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PsychiatryRounds Psychiatry News's Blog – December 2008 Archive (9)

Forensic Issues in Child Sexual Abuse Allegations

(PSYCHIATRIC TIMES) - Of the nearly 3.6 million children who were the subjects of a Child Protective Services investigation in 2006, maltreatment was substantiated or indicated in 28%. Nearly 9% of these substan­tiated/indicated cases were related to sexual abuse allegations.1 When sexual abuse is alleged, children may face investigative interviews, family disruptions, a change in their school environment, mental health counseling, and even trial court testimony. This article reviews factors… Continue

Added by psychiatryRounds Psychiatry News on December 1, 2008 at 11:30pm — No Comments

Medical Comorbidities in Late-Life Depression

(PSYCHIATRIC TIMES) - The prevalence of depression is higher in persons with comorbid medical conditions than in those with no comorbidity. Some conditions that are common in older people, such as stroke, cardiac disease, chronic obstructive pulmonary disease (COPD), and diabetes mellitus, are associated with particularly high rates of depression comorbidity.1,2



Late-life depression is both underrecognized and undertreated, and the impact of medical comorbidity may mask depressive… Continue

Added by psychiatryRounds Psychiatry News on December 1, 2008 at 9:30pm — No Comments

Is There a Gene for Postpartum Depression?

(PSYCHIATRIC TIMES) - The transition to parenthood is filled to the brim with behavioral extremes. Parents who are otherwise emotionally stable are in one moment thrilled and happier than they have ever been and confused and fearful the next. Afriend of mine once theorized that these reactions occur because "parenting is an amateur sport" played by persons who are highly motivated to do the right thing but who often have no idea what that right thing is.



For some couples, the… Continue

Added by psychiatryRounds Psychiatry News on December 1, 2008 at 9:30pm — No Comments

Cognitive-Behavioral Therapy for Adolescent Depression

(PSYCHIATRIC TIMES) - The substantial and often recurrent distress and impairment associated with major depressive disorder (MDD) in youth has prompted increased interest in the identification and dissemination of effective treatment models. Evidence supports the use of several antidepressant medications, specific psychotherapies, and, in the largest treatment study of depressed teenagers, the combination of fluoxetine and cognitive-behavioral therapy (CBT) as effective treatments.1-3 CBT is… Continue

Added by psychiatryRounds Psychiatry News on December 1, 2008 at 9:30pm — No Comments

Computer-Assisted Psychotherapy

(PSYCHIATRIC TIMES) - The prospect of using computers to deliver psychotherapy has been intriguing a number of investigators who have been studying innovative methods of bringing technology into clinical practice. The most dramatic form of computer-assisted therapy (CAT) is virtual reality exposure therapy in which patients are immersed in a virtual environment to help extinguish fears of flying, heights, social situations, or other anxiety-provoking situations. Other commonly used CAT methods… Continue

Added by psychiatryRounds Psychiatry News on December 1, 2008 at 9:30pm — No Comments

Dangerously Paranoid?

(PSYCHIATRIC TIMES) - The term “paranoia,” derived from the Greek &lduo;para” (beside) and “nous” (mind), was coined as a descriptor of psychopathology by Heinroth in 1818.1 By the end of the 19th century, 50% to 80% of patients in asylums in German-speaking coun­tries had received a diagnosis of paranoia.1 Beginning in 1899, Kraepelin’s efforts to define paranoia more precisely resulted in a decrease in diagnoses of paranoia in favor of dementia praecox and, later, schizophrenia.1,2 This… Continue

Added by psychiatryRounds Psychiatry News on December 1, 2008 at 9:00pm — No Comments

Update on Pharmacotherapy for ADHD

(PSYCHIATRIC TIMES)- The American Academy of Child and Adolescent Psychiatry Practic Parameter for the Assessment and Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder1 (ADHD) recommends that initial psychopharmacological treatment consist of an FDA-approved medication. Agents in this category include stimulants (dextroamphetamine, methylphenidate, mixed salts amphetamine) and atomoxetine.



The clinician and the patient’s family must decide whether to… Continue

Added by psychiatryRounds Psychiatry News on December 1, 2008 at 8:00am — No Comments

Major Depression After Recent Loss Is Major Depression — Until Proved Otherwise

(PSYCHIATRIC TIMES) - Suppose your new patient, Mr. Jones, tells you he is feeling “really down.” He meets all DSMIV symptomatic and duration criteria for a major depressive episode (MDE) after having lost his wife to cancer 2 weeks ago. Should you diagnose major depressive disorder?



I’m guessing most psychiatrists would be reluctant to do so. Indeed, DSM-IV permits a “bereavement exclusion” in such circumstances, provided the patient lacks “certain symptoms that are not… Continue

Added by psychiatryRounds Psychiatry News on December 1, 2008 at 5:00am — No Comments

Between Reason and Panic

(PSYCHIATRIC TIMES) - One minute she's breathing room air

and the next you're barking orders

at a team wheeling in a crash cart.

You review signs and symptoms you missed,

the rough rhythm of her heart before she coded.

You want to believe your reasoning

was as elegant as a glass filled with cabernet,

and you want to forget the bottle you imagine

resting on a tray table at forty thousand feet,

ready to tumble when the captain announces

the plane… Continue

Added by psychiatryRounds Psychiatry News on December 1, 2008 at 4:30am — No Comments

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