Sleeping Through Detox Poses Hazards
December 1st 2005Anesthesia-assisted rapid opioid detoxification has been touted as a painless way to kick an addiction. In a randomized trial comparing it to two other rapid detox methods, it was found to be similar on several methods, but resulted in greater risks for life-threatening adverse events. Opioid dependency is a chronic, remitting disorder and the greatest need is not a fast painless method of getting detoxed, but a reliable method of maintaining abstinence.
CATIE Phase I Helps Clinicians Tailor Schizophrenia Treatment
December 1st 2005Are all treatments for schizophrenia created equal? With Phase I of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study completed, five pharmacological options have been compared in an attempt to answer this question. Results from this portion of the trial have been released and are discussed.
Ethical Issues in Forensic Psychiatry With Children and Adolescents
December 1st 2005Forensic examinations involving children and adolescents are particularly difficult, due to the vulnerability of this patient population. What ethical guidelines should be followed and what sorts of pitfalls should clinicians attempt to avoid?
The Role of PTSD in Litigation
December 1st 2005Attempting litigation based on a claim of posttraumatic stress disorder can be difficult. What is the proper DSM definition of PTSD and in what ways can and can't it be used in court to properly defend a client? What should the role of the psychiatrist be in this process?
Setting Up a Forensic Psychiatry Practice
December 1st 2005Forensic psychiatry is increasingly emerging into treatment psychiatry as a respected subspecialty. However, there are important clinical and business distinctions between the practice of treatment psychiatry and the practice of forensic psychiatry. The essential components of setting up a forensic psychiatry practice are outlined.
Preventing and Reducing Professional Liability Risk Related to Psychopharmacology
December 1st 2005Several significant factors have converged to impact and heighten concern about the potential for malpractice litigation related to psychopharmacology. Current influences as well as frequent sources of professional liability risk related to psychopharmacology are reviewed and suggestions for preventing and reducing risk are made.
Forensic Issues in Consultation-Liaison Psychiatry
December 1st 2005Consultation-liaison psychiatrists frequently encounter clinical situations that have legal implications. Competency evaluations, which are the most common legal question in C&L psychiatry, are reviewed in this article. In addition, the authors discuss guardianship, decision making in patients who refuse treatment, confidentiality and the role of the psychiatric consultant in against medical advice discharges.
Assessing and Treating Sleep Disturbances in Patients With Alzheimer's Disease
November 2nd 2005Patients with Alzheimer's disease may suffer the same age- and disease-related changes to sleep as their age-matched peers. However, as the dementia progresses, even more severe disturbances develop, with impairments in both nighttime sleep continuity and daytime alertness. This article focuses on long-term, holistic approaches to treatment, including environmental and behavioral interventions to augment sleep medications.
Apathy and Its Treatment in Alzheimer's Disease and Other Dementias
November 2nd 2005Affecting 70% of patients with Alzheimer's disease and common in patients suffering from other dementing illnesses, apathy is associated with functional impairment and caregiver distress at all levels of disease severity. Assessment and treatment for this under-recognized syndrome are discussed.
Developing Technology for People with Dementia
November 2nd 2005Advances in technology are providing assistive and supportive interventions for people with dementia across all aspects of their lives. These interventions are mainly addressed at meeting the safety, security and social needs of people with dementia. The psychological needs of people with dementia for conversation and other forms of positive social interactions are also being tackled through developments such as the CIRCA project.
Psychiatric Manifestations of HIV Infection and AIDS
November 2nd 2005Patients with HIV infection are at risk of developing psychiatric symptoms and disorders similar to those seen in the general population. What unique biological, psychological and environmental factors are involved in treating this population?
National Survey Shows High Prevalence of Impulse Control Disorders
November 2nd 2005Published a decade ago, the original National Comorbidity Survey focused largely on anxiety and depression. In an exclusive interview, the survey's designer, Ronald C. Kessler, Ph.D., talks with Psychiatric Times about the just-published replication study, which found that the combined lifetime prevalence of impulse control disorders is higher than that for either mood or substance use disorders.