Addiction & Substance Use

A small percentage of educators use their position of power to sexually exploit their students. While it is assumed that men are often responsible for this type of behavior, in recent years, a number of high-profile cases of female educator sexual misconduct have been covered by the media.

Two recent studies by Harvard psychologists deliver promising data from 2 tests that may help clinicians predict suicidal behavior. The markers in these new tests involve a patient’s attention to suicide-related stimuli and the measure of association with death or suicide.

The discipline of evolutionary psychology views modern human behaviors as products of natural selection that acted on the psychological traits of our ancestors. A subdiscipline, evolutionary psychiatry, tries to find evolutionary explanations for mental disorders.

The goal of palliative care is to prevent and relieve suffering and to improve quality of life for people facing a serious, complex illness.

Opioid Dependence and XR Naltrexone

Psychiatric Times bids a very fond farewell to our long-time board member Jeffrey L. Cummings, MD, who was the originator of the Psychiatric Times “Brain and Behavior” column, which he penned for several years.

A brief report recently published in Science confirms the key role of dopamine (DA) in impulsive behavior. The researchers found that impulse control directly correlated with the amount of DA released in the striatum.

Recent findings indicate that social interaction is a key to living longer. Theoretical models have suggested that social relationships influence health through stress reduction and by more direct protective effects that promote healthy behavior.

Researchers who have spent their careers studying schizophrenia and mood disorders might be forgiven a bit of “biomarker envy.” At long last, it seems that the neurologists and neuropsychiatrists have developed some fairly sensitive and specific “lab tests” for Alzheimer’s Disease (AD).

Is there a link between heartbreak and addiction? A recent study shows that the same areas of the brain were affected as those associated with addiction, reward, craving, and depression.

Decreasing the Clinician’s Risk

Keys to diagnosis, assessment, and management.

Business groups and leading behavioral managed care companies have mounted a multifront attack on the new mental health parity law. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) went into effect on January 1, 2010, for employer plans starting after that date. However, companies have been awaiting a delayed final rule interpreting the terms of the MHPAEA.

As many as 80% of patients who use herbal preparations and other natural products regard these therapies as the primary treatment of their ADHD symptoms.

Fads in psychiatric diagnosis come and go and have been with us as long as there has been psychiatry. The fads meet a deeply felt need to explain, or at least to label, what would otherwise be unexplainable human suffering and deviance.

From 19th century French impressionists to current-day “rockers,” it has always been a loosely held belief that creative genius encompasses (even embraces) substance use. But a recent study found that substance use impedes artistic creativity.

As early as the 1970s, researchers and practitioners became increasingly aware of the necessity for services that would address the varied needs and treatment implications for consumers with the co-occurring disorders of substance abuse and mental illness. High percentages of consumers in substance abuse treatment centers were identified with mental illness disorders, and consumers admitted to psychiatric facilities often were identified as having additional substance use disorders.

When I was an undergraduate studying molecular biology in the early 1990s when the Human Genome Project had just begun, my required coursework included several lectures on the ethical implications of sequencing, understanding, and ultimately being able to manipulate the “code of life.”

I don’t believe in witches or ghosts or things that go bump in the night. I’ve always thought that the Salem witch trials were a result of mass hysteria (on the part of the persecutors) rather than a phenomenon of dark forces at work. And seeing Arthur Miller’s The Crucible a few years ago, only confirmed my suspicions. So I was gratified to see Dr Quintanilla’s poster at this year’s meeting of the American Psychiatric Association. As a physician and researcher, she factually explains the fallacy of witchcraft. Looking at historical documents dating back to the 15th century, Dr Quintanilla was able to match the symptoms of people condemned as witches with associated neurological and psychiatric disorders, such as epilepsy and hysteria. [Editor’s Note: Natalie Timoshin]

A 17-year study found that children raised in lesbian-mother families appear to grow up to be well adjusted and have fewer psychological problems than do children reared in more traditional families.

Many have challenged the claim of the APA/DSM-5 Task Force that the current process is the most “open process in the history of the manual.” Few have actually provided an argument or evidence of why this might, or might not, be so. What has changed dramatically in the DSM process since DSM-IV in 1994, and even DSM-IV-TR in 2000, is the rise of Internet culture and the “blogosphere.” What does this have to do with DSM-5?

Ethical Questions at the Intersection of Neurotechnology and Psychiatry

When I was a grad student-back in the Jurassic Era of molecular manipulations-my lab mates and I were all transfixed by the notion of a new technology: knockout animals (KOAs). This was because of its promise to solve a vexing problem.

After reading Dr Daniel Carlat’s heartfelt piece in the April 19, 2010, New York Times Magazine (“Mind Over Meds”), I was struck by several things. The first was Dr Carlat’s eloquence regarding the dilemmas of psychiatric practice. Second was how his experience may represent a generation of psychiatrists who were trained during an era of drug discovery wrapped in the exciting promise of “Biological Psychiatry.”

In addition to their use in the management of epilepsy, anticonvulsants are indicated for management of bipolar disorder, mania, neuralgia, migraine, and neuropathic pain.

Perhaps one of the positive things to come out of the Kansas v Hendricks wave of sexually violent predator (SVP) commitment laws during the past decade is that our knowledge base on sex offenders has grown tremendously.

Included in this list of disorders is the recommendation that the category include substance use disorders and non-substance addictions such as gambling and Internet addiction. The category has tentatively been retitiled "Addiction and Related Disorders."

Nothing can replace talking with patients. This can take substantial amounts of time, but it is the only way to obtain as clear a view as possible about whether a patient is benefiting from treatment.

The recently posted first draft of DSM-5 has suggested a whole new category of mental disorders called the "Behavioral Addictions." The category would begin life in DSM-5 nested alongside the substance addictions and it would start with just one disorder (gambling).

Insurance restrictions sometimes make for strange bedfellows. My story begins with a phone call from a man about to lose his job. He said that he had been placed on probation and was about to be fired. He asked if he could see me. We met the following day.