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Psychodynamic Treatment of Panic DisorderPanic disorder is a prevalent, debilitating illness associated with high utilization of multiple medical services, poor quality of life and a high incidence of suicide. Short-term efficacy of time-limited cognitive-behavioral and medication treatments has been demonstrated in many studies. Evidence for long-term efficacy of these treatments, however, is sparse and less convincing.
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Integrating Psychotherapy and Psychopharmacology in the Treatment of Major Depressive DisorderAlthough multiple interventions exist for major depressive disorder (MDD), only partial response is achieved in many patients and recurrence is common. Combining medication and psychotherapy may enable more effective treatment of MDD.
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Breast Cancer: What Psychiatrists Need to KnowTo support patients with breast cancer, psychiatrists should be aware of possible medication interactions, psychiatric or neurologic adverse effects of treatment, and signs of disease progression--issues that are the focus here.
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Hypochondriasis: A Fresh Outlook on TreatmentThis is the fourth in a series of five articles regarding obsessive-compulsive spectrum disorders. The first three articles ran in the March 1997, June 1997 and January 1998 issues of Psychiatric Times. The first article gave an overview of spectrum disorders, the second discussed obsessive-compulsive disorder and the third examined body dysmorphic disorder.
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Novel Methods to Predict Outcome Using NeuroimagingThe capacity of cognitive neuroscience to inform clinical practice has stimulated both excitement and controversy.
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Treating Aggression in Patients With DementiaDementia is characterized as a progressive and chronic decline in cognitive function, not limited to memory impairment, which significantly interferes with baseline daily functioning and frequently involves behavioral disturbances. It is known that behavioral problems in dementia negatively affect patients and caregivers. These disturbances lead to institutionalization, increased costs and caregiver burden, and a poorer prognosis.
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Religious Understanding as Cultural Competence: Issues for CliniciansImproving religious competence among clinicians is vital if everyday psychiatric care is to become truly person-centered.
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Does the Biopsychosocial Model Help or Hinder Our Efforts to Understand and Teach Psychiatry?In this essay, I approach the question about the BPSM from the perspective of a teacher of psychiatry, medical school dean responsible for (among other matters) student career advising, and clinician. In those capacities, my duties include fostering an understanding of psychiatric disorders among medical students and residents, instilling confidence in and respect for the discipline of psychiatry among students as well as nonpsychiatric colleagues, and explaining psychiatric diagnosis and treatment to patients and their families.
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Atypical Antipsychotic Augmentation in the Treatment of DepressionDespite the clinician's goal of treating the depressed patient to the point of remission, this state is generally achieved in only 15% to 30% of patients. Another 10% to 30% of patients respond poorly to antidepressant treatment, while 30% to 40% have a remitting and relapsing course.1 Patients without a major depressive disorder are likely to be treated successfully by primary care physicians and/or other mental health professionals, which leaves psychiatrists to treat patients who have forms of depression that are less responsive to treatment.
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Practice Patterns for ADHD and Other Disorders CollideRecent data show that widespread discrepancy exists between clinical guidelines and practice patterns for ADHD, dementia, and bipolar disorders.
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Neuroscience Research for Psychiatry: The Brain and Behavior LinkInteraction between the brain and behavior implies that comprehensive progress cannot be made to relieve the suffering of patients without systematically addressing the brain basis of such conditions.
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Effects of Psychotherapy on Brain FunctionUnipolar major depressive disorder is a debilitating condition with a lifetime prevalence of 17%. Recent epidemiological evidence indicates that MDD is the fourth leading cause of disease burden and the leading cause of disability-adjusted life years.
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We’ve Got Issues: Children and Parents in the Age of MedicationFor those of us who treat seriously emotionally disturbed children, We’ve Got Issues is a welcome change from the invectives of those who believe that the use psychotropic medication is virtually criminal.
