Current Psychiatry

Articles from Vol. 10, No. 4, April

Comorbid Bipolar Disorder and Substance Abuse: Evidence-Based Options: Medication Selection May Very Based on Which Substance Patients Abuse
Among DSM axis I diagnoses, bipolar disorder (BD) has the highest rates of comorbid substance use disorders (SUDs). (1-3) Approximately 60% of patients with bipolar I disorder have a lifetime diagnosis of an SUD.1 Excluding tobacco, alcohol is the...
Depression and Suicide among Physicians: Stigma, Licensing Concerns, Other Barriers to Treatment Can Be Overcome
Dr. G, a second-year surgical resident, becomes depressed when his girlfriend abruptly ends their relationship. His phone calls and e-mails seeking an explanation go unanswered. Having long struggled with his self-esteem, Dr. G interprets this rejection...
Diabetic and Depressed: Tearful and Depressed, Mr. N Plans to Shoot His Daughter's Abusive Husband and Himself. He Has Poorly Controlled Diabetes and Other Comorbidities. What Is Exacerbating His Mood Symptoms?
CASE Worsening depression Mr. N, age 64, is a disabled factory worker with a complicated medical history. He has poorly controlled type II diabetes mellitus; obesity (body mass index 40 kg/ [m.sup.2] ); complicated cryptogenic cirrhosis with prior...
Glutamate: New Hope for Schizophrenia Treatment: Research on Glutamatergic Dyfunction May Lead to Therapies Targeting Negative and Cognitive Symptoms
In patients with schizophrenia, positive symptoms typically respond to treatment, while negative and cognitive symptoms often persist M and contribute to chronic disability. (1) Schizophrenia also is associated with widespread neurocognitive deficits--including...
HIV Screening: Latest Testing Guidelines
Substance use and high-risk sexual behaviors are common among persons with severe mental illness and make them vulnerable to human immunodeficiency virus (HIV) infection.(1- 3) The prevalence of HIV is 3 times higher among these patients compared with...
Mood Swings and BPD
I thought Dr. Kowatch and colleagues took an important first step in pointing out that not all mood swings in children and adolescents are symptoms of bipolar disorder ("Not all mood swings are bipolar disorder," Current Psychiatry, February 2011,...
Mood Swings and ODD
I needed an intellectual oasis to deal with the anguish and frustration triggered by the monumental amount of misleading information that was included in the well-written article "Not all mood swings are bipolar disorder" (Current Psychiatry, February...
New-Onset Psychosis: Consider Epilepsy
Interictal psychosis of epilepsy (IPE) is schizophrenia-like psychosis associated with epilepsy that cannot be directly linked to an ictus. IPE often is indistinguishable from primary schizophrenia. This phenomenon commonly occurs in patients with...
Polypharmacy Subtypes the Necessary, the Reasonable, the Ridiculous, and the Hazardous
You've heard about the 2 certainties in life: death and taxes. In psychiatric practice with complex and chronic patients, there is a third certainty: polypharmacy. It ranges from thoughtful to indiscriminate and seems to be entrenched in clinical practice,...
Subjective Cognitive Impairment: When to Be Concerned about 'Senior Moments': Thorough Evaluation Can Differentiate Benign Memory Problems from Dementia
Ms. F, age 66, requests genetic testing because she is concerned about mild memory difficulties, such as forgetting names and where she puts her keys or checkbook, and fears she may be developing Alzheimer's disease (AD). Her mother and sister were...
Temporary Tattoos: Alternative to Adolescent Self-Harm?
Although self-harm behaviors such as burning or cutting are common among adolescents, they are a source of concern for parents and friends, and challenging to treat. Treatments have focused on distracting stimuli such as ice or the sting of a rubber...
The Authors Respond
We welcome comments about the importance of a thorough diagnostic evaluation to tease out possible etiologies of "mood swings," including psychosocial factors, as in personality disorders. Nevertheless, the debate about diagnosing personality disorders...
Treating Depression in Medical Residents
Residents in psychiatry and other specialties experience depressive illness at rates similar to or higher than the general population. Residency training is a major psychosocial stressor (1) Having to master a large body of medical knowledge while...
Vilazodone for Major Depressive Disorder
In January 2011, the FDA approved vilazodone for the treatment of major depressive disorder (MDD) (Table 1). Table 1 Vilazodone: Fast facts Brand name: Viibryd Class: Serotonin reuptake inhibitor and 5-HT1A receptor partial agonist Indication:...