"Chemical Imbalance": Oversimplification or Metaphor?
April 5th 2006Until recently, direct-to-consumer advertisements for selective serotonin reuptake inhibitors (SSRIs) touted their ability to correct a chemical imbalance, most memorably through the cartoon "ovoid creature" that thanked a drug for improving its mood. Over the past few years, consumer groups and patients have implored the FDA to require more accurate wording in ads. This has resulted in the appearance in ads of such qualifiers as "helps to restore," "appears to work," "may be related to," and "presumed to be linked."
Cognitive Impairment in Patients Receiving Cancer Chemotherapy
April 1st 2006Anxiety and depression are the most often cited problems related to a cancer diagnosis, because receiving this diagnosis is often very frightening. Feeling sad, worrying relentlessly, and being unable to experience pleasure often lead people to feel that they may be on the path to losing their minds. However, in the past few years a more subtle phenomenon has been identified related to cognitive deficits allegedly associated with chemotherapy treatment, sometimes called chemobrain.
Psychosomatic Medicine in the Clinic and the Lab
April 1st 2006The fiscal 2007 budget that PresidentBush proposed in early February keepsa tight lid on most domestic spendingprograms, including those at the Centersfor Mental Health Services (CMHS)and the National Institute of MentalHealth (NIMH). Budgets for both willactually decrease for the second yearin a row unless Congress steps in.
Clinical Service Delivery and Benefits in General Medical Care of Psychosomatic Illness
April 1st 2006The renaming of consultation-liaison psychiatry as psychosomaticmedicine, a new formal subspecialtyof psychiatry, may require someadjustment in our understanding ofthese terms. Both consultation-liaisonpsychiatry and psychosomatic medicinehave focused on treatment and researchof illnesses with mind-body interactions.Despite considerable overlap,consultation-liaison psychiatry hastraditionally been associated with treatmentand clinical research of comorbidmental disorders of the medicallyill, while psychosomatic medicine hasbeen associated with research into thephysiologic mechanisms underlyingmind-body interactions and classicalpsychosomatic diseases such as hypertension,asthma, and ulcerative colitis.
Electroconvulsive Therapy and Medical Illness
April 1st 2006Physicians who use electroconvulsivetherapy (ECT) need tobe vigilant for unstable medicalconditions before and during the courseof treatment. This brief review is intendedto highlight some basic principlesand specific concerns that maybe encountered in the use of ECT inpatients who have comorbid medicalillness.
Progress and Promise: Research and Education in Psychosomatic Medicine
April 1st 2006Practitioners understand the wholeness and unity of their patients. Instead of being considered isolated organ systems or enzyme cycles, patients are understood as coherent entities composed of coordinated and interrelated processes and systems. This fundamental understanding guidesinvestigative and clinical care approaches in psychosomatic medicine.
Mental Health Budgets Take Another Hit
April 1st 2006The fiscal 2007 budget that PresidentBush proposed in early February keepsa tight lid on most domestic spendingprograms, including those at the Centersfor Mental Health Services (CMHS)and the National Institute of MentalHealth (NIMH). Budgets for both willactually decrease for the second yearin a row unless Congress steps in.
Neuropsychiatry: A Renaissance
April 1st 2006The 5 papers in this Special Report on neuropsychiatry provide compelling evidence for the renaissance of neuropsychiatry as a clinical discipline. Wehave every reason to hope that this will lead to a better understanding of the complex interactions between brain and behavior and will reduce the artificial distinction between neurology and psychiatry.
Child and Adolescent Psychiatry: Update on the Antidepressant Controversy
April 1st 2006A black box warning about increased suicidality in pediatric patients is now required for all antidepressant medications. This column reviews a number of studies on this topic that were published after the FDA advisory was issued.
Diffusion of Medical Innovation
April 1st 2006In the late 18th century, a French surgeon named Pouteau performed 120 successive lithotomies with an extraordinarily low mortality rate. His secret was the use of innovations used widely today. Why weren't his methods more widely adopted by other physicians in his time?