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The Implications of Chronobiology for PsychiatryChronobiology-the science of daily (circadian), monthly, tidal, and seasonal rhythms-has undergone exponential growth in the past decade, with major discoveries at the molecular and neuroanatomic level.
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Adjustment Disorders: Diagnostic and Treatment IssuesAdjustment disorder is one of the few psychiatric diagnoses for which the etiology, symptoms, and course, rather than symptoms alone, are central to making the diagnosis. Both emotional and behavioral disturbances are present and include low mood, tearfulness, anxiety, self-harm, withdrawal, anger, and irritability.
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Would a Suicide Barrier on the Golden Gate Bridge Save Lives?The Golden Gate Bridge in San Francisco has the regrettable distinction of being the number one spot for suicide in the world. There have been more than 1300 known suicides from the bridge, and in 2007 at least 35 people committed suicide by jumping off the Golden Gate Bridge, more than in any other year.
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Brain Aging and Dementia: Practical Tips From Clinical ResearchAge is a major risk factor for the development of Alzheimer disease and other dementias. New technologies in brain imaging represent major advances in our ability to diagnose age-related cognitive and behavioral disorders.
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Social Anxiety in AdolescentsAlthough social anxiety can be a challenge at any point across the lifespan, it can present a unique set of challenges during the teenage years. More in this podcast.
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Treating Adolescent Depression With Psychotherapy: The Three TsDespite the high prevalence of depression among youths, there are empirically supported treatments that have been shown to reduce depressogenic symptoms, including the 3 therapies outlined in this article.
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The King’s Speech: A Talking Cure for the Stiff Upper LipIn this blog, Annemone Ligensa reviews The King's Speech from a psychological and historical perspecive.
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Did California Dodge a “Right-to-Die” Bullet?How a radical proposal from California and 3 cases of anorexia nervosa from Colorado exemplify the "slippery slope" of physician-assisted suicide.
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Clinical Assessment of Dysexecutive SyndromesDysexecutive syndromes result from damage to the anterior regions of the brain and present as a combination of disinhibition, disorganization, or apathy.
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Transcending MedicineTruth be told, gender identity variations are not psychiatric disorders. That said, if you were there, what would you have done?
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Psychiatric Malpractice: Basic Issues in Evolving ContextsThis article focuses on 4 issues in psychiatric malpractice: prescribing, liability for suicide, informed consent, and duty to protect under the Tarasoff v Regents of the University of California ruling. Malpractice is a civil wrong actionable by law. There are 2 goals of malpractice suits: the first is to make an injured plaintiff whole by an award of money, and the second is to inform the profession how courts will decide similar cases in the future.
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Reporting Under Fire: Understanding Psychopathology of War JournalistsThe dozens of journalists killed while covering the current war in Iraq gives currency to the dangers encountered by those who bring us the news from the world's conflict zones. Despite the risks inherent in their profession, it is only recently that the psychological health of war reporters has been captured in a systematic and empirical manner.
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The Light-er Side of Treating Seasonal Affective DisorderSeasonal affective disorder affects 1% to 3% of the North American population. Evidence exists for the efficacy of high-intensity bright, fluorescent light. Pharmacological management with SSRIs has shown equivalent efficacy to light therapy. How can these two therapies be combined? What other therapies are available?
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Future ADHD Treatment OptionsExperts in attention-deficit/hyperactivity disorder discuss future nonmedication interventions, like trigeminal nerve stimulation and digital therapeutics.
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Managed Care: The New ColonialismThe term managed care has become the new blasphemy in the health care industry. Symposia, lectures and other presentations on this topic at the 1997 American Psychiatric Association convention all seemed to conclude that managed care in any form is evil and unethical and that by maintaining the moral high ground, physicians holding out against managed care would ultimately win because the cause is just.
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Deconstructing ADHD, Addiction, and BeyondNews and research highlights on ADHD, conduct disorder, substance use disorder, and behavioral addictions, including compulsive social networking.
