Alcohol Abuse

Cognitive impairment is a common symptom in many psychiatric and neurologic conditions. The articles selected for this Psychiatric Times special report provide a sampling of some important and topical issues regarding the influence of various factors on cognition in individuals with neuropsychiatric conditions.

Cognitive deficits, which play a crucial role in the pathogenesis and prognosis of schizophrenia, can lead to noncompliance and poor outcomes. New treatment options need to be tested that may offer surplus effects on neurocognition.

In looking at the history of ECT, it appeared to have been quite successful in treating a variety of psychiatric disorders. If that is the case, then why did it disappear from the "psychiatric map" for a number of years? What obstacles need to be overcome to return ECT to its place as a viable treatment option?

Patients who use or abuse alcohol and other substance are at high risk for insomnia and present unique challenges for treating this debilitating disease. The three avenues of treatment--behavioral, OTC medications and prescription medications--are reviewed and future trends are outlined.

Reported by two out of every five college students nationally, heavy episodic or binge drinking may be the most frequently reported and researched mental health problem among college youth. Effective prevention and treatment should reflect the heterogeneity of binge drinking, as it can cause substantial and serious harms.

espite the fact that about 30% of our life is spent sleeping and decades of research have been spent on sleep, we still do not know its real function. What we do know is lack of sleep can have serious implications, such as increased risk of depressive disorders, impaired breathing and heart disease. On the other hand, nighttime sleep disturbance is usually followed by excessive daytime sleepiness that is associated with delayed problems like memory deficits and impaired social and occupational function, and immediate consequences such as car accidents (Kupfer and Reynolds, 1997; Roehrs and Roth, 1995).

Chronic infection with the hepatitis C virus (HCV) is frequently complicated by the presence of co-existing substance use disorders and mental illnesses. It is important to find improved ways to address barriers to care, and to provide effective and humane care to patients suffering from HCV infection.

This year marks the 70th anniversary of the first use of induced seizures to treat mental disorders. Read about the career of Ladislas Meduna, M.D., the Hungarian neuropathologist who pioneered this treatment method. Although his theory that convulsive therapy is effective because it increases glial cell function was disproved, it remains one of the

According to a recent Human Rights Watch report, U.S. prisons hold three times as many people with mental illness as psychiatric hospitals. The majority of these individuals are there because community-based treatments are not available, they have co-occurring substance abuse problems or they have previous involvement with the criminal justice system. Partnering with law enforcement agencies is key to devising workable solutions that ensure individuals with mental illnesses get the treatment they need.

Women with schizophrenia may benefit from hormone replacement therapy. A new study measured the efficacy of estrogen, progesterone, Prolactin, luteinizing hormone, follicle stimulating hormone and testosterone on women with the disorder.

The current climate of managed care has dramatically changed how psychiatrists deal with the issue of suicide. What should clinicians know, both about the safety and welfare of their patients and to protect themselves legally, when dealing with managed care companies in cases of potential suicidality?

Unlike other forms of self-injury, suicidal self-injury has special meaning, particularly in the context of borderline personality disorder. How is suicidal self-injury differentiated from non-suicidal self-injury in these patients, and how can their behavior be properly assessed and treated?

Assessing and treating suicidal behavior in the elderly can be difficult. What are the risk factors and how can this population best be treated?

This article reviews the Adverse Childhood Experiences (ACE) Study that examined the association between multiple childhood traumas and health outcomes in adults. These findings have significant public health implications for individuals exposed to childhood trauma, and the authors present a vision for a children's mental health care and wellness infrastructure in the United States derived from the Report of the Surgeon General's Conference on Children's Mental Health.

Hispanics are now officially the largest minority in the United States. They are also highly prone to psychiatric disorders. What are the unique challenges of treating this ethnic population?

The chief psychiatrist of the Community-University Health Care Clinic in Minneapolis reflects on what he's learned caring for refugees from Southeast Asia and Somalia. His experiences can educate others caring for immigrants and refugees.

Can olanzapine (Zyprexa) delay or even prevent psychosis in patients with prodromal symptoms of schizophrenia? A new study being conducted in four research centers in North America is attempting to answer that question. Prevention Through Risk Identification Management and Education (PRIME) uses several new scales developed specifically for this study to identify and rate symptoms of prodromal symptoms to assist in early intervention research.

Although studies have already shown that alcoholism can greatly increase the risk of suicide, a new published study has discovered that age is also a factor in suicide among alcoholics.

An increasing amount of systemic research has galvanized opinions regarding pediatric-onset bipolar disorder (BD). Although originally thought to be a rare condition, the number of pediatric-onset BD diagnoses is rising. This article summarizes current thinking regarding pediatric BD, including work focusing on presentation, psychiatric comorbidity and recent treatment data

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?