BasicNeeds: Successful Mental Health Programs With Scarce Resources
October 1st 2006Ahmed Abdullai often wandered aimlessly and slept in a graveyard in Tamale, northern Ghana. Now, with the help of BasicNeeds--an international development charity--Abdullai takes medications to stabilize his mental illness, learns gardening skills, lives at home, contributes to the family farm, and feels like a "human being once again."
Youth Aggression: Economic Impact, Causes, Prevention, and Treatment
October 1st 2006The increase in youth violence and aggression in the past 50 years has been called an "epidemic." This epidemic has had a tremendous impact on society. From an economic and public health perspective, primary prevention of youth violence is obviously desirable.
Treating Delirium: When the Brain Goes Off Track
October 1st 2006Typically, delirium worsens at night ("sundowning"), with lucid intervals often present in the morning. It is important to realize that delirium may appear before any abnormal laboratory values are detected and may persist after the resolution of these abnormalities.
Cortisol and Seasonal Changes in Mood and Behavior
October 1st 2006The degree to which season changes affect mood, energy, sleep, appetite, food preference, or desire to socialize with others has been called "seasonality." Identification of a seasonal pattern can only be made if both the patient and physician actively look for it.
Children's and Parents' Attitudes About Participation in Treatment Research
October 1st 2006Since children are a vulnerable population, ethical issues in the conduct of medication studies involving them are extremely important. We recently reported the results of a study that examined youths' and parents' attitudes about, and experiences with, participation in psychopharmacology treatment research.
Addressing Psychiatric Comorbidities in Patients With Epilepsy
October 1st 2006In a presentation given at the midyear meeting of the American Epilepsy Society, Andres Kanner, MD cited studies from the literature showing that the rates of depression, anxiety, psychosis, and attention-deficit/hyperactivity disorder (ADHD) are significantly higher among persons with epilepsy than among the general population
Understanding and Using the Placebo Effect
October 1st 2006Most physicians make at least some use of the placebo effect to enhance treatments, whether they realize it or not. This article examines the extent of the placebo effect in patients with psychiatric illness, and reviews what is known about how placebos work.
Treating Adolescents With Major Depression and an Alcohol Use Disorder
October 1st 2006Alcohol is the drug of choice for adolescents, with cigarettes and marijuana being second and third. Contrary to widespread belief, alcohol dependence is most common in 18- to 20-year-olds, with progressively decreasing rates of alcohol dependence in older age groups.
Depression Management in Cancer Patients
October 1st 2006Depressive disorders and symptoms are common in cancer patients (up to 58% have depressive symptoms and up to 38% have major depression), worsen over the course of cancer treatment, persist long after cancer therapy, recur with the recurrence of cancer, and significantly impact quality of life.
Bipolar Disorder: Defining Remission and Selecting Treatment
October 1st 2006The longitudinal course of bipolar disorder (BD) is characterized by a low rate of recovery, a high rate of recurrence, and poor interepisodic functioning. There is a need to invoke a chronic disease management model (CDMM) when treating individuals with BD.
Should Emergency Medicine Physicians Screen for Psychiatric Disorders?
October 1st 2006Emergency department (ED) visits have increased from 89 million in 1992 to more than 110 million in 2002, while the number of EDs decreased by about 15% during the same period. One suspected consequence of ED overcrowding is an increased tendency to disregard a psychiatric problem, especially if it is not the chief complaint.
The Camelford Hysteria: A Lesson for ECT?
October 1st 2006Complaints of persistent memory loss in otherwise well-functioning individuals after recovery from a psychiatric illness through electroconvulsive therapy (ECT) are best viewed as a conversion reaction or a somatoform disorder. The Camelford experience is a model for the complaints of ECT's profound personal memory losses.
Combining Drug Therapy and Psychotherapy for Depression
October 1st 2006It was just over a generation ago that the routine combination of psychotherapy and drug therapy seemed impossible. Then, one meta-analysis found that combined treatment with psychotherapy and medication was found to be notably superior to either treatment alone.
Alternative Brief Interventions for Mild Depression
October 1st 2006Depression has long been recognized as a primary concern for health care providers. Many approaches to treating depression have been developed, ranging from medications, to long-term psychotherapy, to shorter, more structured cognitive-behavioral treatments--all of which help some of the patients, some of the time, to some extent.
Causes, Diagnosis, and Prognosis of ICH, Part I
September 2nd 2006Spontaneous nontraumatic intracerebral hemorrhage is associated with greater mortality and more severe neurologic deficits than any other stroke subtype, with as many as half of all patients dying within 30 days and only 10% of survivors regaining functional independence.