From the Pages of Psychiatric Times: October 2023

In the October 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 risks of reversible clomiphene-associated manic episodes to concurrent treatment of eating disorders and PTSD. Here are some highlights from the issue.

Psychiatry in the Courtroom: Climate Disruption and ACEs

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Supported by psychiatrists, a group of 16 Montana youth brought forward a constitutional climate lawsuit against their state, fighting to protect their rights to a healthy environment, life, dignity, and freedom—in the first ever youth climate case to go to trial. And they won.

Psychiatric Testimony

“A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient… A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.” Continue Reading

Examining Risks of Reversible Clomiphene-Associated Manic Episodes to Patients

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We recently managed a case of clomiphene (Clomid)–induced acute mania that was resolved following empiric treatment with olanzapine and discontinuation of clomiphene. Based on our experience with this case, we advise physicians to consider clomiphene-associated phenomena with acute psychiatric presentations shortly after use of clomiphene.

Discontinuing clomiphene, engaging in close serial clinical observation of mental status, empirically managing psychiatric symptoms, subsequently avoiding clomiphene, and following up clinically are indicated. Continue Reading

Concurrent Treatment of Eating Disorders and PTSD Leads to Long-Term Recovery

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Research shows an undeniable connection between posttraumatic stress disorder (PTSD) and eating disorders (EDs). Individuals with significant traumatic histories and/or PTSD have more severe ED symptoms, more suicidality, and more anxiety and depressive symptoms. Studying the intersection between these 2 mental health illnesses helps us understand how to treat them together moving forward, specifically in higher levels of care, including residential ED treatment programs.

Groundbreaking research published in the Journal of Eating Disorders shows the effectiveness of integrating trauma treatment with evidenced-based ED treatment in residential programs. The conventional thinking in psychiatry had been that it was best to refrain from trauma work while in intensive treatment settings, deferring this to later outpatient treatment. Continue Reading

Cannabis, Psychosis, and the Legal Implications: Chicken or Egg?

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Cannabis is the most commonly used illicit drug in the US, with 15.3% of the population using the drug. The main active ingredient in the cannabis plant is Δ-9-tetrahydrocannabinol (THC), just 1 of more than 100 cannabinoids identified. The potency and THC content in cannabis directly correlate with the prevalence of psychotic features among users.

Results of a study from 2002 to 2013, the National Epidemiologic Survey on Alcohol and Related Conditions, showed that as compared with nonusers, those with any use of nonmedical cannabis and those with cannabis use disorder were at increased risk of self-reported psychosis regardless of degree of use. Moreover, the literature suggests that cannabis increases the risk of developing schizophrenia 3-fold in a dose-response relationship. Continue Reading

See the full October 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.