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Psychiatric Care of Peripartum WomenThis article summarizes clinically relevant advances in the psychiatric care of women during and after pregnancy, including recent changes in how the FDA classifies pregnancy risk for medications, and best practices in perinatal psychopharmacology.
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Drug-Drug Interactions in PsychopharmacologyCoping with the issue of drug-drug interactions (DDIs) is one of the most challenging aspects of modern psychopharmacology. Psychiatrists are treating patients with medication regimens of ever-increasing complexity.
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Psychiatrists and Peacemaking: A Cultural Psychiatry PerspectiveH. Steven Moffic, MD, interviews Neil Krishan Aggarwal, MD, MBA, MA, DFAPA, on his new book and the concept of peacemaking.
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Psychiatric PowerThe state of North Carolina has relatively liberal policies regarding petitions for involuntary commitment. If such documents bear words like "dangerous" or "mentally ill," even in the most nebulous sense imaginable, the police will surely locate the relevant individuals and dutifully bring them to the emergency department. This generosity of interpretation produces some sticky situations for the lucky ED resident of the day.
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Providing Culturally Competent Care: Understanding the Context of PsychosisCulture-the way people make meaning and live their lives in particular social worlds-matters in psychosis. The authors explore how a patient's cultural background should influence the way clinicians think about treatment and care.
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Bipolar Disorder in the Elderly: Differential Diagnosis and TreatmentBipolar disorder (BD) in later life is a complex and confounding neuropsychiatric syndrome with diagnostic and therapeutic challenges.
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Will Biology Tell Us All We Need to Know About Mental Disorder?At the very heart of psychiatry, people seem totally unconcerned about making claims that, for example, philosophers have never been able to prove.
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Depression in Patients With Alzheimer DementiaAlzheimer dementia (AD) represents a profound global health concern. By the year 2050, the prevalence of AD in the United States is expected to reach 15 million. At present, there are 4.5 million cases in the United States, which equals an estimated cost of $100 billion each year in medical and family expenses.
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The Effects of Antidepressants on SleepKnowledge of how different antidepressants are likely to affect parameters of sleep can provide an important basis for selecting an appropriate antidepressant drug among the roughly 2 dozen marketed options to meet the needs of depressed patients.
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Understanding the Usefulness of Psychosocial Interventions for Personality DisordersAn examination of recent research on psychosocial treatments for personality disorders, including randomized controlled trials and empirically supported therapies as well as dialectical behavior therapy.
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The Dog That Did Not BarkSome thoughts on the pathogenesis and persistence of prevalence of schizophrenia and bipolar affective disorder in view of current discoveries.
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A Risk Stratification Approach to Alcohol DetoxificationThe challenges of identifying patients at risk for alcohol withdrawal have been found to be mitigated by the development of a Risk Stratification Questionnaire, now being adopted by the VA regionally throughout New England. More in this video.
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Psychiatric Issues in SpaceThe many potential stressors for astronauts during space missions present unique and fascinating 21st century psychiatric and psychological issues.
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A Word From Sandy HookIt has become clear over the last couple of days that Sandy Hook Elementary School and Newtown have become an area of great concern locally, nationally, and internationally. We as a world community need to go through a grieving process that includes this type of sharing, especially for parents out there.
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Atypical Antipsychotics for Children and Adolescents With Schizophrenia-Spectrum DisordersAlthough the onset of psychotic symptoms before the age of 13 years is exceedingly rare, the incidence of schizophrenia rises sharply after the onset of puberty.1 Only 1% of the population has schizophrenia and 30% of these patients experience an onset of psychotic symptoms by age 18 years.2-8 The period that precedes the onset of frank psychotic symptoms (ie, the prodromal phase) has not been well characterized in early-onset schizophrenia-spectrum disorders (EOSS), but retrospective reports have shown that symptoms include high levels of depression and anxiety, emerging cognitive and social deficits, unusual thought content, and (not infrequently) school failure.
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When Validation Is HarmfulValidating some patients could lead to both clinician and patient harm.
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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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The Link Between Immune System Dysregulation and SchizophreniaOn the wide range of symptoms in schizophrenia, including alterations of the dopaminergic and/or glutamatergic systems, abnormal neurodevelopment, and the theory of immune system imbalance.
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Heatstroke and Psychiatric PatientsA variety of commonly used psychiatric medications increase the risk of heatstroke, leaving psychiatric patients in jails and prisons at risk.
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Issues in Treating Patients With Intellectual DisabilitiesPsychiatric disorders in persons with intellectual disabilities are typically more severe and more difficult to diagnose than in the general population. Clearly, those who diagnose ID and treat patients with this condition face a number of challenges.
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Beyond AddictionThe authors of this book leave readers feeling empowered, knowing that they can be an important driver of change. It also reminds psychiatrists about some core components of the patient experience.
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Culture as a Factor in Adherence: Learning From Latino ExperiencesSuccessful culturally adapted interventions to improve adherence among Latino patients with depression and schizophrenia confirm how important it is to understand a patient’s entire sociocultural environment.
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Violence, Crime, and Violent Video Games: Is There a Correlation?What effect does exposure to violence in video games have on behavior? These authors examine the evidence.
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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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Deep Brain Stimulation in Chronic and Severe Anorexia NervosaDeep Brain Stimulation is a neurosurgical procedure initially developed for the management of treatment-refractory movement disorders. More recently, the rationale for the use of DBS in anorexia nervosa derives from several sources.
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New Approaches to Juvenile Delinquency: Psychopathology, Development, and NeuroscienceNew findings in epidemiology, developmental psychiatry, and neuroscience offer the opportunity for a new perspective on the problems of juvenile delinquency and bring to bear the insights of modern psychiatry in the treatment and successful rehabilitation of juvenile offenders.
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Management of Acute Ischemic Stroke: Reviewing the OptionsDespite the significant progress in stroke prevention and treatment over the past 10 years, stroke remains the third leading cause of death in the United States.1 Approximately 700,000 strokes occur every year; the majority are ischemic.1 In 1996, the FDA approved the use of intravenous tissue-type plasminogen activator (t-PA).
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Augmentation Strategies in MDD TherapyFor many patients with depression, full symptom remission remains elusive despite multiple trials of antidepressants. This article focuses on psychopharmacological and related interventions.
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New Insights Into the Effects of Alcohol on the BrainWhat are the latest findings on acute and chronic effects of alcohol on the human brain?
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Psychiatric Informatics: Exploring Myths and BarriersMyth #1; I don't need computers in my work. Myth # 2: If I wait, things will stabilize and the prices will come down. Myth # 3: I'm too old to begin thinking about computers. Myth # 4: It's easier for men to understand computers than women.
