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Hard Choices: Whether and How to Address SUDEP With Epileptic PatientsNeurologists have always faced tough decisions when it comes to sudden unexpected death in epilepsy (SUDEP). Not the least of these is how to explain to bereaved family members what happened to their loved one and how it could have been prevented, because no one really knows.
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Mini Quiz: Informed ConsentWho wrote the legal opinion that is considered to be the birth of the informed consent doctrine?
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Hoarding in Late Life: Implications for CliniciansDSM-5 criteria for hoarding disorder necessitate that the hoarding behaviors cause clinically significant impairment in the patient’s ability to function.
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Confabulation: A Bridge Between Neurology and Psychiatry?Mr A is a 73-year-old resident of a nursing home, where the irate aides describe him as “a liar and a troublemaker.” Mr A’s “stories” were regarded by the staff as deliberate mischief on his part.
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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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A Brief Overview of Child-Parent PsychotherapyChild-parent psychotherapy has been shown to be an effective treatment in helping caregivers and their children when they have experienced significant life trauma, often domestic violence. More in this podcast.
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Assessing Psychosis: A Clinician’s GuideMethods of identifying and understanding the intricacies of psychosis in clinical settings.
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Behavioral and Emotional Problems Among Children of Drug AbusersBehavioral and Emotional Problems Among Children of Drug Abusers
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Marketing Off-Label Uses: Shady Practices Within a Gray MarketFor pharmaceutical companies, off-label use of a drug represents a substantial “gray market,” to which the company is unable to sell their product directly, yet may be a significant revenue stream. Some drugs have been used more for off-label purposes than for originally approved indications.1
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Taking Culture Into Account When Assessing a Young PatientThis list serves as a guide when treating persons of diverse cultures and backgrounds.
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Financial Policies, Money Transference, and NonpaymentThe goal of this article is to further assist psychiatrists in tackling some of the more difficult financial issues in hopes of managing and reducing risk.
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Drug Therapies for the Neurobehavioral Sequelae of Traumatic Brain InjuryTraumatic brain injury (TBI) is one of the most common causes of morbidity and mortality, especially in young adults. Recognition and early accurate diagnosis of neurobehavioral TBI sequelae are important in reducing the severity of postinjury symptoms. Sequelae of TBI include cognitive impairments, personality changes, aggression, impulsivity, apathy, anxiety, depression, mania, and psychosis.
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PTSD and Suicide After Natural DisastersThis article summarizes literature on post-disaster mental health and describes the public health crisis in Puerto Rico. Special attention is given to highlight higher suicide rates and PTSD that develop in post-disaster areas.
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The Psychiatric Dimensions of NarcolepsyNarcolepsy, cataplexy: symptoms are broad and associated with a range of medical and psychiatric comorbidities. Here: diagnostic and treatment strategies and a look at the BOND study.
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An Expectation to HealIn a tale of two cases, the author comes to realize he is but one agent of change in the lives of his patients.
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7 Medical Illnesses That May Present as AnxietyBeyond psychosocial implications of anxiety disorders, an array of physiological effects may ensue.
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Mini Quiz: Perinatal DepressionYour patient is excited to be pregnant. She is currently on sertraline, and has been stable on this for many years. She is very insistent that she would like to stop her medication. What should you do?
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ADHD and Substance Use: Current Evidence and Treatment ConsiderationsBecause comorbid substance abuse is the rule rather than the exception in individuals with ADHD, accurate diagnosis, prognosis, and management of ADHD is challenging even for the most skilled practitioners.
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The Neurobiology of Cocaine Dependence and Its Clinical ImplicationsCocaine dependence is a devastating disorder that is associated with a host of medical and psychosocial risks. This complex disorder is made up of distinct clinical components that are interwoven into a cycle of addiction (Figure 1). Cocaine activates ancient pleasure centers that dominate our thoughts, behaviors, and priorities, producing a pleasure-reinforced compulsion to use the drug. Repeated use dysregulates brain pleasure centers and paves the way to addiction through craving and impaired hedonic function.1 Euphoria and craving drive the cycle of addiction through positive and negative reinforcement, respectively, and they provide targets for pharmacological interventions.
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Why Aren’t We All in Therapy?The looming specter of emotional and physical exhaustion in residency often takes hold well into a physician's career. So what are we doing about it?
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Unraveling the Threads of Trepidation: The Prevalence and Evolving Contours of Anxiety and Traumatic StressAn understanding of evolving risk factors and pathophysiology is vital to optimal clinical management of anxiety disorders and PTSD.
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Mini Quiz: Treatment-Resistant Bipolar DisorderWhat are the guidelines for working with patients who do not respond to FDA-approved medications for bipolar disorder?
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Pathological Lying: Symptom or Disease?Mr A was desperate. He was about to lose yet another job, not because he was at risk for being fired, but because his lying behavior had finally boxed him into a corner. He had lied repeatedly to his colleagues, telling them that he had an incurable disease and was receiving palliative treatment. . .
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Compromised Confidentiality Is Harmful: Military Owes Proof to the ContraryGiven that rates of military suicide have risen to unprecedented levels, the burden of empirical proof in support of weak military mental health confidentiality standards is squarely on the military.
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Identifying and Reducing Professional Liability When Treating Older AdultsActions You Can Take to Decrease Risks While Increasing Patient SafetyIdentifying and Reducing Professional Liability When Treating Older Adults, by Jacqueline M. Melonas, RN, MS, JD and Charles D. Cash, JD, LLM, ARM
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Venlafaxine in the Treatment of Depression: Practical ConsiderationsVenlafaxine (Effexor) is a novel antidepressant recently released to the American market. Its entry into the antidepressant market has been much heralded. The lay press has described the drug as "Prozac with a punch," and many patients were asking for it long before it was available. As the hoopla settles down, we are learning that venlafaxine is a potentially important drug with both advantages and disadvantages over other available antidepressants, including the selective serotonin reuptake inhibitors (SSRIs).
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Metabolic Syndrome in Patients With Major Depressive DisorderAssociated Risk FactorsAlthough 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.
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A Spirited Defense of ECT: From Our ReadersA Psychiatric Times point/counterpoint feature on electroconvulsive therapy elicited strong responses.
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AIDS Dementia: Current Status and New Treatment ApproachesAIDS Dementia: Current Status and New Treatment Approaches
