Authors
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Neurobiology of Eating Disorders: Clinical ImplicationsNew insights into neural pathways that play a role in anorexia nervosa, bulimia nervosa, and binge eating disorder.
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Parent Project Muscular Dystrophy: Advocacy and SupportThe diagnosis of Duchenne muscular dystrophy (DMD) is devastating for patients and their families. There is no standardized treatment and no cure, and boys with this disorder typically die by age 25 years because of respiratory failure or failure of the heart muscle. Until 13 years ago, parents of boys with DMD had nowhere to turn for support and no concerted efforts in clinical research were being made. This changed in 1994 with the founding of Parent Project Muscular Dystrophy (PPMD), a grassroots organization started by parents with the goal of creating awareness of DMD and generating interest and funding for research.
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Cognitive Remediation for Psychiatric PatientsImproving Functional Outcomes for Patients With SchizophreniaMany people assume that it is the emotional and psychotic symptoms that make it difficult for a person with schizophrenia to function in everyday life. In fact, research indicates that cognitive impairment is a major reason why functional outcome is so poor.1
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Treatment-Resistant Depression: Strategies for ManagementDespite advances in our understanding of depression therapy, many patients with depression remain unresponsive to treatment. As many as 50% of patients who begin treatment with an antidepressant do not respond.
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When the Psychiatrist Has PTSDFor PTSD in psychiatrists and other mental health care providers to be addressed, a major shift in medical culture and thinking is needed.
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The NICHD Study of Early Child CarePrevious research on the effects of early child care had led to controversy and confusion. The most provocative finding was that when infants were in nonmaternal child care 20 or more hours a week, starting in the first year of life, they were less likely than infants without such experience to form a secure emotional attachment to their mothers.
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Confidentiality and the Family: 5 Guidelines for Better OutcomesFamily involvement is often misunderstood as being a hindrance to individuation, when in fact family-oriented interventions can improve patient functioning, agency, and autonomy.
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Surveying Attitudes Towards Digital Mental Health68% of Americans reported their mental health could be improved.
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Intimate Partner Violence: Practical Issues for PsychiatristsThe term “domestic violence” emerged in the United States with the rise of the women’s movement in the 1970s. Before that, violence between partners was considered a private matter. A specific type of domestic violence, intimate partner violence, refers to violence between intimate partners. Public awareness campaigns help us identify one type of intimate partner violence in which one partner, typically the male partner, is the aggressor, and the other partner, typically the female, is the victim.
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Psychiatric Diagnosis and Treatment of Somatizing Neuropsychiatric DisordersAlthough the somatizing disorders cover a vast array of symptomatic domains across many medical specialties, this article addresses the broad topic conceptually.
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The Role of Cortisol and Depression: Exploring New Opportunities for TreatmentsAfter reading this article, you will be familiar with:The function of the hypothalamic-pituitary-adrenalaxis and the significance of cortisolin the etiology of depression.
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Understanding and Managing Adolescent Disruptive BehaviorThe words attributed to Socrates resonate with the perspectives of many contemporary parents and clinicians.1 The endurance of the concern suggests something fundamental about the psychopathology of deviant, disruptive behavior of youth. Yet clinicians struggle to understand its origins, to help parents control their children, and to help the children control themselves. Clinically, this manifests in failed pharmacological treatments, incompleted courses of individual therapy, problems in engaging families in treatment, and controversies over which therapy is most effective.
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The Arts and Humanities in Psychiatry . . . A DebutCreativity should not be seen as “optional” in psychiatry. Rather, it helps us to approach clinical problems in new ways.
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Treatment Resistance: Anorexia Nervosa in a Middle-Aged WomanEating disorders like anorexia nervosa are resistant to treatment. This case briefly outlines a treatment approach using a community-based, patient-centered model of care.
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This Is the Water: The Social Determinants of Mental Health and the Future of PsychiatryHere's why we need more effective training, practice, and advocacy regarding the social determinants of mental health.
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Depressive Symptoms After LossTo improve validity, we proposed extending the current MDD bereavement exclusion-which excludes “uncomplicated” (relatively brief, lacking certain severe symptoms) depressive bereavement from diagnosis-to also exclude uncomplicated reactions to other major stressors, such as romantic breakups, job loss, and serious medical diagnoses.
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Mini Quiz: Pharmacotherapy for Eating DisordersSSRIs are effective for the treatment of eating disorders, but what treatment is best for which disorder? More in this quiz.
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Stages of Change Common to All PsychotherapiesDespite their differences, all psychotherapies have these things in common—and are important to consider.
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Factitious Disorder: Detection, Diagnosis, and Forensic ImplicationsFew phenomena in medicine aremore confounding than the diagnosesinvolving deception:malingering, Munchausen syndrome,Munchausen by proxy (MBP), and factitiousdisorder.
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Violence in Bipolar DisorderWhat is the association between bipolar disorder, trauma, and violence? Here: a guide to assessing violence potential in bipolar patients.
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Management of ICH, Part IIThe prognosis for patients with intracerebral hemorrhage (ICH) is poor. The 30-day mortality rate is 25% to 50%, and half of these deaths occur within the first 48 hours.
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EEG Neurofeedback for Treating Psychiatric DisordersNeurofeedback, a way for patients to learn to create and maintain desirable brainwaves, may be an affective adjunct therapy for many psychiatric disorders. Which procedures are most effective, and what are the benefits and risks?
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Trauma and Violence in Childhood: A U.S. PerspectiveThis article reviews the Adverse Childhood Experiences (ACE) Study that examined the association between multiple childhood traumas and health outcomes in adults. These findings have significant public health implications for individuals exposed to childhood trauma, and the authors present a vision for a children's mental health care and wellness infrastructure in the United States derived from the Report of the Surgeon General's Conference on Children's Mental Health.
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Overcoming Challenges Associated With TBI, Intellectual Disability, and Developmental DisabilityYour patient walks in with signs of traumatic injury, or intellectual or developmental disability. What special considerations are necessary in assessing and treating this patient?
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The Clinical Management of Amyotrophic Lateral SclerosisAmyotrophic lateral sclerosis (ALS) is a progressive, debilitating, fatal disease that involves degeneration of upper and lower motor neurons. Patients often initially present with limb or bulbar weakness, atrophy, and spasticity, followed by progressive loss of ambulation and, ultimately, respiratory failure, which is the most common cause of death.
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Treating Comorbid Anxiety Disorders in Patients With Schizophrenia: A New PathwayIdentifying comorbid anxiety disorders as potential treatment targets may contribute to more positive outcomes for patients with schizophrenia. Details here.
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Coaching Families to Address Addiction"He'll just have to hit bottom." That bit of outdated advice can be terrifying. How do clinicians trying to help the person with an addiction who refuses to set foot in our office render assistance?
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Psychodynamic Psychiatry: A Case ReportThe author presents a fictionalized case based on a real patient to encourage colleagues to pursue psychodynamic psychiatry.
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Autism Spectrum Disorders, Down Syndrome, and 22q Deletion SyndromeWith aging, a multitude of medical conditions can occur and/or existing conditions can be exacerbated, contributing causally to or amplifying neuropsychiatric comorbidities.
