Alcohol Abuse

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.

Noting the frequent unresponsiveness of posttraumatic stress disorder (PTSD) to standard drug treatments, Stein and colleagues reported results of the first double-blind, placebo-controlled trial of an adjunct to selective serotonin reuptake inhibitors for the treatment of this disorder.

Epilepsy is one of the most common chronic neurological disorders of childhood. Therapy should consist of education to reduce fears and concerns, psychotherapy to decrease triggers for seizures, and careful medication monitoring to avoid those drugs that reduce seizure threshold or have excessive interactions with antiepileptic drugs.

Catatonia is found in at least 10% of patients admitted to acute psychiatric services, so any young patient with stupor, unexplained excitement or persistent motor signs should be formally assessed for this syndrome. From among the 20 to 40 now-identified features of catatonia, its proper diagnosis must be differentiated from other mental illnesses.

In the last third of the 20th century, psychiatry boldly shook off a 120-year-long philosophical funk and rushed to catch up in the thrilling march of medicine. The biopsychosocial model that once sounded trendy now seems to be an indispensable approach. The pioneers of psychopharmacology who once labored at the margins have now been joined by thousands of bright young doctors who treat patients with depression, psychosis and impulsive aggression and realize that a troubled soul is often expressing the cries of a troubled brain. This issue of Psychiatric Times celebrates the stirring giant that is 21st-century neuropsychiatry--a discipline that derives its immense power and scope from the glad embrace of the twin Enlightenment ideals of humanism and the scientific method.

What effects will the verdict from the murder case against Andrea Yates have on the public's view of the insanity defense?

New medications for the treatment of various addictions are currently under investigation. However, there are still substantial barriers, on the part of health and social policies and the patients themselves, to patients receiving these new treatments. Many of these issues were explored at the 2001 American Society of Addiction Medicine's State of the Art in Addiction Medicine conference.

For various reasons, up to half of patients stop taking their prescribed antidepressant within three months. Side effects are often the biggest obstacle in maintaining treatment adherence. How can clinicians help patients deal with the sexual dysfunction and weight gain that often accompany psychotropic treatment?

There is a range of meaning that underlies patients' violent acts against themselves. The usefulness of so-called "safety contracts" to actually predict suicidal behavior is questioned.

Although it may be tempting to say that almost any rewarding activity can become addicting, new research appears to indicate that, at least in the case of Internet use, that may not be the case. In fact, "Internet addiction" may actually be a sign for other psychiatric disorders.

In the 1800s there was widespread concern over the increase in the number of individuals with severe mental illnesses. Evidence from the 20th and 21st centuries is building that shows a similar trend. Why, then, is this increase not being currently addressed?

Jose R. Maldonado, M.D., assistant professor of psychiatry and behavioral sciences at Stanford University, was named the 2001 recipient of the Psychiatric Times Teacher of the Year award. The award was presented to Maldonado at the 14th Annual U.S. Psychiatric & Mental Health Congress in honor of his outstanding achievements in and steadfast dedication to psychiatry. For his work with geriatric psychiatry, Dilip V. Jeste, M.D., has been appointed to the endowed Estelle and Edgar Levi Memorial Chair in Aging at University of California, San Diego (UCSD). Jeste is founder and chief of UCSD's division of geriatric psychiatry and Founding President of the International College of Geriatric Psychoneuropharmacology. He focuses his research on schizophrenia and other psychotic disorders in late life and their successful treatment with the use of safer and more effective drug and psychosocial treatments.Helping people of all ages with schizophrenia to reintegrate into society is the focus of the Eli Lilly and Company-sponsored Reintegration Awards. Recognizing both patient advocates and mental health care professionals, these awards provide grants for their recipients' respective reintegration programs. In the Honorary category, the 2001 "Public Eye Recipient" is Elizabeth Baxter, M.D., a Tennessee-based psychiatrist who, while suffering from psychosis herself, is a mental health advocate on the national level. The 2001 Reintegration Awards were also given in the categories of Advocacy (New Jersey Association for Mental Health Agencies Inc. in Manasquan, N.J.), Clinical Medicine (The Whole Person Family Medicine Clinic in Torrance, Calif.), Education (The Guidance Center Supported Education Program in New Rochelle, N.Y.), Housing (Fred Geilfuss, Scott Reithel, Jack Rosenberg in Milwaukee), Occupational (Restoration Project in Acton, Mass.) and Social Support/Rehabilitation (Fountain House in New York City).