A funny thing happened to me on the way back from the New Hampshire Governor’s Statewide Conference on Domestic & Sexual Violence. I don’t mean funny in a comedic...
Working With Physicians in the Emergency Department
Time is a vanishing resource that shapes our collaboration with colleagues in emergency medicine.1 These colleagues evaluate more patients in less time, because the number of emergency department (ED) visits has...
Early Signs of Autism Spectrum Disorders
Recent attention has focused on identification of early signs that may identify children at risk for development of autism spectrum disorders (ASD). Differences in feeding patterns, vocalization, and visual attention have been found between children with ASD and controls.
The “Minimum Necessary”: How Much Will You Need to Divulge to Insurers?
Final guidance from the federal government is imminent about how much of a patient’s protected health information (PHI)—including psychotherapy notes—a psychiatrist must provide to a health insurer. The economic...
Navigating the Straits of Chronic Pain and Addiction
The ancient metaphor from Homer's Odyssey of being caught between the two monsters of Scylla and Charybdis could describe the predicament of contemporary physicians treating chronic pain. These...
Efficacy of Drugs in Bipolar Depression: What the Data Show
In this article, clinically relevant research is briefly discussed and, perhaps more important, a few tips on how to read and interpret research studies are presented. Your feedback, suggestions, and questions are eagerly solicited at
Successful Treatment of Physicians With Addictions
Physicians generally display better health and have lower rates of all-cause mortality than the general population.1 However, their education, nutrition, and lifestyle do not offer similar protection from substance abuse and...
Violence in Bipolar Disorder: What Role Does Childhood Trauma Play?
The relationship between mental illness and violence is controversial. On the one hand, there is considerable unfounded stigma and discrimination toward the mentally ill based on the popular notion...
Psychiatric Comorbidity Associated With Pathological Gambling
Gambling has become a major recreational activity in the United States. Formerly confined to a few states such as Nevada and New Jersey, legal gambling opportunities have exploded across...
The Impact of Screen Media on Children
Are screen media good or bad for children?” In essence, screen media constitute neurologically potent, arousing input to the developing brain. Unlike conventional toxins, their effects are ...
Keys to Success in ADHD Treatment: Partnering with Families
Clinicians who treat children with attention-deficit/hyperactivity disorder (ADHD) face a challenging conundrum. Although our understanding of ADHD and its evidence-based treatments has increased significantly in recent years, the...
Secondary Trauma Issues for Psychiatrists
Psychiatrists face growing challenges both as health practitioners and as sources of reassurance and empathy for their patients. But what if the effort to understand and help patients itself...
E-Psychiatry: Using Web-Based Communications to Connect With Patients
E-mail, instant messaging (IM), video chat, and social networks—notably blogs and online communities such as Facebook and Twitter—have emerged as essential business and social communication tools.1 Electronic communication is...
Antipsychotic Prescribing in Children: What We Know—What We Need to Know
A pair of recent research articles has cast the public spotlight on treating children and adolescents with antipsychotic medications.1,2 In the first report, a large and broadly representative group of child and adolescent patients, all naive to antipsychotic medications, was followed for approximately 10 weeks after initiating treatment with olanzapine, risperidone, quetiapine, or aripiprazole.
Health Information Technologies for Practicing Psychiatrists
In today’s practice of medicine, it is highly unlikely that any physician entering into or already in practice will remain in the analog age without some type of health...
Strategies to Avoid Burnout in Professional Practice
Professional burnout, with its attendant detrimental effects on career satisfaction and success, is an issue of concern for many practicing psychiatrists. Burnout is a work-related syndrome distinct from depression....
Is Major Depression “Adaptive”? Clinical Data Say No
The poet Denise Levertov was no stranger to sorrow and loss. In her poem, “Stepping Westward,”1 she writes of the aging process, as both a burden and a gift. The poem begins,What is green in me/darkens, muscadine . . .
Cyber Bullying: Recognizing and Treating Victim and Aggressor
When most people think of bullying, they envision the schoolyard thug verbally or physically threatening hapless victims on the playground or on the school bus.1-3 The past few years,...
New Guidelines For Diagnosing Alzheimer’s: Wishful Thinking…Dangerous Consequences
Previously, I have been quite critical of the DSM-5 suggestion to introduce a new diagnosis--Minor Neurocognitive Disorder--on the grounds that it would create a large false positive problem and would lead to...
Psychiatry Comes to China: Will You?
Confucius say: "If three of us travel together, I will find two teachers." The American visitor to China will likely not be surprised by seeing McDonalds here and there, as...