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Psychotherapy Supervision (2nd ed)who remarked that the problem with most new books he reads these days is that there is “too much space between the covers.” After all, he queried rhetorically, “Do I really need more than 250 pages or so on any one subject?” Days before this conversation, I had accepted an invitation to write a review of Psychotherapy Supervision and had received the 632-page tome by mail.
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Brain Pathways: New Approaches to Structure-Function LocalizationIs it time again for greater unification of neurology and psychiatry?
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Drugs On Our Minds: Historical, Social Perspectives on 'Modifiers of Affect'To understand our fascination with drugs in the first place, we need to ask some basic questions, such as "Why do we like to take poison in small quantities?" The truthful answer is always some variation of "To feel better." How does this come about, and why do we have so much trouble with it?
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Update on Bipolar Disorder, Part 2: Bipolar Depression and Cyclothymic DisorderThis article reviews DSM-5 changes to symptom criteria for bipolar disorder with a focus on treatment of bipolar depression and cyclothymic disorder.
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An Update on the Diagnosis and Treatment of Bipolar Disorder, Part 1: ManiaThis article reviews DSM-5 changes to symptom criteria for bipolar disorder. The primary focus is on the diagnosis and treatment of mania and hypomania.
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Schizophrenia and Smartphones: Separating Speculation From ScienceCan mobile technologies advance care for schizophrenia? The research literature strongly supports feasibility, although clinical data on validity, safety, and efficacy are still lacking.
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Some Concerns Regarding DiagnosisThe mental health professions are currently awaiting the American Psychiatric Association’s newest version of the Diagnostic and Statistical Manual. The need for a fifth revision underscores the lack of satisfaction within the professions with our diagnostic schema
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Neoplasm or Demyelinating Lesion?A 32-year-old left-handed woman presented with a 4-week history of progressive left hand numbness, tingling, and clumsiness. Symptoms worsened until she found it difficult to write and perform fine motor tasks. She reported having no transient neurological symptoms in the past. Her medical history was significant only for Dengue fever acquired several years ago while on a visit to Southeast Asia. She was taking no medications, and a review of systems was noncontributory.
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Assessing Malingered Voice-HearingMalingering in clinical settings is usually motivated by an attempt to obtain care or social services (eg, hospital admission, medication, disability income) and often co-occurs with real mental illness, hence the dilemma.
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Antecedents of Personality Disorders in Young AdultsPersonality disorders are characterized by the presence of inflexible and maladaptive patterns of perceiving oneself and relating to the environment that result in psychosocial impairment or subjective distress. The enduring nature of the behaviors, their impact on social functioning, the lack of clear boundaries between normality and illness, and the patient's perception of the symptoms as not being foreign make this group of conditions more difficult to conceptualize than the more typical, episodic mental disorders.
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Telepsychiatry: The Perils of Using SkypeWhat Skype does not offer is a means of communication clearly suitable for clinical services-especially in mental health and psychiatry.
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Hemicraniectomy for Massive Basal Ganglia Hemorrhageintracerebral hemorrhage, hemicraniectomy, stroke, neurosurgery, traumatic brain injury
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Psychiatric Problems in Patients Who Survive Critical Illnesses (Part 2)The psychiatric aftermath of critical illness can involve emerging from the ICU with horrifying memories (of being tortured, raped, assaulted, or imprisoned).
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What’s New in Our Understanding of SchizophreniaDuring the past 5 years, new insights into the pathophysiological processes that underlie schizophrenia have been revealed. Here's a quick update.
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The State of the Mental Health SystemThe federal government must realize that decades of allowing mental health care to go begging leaves a very weak chance of detecting or treating those who need help.
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Progress in the Treatment of Bipolar Depression: Advances and ChallengesA discussion of the pharmacologic management of bipolar depression, including emerging treatments and expert recommendations.
