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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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Abdicated Authority: How We Fail ConservateesHow can we ensure an accountable, effective, and limited conservatorship system? Here are some actionable concepts.
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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.
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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).
