Authors
Latest:
Irreversible Monoamine Oxidase Inhibitors RevisitedGiven the likelihood that insufficient numbers of patients will be available for a randomized controlled trial of MAOIs in refractory depression or atypical depression, we must still rely on consensus guidelines and expert opinion.
Latest:
6 Myths About Integrative PsychiatryAs we shift from treating disease and toward supporting health, medication is merely one possible intervention in a spectrum of possible ones.
Latest:
Perinatal Psychiatry: What We Still Don't KnowA number of highly publicized cases in the lay press have underscored the significance of, and dangers associated with, perinatal psychiatric illness. Unfortunately, the field of psychiatry has failed to use these tragic cases to disseminate accurate information and educate the public about the high frequency of perinatal depression and anxiety, as well as the relative rarity of postpartum psychosis and infanticide. Moreover, psychiatrists continue to have difficulty in educating their medical colleagues about the need to screen for these illnesses, so most obstetricians and pediatricians still do not screen for perinatal depression and anxiety, much less manage it effectively. Decisions about appropriate treatment are further complicated by a lack of empiric outcome data.
Latest:
Neurostimulation for Mood DisordersWe have medications that can affect serotonin, norepinephrine, and-to a lesser extent-dopamine. Many other neurotransmitters are involved with mood disorders, but we have no medications yet to target them. Neurostimulation offers a non-systemic somatic approach to depression, often with an improved side effect profile. More in this Q&A.
Latest:
Drs McGlashan and Woods Respond to Dr FeinbergDr Feinberg takes exception to much of what we wrote, or what he thinks we wrote, in our article “Early Antecedents and Detection in Schizophrenia”. We will do our best to reply to his criticisms of what we did write and try to point out where he is shadowboxing at issues that he has created but that we do not hold or endorse.
Latest:
Emergency Psychiatry in an Extraordinary AgeWelcome to the Emergency Psychiatry Special Report.
Latest:
SSRIs as Antihypertensives in Patients With Autonomic Panic DisorderThe cardiovascular properties of serotonin (5-HT) have been known for some time-its name reflects its presence in serum and its action in increasing vascular tone. Serotonergic medications are routinely used to treat depressive and anxiety disorders, and the association of depression with cardiovascular disease has become well established.2 Recent studies have confirmed the colloquial wisdom that anxiety (especially panic) and hypertension are linked.
Latest:
A First-Episode Psychosis Treatment Program: “The Disease Doesn’t Define Me”The Psychiatric Transition Program at the Naval Medical Center in San Diego is a specialized first-episode psychosis program that provides coordinated specialty care to active-duty service members with serious mental illness.
Latest:
Subtle Nuances in Diagnosis of SchizophreniaAn analysis of symptom severity across domains may enable us to reevaluate how we categorize symptoms within the spectrum of psychotic illness.
Latest:
My Patient Lost Their Job…Now What?Unemployment is associated with an array of social and psychological complexities, directly affecting patients' self-esteem and perceptions of self-worth. When a patient loses their job, the psychiatrist has 4 tasks.
Latest:
Impulse Control, Impulsivity, and Violence: Clinical ImplicationsThe authors explore ways to address aggression in clinical practice and examine the potentially dangerous impulsivity-violence link across a broad range of conditions.
Latest:
Intimate Portrait: Richard M. Berlin, MDA brief psychological portrait of this psychiatrist/poet.
Latest:
Are the Media and the Public Still Missing the Clues?It is our responsibility as psychiatrists to educate the media and the public in general.
Latest:
The Diagnosis of Psychogenic Nonepileptic SeizuresAbout 25% of patients seen in epilepsy clinics and monitoring units who do not respond to antiepileptic drugs (AEDs) have received a misdiagnosis.1-3 The eventual diagnosis for most of these patients will be psychogenic nonepileptic seizure (PNES)1,4-a somatoform conversion disorder. It is treatable, but diagnosis, delivery of the diagnosis, and management present significant challenges. A major barrier to care has been the stigma associated with the label "psychogenic."
