FDA-Approved Office Lithium Test Expected To Enhance Clinical Care
August 1st 2005Although lithium is still a first-line treatment for bipolar disorder, many psychiatrists are reluctant to use it due to blood monitoring requirements. The FDA has approved an in-office blood test that allows lithium blood levels to be obtained in minutes. The test is similar to glucose monitoring devices used for diabetes, and experts on BD are hoping it will increase the use of lithium, which has also been shown to lower the suicide rate among patients with this disorder.
Pharmacogenomic Screening for Depressed Children and Adolescents
August 1st 2005While the utilization of clinical genotyping to determine drug response and dosage has been anticipated for many years, the actual utilization of screening for atypical drug metabolizers has only recently become a reality. What is the promise of this technology, as well as the limitations?
The Molecular Genetics of ADHD: A View From the IMAGE Project
August 1st 2005New research into the genetic basis and possible genetic markers for attention-deficit/hyperactivity disorder may open the door for new treatments. There is a clear concordance between twins who have ADHD, as well as siblings. What can genetic mapping tell us about treating ADHD?
The Genetic Basis for Suicidal Behavior
August 1st 2005Suicidal behavior is a complex and multi-factorial phenomenon for which epidemiological genetics suggests a genetic basis that may be specific and independent from those implicated in the vulnerability to the psychiatric disorders associated with SB. Recently, new molecular biology tools have been designed to identify predisposition factors to complex disorders. One of the main goals of current studies is to specify the suicidal phenotype, as well as the intermediate phenotypes associated with these genes.
Deciding Appropriateness of Restraint and Seclusion
August 1st 2005Many physicians who work in the emergency department (ED) consider the agitated patient the bane of their existence. These patients are frequently difficult to deal with, are uncooperative, and can bring an already busy ED to its knees. Although it is easy to understand why severely agitated patients are commonly placed in restraints or seclusion, it is essential that cooler minds prevail when an agitated patient presents to the ED. The patient should be treated with dignity, respect, and understanding. Because these patients often cannot express their feelings adequately, many who work in the ED do not realize that these patients do not like the feeling of being out of control.
PES Research: Look to the Future
August 1st 2005Articles on psychiatric emergency services (PESs) published between 1983 and 2003 were reviewed to evaluate research on providers, clients, and services; access, use, evaluation, treatment, and continuity of care; and outcomes of the use of PESs. Eighty-five articles were selected as representative of the literature on variation in PES arrangement and effectiveness. The Donabedian model (structures, processes, and outcomes) was used to evaluate health care services.
Use of Restraint and Seclusion in the Emergency Department
August 1st 2005Restraints and seclusion have been used for many years in emergency departments (EDs) and psychiatric emergency services (PESs), but anecdotal case reports and newspaper investigations as well as clinical advances have led to restrictions in their use.
Perspective on the Use of Seclusion and Restraint
August 1st 2005Dr Zun has done an excellent job of reviewing the many controversies and complexities that surround the use of mechanical and chemical restraint as well as seclusion. He also shows us how many unanswered questions there are about such interventions. For example, an insightful psychiatric resident once raised the question of which intervention was more restrictive and stigmatizing: seclusion or restraint?
Nature Versus Nurture: How Is Child Psychopathology Developed?
July 1st 2005In an attempt to reframe the either-or debate over the impact of genetics versus environment on emotional makeup, a panel convened at the American Psychoanalytic Association’s Winter 2005 Meeting in New York City. This article highlights studies presented at the meeting.
Managing Treatment-Resistant OCD
July 1st 2005Obsessive-compulsive disorder is a prevalent, disabling and chronic illness. Serotonin reuptake inhibitors are the first-line of treatment; however a large proportion of patients will have either a partial or nonresponse. This review outlines the strategies for treatment-resistant OCD, including augmentation agents, alternative monotherapies, intravenous strategies and newer nonpharmacologic somatic treatments under development.