Interventions Aim To Prevent Depression in High-Risk Children
September 1st 1999Children whose parents have been diagnosed with affective disorders are far more likely to be diagnosed with a mental illness-especially affective disorder-than their peers whose parents do not have mood disorders (Beardslee, 1998; Burge and Hammen, 1991; Downey and Coyne, 1990).
The AMA Unionizes-What Role Will the APA Have in Labor Negotiations for Psychiatrists?
September 1st 1999As traditional unions successfully expand the ranks of organized physician employees, and as the U.S. Congress considers an antitrust exemption so that all doctors can collectively bargain, the American Medical Association decided to unionize. Doing nothing would have been tantamount to leaving the bargaining table even before the negotiations began.
Financial Crisis Threatens Future of Teaching Hospitals
September 1st 1999America's teaching hospitals are facing an unprecedented financial crisis that could leave more than one-third of the most respected institutions operating at a loss within the next five years, according to leaders in academic medicine. In addition to reducing their traditional educational programs, teaching hospitals may have to eliminate a wide variety of community health projects, poison control centers, safety programs and indigent care programs if budget cuts imposed by third-party payers are not reversed.
The Crisis of Present-Day Psychiatry: Regaining the Personal
September 1st 1999Present-day psychiatry has fallen into crisis because of the severe limitations of its conception of the person and, as a result, its conception of the patient. It objectifies the patient in a number of ways. Because of this reductionism, psychiatry fails to distinguish between healthy and pathological features of human life. It fails to consider adequately the psychological and social factors that cause and maintain each patient's problems.
PTSD, the Traumatic Principle and Lawsuits
August 2nd 1999The most common psychiatric sequelae following trauma include major depressive disorder, somatoform pain disorder, adjustment disorder and posttraumatic stress disorder (PTSD). In law, trauma that precipitates PTSD is viewed as a tort, which stems from the root word "torquere" (to twist), as does the word torture. In a sense, plaintiffs do allege torture in personal injury cases. A tort constitutes a civil or private wrong, as opposed to a criminal wrong, and rests on the general principle that every act of a person causing damage to a legally protected interest of another obliges that person, if at fault, to repair the damage (Slovenko, 1973).
When Johnny Comes Marching Home Again - POWs Face Emotional Challenges
August 1st 1999With the end of the Cold War, there is a new dimension to America's military entanglements. The demise of the Soviet bloc has opened the door for the U.S. military to take a more active role in political hot spots, with the result being an increasing willingness to engage in peacekeeping and humanitarian operations throughout the world.
Bridging the Divide: Can Forensic Psychiatrists and Lawyers Just Get Along?
August 1st 1999Psychological testimony is required in more than half the civil trials that unfold each year in the nation's courtrooms, and it is a rare criminal case that doesn't include a psychiatric evaluation during some stage of the proceedings. Yet despite the significant number of interactions between lawyers and forensic psychiatric experts that occur daily, there is still a fault line that separates them.
Legal Duty of Therapists to Third Parties
August 1st 1999When do therapists legally owe a duty of care to persons other than their patients? It is an axiom that good medical care involves consideration not only of the patient but also of others. In law, the general principle is that the risk which may result from one's behavior, as reasonably perceived, determines the duty of care.
Clinical Concerns in Boundary Issues
August 1st 1999It is relatively recent that boundary issues in clinical practice have attained professional awareness, although some early concepts portended the issue. Several decades ago, for example, the term boundary violations referred almost exclusively to what we now term sexual misconduct.
The Crisis of Present-Day Psychiatry: The Loss of the Personal
August 1st 1999Let us begin with an example. Suppose I am traveling from the United States to Switzerland, anticipating skiing with my son in the Alps. My anticipation becomes vivid and lively. I recall excitement mixed with joy at rapidly soaring down the mountainside, and I am now quite anxious to re-experience this thrilling adventure with my son-eager to be heading down the mountain with him. Later, as we stand on the crest of a deep and winding slope, the speed, thrill and admixture of danger and adventure will infuse my being.
