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Unexplained Physical Symptomshe key manifestations of DSM-IV somatoform disorder are unexplained physical symptoms or complaints that tend to coexist with other psychiatric syndromes or are linked to psychological issues. These symptoms typically lead to repeated medical or emergency department visits; are associated with serious discomfort, dysfunction, and disability; and lead to significant health expenditures.
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The History and Value of Guidelines for Best Practices of Telemental HealthTelepsychiatry has its origins in the 1950s and has moved from an esoteric curiosity to mainstream practice. However, it has been challenged along the way at many turns.
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Second Messenger Systems, Genes, Neurogenesis, and Mood DisordersFor many years, research on mood disorders has focused on neurotransmitters, particularly on the monoamines (serotonin, norepinephrine, and dopamine) and their action at the neuronal junction, or synapse. Although the monoamine theory helps explain the action of tricyclics, monoamine oxidase inhibitors, and SSRIs, it fails to account for many other things.
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What Are Common Comorbidities in ADHD?In this article, Julie Sherman, PhD and Jay Tarnow, MD briefly discuss the latest research findings on ADHD.
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Highlighting Brain-Based Inequalities for Women: From Bedside and Boardroom to PolicyThe COVID-19 pandemic has exacerbated mental health and gender inequalities around the world. Understanding the causes is the first step toward finding solutions.
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Quitting Smoking: Therapeutic in Mental Health TreatmentMany patients report that smoking helps them with their stress and psychological disturbances. However, smoking may actually worsen some of these symptoms. When is the right time for your patients to quit?
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An Autistic Child With Psychotic SymptomsAutism and schizophrenia may present as 2 separate disorders that need to be differentiated, or treated as comorbid conditions. It is important to remember that some individuals may have both disorders, which has implications when designing appropriate biopsychosocial interventions.
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The Value of Measuring Health Care QualityConsider the following scenario: You are contacted by the major health plan with which you contract and are told that your average length of inpatient stay is longer than their standard. You believe this is because your patients are more severely ill than average. How do you respond?
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Understanding Addiction as Self Medication: Finding Hope Behind the PainWhy do people get addicted? Of the countless books that have been published on this topic, this is the first that focuses on the self-medication hypothesis (SMH). Understanding Addiction as Self Medication is largely based on the experiences of the authors and other clinicians with individuals who struggle with addiction.
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Suicide Prevention in Diverse Populations: A Systems and Readiness Approach for Emergency SettingsIn the US, suicide is a leading cause of death, ranking third among youths aged 15 to 24. Rates of suicide attempts and death are highest among US Pacific Island indigenous youths. Emergency departments play a key role in suicide prevention, especially in this and other minority populations.
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10 Salient Points About Migraine and Psychiatric ComorbidityWhere do migraines and psychiatric disorders intersect? Learn more.
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Are Assessment and Treatment Influenced by Ethnicity and Gender?Results from three statewide studies of the clinical practices for assessing and treating children and adolescents with a primary diagnosis of conduct disorder, ADHD or bipolar I disorder demonstrate gender and ethnic differences only for those diagnosed with conduct disorder. The implications of these findings and their similarities to the literature on adults with psychiatric disorders are discussed.
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Nutritional Treatments: The Next Frontier in PsychiatryHere’s how nutrients can ameliorate psychiatric conditions.
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Understanding Child MaltreatmentWithout normative attachment, children can move into their middle years without the tools to succeed in peer relationships, school, and extracurricular activities, opening the door to perils in adolescence.
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Psychiatric Evaluation of Children and Adolescents: It Takes TimePsychiatrists know that it takes longer to interview children and adolescents than adults. Child and adolescent psychiatrists are universally struck by how comparatively easy it is to interview an adult patient, whereas general psychiatrists face the evaluation of a child or adolescent with apprehension.
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A Love of GroupsI am a Registered Nurse of 37 years who has worked in hospice care and psychiatric emergency; I’ve worked as a med/surgical manager and (now) as an inpatient psychiatric nurse. Throughout it all, I most enjoy seeing a patient realize he/she is getting well; I also enjoy conducting small teaching groups to help the patient know how to stay well.
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Pseudobulbar Affect Versus Depression: Issues in Diagnosis and TreatmentThe most challenging aspect of pseudobulbar affect is differentiating it from depression. Episodes of uncontrollable, sudden, and even inappropriate emotions may point to neurologic or psychiatric conditions.
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The Psychiatric Dimensions of NarcolepsyNarcolepsy, cataplexy: symptoms are broad and associated with a range of medical and psychiatric comorbidities. Here: diagnostic and treatment strategies and a look at the BOND study.
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Incorporating Well-Being Into Child and Adolescent PsychiatryA well-being centered approach expands assessment and treatment for the child’s strengths and opportunities for positive experiences with the family.
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Diagnosis and Treatment of Delirium in 2006Delirium must be diagnosed accurately, prevented, and treated because of its pervasiveness and the associated risks of morbidity and mortality.
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GREAT EXPECTATIONS A Warm Welcome to 21st Century PsychiatryIn the last third of the 20th century, psychiatry boldly shook off a 120-year-long philosophical funk and rushed to catch up in the thrilling march of medicine. The biopsychosocial model that once sounded trendy now seems to be an indispensable approach. The pioneers of psychopharmacology who once labored at the margins have now been joined by thousands of bright young doctors who treat patients with depression, psychosis and impulsive aggression and realize that a troubled soul is often expressing the cries of a troubled brain. This issue of Psychiatric Times celebrates the stirring giant that is 21st-century neuropsychiatry--a discipline that derives its immense power and scope from the glad embrace of the twin Enlightenment ideals of humanism and the scientific method.
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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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POTUS, Politics, & Neuropsychiatric Assessment: What Do We Need to Know and When Do We Need to Know It?Where do we draw the line on level of impairment for our presidential candidates?
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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.
