Dependent Personality Disorder

The use of supportive psychotherapy, where the clinician acts as a watchful parent, may be of some use to certain patients as opposed to traditional psychoanalysis. This paper gives some examples of cases in which supportive psychotherapy may be more effective.

A new report released by the Bush administration details the fragmentary nature of the current mental health care system. A few successful programs work despite the current system, not because of it.

There is no doubt that the number of applications for disability is rising. How should psychiatrists deal with patients who ask for disability without compromising the therapeutic alliance or the goals of therapy?

How does a clinician deal with those patients for whom they can ultimately do nothing but help them stay numb for the majority of their days?

Psychopharmacology can be useful in all stages of couples' therapy. Using a high-functioning couple as a case example, the author illustrates how psychopharmacology, together with psychotherapy, can be used to facilitate treatment success.

How can psychiatrists and psychotherapists optimize their collaboration and individual skills to facilitate treatment success?

Psychiatrists can help employers better understand the effects of personality disorders on employment litigation. This article looks at some of the consequences that personality disorders may have on employees' work conduct and the role of these disorders in settling employment legal claims.

What happens when a chemically dependent patient is in urgent need of timely medical and/or surgical interventions? According to one psychiatrist, logic and humility are two core principles essential to providing these patients with the care they deserve.

Several case examples of how psychiatrists can be a valuable asset in a workplace environment are given. What are the similarities and differences between this situation and clinical practice?

What is abandonment? Who is responsible? Where is the line drawn between no liability to treat and abandonment? Read how psychiatrists can protect themselves from the legal ramifications of abandonment.

When treating alcohol-dependent patients, clinicians may be well advised to integrate disulfiram into the treatment plan. Who are good candidates, and who are not? How can you enlist the aid of family members and friends to ensure compliance?

Carveout programs for behavioral health care are becoming more common. Who do they benefit3/4the patient, the doctor or the insurance company?

Psychiatrists can play a vital role in determining whether or not a patient will be a good candidate for an organ transplant. Using a case vignette, Dr. Garton explains how she helps a transplant team make the best possible decision.

Methods for detecting possible abuse and how to help victims (even if they are unable to help themselves or leave their abuser).

Most studies have found clear gender differences in the prevalence of depressive disorders. Typically, studies report that women have a prevalence rate for depression up to twice that of men (Bebbington, 1996; Nolen-Hoeksema, 1987).

Dementia produces significant dependency and contributes to costly long-term care; depression contributes to high rates of suicide; and both contribute to lower quality of life and higher disability among older patients. Therefore, researchers are eager to find new ways of preventing and treating these conditions. Studies currently underway include evaluating the role of health specialists in treating depressed patients, looking at bereavement and its effects on patients, and the role of estrogen, vitamin E, NSAIDs and COX-2 inhibitors in preventing and treating Alzheimer's disease.

By the time I interviewed Robyn in the emergency room, her panic attack had all but passed. But this 21-year-old woman was still shaken and tearful. This was her first panic attack, and she did not know what hit her. She thought she was having a heart attack. She had a tight feeling in her chest, she was hyperventilating. Her fingers and feet were numb and tingling. She experienced what she called a "closing in feeling." Robyn thought she was going to die.

Children whose parents have been diagnosed with affective disorders are far more likely to be diagnosed with a mental illness-especially affective disorder-than their peers whose parents do not have mood disorders (Beardslee, 1998; Burge and Hammen, 1991; Downey and Coyne, 1990).

Present-day psychiatry has fallen into crisis because of the severe limitations of its conception of the person and, as a result, its conception of the patient. It objectifies the patient in a number of ways. Because of this reductionism, psychiatry fails to distinguish between healthy and pathological features of human life. It fails to consider adequately the psychological and social factors that cause and maintain each patient's problems.

It is relatively recent that boundary issues in clinical practice have attained professional awareness, although some early concepts portended the issue. Several decades ago, for example, the term boundary violations referred almost exclusively to what we now term sexual misconduct.

Marc Schuckit, M.D., professor of psychiatry at the University of California, San Diego, School of Medicine, examined recent developments in the treatments for alcohol and drug dependence, and examined important changes in DSM-IV's classification of substance use disorder at the 11th Annual U.S. Psychiatric & Mental Health Congress.

Considered a "fringe" therapy 25 years ago, biofeedback has matured today to a modality much closer to mainstream treatment. Its value is accepted by a growing number of professionals, and it is covered by Medicare for some conditions, as well as by most health insurers.

Aware that there is a "rush to hold all providers delivering mental health and chemical dependency services accountable for the accessibility, quality and satisfaction of such services," the American Managed Behavioral Healthcare Association (AMBHA) recently released the second version of its Performance Measures for Managed Behavioral Healthcare Programs (PERMS 2.0).

Consider the following scenario: You are contacted by the major health plan with which you contract and are told that your average length of inpatient stay is longer than their standard. You believe this is because your patients are more severely ill than average. How do you respond?

Because of the very prominent physical symptoms of panic disorder, many see their primary care doctor or a specialist, such as a pulmonologist, first.

Day in and day out, psychiatrists-especially those involved with couples therapy-counsel and treat patients experiencing relationship problems with their spouses or partners. But what about the psychiatrist having a similar problem in his or her own life? Who does a doctor turn to for guidance and insight regarding such intimate matters?

Results of a multicenter, open-label observational trial of DuPont Merck's REVIA (naltrexone) demonstrated that patients were able to decrease their alcohol consumption from 57 to four drinks per week when the medication was part of an overall treatment program.

In 1995, I noticed that I was spending more and more time playing solitaire on my computer. I was trying to learn a new computer program and was very frustrated by it.

The increasing complexity and specificity of clinical trials, widely publicized research scandals and major advances in psychopharmacology have created a dilemma for academic institutions and private research organizations alike--how to find appropriate volunteers to participate in clinical drug trials. A major obstacle to patient recruitment is finding patients who are protocol-appropriate, said Nancy Hashim, affiliated with the Feighner Research Institute in San Diego.

Although adoption dates back centuries, the issue of whether or not adopted children are at risk for psychological maladjustment remains controversial. That this dispute would occur at all is not surprising, since as recently as 1926 laws which liberalized adoptions in England were faced with a widespread objection that adoption would encourage depraved conduct.