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New Directions in PsychiatryIn order to make positive changes in the field of psychiatry, it is important to appreciate and understand the current challenges and significant limitations of the present approach to psychiatric therapy.
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Violence in Bipolar DisorderWhat is the association between bipolar disorder, trauma, and violence? Here: a guide to assessing violence potential in bipolar patients.
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Neurobiological Underpinnings of Obesity and Addiction: A Focus on Binge Eating Disorder and Implications for TreatmentThis CME is intended to help differentiate binge eating disorder (BED) from other eating disorders and understand the mechanisms that may put BED into the realm of addiction disorders.
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Multiple Chemical SensitivitiesThe patient who presents with vague psychiatric somatic complaints may, in fact, be suffering from chemical sensitivities. Such sensitivities are tied to lower incidences of certain psychiatric disorders while correlating with the higher prevalence of others. Neurogenic inflammation, limbic kindling and psychiatric co-factors are discussed.
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STAR*D’s Cumulative Remission Rate and Why It Still MattersContesters of STAR*D discuss the impact and relevance of the study's remission rates.
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A Unifying Premorbid DiagnosisOne cannot but be impressed at the ingenuity of our DSM-5 mavens at conjuring up new diagnostic syndromes.
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The Role of B Vitamins, Homocysteine in AD and Vascular DementiaAlzheimer's disease (AD) is a devastating and debilitating neurodegenerative condition, and the most common cause of dementia among the elderly. Despite considerable advances in the cellular and molecular biology of AD, however, little progress has been made in identifying the causes of the disease.
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Preventive Interventions for Children of DivorceStudies have shown that children of divorced parents may suffer more mental health problems, particularly conduct disorders. What programs might be effective in helping these children deal with the stress of their parents' divorce? Are there effective programs to teach parents better coping skills?
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Je Suis Charlie: A First-Person Account From the Paris RallyA commentary on France's response to recent acts of terrorism that unified a nation and the world, co-written by a psychiatrist who was at the Paris Rally.
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Addictive Disorders: Updates and FindingsAn introduction to the Annual Meeting of the American Academy of Addiction Psychiatry and its coverage of topics such as alcohol use disorders, e-cigarettes, prescription opioid use and abuse, cannabis use, stimulant use, medical marijuana, gambling, and opioid antagonist therapy to prevent overdose.
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Alcohol Disorders: Practical Tips From New ResearchIn this review, we discuss the established medications as well as experimental therapeutic options that may emerge as future medications for alcohol intoxication, withdrawal, and/or long-term abstinence maintenance or harm-reduced drinking.
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A Fun, Powerful Technique for Teaching Children How to Stop Being BulliedThe bullying prevention program is very popular but not very effective because bullying is an inevitable part of life.
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Lifetime Psychiatric Comorbidity of Illicit Drug Use DisordersWhat is comorbidity? Psychiatric comorbidity refers to the occurrence of 2 or more mental or substance use disorders within a certain period. Research shows that comorbidity of substance use and other psychiatric disorders is common and often worsens the prognosis for each disorder.
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Adjunctive Treatment Options for Patients With Residual Symptoms of DepressionPatients with residual symptoms of depression may continue to experience significant occupational and social impairment. The focus of this article is on the residual burden that so often remains after remission is achieved.
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Coyne Battles Darwin, Many Other Evolutionary Biologists-and HimselfErroneous conclusions, and medical harm, can come from accepting any hypothesis uncritically, and growing evidence indicates that treatments based on disorder hypotheses for depression do cause harm.
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Mindfulness and the Medication Management VisitEngaging in mindfulness activities either individually or with patients who come to us for brief medication visits can have a profound influence on the therapeutic process.
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7 Tips for Treating Trauma in Refugee PatientsMany refugees have been victims of severe violence that has profoundly affected their physical, psychological, and spiritual lives. Take home points here.
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PTSD in the Emergency SettingThe following 3 cases illustrate the diagnostic challenges related to differentiating brain injury and posttraumatic stress disorder (PTSD) in patients presenting to the emergency department (ED) in the acute period following a traumatic injury. Such patients pose a dilemma for ED clinicians because of the interplay between head injury and PTSD in the clinical presentation of cognitive impairments in the aftermath of trauma.
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A Literature Review of Videophone Use in Mental HealthIn our survey, we found videophones a surprisingly understudied and underutilized tool in spite of the fact that they are easy to use and do not require any technical support.
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The Relationship Between Antidepressant Initiation and Suicide RiskTen years ago, the FDA placed a black box warning on all antidepressants because of concerns that the medications increase risk of suicidal thoughts and behavior in youths. It's time for the FDA reevaluate that decision.
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New Directions in PsychiatryIn order to make positive changes in the field of psychiatry, it is important to appreciate and understand the current challenges and significant limitations of the present approach to psychiatric therapy.
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Knee pain in an 81-year-old manAn 81-year-old man presented to an urgent care facility with a 1-year history of pain in his right knee.
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Mini Quiz: Treatment for Pedophilia?What does the scientific evidence tell us about treatment for pedophilia? The answer might surprise you.
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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.
