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Polypharmacy in Older AdultsClinicians should carefully weigh the risks and benefits of each prescribed medication for an older adult with neuropsychiatric diseases and periodically review all prescribed medications. Learn more here.
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Introduction: Meeting Our Personal and Professional GoalsBy building a practice model that we enjoy, it enhances our ability to “cure sometimes, treat often, and comfort always.”
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Advances and Challenges in Treating Alcohol Dependence With PharmacotherapyAlcoholism is a chronic and serious disorder with often devastating consequences. One out of three families in the United States is negatively impacted by a family member's excessive drinking and painful drinking-related problems.
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The Patient-Physician BondDuring my medical training in the early 1980s, I attended a Grand Rounds on health care reform. Sleep-deprived physicians-in-training are easily conditioned to snooze upright in their auditorium seats, and economics is not an interest of choice for me, but when the speaker told us that there would be no solution to rising health care costs except to fracture the bond between patient and doctor, I found myself engaging in nightmarish fantasies that in subsequent decades have come true.
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Risk Management for the Supervising PsychiatristThe need for expert supervision of residents and other health professionals by psychiatrists is growing as a result of the increased demand for accountability by third parties and the expanded number of clinical specialists seeking supervision in psychiatry. The Accreditation Council for Graduate Medical Education has placed professional competency of graduating residents in the national spotlight, and insurers are increasingly scrutinizing patient care provided by trainees and oversight provided by their supervisors.
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Psychedelic Medicine: New Evidence for Hallucinogenic Substances as Treatments (2 volumes)The use of psychedelic plants and drugs in psychiatric medicine has been a promise for more than half a century, suppressed by a draconian legal response to the epidemic of drug abuse in the 1960s. This 2-volume work seeks to reverse the suppression of scientific inquiry in this field by bringing together a comprehensive airing of the topic.
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The Supportive Component of PsychotherapyIn view of the fact that support is an important aspect of all models of psychotherapy, it is remarkable that beginning practitioners are not taught how to be supportive. Only limited attention has been paid to discussion of the principles underlying supportive interactions. It seems to be taken for granted that good sense, kindness, innate empathy and life experience will enable psychotherapists-and physicians in general-to meet their patients' needs for support by communicating interest, liking and understanding. Just as the literature on psychoanalysis is a source for much of what we know about the expressive component of therapy, the limited literature on supportive psychotherapy is a source for ideas pertinent to the supportive component.
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Topiramate and Heavy Drinking: Implications for Personalized MedicineVery few heavy drinkers receive treatment and fewer still are prescribed medications with demonstrated efficacy. Here, a summary of current research, key takeaways, and highlights from a study on topiramate treatment for heavy drinkers by the lead author of that study.
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Challenges and Obstacles in Treating Mentally Ill Black PatientsAs the United States becomes more culturally, racially, and ethnically diverse, psychiatry will be faced with the need to treat more diverse populations. This article focuses on challenges and obstacles encountered when treating black patients with mental illness.
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Progress and Promise: Research and Education in Psychosomatic MedicinePractitioners understand the wholeness and unity of their patients. Instead of being considered isolated organ systems or enzyme cycles, patients are understood as coherent entities composed of coordinated and interrelated processes and systems. This fundamental understanding guidesinvestigative and clinical care approaches in psychosomatic medicine.
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The Lasting Effects of Marijuana UseThere is increasing evidence that individuals who try marijuana during their early teenage years are affected neurologically for a decade or more at least until one's 20s and perhaps even longer. More in this video.
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Commentary: The Case Against Physician-Assisted Suicide: For the Right to End-of-Life CareEuthanasia is a word coined from Greek in the 17th century to refer to an easy, painless, happy death. In modern times, however, it has come to mean a physician's causing a patient's death by injection of a lethal dose of medication. In physician-assisted suicide, the physician prescribes the lethal dose, knowing the patient intends to end their life.
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Global Findings in Developmental Psychopathology Presented at ESCAPA greater understanding of how the brain works, including the effect of environment on it development, has led to advances in diagnosing and treating psychopathology. The latest findings will be presented at an international meeting, along with a discussion of how much work is to be done and the great need for qualified child psychiatrists, especially in developing countries.
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Refractory Psychosis: Treatment Options and StrategiesPsychosis is one of the key dimensions of schizophrenia, bipolar disorder, and psychotic depression. Clinicians are familiar with patients whose psychosis improves dramatically with antipsychotic treatment; however, these patients may be left with cognitive impairment, negative mood symptoms, or suicidal symptoms, as well as impaired work and social functioning.
