Psychotherapy 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.
Parents 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?
There 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.
What psychiatric illnesses are most prevalent among veterans? And how can clinicians help them overcome obstacles to care?
In 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.
This 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.
Studies have shown that many pharmacologic agents are effective in the treatment of acute mania and bipolar relapse education.
Impulsive 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.
The 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
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.
Unhinged 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.
What factors predispose patients to TRD and what treatment strategies achieve response? Find out here, with a bonus case vignette.
In 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.
This review provides an overview of the efficacy, safety, and mechanisms of action in the treatment of depression.
The authors describe an alternative model for BPD diagnosis that is dimensional in nature and requires fulfillment of 4 of 7 personality traits.
The average patient with bipolar disorder struggles with sleep disorders. Here's how you can help.
Stopping 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.
Recent reports have noted an alarming decrease in the practice of psychotherapy among psychiatrists.
This 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.
Here we present an excerpt from a screenplay to commemorate the 70th anniversary of the liberation of the concentration camps.
I 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.
The effects of climate change are severe and global, affecting world economies, triggering migrations and wars, and having profound effects on mental and physical health.
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.
Anxiety 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.
It 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.
The 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
New insights into neural pathways that play a role in anorexia nervosa, bulimia nervosa, and binge eating disorder.
Research 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.
Here: a review of the definition of sexual harassment, its prevalence among physicians and medical students, its potential impact on physicians and trainees, and guidance about its management.
How do foods containing tyramine (eg, aged cheeses, fermented foods, cured meats) interact with some psychiatric medications?