In Comfortably Numb, author Charles Barber reports that in 2002, 16% of the inhabitants of Winterset- a quintessentially American town in Iowa-had an antidepressant prescribed for them and asks, “Why did Winterset want to get numb?” With this question, Barber begins a journey through the world of psychiatry and psychopharmacology that spans most of the book.
Through patient self-management, mental health clinicians can transfer the focus from managing symptoms to allowing patients to live well in the context of their mental illness and medical comorbidities.
With more and more baby boomers turning 65 every day, there will be an enormous increase in elderly patients needing psychiatric care over the next 20 years.
The following 3 cases illustrate the diagnostic challenges related to differentiating brain injury and posttraumatic stress disorder (PTSD) in patients presenting to the emergency department (ED) in the acute period following a traumatic injury. Such patients pose a dilemma for ED clinicians because of the interplay between head injury and PTSD in the clinical presentation of cognitive impairments in the aftermath of trauma.
This article focuses primarily on the issues facing a psychiatrist who has been retained as an expert witness in a will or trust contest involving claims of a lack of capacity.
Cozolino reveals how much those “givens” have strong scientific underpinnings and underlines the urgency of re-integrating them into the training and the minds of 21st century therapists.
Half of all mental health disorders occur by age 14. Early interventions may mitigate progression to more serious and persistent mental health concerns.
There is and has been much debate about the issue of assisted suicide as physicians, lawyers and lay people argue the pros and cons of assisting in someone's death. The physician who agrees to participate in this endeavor points out that his or her concern is to alleviate suffering. Notwithstanding that, painkillers are notoriously prescribed in inadequate, understrength doses; people with serious illness who are depressed are considered unlikely candidates for treatment of their depression because, sayeth the physician: "It is only natural, understandable, to be depressed with that kind of terrible illness."
The idea that drug response could be based on a patient's genetic background first surfaced over 100 years ago. Since then, technology has advanced to the point where prescribing medications based on a patient's genetic makeup no longer seems like science fiction. This article looks at the latest research on the pharmacogenetics of psychotropic medications and shows how far we still have to go.
Parkinson disease (PD) is a progressive neurodegenerative disorder affecting 1% of people 65 years and older. The core symptoms include the motor manifestations of tremor, bradykinesia, and rigidity.
Is valproic acid dismissed out of hand? Three doctors discuss its potential as a treatment.
Trauma, by definition, is the result of exposure to an inescapably stressful event that overwhelms a person's coping mechanisms. Since it would be immoral to expose laboratory subjects to the sort of overwhelming stimuli that give rise to the dissociated sensory reexperiences characteristic of posttraumatic stress disorder (PTSD), we are uncertain to what degree the vast literature involving laboratory studies of less stressful events is relevant to understanding how people process traumatic memories.
Regulatory bodies that oversee hospitals and graduate medical education have begun to place an ever growing importance on patient safety and quality improvement, from which psychiatry is not immune. More in this case study.
This CME outlines distinguishing features of PTSD, complex trauma, and the dissociative subtype of PTSD (DPTSD), with an explanation of the distinctive neurobiological subtype of DPTSD.
What are the options for treating major depressive disorder in children and adolescents? This case offers readers a chance to give their feedback and to interact with the authors, who will present teaching points based on your comments.
An ABN is a written communication given to a Medicare beneficiary by a physician prior to providing a service that is expected to be denied by Medicare Part B.
While psychotropic medications for schizophrenia, bipolar disorder, and other psychiatric disorders can cause weight gain, patients can take small steps to improve their health.
Here's compelling reason for judicious use of restraint and seclusion, and a review of various alternative approaches.
Which sleep parameters are increased in alcohol use disorders? Take the quiz and learn more.
Billing 99213 for individual patients seen together in a group visit is fraud.
Delirium is characterized by an altered level of consciousness, decreased attention span, acute onset, and fluctuating course. Approximately 15% of elderly patients admitted to the hospital have delirium as a presenting or associated symptom. Delirium will develop in another 15% of elderly patients during hospitalization.
A 20-year-old college sophomore with “depression and anxiety,” who is exercising ferociously and who is literally dying to lose more weight sets the stage.
BPD appears to be a neurodevelopmental disorder, influenced by the person’s genetics and brain development and shaped by early environment, including attachment and traumatic experiences.
Ringing the Bell to Save the Bereavement Exclusion.
Tuesday's oral arguments on the Affordable Care Act produced at least one truly riveting exchange.
Comparing the consequences of caregiving across countries for a person with a serious mental illness needs to take into account not only different languages, but also different cultures, quality of mental health services and standards of living. So far, one questionnaire has shown the most validity and become the exemplar in cross-national research; yet it is still not free from possible cultural bias or criticism from its creators who acknowledge that much more research needs to be done.
Although most studies have focused on the risk of metabolic syndrome for patients with schizophrenia exposed to atypical antipsychotics, other psychiatric patients appear to be at risk for metabolic disturbances as well.7-9 Major depressive disorder (MDD) may be of particular interest because it is much more common than schizophrenia and is treated with a broad range of psychotropics.
"I've lost my interest in sex." As psychiatrists, we hear this concern (if we ask) from women in a variety of situations: those who are depressed, postpartum, menopausal, traumatized, and those who have been treated with psychotropic medications. Thankfully, we have many interventions, both behavioral and pharmacological, to use in addressing sexual issues.
People feel free to post comments on social media sites that they would never dare say to someone’s face. The cure, if only a partial one, is to get out of social media and to start living a real life. What is your opinion on this issue?