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Confidentiality and the Family: 5 Guidelines for Better OutcomesFamily involvement is often misunderstood as being a hindrance to individuation, when in fact family-oriented interventions can improve patient functioning, agency, and autonomy.
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Flakka: A Deadly HighThe abuse of this dangerous designer drug that can be purchased online is rapidly on the rise in the US.
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Psychiatric Care of Peripartum WomenThis article summarizes clinically relevant advances in the psychiatric care of women during and after pregnancy, including recent changes in how the FDA classifies pregnancy risk for medications, and best practices in perinatal psychopharmacology.
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Posttraumatic Spectrum Disorder: A Radical RevisionThe introduction of posttraumatic stress disorder (PTSD) into psychiatric nosology has brought about a great deal of insight as well as controversy. Have complex clinical manifestations of PTSD created a need for further clarification of the disorder?
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Gone to the DogsInsurance restrictions sometimes make for strange bedfellows. My story begins with a phone call from a man about to lose his job. He said that he had been placed on probation and was about to be fired. He asked if he could see me. We met the following day.
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The Role of Psychiatrists in Countering Violent ExtremismThere is no predictive tool that is likely to have validity for rare outcomes such as terrorist attacks. More here.
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Lasting Ties in Just 8 Days: Mental Health in a World Without PsychiatristsDuring their time in Ayacucho, these visiting psychiatrists learned that American psychiatric training has wide-reaching cultural value.
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Metabolic Syndrome in Patients With Major Depressive DisorderAssociated Risk FactorsAlthough most studies have focused on the risk of metabolic syndrome for patients with schizophrenia exposed to atypical antipsychotics, other psychiatric patients appear to be at risk for metabolic disturbances as well.7-9 Major depressive disorder (MDD) may be of particular interest because it is much more common than schizophrenia and is treated with a broad range of psychotropics.
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Update on Depression Treatments for YouthFurther evidence-based antidepressant treatments are needed for children and adolescents with depression.
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Forensic Psychiatrists Vote No on Proposed ParaphiliasForensic psychiatrists expressed near-unanimous opposition to 3 controversial new sexual diagnoses after a spirited debate at a recent conference of the American Association of Psychiatry and Law (AAPL).
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Tobacco MadnessBetween 50% and 80% of people with mental disorders smoke cigarettes. Are the tobacco companies targeting this population, and are mental health care facilities promoting the use of tobacco? What are psychiatrists' responsibilities in the overall health of their patient?
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Comprehensive Treatment of Stalking VictimsPsychiatrists may encounter patients who present with severe emotional consequences because they are victims of stalking. In addition, psychiatrists themselves are at increased risk for becoming victims of stalking because of the nature of their profession and their interaction with lonely and unhappy individuals.
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Depressive Symptoms Associated With AggressionThe authors review the association between depression and violence, and the role that anger and emotional dysregulation play.
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Deliberate Self-Harm in Adolescents: the Importance of GenderWorldwide, nonfatal deliberate self-harm is common among young people. However, when studying this phenomenon, methodological issues arise. Differences between genders have been found in presenting to the hospital following self-harm and in motive for engaging in this troubling behavior.
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Genetics of PTSD: A Neglected Area?Posttraumatic stress disorder is one of the most devastating psychiatric disorders. Research has shown that a combination of multiple genes can lead to conditions for PTSD. Environmental factors, as well as comorbidities, must also be considered when looking for genetic conditions of PTSD.
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Clinical Pearls for the Management of Patients Suffering from NarcolepsyKarl Doghramji, MD, FAASM, DFAPA, and Chelsie Monroe, MSN, APN, PMHNP-BC, conclude the discussion with advice for clinicians who treat patients with narcolepsy.
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Achieving Remission in Generalized Anxiety DisorderGeneralized anxiety disorder (GAD) is a prevalent, chronic, debilitating mental illness associated with marked impairment in daily functioning.1 An ongoing evolution of the definition of GAD has resulted in a bifurcation of the historical anxiety neurosis designation.2 A diagnosis of GAD currently implies chronic, excessive worry lasting at least 6 months and 3 of the possible 6 somatic or psychological symptoms (restlessness, fatigue, muscle tension, irritability, difficulty concentrating, and sleep disturbance).3 GAD typically presents in an episodic pattern of moderate improvement or remission and relapse characterized by a chronic and complicated clinical course.
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The Vesicular Monoamine TransporterThe vesicular monoamine transporter (VMAT) is a membrane-embedded protein that transports monoamine neurotransmitter molecules into intraneuronal storage vesicles to allow subsequent release into the synapse.1,2 By accumulating both newly synthesized neurotransmitter molecules and freshly returned neurotransmitter molecules from the synapse, VMAT function plays a critical role in the signaling process between monoamine neurons. The VMAT exists in 2 distinct forms: VMAT1 and VMAT2.3
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Refinements in ECT TechniquesWith ECT‚ the response rate for treatment-refractory patients is sobering‚ and the treatment is not without risks and adverse effects.
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Adjunctive Treatment Options for Patients With Residual Symptoms of DepressionPatients with residual symptoms of depression may continue to experience significant occupational and social impairment. The focus of this article is on the residual burden that so often remains after remission is achieved.
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Suicidal Behavior in the ElderlyAssessing and treating suicidal behavior in the elderly can be difficult. What are the risk factors and how can this population best be treated?
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Treatment Options in Late-Life Treatment-Resistant DepressionThis article sheds light on the strengths and weaknesses of various approaches to TRD management in adults 60 years and older.
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Taking a Leave of Absence from Your Medical PracticePlanning a break from your practice for a while? Here are some tips to help you work with your partners and patients for a meaningful long-term absence.
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Chronic Disease Self-Management Programs in PsychiatryThrough patient self-management, mental health clinicians can transfer the focus from managing symptoms to allowing patients to live well in the context of their mental illness and medical comorbidities.
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Treatment Resistance: Anorexia Nervosa in a Middle-Aged WomanEating disorders like anorexia nervosa are resistant to treatment. This case briefly outlines a treatment approach using a community-based, patient-centered model of care.
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Heritability of Childhood AnxietyAnxiety disorders are highly prevalent and potentially debilitating psychiatric conditions. Is heredity linked to anxiety disorders? The importance of early identification and management of children at risk for anxiety disorders is emphasized.
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Two Mentors and an Inspiration From the PastOne doctor shares how 2 mentors and a notable artist from history have inspired her.
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Eating Disorders in SchizophreniaEating disorders in patients with schizophrenia have been underappreciated and poorly studied. Profiling characteristic phenotypic patterns will help clarify the distinctions among eating behaviors that are part of the spectrum of schizophrenia, those that represent distinct coexistent entities, and those that represent overlapping comorbidity.
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Cognitive Impairment in Patients With Bipolar DisorderIt is widely accepted that patients with schizophrenia have some degree of cognitive deficiency and that cognitive deficits are an inherent part of the disorder. Historically, there has been less focus on cognitive deficits in patients with bipolar disorder; however, numerous studies of cognition in patients with bipolar disorder, including several comprehensive meta-analyses of bipolar patients who were euthymic at the time of testing, have recently been undertaken.1-4 Each of these analyses found that cognitive impairment persists during periods of remission, mainly in domains that include attention and processing speed, memory, and executive functioning.4