Latest:
Treatment-Resistant SchizophreniaStrategies for Recognizing Schizophrenia and Treating to Remission
Latest:
Utilization of MRS to Identify Neurochemical Abnormalities in Patients With Bipolar DisorderThe number of magnetic resonance spectroscopy studies that assess the levels of different neurochemicals in bipolar disorder has increased considerably in recent years. Abnormalities were reported mainly in the brain regions implicated in the pathophysiology of BD: the dorsolateral prefrontal cortex, cingulated gyrus, hippocampus and basal ganglia. Although these findings are not diagnostic, future research in this area may help to elucidate the pathophysiology of BD and monitor treatment effects.
Latest:
Assessing Suicide Risk in Patients With Borderline Personality DisorderPatients with borderline personality disorder are at a much higher risk for suicide attempts than patients with almost any other mental illness. Here, a case report and examples are presented to help clinicians assess, diagnose and treat patients with BPD who have attempted or are threatening suicide.
Latest:
Ethical Issues: The Patient’s Capacity to Make Medical DecisionsThis article provides a practical framework that can guide consultation-liaison psychiatrists through solving problems of capacity and informed consent.
Latest:
Psychiatric Comorbidity in Emergency Department PatientsEmergency medicine provides care to a vast number of patients each year. In 2005, 115.3 million people visited emergency departments (EDs).
Latest:
Commentary: A Telling MomentWhat Z has done is momentarily lift the veil that conceals...another veil. Thrilling because he is doing in public what I do in private. Stripping the professional illusion that psychiatrists are invisible machers, not just real friends and enemies, creditors and debtors, parents and partners, but detached angels. An illusion fostered by a xenophobic profession carefully cultivating the illusion of transcendental social levitation.
Latest:
Malingering as a Maladaptive Pattern of Survival During the PandemicMalingering is a common challenge for emergency department clinicians, particularly during the pandemic. Here are 3 cases of COVID-19–induced malingering.
Latest:
The Impact of Appearance on Coping With LifeIn planning a media workshop to present Glenn Gers’ independent film disFigured for the May 2009 American Psychiatric Association meeting in San Francisco, my co-presenters and I devoted special attention to the diagnosis and treatment of anorexia nervosa. (The content was originally prepared by Katherine Halmi, MD, and was presented at the workshop by James Mitchell, MD, when Dr Halmi was unable to attend.) The film deals with the problems of body image represented by opposite ends of the spectrum of eating disorders-obesity and anorexia.
Latest:
Treating Cognition and Function in Patients With Alzheimer DiseaseThe cost-effectiveness of treatment for Alzheimer disease has been questioned. But until the next generation of therapeutics arrives, cholinesterase inhibitors and memantine will probably remain essential components of therapy for cognition and function.
Latest:
Beyond Emotional Labor: Exploring How Trauma Becomes an Occupational Hazard for CliniciansWe are all familiar with the heavy emotional labor loads that are part and parcel of clinical life. But what about the toll of exposure to verbal abuse and hostility in the workplace? Is there another labor that clinicians must contend with?
Latest:
Postpartum Anxiety or Depression? Diagnosis and Treatment in Nursing MothersWomen with postpartum depression frequently experience intrusive, obsessive ruminations that are part of a depressive episode. Many women with postpartum depression have significant anxiety, and many reach the level of meeting criteria for full-blown anxiety disorders. An anxiety disorder may also precede and contribute to the development of a depressive episode.
Latest:
Treatment Implications for Comorbid Diabetes Mellitus and DepressionDiabetes mellitus and depression symptoms are associated with with decreased self-care and less adherence to exercise, medications, smoking cessation, and eating a healthy diet.
Latest:
Clinical Implications of Substance Use on Suicidality Among YouthsBoth the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry have identified substance abuse as a top risk factor for suicide in youths.
Latest:
Introduction: Comorbidity, Cognition, and PharmacotherapiesIn this Special Report, Helen M. Pettinati, PhD, and William D. Dundon, PhD, discuss prevalence, assessment, clinical features, and treatment issues with respect to individuals with co-occurring major depression and alcohol dependence.
Latest:
Preventive Interventions for Children of DivorceStudies have shown that children of divorced parents may suffer more mental health problems, particularly conduct disorders. What programs might be effective in helping these children deal with the stress of their parents' divorce? Are there effective programs to teach parents better coping skills?
