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They called him Silk for the moveshe wove intothe fabric of his game

After reading this article, you will be familiar with:The function of the hypothalamic-pituitary-adrenalaxis and the significance of cortisolin the etiology of depression.

Psychopharmacologic management has become increasingly complex, and physicians run the risk of precipitating drug-drug interactions when certain drugs interact via the cytochrome P450 system. In addition, the P-glycoprotein transporter may play a role in certain drug-drug interactions. While physicians currently rely on Web sites and textbooks to avoid potentially morbid and lethal interactions, electronic medical records may play a crucial role in the future.

Since the introduction of the SSRIs in the early 1990s, the rate of antidepressant prescribing has increased dramatically. This look at five national data sets concludes that greater recognition of depression and greater rates of treatment with medication and psychosocial interventions has made a significant contribution to reducing suicide rates.

Anorexia nervosa, bulimia nervosa and binge-eating disorder remain challenging disorders for the practicing psychiatrist. While psychopharmacological agents play an important role in the overall treatment of eating disorders, current empirical evidence does not support their sole use. A recipe consisting of evidence-based psychopharmacological agents together with evidence-based psychotherapeutic approaches is usually required for a successful outcome.

According to a large international study, BD-II mixed depression can easily be misdiagnosed as major depressive disorder. Proper assessment and treatment of mixed depression in BD-II could have a positive impact on outcomes in bipolar disorder.

In modern practice, psychiatrists will invariably have patients who come from different ethnic or cultural backgrounds. Practitioners will need to consider socioeconomic status, diet, use of herbal medications and immigration status, as well as patients' own self-perception of ethnicity, in assessing patients and planning treatment.

A longitudinal study of the nicotine patch for smoking abstinence and a look at new drugs to lower blood pressure in patients with cerebrovascular disease are among the various research studies from Europe, Australia and Asia highlighted in this column.

Several international algorithm projects are underway, some of which have been in use for years. What are the roadblocks for their successful implementation?

A recent survey of 1,200 Australians found that many respondents did not understand how best to help people with depression.

Headache is a frequent somatic complaint in childhood and adolescence, and its prevalence has increased over the last few decades. The presence of a comorbid psychiatric disorder tends to worsen the course of headache by increasing attack frequency and severity, making the headaches less responsive to treatment, and increasing the risk of chronification. Identification and treatment of comorbid psychiatric conditions is, therefore, important for the proper management of headache, especially in children and adolescents.

Despite increased knowledge of child and adolescent mental health disorders worldwide, there is still a dearth of economic and human resources available to meet treatment needs, especially in developing countries. In this article, the impact of developed countries and the dimensions of this problem are discussed.

While the symptoms of somatoform and dissociative disorders are influenced by the patient's culture, these syndromes are heterogeneous and may have overlapping features. Although more frequently reported in non-Western cultures and thought of as exotic and culture-bound, multiple personality disorder may be a North American example of one such disorder.

How does the role of culture affect disease presentation? The author reviews the impact of religion, ideology and upbringing on the epidemiology of OCD in Egypt.

Comparing the consequences of caregiving across countries for a person with a serious mental illness needs to take into account not only different languages, but also different cultures, quality of mental health services and standards of living. So far, one questionnaire has shown the most validity and become the exemplar in cross-national research; yet it is still not free from possible cultural bias or criticism from its creators who acknowledge that much more research needs to be done.

Psychological debriefing is a popular crisis intervention designed to alleviate immediate distress and prevent posttraumatic psychopathology following exposure to traumatic events. Despite a flourishing "debriefing industry," the author argues that there is no convincing evidence that it prevents posttraumatic psychopathology.

One of the spin-offs of the consensus statement is a study of the risk for metabolic disorders with antipsychotic use in children and adolescents. Here, the lead researcher discusses some of the group's initial findings.

Community awareness of traumatic events and their effects on individuals has increased in the last decade. The articles in the special report section of Psychiatric Times enhance our appreciation of the divergent research and clinical efforts being made assist those who have suffered from the consequences of trauma and its aftermath.

With proposed cuts in state budgets nationwide, social services--including mental health care--are taking a financial blow. As a result, mental health care facilities are closing and services are disappearing. What will the effect be on patient care?

Research presented at an international meeting in Australia found that lamotrigine may be beneficial against depressive relapse for patients either currently or recently in a manic phase.

For decades, personal essays on ECT highlighted pain and discomfort, a dismaying loss of memory, and an indifference of practitioners who forced the treatment on unwilling patients. The attacks on ECT by popular writers in the press and in film drowned out the voices that described its benefits. However, the public testimony has slowly changed toward a greater acceptance of ECT; it is time to hearken to the testimony of these witnesses and roll back the unethical restrictions that commit our most disadvantaged citizens to unnecessary chronic illness, prolonged hospital care and even death.

In the wake of the Columbine school shootings, it is of utmost importance for psychiatrists to be aware of the role they can play in preventing violence and bullying in our schools. What programs have been tried and how have they fared? What are the elements for a successful program?

The distress and functional impairment associated with PTSD may make it difficult for IPV victims to benefit from interventions to increase their safety and reduce their exposure to violence. Empirically supported PTSD treatments include pharmacotherapy and cognitive behavioral therapy. Incorporating these treatments into interventions to improve victims' safety and reduce exposure to violence may improve their effectiveness in protecting women from IPV.

A new consensus statement has been issued regarding the high risk of diabetes and associated disorders with use of atypical antipsychotics. Several of the major pharmaceutical companies have responded negatively to this statement.

Will the most effective treatments be available for your patients? Atypical antipsychotics and antidepressants that are being marketed or developed worldwide are reviewed.

How is it that anti-anxiety drugs can cause anxiety and insomnia, sometimes within the first day or two of treatment? These are not the soothing qualities we expect for anti-anxiety medications.

Little attention has been paid in the professional literature to a phenomenon that non-professionals have recognized since ancient times: Trauma can lead to personal growth. This article focuses on how traumatic events set processes in motion that produces new perspectives on the self, relationships and philosophy of life. Implications for clinical work with trauma survivors are discussed.

Individuals exposed to horrifying, life-threatening events are at heightened risk for posttraumatic stress disorder. Given the substantial personal and societal costs of chronic PTSD, mental health care professionals have developed early intervention methods designed to mitigate acute emotional distress and prevent the emergence of posttraumatic psychopathology.

There is a long tradition in psychiatry, reaching at least back to World War I, of studying the response of people who are faced with traumatic circumstances and devising ways to restore them to psychological health. The main focus of this work has been on the ways in which traumatic events are precursors to psychological and physical problems.

We waited for the broken and the burned.