Authors
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The Behavioral Neurology of White Matter: Diagnosis of Major Disordersand SyndromesMore than 100 neurologic diseases, injuries, and intoxications are known to prominently or exclusively involve the white matter of the brain.
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Forced Medication and Competency to Stand Trial: Clinical, Legal, and Ethical IssuesThe authors examine legal and ethical challenges for the psychiatrist when a defendant who is incompetent to stand trial declines to take prescribed psychotropic medication.
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Sweet Sorrow: The Relationship Between Depression and Diabetes MellitusMultiple studies show that diabetes approximately doubles the risk of comorbid depression. Furthermore, major depressive disorder is a risk factor for the subsequent development of type 2 diabetes mellitus. Treatments for depression in the setting of diabetes must be evaluated for their effects on blood glucose levels, propensity for weight gain, possible concomitant use for diabetic neuropathy and potential drug interactions.
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Interventions for Perpetrators of Intimate Partner ViolenceSubstantial progress has been made in the development of etiologic models of intimate partner violence and interventions for individuals who assault their intimate partners. These authors provide details.
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Development of a Transdiagnostic Unified Psychosocial Treatment for Emotional DisordersResearch emerging from the field of emotion science suggests that individuals who have anxiety and mood disorders tend to experience negative affect more frequently and more intensely than do healthy individuals, and they tend to view these experiences as more aversive, representing a common diathesis across anxiety and mood disorders.1-5 Deficits in the ability to regulate emotional experiences, resulting from unsuccessful efforts to avoid or dampen the intensity of uncomfortable emotions, have also been found across the emotional disorders and are a key target for therapeutic change.
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The Effects of Age on Cognitive Deficits in SchizophreniaRecent studies have shown that patients with schizophrenia experience a greater decline in cognitive abilities with age. Given the large baby boomer population, how will this influence treatment for aging patients with schizophrenia?
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Serious Delinquency and Gang MembershipYouth gangs are a recognized risk factor for adolescent violence and delinquency. This article reviews recent research on these topics, including the prevalence, characteristics and influence of youth gangs, and discusses the implications of those findings for clinical practice.
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Post-COVID Stress Disorder: Another Emerging Consequence of the Global PandemicThe pandemic has triggered an array of emotional, physical, and economic issues but in the midst of this crisis, nations have shared and learned from each other’s experiences.
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Extraordinarily OrdinaryMy “most important achievement to date” is that I’m capable of even the simplest forms of basic cognition. I can remember, perceive, speak, feel, think, solve, and-sometimes-pay attention.
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The Relevance of New Alzheimer Guidelines for Clinical PracticeThe proposed new diagnostic categories and guidelines for Alzheimer's disease include not only dementia, but also the preclinical and mild cognitive impairment (MCI) phases of AD.
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Strategies for Treating Osteoporosis and Its Neurologic ComplicationsOsteoporosis is a disorder characterized by low bone mass and microarchitectural deterioration with resulting compromised bone strength and increased risk of fracture.1 The World Health Organization defines osteoporosis based on T-scores, which reflect bone mineral density (BMD) relative to mean BMD for healthy 25-year-old same-sex populations. A T-score between 0 and 21 is considered normal density, a score between 21 and 22.5 indicates osteopenia, and a score of less than 22.5 signifies osteoporosis.2 Severe osteoporosis is defined as a T-score of less than 22.5 combined with a fragility fracture.2
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How to Write a Suicide Note: Practical Tips for Documenting the Evaluation of a Suicidal PatientProper suicide assessment is probably the most important part of a clinician's job; appropriately, heavy emphasis is placed on this in our education. Unfortunately, psychiatrists receive comparatively little practical guidance in documenting the history and physical examination (H&P) of a suicidal patient.
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ADHD, Bipolar Disorder, or Borderline Personality DisorderADHD can present with symptoms such as irritability, mood lability, low frustration tolerance and low self-esteem, making it easily confused with mood disorders and personality disorders.
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Personalized Medicine and Psychiatry: Dream or Reality?This article explores the current state of knowledge regarding personalized medicine in psychiatry and discusses how the tools might be used to help psychiatrists understand the components of their patients’ unique endophenotypic profiles.
