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The Neurochemistry of Pediatric Major Depressive DisorderMajor depressive disorder (MDD) in pediatric populations represents a significant public health concern. Rates of MDD rise dramatically in adolescence, with an estimated lifetime prevalence of 15% in adolescents aged 15 to 18.
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A Partnership of Increasing SignificanceThe role of psychiatry in primary care is an area of rapid expansion and increasing significance. Given the fact that inadequate diagnosis and treatment of psychiatric disorders are major public health problems, it is essential to integrate psychiatrists into multidisciplinary primary care teams. Since primary care physicians are increasingly called upon to act as "gatekeepers" in managed care programs, they will have to meet the important and growing need for broader psychiatric diagnostic and referral skills.
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Mini Quiz: Cognitive EnhancersWhich pharmacotherapeutic approach is most effective for cognitive enhancement? Test your knowledge with this quiz.
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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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Research That Can Change Clinical Practice in Psychotic DisordersThe need to stay up-to-date with the most current evidence-based information is becoming harder than ever. For this reason, the authors identify and evaluate published research that may have a direct bearing on clinical practice.
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Clinically Based Policy Decisions: In-Person Requirements for Telehealth Create Unnecessary BarriersMedicare's in-person requirement threatens access to quality care.
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Managing the Suicidal College Student: Advice for Community ProvidersAlthough college students are in many ways similar to any patient in their age group, their environment and stressors differ in significant ways. The authors identify issues to consider in assessing and managing suicidality in this population.
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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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Shadows on a Wall: Phenomenology in an Acute Care SettingWe present the case of a patient for whom different attending providers had markedly different interpretations. As the case unfolds, we invite you to reflect on your diagnostic understanding of each presentation.
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Key Takeaways for Treatment of Bipolar 1 DisorderAndrew Cutler, MD, shares his key takeaway advice to psychiatrists for the diagnosis and treatment of patients with bipolar 1 disorder.
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Crossing the Blood-Brain Barrier: Integrating Scientific Innovation With Socio-Ethical Reflection in Predictive MedicineIn this article, we discuss recent advances in drug transporters and nutrient-transporter interactions that can impact drug bioavailability in the systemic circulation and the brain. We also present emerging research strategies that may facilitate the discovery and clinical development of predictive diagnostic tests to identify patients at risk for treatment resistance.
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Clinical Manual of Couples and Family TherapyThe Clinical Manual of Couples and Family Therapy is a succinct, well-written volume that provides evidence for the wisdom behind treatment of the family and/or involvement of the family when treating the patient.
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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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Traditional Healing Concepts and Psychiatry: Collaboration and Integration in Psychiatric PracticeThe authors share a model for psychiatrists interested in collaborating with traditional healing and medicine.
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Mini Quiz: Evaluating Biomarkers of NeurotoxicologyA quiz on biological approaches to evaluating biomarkers of neurotoxicity in the psychiatric setting.
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The Correlation Between Sleep Disturbance and SuicideAll psychiatrists know the risk factors for suicide. Among the newest modifiable risk factors to join the list are insomnia and nightmares.
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Using Complementary TreatmentsThe promise of natural products as possible sources of new treatments for Alzheimer's disease and other dementing illnesses is on the rise. Scientific evidence for the 13 dietary supplements most commonly used for memory impairment is analyzed and evaluated.
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Outcome Assessment in DepressionRegular interval administration of outcome measurement tools has proved to be beneficial in improving the quality of care that we all hope to provide for our patients.
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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.
