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My First Lesson in CountertransferenceHere's the story of one of my very first patients -- 45 years ago -- who taught me a powerful lesson about countertransference.
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Treatment Advances for Glioblastoma: Tumor Markers and Targeted TreatmentsAlthough malignant brain tumors affect thousands of persons each year, treatment has not significantly advanced. For 3 decades, the standard of care was palliative surgery, radiation, and chemotherapy. Of these, radiotherapy was the only proven way to lengthen survival time. However, since 2005 the standard of treatment has changed thanks to studies showing posi- tive results from daily temozolo- mide (Temodar) combined with radiotherapy.
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Oxford Handbook of Psychiatric EthicsAs our understanding of the brain and new technologies have rapidly evolved, such an extensive text on psychiatric ethics is clearly timely.
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E-mailing With Patients: Think Before You ‘Send’When it comes to e-mail, I typically warn my [physician] clients of the following.
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Depression and Diabetes: Improving Outcomes Through Collaborative CareDepression and diabetes can prey on the shortcomings of our health care system, such as fragmented, episodic care and poor continuity. Coordinating care can be fraught with difficulties, but it is the goal of many current efforts in health care reform.
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Can Your Older Patient Drive Safely?Medical professionals may be reluctant to initiate a discussion about driving with older patients in anticipation of a negative impact on the physician-patient relationship.
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Mood Stabilizers and Novel Antipsychotics in the Treatment of Borderline Personality DisorderThis article focuses on data concerning the efficacy of mood stabilizers in the treatment of BPD.
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Does Flibanserin Have a Future?Before flibanserin, there were no FDA-approved treatments for hypoactive sexual desire disorder. The authors clarify the intricacies of an HSDD diagnosis and discuss implications for treatment.
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Inflammation, Psychosis, and the BrainWhen the solution to a clinical or scientific puzzle eludes us for more than a century, as with schizophrenia, we need new methods to examine the pathology. If we want to make an impact on the disease we must shift research paradigms and focus on the early detection, early intervention, and new avenues of treatment that address different symptoms of schizophrenia.
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Synthetic Cathinones: Signs, Symptoms, and TreatmentSometimes viewed as “legal cocaine,” the over-the-counter status of synthetic cathinones (aka bath salts) gives the illusion that they are safe. In fact, they are highly toxic.
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Quality of Life in Patients With Bipolar Disorder: Defining and Measuring GoalsA complex and heterogeneous condition characterized by a variety of symptoms and marked variability in disease course, bipolar disorder is marked by episodes of depression, hypomania, mania, or psychosis and,patients can experience a mixture of emotional states.
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Evolution of Mental Health Disorders: An Alternative PerspectiveIn Angst: Origins of Anxiety and Depression, Dr Jeffrey Kahn offers an alternative perspective on the evolution of common mental health disorders by considering the adaptive nature of symptoms that modern clinicians deem pathological.
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The Double-Edged Sword of Social Media: Exploring the Complex Relationships Between Social Media Use and Youth Mental HealthYouth today have a relatively nuanced and mixed experience with social media. How can you best navigate this relationship as a mental health clinician?
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Inflammation, Immune Function, and Schizophrenia: An OverviewCurrent research investigates new pathophysiologic mechanisms and lays the groundwork for redefining schizophrenia based on distinct medical subclasses-which may lead to more targeted and effective treatments. Details here.
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Symposium on Psychology and National Security at the Italian EmbassyThe Embassy of Italy in Washington, DC recently hosted the first of 2 workshops on “Leaders and Terrorists: Psychological Perspectives on National Security.”
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Multiple Sclerosis: MRI in Diagnosis, Management, and MonitoringMRI has provided important insights into the pathophysiology of multiple sclerosis (MS).1 However, conventional MRI scans furnish only gross estimates of the nature and extent of tissue damage associated with MS,2 and the data correlate poorly with measures of concurrent disability in patients.
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Trauma-Focused Cognitive-Behavioral Therapy for Sexually Abused ChildrenCognitive-behavioral therapy can be tailored for use with children who have experienced sexual abuse in order to relieve symptoms of PTSD.
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Ketamine Anesthesia for Electroconvulsive TherapyThe authors review the clinical use of ketamine as the anesthetic induction agent in ECT and discuss the evidence that it augments antidepressant response and reduces cognitive adverse effects.
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How To Work Through Erotic TransferenceErotic transference can be one of the most difficult issues to work through in psychotherapy. What is the history of the understanding of erotic transference, and what factors may play into its emergence in therapy?
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Children and Video Games: How Much Do We Know?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.
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Supportive Psychotherapy in Everyday Clinical Practice: It’s Like Riding a BicycleSupportive psychotherapy can serve as the first bridge out of social isolation and marginalization and addresses personality issues, such as deficits in character structure and defense mechanisms.
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What to Do When Being There Means Being VulnerableIn the early days of the pandemic, there was debate about whether clinical services for patients with psychiatric illness were “essential.” The evolution of psychiatric consultation-liaison services to medically hospitalized patients was no less complex.
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6 Strategies to Prevent Physician BurnoutOnce a health care professional has reached a chronic stage of burnout, lives may be at stake. But prevention and treatment are possible.
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Psychodynamic TreatmentsMentalization-based treatment (MBT) and transference-focused psychotherapy (TFP) are relatively complex and specialized treatments for the treatment of borderline personality disorder.
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Chronic Disease Self-Management Programs in PsychiatryThrough patient self-management, mental health clinicians can transfer the focus from managing symptoms to allowing patients to live well in the context of their mental illness and medical comorbidities.
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An Overview of Eating DisordersEating disorders, such as anorexia nervosa, bulimia nervosa, and binge eating disorder remain a challenge, but research continues and more is learned every day. Experts discuss symptoms, diagnostic criteria, and medical complications of eating disorders, as well as implications for treatment.
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Gender Differences, Gamma Phase Synchrony and SchizophreniaThe authors discuss gender differences found in patients with schizophrenia. Their group is the first to explore the possibility that gender differences in schizophrenia are mediated by differences in integrative network activity, reflected in a synchronous phase of high frequency (40 Hz) gamma activity.
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Psychiatric Manifestations of HIV Infection and AIDSPatients with HIV infection are at risk of developing psychiatric symptoms and disorders similar to those seen in the general population. What unique biological, psychological and environmental factors are involved in treating this population?
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Posttraumatic Stress in Medically Ill PatientsA major physical illness or procedure, such as a myocardial infarction (MI), a transplant operation, or a life-threatening attack of asthma, can be emotionally traumatic,1,2 but the study of posttraumatic reactions in the medically ill is relatively new. Only in the past 2 decades or so it has been recognized that, in fact, medical illness and its treatment can be traumatic, and only since the publication of DSM-IV in 1994 has medical illness been included as a potentially traumatic event that may lead to the development of posttraumatic symptoms.
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Prenatal Risk Factors in SchizophreniaSignificant research developments in the etiopathogenesis of schizophrenia have occurred during the past several years. One such advance is the "neurodevelopmental" hypothesis that events during early brain development, especially the prenatal and perinatal periods, may play an important causal role in at least some, and perhaps many, cases of schizophrenia.
