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Beyond 'Handholding': Supportive Therapy for Patients With BPD and Self-Injurious BehaviorCan supportive therapy be modified to successfully treat patients with borderline personality disorder? By using a previously developed model, NIMH-funded researchers have found supportive therapy helpful in engaging patients in treatment, developing a therapeutic alliance and achieving treatment goals. Their outcome data may provide a new treatment approach for this difficult-to-treat population.
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Combining Family Practice and Psychiatry Resident TrainingIn 1995, the American Board of Family Practice and the American Board of Psychiatry and Neurology issued a white paper describing board requirements for residency training programs that combine the specialties of family practice and psychiatry. The first few students of these programs have graduated and are on their career paths. Might this be an opportunity for you?
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Management of Treatment-Refractory SchizophreniaBecause cognitive and negative symptoms have the greatest impact on overall recovery, interdisciplinary strategies that target these symptoms are necessary. This article offers details.
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Nothing Is EasyConcerned about increasing medical costs, Congress began to tinker with physicians' fees under Medicare with the Omnibus Budget Reconciliation Act of 1989. The result, the Resource-Based Relative Value Scale (RBRVS), altered our fees in the Medicare system.
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Introduction to Culture-Bound SyndromesA startled Malay woman with latah mocks the photographer.Source: Simons RC (1983)
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ADHD and Sleep Disorders in ChildrenSleep changes associated with psychotropic drugs are common enough to justify routinely obtaining a baseline sleep diary before beginning treatment, even when the initial screening for sleep disorders indicates that no further investigation is needed.
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What Is Organizational and Occupational Psychiatry?Organizational and occupational psychiatry represents the extension of psychiatric knowledge and skill to the day-to-day functioning of individuals in the workplace and their organizations, with the goal of helping both to function better. To this end, psychiatrists have played an important role both in the treatment of workers and consultation to organizations since the early part of the 20th century.
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Processing Post-election Reactions: Our Patients, OurselvesHow can psychiatric clinicians help their patients (and themselves) identify and navigate the aftermath of the election?
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Introduction: Cross-Cultural PsychiatryDuring the past 2 decades, there has been enormous growth of interest in and visibility of cultural psychiatry. Much of this is due to the steady increase in migration of the world’s population from low-income to higher-income regions and countries.
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Secondary Traumatization in Mental Health Care ProvidersWhat is secondary traumatization? The authors discuss current research and implications for this controversial and emerging field of study.
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A Critical Moment in Psychiatry: The Need for Meaningful Psychotherapy Training in PsychiatryThe goals of psychotherapy education in medical school should be based on these seven ideals.
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On the Cannabinoid Receptor: A Study in Molecular PsychiatryGiven that cannabis (marijuana, hashish, ganja, dagga, etc.) is the most widely used illicit substance in the Western world, it behooves us as physicians to understand as much about it as possible. The cannabinoid receptor is a good starting point in such a pursuit. Marijuana is not a single substance, but a collection of substances or compounds which become 2,000 on pyrolysis. Numbered among the 400 constituents of the plant Cannabis sativa are some 60 cannabinoids.
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Couples Therapy and PsychopharmacologyPsychopharmacology can be useful in all stages of couples' therapy. Using a high-functioning couple as a case example, the author illustrates how psychopharmacology, together with psychotherapy, can be used to facilitate treatment success.
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8 Distinguishing Features of Primary Psychosis Versus Cannabis-Induced PsychosisThe authors compare the clinical features of idiopathic psychosis (eg, schizophrenia) with cannabis-induced psychosis.
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Introduction: Mental Health Correlates of TraumaOver half of the population is exposed to at least one lifetime traumatic event, yet relatively few of those exposed have lasting psychiatric sequelae. As psychiatrists, we attend to the needs of those who suffer.
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Treatment of Somatic Symptoms in Generalized Anxiety DisorderGeneralized anxiety disorder (GAD) is characterized by excessive or unrealistic anxiety and worries about life circumstances. In the general population, the prevalence of GAD is 2% to 5%. It is the most frequent anxiety disorder seen in primary care, where 22% of patients complain of anxiety problems.1 DSM-IV lists 6 somatic symptoms associated with GAD: restlessness, increased fatigability, difficulty in concentrating, irritability, muscle tension, and sleep disturbance. These symptoms may present with hyperarousal, hypervigilance, and heightened muscle tension; autonomic symptoms are milder than in other anxiety disorders and can be absent.
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Persistent Depressive Disorder, Dysthymia, and Chronic Depression: Update on Diagnosis, TreatmentAn update on the diagnosis, causation, and treatment of chronic depressive problems. The focus is on the recently introduced diagnostic category of persistent depressive disorder.
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7 Medical Illnesses That May Present as AnxietyBeyond psychosocial implications of anxiety disorders, an array of physiological effects may ensue.
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Research Developments and Their Implications for Clinical Care of the ADHD ChildAttention-deficit/hyperactivity disorder (ADHD) has received an extraordinary amount of attention in the popular media over the past eight months. Stories concerning the disorder, and especially its treatment with stimulant medication, have appeared in many major newspapers, news magazines and television news, entertainment and talk show programs.
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Augmentation Strategies in Treatment-Resistant DepressionThe treatment of unipolar major depression presents a substantial challenge for the clinician. Major depression is a common disorder with a high propensity for relapse and recurrence.
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Investing: It's All About Making Your Money WorkDaniel Chaffin, M.D., says he has never been at the top of the physician pay charts. That's why the solo practitioner in San Rafael, Calif., decided long ago to pay close attention to his finances. He dutifully put money in a retirement plan each year, avoided speculations, and focused his attention on growth-oriented stocks and stock mutual funds. The result: A seven-digit retirement account, additional investments on the side and, in short, financial security for himself and his wife as he nears his 70th birthday.
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The Intertwining Effect of Mood Disorders and InfertilityMatters around child-bearing bring up emotions ranging from joy and elation to profound despair, anger, and resentment. Psychiatrists are trained to recognize such issues.
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Reexperiencing/Hyperaroused and Dissociative States in Posttraumatic Stress DisorderDissociation-a common feature of posttraumatic stress disorder (PTSD)-involves disruptions in the usually integrated functions of consciousness, memory, identity, and perception of the self and the environment.
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Mini Quiz: Psychiatric Emergency Assessment of YouthsNearly half of children who present to emergency departments with self-harm receive no mental health assessment. What are the essential elements needed to interview children and adolescents in the context of a psychiatric emergency?
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Thank you, Drs. Ronald Pies and Joseph PierreWith antipsychotics, my once-brilliant child can again speak, write, read, and maintain hygiene and has regained motor functioning.
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Considering Edison’s Predictions: Prevention as the Next Frontier for PsychiatryThe authors emphasize the importance of risk and protective factors and risk prediction models; analyze the growing evidence base for preventive interventions; and describe the concept of mental health promotion.
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Consent in Psychiatric Emergencies: What Clinicians Need to KnowIt is important to recognize and document the abilities and deficits of a patient in order to determine capacity.
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The Death Penalty and Mental Illness: An Evolving Standard?Although a majority of states still permit capital punishment, this may not represent the true national mood: many of these states have not had an execution in more than 10 years.
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Restless Legs Syndrome: Clinical Implications for PsychiatristsWhile patients with restless legs syndrome may be successfully treated with a number of medications, comorbid psychiatric conditions present a unique challenge because many commonly prescribed psychiatric medications may worsen RLS symptoms.
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Introduction: The State of Addiction PsychiatryThe articles in this Special Report provide a broad, cross-cutting perspective on the current state of addiction psychiatry, insofar as it may pertain to your own clinical practice.
