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Drug Therapies for the Neurobehavioral Sequelae of Traumatic Brain InjuryTraumatic brain injury (TBI) is one of the most common causes of morbidity and mortality, especially in young adults. Recognition and early accurate diagnosis of neurobehavioral TBI sequelae are important in reducing the severity of postinjury symptoms. Sequelae of TBI include cognitive impairments, personality changes, aggression, impulsivity, apathy, anxiety, depression, mania, and psychosis.
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Diagnosing Adults With ADHD Based on Patient PresentationDrs Stephen Faraone, Theresa Cerulli, Craig Chepke, and Andrew J. Cutler discuss how to diagnose adults with ADHD based on patient presentation.
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Looming Technological Imperatives and the Physician-Patient RelationshipThe past decade has seen an explosion of new drugs, procedures, and technology. This upward trajectory of health care breakthroughs shows no sign of slowing; such innovations as molecular imaging and pharmacogenetics are within years of going prime time.
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Neuropsychiatry: A RenaissanceThe 5 papers in this Special Report on neuropsychiatry provide compelling evidence for the renaissance of neuropsychiatry as a clinical discipline. Wehave every reason to hope that this will lead to a better understanding of the complex interactions between brain and behavior and will reduce the artificial distinction between neurology and psychiatry.
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Criteria for Social Security Psychiatric DisabilityWhat is necessary in order to make a psychiatric disability determination? For one thing, treating clinicians should be aware of how the domains that are important for the consideration of impairment differ from the domains that are important to consider diagnostically.
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Telepsychiatry: Watching Your Back While Staying in the BlackTelehealth is at a tipping point and is gaining momentum. Although there are some technological and logistical hurdles, most clinicians would likely find these to be minor and outweighed by the benefits of expanding access to mental health care to those in need.
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Seeing the Forest Through the Fees: Earning Your Green Using the New, Confusing CPT CodesE&M codes are more complicated to learn, but psychiatrists can now deservedly get paid more for treating their more complicated patients or for engaging in time-consuming activities. Here: a focus on codes 99212 to 99215.
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Testosterone Deficiency, Depression and Sexual Function in Aging MenThere is growing epidemiologic and clinical data that confirm progressive hypothalamic-pituitary-gonadal hypofunctioning in aging men. What role does the HPG axis play in the complex psychobiology of male sexual and affective disorders? The treatment rationale, clinical indications and risks in using exogenous testosterone for late-life depression are explored.
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Preventing Violence in SchoolsIn the wake of the Columbine school shootings, it is of utmost importance for psychiatrists to be aware of the role they can play in preventing violence and bullying in our schools. What programs have been tried and how have they fared? What are the elements for a successful program?
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Art Therapy in a Patient With Bipolar Disorder: Pictures Speak More Than a Thousand WordsHere: the case of a woman with bipolar disorder who was admitted for aggressive behavior and nonadherence to medications. Art therapy and pharmacotherapy played a pivotal role in her recovery.
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Managing Psychosis in Patients With Alzheimer DiseaseAlzheimer disease psychosis appears to be a distinct clinical entity. This article focuses on management strategies.
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Anxiety Disorders in Children and AdolescentsAnxiety disorders are one of the most common psychiatric disorders in children and adolescents, but they often go undetected or untreated. Identification and effective treatment of childhood anxiety disorders can decrease the negative impact of these disorders on academic and social functioning in youth and their persistence into adulthood.
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Impulse Control Disorders: Clinical Characteristics and Pharmacological ManagementImpulse control disorders are common psychiatric conditions in which affected individuals typically report significant impairment in social and occupational functioning, and may incur legal and financial difficulties as well.
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Substance Abuse in Women: Does Gender Matter?There has been a growing awareness in recent years of the importance of gender in medical treatment and research. While much past research in addiction focused on men, there is now recognition that biologic and psychosocial differences between men and women influence the prevalence, presentation, comorbidity, and treatment of substance use disorders.
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Review – The Protest Psychosis: How Schizophrenia Became a Black DiseaseIt is well known that black people, compared to white people, are much more likely to be diagnosed as suffering from ‘schizophrenia’ if they are seen at psychiatric units in the UK or USA. .
