Addiction & Substance Use

Certain aspects of depression result from maladaptive stress-induced changes in reward circuits of the brain.

Which of the following complementary and alternative medicine (CAM) therapies may have beneficial effects on symptoms of mild cognitive impairment (MCI) and Alzheimer disease (AD)?

The Department of Psychiatry at the Mount Sinai School of Medicine and the James J. Peters Veterans Affairs Medical Center is seeking a faculty member in its Substance Abuse Services at the rank of Assistant Professor or Associate Professor to conduct clinical care and teaching in the field of addiction medicine. The position will be based at the James J. Peters Veterans Affairs Medical Center, a major affiliate hospital which serves as a training site for medical students, residents and an ACGME credited fellowship in addiction psychiatry. There are opportunities to join ongoing funded programs or to develop new research or academic initiatives.

Being a Therapist features intimate portraits of psychotherapists in their own work spaces. An excerpt of his interview with Otto Kernberg, MD, follows.

The poorly conceived DSM-5 Somatic Symptom Disorder substitutes a false psychiatric certainty that misleadingly covers medical uncertainty about the appropriate diagnosis. It is better to admit what we don't know than cover it with meaningless labels.

Has the Mental Health Parity and Addiction Equity had any real impact on your ability to provide care to patients, or are you experiencing the shells and mortars of paperwork and denials? And will the average patient ever really benefit from the laws, or were they just passed to make the country feel better about the state of psychiatric care in the US?

Psychiatrists need to understand how living in violent families and neighborhoods increases the likelihood of trauma and the psychiatric sequelae associated with it as well as how to respond in the aftermath.

The ethical aim of psychiatry is the relief of suffering and incapacity.

Psychiatrists vary in their eagerness to share therapeutic decisions with patients: some believe that adherence is paramount and paternalism is often necessary to prevent loss of insight with consequent impaired judgment and functional decline. These authors argue in favor of a radically more collaborative style.

Plaintiffs in this lawsuit claim that CPT coding policy has resulted in decreased reimbursement for psychiatrists, who will now receive 20% less for evaluation and management services than what Anthem pays other physicians.

While the diagnostic categories of DSM-III and DSM-IV (and soon DSM-5) have provided the basis for much useful research, little has been written about how much of DSM-and how much “evidence-based medicine”-is built on a foundation of fantasy.

Changes will mean patients will only be covered for psychiatrists’ services that include medical evaluation and management; CPT coding will not allow for coverage of psychotherapy as a separate and equal category for payment.

Frame analysis can not only help us to discern the roots of such standoffs but also to conceptualize specific ways of addressing the conflicts in therapeutic language with the patient, with the goal of forging an integrated approach to treatment.

Historically, there has been conflict between psychiatry and religion.

Preliminary evidence shows that dialectical behavior therapy may be beneficial in treating patients with bipolar disorder.

A recently published NIH study of 112 children suggested that some children might possibly outgrow autism.

The federal government must realize that decades of allowing mental health care to go begging leaves a very weak chance of detecting or treating those who need help.

After each violent tragedy, the politicians hypocritically mourn and harrumph, but wind up buckling under pressure from the NRA, fiscal constraints, and the prison and gun lobbies. Repeated dramatic events can shake the complacency and cowardice of a stalemated Congress and state legislatures.

Concerns are raised about DSM-5 revisions in the definition of depression. Many worry that eliminating the bereavement exception in the guidelines for the diagnosis of major depressive disorder represents a dangerous move.

A recent symposium brought together some of the nation’s leading experts to talk about promising advances in psychiatry and to address areas where progress has faltered.

Chronic exposure to addictive drugs like cocaine produces a progressive pattern of synaptic plasticity in reward circuits that can continue to develop well into periods of drug abstinence.

The Embassy of Italy in Washington, DC recently hosted the first of 2 workshops on “Leaders and Terrorists: Psychological Perspectives on National Security.”

About a year ago, I wrote the blog “Are Dogs Man's Best Therapist?” To my surprise, it turned out to be a very popular one. Since then, dogs continue to be in the news for their therapeutic effect, including being brought to Newtown right after the mass murder there.

Psychiatric disorders, such as primary sleep disturbances, depression, substance abuse, mania, sexually inappropriate behaviors, and psychosis, can complicate the care of patients with dementia.

DSM-5 must emphasize that physical symptoms deserve the respect of a thorough work-up before assuming their cause is psychiatric. And people with defined medical illnesses should not be casually mislabeled as also mentally ill just because they are upset about being sick.

It is clear that the prognosis for schizophrenia is much better when patients achieve drug abstinence, including in the domains of depression, quality of life, and community integration.

The news media has always been in the business of searching for "the right sort of madness" to capture the public's imagination.

Mindfulness training is a viable treatment tool that rivals psychopharmaceutical agents for the treatment of addiction, anxiety, depression, and other psychiatric disorders.

The goal of this article is to improve recognition of comorbid psychiatric and movement disorders and to help the reader formulate a management strategy using a multidisciplinary approach.

The issue of context and its relationship to disorderness extends well beyond panic attacks: it arises in nearly all psychiatric diagnoses not explicitly defined contextually.