Psychiatrists' Median Net Income Increased in 1997
August 1st 1999Income increased for psychiatrists in 1997, although it dropped for the combined all-physicians category. Dissemination of physician income data became a controversial issue at the AMA House of Delegates meeting last year (Baldwin, 1999; Booth, 1999). Angered by media reports of rising physician income without consideration of hours worked or differences between demographic groups of physicians, delegates voiced concern with the AMA's collection and release of physician income data.
Costs, Quality of Life With Olanzapine, Risperidone
August 1st 1999Schizophrenic patients treated with olanzapine (Zyprexa) required less health care services and incurred less overall health care costs over a 28-week period than patients treated with risperidone (Risperdal). This was the result of a study presented by Eli Lilly and Company researchers at the European College of Neuropsychopharmacology meeting held in Paris from Oct. 31, 1998 to Nov. 4, 1998.
Olanzapine Versus Risperidone Rematch
August 1st 1999One day after Eli Lilly and Company researchers reported finding olanzapine (Zyprexa) superior to risperidone (Risperdal) on some measures in a 28-week comparative study presented to the American College of Neuropsychopharmacology (ACNP) meeting in 1996, Janssen Pharmaceutica Inc. issued a press statement critical of the methodology and results of the study. Janssen then announced it would undertake its own comparative trial. The results of this trial's initial eight-week acute treatment phase were presented at the European College of Neuro-psychopharmacology meeting held Oct. 31, 1998, through Nov. 4, 1998, in Paris. They indicate risperidone has an advantage for positive symptoms such as hallucinations and delusions, and for anxiety/depression in patients with schizophrenia and schizo-affective disorder.
Marsha Linehan: Dialectic Behavioral Therapy
July 2nd 1999For her work in establishing the Dialectic Behavioral Therapy (DBT) model for use with chronically suicidal individuals suffering from borderline personality disorder (BPD), Marsha M. Linehan, Ph.D., is this year's recipient of the annual research award given by the New York City-based American Foundation for Suicide Prevention (AFSP).
Mental Health Threatened by Aetna/Prudential Merger
July 1st 1999Proposed in December 1998, the merger has turned Aetna into a managed care powerhouse providing coverage for about one in 11 Americans and having contracts with some 400,000 physicians, more than half the national total. This concentration of economic power, opponents charge, will substitute profit-driven "minimally acceptable clinical guidelines" for treatment plans determined by physicians operating in their patients' best interests. Mental Health Threatened by Aetna/Prudential Merger
Psychotherapy Strategies and the Chronically Suicidal Patient
July 1st 1999The benefits of psychotherapy in treating the chronically suicidal patient, as well as strategies that can help the potential suicide patient imagine and reflect others' reactions to this most final of acts, was the subject of a conference by Glen O. Gabbard, M.D., at the 11th Annual U.S. Psychiatric & Mental Health Congress. Gabbard is the Bessie Callaway Distinguished Professor of Psychoanalysis and Education at the Karl Menninger School of Psychiatry and Mental Health Sciences.
Marsha Linehan: Dialectic Behavioral Therapy
July 1st 1999For her work in establishing the Dialectic Behavioral Therapy (DBT) model for use with chronically suicidal individuals suffering from borderline personality disorder (BPD), Marsha M. Linehan, Ph.D., is this year's recipient of the annual research award given by the New York City-based American Foundation for Suicide Prevention (AFSP). Linehan is professor of psychology and adjunct professor of psychiatry and behavioral sciences at the University of Washington.
Dynamically Based Psychotherapy: A Contemporary Overview
July 1st 1999This article addresses several important theoretical issues related to dynamically oriented psychotherapy. These issues include the therapeutic alliance and transference, the authority of the therapist and neutrality, the stability of the therapeutic environment, countertransference, empathy, and basic strategy. Efforts are made to present these issues in a contemporary context.
Psychotherapy Training in Residency Programs in Demand and in Peril
July 1st 1999Psychiatry residents want and need solid training in psychotherapy in order to best serve their patients and to remain competitive in the mental health marketplace, concluded a March conference sponsored by the American Psychiatric Association's Commission on Psychotherapy by Psychiatrists (COPP). The event, entitled "Integration and Specificity in Psychotherapy Education," drew 120 training directors, residents and faculty from around the country, and represented approximately 40% of U.S. residency training programs.