Narcissism and Its Discontents: Diagnostic Dilemmas and Treatment Strategies With Narcissistic Patients
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Book Reviews Source Type: research

Treatment of Severe Personality Disorders: Resolution of Aggression and Recovery of Eroticism
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Book Reviews Source Type: research

Increasing Access to Psychiatric Services in Schools: The Bridge Program
This article describes the Bridge Program, a school-based psychiatric program funded by a county-wide mental health tax initiative designed to provide psychiatric services in local schools without any out-of-pocket expenses for youth and families within 10 days of referral. Two case reports provide a description of the delivery of psychiatric services through the Bridge Program. Future research is needed to compare the feasibility and effectiveness of different approaches to increasing access to youth psychiatric care. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Practitioner's Corner Source Type: research

A Case Report of Neurosyphilis Limbic Encephalitis With Reversible Geschwind Syndrome and Mood Disorder
We describe a case of neurosyphilis limbic encephalitis, presenting with reversible Geschwind syndrome (hyperreligiosity and hypergraphia) and mood disorder due to the predominant involvement of left mesial temporal structures in a previously healthy 34-year-old, left-handed woman. Because neurosyphilis can mimic common neuropsychiatric syndromes, it should be included in the differential diagnosis of psychiatric disorders with suspected general medical causes. This case of nondominant limbic encephalopathy caused by syphilis infection highlights the relevance of a careful investigation for secondary psychotic, mood, and p...
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Cerbera odollam: A Case Report of Attempted Suicide by Pong Pong
Cerbera odollam, commonly referred to as the “suicide tree” or “pong pong,” produces highly toxic seeds that are used for suicidal and homicidal purposes. It is important that western physicians be aware of the symptoms associated with these seeds and how to diagnose and treat them. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Clinical Case Discussions Source Type: research

Texting Among Academic Psychiatrists: What Does HIPAA Allow?
The texting of protected health information (PHI) has raised concerns about breach of privacy as it relates to the Health Insurance Portability and Accountability Act (HIPAA). Within psychiatry, limited guidelines exist on HIPAA-permissible texting. Given the legal implications of a breach, we sought to better understand texting patterns among psychiatrists by surveying members of the Association for Academic Psychiatry, 53 of whom responded. Only 63% of respondents felt confident in their knowledge of HIPAA. While 64% reported that texting PHI is prohibited, most (53%) still used texting to communicate PHI. Currently, HIP...
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Columns Source Type: research

What Psychotherapists Should Understand About DNA Methylation
This column reviews the basics of DNA methylation and how this molecular mechanism is related to the experience of trauma, the causation of mental disorders, and recovery from both trauma and mental disorders. Emerging molecular genetic findings about the role of DNA methylation in mental disorders fit well with our understanding of what is valuable about psychotherapy. DNA methylation offers a heuristically useful metaphor to broaden our understanding of how psychotherapy works. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Columns Source Type: research

Drug-Drug Interactions (DDIs) in Psychiatric Practice, Part 5: Major Types of Pharmacodynamic DDIs Based on Mechanism of Action (With Updated Neuroscience-based Nomenclature)
This column is the fifth in a series exploring drug-drug interactions (DDIs) with a special emphasis on psychiatric medications. In the preceding column, a classificatory system based on mechanism of action was presented and a table was provided outlining the primary, known mechanism(s) of action of all commonly used psychiatric medications. This column presents a parallel table summarizing major types of pharmacodynamic DDIs based on mechanism of action. Clinicians can use these 2 tables to predict pharmacodynamically mediated DDIs. As discussed in the third column in this series, a classification scheme for drugs based o...
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Columns Source Type: research

Effectiveness of a 6-Week Day Hospital Treatment for Personality Disorders: Data From a Naturalistic Study
Conclusions: This study conducted in a naturalistic setting suggests that a time-limited, 6-week day-hospital treatment program tailored to patients wiith PDs may be effective in reducing overall symptomatology in patients experiencing a crisis episode. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Articles Source Type: research