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Expressions of Social Anxiety in Asian-AmericansWhy do Asian-Americans (especially university students) appear to suffer from higher levels of symptoms of social anxiety than white Americans, yet their high symptom reports are not accompanied by behavioral signs of social anxiety? Is this discrepancy due to culturally determined display rules or biased assessment by those who are culturally different? How does this discrepancy make it difficult for clinicians to accurately assess the severity of social anxiety among Asian-Americans?
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Eating Disorders in SchizophreniaEating disorders in patients with schizophrenia have been underappreciated and poorly studied. Profiling characteristic phenotypic patterns will help clarify the distinctions among eating behaviors that are part of the spectrum of schizophrenia, those that represent distinct coexistent entities, and those that represent overlapping comorbidity.
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Prevalence and Consequences of Metabolic Syndrome in Bipolar DisorderMedications used in the treatment of bipolar disorder are commonly associated with weight gain. Antipsychotic drugs have been implicated in new-onset diabetes.
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Mini Quiz: Addiction on CampusWhat are some of the most commonly abused drugs among college students?
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Psychiatrists Should Not Fall Back on DSMThe polemics between Drs Pies and Wakefield and Horwitz (“An Epidemic of Depression,” Psychiatric Times, November 2008, page 44) have validity, but their commentaries did not touch on the real bone of contention. Dr Pies does not believe that just because psychosocial precipitators of a depression-specifically, bereavement-are known, somehow the significance of the depression should be viewed differently.
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Therapist-Patient Race and Sex Matching: Predictors of Treatment DurationMany of the factors purported to influence accessing mental health services by men and ethnic minorities are systemic in nature, ingrained within our culture, and consequently, difficult to change (e.g., gender differences in attitudes toward help-seeking, ethnic differences in the use of alternative healing resources). However efforts have been made within the mental health system to make services more acceptable to men and minority group members who choose to, or are able to, access the system.
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Spirit Chicken-or Lunch? Medical Tales From the Far Side of the WorldTo many Lao, the concepts of mental illness and spirituality are tightly intertwined.
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Irritable Bowel Syndrome: Psychiatric Factors and TherapiesIrritable Bowel Syndrome: Psychiatric Factors and Therapies
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Confabulation: A Bridge Between Neurology and Psychiatry?Mr A is a 73-year-old resident of a nursing home, where the irate aides describe him as “a liar and a troublemaker.” Mr A’s “stories” were regarded by the staff as deliberate mischief on his part.
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Cognitive-Behavioral Therapy for Adolescent DepressionProcesses of Cognitive ChangeThe substantial and often recurrent distress and impairment associated with major depressive disorder (MDD) in youth has prompted increased interest in the identification and dissemination of effective treatment models. Evidence supports the use of several antidepressant medications, specific psychotherapies, and, in the largest treatment study of depressed teenagers, the combination of fluoxetine and cognitive-behavioral therapy (CBT) as effective treatments.1-3 CBT is the most extensively tested psychosocial treatment for MDD in youth, with evidence from reviews and meta-analyses that supports its effectiveness in that population.3-5
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Reframing ADHD in the Genomic EraIn the era of genomics, psychiatry-like all areas of medicine-will likely undergo radical change. As genetic risk factors are uncovered and the dynamic nature of gene expression is elucidated, novel approaches to prevention will diminish or preempt diagnosis and treatment for many psychiatric and neurobehavioral disorders.
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From Mars to Venus-Couples Sex TherapyBefore Masters and Johnson came on the scene in the late 1950s, any sexual problem was thought to be the result of a deep-seated neurosis that needed to be unearthed. It is now recognized that an understanding of physiology and couples dynamics-along with a practical approach-are required interventions
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The Hidden Lives of Children of HoardersUntil recently, most people believed that hoarders were eccentric people who died surrounded by a lifetime collection of stuff. Hoarding in families was cloistered in a vault of family secrets or passed off as an individual peculiarity.
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Psychiatric Issues in HoardingHoarding has broad-reaching implications, including a substantial public health burden linked to occupational impairment, poor physical health, and demand for social services.
