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Dynamic Psychotherapy for Cancer Patients and Their PartnersThe estimated number of patients with cancer in this country is 10.5 million. Close to a million and a half are new cases, and it is estimated that 560,000 people die of cancer each year.1 There is clearly a large group of cancer patients and their families at high risk for serious psychiatric illness. In this article, I focus on the advantages of a psychodynamic approach and address how this approach is helpful in the liaison function and psychotherapy of cancer patients and their partners.
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Clinical Considerations in Renal Failure, Depression, and DeliriumRenal failure is not an uncommon disorder either in the general public or in patients with psychiatric disorders, but accompanying depression, anxiety, and loss must be attended to during such an illness.
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Botulinum Toxin for Depression? Emotional ProprioceptionIf larger trials confirm the strong antidepressant effects observed so far, botulinum toxin may become a standard therapeutic addition to the psychiatric armamentarium.
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Stroke Complications: Hiding in Plain Sight?Despite the enormous progress made in stroke diagnosis and treatment in recent years, patients continue to experience stroke-related deficits that clinicians-even those working on stroke rehabilitation units-do not always recognize or record. In a recent study of 53 patients who underwent screening tests within 10 days of admission to a stroke unit, every impaired patient had at least 1 undocumented cognitive or sensory deficit. The authors suggested that without formal testing with standardized assessments, much stroke-related impairment goes unrecognized and perhaps untreated.
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The Neurochemistry of Pediatric Major Depressive DisorderMajor depressive disorder (MDD) in pediatric populations represents a significant public health concern. Rates of MDD rise dramatically in adolescence, with an estimated lifetime prevalence of 15% in adolescents aged 15 to 18.
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Rehabilitative Management of Complications of Spinal Cord InjuryPredicting extent of neurologic recovery is crucial. The most accurate and standardized method is clinical neurologic examination using the International Standards for Neurological Classification of Spinal Cord Injury.
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Are Migraines and Bipolar Disorder Related?Migraine is characterized by episodes of headache with qualities such as unilateral location, throbbing pain and aggravation by routine physical activity. Additional symptoms include nausea, photophobia and phonophobia. Some patients have aura symptoms, usually visual, before the headache phase (Davidoff, 1995). Prodromal and accompanying symptoms of migraine attacks often are psychiatric in nature, such as depression, elation, irritability, anxiety, overactivity, difficulty thinking, anorexia or increased appetite. In some patients, an organic mental syndrome can be part of a migraine attack (Davidoff, 1995). In other patients, an acute psychotic condition is the dominating clinical feature. This presentation, with paranoid delusions, hallucinations and anxiety, has been described in families with hemiplegic migraine (Spranger et al., 1999). Migraine is, therefore, an important differential diagnosis in relation to episodic phenomena with a mixture of somatic and psychiatric symptoms. In addition, psychosocial stress is the most common precipitating factor for a migraine attack (Davidoff, 1995).
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Mental Health Services in a Single Payer SystemWith so many Americans lacking appropriate health care insurance and so much of the large insurance companies' premiums going to overhead and profit, it makes sense to move forward with a single payer system. The author discusses some of the basic features of a proposed system.
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Differential Diagnosis of Psychotic Symptoms: Medical “Mimics”The number of medical diseases that can present with psychotic symptoms (ie, delusions, hallucinations) is legion. A thorough differential diagnosis of possible medical and toxic causes of psychosis is necessary to avoid the mistaken attribution of psychosis to a psychiatric disorder.
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Understanding Comorbid Depression and AnxietyComorbidity of psychiatric syndromes is quite common-in a 12-month period, almost 50% of adults in the United States with any psychiatric disorder had 2 or more disorders.
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5 Clinically Relevant Studies on CBTA summary of important CBT studies with the most current evidence-based information, chosen for their relevance and clinical utility.
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Substance Abuse in Aging and Elderly AdultsAs we are faced with a growing population of older adults, a better understanding of the issues that they confront is crucial.
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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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Diabetes-Related Risk Factors and Cognitive AgingFocus on Obesity, Insulin Resistance, and the Metabolic Syndrome
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Mini Quiz: Psychogenic Non-Epileptic SeizuresWhich psychiatric disorder has the highest rate of co-occurrence with patients suffering from PNES? Take the quiz and learn more.
