Current Psychiatry

Articles from Vol. 8, No. 4, April

A Mysterious Loss of Memory: Mrs. K. Develops Depressive Symptoms and Memory Loss While Being Successfully Treated for Multiple Sclerosis and Migraines. How Would You Address Her Cognitive Decline?
CASE Worsening memory Mrs. K, age 46, is being treated by a neurologist for stable relapsing-remitting multiple sclerosis (MS) and migraine headaches when she complains of worsening memory over the past 5 years. She reports having difficulty recalling...
Clinical Guide to Countertransference: Help Medical Colleagues Deal with 'Difficult' Patients
Two strangers meet in the hospital cafeteria. Mrs. R, an elderly woman, asks Dr. W, a first-year medical resident, for help in getting a bottle of soda from the cooler. Afterward, Dr. W comments to a colleague with whom she is having lunch, "That woman...
Improve Sleep with Group CBT for Insomnia
Cognitive-behavioral therapy for insomnia (CBT-I) can be effective, regardless of whether chronic insomnia is primary or secondary to psychiatric, substance dependence, or psychophysiologic causes.1 In fact, with a response rate of 70% to 80%,2 CBT-I...
Informed Consent: Is Your Patient Competent to Refuse Treatment? Adult Patients with Psychotic Disorders Are Not Automatically or Always Incompetent
Mr. D, age 45 with a history of schizophrenia, is admitted to an inpatient psychiatric unit. The psychiatrist recommends an antipsychotic to help Mr, D with fears that the FBI has implanted a radio signal device into his tooth filling. She explains...
Is Bipolar Disorder Overdiagnosed?
I note with some dismay an increasing trend in Current Psychiatry to identify almost any mood disorder as bipolar disorder. I found the clinical logic expressed in the supplement "Diagnosing and managing psychotic and mood disorder" (CURRENT PSYCHIATRY,...
Long Overdue: Measurement-Based Psychiatric Practice
Can you imagine an internist starting insulin for a patient with diabetes without obtaining a baseline glucose level? How would that internist know from visit to visit whether treatment was working and to what extent? How would he or she know how and...
Workplace Mobbing: Are They Really out to Get Your Patient? Consider That Coworkers' Hostile Behavior Could Be Causing Paranoid Symptoms
Mr. G, age 46, works for a large federal government agency in a middle-management position. He presents seeking treatment for insomnia. He says, "I just need a sleeping pill. I haven't been able to sleep for the last 3 months because everybody at work...
Worried about High-Dose Prescribing? Manage Risk for You and Your Patient: Communicate and Document Informed Consent When Using Medications Off-Label
Mr. B, age 35, is admitted for the fourth time to the inpatient service with hallucinations and delusions related to chronic schizophrenia. After appropriate attempts to control his symptoms, he has begun to respond to usual treatment with an atypical...