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Of Two MindsA therapist forgets about a patient’s appointment. She becomes abnormally angry, unusually forgiving, atypically bored, or excessively voyeuristic. What is going on? The therapist’s countertransference is making itself known.
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Violence, Crime, and Violent Video Games: Is There a Correlation?What effect does exposure to violence in video games have on behavior? These authors examine the evidence.
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Anxiety Disorders: Aortic Aneurysm in the Differential?Worsening anxiety is a common symptom that may result in psychiatric consultation or evaluation in an emergency setting. Aneurysms are rarely considered in the medical differential for anxiety disorders, and the available literature and research regarding this possible connection are very limited. Overlooking this diagnosis, however, can have disastrous consequences. Here we present 2 case reports as well as a review of the literature regarding a possible relationship between aortic and thoracic aneurysms and psychiatric symptoms.
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Developing an Effective Treatment ProtocolAnxiety disorders are the most prevalent disorders among children and adolescents in both community and clinical settings. The high prevalence of anxiety disorders in children and adolescents leads to increased interest in the development and implementation of effective treatments.
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Contraception and MisconceptionsPsychiatrists who treat women and adolescent girls may find it necessary to discuss with their patients reproductive planning and the role of contraception in setting comprehensive treatment goals. Here's why.
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The Hoarding of Animals: An UpdateThe authors provide information about the human-animal bond that may provide a starting point for understanding the development of animal-hoarding disorder.
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About To Have ECT? Fine, but Don't Watch It in the Movies: The Sorry Portrayal of ECT in FilmHollywood has had a long-standing love affair with psychiatry and its portrayals of electroconvulsive therapy reflect and influence public attitudes toward the treatment. One-third of medical students decreased their support for the treatment after being shown ECT scenes from movies, and the proportion of students who would dissuade a family member or friend from having ECT rose from less than 10% prior to viewing to almost 25% afterward. So what is the legacy of portrayals that have been so abhorrent, and are there any exceptions to the rule?
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Chronic Daily Headache: Understanding and Treating ItChronic primary daily headache may not be a singular disorder but rather one with various subtypes. Chronic migraine (also referred to as evolved migraine or transformed migraine), chronic tension-type headache, newly defined daily persistent headache, hemicrania continua, and post-traumatic headache are now recognized as subcategories of chronic daily headache
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The Silver Lining in the Graying of America: Healthy Aging Is the New NormClearly, old age is associated with unavoidable decline but in some instances can be mitigated by mental and physical exercise and social activity. How is the preservation of function despite illness and decline accomplished? Insights here. . .
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Understanding the Dynamics of Abusive RelationshipsAn explanation of the cycle of abusive dynamics as it exists in abusive relationships, in commonsense language.
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Addressing Psychosomatic Illness in the Elderly: Integrated CareThe need to integrate psychiatric treatment with somatic care puts psychosomatic medicine in a unique position to focus on older patients who would not otherwise seek specialized treatment.
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Marketing Off-Label Uses: Shady Practices Within a Gray MarketFor pharmaceutical companies, off-label use of a drug represents a substantial “gray market,” to which the company is unable to sell their product directly, yet may be a significant revenue stream. Some drugs have been used more for off-label purposes than for originally approved indications.1
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The Hoarding of Animals: An UpdateThe authors provide information about the human-animal bond that may provide a starting point for understanding the development of animal-hoarding disorder.
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Beyond the Addict: Keeping Countertransference in CheckMedicine is not about making us feel better about ourselves-although this doesn’t hurt. In the case of addicts, it is about looking at the root cause of addictions and seeing the person-not just the addict-in front of us.
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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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The OPTICS Project: An Open-Science Framework for the Analysis of Clinical Trial DataA report of initiatives that have raised awareness of and promoted data sharing and data transparency in order to advance science and improve public health and health care.
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Quitting Smoking: Therapeutic in Mental Health TreatmentMany patients report that smoking helps them with their stress and psychological disturbances. However, smoking may actually worsen some of these symptoms. When is the right time for your patients to quit?
