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Psychiatry has gone wrong by being too symptom-focused, too brain-oriented, and riddled with misdiagnoses. It should go back to seeking the "meaning" of things in patients' subjective experiences. This is the main theme of this short polemic based on case studies. The author selectively cites studies or opinions to make his point rather than trying to get at the truth by offering other perspectives. As George Orwell pointed out, books are of 2 types: those that seek to justify an opinion and those that seek the truth.

What is the effectiveness (if any) of antidepressants in bipolar depression? What is the risk of manic switching? How effective are antidepressants in preventing relapse of bipolar depression? Insights here.

As psychiatrists we need to clarify within our profession and with our patients what therapies actually treat an illness and what therapies help one learn to function better.

Psychiatry is changing so rapidly that it seems impossible to predict 1 year ahead, let alone 10 years. In 1967, when my psychiatry training ended, the community psychiatry movement had just begun, DSM-II was in the works, and the biological revolution was still around the corner.

Despite an abundance of studies linking both traumatic experiences and anxiety disorders with eating disorders, relatively little has been reported on the prevalence of associated posttraumatic stress disorder (PTSD) or partial PTSD in patients with eating disorders.

Prognostication is a major part of what physicians do in many fields of medicine, and it is particularly relevant when a treatment or procedure is controversial or anxiety-provoking. Being able to accurately tell a prospective ECT patient how likely he or she is to respond would be helpful.

Anorexia nervosa is often complicated by devastating medical problems and may result in death. Although studies suggest a multifactorial cause for the disorder, treatment trials have yet to provide clinical guidance about how best to approach anorexia nervosa.

In the past several years, there has been an increasing awareness of the syndromal persistence of ADHD into adulthood. Once considered only a childhood disorder, ADHD has become increasingly recognized as a valid psychiatric disorder in adults.

Patients with low back pain (LBP) face many decisions, ranging from the nature and extent of the evaluation they should undergo to determining which treatments are likely to be most effective. These choices can be confusing not only to those who are in pain but also to their health care providers.

The Psychodynamic Diagnostic Manual1 (PDM) was created by a task force chaired by child psychiatrist Stanley Greenspan, MD, in cooperation with the American Psychoanalytic Association, the International Psychoanalytical Association, the Division of Psychoanalysis of the American Psychological Association, the American Academy of Psychoanalysis and Dynamic Psychiatry, and the National Membership Committee on Psychoanalysis in Clinical Social Work.

When historians try to understand why psychiatric diagnosis abandoned validity for the sake of reliability in the years surrounding the millennium, they will rely on The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder.

Traumatology has become an increasingly multidisciplinary field. Originally the province of psychiatry and clinical psychology, the field has now been enriched by the contributions of epidemiologists, neuroscientists, anthropologists, and historians.

Considering that the brain is increasingly being credited with having a role in everything we think, feel, and do, it was probably just a matter of time before it was postulated that religious belief has a neural substrate.

The March 27 announcement from the FDA that it is looking into a possible connection between Merck's biggest seller, Singulair (montelukast sodium) and suicidality once again raises questions about whether the agency is requiring close enough scrutiny during clinical trials of possible connections between new drugs and psychiatric effects.

One recent survey found that more than 1 in 4 patients who have mild cognitive impairment (MCI) were receiving cholinesterase inhibitors in Italian AD treatment centers even though these medications were being used "off-label."

Discovering the biological basis of major depressive disorder (MDD) could lead to improved medication and therapeutic treatment for patients with this condition. To date, the cause of MDD is not well understood, but researchers believe that elevated levels of the brain serotonin, 5-hydroxytryptamine (5-HT), may play a role.

Maintaining abstinence from alcohol "one day at a time" may be easier with appropriate treatment, but even with the best treatment it can become more difficult as the days add up.

Bulimia nervosa is a disorder with a complex cause. The disorder is most commonly seen in women, generally with onset in adolescence.

A syndrome described as purging following the ingestion of normal or small amounts of food in normal-weight persons has gained increasing attention in the field of eating disorders. Various terms have been used in the literature for this newly characterized syndrome, with purging disorder and eating disorder not otherwise specified-purging (only), or EDNOS-P, used most frequently.

Patients' beliefs about antidepressant drugs are a key factor driving adherence to therapy. According to a recent study, beliefs about efficacy and adverse effects, along with demographic attributes, are among the factors affecting antidepressant adherence.

Psychiatry has seen a transition from art to science in the past century and, largely because of 2 developments in the past several decades, this has also been the case for the field of eating disorders.

In this overview of pica, we review its causes and prevalence. In addition, we discuss some of the associated complications as well as current treatment strategies.

Although several antimanic agents are available to treat individuals with bipolar disorder (BD), many patients have a less than satisfactory response or experience adverse effects.1 With the exception of lithium, all of the current antimanic agents are either anticonvulsant or antipsychotic drugs. It is remarkable that no drug has been developed specifically for BD, especially because this illness was conceptualized more than a century ago.

This article discusses the role of µ-opioid receptors (MORs) in antidepressant treatment and major depressive disorder (MDD). Specifically, it focuses on how the endogenous opioid system affects response to pharmaceuticals.

Since the discovery of dopamine as a neurotransmitter in the late 1950s, schizophrenia has been associated with changes in the dopaminergic system. However, the dopamine hypothesis of schizophrenia cannot explain all the symptoms associated with this disorder. Therefore, research has also focused on the role of other neurotransmitter systems, including glutamate, g-aminobutyric acid, serotonin, and acetylcholine (ACh) in schizophrenia.

The vesicular monoamine transporter (VMAT) is a membrane-embedded protein that transports monoamine neurotransmitter molecules into intraneuronal storage vesicles to allow subsequent release into the synapse.1,2 By accumulating both newly synthesized neurotransmitter molecules and freshly returned neurotransmitter molecules from the synapse, VMAT function plays a critical role in the signaling process between monoamine neurons. The VMAT exists in 2 distinct forms: VMAT1 and VMAT2.3

Everyone would probably agree that the practice of clinical psychiatry has changed profoundly over the second half of the past century. One of the most remarkable changes has been the rapid development and expansion of clinical psychopharmacology, which has become, like it or not, a dominant part of the clinical practice of most psychiatrists. Available treatments for mental disorders changed and our armamentarium broadened. We have numerous medications for psychiatric disorders. We even use medications for disorders traditionally considered only amenable to and suitable for psychotherapy.

The modern era of psychopharmacology is only 60 years old, having begun with the discovery of the psychotherapeutic benefits of reserpine, lithium, monoamine oxidase inhibitors, and chlorpromazine in the late 1940s and early 1950s, which was followed a few years later by the synthesis and testing of the tricyclic antidepressants and benzodiazepines.

If you had asked me a year ago if I could have faced what I am about to describe and come out on the other side I would have said "Hell, no!" It has been a year of pain and struggle, and although certain parts cannot be changed, I still think that if things had been handled a little differently I might not have gone through some of what I did. Here is my story.

"I've lost my interest in sex." As psychiatrists, we hear this concern (if we ask) from women in a variety of situations: those who are depressed, postpartum, menopausal, traumatized, and those who have been treated with psychotropic medications. Thankfully, we have many interventions, both behavioral and pharmacological, to use in addressing sexual issues.