July 11th 2024
What is new in research on alcohol use disorder?
Southern California Psychiatry Conference
September 13-14, 2024
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Updates on New and Emerging Therapies to Improve Outcomes for Patients With Major Depressive Disorder
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PER® Psychiatry Summit
November 7, 2024
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5th Annual International Congress on the Future of Neurology®
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2023 Annual Psychiatric Times™ World CME Conference
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Clinical Consultations™: Managing Depressive Episodes in Patients with Bipolar Disorder Type II
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Patient, Provider, and Caregiver Connection™: Exploring Unmet Needs In Postpartum Depression – Making the Case for Early Detection and Novel Treatments
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Medical Crossfire®: Understanding the Advances in Bipolar Disease Treatment—A Comprehensive Look at Treatment Selection Strategies
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'REEL’ Time Patient Counseling: The Diagnostic and Treatment Journey for Patients With Bipolar Disorder Type II – From Primary to Specialty Care
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Real Psychiatry 2025
January 17 - 18, 2025
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More Than ‘Blue’ After Birth: Managing Diagnosis and Treatment of Post-Partum Depression
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Patient, Provider & Caregiver Connection™: Reducing the Burden of Parkinson Disease Psychosis with Personalized Management Plans
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Expert Perspectives in the Recognition and Management of Postpartum Depression
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Pathological Gambling: Update on Assessment and Treatment
August 27th 2009Surveys show that approximately 60% of the general population has gambled within the past 12 months.1 The majority of people who gamble do so socially and do not incur lasting adverse consequences or harm. Beyond this, approximately 1% to 2% of the population currently meets criteria for pathological gambling.2 This prevalence is similar to that of schizophrenia and bipolar disorder, yet pathological gambling often goes unrecognized by most health care providers.
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Challenging the "Dis-ease" Model
August 27th 2009>I greatly enjoyed Dr Ron Pies’ editorial “What Should Count as a Mental Disorder in DSM-V?”1 in which he encouraged framers of DSM-V to critically examine the boundaries of mental illness and to more carefully distinguish between diseases, disorders, and syndromes. As I have noted elsewhere, current plans to integrate a “spectrum” approach into DSM-V require a careful consideration of these issues that must be defensible to critics of diagnostic expansion within psychiatry.2
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Atypical Antipsychotics for Children and Adolescents With Schizophrenia-Spectrum Disorders
August 11th 2009Although the onset of psychotic symptoms before the age of 13 years is exceedingly rare, the incidence of schizophrenia rises sharply after the onset of puberty.1 Only 1% of the population has schizophrenia and 30% of these patients experience an onset of psychotic symptoms by age 18 years.2-8 The period that precedes the onset of frank psychotic symptoms (ie, the prodromal phase) has not been well characterized in early-onset schizophrenia-spectrum disorders (EOSS), but retrospective reports have shown that symptoms include high levels of depression and anxiety, emerging cognitive and social deficits, unusual thought content, and (not infrequently) school failure.
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This statistic is as familiar as it is startling. According to the National Comorbidity Survey-Replication (NCS-R), the peak age of onset for any disease involving mental health is 14 years. True for bipolar disorder. True for anxiety. True for schizophrenia and substance abuse and eating disorders. The data suggest that most mental health challenges emerge during adolescence. If true, this brings to mind an important developmental question:
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Inflammation, Psychosis, and the Brain
July 11th 2009When the solution to a clinical or scientific puzzle eludes us for more than a century, as with schizophrenia, we need new methods to examine the pathology. If we want to make an impact on the disease we must shift research paradigms and focus on the early detection, early intervention, and new avenues of treatment that address different symptoms of schizophrenia.
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Delirium With Catatonic Features: A New Subtype?
July 10th 2009Delirium has been recognized and described since antiquity. It is a brain disturbance manifested by a syndrome of diverse neuropsychiatric symptoms. Various terms have been used for delirium, such as acute brain disorder, metabolic encephalopathy, organic brain syndrome, and ICU psychosis.
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PTSD Is a Valid Diagnosis: Who Benefits From Challenging Its Existence?
July 10th 2009PTSD filled a nosological gap by providing a way to characterize the long-lasting effects of trauma exposure.1 This led to a plethora of previously lacking scientific observations. Now the existence of PTSD is being called into question because some of the original assumptions that helped make the case for it have proved to be incorrect.2-4 However, it is possible to update some of the flawed assumptions of PTSD without rescinding the diagnosis. There is no reason to throw the baby out with the bathwater.
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Through high-profile media cases and in film, the American public has had glimpses into the psychological phenomenon and criminal behavior known as stalking. But do these glimpses truly represent the types of stalking offenses that are commonly perpetrated? Academicians and public policy makers have only begun to focus attention on stalkingin the past 10 to 15 years. As is often the case, the dissemination of information relevant to treating clinicians often lags behind by many years. Thus, many mental health professionals have not been adequately trained to recognize stalking behavior and to treat those who perpetrate it.
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Functional Magnetic Resonance Imaging: Round 2
July 1st 2009This is the second installment in a 3-part series that discusses some of the mechanisms behind functional magnetic resonance imaging (fMRI) technology. As you may recall, the genesis for this series was reactive…I got mad while sitting on an airplane reading a magazine article about how fMRIs can predict everything from product preferences to political inclination. The article hinted at something I have been noticing with increasing alarm-the confusion about what fMRI can and cannot reveal about information processing in the brain. I decided to write this series hoping that knowledge of the basic science behind fMRI technology could contribute to making more nuanced conclusions about the data it reveals.
