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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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The Nursery: A Raw Portrait of Intrusive Thoughts and New MotherhoodA book for all psychiatrists with woman patients and for all parents.
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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.
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Dangerously Paranoid?Overview and Strategies for a Psychiatric Evaluation of a Highly Prevalent SyndromeThe term “paranoia,” derived from the Greek &lduo;para” (beside) and “nous” (mind), was coined as a descriptor of psychopathology by Heinroth in 1818.1 By the end of the 19th century, 50% to 80% of patients in asylums in German-speaking countries had received a diagnosis of paranoia.1 Beginning in 1899, Kraepelin’s efforts to define paranoia more precisely resulted in a decrease in diagnoses of paranoia in favor of dementia praecox and, later, schizophrenia.1,2 This narrowing of the definition of paranoia is reflected in current nosology and practice. In DSM-IV-TR, the prevalence of delusional disorder is estimated at 0.03% of the general population and accounts for 1% to 2% of psychiatric admissions. The prevalence of paranoid personality disorder is 0.5% to 2.5%; this condition accounts for 10% to 30% of psychiatric admissions.3
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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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Using Telehealth to Enhance Access to Evidence-Based CareFindings suggest that telemental health is not only effective for diagnosis and assessment across many populations and disorders in many settings, but it appears to be comparable to face-to-face care.
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How Many Psychiatrists Does it Take to Change a DSM - - or Rowing Backwards Into the Future . . . The DSM ProcessIt used to be that the answer to the above question was: “One . . . but he or she must really want to change.” Now that we are in the DSM process, many other things must be considered. We have watched as the Board assembled the Task Force and Work Groups for almost 2 years, choosing among expertise, years in the field, academic appointments, geographic distribution and freedom from excessive attachments to pharmaceutical and medical device manufacturers, etc, to complete what appears to be a very scientific, secret recipe for “DSM stew.”
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Top Research Findings That Can Change Clinical PracticeFour studies sprang from the TORDIA trial on treatment-resistant depression in children and adolescents and showed that several factors influence treatment efficacy following treatment resistance.
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Religion, Spirituality, and PsychiatryHistorically, there has been conflict between psychiatry and religion.
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Religious/Cultural Heritage and Patient Perceptions of Psychotropic DrugsOne of the major concerns of health professionals working in the area of psychiatry is understanding the conditions under which patients adhere to prescribed treatments. While adherence is linked to some extent to the patients' comprehension of their illness, it is also a function of their social and demographic characteristics, such as age, social milieu, or sex. Another attribute also merits our attention, however: the patient's cultural affiliation and in particular, his or her religious background.
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The Person of the Psychotherapist: Let’s Hear Not the Song but the SingerWhen we write about psychotherapy, we usually write about the patients and their cognitions and psychodynamics; or we talk about the techniques of psychotherapy, schools of psychotherapy, and efficacy studies. These are all songs of psychotherapy.
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Providing Culturally Competent Care: Understanding the Context of PsychosisCulture-the way people make meaning and live their lives in particular social worlds-matters in psychosis. The authors explore how a patient's cultural background should influence the way clinicians think about treatment and care.
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STEPPS: A Viable Supplement to Treatment of Borderline Personality DisorderTwo randomized controlled trials have shown the Systems Training for Emotional Predictability and Problem Solving (STEPPS) program to be effective in reducing the intensity of core aspects of borderline personality disorder (BPD), Dr Donald Black and social worker Nancee Blum announced at the annual meeting of the American Psychiatric Association held recently in San Francisco. Black summarized, “Data from several studies show that STEPPS reduced global severity as rated by clinicians and patients, borderline personality disorder symptoms, and depressive symptoms.”
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The Evil HoursA Q&A with David J. Morris, author of The Evil Hours, a moving biographical book based on a young veteran’s experience with PTSD.
