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Custody DisputesCustody disputes often produce anxiety for all involved. Whether you are a treating child psychiatrist or custody evaluator, it is imperative to have a clear idea of your role.
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Treating Tobacco Dependence in Patients With Psychiatric ComorbiditiesWhat does the new set of U.S. Public Health Service guidelines for treating tobacco dependence say? Should everyone, regardless of mental health status, receive treatment?
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Traumatic Brain Injury Among Veterans Returning From Afghanistan and IraqThis article addresses the epidemiology, diagnosis, and treatment of mild TBI among combat veterans, with a particular focus on blast injury and the presence of comorbid posttraumatic stress disorder (PTSD).
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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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Where Psyche Meets Soma in AsthmaAsthma is a serious health condition that can be exacerbated by emotional triggers. Furthermore, depression in these patients can affect treatment compliance, thus worsening prognosis. What role does psychiatry play in treating these patients?
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Mini Quiz: Physical Assault in the Clinical SettingVerbal de-escalation involves validating a patient’s experience, establishing a collaborative relationship, and finding solutions to ensure the patient’s needs are met. More in this quiz.
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Strategies to Reduce and Prevent Restraint and Seclusion in Pediatric PopulationsHere's compelling reason for judicious use of restraint and seclusion, and a review of various alternative approaches.
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The Vote on Tutu: Fair Hearing?More details on the APA Assembly meeting in Washington discussing Desmond Tutu being designated as convocation speaker for the American Psychiatric Association’s recent annual meeting.
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The Border Zone Between bvFTD and Primary Psychiatric DisordersIn this CME, learn more about frontotemporal lobar degeneration and the several overlapping syndromes that it encompasses, as well as how to distinguish behavioral variant frontotemporal lobar degeneration from other psychiatric disorders.
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The NIMH Research Domain Criteria (RDoC): New Concepts for Mental DisordersThe Research Domain Criteria (RDoC) program: how it evolved, clinical applications, and goals.
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Frontolobular Cystic Mass and Hydrocephalus in Woman With Headache and LethargyA previously healthy 35-year-old woman was admitted to a New York City hospital after presenting to the emergency department (ED) with a 10- to 14-day history of generalized weakness, progressive frontal headache, and lethargy. She immigrated to Brooklyn, New York, from urban Haiti 9 years previously and had not returned to Haiti since. She denied any recent travel elsewhere and had no pets. An HIV antibody test, performed 4 months before ED presentation, was negative.
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Pay-for-Performance: Is It Quality or Cost That Matters?Insurance, Medicare, Pay-for-performance, P4P
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Treatment of Depression in Adolescents: TADS Results and Future DirectionsThe Treatment for Adolescents With Depression Study (TADS) represents the single largest and potentially most informative clinical trial of adolescents with depressive illness. The overall aim of the study was to investigate the effectiveness of standard interventions for adolescent outpatients with moderate to severe depression.
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Healthcare Policy: From Washington, D.C., to Your PracticeI believe that holistically understanding health policy - as seen through both “donkey” and “elephant” eyes - makes me a better clinician.
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Adult Implications of Childhood MaltreatmentMaltreatment at an early age casts a very long shadow. Here: a look at the long-term effects of early childhood trauma.
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Update on AutismAutism is demanding increased attention by professional and lay audiences; prevalence seems to be increasing. There are differing opinions about whether the increase is due to greater recognition and reporting, diagnostic expansion and substitution, or increasing acceptability.
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Post-TBI Gait RehabilitationHypertonicity in plantar flexion is a frequent complication of traumatic brain injury (TBI), which affects more than 1.5 million persons in the United States.
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Climate Disruption and the Psychiatric PatientWhile some psychiatrists may doubt the connection between climate disruption and psychiatric disorders, the evidence is growing stronger every day.
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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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Tips for Conducting Disability EvaluationsPsychiatrists may find themselves embroiled in matters that extend beyond the routine doctor-patient relationship unless they are clear about the differences between their treatment and forensic roles.
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Correctional Psychiatry: Room for ImprovementDr Jeffrey Metzner's brief article, "Evolving Issues in Correctional Psychiatry" (Psychiatric Times, September 2007) related many of the difficulties and complexities of the corrections world; however, it did not mention the greatest problem of all--"deinstitutionalization," which, over the past half century, has resulted in the wholesale diversion of patients with chronic mental illnesses--many of whom cannot be managed as outpatients--from hospitals to jails and prisons.
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SSRI Prescribing Rates and Adolescent Suicide: Is the Black Box Hurting or Helping?Suicide is the third leading cause of death in younger (10- to 14-year-old) adolescents in the United States and the leading cause of death in this age group in other countries, including China, Sweden, Ireland, Australia, and New Zealand.
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Insights Into Depression & Anxiety: Living With an Ambiguity in Clinical Practice: Antidepressant Drug-Drug InteractionsInsights Into Depression & Anxiety: Living With an Ambiguity in Clinical Practice: Antidepressant Drug-Drug Interactions
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Study Links CSF and Brain Imaging for Identifying DementiaMeasuring amyloid-beta (Abeta) protein levels in cerebrospinal fluid (CSF) and using positron emission tomography (PET) to image amyloid in the brain might become the best diagnostic test for presymptomatic Alzheimer disease (AD), according to a study published online in December 2005 and appearing in the March issue of Annals of Neurology.
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Computerized Neurocognitive Tests in Clinical PracticeAs with most tests in medicine, the results of computerized neurocognitive tests are not diagnostic, but they are useful adjuncts to the diagnostic process.
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PTSD, the Traumatic Principle and LawsuitsThe most common psychiatric sequelae following trauma include major depressive disorder, somatoform pain disorder, adjustment disorder and posttraumatic stress disorder (PTSD). In law, trauma that precipitates PTSD is viewed as a tort, which stems from the root word "torquere" (to twist), as does the word torture. In a sense, plaintiffs do allege torture in personal injury cases. A tort constitutes a civil or private wrong, as opposed to a criminal wrong, and rests on the general principle that every act of a person causing damage to a legally protected interest of another obliges that person, if at fault, to repair the damage (Slovenko, 1973).
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Understanding and Treating Bipolar DepressionBipolar disorder is a longitudinal disorder defined by multiple episodes that may occur years apart. As a result, the proper diagnosis requires careful evaluation of both the current symptoms and the patient’s history.
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Introduction: The Successful Management of PsychosisIn the first of a two-part Special Report, the evaluation and management of psychosis is explored across a range of disorders and clinical contexts.
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Update on Diagnosis and Treatment of Alzheimer DiseaseAlzheimer disease (AD) affects between 6% and 8% of Americans older than 65 years. As the population of older adults increases, the number of persons with AD is expected to rise from 4.5 million in 2000 to 13.2 million by 2050.1 This disease is important not only because of the number of patients affected but also because it leads to significant physical and emotional burdens on families and caregivers.
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Considering PTSD in the Treatment of Female Victims of Intimate Partner ViolenceThe distress and functional impairment associated with PTSD may make it difficult for IPV victims to benefit from interventions to increase their safety and reduce their exposure to violence. Empirically supported PTSD treatments include pharmacotherapy and cognitive behavioral therapy. Incorporating these treatments into interventions to improve victims' safety and reduce exposure to violence may improve their effectiveness in protecting women from IPV.
