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Inflammation and Treatment Resistance in Major Depression: The Perfect StormNew findings provide powerful evidence that inhibition of inflammation or its downstream effects on mood may open up a host of new approaches to treatment for depression, especially for patients with treatment-resistant depression.
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Forensic Issues in Child Sexual Abuse AllegationsWhen sexual abuse is alleged, children may face investigative interviews, family disruptions, a change in their school environment, mental health counseling, and even trial court testimony.
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Implementation of a Diet Program for Inpatients With SchizophreniaWeight gain is a major concern in patients with schizophrenia, especially in those taking atypical antipsychotics. Although the exact mechanism of weight gain associated with atypical antipsychotics is unknown, we often hear patients complain about an increase in appetite and a decrease in satiety.
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Psychotherapy with Opioid-Dependent PatientsPsychotherapy as a sole treatment for noncoerced opioid addicts in outpatient settings has been shown to have little patient interest and low chances for success. However, when integrated into a treatment plan that includes methadone maintenance and drug counseling, it can be associated with additional benefits for patients who have moderate to severe levels of psychiatric symptoms.
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Intergenerational Transmission of Trauma: An Introduction for the ClinicianParents who have witnessed traumatic events may pass dysfunctional life views on to their children. How much more vulnerable are these second-generation victims to PTSD and other psychiatric disorders?
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Neurostimulation Treatments in Psychiatry: An Overview and Recent AdvancesThere have been considerable advances in the research on and clinical use of neurostimulation for psychiatric disorders, especially mood disorders and MDD. Three of the most recognized are reviewed here. An experimental new treatment-- trigeminal nerve stimulation-- is also briefly discussed.
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Treatment of Military PopulationsWhat psychiatric illnesses are most prevalent among veterans? And how can clinicians help them overcome obstacles to care?
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The Dialogue Between Science and ArtIn a variety of creative fields, psychiatrists have been portrayed in many ways. This Special Report is psychiatry's turn to address creativity with offerings as diverse as the creative arts themselves. From Shakespeare to rock 'n' roll, there's something for everyone.
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Introduction: The Inflammation ConnectionThis 2-part Special Report devotes itself to the new inflammatory world that clinicians and researchers find themselves in. Most of our prior and current preconceptions about the role of immunity and mental illness have been-and are-wrong.
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Bipolar Disorder: Increasing the Effectiveness and Decreasing the Side Effects of TreatmentStudies have shown that many pharmacologic agents are effective in the treatment of acute mania and bipolar relapse education.
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The Conceptualization and Role of Impulsivity: Bipolar Disorder and Substance AbuseImpulsive behaviors play an important role in both bipolar and substance abuse disorders. However, results of studies investigating this link are often ambiguous, in part, due to the multidimensional nature of the impulsivity construct and the fact that many studies use a single measurement technique. We describe a model of impulsivity characterized by three components: response initiation, response inhibition and consequence sensitivity. How these components differ from one another in terms of their use, behavioral theory and biological function is discussed, along with measurement techniques.
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Continuation Treatment and Relapse Prevention in Pediatric DepressionThe prevalence of depression in children and adolescents ranges from 2% to 8% in the general population, which indicates that depression in this population is a major public health concern.1-3 This is especially apparent when rates of depression are compared with other serious medical conditions in childhood, such as diabetes, which has a prevalence of 0.18%.4 The burden of depressive illness-including significant functional impairment in interpersonal relationships, school, and work-on the developing child has been well documented. Affected youths are frequently involved in the juvenile justice system.5-8 Furthermore, adolescents with depression are at increased risk for substance abuse, recurrent depression in adulthood, and attempted or completed suicide.3,9-15
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Children and Video Games: How Much Do We Know?There is no shortage of hyperbole when politicians of all stripes describe the nature and effects of video games. Republican presidential candidate Mitt Romney proclaimed, "Pornography and violence poison our music and movies and TV and video games.
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Unhinged: The Trouble With Psychiatry-A Doctor’s Revelations About a Profession in CrisisUnhinged is one of many books published in the past few years critical of psychiatry. A book of scandals and debates, and a polemic of sorts-a “trahison des clercs”-rather than an intellectual discussion about psychiatry. Therein lies the trouble with psychiatry.
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6 Signs Your Patient Is at Risk for Treatment-Resistant DepressionWhat factors predispose patients to TRD and what treatment strategies achieve response? Find out here, with a bonus case vignette.
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Depression, Stress and the Risk of Heart DiseaseIn recent years, depression and stress have emerged in the discussion of the impact of psychosocial aspects on coronary heart disease. Several studies indicate that these factors result in risk elevation comparable to hypercholesterolemia and hypertension.
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The Use of Omega-3 Fatty Acids in Treatment of DepressionThis review provides an overview of the efficacy, safety, and mechanisms of action in the treatment of depression.
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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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New Directions for Insomnia and Bipolar DisorderThe average patient with bipolar disorder struggles with sleep disorders. Here's how you can help.
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The Role of Electronic Cigarettes for Tobacco Dependence TreatmentStopping smoking affects the metabolism of a number of drugs used in the management of mental illness. Here, a summary of the author's published study on whether e-cigarettes with nicotine were more effective for smoking cessation than nicotine patches.
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In Support of Early Psychotherapy TrainingRecent reports have noted an alarming decrease in the practice of psychotherapy among psychiatrists.
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Fee Agreements: What Works, What Doesn’t- and How to Use ThemThis article reviews the many forms of fee agreement and notes the important factors to consider as well as questions to ask to properly assess and vet what may be best for one’s practice.
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Scene From The Fall: Mental Ward US Military Hospital, Nuremberg, GermanyHere we present an excerpt from a screenplay to commemorate the 70th anniversary of the liberation of the concentration camps.
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Scared of HeightsI am scared of heights. As a psychiatrist, it’s faintly embarrassing to have such a phobia-but given that I live in a Boston suburb, not the Rockies, it’s a problem that hardly ever comes up. Ski lifts and I don’t get along all that well, but other than that, I barely ever think of this as an issue in my life.
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Climate Change and Mental HealthThe effects of climate change are severe and global, affecting world economies, triggering migrations and wars, and having profound effects on mental and physical health.
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Treating Complex Trauma SurvivorsThis 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.
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Cognitive Impairment in Patients Receiving Cancer ChemotherapyAnxiety and depression are the most often cited problems related to a cancer diagnosis, because receiving this diagnosis is often very frightening. Feeling sad, worrying relentlessly, and being unable to experience pleasure often lead people to feel that they may be on the path to losing their minds. However, in the past few years a more subtle phenomenon has been identified related to cognitive deficits allegedly associated with chemotherapy treatment, sometimes called chemobrain.
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Treatment for Cannabis Use Disorders: A Case ReportIt is vital that psychiatrists are able to identify and characterize cannabis use disorders; provide education; and offer effective, evidence-based treatments. This article provides a brief overview of each of these topics.
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Cognitive-Behavioral Therapy for Adolescent DepressionProcesses of Cognitive ChangeThe substantial and often recurrent distress and impairment associated with major depressive disorder (MDD) in youth has prompted increased interest in the identification and dissemination of effective treatment models. Evidence supports the use of several antidepressant medications, specific psychotherapies, and, in the largest treatment study of depressed teenagers, the combination of fluoxetine and cognitive-behavioral therapy (CBT) as effective treatments.1-3 CBT is the most extensively tested psychosocial treatment for MDD in youth, with evidence from reviews and meta-analyses that supports its effectiveness in that population.3-5
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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.
