ADHD

A parent's heavy drinking can increase a child's risk of substance use disorder.

Seventy percent of antidepressants are prescribed by primary care doctors with little training in their proper use, under intense pressure from Big Pharma, drug salespeople, and misled patients, after rushed 7-minute appointments and subject to no systematic auditing. The cash-strapped FDA is beholden to industry for funding. And it gets worse.

Sleep changes associated with psychotropic drugs are common enough to justify routinely obtaining a baseline sleep diary before beginning treatment, even when the initial screening for sleep disorders indicates that no further investigation is needed.

In light of our problems and uncertainties about the state of current psychiatry, or perhaps because of them, what might describe good psychiatry? Following are some suggestions for what we, as psychiatrists, can do.

A video on ADHD and impulsivity from childhood to adulthood.

Ongoing shortages of several psychotropic medications have wreaked havoc among patients and their families, caused frustration and reluctant prescription switches among physicians, and prompted investigations by Congress.

ADHD has been significantly associated with a primary diagnosis of impulse control disorder and bipolar disorder and most commonly associated with social phobia and major depressive disorder. Details here. . .

Research suggests there are varying versions of ADHD, and like multiple subtypes of cancer, ADHD encompasses an entire family of disorders.

The paradigm for modern psychiatry is evidence-based medicine (EBM)-it represents proven treatments for defined diagnoses. But there are major problems with this position, starting with the fact that while they are superior to placebo, evidence-based treatments too often are ineffective.

In a recent interview on 60 Minutes, Harvard psychologist Irving Kirsch, PhD, commented, “the difference between the effect of a placebo and the effect of an antidepressant is minimal for most people.”

Agitated patients who display “excessive verbal and/or motor behavior”-can be loud, disruptive, hostile, sarcastic, threatening, hyperactive, and even combative. This article discusses new best practices and guidelines for agitation.

This discussion focuses on approaches to improve medication adherence, particularly in reference to helping adolescents remain on recommended psychopharmacological regimens when transitioning from acute to long-term maintenance.

This list serves as a guide when treating persons of diverse cultures and backgrounds.

The responsibility for improvement was placed on psychiatrists: diagnostic skills had to be improved and patients and their families and caregivers as well as the general public needed to be better educated about the disorder and treatment options.

Effective, early intervention and appropriate support for and treatment of the caregivers of these vulnerable children will improve short-term outcomes and also may provide positive lifelong benefits.

Each of the boys in question could meet criteria for the DSM-5 proposed criteria for Disruptive Mood Dysregulation Disorder (DMDD). But do you think that these presentations are all the same syndrome that share a similar neurobiological basis, family history, and response to treatment?

Charles Dickens might well say of American psychiatry, “These are the best of times and the worst of times.”

Dr Angell and others may be right to claim that we should be concerned about the current practice of psychiatry. But the simple fact that mental illnesses seem to be common is not one of them.

How often do insomnia and anxiety disorders coexist? And how best to treat patients with comorbid insomnia and anxiety? Answers here..

Beyond safety benefits, pharmacogenomic testing may improve adherence by helping patients avoid suboptimal or harmful treatments.

ADHD is often inaccurately diagnosed and prematurely treated with medication-especially under the pressure of heavy drug company marketing to physicians and direct advertising to parents and teachers.

Despite its caveats and good intentions, the AAP guideline will surely invite an inappropriate glut of medication for preschoolers . . .

Substance use disorders are associated with significant morbidity and mortality that affects individuals and their families. Preventing the onset of an SUD in adolescence remains a critical area of clinical and public health significance.

Several available agents in addition to methylene blue are being investigated for bipolar disorder and were in a in a recent review.

I recently experienced the odd coincidence of receiving 2 separate emails on the same morning each asking almost the very same question. . . how can I remain so high on psychiatry while at the same time being so critical of some of its recent trends and so fearful of the likely future harmful impact of DSM-5?

Hoarding has broad-reaching implications, including a substantial public health burden linked to occupational impairment, poor physical health, and demand for social services.

Doubt and confusion as to where ADHD fits into the general spectrum of illness further feeds the general perception that ADHD is a socially constructed disorder rather than a valid neurobiological disorder

Martin Whiteley is an MP who represents Perth in the Australian parliament. He has been actively involved in mental health issues and succeeded in a crusade to curb what had been Perth's alarming overdiagnosis and overmedication of Attention Deficit Disorder (ADD).

I just received a very important email from Dr Dayle Jones who chairs the DSM-5 Task Force of the American Counseling Association (ACA). The ACA has provided a much needed wake-up call for the American Psychiatric Association.

In a decade-long study of antipsychotic prescribing for hospitalized children and adolescents, researchers found that antipsychotics were used in 44.3% of patients and were often prescribed for behavioral disorders, PTSD, and other anxiety disorders as well as psychotic disorders.