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Racism: Psychiatry's Unsolved DilemmaWhat has happened to our nation since the 1960s and 1970s? The quest for racial equality appears to be rapidly dissipating. Blatant pre-civil rights racism has been replaced by a more virulent, yet camouflaged, form of racial bigotry.
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Setting the Record Straight: A Response to Frances Commentary on DSM-VThe commentary “A Warning Sign on the Road to DSM-5: Beware of its Unintended Consequences” by Allen Frances, M.D., submitted to Psychiatric Times contains factual errors and assumptions about the development of DSM-V that cannot go unchallenged. Frances now joins a group of individuals, many involved in development of previous editions of DSM, including Dr. Robert Spitzer, who repeat the same accusations about DSM-V with disregard for the facts.
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Social Anxiety in AdolescentsAlthough social anxiety can be a challenge at any point across the lifespan, it can present a unique set of challenges during the teenage years. More in this podcast.
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Adaptation and Implementation of the Integrated Dual Diagnosis Treatment Model Into a Psychiatric Inpatient Facility: A 12-Year PerspectiveAs early as the 1970s, researchers and practitioners became increasingly aware of the necessity for services that would address the varied needs and treatment implications for consumers with the co-occurring disorders of substance abuse and mental illness. High percentages of consumers in substance abuse treatment centers were identified with mental illness disorders, and consumers admitted to psychiatric facilities often were identified as having additional substance use disorders.
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Psychiatrists Can Help Prevent DeliriumI teach doctors and nurses how to assess, treat, and prevent delirium-an acute confusional disorder caused by multiple medical problems that mimics mental illness-but is actually a medical emergency.
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6 Psychotherapy Questions for Medically Ill PatientsA brief psychosocial tool that offers compassionate, tailored care using existential neuroscience, a new perspective for conducting bedside psychotherapy.
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Leveraging and Balancing Skills in a Big Data EraLearn more about topics of interest in forensic psychiatry in this month's Special Report!
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Psychopharmacology for Medically Ill PatientsThe prescription of psychotropic medications for patients with complex comorbid medical and psychiatric conditions is a cornerstone of psychosomatic medicine (PM) practice.
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COVID-19 and Mental Health: Global Consequences and CAM ApproachesIn this CME article, explore the mental health consequences associated with the COVID-19 pandemic as well as the potential role for complementary and alternative approaches.
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Patient Resistance in Eating DisordersWhy do patients with eating disorders resist treatment? How can the clinician address resistance?
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Concurrent Treatment With SRIs and Anticoagulants: Minimizing the Hemorrhagic HazardAn important adverse effect of SRIs: their association with increased bleeding.
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Think Zinc: Micronutrient Supplementation for the Treatment of Anorexia NervosaCan zinc help improve symptoms of anorexia nervosa?
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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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Reading the Ability of a Patient to Change His or Her LifeReading the Ability of a Patient to Change His or Her Life
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The Cognitive Behavioral Analysis System of PsychotherapyI have been invited to write a clinical article on psychotherapeutic interventions for chronic depression.
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4 Ways to Cope With Bipolar UncertaintyHere are 4 means of coping with the diagnostic uncertainty of bipolar mixed states.
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PTSD in DSM-5: Understanding the ChangesDespite the efforts of a dedicated Work Group, DSM-5 has not significantly changed the problems with PTSD that beset DSM-IV.
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Providing Psychotherapy Over the InternetAlthough the prospect of online mental health care raises obvious questions, it also offers an opportunity to make cost effective services available to many who may not otherwise have access. By understanding issues such as confidentiality, emergencies and lack of face-to-face contact, psychiatrists can determine if this area of treatment is right for them.
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Multiple Sclerosis: MRI in Diagnosis, Management, and MonitoringMRI has provided important insights into the pathophysiology of multiple sclerosis (MS).1 However, conventional MRI scans furnish only gross estimates of the nature and extent of tissue damage associated with MS,2 and the data correlate poorly with measures of concurrent disability in patients.
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Psychosomatic Medicine: An Idea Whose Time Has ComeMedical-psychiatric comorbidity predicts poorer outcomes and increased health care utilization and cost. The collection of articles in this Special Edition is clinically informative and an illustrative set of examples of the unique practice of psychosomatic medicine in different medical-surgical settings.
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Use of a Nasal Naloxone-Containing Kit in the Transition From Regional Psychiatric Hospital to Community Care: A 1-Year Follow-up StudyDetails here about a protocol for opioid abusers and the mentally ill that helped avoid deaths from drug overdose after psychiatric hospitalization.
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Anti-NMDA Receptor Encephalitis: Diagnostic Issues for PsychiatristsThis articles focuses on the psychiatric and neurological implications of anti-NMDA receptor encephalitis.
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It’s Still Possible-Even in a Managed Care WorldIt is still possible for a psychiatrist to have a successful and very gratifying practice that provides psychotherapy (along with medication to those who need both)-even “in a managed care environment.”
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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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Reexperiencing/Hyperaroused and Dissociative States in Posttraumatic Stress DisorderDissociation-a common feature of posttraumatic stress disorder (PTSD)-involves disruptions in the usually integrated functions of consciousness, memory, identity, and perception of the self and the environment.
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Antidepressants: Brand Name or Generic?For many antidepressants, the issue of brand-name versus generic has no practical significance. Elavil was first marketed almost a half century ago, and its patent has long expired. It lives on, however, but as generic amitriptyline. Today, only a few antidepressants are still fully protected by patents, namely, Cymbalta (2010), Lexapro (2012), and Pristiq (2022) for major depressive disorder (MDD); and Seroquel (2011) and Symbyax (2017) for bipolar depression.
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Does Ketamine Hold Promise in Mitigating Suicide Risk?The authors review mechanisms of suicide and the effectiveness of current treatments, and zero in on ketamine--a potential novel, rapidly acting treatment for suicidality.
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The Assessment and Management of Depression in Children With AsthmaAsthma is one of the most impairing diseases of childhood, affecting more than 6% of children. Each year, it is responsible for 14 million lost school days and $3 billion in treatment costs.
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Rock, Paper, Scissors-PicaPica, a condition in which a person is compelled to eat non-food items such as dirt, paper, plaster, cigarette ashes, and other substances, is increasing in prevalence in adults. More in this patient education summary.
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Exploring Gender Difference in DepressionMost studies have found clear gender differences in the prevalence of depressive disorders. Typically, studies report that women have a prevalence rate for depression up to twice that of men (Bebbington, 1996; Nolen-Hoeksema, 1987).
