Psychiatric Times Vol 25 No 3

Your Child in the Balance provides parents with a unique and insightful look into the role of psychotropic medications in the treatment of children and adolescents. Dr Kalikow does a stellar job of systematically and comprehensively addressing this complex and provocative topic in this guide for parents from the perspective of a practicing child and adolescent psychiatrist.

It is a pleasure to introduce this series of 4 special articles on schizophrenia. As industry support has shaped postgraduate psychiatric education, the quantity of educational programs has grown dramatically while the breadth of topics has not.

Washington Report

It was opening night for the critically acclaimed Canadian independent film Away From Her. Based on a short story by Alice Munro, the film is about a retired literature professor, Grant (played by Gordon Pinsent), and his wife, Fiona (played by Julie Christie), whose idyllic golden years together end when she succumbs to the ravages of Alzheimer dementia.

Overcoming Resistant Personality Disorders is a provocative and well-reasoned, yet frustrating volume. In it, the authors challenge various authorities on the subject; for example, they criticize the DSM for its failure to "officially endorse an underlying set of principles that would interrelate and differentiate the categories in terms of their deeper principles" and for its current Axis II categories.

When I finished reading "Sexual Offenders With Mental Issues: Special Considerations for a Special Population," Psychiatric Times, September 2007) I could hardly believe that Dr Rotter had not mentioned genetics!

Parkinson disease (PD) is a progressive neurodegenerative disorder that is characterized by its motor signs, including resting tremor, rigidity, bradykinesia, and postural instability. PD is more common in the elderly, and there is usually no family history of the disease.

Each year more than 440,000 people in the United States die of smoking-related illness, and nearly half a billion dollars in health-related economic losses are directly attributable to smoking.

In recent years, we have learned a great deal about posttraumatic stress disorder (PTSD) and its public health implications. From 9/11 to Katrina and the present Iraq war, PTSD has been in the forefront of health concerns and public policy.

On October 20, 2007, leading researchers in the fields of mood disorders and meditation discussed the promise-and limitations-of meditation for the prevention and treatment of major depression. Participating in a day-long symposium titled "Mindfulness, Compassion, and the Treatment of Depression" was His Holiness the Dalai Lama.

Extensive evidence supports the importance of the involvement of families in the mental health care of patients with schizophrenia and other serious mental illnesses. Family involvement is endorsed by the President's New Freedom Commission and the American Psychiatric Association Practice Guidelines on schizophrenia.

The therapeutic challenges presented by comorbid psychiatric and substance abuse disorders, along with strategies and initiatives to improve treatment, were the focus of a recent collection of studies and reviews in the Journal of Substance Abuse Treatment.

Major depressive disorder (MDD) in pediatric populations represents a significant public health concern. Rates of MDD rise dramatically in adolescence, with an estimated lifetime prevalence of 15% in adolescents aged 15 to 18.

Concern about the rising number of preschool-age children receiving atypical antipsychotics, α-agonists, or other psychotherapeutic medications recently motivated pediatric mental health professionals to develop best-practice algorithms for psycho-pharmacological treatment of young children. It also prompted some states and mental health providers to initiate medication monitoring and consultation programs.

This 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.

It is estimated that at least half of persons who begin antidepressant treatment will not respond to monotherapy.

The number of prescriptions for antipsychotic treatment of teenagers has increased sharply in office-based medical practice. Adolescents with psychotic symptoms frequently present for clinical evaluation, and early-onset schizophrenia spectrum disorders (onset of psychotic symptoms before the age of 18 years) represent an important consideration in the differential diagnosis in these youths

Treatment of negative symptoms of schizophrenia -- eg, problems with motivation, social withdrawal, diminished affective responsiveness, speech, and movement -- is associated with a variety of improved functional outcomes and is a vital unmet clinical need.

In Defense of Childhood, by Chris Mercogliano, is an elegant book about societal challenges to children's innate spontaneity and exuberance. It is based on the author's more than 3 decades of experience as teacher and, ultimately, director of the Albany (New York) Free School.

Aware that mental illness generally begins early in life and that four teenagers commit suicide every day, several organizations and agencies are stepping up efforts to expand voluntary mental health screening and suicide prevention initiatives for youth--but they are doing so in the face of stigma and vocal opposition.

Anxiety disorders are the most common mental conditions in the general population, including in children and adolescents. Young people can present with a pattern of anxiety symptoms somewhat different from that typically seen in adults. One of the most common aspects of this difference is that children (especially younger ones) may not report overt worries or fears, but instead manifest pronounced physical symptoms.

Panic 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.