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Improving Understanding of Veteran Suicide Relative to VHA Service UseThe authors summarize findings from the first study to compare suicide risk for veterans who do and those who do not use VA services.
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Psychotherapy Strategies and the Chronically Suicidal PatientThe benefits of psychotherapy in treating the chronically suicidal patient, as well as strategies that can help the potential suicide patient imagine and reflect others' reactions to this most final of acts, was the subject of a conference by Glen O. Gabbard, M.D., at the 11th Annual U.S. Psychiatric & Mental Health Congress. Gabbard is the Bessie Callaway Distinguished Professor of Psychoanalysis and Education at the Karl Menninger School of Psychiatry and Mental Health Sciences.
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Pharmacotherapy, Epilepsy, and Comorbidities: Causes for ConcernMany persons with epilepsy have comorbid conditions that are treated with concomitant medications. However, patients for whom first-generation antiepileptic drugs (AEDs) are prescribed have been shown to be at high risk for drug interactions with medications that involve the cytochrome P-450 pathway, specifically antipsychotics, contraceptives, tricyclic antidepressants (TCAs), calcium channel blockers, and warfarin.
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Understanding the Neurobiological Basis of Drug Abuse: Comorbidity in SchizophreniaIt is clear that the prognosis for schizophrenia is much better when patients achieve drug abstinence, including in the domains of depression, quality of life, and community integration.
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Functional GI Disorders and PsychiatryThis article provides background information on the FGIDs for psychiatrists and a review of recent research on the biopsychosocial mechanisms that contribute to the illness experience.
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Characteristics of Sleep Disorders in WomenThis brief review addresses what is currently known about sleep problems in women. The main focus is on sleep issues that are particularly relevant to reproductive stages in a woman’s life cycle and therefore potentially linked to reproductive and/or hormonal factors.
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Assessment and Management of Sleep Disorders in ChildrenSleep disorders are very common and are often underrecognized and underreported in children. If left untreated, these disorders can cause serious developmental and physiologic problems.
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Assessing and Treating Sleep Disturbances in Patients With Alzheimer's DiseasePatients with Alzheimer's disease may suffer the same age- and disease-related changes to sleep as their age-matched peers. However, as the dementia progresses, even more severe disturbances develop, with impairments in both nighttime sleep continuity and daytime alertness. This article focuses on long-term, holistic approaches to treatment, including environmental and behavioral interventions to augment sleep medications.
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Underdiagnosing and Overdiagnosing Psychiatric ComorbiditiesDiagnostic assessment of psychiatric disorders and their comorbidities is a challenge for many clinicians. In emergency settings, there is no time to conduct lengthy interviews, and collateralinformation is often unavailable.
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The Intersection of Mental Health and Successful AgingOne consequence of the "graying" of the world's population is that psychiatrists, along with all health care professionals, will increasingly be providing services to older adults. In the United States, the first set of people belonging to the baby boom generation turned 60 in 2005, and the number of people older than 60 will soonoutnumber children for the first time in recorded history.
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Repetitive Self-Injurious Behavior: The Emerging Potential of Psychotropic InterventionRepetitive self-injury can be one of the more difficult conditions to treat. What is the biochemical basis for self-injury and how can psychiatrists treat this condition?
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Frontiers in Imaging Markers for EpileptogenesisContributing to the problem is the relative unreliability of EEG tracings recorded from patients during the interictal period. Although these tracings can reveal certain abnormalities that are characteristic of epilepsy, such as spikes, they tend to be relatively nonspecific. Interictal spikes, for instance, occur inconsistently; they are present in some persons who do not have epilepsy and absent in others who do.
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Lessons Learned in Residency: Working 5 to 9A resident describes her experience in dealing with a potentially agitated patient.
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Benefits of Early Pharmacological Treatment in Alzheimer DiseaseSuccessful intervention for Alzheimer disease requires an early and timely diagnosis. Caregivers of persons with AD often state that an average of 2 years passes from the onset of symptoms to a formal diagnosis.
