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Managing the Adverse Effects of AntidepressantsMost, if not all, antidepressants can cause bothersome adverse effects. These are described here along with strategies to help patients cope.
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Psychotherapy for Late-Life DepressionThis article provides a practical overview of the available evidence-based treatment and discusses circumstances in which certain interventions may be preferred over others.
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Apathy and Its Treatment in Alzheimer's Disease and Other DementiasAffecting 70% of patients with Alzheimer's disease and common in patients suffering from other dementing illnesses, apathy is associated with functional impairment and caregiver distress at all levels of disease severity. Assessment and treatment for this under-recognized syndrome are discussed.
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Adjustment Disorders: Diagnostic and Treatment IssuesAdjustment disorder is one of the few psychiatric diagnoses for which the etiology, symptoms, and course, rather than symptoms alone, are central to making the diagnosis. Both emotional and behavioral disturbances are present and include low mood, tearfulness, anxiety, self-harm, withdrawal, anger, and irritability.
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“Designer Drug” Use and Abuse: Implications for PsychiatristsPsychiatrists are urged to familiarize themselves with these new drugs and the typical presentations of patients who use them since implications of misdiagnosis can be far-reaching.
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Neurobiology and Neurophysiology of Breath Practices in Psychiatric CareSlow voluntarily regulated breathing practices are noninvasive, easy to learn, and generally safe for treating patients with symptoms of anxiety, insomnia, depression, stress- and trauma-related disorders, ADHD, schizophrenia, and substance abuse.
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The Long War Comes HomeMost military families successfully adapt to a service member's deployments for military duties. Nevertheless, almost a decade of wartime stress associated with the current wars in Iraq and Afghanistan has presented unprecedented challenges for military families.
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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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An Update on the Maintenance of Certification Program for PsychiatryEverything you need to know about the MOC process.
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Understanding and Fostering Resilience in Persons Exposed to TraumaWhen attempting to incorporate resilience-building strategies into practice, it is worthwhile to note that resilience is a dynamic concept in which successful coping may mean a mixture of major real-life successes in the context of continuing difficulties.
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Culture and Substance Abuse: Impact of Culture Affects Approach to TreatmentThere have been numerous definitions of culture. Dwight Heath1 offers a simple definition: "It [culture] is a system of patterns of belief and behavior that shape the worldview of the member of a society. As such, it serves as a guide for action, a cognitive map, and a grammar for behavior."
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Stage-Specific Treatment of Psychotic DisordersPsychotic disorders are potentially serious and enduring and have been seriously neglected in health systems worldwide. The good news is that better medium-term outcomes are now achievable.
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Reducing Risk Associated With Seclusion and RestraintThis article briefly reviews the federal standards regarding S/R and methods of reducing the risk associated with their use. CMS standards that went into effect February 6, 2007, will be emphasized; however, some of these standards vary from JCAHO standards.
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Depression in Adults With DiabetesDiabetes doubles the likelihood of comorbid depression, which impairs functioning and quality of life. This mood disorder has a unique importance in diabetes because of its associations with treatment noncompliance, insulin resistance, hyperglycemia and an increased risk for diabetes complications.
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Borderline Personality Disorder: New Reasons for HopeBorderline Personality Disorder: New Reasons for Hope is one in a series being published by Johns Hopkins University Press on major psychiatric disorders.
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Suicidal Patients: Defining and Addressing EmergenciesHere: a review of issues related to assessment of patients for suicide risk in the ED -- and an overview of emerging approaches and research that one day will lead to more reliable assessment and interventions based more on science than on art or luck.
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Reading the Humanities for HumanityCynthia Geppert has done it again! She has written a timely article that expresses what I have thought for a long time (“Why Psychiatrists Should Read the Humanities,” Psychiatric Times, February 2008, page 10). Recently, I was sitting in a nonscience course for first-year medical students wondering why it was difficult for some of them to respond to the professor’s questions.
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Quitting Smoking: Therapeutic in Mental Health TreatmentMany patients report that smoking helps them with their stress and psychological disturbances. However, smoking may actually worsen some of these symptoms. When is the right time for your patients to quit?
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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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Japan: Denial of Hikikomori Could Hinder Relief EffortsThe current situation in Japan has been called the worst crisis in the country since World War II. Relief effort organizations are urged to take hikikomori seriously when planning strategies to help the victims of the recent disasters in Japan.
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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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Stalkers and Their Victims"Stalking" is defined as repeated and persistent unwanted communications and/or approaches that produce fear in the victim. The stalker may use such means as telephone calls, letters, e-mail, graffiti and placing notices in the media. A stalker may approach or follow the victim, or keep their residence under surveillance.
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Apathy and Its Treatment in Alzheimer's Disease and Other DementiasAffecting 70% of patients with Alzheimer's disease and common in patients suffering from other dementing illnesses, apathy is associated with functional impairment and caregiver distress at all levels of disease severity. Assessment and treatment for this under-recognized syndrome are discussed.
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Two Stories We Tell Ourselves About CancerLike more and more cancer patients today, I have outlived several prognoses and am still hanging around, in a diminished life, trying to outlive the latest. Sooner or later, all of us get swept up into one or another of the collectively available cancer story lines in the culture.
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Implications for Treatment and Prognosis of Borderline and Substance Use DisordersBorderline personality disorder (BPD) and substance use disorder (SUD) often co-occur. Comorbid BPD and SUD is related to a variety of severe adverse outcomes.
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ADHD in AdultsAttention-deficit/hyperactivity disorder (ADHD) in adults is a common-and, frequently undiagnosed-psychiatric disorder. This article will focus on the symptoms, associated features, diagnosis, differential diagnosis, prevalence, etiology and treatment of this illness.
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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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Anticonvulsant Strategies for Treating Bipolar Disorder: What Works, What Doesn'tClinical applications for the most commonly used anticonvulsants are reviewed here, along with complications and recent findings for day-to-day practice. Also: an update on findings from research on anticonvulsants used less often, but which may be potentially beneficial.
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Helping Children Hospitalized for RagesRages are part of a syndrome of severe mood dysregulation, which is defined by markedly increased and frequent reactivity to negative emotional stimuli.
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Comorbid Clinical and Personality Disorders: The Risk of SuicidePersonality disorders are arguably the most challenging for psychiatrists because they are difficult to diagnose and frequently coexist with psychotic, affective, and anxiety disorders.
