Science Versus Pragmatism in the DSM: Finding A Middle Ground
November 18th 2010The DSM does and must involve both science and pragmatism. It must use the science that is available, but it must also make countless judgment calls that are not grounded in solid empirical evidence-and surely it makes sense to consider practical consequences in doing the latter.
Biological Consequences and Transgenerational Impact of Violence and Abuse
November 17th 2010Every year, more than 1 million children are exposed to sexual or physical abuse or neglect in the US. The research summarized here clearly demonstrates that exposure to stress before adulthood can result in persistent effects on both mental and physical health.
Secondary Trauma Issues for Psychiatrists
November 17th 2010The characteristics that bring people into the caring professions are, ironically, the very factors that make them vulnerable to vicarious trauma and job burnout. It is our responsibility to ensure that these adverse outcomes are minimized among those who have chosen such a career.
Working With Traumatized Patients
November 17th 2010There are feasible and replicable ways for caring adults to help heal themselves as well as the next generation through mass application of reflection and altruistic caring for the remaining offspring, whether in Sichuan, Gaza, New Orleans, or Haiti.
Review of Darryl Cunningham's Psychiatric Tales
November 17th 2010In this autobiographic work, Darryl Cunningham explains mental illness in a succinct and novel way. It is already proving to be of use to both health professionals and mental health service clients. Published in the UK this year, its US release is scheduled for February 2011.
The “Goldberg” Variations, Walden-And Informed Consent
November 16th 2010An antidote to the ubiquitous arrogance, impulsivity, and knee-jerk reactivity surrounding us is to gather as much information as possible, weigh the pros and cons of any intervention, think critically and act mindfully. We can, as Thoreau decided to do, “live deliberately.”
Combining High-Yield CBT Methods and Pharmacotherapy in Brief Sessions
November 2nd 2010There is evidence that the combination of medication and psychotherapy improves outcomes for many psychiatric illnesses. Among the several forms of psychotherapy that might be considered, cognitive-behavioral therapy (CBT) is the most extensively studied.
Reasons Patients Doubt Medication-Resistant Delusions in Schizophrenia
October 30th 2010Our study suggests that most delusional patients, even those with high positive symptom scores, may have at least 1 RFD that precedes a clinical intervention specifically directed toward encouraging doubt. These preexisting “islands of doubt” may offer a useful foothold to begin the CBT process.
Prime Time: Maximizing the Therapeutic Experience-A Primer for Psychiatric Clinicians
October 29th 2010The preface explains why Prime Time is so needed. It provides a refreshing, nonjudgmental summary of how and why we’ve arrived at the 20-minute hour. This is important for disgruntled clinicians from the “good old days” as well as for early-career clinicians who have not learned anything better.
Tales From the New Asylum: Machiavelli Part 1
October 28th 2010He had returned to a familiar place, and his peers welcomed him back. The word "recidivist" comes from the French word "recidiver," meaning to "fall back." This was not the first time he had fallen back. He would surely tell you that his return was not by choice, but sometimes such things are hard to determine.
Opiate Substitution Treatment Found to Reduce Mortality Rate in Addicts
October 28th 2010A recent study reports that patients have a greater chance of survival when given opiate substitution treatment (OST) for over 12 months. Although there has been a 2-fold increase in opiate prescriptions in the past 10 years, the mortality rate from OST has fallen, making it a viable treatment for opiate abusers.