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Managing Treatment-Resistant OCDObsessive-compulsive disorder is a prevalent, disabling and chronic illness. Serotonin reuptake inhibitors are the first-line of treatment; however a large proportion of patients will have either a partial or nonresponse. This review outlines the strategies for treatment-resistant OCD, including augmentation agents, alternative monotherapies, intravenous strategies and newer nonpharmacologic somatic treatments under development.
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Insomnia and Its Risks: Causes, Consequences and TreatmentCMEducator: Insomnia and Its Risks: Causes, Consequences and Treatment - application for credit only; article not available online
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Final Ruling Can Benefit Psychiatrists and Their PatientsThe mental health community was given some much needed relief when the Obama Administration implemented the final rule be put in place from the 2008 Mental Health Parity and Addiction Equity Act. The new mandate will ensure that most health plans cover mental health and addiction services in the same way they treat other medical issues.
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Coming Up for AirAs I lie in my hospital bed, attempting to breathe through my trach tube at a normal rate, waiting for my morning medication, and hoping to hear good, or at least manageable, results from my doctors when they come to me on rounds, my mind wanders. Despite the precariousness of my situation, I can’t help but smile as I think of my now monthly psychotherapy sessions.
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Psychopharmacology of Aggression and Violence in Mental IllnessSeveral studies have been undertaken to test the efficacy of drugs in the management of aggression and hostility in patients with schizophrenia and other mood disorders.
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Is ECT an Ethical Treatment?Although there are many social impediments to the use of ECT, it appears to meet the four ethical principles of health care.
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Sleep Disorders in the ElderlyA variety of conditions may account for the sleep difficulties experienced by many older adults, including specific sleep disorders, circadian rhythm disturbances, and medical and psychiatric comorbidities.
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The Lunch HourHere is a glimpse into the understated yet basic importance of taking a lunch break as a way of recharging during the workday.
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Optimizing Care in a Team Setting: A Program for People With SchizophreniaA look at a multidisciplinary team -- and its focus on meaningful recovery -- for patients with schizophrenia.
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Enlisting Family Members to Address Treatment Refusal in Substance AbusersAnyone who is close to someone who abuses alcohol or drugs knows all too well that substance abusers do not typically seek treatment until they have experienced years of substance-related problems. During the first year after onset of a diagnosable substance use disorder, only 1 of 5 alcohol-dependent persons and 1 of 4 drug-dependent persons receive treatment.
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2021 Sigourney Award Winner: Supporting the MissionThis Sigourney Award winner is glad the recognition can continue supporting the mission of their work.
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Youth-Led Suicide Prevention in an Indigenous Rural CommunitySuicide is a pervasive public health issue for adolescents in Hawaii. In response, a youth leadership model was initiated to empower young leaders in suicide prevention through evidence-based training, relationship building, and community awareness.
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Diagnostic Manual-Intellectual Disability: A Textbook of Diagnosis of Mental Disorders in Persons With Intellectual DisabilityThe editors of Diagnostic Manual-Intellectual Disability (DM-ID) have set out to complete the difficult task of compiling the evidence base on mental disorders in the field of intellectual disability (ID) into one reference book while modifying DSM-IV diagnostic criteria for use in persons with the disorder who present with mental and behavioral disorders.
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Psychosis and Suicidality in AdolescentsInformation from studies on adolescents with psychosis and a review of the evidence about the risk of suicide and suicidal behavior in this patient population.
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Fostering Human Connection in a Sustainable Virtual WorldHow can psychiatry meet its ethical duty to mitigate climate change while also promoting collegiality at conferences?
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Mini Quiz: Perinatal DepressionYour patient is excited to be pregnant. She is currently on sertraline, and has been stable on this for many years. She is very insistent that she would like to stop her medication. What should you do?
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The Clinical and Treatment Implications of Co-Occurring Mania and ADHD in YouthsThe relationship between bipolar disorder and ADHD remains unclear; however, this combined condition may represent an important genetic and clinical subtype with distinct psychopathology, familiality, and treatment response.
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Huntington Disease: Hopes for the FutureInitial symptoms include personality changes and the gradual appearance of small involuntary movements. These move- ments progress to frank chorea, ballism, and dystonia. Later in the disease course, a bradykinetic parkinsonian phenotype manifests. It is characterized by rigidity, severe dystonia, and contractures. Falls are common. Dysphagia is common as well and is progressive, becoming severe and often contributing to death from aspiration pneumonia.
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We Shall Fight Them on the BeachesSettlements by two insurance companies in the RICO lawsuit could have an major impact on psychiatry practices.
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The Differential Diagnosis of Childhood Developmental DisordersReducing complex human experiences into a psychiatric diagnosis can be a daunting task. For children with developmental disorders, this process is even more complicated and requires distilling often incomplete and frequently contradictory scientific evidence.
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Synthetic Cathinones: Signs, Symptoms, and TreatmentSometimes viewed as “legal cocaine,” the over-the-counter status of synthetic cathinones (aka bath salts) gives the illusion that they are safe. In fact, they are highly toxic.
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Update on Psychogenic Nonepileptic SeizuresThe authors take an in-depth look at the evaluation, diagnosis, and fundamental treatment recommendations, protocols, and guides to therapy for psychogenic nonepileptic seizures.
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Elder Abuse and Neglect: Appearances Can Be DeceptiveThe number of persons affected by elder mistreatment and self-neglect is growing-with consequent increases in morbidity and premature mortality.
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The Death Penalty and Mental Illness: An Evolving Standard?Although a majority of states still permit capital punishment, this may not represent the true national mood: many of these states have not had an execution in more than 10 years.
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Cognitive Difficulties Associated With Depression What Are the Implications for Treatment?Subjective complaints of impaired concentration, memory, and attention are common in people with major depressive disorder (MDD), and research shows that a variety of structural brain abnormalities are associated with MDD.1 These findings have intensified the interest in quantitative assessment of cognitive and neuropsychological performance in patients with mood disorders. Many studies that used standardized cognitive tests have found that mild cognitive abnormalities are associated with MDD and that these abnormalities are more pronounced in persons who have MDD with melancholic or psychotic features
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Taking Culture Into Account When Assessing a Young PatientThis list serves as a guide when treating persons of diverse cultures and backgrounds.
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Gender Differences in Panic DisorderAccording to National Comorbidity Survey data, panic disorder is 2.5 times more prevalent in women than in men. Do physiological changes for women during the perimenstrual and perimenopausal phase play a role in this disorder?
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Risk of Aggressive Behavior in Bipolar DisorderRanked by the World Health Organization among the top 10 most disabling disorders in the world, bipolar disorder was the subject of review in a recent study. Here, a video summary by the lead author of a study on bipolar disorder and aggression.
