefit from long-term psychoanalytically oriented psychotherapy.
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ECT for Self-Injurious Behavior in Autism: A New IndicationECT has been found effective in mitigating the deleterious consequences of SIB.
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The Correlation Between Sleep-Disordered Breathing and PsychiatrySleep-disordered breathing is common in patients with mood and anxiety disorders. This article explores the implication for practicing psychiatrists whose patients have sleep disorders.
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The Relevance of Neuroscience for PsychiatristsMany psychiatrists are not familiar with the latest developments in neuroscience and many clinicians are a bit skeptical about the relevance of neuroscience in their practice.
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Treatment-Resistant Bulimia Nervosa: Clinical Implications and Future DirectionsDialectical behavior therapy may be particularly effective in mitigating biologically-driven vulnerabilities, and zonisamide and lamotrigine may play a role.
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Telepsychiatry TrainingTelemedicine-the use of electronic technologies to deliver medical care at a distance-continues to gain popularity and widespread use in all medical specialties, including psychiatry. However, many residents enter their training without any clinical experience in telemedicine in general or its applications in psychiatry.
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Management of Antipsychotic-Induced Weight GainIndividuals with schizophrenia are at greater risk for weight gain than the general population. From recent research, it appears that some of the second-generation antipsychotics may be more likely to cause weight gain than others. Recommendations for treatment strategies are provided.
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Weight Loss Associated With Cholinesterase Inhibitors in the ElderlyDo cholinesterase inhibitors lead to weight loss in older adults with dementia? Here's a wrap up of a large study of patients in a real-world setting who had newly started these medications.
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QTc Prolongation Associated With Psychotropics: Therapeutic ConsiderationsA focus on QTc monitoring in patients receiving psychotropics, especially when multiple medications are prescribed.
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Psychiatric Polypharmacy: The Good, the Bad, and the UglyA great deal of data exists about the dangers of polypharmacy. Persons with psychiatric disorders experience increased risk for adverse drug interactions because of the great frequency with which multiple medications are used.
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Cyberbullying and College Students: What Can Be Done?Clinicians have a powerful voice that can be used to address cyberbullying, improve campus climate, and support a positive undergraduate experience.
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The Complex Interrelationships of Menstrual Cyclicity and Anxiety DisordersThe ocurrence and severity of anxiety disorders have been correlated with fluctuations in female sex steroid levels in both epidemiological and experimental studies.1-5 Female reproductive hormones play a role not only in the development and course of anxiety disorders but also in treatment response.
