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Tipsheet: Physician Substance Abuse in the WorkplaceMany barriers can prevent physicians who have a substance use disorder from obtaining the help they need. However, in many states, all is not lost for physicians who willingly participate in treatment. Here, signs, symptoms, and intervention steps.
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Euthanasia in Animals and Humans: Distinctions to ConsiderHere’s why the euthanasia of animals as an argument for physician-assisted suicide is invalid…
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The New Historical Trauma StudiesRecent decades have seen an outpouring of publications about psychological trauma. With its formal diagnostic category of posttraumatic stress disorder (PTSD), Western psychiatric medicine has led the way in opening up this field of study. Many other disciplines of inquiry, including sociology, anthropology, legal studies, and literary studies, also have contributed their distinctive approaches and methodologies to the subject. Most recently, professional historians in Britain, Germany, Austria, Australia, Canada, and the United States have researched the origins of PTSD to great effect. These “new historical trauma studies” draw heavily on pioneering medical research from earlier places and periods. In addition, empirical findings from and analytical insights into humanity’s troubled, traumatic past provide ideas, observations, and insights that may be useful for mental health practitioners today.
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How Business Pressures Shape the Social Evolution of Modern Private Practice--A Case StudyAll of the forces affecting and influencing my professional life thunder through my day like these footsteps on the bridge. So many times we hear that private practitioners are "dinosaurs" in today's managed health care environment. At times, I admit, I do feel like a hanger-on in some evolutionary cul-de-sac. Yet, as referrals keep coming in, I find myself feeling more and more fit to survive the Darwinian challenges facing psychiatry. Sharing daily life with colleagues I trust and respect better enables me to live with or ignore the "footsteps on the bridge," which in my more optimistic moments I imagine to be the sound of the real "dinosaurs" rumbling off into the mist.
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Instrument Measures for Behavioral Symptoms in Patients With DementiaPsychiatric disorders, such as primary sleep disturbances, depression, substance abuse, mania, sexually inappropriate behaviors, and psychosis, can complicate the care of patients with dementia.
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Improving Medication Adherence: How to Talk With Patients About Their MedicationsImproving Medication Adherence: How to Talk with Patients About Their Medications, by Shawn Christopher Shea, is a slim and excellent primer on the verbal strategies and interviewing tips that clinicians can use to improve medication adherence.
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Faith Is Not Enough: Self-Administered Questionnaire Screening for Bipolar DisorderBipolar disorder screening scales have modest sensitivity; thus, a negative result does not preclude a clinical evaluation.
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The Changing Face of Alcoholism TreatmentAt the core of alcoholism is the pathologically increased motivation to consume alcohol at the expense of natural rewards with disregard for adverse consequences. naltrexone and acamprosate represent the first generation of modern pharmacotherapies that target this pathology.
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Telepsychiatry: The Perils of Using SkypeWhat Skype does not offer is a means of communication clearly suitable for clinical services-especially in mental health and psychiatry.
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Psychiatry and the Menopausal Transition: Clinical CaveatsThe menopausal transition is characterized by sex hormone variability and a vulnerability to depressive symptoms and major depressive episodes. The rate of new-onset major depressive episodes is increased during the menopausal transition, as is the experience of depressive symptoms.
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Inpatient Psychiatry: The Interpretation of Changing SceneryRecently our inpatient psychiatric unit moved into a brand new facility. In the months and weeks preceding “the move,” there was much preparation and nervous energy. We had been preparing our patients and ourselves for this day. “
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Utopia: The Transition From Inpatient to Outpatient PsychiatryOutpatient psychiatry is a critical experience in becoming an independent psychiatrist.
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Treat the Whole Patient: Bring in the PsychiatristBehavioral problems “masquerade” as physical symptoms. The time has come to treat the whole patient and to make psychiatry part and parcel of primary care.
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Suicide in Older Adults: How Do We Detect Risk and What Can We Do About It?Older adults have higher rates of suicide than younger adults in many industrialized nations.
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The OPTICS Project: An Open-Science Framework for the Analysis of Clinical Trial DataA report of initiatives that have raised awareness of and promoted data sharing and data transparency in order to advance science and improve public health and health care.
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Epidemiology and Treatment of Substance Use and Abuse in AdolescentsThis article covers the spread of substance use problems in adolescents and some of the currently available scientifically proven behavioral treatments for these conditions.
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Recognizing Resistance in the Therapeutic EnvironmentDespite the proliferation of competing psychoanalytic theories in the past three decades, for most analysts the recognition and interpretation of resistance (as well as transference) remains at the core of psychoanalytic technique. While resistance has been defined as encompassing all of a patient's defensive efforts to avoid self-knowledge (Moore and Fine), operationally it means those behaviors that help the patient ward off disturbing feelings such as anxiety, anger, disgust, depression, envy, jealousy, guilt and shame.
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Migraine-Preventive Medications: Guidelines for SuccessMigraine-Preventive Medications:Guidelines for Success
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A CASE REPORT: Prepartum or Postpartum Psychosis?Did this woman have (untreated) postpartum psychosis when she became pregnant a second time-- or was this a separate, rare case of prepartum psychosis?
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Psychiatric Conditions Affecting Physicians With Disruptive BehaviorThis study highlights the need to consider a holistic approach when discussing the problem of disruptive behavior in health care settings.
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Treatment Adherence: Strategies and Best PracticesTreatment nonadherence in psychiatric patients contributes to increased suicide rates, illness exacerbation, hospitalization, and mortality. This Special Report countdown highlights the psychiatrist’s role in addressing barriers to treatment in a number of scenarios.
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Psychiatric Comorbidity Associated With Pathological GamblingGambling has become a major recreational activity in the United States. Formerly confined to a few states such as Nevada and New Jersey, legal gambling opportunities have exploded across the nation in the past 2 decades.
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Neurotransmitters, Pharmacologic Synergy, and Clinical StrategiesAlthough studies now suggest that some psychotropic medication regimens have a somewhat higher success rate than the one-third rule would have predicted, psychiatrists are still left with the problem of why it is that only one third to one half of patients who are treated get better, and why fewer still sustain that improvement over time
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Mini Quiz: Cultural Diversity and the Young PatientWhat are the benefits of exploring cultural issues with a young patient and family before proceeding with treatment?
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New York State Moves Toward Involuntary Residential Commitment of the Mentally IllSeveral incidents of serious violence, including the death of one woman, have pushed the issue of involuntary commitment of the noncompliant mentally ill higher on the priority list of the government of New York State.
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Psychopharmacology of Autism Spectrum DisordersAutism is a highly prevalent, highly heterogeneous disorder of unknown etiology. Studies to clearly establish the efficacy of various classes of psychoactive drugs are scarce. Nonetheless, available findings do support the efficacy of atypical antipsychotics and antidepressants in treating the core symptoms of repetitive behavior.
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AAPS Sues over Maintenance of CertificationJane Orient, MD, comments: Many physicians are outraged, not only by the cost -- an expense which must be incurred to maintain certification, but also by the fear that MOC is being advanced as a requirement for hospital privileges, and perhaps even maintenance of licensure. More here. . .
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Sexual Impulsivity Disorders: Psychiatric "Orphans"Paraphilias and paraphilia-related disorders (nonparaphilic sexual compulsivity or sexual addiction) are sexual disorders that predominantly afflict men.
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Brain Pathways: New Approaches to Structure-Function LocalizationIs it time again for greater unification of neurology and psychiatry?
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The “Bar-Coding” of Patients With Electronic Health RecordsDigital technology is a valuable tool, but if it dazzles us with its speed and control, there is the risk that we may forget the old way of connecting.
