Psychiatric Times Vol 26 No 10

Most persons who use CAM modalities to self-treat a mental health problem take prescription antidepressants concurrently. Combined use can result in serious supplement-drug interactions.

The prevalence of depression in children and adolescents ranges from 2% to 8% in the general population, which indicates that depression in this population is a major public health concern.1-3 This is especially apparent when rates of depression are compared with other serious medical conditions in childhood, such as diabetes, which has a prevalence of 0.18%.4 The burden of depressive illness-including significant functional impairment in interpersonal relationships, school, and work-on the developing child has been well documented. Affected youths are frequently involved in the juvenile justice system.5-8 Furthermore, adolescents with depression are at increased risk for substance abuse, recurrent depression in adulthood, and attempted or completed suicide.3,9-15

In 2007, cancer was diagnosed in 10,400 children and adolescents under the age of 15 years.1 While cancer remains the second leading cause of death in children, increasing numbers of children with cancer are surviving into adulthood.2 Over the past 30 years, 5-year survival rates for children with cancer have significantly improved, from 59% in 1975 to 1977 to 80% in 1996 to 2004.3 Pediatric cancer, increasingly considered a chronic rather than an acute condition, is an intense emotional and physical experience for patients and their families.4

In August, the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation released a report based on its systematic review of research on the effectiveness of sexual orientation change efforts.1

In the past few years, college mental health issues have received increasing attention by the mental health community, the public, administrators, and legislators. Events such as the death of MIT student Elizabeth Shin and the subsequent legal battle, and the series of suicides at NYU a few years ago received prominent media coverage.

The FDA’s new rule on “expanded access programs” would allow pharmaceutical companies to give seriously ill patients broader access to investigational drugs outside of clinical trials. A limited number of expanded access programs were created in the past under sketchy FDA rules; the 2 new allied rules-one on the conditions drug companies must meet to create a program, the other on how they can charge for the drugs-ostensibly give pharma a wider berth. Moreover, psychotropic drugs can be provided under the clarified policy.

Those who know Sacha Baron Cohen will tell you he is nothing like Brüno or the other characters he impersonates. The third son of an orthodox Jewish family, he grew up in a suburb of London, went to fancy British schools, and spent a year living in Israel. He read history at Christ’s College, Cambridge, where an interest in the role of American Jews in the Civil Rights Movement led to his thesis on the 1964 murders of James Chaney, Andrew Goodman, and Michael Schwerner in Mississippi. Not the biography of a man you would imagine inventing Ali G, an American ghetto rapper; or Borat, an anti-Semitic TV reporter from Kazakhstan; or Brüno, a gay Austrian fashionista who wants to be as famous as that other Austrian, Adolf Hitler. These characters have made Baron Cohen one of the preeminent icons of popular culture.

Anxiety disorders are one of the most common psychiatric disorders in children and adolescents, but they often go undetected or untreated. Identification and effective treatment of childhood anxiety disorders can decrease the negative impact of these disorders on academic and social functioning in youth and their persistence into adulthood.

Eating disorders are serious and potentially life-threatening, associated with severe food restriction, overexercise, malnutrition, and distorted thinking about body shape and weight or binge eating and purging behaviors.

What safeguards does Psychiatric Times build into its review policies to avoid conflicts of interest (COIs)? Do these policies apply to the “supplements” sometimes mailed out with the regular publication?

There is no magic moment when it becomes clear the world needs a new DSM. The publication dates of previous DSMs were determined by revision dates of the International Classification of Diseases (ICD). Thus, DSM-I appeared with ICD-6 in 1952; DSM-II with ICD-8 in 1968; DSM-III with ICD-9 in 1980; and DSM-IV with ICD-10 in 1994.

A 43-year-old woman presented to the ED at 5:30 am on a weekday. While being triaged, she indicated she was hesitant to speak with anyone. The patient reported to the consulting psychologist that she had been deployed to Iraq as reservist nurse 2 years earlier. During that time, an unknown assailant whom she believed to be an Iraqi national working with military security forces sexually assaulted her. The veteran confided that she had been too embarrassed and ashamed to report the assault.

A 24-year-old veteran of Operation Iraqi Freedom (OIF) presents to the ED mid-morning on a weekday. While the veteran is waiting to be triaged, other patients alert staff that he appears to be talking to himself and pacing around the waiting room. A nurse tries to escort the veteran to an ED examination room. Multiple attempts by the ED staff and hospital police-several of whom are themselves OIF veterans-are unsuccessful in calming the patient or persuading him to enter a room.

A 29-year-old veteran came to the ED complaining of headaches and uncontrolled pain in his upper quadrant. He had been discharged from the military after he sustained a blast injury during duty as a Marine in Iraq. His right arm had been amputated.

Since the time of Homer, warriors have returned from battle with wounds both physical and psychological, and healers from priests to physicians have tried to relieve the pain of injured bodies and tormented minds.1 The soldier’s heartache of the American Civil War and the shell shock of World War I both describe the human toll of combat that since Vietnam has been clinically recognized as posttraumatic stress disorder (PTSD).2 The veterans of Operation Iraqi Freedom (OIF) and of Operation Enduring Freedom (OEF) share with their brothers and sisters in arms the high cost of war. As of August 2009, there have been 4333 confirmed deaths of US service men and women and 31,156 wounded in Iraq. As of this writing, 796 US soldiers have died in the fighting in Afghanistan.3