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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.
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Psychotic Disorders in DSM-5: Clinical Implications of Revisions From DSM-IVThe authors discuss the clinical implications of the changes in the DSM-5 section on schizophrenia spectrum and other psychotic disorders.
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Criticism vs Fact: A Response To A Warning Sign on the Road to DSM-V by Allen Frances, MDAllen Frances, an old friend, writes critically about the DSM-V project. I will address some key issues where his criticisms do not relate to reality as experienced from within the process. I chair the Psychoses Work Group and am a member of the DSM-V Task Force.
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Sweet Sorrow: The Relationship Between Depression and Diabetes MellitusMultiple studies show that diabetes approximately doubles the risk of comorbid depression. Furthermore, major depressive disorder is a risk factor for the subsequent development of type 2 diabetes mellitus. Treatments for depression in the setting of diabetes must be evaluated for their effects on blood glucose levels, propensity for weight gain, possible concomitant use for diabetic neuropathy and potential drug interactions.
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Mini Quiz: Long-Acting InjectablesWhen switching to this long-acting injectable antipsychotic, how long should an oral pre-switch antipsychotic be continued? Find out in this quiz.
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Real-World Office Management of ADHD in AdultsOffice management of attention-deficit/hyperactivity disorder (ADHD) differs in many important ways from ADHD management conducted in a research environment. In clinical trials, treatments and eligible patients are selected in advance by committees, patients are randomized to different management strategies, and both clinicians and pa tients are blinded to the treatments.
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Working With Transgender PersonsUsing a question-and-answer format, we present a brief overview of issues that arise when mental health professionals explore how to best serve this population.
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Lifetime Psychiatric Comorbidity of Illicit Drug Use DisordersWhat is comorbidity? Psychiatric comorbidity refers to the occurrence of 2 or more mental or substance use disorders within a certain period. Research shows that comorbidity of substance use and other psychiatric disorders is common and often worsens the prognosis for each disorder.
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Somatoform and Related Disorders: An UpdatePotentially over-inclusive DSM-5 diagnostic categories for somatic disorders can result in a confusing overlap of criteria. These authors sort through the challenges of the differential diagnosis-and map out a well-structured treatment plan.
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Mini Quiz: Micronutrients and DepressionMicronutrient deficiencies can bring about a range of mental health complications. Take the quiz and learn more.
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An Autistic Child With Psychotic SymptomsAutism and schizophrenia may present as 2 separate disorders that need to be differentiated, or treated as comorbid conditions. It is important to remember that some individuals may have both disorders, which has implications when designing appropriate biopsychosocial interventions.
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Rebels Without a Cause? Adolescents and Their AntiheroesAdolescents reject their parents’ icons and seek out and empower their own. Antiheroes seem deliberately provocative, assailing almost every social convention of the adult generation, and parents often fear they are leading youth astray.
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The Role of Psychiatrists in HIV PreventionBecause over half of persons with HIV infection have a lifetime history of depression or bipolar disorder, psychiatrists are uniquely positioned to provide both preventive and therapeutic interventions to vulnerable patients.
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Suicide in Older Adults: Management and PreventionBeyond demographic characteristics, risk and protective factors for suicide in older adults have been much more clearly defined in recent years by a series of methodologically rigorous, case-controlled psychological autopsy studies.
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Bipolar Disorder: Got Antidepressants?Unspecified bipolar disorder? Comorbid borderline personality disorder? Or, in the case presented here, is it time to break out the mixed specifier from DSM-5?
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Key Stressors in Transplant PsychiatryHere: A summary of indicators for stress and anxiety in patients undergoing transplantation, and why it is important for psychiatrists to be aware of these factors.
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Understanding and Treating DeliriumThis CME article reviews the pathophysiology and epidemiology of delirium and provides strategies for assessment, prevention, and management of this syndrome.
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Dialectical Behavior Therapy Skills Training Is Effective InterventionThe latest research on DBT for treating psychiatric disorders, such as ADHD, bipolar disorder, eating disorders, and depression.
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Mini Quiz: OCD? Phobia? Or Something Else?The inability or difficulty to experience vaginal penetration is most similar to which DSM-5 disorder? Find out in this quiz.
