From the Pages of Psychiatric Times: March 2023

In the March issue of Psychiatric Times®, we worked with experts from multiple psychiatric areas to bring you thoughtful articles about a wide variety of psychiatric topics, from a look at Alzheimer disease treatment to the psychopharmacologic treatment of bipolar II depression. Here are some highlights from the issue.

Alzheimer Disease: Are the Treatments Worse Than the Illness?

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The recent approval of aducanumab caused an uproar: Was it approved too soon? What long-term effects will the treatment have? Is the cost worth it? Are we doing enough to address Alzheimer disease (AD)?

As we grapple with these issues, the problem of AD continues to swell; more than 6 million Americans are living with the disease, and this number is projected to rise to nearly 13 million by 2050.1 AD will kill 1 in 3 affected seniors, and is more deadly than breast cancer and prostate cancer combined. What are the available and upcoming AD treatments and how can you utilize them to best serve your patients? Continue Reading

Psychopharmacologic Treatment of Bipolar II Depression

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Once you have diagnosed acute bipolar II depression accurately according to the DSM-5 criteria (as we reviewed in detail in a recent Psychiatric Times column), you are confronted with the problem of what to select for an evidence-based medication treatment. The problem is that you do not have much evidence to rely on.

In a review of 11 US and international evidence-based treatment guideline recommendations for managing bipolar disorders, only 3 of the guidelines offered any specific recommendations for bipolar II disorder. The other 8 guidelines all implied—if mentioning bipolar II at all—or stated explicitly, such as in 1 case, that one should more or less use what was recommended for bipolar I depression. Continue Reading

Lewy Body Dementia: Unpacking a Neuropsychiatric Enigma

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To better understand Lewy body dementia (LBD), it is essential for clinicians to understand the potentially confusing terminology used in its diagnosis—and understanding the terminology means understanding the biology. Misfolded aggregates of the abundant physiological presynaptic protein α-synuclein in the somatodendritic compartment of neurons and glial cells form the basis of a group of disorders called the synucleinopathies.

In the Lewy-type α-synucleinopathies, α-synuclein aggregates in the neurons (Lewy bodies) and neuronal processes (Lewy neurites), but the synucleinopathies also include non-Lewy glial cytoplasmic inclusions, axonal spheroids, and other cytoplasmic neuronal inclusions. Continue Reading

Mental Health and the Global Race to Resilience

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The scale of climate change and its devastation has become increasingly apparent. As we witness tenuous and inadequate movement toward effective responses, it is clear that both places and people are falling apart. The emotional suffering from climate change is growing rapidly, and it is alarming from more than a humanitarian perspective.

Emotional and social bandwidth is vital for tackling climate change. People must adapt, endure, transform, and find hope through these challenges if they are to survive in a humane and effective manner. The emotional and social challenges of these tasks—our psychiatric work—have been a neglected part of climate efforts. Continue Reading

See the full March issue of Psychiatric Times here. And be sure to stay up-to-date by subscribing to the Psychiatric Times E-newsletter.

Do you have a comment on any of these or other articles? Have a good idea for an article and want to write? Interested in sharing your perspectives? Write to us at PTeditor@mmhgroup.com.