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Psychiatry and Chronic PainAlthough acute pain typically resolves on its own with little need for intervention, for some persons pain persists past the point where it is considered an adaptive reaction to injury.
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Who Was Karen Horney?Knowing from the start how a personality is organized, especially as theorized by Karen Horney-appreciating the primary and repressed moves of the patient, inner dictates, claims, idealized image, and intrapsychic defensive maneuvers-makes the help we offer most likely to succeed.
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Comorbid Schizophrenia and Substance Use-Moving Toward Improved Functional OutcomesPharmacological and nonpharmacological strategies to treat and manage comorbid schizophrenia and addiction concern psychiatrists who are learning strategies to help improve functional outcomes.
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Advances in Schizophrenia in 2016The year 2016 marks a critical time in our understanding of and approaches to treating schizophrenia spectrum disorders.
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The ABCs of Cognitive-Behavioral Therapy for SchizophreniaThis article examines the use of cognitive-behavioral therapy for psychosis, the evidence for its use, and the implications for practicing psychiatrists given the short-comings of pharmacologic therapy.
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The Complex Interaction of Cognitive IssuesCognitive impairment is a common symptom in many psychiatric and neurologic conditions. The articles selected for this Psychiatric Times special report provide a sampling of some important and topical issues regarding the influence of various factors on cognition in individuals with neuropsychiatric conditions.
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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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Culture and Substance Abuse: Impact of Culture Affects Approach to TreatmentThere have been numerous definitions of culture. Dwight Heath1 offers a simple definition: "It [culture] is a system of patterns of belief and behavior that shape the worldview of the member of a society. As such, it serves as a guide for action, a cognitive map, and a grammar for behavior."
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Treating Adolescents With Major Depression and an Alcohol Use DisorderAlcohol is the drug of choice for adolescents, with cigarettes and marijuana being second and third. Contrary to widespread belief, alcohol dependence is most common in 18- to 20-year-olds, with progressively decreasing rates of alcohol dependence in older age groups.
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Caught in Limbo Between Law and PsychiatryThe case of dentist Charles Sell, who suffers from delusional disorder, still awaits resolution. In the meantime, Sell remains incarcerated while his competency to stand trial is debated. Does this serve justice?
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Working With Patients on a Noninvasive Alternative to SurgeryA comprehensive treatment plan is a systematic, thorough, painstaking therapeutic program that takes time for implementation and results
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Adaptation and Implementation of the Integrated Dual Diagnosis Treatment Model Into a Psychiatric Inpatient Facility: A 12-Year PerspectiveAs early as the 1970s, researchers and practitioners became increasingly aware of the necessity for services that would address the varied needs and treatment implications for consumers with the co-occurring disorders of substance abuse and mental illness. High percentages of consumers in substance abuse treatment centers were identified with mental illness disorders, and consumers admitted to psychiatric facilities often were identified as having additional substance use disorders.
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Mini Quiz: Impulsivity Risk FactorsImpulsivity has long been thought to be an important risk factor for depression and suicide. But recent research suggests that the reality might actually be counterintuitive.
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Bipartisan Mental Illness PlanThe abysmal conditions in state mental hospitals in the 1940s were caused by 3 factors, none of which are now true. Let’s explore.
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The Theory of Self-Medication and AddictionTo understand and to feel understood is a powerful antidote to relieve human psychological suffering. Therein lies the heart of the self-medication hypothesis of addiction.
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Assessing ADHD in Preschool ChildrenDo you know these 10 signs that may help you differentiate early signs of ADHD from the “typical” behavior of a 3- to 4-year-old?
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Clinical Implications of Substance Use on Suicidality Among YouthsBoth the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry have identified substance abuse as a top risk factor for suicide in youths.
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Psychobiological Aspects of Antisocial Personality Disorder, Psychopathy, and ViolenceThe key focus is on understanding violent offending (eg, reactive, proactive, firearm violence) tied to antisocial personality disorder and psychopathy using a psychobiological lens.
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Assessment and Diagnosis of Posttraumatic Stress DisorderThis article, based on a comprehensive review by Weathers and associates, provides a selective and brief summary of trauma and PTSD assessments in adults.
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Can Atypical Antipsychotics Reduce Suicide Risk in Patients With Schizophrenia?Suicide is a devastating, tragically frequent outcome for persons with varying psychiatric conditions, including schizophrenia. An estimated 5% to 10% of persons with schizophrenia commit suicide and 20% to 50% attempt suicide during their lifetime.1,2 Patients with schizophrenia have more than an 8-fold increased risk of completing suicide (based on the standardized mortality ratio) than the general population.3
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Cultural Variables in PsychiatryIn modern practice, psychiatrists will invariably have patients who come from different ethnic or cultural backgrounds. Practitioners will need to consider socioeconomic status, diet, use of herbal medications and immigration status, as well as patients' own self-perception of ethnicity, in assessing patients and planning treatment.
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HIV and Psychiatric IllnessMost estimates suggest that there are just over a million persons living with HIV/AIDS in the United States. According to CDC data, between 2001 and 2005, an average of 37,127 new cases of HIV infection, HIV infection and later AIDS, and concurrent HIV infection and AIDS were diagnosed each year.
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Comorbid Depression and ADHD in Children and AdolescentsADHD, the most common diagnosis in child psychiatry, appears to be more challenging to diagnose and treat when there is a comorbid depressive disorder.
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Life Lessons Learned From AddictionsA reminder that success in life requires paying attention to the basics, starting with showing up and hanging in there.
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New Directions in PsychiatryIn order to make positive changes in the field of psychiatry, it is important to appreciate and understand the current challenges and significant limitations of the present approach to psychiatric therapy.
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Neuropsychiatric Aspects of Traumatic Brain InjuryEach year, more than 2 million individuals in the United States sustain a traumatic brain injury. Increased vigilance for previously undiagnosed or incidental TBIs in general mental health populations may lead to more effective clinical management.
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Treatment for Cocaine DependenceDr Edward Nunes discusses the latest evidence from research studies on stimulant and cocaine dependence in this podcast.
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Cognitive Therapy: What Is Its Role in Depression Treatment?Although cognitive therapy (CT) is the best-studied form of psychotherapy, its effectivenes compared with antidepressant medication remains controversial. Over the years, there has been some variability in the results of randomized controlled trials and other types of clinical trials, as well as meta-analyses.
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Improving the Mental Health System by Addressing Core ProblemsWhat psychiatry needs is a new approach to “psychiatric theory.” Here are a few practical suggestions.
