Authors
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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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Culture as a Factor in Adherence: Learning From Latino ExperiencesSuccessful culturally adapted interventions to improve adherence among Latino patients with depression and schizophrenia confirm how important it is to understand a patient’s entire sociocultural environment.
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Treating Comorbid Anxiety Disorders in Patients With Schizophrenia: A New PathwayIdentifying comorbid anxiety disorders as potential treatment targets may contribute to more positive outcomes for patients with schizophrenia. Details here.
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Psychiatric Disorders During PregnancyTreatment with psychopharmaceuticals may prove problematic for pregnant women. The decision to discontinue medications or to adjust dosages to minimize the risk to the fetus has to be addressed. The dynamic balance of treatment options, maternal concerns and practitioner responsibility depends upon staying abreast of the latest research in psychopharmacology and pregnancy.
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Illuminate Life Processes by Taking a Sexual HistorySexual life is not just about sexual identity and sexual behavior.
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Medicare to Drop Antidepressants as Part D “Protected Class”Starting in 2015, psychiatrists will have to juggle antidepressant selections for Medicare patients. What might this mean for your patients?
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Detainee Interrogations: American Psychological Association Counters, but Questions RemainI am writing to correct several inaccurate assertions in the essay, “The American Psychological Association and Detainee Interrogations: Unanswered Questions” (Psychiatric Times, July 2008, page 16), by Kenneth S. Pope, PhD, and Thomas G. Gutheil, MD.
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Clinical Issues and Strategies Associated With Smoking CessationHere: assessment approaches, treatment options, and potential risks inherent in treating tobacco dependence in individuals with major mental illnesses and substance use disorders.
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Psychological Aspects of Human Reproductive Clones: What Can We Infer From the Clone-Like?The world began to face the prospect of human cloning when the journal Nature published Dolly the sheep's "birth announcement" in the form of a letter authored by Wilmut and colleagues. But despite all the attention given the issue, including two presidential commissions, the psychological consequences of cloning have been little addressed.
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Changing Healthcare Practices are Hard, Changing Culture HarderIt seems that all the changes in the healthcare system over recent decades have been top down, and without a lot of input from the folks at the delivery end.
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Areas for Future ResearchElderly patients are a heterogeneous population with myriad issues facing them. The group of articles in this Special Report should stimulate thinking, discussion and future research in a variety of areas.
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Psychopharmacology for Medically Ill PatientsThe prescription of psychotropic medications for patients with complex comorbid medical and psychiatric conditions is a cornerstone of psychosomatic medicine (PM) practice.
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Delirium: Emergency Evaluation and TreatmentDelirium is a disorder that lies at the interface of psychiatry and medicine. It is an acute organic syndrome caused by an underlying medical condition and is defined clinically by disturbances in cognitive function, attention, and level of consciousness.1 Delirium is considered a syndrome because of the constellation of signs and symptoms associated with the disorder, coupled with a wide variety of potential etiologies.
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A Clinician’s Guide to Statistics and Epidemiology in Mental Health: Measuring Truth and UncertaintyIs A Clinician’s Guide to Statistics and Epidemiology in Mental Health what we have been waiting for? Yes and no. It contains solid descriptions of concepts such as the P value and confidence intervals, and it has extensive discussions of the history of modern statistical methods. Perhaps its greatest strength involves critiques of the interpretations of several studies that have mistakenly become cornerstones of clinical lore.
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The Four Categories of Elder Abuse: Evaluation ApproachesThis article reviews the different categories of elder abuse, emphasizing the role and requirements for psychiatrists, with a focus on financial elder abuse.
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Clinical Service Delivery and Benefits in General Medical Care of Psychosomatic IllnessThe renaming of consultation-liaison psychiatry as psychosomaticmedicine, a new formal subspecialtyof psychiatry, may require someadjustment in our understanding ofthese terms. Both consultation-liaisonpsychiatry and psychosomatic medicinehave focused on treatment and researchof illnesses with mind-body interactions.Despite considerable overlap,consultation-liaison psychiatry hastraditionally been associated with treatmentand clinical research of comorbidmental disorders of the medicallyill, while psychosomatic medicine hasbeen associated with research into thephysiologic mechanisms underlyingmind-body interactions and classicalpsychosomatic diseases such as hypertension,asthma, and ulcerative colitis.
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The Facts About Violence Against Historically Disadvantaged PersonsRacial/ethnic and sexual orientation minorities and women historically have been relegated to social, legal, and economic disadvantage in the United States.
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Informed Consent and Civil Commitment in Emergency PsychiatryMedical school graduation usually involves taking the Hippocratic oath, in which physicians vow not to intentionally harm their patients. Keeping patients safe is another basic principle of patient care. Physicians are charged with ensuring that their patients are in a safe environment and minimizing risks to their patients by carefully selecting treatment options.
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The Rise of Cranial ElectrotherapyCranial electrotherapy devices, soon to be only home-use device approved to treat depression, can be an essential adjunctive treatment to standard modalities of care for soldiers and veterans, says this psychiatrist.
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Evaluating Capacity to Make a WillPsychological Autopsy and Assessment of Testamentary CapacityIt is an ancient practice to state instructions for distributing one’s property after death. In Genesis 48, Jacob verbally bequeaths his property to Joseph, Joseph’s siblings, and Joseph’s 2 sons. Wills existed in ancient Greece and Rome, with restrictions.
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10 Factors Leading to Pain Complaints in the Absence of a Medical DiagnosisWith most chronic pain conditions, the exact pathology is uncertain. In such cases, psychiatrists may be called to assess for illness beyond medical diagnosis.
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The Former Secret Life of an Elvis ImpersonatorStephen R. Shuchter, M.D., professor of clinical psychiatry and associate director of residency training at University of California, San Diego, spends his "down" time performing as Elvis and other rock 'n' roll legends. In these efforts, he expresses his creativity and brings delight to those he entertains. Lessons from each "career" have helped his success in the other.
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Dopamine Receptors in the Human BrainDopamine plays an important role in controlling movement, emotion and cognition. Dopaminergic dysfunction has been implicated in the pathophysiology of schizophrenia, mood disorders, attention-deficit disorder, Tourette's syndrome, substance dependency, tardive dyskinesia, Parkinson's disease and other disorders.
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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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Exploring the Link Between Environmental Noise and Psychiatric DisorderNoise, or unwanted sound, is a pollutant and an environmental stressor. The frequency of noise events seems to have increased in recent years while the amount of the day without noise has lessened.
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Novel Drug Delivery Systems in ADHD and Take-Home MessagesDrs Stephen Faraone, Theresa Cerulli, Craig Chepke, and Andrew J. Cutler discuss novel drug delivery systems and provide take-home messages when treating an adult with ADHD.
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Panic Disorder: Keys to Evidence-Based Effective TreatmentKeys to the management of panic disorder include appropriate use of psychotropic medication and psychotherapy predicated on an understanding of the disorder's biopsychosocial underpinnings. Here, Stephen V. Sobel, MD, focuses on treatment options.
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The Limits of AdvocacyMigrant children were being endangered, with potentially devastating effects on their mental health and development, and we requested policy changes.
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A Psychiatrist Investigates Poet Allen Ginsberg’s Journeys into MadnessThe story of the legendary Beat poet’s involvement with madness and mental illness has never really been told—until now.
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Assessing and Enhancing the Effectiveness of AntidepressantsWith over 2 dozen FDA-approved antidepressants on the market, it is reasonable to ask: which antidepressants are most effective?
