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Neurobiology of PTSDThis is the last installment in a 3-part series discussing the behavioral, cellular, and molecular characteristics of posttraumatic stress disorder (PTSD). In Part 1, I described some basic clinical observations of PTSD and the challenges these observations pose to researchers attempting to understand underlying biological substrates.1 Part 2 examined progress on addressing these challenges at the level of the tissue and cell.2 In Part 3, I will discuss efforts to understand PTSD at the level of DNA, including potential genetic underpinnings and heritable risk factors.
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TV Violence and Brainmapping in ChildrenResearch conducted over the past 30 years leads to the conclusion that televised violence does influence viewers' attitudes, values and behavior.
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Atypical Depression in the 21st Century: Diagnostic and Treatment IssuesIdentification of atypical features is important in the treatment of depression for both treatment selection and prognosis, especially when initial measures prove ineffective. The concept of atypical depression has evolved over many years, and now it appears timely for a further revision.
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Consent in Psychiatric Emergencies: What Clinicians Need to KnowIt is important to recognize and document the abilities and deficits of a patient in order to determine capacity.
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Antidepressants for Bipolar DisorderWhat is the effectiveness (if any) of antidepressants in bipolar depression? What is the risk of manic switching? How effective are antidepressants in preventing relapse of bipolar depression? Insights here.
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Opposition to Medical Aid in Dying: Deserving Serious ConsiderationFurther arguments opposing MAID.
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The Internet as Practice ExtenderIn the early 1960s, the Internet was born out of the idea of a "Galactic Network." By the late 1980s, technology had advanced to allow for computer-based exchange of scientific information between academic and research institutes. From these humble beginnings, the Internet has experienced explosive growth in the last five years, evolving into a powerful global information resource and new media format unto itself. Psychiatrists can now reap the full benefit of this fast-paced evolution to extend the reach of their medical practice.
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Sweet Tea and Mental Health TransformationAcross our nation, mental health care funding and resources are either slashed to the bone or nonexistent. Yet, at the same time, there is a unique opportunity available right now for any and all who want to tackle reform.
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Traumatic Stress in Children and AdolescentsEight Steps to TreatmentTraumatic experiences are common in childhood and adolescence and can have significant psychological effects on the child’s emotional well-being and overall development. Outcomes can be affected positively or negatively depending on responses and interventions.
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Deep Brain Stimulation Surgery for OCD: On Safety, Efficacy-and Financial IncentivesOn Safety, Efficacy-and Financial Incentives
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Integrating Mental Health Apps Into Care With Your Patients: What You Need to KnowHere’s everything you need to know to about how to integrate apps into your clinical practice.
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Addressing the Interface Between Pediatrics and PsychiatryThere has been much thought and discussion about the relationship between pediatrics and psychiatry, but research on the integration of the two leaves much to the imagination.
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Does TMS Hold Promise for Generalized Anxiety Disorder?Available data suggest that transcranial magnetic stimulation holds promise as a treatment for GAD. Here: a look at what we know.
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A Call to Arms to Understand and Treat Aggressive BehaviorDr Thompson introduces a Special Report meant to provoke thoughtful contemplation on various topics related to aggressive behavior.
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An Update on Street and Club Drugs: What Clinicians Need to KnowA review of the pharmacological and symptomatic effects of various classes of designer drugs, including stimulants, hallucinogens, and sedatives.
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Marketing Off-Label Uses: Shady Practices Within a Gray MarketFor pharmaceutical companies, off-label use of a drug represents a substantial “gray market,” to which the company is unable to sell their product directly, yet may be a significant revenue stream. Some drugs have been used more for off-label purposes than for originally approved indications.1
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Restless Legs Syndrome: Clinical Implications for PsychiatristsWhile patients with restless legs syndrome may be successfully treated with a number of medications, comorbid psychiatric conditions present a unique challenge because many commonly prescribed psychiatric medications may worsen RLS symptoms.
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Consequences of Population DriftWriters of diagnostic criteria should consider their work and all its implications. What about adding a new disorder? What might that do to epidemiological capture? Depending on the characteristics of the diagnostic criteria set, many possibilities exist.
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Cormorbidity: Diagnosing Comorbid Psychiatric ConditionsAutism spectrum disorders (ASDs) are a group of 5 neuro developmental conditions (autism, Asperger syndrome, pervasive developmental disorder not otherwise specified [PDD-NOS], Rett syndrome, and disintegrative childhood disorder).1 Once thought to be rare, the incidence of these disorders is now estimated to be 1 in 150 children in the general population.2 Furthermore, the number of recognized cases has increased markedly in recent years.
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Challenges and Obstacles in Treating Mentally Ill Black PatientsAs the United States becomes more culturally, racially, and ethnically diverse, psychiatry will be faced with the need to treat more diverse populations. This article focuses on challenges and obstacles encountered when treating black patients with mental illness.
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What All Psychiatrists Need to Know About AddictionsBecause at least 10% of the US population suffers from a substance use disorder in any given year, the American Academy of Addiction Psychiatry has expanded its longstanding Board Review Course in Addictions to a more inclusive “Addictions and Their Treatment” course.
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Metabolic Monitoring of Antipsychotic Medications: What Psychiatrists Need to KnowBecause patients who have psychiatric illnesses typically receive less frequent medical care, psychiatrists must aim to ensure appropriate monitoring of metabolic parameters when antipsychotic medications are used.
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Managing Autism in ChildrenNo other psychiatric diagnosis has more profound negative implications than autism. On the surface, autism impacts social, emotional, behavioral, and academic functioning. However, autism is pervasive in ways less immediately observable, and, as a result, children with autism require developmental and educational interventions that are different in both form and intensity from those required by children with other special needs.
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OCD and Bipolar Disorder: Novel InsightsBipolar disorder frequently co-occurs with OCD and complicates treatment of OCD symptoms. Special considerations are discussed.
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Cultural Psychiatry Comes of AgeCultural psychiatry can no longer be thought to involve only unusual syndromes that occur in distant societies. The growing literature in attests to the vitality of this field.
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Evidence-Based Therapies in Child and Adolescent PsychiatryEvidence-Based Therapies in Child and Adolescent Psychiatry by Jon McClellan, M.D. Given the lack of large, randomized controlled studies of psychiatric medications that involve children and adolescents, it can be difficult to establish evidence-based therapies that are effective for this population. However, there are studies that have shown the effectiveness of various medications, as well as for various psychotherapy techniques.
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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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The Joker and the Thief: Persistent Malingering as a Specific Type of Therapeutic Impasse"There must be some way out of here," said the joker to the thief."There's too much confusion, I can't get no relief. . . .""No reason to get excited," the thief, he kindly spoke,"There are many here among us who feel that life is but a joke.But you and I, we've been through that, and this is not our fate,So let us not talk falsely now, the hour is getting late."From "All Along the Watchtower," Bob Dylan
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Video: Treating the Whole Patient: Reversing the Long Day’s Journey Into Night: Mind-Body Perspectives on Treatment-Resistant DepressionThe goal of treating the whole patient, ie, integrating the mind-body connection into mental health care inititiatives, is to provide health care professionals with tactics to effectively identify interdependent conditions of the mind and body that impair psychiatric well-being, as well as strategies for successful treatment and management options in the clinical setting to improve patient care, outcomes, and overall wellness.
