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Neoplasm or Demyelinating Lesion?A 32-year-old left-handed woman presented with a 4-week history of progressive left hand numbness, tingling, and clumsiness. Symptoms worsened until she found it difficult to write and perform fine motor tasks. She reported having no transient neurological symptoms in the past. Her medical history was significant only for Dengue fever acquired several years ago while on a visit to Southeast Asia. She was taking no medications, and a review of systems was noncontributory.
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Chronic Traumatic Encephalopathy: Should We Be Worried?The term “CTE” was introduced recently to describe progressive neuropathological changes and diffuse neuropsychiatric symptoms associated with a history of TBI. Here, a clinical overview of TBI and CTE.
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Mini Quiz: Suicide Risk StratificationWhat are the core components of a therapeutic risk management framework for a suicidal patient? Find out in this quiz.
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Psychiatric Epigenetics: A Key to the Molecular Basis of and Therapy for Psychiatric DisordersThe major challenges for epigenetic therapies are target specificity of the drugs-an issue that is also true for most of the currently used drugs in medicine, especially in psychiatry.
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The Rise and Fall of the Biopsychosocial ModelUltimately, Dr Ghaemi endorses a pluralistic approach and a “method-based psychiatry” in contrast to the eclecticism of the BPS. This method-based approach recognizes that one method may be more correct than others on the basis of empirical data and conceptual soundness (the “less is more” view), versus the BPS model, in which all methods can be equally correct (the “more is better” view).
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Essential Issues in Pediatric Psychosomatic MedicinePediatric psychosomatic research shows that emotional, behavioral, and psychiatric symptoms are found more often in children and adolescents with chronic illnesses than in healthy children.
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Treating Mental Illness Before it StrikesPsychotic episodes are devastating for the individuals who have them, their friends, and families. Wouldn’t it be wonderful if individuals could receive treatment before the first psychotic episode strikes, so that it could be avoided altogether?
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New Approaches to Juvenile Delinquency: Psychopathology, Development, and NeuroscienceNew findings in epidemiology, developmental psychiatry, and neuroscience offer the opportunity for a new perspective on the problems of juvenile delinquency and bring to bear the insights of modern psychiatry in the treatment and successful rehabilitation of juvenile offenders.
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Defending a Malpractice Suit: Lessons LearnedAfter being sued for psychiatric malpractice and enduringa 4-year roller-coaster ride of fear, hope, hard work, anxiety, and detachment, the author passes along lessons learned.
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The Conundrum of Psychiatric ComorbiditySince the revision of DSM-III, high rates of co-occurring psychiatric disorders have been observed, particularly in cases of moderate and severe psychiatric illness. The reason lies in the design of the diagnostic system itself: DSM-IV is a descriptive, categorical system that splits psychiatric behaviors and symptoms into numerous distinct disorders, and uses few exclusionary hierarchies to eliminate multiple diagnoses.
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Improving Mental Health Care in America: An Opportunity for Comprehensive ReformThe authors outline the ingredients for the transformation of mental health care in America.
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Adverse Effects of Antipsychotics and Mood StabilizersAlthough psychotropic medications have revolutionized the treatment of many psychiatric disorders, the benefits sometimes come at a price.
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The Once-Forgotten Factor in Psychiatry: Research Findings on Religious Commitment and Mental HealthAs previously discussed, new research has made us look much more closely at the influence of religion and spirituality on overall health. Now more than 30 psychiatric residencies including Harvard, Baylor, and Georgetown provide focused training on addressing patients' religious/spiritual beliefs.
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Patients Versus Therapists: Legal Actions Over Recovered Memory TherapyThe debate over the accuracy of memories of childhood sex abuse that are recovered decades later, usually during the course of therapy, has led to the polarization of psychiatrists and other mental health professionals. There are those who claim that -recovered memories are, in the main, accurate, and there are others who believe that most, if not all, recovered memories are false.
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Fostering Resilience After Trauma: A Clinical Conversation"I refuse to see sexual violence as a 'women’s issue.' It is a human issue and should be addressed as one."
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Psychiatry Residents: Best of Luck!My advice to residents is that you remain open to the opportunities that surround you every day as you continue your education and professional training.
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Illicit Drug Dependence Across the Globe: Results From the Global Burden of Disease 2010 StudyHow prevalent is dependence on amphetamines, cocaine, opioids, and other illicit drugs across the world? What is the associated disease burden? Insights here.
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Protecting Yourself and Your PatientsGood risk management is part of, but also distinct from, good clinical practice. The principles of risk management evolved in the 1960s as a way to defend businesses from loss of financial assets from tort claims
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End-of-Life Care and the ElderlyEvery life ends with death. For the elderly, death is the end of a long life that has been shaped by personal history and world events, various relationships, well-set personality characteristics and, of course, happenstance. Each of these, in addition to the specific circumstances that herald death, shapes the experience of dying in old age.
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Transit: Already in HellChristian Pitzold’s haunting 2019 film, based on Anna Seghel’s masterful 1942 novel.
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How Psychotherapy Changes the BrainPsychotherapy outcomes and the mechanisms of change that are related to its effects have traditionally been investigated on the psychological and social levels, by measuring changes in symptoms, psychological abilities, personality, or social functioning.
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Understanding the Differences Between Impulsivity and CompulsivityA review of targeted treatment strategies for symptom domains when impulsivity and compulsivity become dysfunctional.
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FDA Committees Vote to Dismiss Clozapine REMSCalling it a barrier to care, FDA committees decide to end clozapine REMS.
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Key Takeaways and the Future of Narcolepsy TreatmentAn expert panel concludes the discussion by reviewing factors to consider when diagnosing and treating narcolepsy.
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Rape-Related PTSD: Issues and InterventionsRape is a crime that is defined as an unwanted sexual act that results in oral, vaginal, or anal penetration. Generally speaking, there are 2 major types of rape. Forcible rape involves unwanted sexual penetration obtained by the use of force or threat of force. Drug- or alcohol-facilitated rape occurs when the victim is passed out or highly intoxicated because of voluntary or involuntary consumption of alcohol or drugs. Rape can happen to boys and men as well as to girls and women but this article will focus primarily on women.
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Apps for Suicide Prevention: What the Research SaysA review of smartphone tools for suicide prevention and recommendations for clinicians.
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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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The Science, Ethics, and Art of Disclosing a Dementia DiagnosisHow can you communicate the diagnosis in a way that relieves suffering and helps patients and their caregivers prepare for the future?
