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The Maintenance of Certification Exam as FetishIn the opinion of this psychiatrist, the point of the MOC test isn’t to measure competence, but to convey the impression that competence was measured. The point of the test is to say that a test was given-and nothing else. More in this commentary.
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Physician, Heal ThyselfOsama Bin Laden is dead. 9/11 lives on. The sudden annihilation of the man responsible for that cruel and ultimately defining act brought me joy, and rekindled a sense of pride in our country and its capabilities.
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From Our ReadersThe totalitarian system as we know it today may also be called 'managerial capitalism' since the decisions dictated by technical and economic considerations are no longer hampered by the rights of ownership and title holders. Yet it should be emphasized, speaking of 'managers,' that the true technical directors have nowhere acquired the disposing power of technocrats; the real power rests mainly with economic and business managers. This was written by H. Bruggers in 1941 in his "Stages of Totalitarian Economy," in the publication Living Marxism.
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Anxiety and Depression in a Psychiatrically Informed Pain Medicine PracticePatients with chronic pain and head injury frequently have comorbid anxiety and depressive disorders, with depressive disorders appearing to be more predominant. A number of studies show that depressive spectrum illness develops in 40% to 80% of patients with chronic pain; in a majority of these cases, the mood disorder is caused by chronic pain.
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Neuronal Plasticity and Mood DisordersRecent evidence suggests that reorganization of neuronal connectivity might play an important role in the pathophysiology of mood disorders and in both pharmacological and psychological treatments of depression. This evidence suggests a new framework for the etiology of mood disorders that focuses more on the problems in neuronal connectivity, plasticity and information processing in the brain than on abnormalities in chemical neurotransmission. Although this framework is still controversial and far from being complete, improved familiarity with the concepts of neuronal development and activity-dependent plasticity among mental health professionals would be useful.
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Psychiatry and ArtFreud famously quipped: "The creative writer cannot evade the psychiatrist nor the psychiatrist the creative writer."
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Psychiatric Consultation to the Postpartum MotherThe authors examine the potential areas of concern during the postpartum period, as well as practical approaches to differential diagnosis and treatment.
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Identifying and Treating Common Psychiatric Conditions Comorbid with Myalgic Encephalomyelitis and/or FibromyalgiaThis article reviews the diagnostic criteria for both myalgic encephalomyelitis and fibromyalgia and describes how to differentiate them from depressive and anxiety disorders, the psychiatric conditions with which they are most often confused.
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Does Marijuana Withdrawal Syndrome Exist?The question of whether a clinically significant marijuana (cannabis) withdrawal syndrome exists remains controversial. In spite of the mounting clinical and preclinical evidence suggesting that such a syndrome exists, the DSM-IV does not include marijuana withdrawal as a diagnostic category.
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Introduction: Impulsivity-A Transdiagnostic TraitThe topics selected for this special issue highlight the broad relevance of this symptom domain to clinical practice in psychiatry and beyond.
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The Federal Government Ignores the Treatment Needs of Americans With Serious Mental IllnessFor too long the treatment needs of the seriously mentally ill have been ignored by SAMSHA, and this needs to change, says this psychiatrist.
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Integrating Psychosocial Treatment for PTSD and Severe Mental IllnessPatients with severe mental illness (SMI), such as schizophrenia, bipolar disorder, and major depression, are more likely to have experienced trauma in childhood, adolescence, and throughout their adult lives than the general population. This high exposure to traumatic events such as physical and sexual abuse and assault takes a heavy toll.
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Treatment of Insomnia in Anxiety DisordersHow often do insomnia and anxiety disorders coexist? And how best to treat patients with comorbid insomnia and anxiety? Answers here..
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A Look at the Ethical, Legal, and Clinical Issues Associated With Information TechnologyNew technologies pose challenges in the need to maintain boundaries and confidentiality. The same boundaries and ethical standards that existed in the 20th century must be thoughtfully applied with all new and developing technologies of the 21st century.
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Introduction: Mental Health Correlates of TraumaOver half of the population is exposed to at least one lifetime traumatic event, yet relatively few of those exposed have lasting psychiatric sequelae. As psychiatrists, we attend to the needs of those who suffer.
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Outside the Pill Box: The Systems-Based Practice of PsychiatryMeet "Gary," whose case provides an introduction to the value of systems-based practice.
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Dispatch From the Repressed-Memory Legal FrontDespite the fact that recent juries have discounted repressed-memory testimony as viable, the emotional cost of such cases still takes its toll. Why are such cases so controversial, and how can psychiatrists avoid their pitfalls?
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Recognizing and Addressing Domestic Violence: Issues for PsychiatristsA cultural shift has occurred and intimate partner violence (IPV) is no longer defined as a family affair, but one that has lasting effects on the individual, the family, and the community.
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Evacuation of Psychiatric Inpatients from Bellevue Hospital Post Hurricane SandyIn the immediate aftermath of Hurricane Sandy, incarcerated psychiatric patients at Bellevue Hospital had to be evacuated. Because the hospital was flooded and without power, those inpatients had to be moved without the help of elevators, electronic or phone communication, or even running water.
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Group Therapy Requires Good Clinical Judgment, Careful Screening"You really have to prepare patients for group treatment and have to compose your groups and select patients for that particular group with some care."
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What Depression Does to Our Minds When It Attacks"Depression is overwhelming and overpowering, and it crushes its prey." Here: a pediatrician tells of her 40-year battle with severe depression, and offers insights about how to talk with someone who is depressed.
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Optimizing ADHD TreatmentWeight-based dosing strategies have been used in psychostimulant studies for ADHD in children between the ages of 6 and 12 years. The efficacy of weight-based psychostimulant doses changes throughout early childhood and into adolescence in ways that are not in keeping with weight-based dosing practices. Future treatment and research must explore new possibilities in order to afford patients the most benefit for the least amount of effective drug intervention.
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Psychological Therapies for Schizophrenia: Family and Cognitive InterventionsPsychological Therapies for Schizophrenia: Family and Cognitive Interventions
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The Perinatal Psychiatric ConsultationWhat happens when our patients get pregnant or plan to get pregnant? What if psychiatric illness manifests during pregnancy or the perinatal period? Dr Elizabeth Fitelson answers these questions and more in this video.
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Understanding and Managing Psychosis in Late LifeAlthough late-onset psychosis is not as common as the early-onset variety, it can still pose difficulties in diagnosing and treating patients. How are patients with late-onset psychosis different from those who have early-onset, and what sorts of issues should clinicians be aware of?
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Confidentiality and the Family: 5 Guidelines for Better OutcomesFamily involvement is often misunderstood as being a hindrance to individuation, when in fact family-oriented interventions can improve patient functioning, agency, and autonomy.
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Exploring the Link Between Conduct Disorder in Adolescence and Personality Disorders in AdulthoodThe evidence showing a relationship between mental disorders in childhood and adulthood has increased in the last several decades.
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Circadian Rhythms Factor in Rapid- Cycling Bipolar DisorderAt this time, both patients and professionals seem to have an unprecedented interest in circadian rhythms. We now know that the body's clock is located in the suprachiasmatic nucleus (SCN) of the hypothalamus, and that the SCN regulates the pineal gland's secretion of the hormone melatonin.
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Cyberbullying and College Students: What Can Be Done?Clinicians have a powerful voice that can be used to address cyberbullying, improve campus climate, and support a positive undergraduate experience.
