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“Switching” of Mood From Depression to Mania With AntidepressantsMood switching is not uncommon and it is much more prevalent in depressed juveniles than in depressed adults, and there is a large apparent excess of antidepressant-associated switching over reported spontaneous diagnostic changes to bipolar disorder. Details here.
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The Freedom in Accepting Our LimitsA psychiatrist realizes he is completely powerless against his patient's opiate addiction.
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Working With Traumatized PatientsThere are feasible and replicable ways for caring adults to help heal themselves as well as the next generation through mass application of reflection and altruistic caring for the remaining offspring, whether in Sichuan, Gaza, New Orleans, or Haiti.
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Lithium Therapy, Bipolar Disorder- and NeurocognitionFunctional mood stability can be attained with lithium therapy, but guidelines on how to get there have become increasingly sophisticated.
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Prevalence and Consequences of Metabolic Syndrome in Bipolar DisorderMedications used in the treatment of bipolar disorder are commonly associated with weight gain. Antipsychotic drugs have been implicated in new-onset diabetes.
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How to Fix the Broken Mental Health System: Ten Crucial ChangesThe Foundation for Excellence in Mental Health Care suggests a total redesign of the mental health system from the federal level down to the local level. Three overarching themes are articulated.
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The Relationship Between Anxiety Disorders and Sexual DysfunctionIn this article, we examine the relationship between anxiety disorders and SDs, using DSM-IV-TR categories, although we are conscious of the limits of this approach. In doing so, we will consider not only the dichotomy between normal and pathological functioning but also the issue of sexual satisfaction as part of wellness.
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The Concept of Recovery in Major DepressionIn clinical medicine, the term recovery connotes the act of regaining or returning to a normal or usual state of health. However, there is lack of consensus about the use of this term (which may indicate both a process and a state), as well as of the related word remission, which indicates a temporary abatement of symptoms. Such ambiguities also affect the concepts of relapse (the return of a disease after its apparent cessation) and recurrence (the return of symptoms after a remission).
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Culture and Urban Mental HealthMostly because of increased speed and decreased costs of communication and transportation, cities are growing increasingly diverse in their population. Consequently, cultural factors have taken center stage in the understanding of urban mental health. This article will focus on the main approaches to urban mental health and briefly summarize the 3 lines of research in this area. It will then discuss the main themes of a vast body of literature on the cultural aspects of urban mental health.
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“Switching” of Mood From Depression to Mania With AntidepressantsMood switching is not uncommon and it is much more prevalent in depressed juveniles than in depressed adults, and there is a large apparent excess of antidepressant-associated switching over reported spontaneous diagnostic changes to bipolar disorder. Details here.
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Clergy and Psychiatrists: Opportunities for Expert DialogueThe World Trade Center attack changed the face of the United States and of psychiatry. Men and women of the cloth and of the clinic came together to care for the stricken masses. Yet, members of the clergy do not always refer congregants who exhibit duress to the psychiatrist, nor do psychiatrists refer patients to the clergy. What keeps these two fields apart? What is best for your patient?
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Deconstructing the “Med Check”A graduating resident recently told me that a psychiatric group attempting to recruit him informed him that he would have 10 minutes for medication appointments and 30 minutes for new patient evaluations. He was horrified. (So was I.)
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A Landmark Report on Addiction by Our Nation’s DoctorVivek Murthy, MD presented for the first time a report by a Surgeon General focused solely on addiction and its consequences.
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Infographic: What Happens to Depressed Adolescents?The high rate of recurrence of depressive symptoms and ongoing psychosocial challenges point to the need for a longer-term view of the management of adolescents with depressive disorders.
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Are Women at Greater Risk for PTSD than Men?Differences between the sexes regarding the prevalence, psychopathology and natural history of psychiatric disorders have become the focus of an increasingly large number of epidemiological, biological and psychological studies. A fundamental understanding of sex differences may lead to a better understanding of the underlying mechanisms of diseases, as well as their expression and risks.
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APA Guidelines for DSM-5 UsersSurprisingly, the American Psychiatric Association (APA) has never established formal guidelines that address what qualifications are required for one to use DSM.
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DisFigured: The Making of a MovieI wrote, directed, coedited, and financed DisFigured because it’s a movie I wanted to see. I’m not a woman and I don’t have an eating disorder, but the issues of appearance, control, isolation, and our complicated relationships with our bodies seem universal to me. They are also sadly underexplored or horribly twisted in almost every form of media. I am particularly aware of this because my wife Jenn is beautiful, graceful, stylish and-according to popular culture-fat.
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Treatment of Psychiatric Disorders in Patients With HIV/AIDSMental illness is a risk factor for HIV infection. It brings a number of behavioral correlates that put patients at risk for getting infected. As HIV infection worsens, it begins to affect the brain, and cyclical relationship between the disease and mental illness begins.
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Are We Overdiagnosing and Overtreating ADHD?This article speaks to the care with which ADHD must be diagnosed and managed to reduce the significant negative impact of the disorder on the individual, family, and society.
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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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Challenges Faced by Psychiatrists in the Internet AgeIn January of my third year of medical school while attempting to study for my medical licensing examination, I began a blog. (Any distraction from learning about the Krebs cycle was heartily welcomed!) Within a week, I had posted photos of my family members, criticized an episode of ER, and griped about my studies. A social addict, I was hooked on this self-disclosure.
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6 Key Questions When You Suspect MelancholiaMost depressed people acknowledge impaired concentration and other related symptoms-but skilled clinicians can distinguish between non-melancholic depression and melancholia. How? They ask the right questions.
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Fee Agreements: What Works, What Doesn’t- and How to Use ThemThis 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.
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Life Support for Confidentiality in the Electronic DatabaseMany of us have heard the horror stories and seen them reported on the national news wire services: publicly known persons or their family members have their medical records published, names of HIV-positive persons are released, clerks are bribed to deliver the names of patients and their diagnoses, physicians are given free software in return for their lists of patients' names and addresses. It is not that these breaches of confidentiality could not and did not take place with hard copy medical records, it is just that they are so much easier to accomplish now, and can be done in great number and from remote locations, anonymously.
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Pediatric Major Depressive Disorder: Questions to ConsiderWhat are the options for treating major depressive disorder in children and adolescents? This case offers readers a chance to give their feedback and to interact with the authors, who will present teaching points based on your comments.
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Psychotherapy and Sculpture: A Rewarding New LifeIn the process of both psychotherapy and sculpture, this psychiatrist discovered there is potential for an exciting and rewarding life. Here, a representative piece from his collection.
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Tips for Conducting Disability EvaluationsPsychiatrists may find themselves embroiled in matters that extend beyond the routine doctor-patient relationship unless they are clear about the differences between their treatment and forensic roles.
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Into the Snake Pit: An Interview with Ben Harris, PhDTwo doctors discuss the controversial, highly debated film, The Snake Pit.
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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.
