Alcohol Abuse

Rather than looking at the biological basis for depression, it may be more useful to look at the patient's worldview and how that may have primed them for depression. Examining events that took place in the patient's past lead to a solution to their current depression.

Stereotypical portrayals of people with mental illness are as old as Hollywood itself. What are some of the clinical implications of the continued stigmatization of the mentally ill in television and film?

Theater, film, literature and poetry are forms of expression that allow artists and their audiences to explore the compelling issues of their lives. By understanding which pieces "speak" to patients and physicians, the dialogue and therapy may be enhanced.

The inability to create an accurate picture of self-awareness is a feature in many mental illnesses, such as schizophrenia, autism, ADHD, personality disorders and substance abuse. At a Kansas City, Mo., conference, researchers begin to establish a biological basis for self-awareness and hope to isolate the deficits in the brain that causes abnormal functioning.

In presenting the subject of dangerousness assessments at my hospital, I told a story about my grandchildren that illustrated the fact that we all make such assessments and act on them regularly in various contexts.

Substance abuse and addiction are among the most challenging health problems facing our society. Breakthrough discoveries in science continue to refine our understanding of drug abuse and addiction and are yielding new opportunities to translate basic research findings into tangible treatment products. Read about the progress being made by the National Institute on Drug Abuse, the world's largest supporter of research on the health aspects of addiction.

Increasing variations in mechanisms of action of atypical antipsychotics, side-effect profiles, and efficacy among the atypicals enable clinicians to tailor treatments to individual response, side-effect history, and current medical conditions.

The field of schizophrenia recently has seen remarkable progress in the understanding and treatment of this disabling condition. Dr. Buckley provides highlights of this special report.

While housing problems for the mentally ill are usually associated with patients receiving public care, private patients also face obstacles over obtaining and keeping adequate housing. What are the issues, and what can agencies do to ensure all patients, regardless of socioeconomic status, have adequate housing?

Schizophrenia is a devastating psychiatric disorder that affects 1% of the population worldwide. Patients often suffer their first psychotic outbreak in their late teens or early 20s. Despite advances in neuroleptic drugs, many patients' symptoms remain refractory to treatment, with recurrent episodes of auditory and visual hallucinations, bizarre delusions, depression, and social withdrawal that can last an entire lifetime.

Although late-onset psychosis is not as common as the early-onset variety, it can still pose difficulties in diagnosing and treating patients. How are patients with late-onset psychosis different from those who have early-onset, and what sorts of issues should clinicians be aware of?

The atypical antipsychotics have become the treatment of choice for patients with psychotic and other behavioral disorders. However, case reports, retrospective studies and epidemiological data suggest that these medications may be associated with new-onset type 2 diabetes and diabetic ketoacidosis.

While fear stirred the nation during the Washington, D.C.-area sniper episodes, some members of the media were irresponsible in their analysis of the sniper's motives. Has this confirmed the general public's false belief that mental illness is linked to violence?

Groups are important throughout the course of a patient's therapy, especially for patients who have substance use disorders. Group therapy's clinical and cost benefit is evaluated for its efficacy in preventing and treating substance abuse.

Repetitive self-injury can be one of the more difficult conditions to treat. What is the biochemical basis for self-injury and how can psychiatrists treat this condition?

Behavioral and Emotional Problems Among Children of Drug Abusers

When physicians struggle with substance use disorders, physician health programs are an important source of information and support. Certain medical specialties are at higher risk for substance use disorders than are others, and drugs of choice vary by specialty. Physician health and patient safety must be considered, but colleagues can help.

Combination treatment with both a selective serotonin reuptake inhibitor and a form of cognitive-behavioral therapy may be more effective than either treatment alone for this debilitating and often chronic disorder.

Medication and psychotherapy or counseling can be safely and effectively combined in patients with substance use and other psychiatric disorders. Differentiating between substance-induced psychiatric disorders and pre-existing psychiatric disorders facilitates the successful treatment of dually diagnosed patients. Find out what the latest research offers in the prognosis of psychiatric disorders and substance use.

The patient who presents with vague psychiatric somatic complaints may, in fact, be suffering from chemical sensitivities. Such sensitivities are tied to lower incidences of certain psychiatric disorders while correlating with the higher prevalence of others. Neurogenic inflammation, limbic kindling and psychiatric co-factors are discussed.

Treatment with psychopharmaceuticals may prove problematic for pregnant women. The decision to discontinue medications or to adjust dosages to minimize the risk to the fetus has to be addressed. The dynamic balance of treatment options, maternal concerns and practitioner responsibility depends upon staying abreast of the latest research in psychopharmacology and pregnancy.

The threat that a patient may commit an act of violence challenges psychiatrists to wrestle with the legal system as they attempt to successfully build a therapeutic alliance. Patient history, solid medical care, and the duties to warn and to protect must be successfully balanced to navigate the crossroads between psychiatry and the law.

Despite the widespread, long-standing notion that pregnancy is a time of happiness and emotional well-being, accumulating evidence suggests that pregnancy does not protect women from mental illness. Like their nonpregnant counterparts, pregnant women experience new onset and recurrent mood, anxiety and psychotic disorders.

The promise of natural products as possible sources of new treatments for Alzheimer's disease and other dementing illnesses is on the rise. Scientific evidence for the 13 dietary supplements most commonly used for memory impairment is analyzed and evaluated.

Patients with Alzheimer's disease and psychosis often have a more severe course of illness, with higher incidence of caregiver burden and hospitalization. Differentiating this disorder from Alzheimer's disease uncomplicated by psychosis is key to maximizing more positive outcomes.

While the deaths of several students have figured prominently in recent news, studies show that college students actually have a lower rate of suicide than their nonstudent peers. What can be done to lower suicide rates even further?

Many activities that are not themselves diseases can cause diseases, and a foolish, self-destructive activity is not necessarily a disease. When we find a parallel between physiological processes and mental or personality processes, we can mistakenly assume the physiological process is what is really going on, and the mental process is just a passive result of the physical process.

Deficient omega-3 fatty acids can result in myriad pathological changes including altering the central nervous system. Their balance or imbalance changes receptor function, prostaglandin and cytokine production. Understanding the roles of these essential fatty acids is vital to remedying the fatty acid abnormalities found in a number of psychiatric disorders.

Addiction-as-disease or addiction-as-choice may be better defined by delineating initial experimentation with addictive drugs from ongoing drug use. Repeated exposure to addictive substances changes the molecules and neurochemistry of the addict. Addiction-as-disease accepts the responsibility of the health care professional to treat the patient and precludes the stigmatization that addiction is a choice.

College students are far less likely to kill themselves than are nonstudent peers, according to a 10-year research study examining suicide rates at 12 Midwestern campuses.