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Correctional Psychiatry: Challenges and RewardsPracticing psychiatry in a correctional environment differs from traditional outpatient and inpatient venues and presents unique challenges. It can be a rewarding choice of workplace.
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The OPTICS Project: An Open-Science Framework for the Analysis of Clinical Trial DataA report of initiatives that have raised awareness of and promoted data sharing and data transparency in order to advance science and improve public health and health care.
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From Our ReadersThe totalitarian system as we know it today may also be called 'managerial capitalism' since the decisions dictated by technical and economic considerations are no longer hampered by the rights of ownership and title holders. Yet it should be emphasized, speaking of 'managers,' that the true technical directors have nowhere acquired the disposing power of technocrats; the real power rests mainly with economic and business managers. This was written by H. Bruggers in 1941 in his "Stages of Totalitarian Economy," in the publication Living Marxism.
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Career Q&A With Joseph Weiner, MD, PhD (Part 2)During a presentation at a past Psychiatric Times Virtual Career Expo, Dr Joseph Weiner answered questions submitted by attendees, offered here in this brief Q&A.
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Borderline Personality Disorder and Bipolar Disorder-Distinguishing Features of Clinical Diagnosis and TreatmentSince the inclusion of the borderline personality disorder (BPD) diagnosis in DSM, there have been multiple efforts to recast the disorder as part of an Axis I illness category. While the initial focus was on the schizophrenia spectrum, more recent authors have attempted to link BPD to mood disorders.
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Special Risk Management Issues in Child and Adolescent PsychiatryNumerous studies have documented the increasing prevalence of mental health and substance abuse issues in youths nationwide. As many as 1 in 5 children and adolescents in the United States have a behavioral or emotional disorder.
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Comorbidity and Psychiatric Disorders: Support or Hindrance for Psychiatric Care?The revolution inherent in the move from DSM-II to DSM-III primarily involved a growing emphasis on comorbidity. For several decades before DSM-III, the emphasis had been on diagnostic economy: fewer diagnoses were considered more elegant, more accurate, and more useful in guiding care.
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Light Treatment for Nonseasonal DepressionDaniel F. Kripke, M.D. has studied the relationship between biological rhythms and depression since the early 1970s. He states that seasonal responses in many mammals are controlled by the photoperiod. Therefore, it seemed that depression might be analogous to winter responses and that light might be an effective treatment.
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Polypharmacy to Optimize Depression OutcomesPolypharmacy is used increasingly in the treatment of depression.1 Although it can be beneficial-and at times may even be unavoidable-it can also be overused, resulting in drug-drug interactions, accumulation of adverse effects, reduced treatment adherence, and unnecessary increases in the cost of health care.2 This article describes current trends in psychiatric polypharmacy in the treatment of depression along with ways to use polypharmacy to optimize treatment outcomes.
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Loss and Managing the Crisis at HandIf we acknowledge our feelings of grief and loss over the pandemic, we can begin to come together, encourage hope, find meaning, and stay connected. Dr Morganstein talks on this.
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Confounding Factors in Treatment-Resistant Depression (Part 2): Comorbidities and Treatment ResistanceThe role of subtyping and bipolarity in TRD was discussed in Part 1 of this 2-part article. Here we review a number of the most common confounding factors of TRD but limit our scope to comorbidities that can be directly addressed and treated by psychiatrists.
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Psychotherapy for Social Anxiety DisorderWhile social anxiety disorder (SAD) may cause observable signs of anxiety and social awkwardness in some, many others suffer silently. Cognitive-behavioral therapy can be helpful for most patients with SAD, with alternative therapies such as psychodynamic therapy and interpersonal therapy filling the gaps.
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Detox Diagnosis--Keeping Medicine in PsychiatryThe following are case studies discussing the impact of proper evaluation of comorbid psychiatric illness and medical disorders. To read more case studies and find out how to effectively recognize and treat patients with these disorders, please see the January 2002 issue of Psychiatric Times.
