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A Missed OpportunityHow accurate is this picture, and what explains the changing patterns of psychiatric practice? Gardiner Harris and The New York Times were near these important stories and missed them.
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Brain Mapping in Adolescents With Very Early Onset SchizophreniaSchizophrenia is a devastating psychiatric disorder that affects 1% of the population worldwide. Patients often suffer their first psychotic outbreak in their late teens or early 20s. Despite advances in neuroleptic drugs, many patients' symptoms remain refractory to treatment, with recurrent episodes of auditory and visual hallucinations, bizarre delusions, depression, and social withdrawal that can last an entire lifetime.
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Coyne Battles Darwin, Many Other Evolutionary Biologists-and HimselfErroneous conclusions, and medical harm, can come from accepting any hypothesis uncritically, and growing evidence indicates that treatments based on disorder hypotheses for depression do cause harm.
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Bereavement-Related DepressionThe loss of a loved one is one of the most traumatic events in a person’s life. In spite of this, most people cope with the loss with minimal morbidity. Approximately 2.5 million people die in the United States every year, and each leaves behind about 5 bereaved people.
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Bereavement-Related DepressionThe loss of a loved one is one of the most traumatic events in a person’s life. In spite of this, most people cope with the loss with minimal morbidity. Approximately 2.5 million people die in the United States every year, and each leaves behind about 5 bereaved people.
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Positive Psychology: A More Direct Route to Happiness?Like medicine in general, psychiatry and psychotherapy have long focused on relieving illness and pain. Traditional psychotherapeutic approaches have often emphasized examination and understanding of painful experiences as a route toward obtaining relief from suffering.
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Optimizing Care in a Team Setting: A Program for People With SchizophreniaA look at a multidisciplinary team -- and its focus on meaningful recovery -- for patients with schizophrenia.
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Key Stressors in Transplant PsychiatryHere: A summary of indicators for stress and anxiety in patients undergoing transplantation, and why it is important for psychiatrists to be aware of these factors.
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3 Features of Eating DisordersA special collection of current clinical work and issues surrounding eating disorders-specifically comorbidity, prevalence in men, and mortality.
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Introduction: Treatment Along the Life CycleThe diagnosis and management of unipolar depression remain challenging. The articles in this Special Report remind us of the wide knowledge base that is needed in the management of the depressed patient and of the multiple conceptual levels that must be integrated in the care of our patients.
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Cognitive Difficulties Associated With Depression What Are the Implications for Treatment?Subjective complaints of impaired concentration, memory, and attention are common in people with major depressive disorder (MDD), and research shows that a variety of structural brain abnormalities are associated with MDD.1 These findings have intensified the interest in quantitative assessment of cognitive and neuropsychological performance in patients with mood disorders. Many studies that used standardized cognitive tests have found that mild cognitive abnormalities are associated with MDD and that these abnormalities are more pronounced in persons who have MDD with melancholic or psychotic features
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Consumer Employment: Advocacy Assumes Another FaceThe goals of National Coalition for Mental Health Professionals and Consumers are to educate the public about the problems of managed mental health care and to develop alternative health delivery models. I think greater media coverage has spawned greater awareness of the difficulties with managed care and has provided legislators with vital information. Certainly sharing their stories has made many people feel less alone and isolated within a system they find frustrating and depriving. I think media advocacy has helped doctors find support for their right to stand up to these abuses and band together in greater numbers to fight for integrity and quality in mental health care delivery.
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Mini Quiz: Physicians as PatientsWhen physicians behave disruptively in the workplace, what is the most likely cause?
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Neuropsychiatric Dimensions of Movement Disorders in SleepSleep-associated movement disorders are common in the general population. When patients complain of sleep disturbance, psychiatrists should consider,and question for, features of nocturnal movement disorder.
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Issues in the Recovery of Physicians From Addictive IllnessesWhen physicians struggle with substance use disorders, physician health programs are an important source of information and support. Certain medical specialties are at higher risk for substance use disorders than are others, and drugs of choice vary by specialty. Physician health and patient safety must be considered, but colleagues can help.
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The Making of a Homegrown TerroristThe author applies psychodynamic psychology to understand and recognize so-called "homegrown" terrorists, individuals who are familiar with American culture and thus more difficult to detect.
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Depression and Cardiovascular DiseaseDepression is a risk factor for cardiovascular disease and death in many ways, directly and indirectly. It is independently linked to smoking, diabetes, and obesity-all of which are risk factors for coronary heart disease (CHD).1 Depressed patients are more likely to be noncompliant with treatment recommendations, including diet, medications, and keeping appointments, and are more likely to delay presentation for treatment with an acute coronary event.2-4
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The Adolescent Brain Is DifferentAssessments of partial culpability of adolescents are difficult in individual cases; however, the courts are moving away from mandatory sentencing to individual determinations, even for the most heinous crimes.
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Therapeutic Neurostimulation and SchizophreniaThe authors review the evidence for the use of ECT and other novel neurostimulation techniques in the treatment of schizophrenia.
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Immigration and Post-Adolescent Psychology of Young TerroristsRadicalization by Norwegian converts to the Prophet’s Ummah produced massive and terrible social consequences. The explanations offered may be pertinent to the current attraction that ISIS offers for too many young persons in many countries of the civilized world.
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Outside the Pill Box: The Systems-Based Practice of PsychiatryMeet "Gary," whose case provides an introduction to the value of systems-based practice.
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Alzheimer Dementia and Sleep Disorders: Issues in Diagnosis and TreatmentSleep disorders represent a significant problem in patients with Alzheimer disease. Here: assessment strategies and a review of drug and non-drug interventions.
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The “10 Knows” Psychiatric Clinicians Need to Prepare for a Job InterviewWhat 10 things do you need to know before entering a job interview?
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Trait Stages of Diagnosis for Borderline Personality DisorderThe authors describe an alternative model for BPD diagnosis that is dimensional in nature and requires fulfillment of 4 of 7 personality traits.
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10-Point Clock Test Screens for Cognitive Impairment in Clinic and Hospital SettingsThe obvious sometimes bears repeating: Sick people have trouble thinking. They may be suffering from a delirium, a dementia or a more subtle disturbance of cognition caused by fever, drugs, infection, inflammation, trauma, hypoxemia, metabolic derangement, hypotension, tumor, intracranial pathology, pain and so forth.
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You Say “Yes,” I Say “No,” You Say “Goodbye,” and I Say “Hello”In theory, psychiatrists possess no special skills for determining capacity of a patient to accept or refuse medical care, yet a large percentage of a psychosomatic physician’s work nonetheless involves capacity evaluations.
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Reframing Approaches to SchizophreniaThe history of new treatments coming to schizophrenia should serve as a warning...
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Intrapsychic Focus Can Have Lasting Benefits for PatientsIn recent years, psychiatry and psychoanalysis have been drifting apart. As has been stated, psychiatry is losing its mind as it concentrates on chemistry and biology. This is a pity, because it is always good to have a mind.
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Geriatric Psychiatry: A Niche in DemandThe ranks of the elderly are swelling, yet fewer and fewer physicians are choosing to practice geriatric psychiatry. What will be the impact on older patients who receive their mental health care from primary care physicians?
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Tough Love of Community: The Citizen Review Committee of the Houston Police DepartmentThe story is decades old, but it reverberates today -- incidents of police brutality and excessive force, sometimes lethal. Here's a psychiatrist's story of serving on a citizen's review committee in Houston back in the day.
