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Telepsychiatry for Vulnerable and Underserved PopulationsWhen timely psychiatric care or consultation is difficult or impossible to obtain, telepsychiatry may be an acceptable, economical, and effective alternative.
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10 Salient Points About Migraine and Psychiatric ComorbidityWhere do migraines and psychiatric disorders intersect? Learn more.
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Antipsychotics and the Shrinking BrainPsychosis at any phase of the illness can be extremely distressing, disruptive, and potentially dangerous for patient and family.
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Predicting, Assessing, and Treating Self-Harm in AdolescentsThe authors differentiate between 3 types of deliberate self-harm: nonsuicidal self-injury, culturally sanctioned body modifications (tattooing or body piercing), and unintentional or accidental injury.
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Current Obstacles to Drug DevelopmentWhile pharmaceutical research in the United States provides for unparalleled high quality of treatment, many drugs already proven effective in other countries may never become available here due to a combination of obstacles.
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Pharmonitor FeedbackDr Stone’s Pharmonitor essay justly skewers drug promotion hubris disguised as a CME article.
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Narcissistic Leaders: Who Succeeds and Who FailsMost of what we read confirms the correctness of our approach and technique. Reasonably proud of our successes as clinicians, we blame the illness rather than the patient when we fail.
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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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Drug Therapies for the Neurobehavioral Sequelae of Traumatic Brain InjuryTraumatic brain injury (TBI) is one of the most common causes of morbidity and mortality, especially in young adults. Recognition and early accurate diagnosis of neurobehavioral TBI sequelae are important in reducing the severity of postinjury symptoms. Sequelae of TBI include cognitive impairments, personality changes, aggression, impulsivity, apathy, anxiety, depression, mania, and psychosis.
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Differentiating Epileptic Seizures From Other SpellsIt can be difficult to determine whether unusual, paroxysmal behavior represents a seizure or a nonepileptic event. Patients with convulsive, clonic movements may, in fact, be experiencing psychogenic events.
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Psychiatric Comorbidity Associated With Pathological GamblingGambling has become a major recreational activity in the United States. Formerly confined to a few states such as Nevada and New Jersey, legal gambling opportunities have exploded across the nation in the past 2 decades.
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Treatment Challenges in Schizophrenia: A Multifaceted Approach to Relapse PreventionWhile an antipsychotic medication is the first step of treatment for schizophrenia, it is increasingly recognized that comprehensive care requires the integration of adjunctive therapies and attention to long-term treatment goals.
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6 Things to Remember When Practicing TelemedicineWhat 6 things are important to keep telemedicine practice running smoothly?
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Psychotherapy for Treatment-Resistant Depression Is Overlooked, Underused"Evidence indicates that psychotherapy may yield greater durability of treatment gains than pharmacotherapy."
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Medicolegal Considerations in the Treatment of Psychosis With Second-Generation AntipsychoticsAre the metabolic side effects of the atypical antipsychotics fueling the next round of malpractice suits being filed against psychiatrists? Guidelines are being created, but how can clinicians protect themselves and their patients, while continuing to give their patients the best care available?
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Coping When Mother Kills FatherIn almost all cases where the mother kills the father, the mother has endured years of abuse at the hands of the father. Unfortunately, the children also suffer. How can psychiatrists help these children heal after such a tragedy?
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Insights Into Mood and Cognitive Disability in MS: Recognition and TreatmentDepression and cognitive impairment are common in patients with multiple sclerosis (MS) but often are overlooked. These complications affect not only general quality of life but also complicate core symptoms of the disease. Depression in MS is well documented and easily treated while cognitive impairment sometimes needs a sharper eye to detect.
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Asperger Disorder: Gone But Not ForgottenAlthough Asperger disorder is now included as part of the overall autism spectrum disorder, some say Pandora’s box has been opened.
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Perspectives on College Student SuicideLoneliness, substance abuse, dating violence, and hopelessness, are just some of the risk factors for suicide, which remains the second leading cause of death for college students.
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Comorbidity in Bipolar DisorderThe central tenet of clinical comorbidity, the occurrence of 2 syndromes in the same patient, presupposes that they are distinct categorical entities.
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Treatment-Resistant Anxiety Disorders: Neurotrophic PerspectivesAnxiety disorders are the most prevalent psychiatric disorders in the United States. Although effective treatments are available, such as the SSRIs and cognitive-behavioral therapy (CBT), it is estimated that in about 40% of patients, anxiety disorders are partially or completely resistant to first-line treatment.
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Child and Adolescent PsychiatryOne of the major challenges in child psychiatry is teaching the essentials of the field to the general physician or medical school student who needs some understanding of developmental issues and psychopathology. Dorothy Stubbe's contribution to this challenge is a small and well-written handbook published as part of the series, Practical Guides in Psychiatry.
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Cognitive Behavioral Therapy: Escape From the Binds of Tight MethodologyCBT has become rooted as proven dogma in the treatment of depression despite large problems remaining in methodology of CBT clinical trials and the logic behind how CBT works. This article will describe the major methodologic problems in the clinical trials of CBT.
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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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An Alternative Approach To The Suicidal Patient: Crisis InterventionThere are currently several disturbing phenomena in the field of suicidology: •Many papers are describing risk assessment and suggesting the need for high-risk patients to be hospitalized. •Emergency department (ED) staff are complaining about spending much of their time trying to find beds for patients. •Programs are claiming “crisis intervention” when, in fact, they only provide triage.
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Remembering: A Gentleman and a PsychiatristJohan Verhulst, MD, left this world exactly as he lived-with grace, honor, integrity, humor, love, humility, intellect, and a continuing interest in our ongoing professional conversations.
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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.
