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Lhermitte-Duclos Disease or Neoplasm?A 5-month-old girl was brought to her local emergency department because she displayed increasing fussiness and back arching for 3 days. She vomited once and was febrile on the day of presentation. Meningitis was suspected. A lumbar puncture was performed. It revealed a cerebrospinal fluid (CSF) protein level of 120 mg/dL and a CSF white blood cell count of 10/µL, with 50% polymorphonuclear cells. Antibiotics were empirically administered, and the infant was transferred to a tertiary care facility for further treatment.
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Addiction Resource Guide: An Internet Publishing AdventureA psychiatrist took his expertise in addiction medicine and coupled it with his desire to start a business. An addiction treatment facility clearinghouse, this Internet venture provides consumers with the opportunity to compare and contrast different treatment centers to find the one best suited to their needs.
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A Different March Madness: College Mental HealthAs parents and students experience the madness of selecting a college, here’s why weighing a school’s mental health services must not be overlooked.
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Addiction Is a ChoiceMany activities that are not themselves diseases can cause diseases, and a foolish, self-destructive activity is not necessarily a disease. When we find a parallel between physiological processes and mental or personality processes, we can mistakenly assume the physiological process is what is really going on, and the mental process is just a passive result of the physical process.
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Management of Mild Traumatic Brain InjuryA considerable overlap exists between TBI and disorders in cognition, behavior, and personality, which can provide even greater clinical challenges. More than 70% of the cases of TBI are mild, which makes this subgroup of particular clinical interest.
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Traumatic Brain Injury in Children and AdolescentsTraumatic brain injury (TBI) in children and adolescents is a major public health problem. Psychiatrists have a crucial role in the management of young persons who have a TBI.
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Beyond AddictionThe authors of this book leave readers feeling empowered, knowing that they can be an important driver of change. It also reminds psychiatrists about some core components of the patient experience.
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Late-Life Depression, Dementias- Top Educational Priorities for AAGPLack of energy, recurrent thoughts of death and difficulty with concentration are viewed by more than half of medical decision-makers in families as natural components of aging rather than as symptoms of clinical depression, according to a Louis Harris and Associates survey. Additionally, 93% of all adults polled said they believe depression is a normal side effect for those suffering from a medical condition.
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Childhood Adversities Associated With Risk for Suicidal BehaviorChildhood adversities associated with suicide risk include childhood maltreatment, problematic family relationships, socioeconomic hardship, and difficult relationships with peers. Acute suicide prevention strategies should focus on the treatment of contributory psychiatric disorders and on the crises that may precipitate suicidal behavior.
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Introduction: Navigating the Waters of Digital TechnologyModern communication capacities have the potential to decrease or to increase stigma and the isolation of persons with serious mental illness. Psychiatrists especially need to know how to navigate these largely uncharted waters.
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To Supplement or Not to Supplement: That Is the Bipolar Depression QuestionWith the multitude of nutritional products available to patients via the Internet and health-food stores, psychiatrists need to be prepared to respond to questions from patients about the value of these supplements.
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Family Involvement in Cognitive-Behavioral Therapy for Children’s Anxiety DisordersCognitive-behavioral therapy (CBT) for children with anxiety disorders may be especially effective when the family is included in treatment.
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Shooting for What I Want, Part 2How time flies! It has been more than a year since my last column, when I staked my claim in psychiatry. I planned to eschew the medical rat race and find my own little piece of medicine as it used to be, when doctors were doctors, nurses were nurses, and insurance salespeople were . . . salespeople. Should one read anything into the long delay between that column and this one? Absolutely! But I'll get to that.
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Evolving Issues in Correctional PsychiatryThere is no disputing that the rapidly escalating rate of incarceration during the past decade in the United States has been associated with an increasing number of imprisoned individuals with a mental illness. Research indicates that as many as 20% of inmates in jail or prison are in need of psychiatric care, frequently because of a serious mental disorder.