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Enlightenment and Dimmed EnlightenmentPsychiatrists cannot, with impunity, disregard an important domain of man’s personality makeup. He ought to remain a searcher of the soul at large.
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Treatment of Traumatic Stress Disorder in Children and AdolescentsThe role of prevention of trauma and prevention of functional impairment after trauma is paramount, because this may disrupt the accumulated physiological and psychological effect of stressors in the individual.
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Light Treatment for Nonseasonal DepressionDaniel F. Kripke, M.D. has studied the relationship between biological rhythms and depression since the early 1970s. He states that seasonal responses in many mammals are controlled by the photoperiod. Therefore, it seemed that depression might be analogous to winter responses and that light might be an effective treatment.
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Advances in Psychiatry: Understanding Indigenous CulturesEpidemiological research has shown that the Māori people of New Zealand are approximately twice as likely to have serious psychiatric illness compared with non-Māori. Here, a child and adolescent psychiatrist describes her work in Aotearoa, New Zealand.
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Effect of Gender Differences on the Cardiovascular System in Patients With Mental DisordersTricyclic antidepressants and antipsychotics are known to prolong cardiac repolarization and induce QTC interval prolongation, possibly putting patients with mental disorders at higher risk of cardiovascular diseases. The mechanism of gender difference in vulnerability for cardiovascular diseases is still unclear, but the role of hormones is one of possible explanatory factors.
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Collaborative Care Meets Hospital Medicine: Proactive Consultation-Liaison PsychiatryMental illness accounts for a third of all years lived with disability and is associated with twice the relative risk of all-cause mortality. An estimated 8 million deaths are attributable to mental disorders every year, with two-thirds due to comorbid medical illness.
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The μ-Opioid System and Antidepressant ResponseThis article discusses the role of µ-opioid receptors (MORs) in antidepressant treatment and major depressive disorder (MDD). Specifically, it focuses on how the endogenous opioid system affects response to pharmaceuticals.
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The Adolescent BrainAn expert Q&A with Laurence Steinberg, PhD. His newest book offers insights into the malleable adolescent brain and provides guidance to parents hoping to better understand adolescents.
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Technology in Psychiatry: Year in ReviewAs technology continues to expand exponentially, so does our potential to harness these technological capabilities to expand the field of psychiatry. At Psychiatric Times this year, we highlighted a range of topics on these advancements.
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Medical Marijuana and Mental Health: Cannabis Use in Psychiatric PracticeHere's why psychiatrists and other mental health professionals need to understand the relationship between cannabis and mental disorders.
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Introduction: Strategies for TreatmentWhen thinking about recent advances in psychopharmacology, we often point to new molecules with similar mechanisms of action but with better safety and tolerability profiles, or to molecules with novel mechanisms that effect positive change greater than that with existing treatments.
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Management of Psychosis in Parkinson DiseaseFor some patients with Parkinson disease, the neuropsychiatric complications are a greater source of morbidity than the motor dysfunction. This article focuses on the management of psychosis in Parkinson disease.
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Intelligence Reframed: Multiple Intelligences for the 21st CenturyPeople are different, according to conventional wisdom - the saying generally used in explaining varying opinions, attitudes or ways of thinking. Why then is it not a given that people are different in basic brain functions such as learning and intelligence?
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Is Computer Addiction a Unique Psychiatric Disorder?Although it may be tempting to say that almost any rewarding activity can become addicting, new research appears to indicate that, at least in the case of Internet use, that may not be the case. In fact, "Internet addiction" may actually be a sign for other psychiatric disorders.
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Avoiding the Path of Least ResistanceIn this insightful interview, experts discuss the journey toward a more humanistic approach in psychiatry, the challenges of integrating biological and psychosocial aspects, and the need for comprehensive training for future psychiatrists.
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Setting Up a Neurology-Based Infusion Center: Rationale and Guidelines"No longer a pipe dream," is the suggestive lead-in of a widely distributed press release issued last October touting the potential benefits of cannabinoid compounds in the treatment of Parkinson disease (PD), Lou Gehrig disease-or amyotrophic lateral sclerosis (ALS)-and a number of other debilitating conditions, as reported during last fall's 2004 annual meeting of the Society for Neuroscience. According to Daniele Piomelli, PhD, an expert in cannabinoid research and professor in the Department of Pharmacology at the University of California, Irvine, certain cannabinoid compounds can be harnessed to "provide select benefits to patients while avoiding some of the unwanted effects" associated with marijuana use. Compounds of greatest interest have been WIN 55212-2, delta(9)-tetrahydrocannabinol (THC), and anandamide.
