Sildenafil Studied in Women With Antidepressant-Associated Sexual Dysfunction
January 26th 2009Sildenafil (Viagra, Revatio) reduced antidepressant-associated sexual dysfunction in women in a randomized controlled trial, which investigators characterize as the first conducted in women with this adverse drug effect.
Enhancing Suicide Risk Assessment Through Evidence-Based Psychiatry
January 2nd 2009Suicide risk assessment is a core competency that all psychiatrists must have.1 A competent suicide assessment identifies modifiable and treatable protective factors that inform patient treatment and safety management.2 Psychiatrists, unlike other medical specialists, do not often experience patient deaths, except by suicide. Patient suicide is an occupational hazard. A clinical axiom holds that there are 2 kinds of psychiatrists: those who have had patients commit suicide-and those who will.
Fishing Expeditions and Autism: A Big Catch for Genetic Research?
January 2nd 2009I am a fan of the television show Deadliest Catch-a documentary series that follows the travails of deep-sea fishermen in the Bering Sea. (Actually, it is mostly about deep crab fishing.) Living in Seattle, I have actually seen some of the boats filmed on the show.
New Technology Could Lead to Card-Swipe Medical Tests
January 2nd 2009Imagine seeing a patient in your office and being able to test for dozens or even hundreds of diseases with just the swipe of a card that contains microscopic samples of the patient’s blood, saliva, or urine. This technology may not be far off.
Metabolic Syndrome in Patients With Major Depressive DisorderAssociated Risk Factors
January 2nd 2009Although most studies have focused on the risk of metabolic syndrome for patients with schizophrenia exposed to atypical antipsychotics, other psychiatric patients appear to be at risk for metabolic disturbances as well.7-9 Major depressive disorder (MDD) may be of particular interest because it is much more common than schizophrenia and is treated with a broad range of psychotropics.
And Now, Your Parents' Relationship?
January 1st 2009She paused for a few moments and then responded, "I don't know when children may begin to think their parents are unhappy with each other except, of course, if there are a lot of arguments and fights. My parents didn't argue or fight, but they were not openly affectionate either.
Toward Credible Conflict of Interest Policies in Clinical Psychiatry
January 1st 2009A recent letter to the American Psychiatric Association (APA) from Sen Chuck Grassley about the APA’s financial relationship with pharmaceutical companies raises concerns about undue industry influence.1 By instituting a disclosure policy for DSM-V, the APA took a halting first step in restoring public trust in the most influential text on psychiatric taxonomy in the world. Unfortunately, the APA’s efforts at creating a conflict of interest (COI) policy have failed to ensure that the process for revising diagnostic and therapeutic guidelines is one that the public can trust. The need for more safeguards was evidenced when the APA reported that of the 27 task force members of DSM-V, only 8 reported no industry relationships.2 The fact that 70% of the task force members have reported direct industry ties-an increase of almost 14% over the percentage of DSM-IV task force members who had industy ties-shows that disclosure policies alone, especially those that rely on an honor system, are not enough and that more specific safeguards are needed.
New Agents of AbuseUnderstanding Prescription Drug Misuse by Adolescents
January 1st 2009A large percentage of youths use and abuse psychoactive substances. According to the 2007 Monitoring the Future (MTF) survey, the percentage of US adolescents who used illicit drugs or drank alcohol continued a decade-long drop, revealing that 19% of 8th graders, more than 36% of 10th graders, and 47% of all 12th graders have taken an illicit drug (other than alcohol) during their lifetime.1 According to the National Survey on Drug Use and Health, the rate was 3.3% for misuse or nonmedical use of prescription drugs.2 The misuse of prescription drugs among adolescents was second only to marijuana use. In fact, prescription drugs increasingly have become a part of the repertoire of drug-using adolescents.
Insanity Defense Evaluations - Basic Procedure and Best Practices
December 2nd 2008The insanity defense represents a prominent symbol of the relationship between law and psychiatry. Despite the fact that it is infrequently raised and seldom successful, the insanity defense is the subject of intense legal and public scrutiny.
Evaluating Capacity to Make a WillPsychological Autopsy and Assessment of Testamentary Capacity
December 2nd 2008It is an ancient practice to state instructions for distributing one’s property after death. In Genesis 48, Jacob verbally bequeaths his property to Joseph, Joseph’s siblings, and Joseph’s 2 sons. Wills existed in ancient Greece and Rome, with restrictions.
Cognitive-Behavioral Therapy for Adolescent DepressionProcesses of Cognitive Change
December 2nd 2008The substantial and often recurrent distress and impairment associated with major depressive disorder (MDD) in youth has prompted increased interest in the identification and dissemination of effective treatment models. Evidence supports the use of several antidepressant medications, specific psychotherapies, and, in the largest treatment study of depressed teenagers, the combination of fluoxetine and cognitive-behavioral therapy (CBT) as effective treatments.1-3 CBT is the most extensively tested psychosocial treatment for MDD in youth, with evidence from reviews and meta-analyses that supports its effectiveness in that population.3-5
Invitation to Disaster: Mutual Attraction Between Therapist and Patient
December 1st 2008Even though there was no name attached to the message, I knew instantly who had sent the vague text that left my heart racing. This was the last communication I had with Mr R, a 36-year-old neuroscience researcher with no past psychiatric history.
When in Rome . . . Museo della Mente
December 1st 2008A revamped museum in Italy is providing a hands-on and heads-on approach to mental illness. The Museo della Mente (Mind's Museum), which originally opened in 2000, is located on the outskirts of Rome in a former psychiatric hospital that closed in 1978