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Dopamine Receptors in the Human BrainDopamine plays an important role in controlling movement, emotion and cognition. Dopaminergic dysfunction has been implicated in the pathophysiology of schizophrenia, mood disorders, attention-deficit disorder, Tourette's syndrome, substance dependency, tardive dyskinesia, Parkinson's disease and other disorders.
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Can We Predict Response to Antidepressants?In this article, we use the example of major depressive disorder (MDD) to review research efforts to identify predictors of treatment response, both to antidepressant medications and to psychotherapy. We describe the promises and limitations of this research, with some emphasis on brain imaging studies, and then discuss how this work may be integrated into clinical practice in the future.
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Consumer Advertisements for Psychostimulants in the United States: A Long History of Misleading PromotionThe prescription of psychotropic medications for children continues to be a controversial area of medical practice. In the United States, academic medical centers, medical researchers, prescribers, and the FDA are all ostensibly committed to the common goal of disseminating accurate information and promoting treatment based on scientific evidence. In the United States, however, medical treatment takes place in the context of legal and pervasive direct-to-consumer advertising (DTCA). There are concerns about the potential for DTCA to affect public health negatively and to increase health care costs.
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Psychiatry on the EdgeAt a time when our field is under attack from many quarters, it is critically important to be able to discuss what it is that we do as psychiatrists in a non-defensive and intellectually rigorous manner. Help here.
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Lessons in Mitigating ViolenceStrategies to reduce aggression in psychiatric treatment settings.
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Commentary Alcoholism and Free WillPsychiatrists, like the rest of America, continue to have trouble with alcoholic and other addicted patients. We are comfortable when patients want to get better, tell us the truth and come to treatment of their own free will, but alcoholics often don't fit this profile. We respond angrily when patients manipulate us. We are surprised when their sincere desire for help evaporates after we suggest a plan that will bring about real change.
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Genetic Testing for Psychiatric Disorders: Its Current Role in Clinical Psychiatric PracticeGenetics seems to be a subject of particular interest for everyone. This article explores how the current state of knowledge regarding genetics might be used to help psychiatrists diagnose psychiatric disorders or predict their onset.
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Treating Adolescent Depression With Psychotherapy: The Three TsDespite the high prevalence of depression among youths, there are empirically supported treatments that have been shown to reduce depressogenic symptoms, including the 3 therapies outlined in this article.
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6 Challenges in Assessing ADHD in Adult PatientsThe clinical presentation and functional impacts of ADHD in adults vary greatly from their child and adolescent counterparts.
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Inflammation and Treatment Resistance in Major Depression: The Perfect StormNew findings provide powerful evidence that inhibition of inflammation or its downstream effects on mood may open up a host of new approaches to treatment for depression, especially for patients with treatment-resistant depression.
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Transition Issues for Patients With Eating DisordersStrategies to decrease the chances that individuals will fall through the cracks in the college years.
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Mini Quiz: Micronutrients and DepressionMicronutrient deficiencies can bring about a range of mental health complications. Take the quiz and learn more.
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Autism Spectrum Disorders and Psychiatry: Update on Diagnostic and Treatment ConsiderationsWhat are the most effective assessment practices for ASD during the developmental stages of early childhood, middle childhood, adolescence, and adulthood?
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Sudden Onset of Tics, Tantrums, Hyperactivity, and Emotional Lability: Update on PANS and PANDASIn the neuropsychiatric disorders PANS and PANDAS, we observe childhood illness with relationships between psychiatric symptoms, infection, and inflammation. Here are keys to early identification and treatment.
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Ethics and Virtues in Clinical PsychiatryCase-based dialogues illustrate some virtues required in psychiatric practice.
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Mini Quiz: Psychiatric Emergency Assessment of YouthsNearly half of children who present to emergency departments with self-harm receive no mental health assessment. What are the essential elements needed to interview children and adolescents in the context of a psychiatric emergency?
