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Brain Aging and Dementia: Practical Tips From Clinical ResearchAge is a major risk factor for the development of Alzheimer disease and other dementias. New technologies in brain imaging represent major advances in our ability to diagnose age-related cognitive and behavioral disorders.
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Depression During PregnancyMajor depressive disorder is common during childbearing. Depression that interferes with function develops in an estimated 14.5% of pregnant women. Some statistics are troubling in that only 13.8% of pregnant women who screen positive for depression actually receive treatment.
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Panic Disorder and Pregnancy: Challenges of Caring for Mother and ChildPanic disorder is a common psychiatric illness that can have a chronic, relapsing course. The question of whether pregnancy represents a time of increased risk for recurrence of panic symptoms has been a matter of debate.
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Interviewing in the Emergency SettingAcute intoxication is the most likely culprit for an increased risk of violence or agitation, but personality, psychosis, and cognitive problems can all play a role. A skilled clinician can glean a great deal of information in a short period of time.
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Antidepressants in Pregnancy: Balancing Needs and Risks in Clinical PracticeThis article summarizes the risks of untreated psychiatric illness during pregnancy as well as the risks and benefits of antidepressant use.
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Shelter-Based Collaborative Mental Health Care for the HomelessHomelessness rates in both Canada and the United States have increased dramatically over the past 10 years. Among the homeless, there is a high prevalence of mental illness and substance use disorders.
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Mini Quiz: Neurobiology of Borderline Personality DisorderWhat do functional magnetic resonance neuroimaging findings reveal about the neurobiology of borderline personality disorder? Take the quiz and learn more.
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A Practical Update on Neuroimaging for Psychiatric DisordersWhich neuroimaging test for which psychiatric patient-and when? What to ask the neuroradiologist?
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The Influence of Diet on ADHDThere is good emerging evidence that aspects of diet can indeed affect ADHD. Clinical recommendations here.
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Inflammation, Psychosis, and the BrainWhen the solution to a clinical or scientific puzzle eludes us for more than a century, as with schizophrenia, we need new methods to examine the pathology. If we want to make an impact on the disease we must shift research paradigms and focus on the early detection, early intervention, and new avenues of treatment that address different symptoms of schizophrenia.
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The Brave New World of Behavioral Therapies for Alcohol Use DisordersIn addition to the approval of novel medications for alcohol use disorders, the past several years have been marked by an emphasis on development, standardization, and dissemination of new behavioral therapies, including computer-based interventions.
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Sexual Harassment and Alcohol UseSince the 1990s there has been an increase in research on sexual harassment and its mental health consequences. These researchers discuss the use of alcohol to self-medicate harassment-engendered distress and the need for greater attention to potential alcohol-related consequences of harassment experiences.
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Child and Adolescent Clinical Psychopharmacology, 4th ed.Each edition of this book, beginning with the first in 1991, has received much use while sitting on my office shelf. The editions have spanned the modern era of child psychopharmacology and, along with the works of S. P. Kutcher, have offered practical clinical guidance in choosing and monitoring medications in children and teenagers while also providing an overview of the literature that supports child psychopharmacology.
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Substance Abuse in Women: Does Gender Matter?There has been a growing awareness in recent years of the importance of gender in medical treatment and research. While much past research in addiction focused on men, there is now recognition that biologic and psychosocial differences between men and women influence the prevalence, presentation, comorbidity, and treatment of substance use disorders.
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ADHD and Substance Use: Current Evidence and Treatment ConsiderationsBecause comorbid substance abuse is the rule rather than the exception in individuals with ADHD, accurate diagnosis, prognosis, and management of ADHD is challenging even for the most skilled practitioners.
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Treatment of Non-Suicidal Self-Injurious Behavior in AdolescentsThis CME article provides an understanding of the treatment modalities for the management of nonsuicidal self-injury (NSSI) in adolescents.
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Transplant Psychiatry: Issues for CliniciansThe role of transplant psychiatrists is to assess both transplant and donor candidates to determine capacity to consent to the surgery, recent stressors and coping skills, social supports and availability of caregivers, and whether there are psychological or substance abuse issues that would affect outcomes.
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A New Focus on Reducing Misdiagnosesepilepsy, migraine, headache, Parkinson disease, parkinsonism
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The Role of Social Media in Private PracticeThe challenges of using social media can be as numerous as the benefits.
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The Anxious Bipolar PatientTreatment of anxiety can be a challenge, since the mainstay of treatment may adversely affect the course of bipolar disorder.
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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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Cultural and Ethnic Issues in PsychopharmacologyThis article aims to provide a glimpse of recent developments that are relevant to cultural and ethnic influences on psychopharmacological responses.
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Telling the Truth in FictionAn author discusses the similarities he has found between creating believable characters and stories and his work as a psychiatrist.
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Contemporary ECT, Part 2: Mechanism of Action and Future Research DirectionsSimply telling patients “we don’t know how ECT works” neglects our abundant knowledge of what this treatment does. The authors review biological actions of ECT and discuss future directions for research.
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Successful Exit Planning for PhysiciansWhether planned or unplanned, a physician's departure from your practice will definitely have an impact, so be prepared.
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The Role of Psychiatrists in HIV PreventionBecause over half of persons with HIV infection have a lifetime history of depression or bipolar disorder, psychiatrists are uniquely positioned to provide both preventive and therapeutic interventions to vulnerable patients.
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Sexual Minority Identity DevelopmentSexual identity development is a complex, multidimensional, and often fluid process. One must consider cognitive, social, emotional, cultural, and familial complexities among other aspects of the individual’s experience to contextualize a narrative concerning sexual identity development.
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Mood Disorders in 3 Clinical ReportsUseful information about mood disorders in 3 key areas-bipolar disorder, comorbid ADHD and depression, and suicide risk.
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The Lost Birds of Wounded KneeI remember as a child gathering wild greens with my Cherokee grandmothers, 2 generations of them, and hearing the lilt of spoken Cherokee. I can still see myself listening quietly in the corner of the room while others came to visit my great-grandmother, a respected traditional healer. We were poor. There is no other way to say it. My mother carried water from a well in the middle of the field, and I remember before going outside to play in the snow that we wrapped bread sacks around our feet to keep them dry. But as a child, while life was hard and even harsh at times, it felt safe and constant.
