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Agitation in Older AdultsAgitation in older adults is frequently associated with multiple psychiatric and medical conditions and comorbidities. It commonly occurs in patients with anxiety, affective illness, psychosis, dementia, stroke, brain injury, delirium, or pain.
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Nonverbal Learning Disabilities and Sensory Processing DisordersIn our presentation at the 2006 annual meeting of the American Academy of Child and Adolescent Psychiatry, we suggested that child psychiatrists who come across a child with the profile of the following hypothetical case should consider whether the child may have deficits that are not currently covered by DSM-IV nosology: either a nonverbal learning disability (NVLD) or a sensory processing disorder (SPD).
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Spiritual Matters: Inspiring Clinical CareA patient’s spiritual “framework” can hold the key to therapeutic breakthroughs.
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Clinical Reflections: Making Difficult ChoicesPsychiatrists can play a vital role in determining whether or not a patient will be a good candidate for an organ transplant. Using a case vignette, Dr. Garton explains how she helps a transplant team make the best possible decision.
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In Support of Early Psychotherapy TrainingRecent reports have noted an alarming decrease in the practice of psychotherapy among psychiatrists.
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Psychiatric and Societal Impacts of TerrorismThe impact of terrorism reaches many aspects of health and health care: acute and chronic symptoms of anxiety and depression, changes in health-related behaviors, and long-term strain and tension.
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Anxiety Disorders: Aortic Aneurysm in the Differential?Worsening anxiety is a common symptom that may result in psychiatric consultation or evaluation in an emergency setting. Aneurysms are rarely considered in the medical differential for anxiety disorders, and the available literature and research regarding this possible connection are very limited. Overlooking this diagnosis, however, can have disastrous consequences. Here we present 2 case reports as well as a review of the literature regarding a possible relationship between aortic and thoracic aneurysms and psychiatric symptoms.
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Sleep Disturbances Associated With Posttraumatic Stress DisorderThe National Comorbidity Survey estimates that approximately 50% of the population in the United States is exposed to traumatic events and that the lifetime prevalence of posttraumatic stress disorder (PTSD) is approximately 7.8%.
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Mini Quiz: ADHD in Young AdultsWhat do you really know about ADHD in young adults? Take this quiz and find out.
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Commercial Influence on Psychiatric Drug StudiesA discussion of the evidence that the pharmaceutical industry influences how physicians evaluate drugs in ways that encourage sales of their products and that are not always in the best interests of the patient.
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Psychologist Prescribing Privileges in Oregon: A Potentially Dangerous Non-solutionAs a fellow Oregonian, I concur with Dr Jim Phelps that the topic of psychologist prescribing is highly complex, and that even balanced opinions generate “affective discharge” approaching “invective."
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Neurostimulation Treatments in Psychiatry: An Overview and Recent AdvancesThere have been considerable advances in the research on and clinical use of neurostimulation for psychiatric disorders, especially mood disorders and MDD. Three of the most recognized are reviewed here. An experimental new treatment-- trigeminal nerve stimulation-- is also briefly discussed.
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Child and Adolescent Psychiatry: The Next 10 YearsPsychiatry is changing so rapidly that it seems impossible to predict 1 year ahead, let alone 10 years. In 1967, when my psychiatry training ended, the community psychiatry movement had just begun, DSM-II was in the works, and the biological revolution was still around the corner.
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What Are Best Practices for Psychiatrists When Serving As Expert Witnesses?An expert shares 7 tips for effectively serving as an expert witness in court.
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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.
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The Muscarinic Hypothesis of SchizophreniaSince the discovery of dopamine as a neurotransmitter in the late 1950s, schizophrenia has been associated with changes in the dopaminergic system. However, the dopamine hypothesis of schizophrenia cannot explain all the symptoms associated with this disorder. Therefore, research has also focused on the role of other neurotransmitter systems, including glutamate, g-aminobutyric acid, serotonin, and acetylcholine (ACh) in schizophrenia.
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Understanding and Overcoming the Myths of SuicideWhat goes on in the minds of those who attempt suicide? Here: a psychologist who explores the myths that surround suicide notes "We need to get it in our heads that suicide is not easy, painless, cowardly, selfish, vengeful, self-masterful, nor rash."
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Introduction: Looking to the Future of PsychopharmacologyThe focus of this Special Report is on some future-oriented aspects of psychopharmacology. First, it is an eclectic set of articles that cover treating resistant depression, using currently illegal drugs to treat psychiatric problems, and finally the potential of using vaccines to treat substance use disorders.
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The OPTICS Project: An Open-Science Framework for the Analysis of Clinical Trial DataA report of initiatives that have raised awareness of and promoted data sharing and data transparency in order to advance science and improve public health and health care.
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The Therapeutic Alliance and Psychosocial Interventions for Successful Treatment of AddictionA discussion of treatment options to help foster the most effective psychosocial treatment for addiction.
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Accept Insurance? I Wish I CouldThere are not enough participating psychiatrists to accommodate all who would seek treatment if it were affordable. This is not a good situation.
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Federal Court Gives Green Light to Deny Coverage"With our country’s ongoing mental health and addiction crisis, the consequences of the Wit v UBH reversal are too great to ignore."
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A New Draft Guide for Developing Stimulant Use Disorder TreatmentsThe FDA has released a draft guide to offer their perspective and thoughts on the development of treatments for stimulant use disorder.
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Marketing Off-Label Uses: Shady Practices Within a Gray MarketFor pharmaceutical companies, off-label use of a drug represents a substantial “gray market,” to which the company is unable to sell their product directly, yet may be a significant revenue stream. Some drugs have been used more for off-label purposes than for originally approved indications.1
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Diagnosing Dementia: Essential for Prognosis, Treatment, and Potential CureDefined as a clinical syndrome involving progressive deterioration in multiple areas of cognitive functioning, dementia is a major cause of disability, institutionalization, and increased mortality among the elderly. Although it can occur in younger persons too, dementia is typically associated with aging. It is often seen as a disease that cannot be prevented or cured. However, there is increasing evidence that some types of dementia can be successfully treated or even reversed.
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Hypothyroidism: An Important Diagnostic Consideration for the PsychiatristHypothyroidism is a common clinical disorder that psychiatrists frequently encounter. However, symptoms of thyroid dysfunction are often vague and nonspecific, which can lead to delayed or missed diagnosis.
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Group Therapy and Cancer Survival-- Where Does the Evidence Lie in 2007?One of the most hotly debated questions within oncology over the past decade has been whether the promotion of psychological wellness can extend survival for patients with advanced cancer. The converse--that psychiatric disorder shortens survival--seems true, with mechanisms of poor self-care and reduced adherence to anticancer treatments resultant from depressive or psychotic disorders explaining this outcome.
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Emerging Treatments and Pharmacogenetics for Cocaine Use DisorderThere are no FDA-approved pharmacotherapies for cocaine use disorder. Here: a review of the off-label use of promising medications for this addiction.
