Psychiatry

New Thinking for an Age-Old Condition: PTSD

Since the dawn of time, humankind has realized that there were negative consequences to experiencing overwhelming stressful situations.

For example, reactions to wartime trauma have many names: soldier’s heart, shell shock, combat fatigue and, since the Diagnostic and Statistical Manual of Mental Disorders (DSM-III, 1980), Posttraumatic Stress Disorder (PTSD).

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Addressing Depression Care Management in PCP Offices: Collaborative Care

If you have read Beacon Health Options’ white paper, “Integration,” you learned that more than half of all adults with major depressive disorder are already managed in primary care settings.

You also learned that most antidepressant medications are written by primary care physicians (PCPs). However, most concerning is that approximately 45 percent of those who complete suicide have seen their PCP within the past month.

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Addressing the Shortage of Child Psychiatrists—It Doesn’t Take Rocket Science, Phone Call Support Will Do It!

The numbers aren’t good. Approximately, 16-20 percent of the nation’s children and adolescents have some kind of behavioral disturbance, with 4-7 percent suffering from significant functional impairment, according to the American Academy of Child & Adolescent Psychiatry. That translates to about 15 million youths who need specialty psychiatry. However, there are only 8,300 practicing child and adolescent psychiatrists. If every youth needing treatment was seen by one, that would be more than 1,800 patients per practitioner – an undoable ratio! However, this problem is not new, and with some creativity and practicality, phone consultation projects have been developed to address it. To get an understanding of just how they work, consider the story of Johnny Marks (a fictional case based…

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Looking to the Past for the Future of Psychiatry

What it means to be a psychiatrist invites many questions. Can psychiatrists go beyond controlling symptoms and managing maladaptive behavior, helping patients become happier rather than just less depressed? Today, can we do better than Freud who promised patients “much will be gained if we succeed in transforming your hysterical misery into everyday unhappiness”? The answer is more nuanced than expected, but exploring the teachings of ancient philosophers can help us understand its ancient roots. Positive Psychology is proactive in that it helps people to have happy and meaningful lives as opposed to treating just dysfunction or mental illness. As a medical specialty, psychiatry has excelled in disease identification (diagnosis); treatment and management of symptoms (therapeutics); and definition of long-term…

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Neuropsychiatry: Psychiatry’s Future?

Recently, a British journal[i],[ii] takes on the thorny issue of (as the authors see it) the artificial and deleterious divide between neurology and psychiatry. The special article by TJ Reilly, “The Neurology-Psychiatry Divide: A Thought Experiment,” takes a brief and whimsical approach to describing the differentiators to a Martian who has no knowledge of the history, while the longer, and impressively academic, editorial piece traces the history of the separation to make the same argument: All future psychiatrists should be neuropsychiatrists, according to a Psychiatrist article[iii]. There are several suggestions of differences between UK and US training (e.g., Reilly states UK training in either specialty may exclude any exposure to the other specialty) and practice (e.g., the treatment of conversion…

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