From the Pages of Psychiatric Times: September 2023

In the September 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 violence risk assessment in emergency departments to the development of effective treatment strategies for women with schizophrenia. Here are some highlights from the issue.

The Making of Adult ADHD: The Rapid Rise of a Novel Psychiatric Diagnosis

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As recently as 2 decades ago, the consensus view in American academic psychiatry was that attention-deficit/hyperactivity disorder (ADHD) rarely, if ever, persists into adulthood. For decades, ADHD was considered a disorder of childhood; adult cases were seen uncommonly and the diagnosis was rarely made. DSM-IV-TR, published in 2000, describes a condition existing in children and makes only scant reference to adults.

Fast-forward to 2023, and adult ADHD is the diagnosis du jour; rates of diagnosis are skyrocketing at an alarming rate as are prescriptions for psychostimulants, the drugs that purportedly treat the condition. The history of psychiatry is a history of fads in theory, diagnosis, and treatment. Such rapid shifts in conceptualization—such as the emergence of the concept of adult ADHD—almost always warrant informed critical examination. Continue Reading

Developing Effective Treatment Strategies for Women With Schizophrenia

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The presentation of schizophrenia differs significantly between men and women, and this influences treatment strategies. The major differentiating factors include age of onset, symptom differences, parenting responsibilities, response to antipsychotic medications, and care during the transition to menopause.

Age of Onset and Differences in Symptoms

The first occurrence of the symptoms and behaviors that conform with the currently accepted definition of schizophrenia occur, on average, several years earlier in men than they do in women. The older age of onset found in women is partially explained by the fact that many large studies include a wide range of ages, sometimes extending into older age. Continue Reading

Violence Risk Assessment in the Emergency Department

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Although substantial progress has been made over the past several decades by mental health professionals to undertake suicide risk assessment with more structured approaches, violence risk assessment has lagged despite emerging evidence that highlights violence as a significant issue.

Violence has become an increasingly recognized problem in health care. Rates of violent behavior toward health care workers, especially frontline workers such as nursing staff, are high. Emergency departments (EDs) are notable for their high rates of violent incidents. A recent meta-analysis found that 77% of ED workers were subject to some form of workplace violence. Continue Reading

Unique Collaborative Care System: Solution to the Youth Mental Health Crisis

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The beginning of our story is not unique. Two of us—Ben Hillyard, MEd, LCMHC, and Jessica Lyons, MS, LMFT—spent decades working in the broken mental health system, alarmed by access-to-care challenges, emergency department (ED) boarding of patients, and the rapidly growing youth mental health crisis. Together, we shared a vision that if providers could collaborate and share clinical information, mental health needs would resolve more quickly. How could we make this happen?

In 2019, we did the unthinkable: We partnered to establish a unique delivery system with a mission to disrupt the status quo and deliver a more progressive, data-driven model of mental health care, particularly for children and adolescents. We called it Aloft Integrated Wellness. Continue Reading

See the full September 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.