The Differential Diagnosis of Childhood Developmental Disorders
October 1st 2008Reducing complex human experiences into a psychiatric diagnosis can be a daunting task. For children with developmental disorders, this process is even more complicated and requires distilling often incomplete and frequently contradictory scientific evidence.
Topical NSAIDs: Old Wine in a New Bottle
October 1st 2008Over the past decade, NSAIDs have been on a roller-coaster ride almost as wild as that now being experienced by this country’s housing and financial markets. The selective COX-2 inhibitors-first celecoxib (Celebrex) and then rofecoxib (Vioxx) and valdecoxib (Bextra)-promised to revolutionize the treatment of pain.
Bone Mass Density Loss and Antidepressants: Another Tough Break for SSRI Users?
October 1st 2008When I was recently asked by a patient about the link between osteoporosis and SSRIs, I dimly recalled this topic’s emergence in a medical journal in 2007, its subsequent meander through several newsletters, and its gradual return to the bottom of my mental risk-assessment checklist.
Patienthood: A Different Form of Being
October 1st 2008Recently, I was involved in a discussion with several other mental health writers and editors regarding the most appropriate term to use for those we treat: patient or client. Our lack of consensus reflected that in contemporary medical and psychiatric literature.
Underdiagnosing and Overdiagnosing Psychiatric Comorbidities
October 1st 2008Diagnostic assessment of psychiatric disorders and their comorbidities is a challenge for many clinicians. In emergency settings, there is no time to conduct lengthy interviews, and collateralinformation is often unavailable.
The Dementias: Neuropsychiatric Syndromes of the 21st Century
October 1st 2008In the new century, the dementias will probably become 1 of the 2 or 3 dominant behavioral health problems in the United States. This article provides an overview of the major clinical features of these cognitive loss syndromes and emphasizes the perspective of the practicing psychiatrist.
Antipsychotics in Dementia: Evidence of Risk Mounts
October 1st 2008The use of antipsychotics to quiet agitated older adults with dementia has come under increasing fire. After a Canadian study demonstrated an increased risk of adverse events or death with these agents,1 the FDA expanded its earlier warning to physicians.
Patient Advocacy-and a Deadly Outcome
October 1st 2008William Bruce, a young man with symptoms of paranoid schizophrenia, was released from Maine’s state-run Riverview Psychiatric Center in April, 2006. Two months later, he killed his mother with a hatchet. Bruce subsequently was found not criminally responsible by reason of insanity and was recommitted to Riverview.
Psychopharmacologic Drugs Advisory Committee Participants Applaud FDA Voting Rules Changes
October 1st 2008Participants in past meetings of the FDA’s Psychopharmacologic Drugs Advisory Committee (PDAC) think changes to FDA advisory committee procedures announced in August will add credibility to those committee votes.
NIMH Plans Accelerating Research to Remedies
October 1st 2008A strategic plan to guide research priorities and resource allocations of the NIMH was released recently by NIMH Director, Thomas R. Insel, MD. The plan is intended to provide direction over the next 5 years toward the institute’s stated vision of “a world in which mental illnesses are prevented and cured.”
Substance Abuse in Women With Bulimia Nervosa
October 1st 2008The high rate of comorbid substance abuse in women with bulimia nervosa (BN) has remained consistent in the literature. This article reviews the prevalence of substance abuse in BN and summarizes treatment approaches for persons with BN and comorbid substance abuse.
Senate Investigations Spread to APA and ACCME
September 2nd 2008Both the American Psychiatric Association (APA) and the Accreditation Council for Continuing Medical Education (ACCME) are embroiled in the widening Senate investigations of pharma’s possible influence on CME in particular and on medicine in general.
Effects of Psychotherapy on Brain Function
September 2nd 2008Unipolar major depressive disorder is a debilitating condition with a lifetime prevalence of 17%. Recent epidemiological evidence indicates that MDD is the fourth leading cause of disease burden and the leading cause of disability-adjusted life years.
Detainee Interrogations: American Psychological Association Counters, but Questions Remain
September 2nd 2008I am writing to correct several inaccurate assertions in the essay, “The American Psychological Association and Detainee Interrogations: Unanswered Questions” (Psychiatric Times, July 2008, page 16), by Kenneth S. Pope, PhD, and Thomas G. Gutheil, MD.