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The Mass Shooter and His Mental FunctioningA tripartite dimensional approach may be used to better understand the mental functioning of those who commit mass violence.
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Integrative Treatment for Adult ADHD: A Practical, Easy-to-Use Guide for CliniciansAlthough there is evidence in the research literature from as far back as 40 years showing that the symptoms of attention-deficit/hyperactivity disorder (ADHD) often persist into adulthood, it has been only in the past decade or so that integrative treatment models designed specifically for adult ADHD have been developed.
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How to Deal with Problem PatientsThe doctor-patient relationship is built upon a foundation of trust. What do we do when a patient compromises or starts to bend the trust?
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Debate: Let the Bereavement Exclusion in DSM-5 DieA team approach, continually balancing the views of the psychopharmacologist, psychologist, social worker, family practice resident, and patient is the clinical Promised Land.
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Psychoneuroimmunology and HIV Disease ProgressionAmong psychiatrists who treat patients with HIV/AIDS, the question of how psychosocial distress effects the progression of HIV disease is likely to arise. Even for healthy individuals, we are only beginning to clarify the complex pathways by which thoughts and emotions impact immune function. Due to the bidirectionality of the communications of the brain and the immune system, this is a complicated scenario. The fact that HIV alters the function of the immune system during the course of its progression creates greater confounds to the understanding of these systems. We will address the rationale that progression from HIV infection to AIDS may be modulated by psychosocial factors, discuss possible reasons for conflicting findings and posit some clinically relevant recommendations drawn from research findings.
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New Approaches to Preventing Incarceration of Severely Mentally Ill AdultsAdults who are severely mentally ill are over-represented in U.S. jails and prisons, leading to an interface between the mental health and criminal justice systems. New intervention strategies involving both systems, such as mental health courts and forensic assertive community treatment, could divert patients away from the criminal justice system and promote engagement in community-based treatment and support services.
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An Unusual Side EffectCeleste, one of my patients, a woman in her mid-30s, unexpectedly had a seizure, fell, and hit her head while at work. She was rushed to a nearby emergency department (ED) where results of laboratory work, an EEG, and an MRI confirmed that she had had a seizure but did not show a cause.
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In Conversation With a Sigourney Award Winner: Gender & SexualityWe sat down with Jack Drescher, MD, to discuss his recent 2022 Sigourney Award win and more.
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Treating Adolescents With Major Depression and an Alcohol Use DisorderAlcohol is the drug of choice for adolescents, with cigarettes and marijuana being second and third. Contrary to widespread belief, alcohol dependence is most common in 18- to 20-year-olds, with progressively decreasing rates of alcohol dependence in older age groups.
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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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The Intersection of Geriatric and Forensic PsychiatryThis article reviews a wide array of medicolegal, risk management, regulatory, and forensic mental health issues in the older population, which is growing at an accelerated rate.
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Hendrix Revisited: Joe’s Final Psychotherapy SessionAfter a code gray, it was clear to me that no matter one’s training, only such fundamental moments can enable one to answer affirmatively when asked, "Are you experienced?"
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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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Management of Treatment-Refractory SchizophreniaBecause cognitive and negative symptoms have the greatest impact on overall recovery, interdisciplinary strategies that target these symptoms are necessary. This article offers details.
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Implications of Impulse Control Disorder in Parkinson DiseaseThe challenges of recognizing behaviors such as hypersexuality, gambling, and excessive buying in Parkinson disease are discussed, as are ways to address them while still managing the underlying condition.
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The Virus Connection: How Viruses Affect Psychiatric PathologiesHere's a deep dive into possible mechanisms by which viruses may contribute to mental illness.
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Epileptic or Nonepileptic Seizure?A right-handed woman aged 19 years is referred for intractable clinical events. The patient's medical history is remarkable for anxiety, depression, and attention-deficit/hyperactivity disorder; migraine headache; and Lyme disease for which she received 6 months of intravenous antibiotic therapy.
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Identifying and Reducing Professional Liability When Treating Older AdultsActions You Can Take to Decrease Risks While Increasing Patient SafetyIdentifying and Reducing Professional Liability When Treating Older Adults, by Jacqueline M. Melonas, RN, MS, JD and Charles D. Cash, JD, LLM, ARM
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Borderline Personality Disorder and Bipolar Disorder-Distinguishing Features of Clinical Diagnosis and TreatmentSince the inclusion of the borderline personality disorder (BPD) diagnosis in DSM, there have been multiple efforts to recast the disorder as part of an Axis I illness category. While the initial focus was on the schizophrenia spectrum, more recent authors have attempted to link BPD to mood disorders.
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The Facts About Violence Against Historically Disadvantaged PersonsRacial/ethnic and sexual orientation minorities and women historically have been relegated to social, legal, and economic disadvantage in the United States.
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Mini Quiz: Neurobiology of Borderline Personality DisorderWhat do functional magnetic resonance neuroimaging findings reveal about the neurobiology of borderline personality disorder? Take the quiz and learn more.
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Smoking Cessation During Substance Abuse TreatmentAn overview of the critical issues involved in overcoming personal and organizational barriers to help substance abusers quit smoking.
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Brain Capital: An Emerging Investment OpportunityBrain Capital: a fresh approach to technologies and investing.
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Critical Care Psychiatry: The Value of Psychiatrists in the ICUIn this CME article, learn more about common clinical conditions, consultation questions, and challenges in the field of critical care psychiatry.
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A Journey of JugglingA psychiatrist discusses his hobby of juggling and demonstrates a few tricks.
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Health and Psychiatric Issues in Children of Rural Methamphetamine Abusers and ManufacturersMany abusers of methamphetamine in rural areas manufacture the drug for their personal use. These "mom-and-pop cooks" produce methamphetamine in and around homes where children are also living. This article provides an overview of the mental health of children whose parents abuse methamphetamine.
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Treatment-Resistant Bipolar DisorderTreatment resistance in bipolar disorder is clinically familiar but lacks a standard definition. Numerous evidence-based treatments exist for all phases of bipolar disorder, and these should be optimized and fully explored.
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Assessing the Violent Patient: An Additional Case of Legal ImplicationsAssessing the Violent Patient: An Additional Case of Legal Implications
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The Case of Factitious Disorder Versus MalingeringPatients who exaggerate, feign, or induce physical illness are a great challenge to their physicians. Trained to trust their patients’ self-reports, even competent and conscientious physicians can fall victim to these deceptions.
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Demystifying Health Reform LegislationThe health reform legislation is likely to affect all mental health professionals throughout their lives, both as consumers and as practitioners of health care services.
