Intimate Partner Violence Among Women With Severe Mental Illness
April 2nd 2008The 1994 death of Nicole Brown Simpson and the subsequent highly publicized murder trial of her ex-husband, O.J. Simpson, brought increasing national attention to the problems of domestic violence and intimate partner murder. In 2000, there were 1247 female victims of intimate partner murder in the United States.1 Fully one third of female murder victims were killed by an intimate partner.1 On the positive side, rates of female victimization by intimate partner violence and murder appear to have decreased in the recent past.
Accountable but Not Responsible
April 2nd 2008"Jack" has been in our emergency department at least 100 times in the 4 years I have worked at the Veterans Affairs Hospital. I first encountered him in the medical ICU, where he was hospitalized multiple times with chest pain and ECG changes after cocaine binges.
Study Faults Selective Publication of Antidepressant Trials
April 2nd 2008Medical journals have a unique image in the US health care system. Because most of them adhere to a strict system of critical peer review, they are often seen as unimpeachable sources of accurate information about the safety and efficacy of new medications.
Mental Health Services for Survivors of Mass Violence
April 2nd 2008Nearly one sixth of the world's population has experienced mass violence, be it abducted Ugandan children who are forced to commit atrocities against their families and serve as child soldiers or Iraqi civilians who daily live with bomb blasts, killings, and sectarian violence.
Why Evidence-Based Medicine Cannot Be Applied to Psychiatry
April 2nd 2008Evidence-based medicine (EBM) is rapidly becoming the norm. It is taught in medical schools and is encouraged by both government agencies and insurance plan providers. Yet, there is little proof that this model can be adapted to fit psychiatry.
Why Evidence-Based Medicine Can, and Must, Be Applied to Psychiatry
April 2nd 2008In the second century ad, a brilliant physician had a powerful idea: 4 humours, in varied combinations, produced all illness. From that date until the late 19th century, Galen's theory ruled medicine. Its corollary was that the treatment of disease involved getting the humours back in order; releasing them through bloodletting was the most common procedure and was often augmented with other means of freeing bodily fluids (eg, purgatives and laxatives).
Prevention and Treatment of Addiction
April 2nd 2008In 2006, substance dependence or abuse was diagnosed in about 22.6 million persons in the United States.1 Addiction-related morbidity and mortality pose a major burden to society, costing our economy more than $500 billion annually: about $181 billion for illicit drugs,2 $168 billion for tobacco,3 and $185 billion for alcohol.4
Boundary Concerns in Clinical Practice
April 2nd 2008In the historical context of American psychiatry, the concept of boundaries is a relatively recent development.1 Freud reportedly analyzed some patients while walking along the river Danube, gave patients gifts, and was known to share a meal with a patient.
Integrative Treatment for Adult ADHD: A Practical, Easy-to-Use Guide for Clinicians
April 2nd 2008Although there is evidence in the research literature from as far back as 40 years showing that the symptoms of attention-deficit/hyperactivity disorder (ADHD) often persist into adulthood, it has been only in the past decade or so that integrative treatment models designed specifically for adult ADHD have been developed.
Boundary Violations and Malpractice Litigation
April 1st 2008Disregard of professional boundaries is a leading cause of malpractice litigation. Boundary violations take many forms. Sexual involvement is a recurring problem that can cause serious damage. Even without erotic physical contact, material boundary crossings can, at least, destroy or interfere with therapy, and at most, injure the patient and lead to litigation. Generally, boundaries are violated by any act that alters or blurs the contours of the professional relationship.
Prevention of Boundary Violations
April 1st 2008Prevention of professional boundary violations in psychotherapy is a matter of crucial importance for the mental health field. Patients are damaged by boundary violations. Psychotherapists' careers are ended. Families of therapists and patients alike are devastated.