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Clinical practice guidelines, produced by various professional organizations and academic institutions, are usually considered the best practices for clinical care. But how do physicians use guidelines, and what factors influence their use?

An appreciation of melancholia as the principal definable mood disorderoffers a better guide to diagnosis and treatment than does DSM-identified major depression.

The idea that schizophrenia and bipolar disorder might be caused by infection is not new. New research on infectious agents in patients with schizophrenia and bipolar disorder has implications for psychiatric clinicians.

Noise, or unwanted sound, is a pollutant and an environmental stressor. The frequency of noise events seems to have increased in recent years while the amount of the day without noise has lessened.

Half of patients with nonpsychotic major depressive disorder can achieve symptomatic remission with no more than two treatments.

Psychiatrists often believe they are protected from liability when conducting third-party evaluations in civil litigation. However, the nature of the physician-patient relationship and the issue of associated liability is not that straightforward.

Caregivers may face years of continuous exposure to physical and psychosocial demands with burdens that can include physical, psychological, social, and financial problems; embarrassment; overload; and resentment.

The shift toward biologic preeminence has led to psychiatric residency programs de-emphasizing psychotherapy education. How does psychotherapy fit into the “age of the brain”?

Increased demand for accountability is requiring more clinicians to supplement their judgments of patient outcome with standardized and objective protocols. The protocol outlined here is a model or jumping-off point for outcome evaluation.

Childhood adversities associated with suicide risk include childhood maltreatment, problematic family relationships, socioeconomic hardship, and difficult relationships with peers. Acute suicide prevention strategies should focus on the treatment of contributory psychiatric disorders and on the crises that may precipitate suicidal behavior.

Antidepressant treatment extended beyond the recommended 6 to 12 months was recently reported to be more effective than monthly psychotherapy in maintaining remission in elderly patients.

Defining "stress" and how it is expressed and managed in both psychiatrists and patients is a difficult proposition. This Special Report focuses on stress and the middle ground between the impulse to say there is no such thing as “stress” and the tendency to describe many explicit addressable issues under the monolithic term "stress."

A review of nonconvention treatments for dementia and mild cognitive impairment, including dietary modification, Ginkgo Biloba, Huperzine-A, Phosphatidylserine, CDP-choline, Idebenone, and exercise.

The impact of terrorism reaches many aspects of health and health care: acute and chronic symptoms of anxiety and depression, changes in health-related behaviors, and long-term strain and tension.

Psychiatrists, primary care physicians, neurologists, nurse practitioners, psychiatric nurses, and other mental health care professionals. Continuing medical education credit is available for most specialties. To determine if this article meets the continuing education requirements for your specialty, please contact your state licensing board.

Because complex regional pain syndrome (CRPS) is commonly misunderstood by both physicians and patients, patients may be misdiagnosed and may not receive appropriate treatment.

Because hoarding occurs in a substantial portion of patients with neurodegenerative disorders, neurologists are likely to encounter patients with this problem. Until recently, they had little to offer their patients or the patients' caregivers. Compulsive hoarding can cause severe impairment and presents intriguing psychopathology, yet it has received little systematic study, and no effective treatment is currently on the market.

Acknowledging Preindustrial Patterns of Sleep May Revolutionize Approach to Sleep Dysfunction

Despite the significant progress in stroke prevention and treatment over the past 10 years, stroke remains the third leading cause of death in the United States.1 Approximately 700,000 strokes occur every year; the majority are ischemic.1 In 1996, the FDA approved the use of intravenous tissue-type plasminogen activator (t-PA).

Neurotechnology's New Wave, Part I: The Rise of the Device Market

Pain relief provided by a greater occipital nerve (GON) block for migraine occurs more rapidly than previously reported-within 5 minutes of injection-according to researchers at Thomas Jefferson University in Philadelphia. In 25 patients with unilateral episodic or transformed migraine, headache

About half of the US population doesn't understand their doctors' instructions, according to health literacy advocates within the AMA and the American Academy of Neurology (AAN). Is it any wonder why clinicians are frustrated with patients' lack of compliance with therapy and lack of follow-through filling prescriptions and presenting for diagnostic tests-not to mention litigation issues that may arise, in part, from physician-patient miscommunication?

Parkinson disease practice parameters

Patients with Alzheimer disease (AD) often have Lewy body pathology (LBP). Although the exact significance of LBP is unknown, LBP appears to be more common in persons with familial AD related to gene mutations of presenilin 1 (PSEN1), presenilin 2 (PSEN2), and amyloid precursor protein. To examine the genetics of LBP, the team from Puget Sound HCS, led by James B. Leverenz, MD, associate professor at the University of Washington in Seattle, reviewed 25 familial AD cases that included 9 known PSEN1 mutations and 14 familial AD cases that included a single PSEN2 mutation. The brain stem, limbic cortex, and neocortex were examined for LBP.

impaired glucose tolerance neuropathy, IGTN, impaired glucose tolerance, IGT, diabetic neuropathy, metabolic syndrome

autism, mirror neuron defect

Yes, there's been a changing of the guard. Larry Hand, who played a major role in launching Applied Neurology as a unique source of clinical news and information, has moved on to other challenges. The editorial staff wishes him well. In a relatively short time, Applied Neurology, which debuted in January 2005, has caught the interest of the specialty by providing a comprehensive range of easy-to-read and timely information for neurologists and other specialists. The staff is committed to continuing in this vein.

Neurologists have always faced tough decisions when it comes to sudden unexpected death in epilepsy (SUDEP). Not the least of these is how to explain to bereaved family members what happened to their loved one and how it could have been prevented, because no one really knows.

The use of psychiatric medications in children, including antidepressants (such as selective serotonin reuptake inhibitors) and drugs used to manage attention-deficit/hyperactivity disorder, are continuing to be reviewed by the FDA.

Attention deficit hyperactivity disorder (ADHD) drugs for children won't require . restrictive black box labeling, as the FDA has reversed its earlier ruling.