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Reporting Under Fire: Understanding Psychopathology of War JournalistsThe dozens of journalists killed while covering the current war in Iraq gives currency to the dangers encountered by those who bring us the news from the world's conflict zones. Despite the risks inherent in their profession, it is only recently that the psychological health of war reporters has been captured in a systematic and empirical manner.
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How Catastrophe Can Change PersonalityThis article explores why Enduring Personality Change After Catastrophic Experience (EPCACE) is a clinically useful diagnosis.
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Introduction: The Connection Between Medical Illness and Psychiatric DisordersThis Special Report focuses on the psychiatric and medical interface of some common medical problems.
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Issues in Treating Anxiety Disorders in PregnancyAnxiety disorders are a frequent occurrence in pregnancy. While some worries and anxiety are experienced by more than 50% of pregnant women, a full-blown anxiety disorder involves risk to both mother and fetus and increases the risk of postpartum depression.
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How Does Your Practice Compare? A How-To Guide to Practice BenchmarkingEveryone is talking about the decline in reimbursements and the increase in overhead costs. While most practices are faltering, some are quite successful--that is, they are economically thriving. So what makes the difference?
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The Crisis of Present-Day Psychiatry: Regaining the PersonalPresent-day psychiatry has fallen into crisis because of the severe limitations of its conception of the person and, as a result, its conception of the patient. It objectifies the patient in a number of ways. Because of this reductionism, psychiatry fails to distinguish between healthy and pathological features of human life. It fails to consider adequately the psychological and social factors that cause and maintain each patient's problems.
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New Agents of AbuseUnderstanding Prescription Drug Misuse by AdolescentsA large percentage of youths use and abuse psychoactive substances. According to the 2007 Monitoring the Future (MTF) survey, the percentage of US adolescents who used illicit drugs or drank alcohol continued a decade-long drop, revealing that 19% of 8th graders, more than 36% of 10th graders, and 47% of all 12th graders have taken an illicit drug (other than alcohol) during their lifetime.1 According to the National Survey on Drug Use and Health, the rate was 3.3% for misuse or nonmedical use of prescription drugs.2 The misuse of prescription drugs among adolescents was second only to marijuana use. In fact, prescription drugs increasingly have become a part of the repertoire of drug-using adolescents.
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Reactivation of PTSD Symptoms Resulting From Sandy Hook Media ExposureCombat veterans who have suffered a moral injury in the past may be predisposed to a recurrence of the painful memories associated with previous trauma after exposure to similar traumatic events with moral overtones.
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Eating Disorders: Much Progress but Still Far to GoPsychiatry has seen a transition from art to science in the past century and, largely because of 2 developments in the past several decades, this has also been the case for the field of eating disorders.
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Black Psychiatrists of America Speak About Desmond TutuOn behalf of the Black Psychiatrists of America, we are writing to the American Psychiatric Association regarding the recent “issues” that have been raised by some members of your association with respect to Archbishop Tutu being this year’s convocation speaker at your annual meeting in Hawaii in May.
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Peer Specialists as Educators for Recovery-Based Systems TransformationProject GREAT efforts in psychoeducation are geared toward educating providers about recovery so that they can, in turn, transform their own practices to be in concert with the recovery model.
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The Impact of Life Stresses on Semen QualityA recently published study found that certain types of stress affect the quality and quantity of men's sperm. The senior author of that study addresses the topic and provides take-away points for psychiatrists in this brief podcast.
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Purging DisorderA syndrome described as purging following the ingestion of normal or small amounts of food in normal-weight persons has gained increasing attention in the field of eating disorders. Various terms have been used in the literature for this newly characterized syndrome, with purging disorder and eating disorder not otherwise specified-purging (only), or EDNOS-P, used most frequently.
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Opportunities and Challenges in Treating Adolescents and Young Adults With Major Depressive DisorderHalf of all mental health disorders occur by age 14. Early interventions may mitigate progression to more serious and persistent mental health concerns.
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Issues in Treating Anxiety Disorders in PregnancyAnxiety disorders are a frequent occurrence in pregnancy. While some worries and anxiety are experienced by more than 50% of pregnant women, a full-blown anxiety disorder involves risk to both mother and fetus and increases the risk of postpartum depression.
