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Spiritual Matters: Inspiring Clinical CareA patient’s spiritual “framework” can hold the key to therapeutic breakthroughs.
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Never Say Dye: the Roots of Modern Psychiatric Medicines in Nineteenth-Century Fabric ColoringsWeaving the story of modern psychopharmacology’s birth leads us to a most surprising origin.
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Insomnia and Its ImpactInsomnia, the subjective sense of having inadequate quantity or quality of sleep, occurs in 20% to 35% of the general population. Not surprisingly, many insomniacs describe a variety of difficulties in their personal and professional lives.
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HoardingMany of the things that we busy ourselves with have no apparent utility. Blogging, playing games, and collecting come to mind. To declare that we are compelled to do these things may be too strong, but we do pursue these activities with little deliberation and without concern as to their usefulness. The ubiquity of these pursuits suggests that these activities or their variants helped humans survive at some point and that they now rest on innate brain programs.
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Schizophrenia Research Congress HighlightsTwenty years after the initial meeting of the International Congress for Schizophrenia Research (ICSR), this year's biennial ICSR remained true to its mission to serve as a venue for active researchers. ICSR hosted investigators in neuroscience, cognitive neuroscience, basic and clinical psychopharmacology, psychosocial interventions, and genetics.
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Pharmacological Management of Treatment-Resistant Anorexia NervosaOnly 13% to 50% of AN patients are considered recovered 1 to 2 years posttreatment, and 20% to 30% go on to develop a chronic and unremitting course of AN. How can we improve these outcomes?
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Methamphetamine Abuse: Consequences and TreatmentMethamphetamine (MA) abuse is not a new problem in the United States, but the current epidemic is more widespread and presents with more pernicious consequences than in the past. MA, frequently called "speed," "crystal," "crank," "ice," or "tina," is a potent psychostimulant that can be swallowed in pill form or administered via intranasal, intravenous, or smoking route.
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Childhood Reactions to Terrorism-Induced TraumaChildhood Reactions to Terrorism-Induced Trauma by Wanda P. Fremont, M.D. The unpredictable, indefinite threat of terrorist events, the profound effect on adults and communities, and the effect of extensive terrorist-related media coverage can contribute to a continuous state of stress and anxiety in children. Current treatment strategies are discussed as well as direction for further research.
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Illicit Drug Dependence Across the Globe: Results From the Global Burden of Disease 2010 StudyHow prevalent is dependence on amphetamines, cocaine, opioids, and other illicit drugs across the world? What is the associated disease burden? Insights here.
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Translational Research: Pathway to Improved Practice?Advances in basic behavior and neuroscience research have been stunning, but until quite recently, efforts to encourage the clinical application of new knowledge have not kept pace. To aid in applying new knowledge to important public health issues, the National Institutes of Health has placed emphasis on "translational research," which aims to provide a bridge between basic research and clinical care. Particularly promising areas of study are highlighted.
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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.
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Medication-Psychotherapy Combination Most Effective for Schizophrenia"Can we talk?" asks a recovering patient who chastises psychiatry for too readily dismissing patients with her diagnosis as unable to benefit from talking therapy (A Recovering Patient, 1986). With managed care administrators quick to seize upon a lack of outcome data as a pretext for limiting treatment and a public mental health system pressed to handle caseloads as high as 200 to 300 patients per clinician, psychiatry's regrettable answer has often been: "No, we're too busy." Recent research findings, however, convincingly demonstrate that a flexible form of individual psychotherapy, when combined with appropriate neuroleptic medication, can yield improvements in social and vocational functioning unobtainable with "treatments as usual."
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Autism Spectrum and Neurodevelopmental DisordersThis article aims to provide the general psychiatric community with an update on the major findings on the biology of ASDs as well as the advances in diagnostic and interventional strategies.
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Health and Psychiatric Issues in Children of Rural Methamphetamine Abusers and ManufacturersMany abusers of methamphetamine in rural areas manufacture the drug for their personal use. These "mom-and-pop cooks" produce methamphetamine in and around homes where children are also living. This article provides an overview of the mental health of children whose parents abuse methamphetamine.
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Using CBT in the Treatment of Social Phobia, Separation Anxiety and GADChildren can now play a more active role in the treatment of their disorders. Using skills and information taught throughout the three treatment phases of cognitive-behavioral therapy (education, application and prevention relapse), they can be taught to understand and address the very fears that cause their disability.
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The Hidden Suffering of the PsychopathThe psychopath has the image of a cold, heartless, inhuman being. But do all psychopaths show a complete lack of normal emotional capacities and empathy?
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Treatment of Parental Alienation: Guidelines for Mental Health and Legal PractitionersMental health clinicians and legal practitioners can learn more about parental alienation and its treatment here.
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Medicolegal Considerations in the Treatment of Psychosis With Second-Generation AntipsychoticsAre the metabolic side effects of the atypical antipsychotics fueling the next round of malpractice suits being filed against psychiatrists? Guidelines are being created, but how can clinicians protect themselves and their patients, while continuing to give their patients the best care available?
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Comorbid Depression and Alcohol DependenceDepression and alcoholism treatment requires the proper use of medication and psychosocial interventions, as well as a solid doctor-patient relationship and a commitment to treat both disorders.
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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.
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Mini Quiz: Depression and CancerWhat is the estimated prevalence of psychiatric disorders in ambulatory patients with cancer? Find out in this quiz.
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Label Me Not: Still Learning After All These YearsThe world is a better place without a "tyrant of the day" taking over and cracking down with rigid rules. This and other life lessons after 40 years in psychiatry.
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The Current Status of Transcranial Direct Current Stimulation as a Treatment for DepressionEvidence has accumulated on the efficacy of transcranial direct current stimulation in major depression. The authors review its potential mechanism of action, findings from recent clinical trials, and potential role in the treatment of depressive disorders.
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The Occupation of Psychiatry?Should we accept the analysis of a journalist who has not treated a patient or implemented a study and reaches conclusions that run counter to well-established practice guidelines?
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Treatment Resistance in Schizophrenia: The Role of Alternative TherapiesIn 1931, Gananath Sen and Kartick Chandra Bose reported on the use of an alkaloid extract from the Rauwolfia serpentina plant in the treatment of hypertension and "insanity with violent maniacal symptoms." They noted that dosages "of 20 to 30 grains of the powder twice daily produce not only a hypnotic effect but also a reduction of blood pressure and violent symptoms
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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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Dynamically Based Psychotherapy: A Contemporary OverviewThis article addresses several important theoretical issues related to dynamically oriented psychotherapy. These issues include the therapeutic alliance and transference, the authority of the therapist and neutrality, the stability of the therapeutic environment, countertransference, empathy, and basic strategy. Efforts are made to present these issues in a contemporary context.
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A Neuroscientific-Medical PerspectiveRecent research emphasizes our need for better understanding of the interface between the specialties of psychiatry and medicine. Psychiatrists need to monitor emerging work that highlights the need for both a neuroscientific and medical perspective in the management of complex disorders.
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Psychiatric Tribalism"Positive Psychology: A More Direct Route To Happiness" (Psychiatric Times, September 2007) brought to mind that no one asks an internist to which school of medicine he or she belongs.