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Trauma-Focused Cognitive-Behavioral Therapy for Sexually Abused ChildrenCognitive-behavioral therapy can be tailored for use with children who have experienced sexual abuse in order to relieve symptoms of PTSD.
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Psychopharmacological Enhancement of Neurocognition in SchizophreniaThis article summarizes efforts to develop neurocognitive enhancement drugs administered individually or as an adjunct to other antipsychotics and cognitive remediation.
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Becoming a Mensch: Timeless Talmudic Ethics for EveryoneThe book emerges as a skillful interweaving of 3 elements: an introduction to the Jewish tradition, a set of down-to-earth case examples in practical ethics, and a fine running commentary about Jewish lore and how we can all reflect on it and be enriched by it.
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Pandemic Stress ManagementHealth professionals' emotional reactions to the COVID-19 pandemic range from numbness, anxiety, fear, and rapid shifts to survivor guilt, helplessness, and feelings of detachment. Here: Stress management tactics and what to expect today and beyond.
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Trait Stages of Diagnosis for Borderline Personality DisorderThe authors describe an alternative model for BPD diagnosis that is dimensional in nature and requires fulfillment of 4 of 7 personality traits.
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Assessing Violence Risk in Psychiatric Inpatients: Useful ToolsPsychiatrists who work in inpatient units are faced with daily decisions about predicting which patients will be violent, both in the hospital and after discharge. These decisions are often made using unstructured clinical judgment based on the clinician's experience and knowledge of the literature. How long such judgment stays the standard of care remains to be seen, because psychiatric researchers have produced a number of assessment and management tools to improve the accuracy and use of violence risk assessment. This article briefly outlines 3 tools: the Brøset Violence Checklist (BVC), the Classification of Violence Risk (COVR), and the Historical Clinical Risk-20 (HCR-20).
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Unrecognized and Untreated: Preventing and Treating Depression in Patients With EpilepsyThe relationship between depression and epilepsy is bidirectional as not only are patients with epilepsy at higher risk of developing depression but patients with depression have a three- to sevenfold higher risk of developing epilepsy. Several studies have found that the presence of depression in patients with intractable epilepsy was a stronger predictor of poor quality of life than the frequency and severity of seizures. The principles of managing depression in epilepsy are reviewed in this article.
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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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Preventing the Onset of Cognitive DeclineBy the year 2050, it is estimated that the number of people with Alzheimer disease and other forms of dementia will explode to 36 million in the US and over 160 million worldwide, over 3 times the current rate.
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The Emerging Field of Sports Psychiatry: A New Niche for Psychiatric PracticeThere are a number of well-established niches in psychiatry, from forensics to addictions to LGBT. This author relates how she established her niche as a sports psychiatrist.
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Delirium With Catatonic Features: A New Subtype?Delirium has been recognized and described since antiquity. It is a brain disturbance manifested by a syndrome of diverse neuropsychiatric symptoms. Various terms have been used for delirium, such as acute brain disorder, metabolic encephalopathy, organic brain syndrome, and ICU psychosis.
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Applications of Transcranial Magnetic Stimulation to Therapy in PsychiatryTranscranial magnetic stimulation has been applied in a growing number of psychiatric disorders as a putative treatment. As a focal intervention that may exert lasting effects, TMS offers the hope of targeting underlying circuitry and ameliorating the effects of psychiatric disorders. The ultimate success of such an approach depends upon our knowledge of the neural circuitry involved, on how TMS exerts its effects and on how to control its application to achieve the desired effects. Current challenges in the field include determining how to enhance the efficacy of TMS in these disorders and how to identify patients for whom TMS may be efficacious.
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Update on Psychogenic Nonepileptic SeizuresThe authors take an in-depth look at the evaluation, diagnosis, and fundamental treatment recommendations, protocols, and guides to therapy for psychogenic nonepileptic seizures.
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Novel Therapies for Cognitive Dysfunction Secondary to Substance AbuseAdvances in the fields of neuropsychological assessment and neuroimaging have enormously expanded our knowledge about the profile and severity of cognitive deficits in patients with substance use disorders.