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Psychiatric Disability: A Step-by-Step Guide to Assessment and Determination
June 11th 2009The epidemiology and management of psychiatric disability have gained increased attention for a variety of reasons in the past 3 decades. There are issues of empowerment, advocacy, and reduction of stigma. There are also concerns about cost containment as well as reliability, validity, and efficacy of the determination process.
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The Book of Ethics: Expert Guidance for Professionals Who Treat Addiction
June 10th 2009Fewer than a handful of books have been published on the ethical dimensions and challenges in treating and helping persons living with an addiction. Therefore, this book is a welcome contribution to the literature almost from the start. The contributors in this 9-chapter text range from community- and hospital-based professionals to behavioral program directors to ethics center directors and researchers to psychology, neurology, and psychiatry professors and fellows. The book aims to provide general advice on central issues encountered routinely by those experienced in addiction services and research. Contrary to the book’s rather biblical and authoritative title, the editors “offer this work modestly,” given the relative newness of focused ethical analysis in addiction treatment and care.
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From Colloquialism to Full Recognition: The Evolution of BPD
June 10th 2009In response to the resolution made in 2008 by the US Congress that proclaimed May to be borderline personality disorder (BPD) awareness month, the American Psychiatric Association (APA) decided to make BPD a key track of this year’s meeting. Among the several excellent presentations on BPD was Dr John G. Gunderson’s lecture on the ontogeny of the disorder. Having spent the past 30+ years studying BPD, both as a researcher and a clinician, Dr Gunderson of McLean Hospital of Harvard Medical School is an expert on the history of BPD.
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DSM-V: Applying the Medical Model
June 9th 2009In “Changes in Psychiatric Diagnosis” (Psychiatric Times, November 2008, page 14) Michael First relates the sad fact that the reorganization of DSM is still without formal guidelines and continues to be subject to the vicissitudes of groupthink and vocal constituencies. He relates that he and Allen Frances envisioned the application of biologically based diagnostic criteria when summarizing the work of DSM-IV, but complains that no criteria are forthcoming as yet.
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Clinical Reflections: The Journey Out of Madness
June 8th 2009I first met 22-year-old “Linda” when she was brought to the emergency department (ED) after a drug overdose. Although the drug Linda had ingested-clonazepam-was a CNS depressant, she did not appear groggy or sedated. In fact, her speech was rapid and pressured; she showed marked psychomotor agitation, which was demonstrated by her twitching feet and the incessant twisting of her hair. This presentation suggested a paradoxical response to her medication. Her chief concern was, “I feel as if I am going to come out of my skin.” I was puzzled.
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Every August, during my lakefront vacation, I kayak to the middle of Otter Pond, lay the paddle across my knees, and drink in the tranquil scene around me. Sunshine glints hypnotically off the rippling water. Every muscle relaxes, my cares recede. But this past summer, my annual reverie was interrupted by the shriek of a young child. “Let me out, let me out!” he cried, teetering halfway out of a passing paddleboat. “I want to swim back to the house!”
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Female Sexual DysfunctionWhat We Know, What We Suspect, and Enduring Enigmas
June 8th 2009From time to time, health conditions emerge that are relative “orphans” when it comes to having the resources of a health care discipline or subspecialty to take ownership or accept responsibility for developing the body of knowledge that underlies their systematic evaluation and treatment. Female sexual dysfunction (FSD) is such a class of conditions.
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Textbook of Violence Assessment and Management
June 5th 2009The foreword to the Textbook of Violence Assessment and Management promptly reminds readers that the mental health system has been invested in the prediction and prevention of violence since its inception. In a field dedicated to promoting wellness via the management of cognition, emotion, and behavior, violent thoughts, feelings, and actions are of primary concern. When psychiatric illness or psychological distress manifests as violence, the costs in terms of human suffering are extreme, wreaking havoc in the lives of patients, clinicians, and society at large-often with irreversible consequences.
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In the Year 2019: Psychiatry in Law and Public Policy
June 4th 2009Whether you credit the idea to Niels Bohr or Yogi Berra, it is true that predictions are very difficult to make, especially about the future. It is a daunting task, yet obviously an intriguing one, to try to imagine what our field will be like in 10 years or more.
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Newer Treatments for Schizophrenia: Benefits and Drawbacks
June 3rd 2009New treatments for patients with schizophrenia may be on the horizon, according to research presented at the annual meeting of the American Psychiatric Association in San Francisco. While some of these therapies may help treat the negative and cognitive symptoms of schizophrenia, a few are associated with QTc interval prolongation.
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Psych Advisory Panel Recommends FDA Approval of Some Uses of Antipsychotics
June 3rd 2009The FDA’s Psychopharmacologic Drugs Advisory Committee (PDAC) flashed partial green lights to 2 manufacturers of atypical antipsychotics. The committee recommended approval for 2 new uses for Seroquel XR (quetiapine fumarate) extended-release tablets and also gave first-time approval in this country for Serdolect (sertindole).
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