Effectiveness of a 5-Week Inpatient Dialectical Behavior Therapy for Borderline Personality Disorder
Objective: The goal of this study was to evaluate whether symptoms are reduced and emotion regulation improves when patients with borderline personality disorder (BPD) receive a 5-week course of inpatient dialectical behavioral therapy (DBT) and if changes in emotion regulation are associated with changes in symptoms. Methods: Forty-four patients with BPD receiving a 5-week course of DBT in a German psychiatry clinic participated. The short version of the “Borderline Symptom List” (BSL-23) was the patient-reported outcome. To measure emotion regulation, the “Self-Report Measure for the Assessment of ...
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Articles Source Type: research

Antipsychotics Do Not Influence Neurological Soft Signs in Children and Adolescents at Ultra-High Risk for Psychosis: A Pilot Study
Conclusions: Consistent with what has been observed in the population of patients with a first psychotic episode and/or with schizophrenia, our results support the conclusion that antipsychotic medications do not influence NSS in children and adolescents who are at high risk for psychosis. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Articles Source Type: research

Chinese Therapists’ Beliefs About Exposure Therapy for Anxiety and Obsessive-Compulsive Disorders
Conclusions: The results of this study support the reliability of the Chinese version of the TBES. Chinese therapists had more negative beliefs about exposure than did American therapists who were evaluated in a different study; however, therapists’ negative beliefs were significantly reduced after they attended an ERP training workshop. Future studies are encouraged to explore effective strategies to improve the disseminiation and delivery of exposure therapy in China. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: Articles Source Type: research

Inpatient Treatment for Patients With Borderline Personality Disorder
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2019 Category: Psychiatry Tags: From the Editor Source Type: research

Acknowledgement of Peer Reviewers
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: Acknowledgement of Peer Reviewers Source Type: research

Textbook of Disaster Psychiatry, Second Edition
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: BOOK REVIEWS Source Type: research

Transcranial Magnetic Stimulation: Clinical Applications for Psychiatric Practice
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: BOOK REVIEWS Source Type: research

Mindfulness-based Cognitive Therapy for Obsessive-Compulsive Disorder: A Pilot Study
Background: Cognitive-behavioral therapy (CBT) is the first-choice intervention for obsessive-compulsive disorder (OCD); however, a notable proportion of patients either do not respond to treatment or relapse after CBT. Mindfulness-based treatment has been suggested as an alternative or complementary therapeutic strategy for OCD. However, only a few studies have focused on its application in clinical samples. Objective: To evaluate the impact of a new treatment, called “Mindfulness-based Cognitive Therapy for OCD.” It is an 11-session manualized group intervention that integrates elements of CBT, mindfulne...
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: PRACTITIONER’S CORNER Source Type: research

What Do Individuals With Borderline Personality Disorder Want From Treatment? A Study of Self-generated Treatment and Recovery Goals
Outcome measurement has progressed in the field of personality disorders. While the majority of trials have evaluated outcomes on the basis of symptom and diagnostic indices, what is considered a meaningful and valued outcome to individuals has seldom been investigated. Self-generated treatment goals were collected from 102 individuals seeking treatment for borderline personality disorder and independently coded by 2 raters. Responses were content-analyzed to determine the categories of goals people want for treatment. A total of 464 individual goal units across 4 main goal types emerged in the content analysis: reducing s...
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: PRACTITIONER’S CORNER Source Type: research

Commentary: Aripiprazole: The Second Wave of the Second-generation Antipsychotics
Three cases are presented describing unique clinical responses to aripiprazole in comparison with other second-generation antipsychotics taken by each patient. One case involved an adverse reaction of problem gambling behavior, the second an enhanced antipsychotic response in delusional disorder, and the third a reversal of weight gain that occurred while the patient continued taking olanzapine. Aripiprazole was the first of a subgroup of atypical antipsychotics that are mixed agonists and antagonists of dopamine, likely contributing to unusual responses in some patients. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: CLINICAL CASE DISCUSSIONS Source Type: research

Escalation of Gambling Associated With Aripiprazole: A Case Report and Literature Review
We present the case of a patient with bipolar disorder and previous gambling behavior, in whom the gambling behavior escalated with the introduction of aripiprazole and its upward titration. The patient’s gambling problems were alleviated with a decrease in aripiprazole dosage. Clinicians should be vigilant for possible gambling and other impulse-control behaviors in patients taking aripiprazole. Our literature review suggests cariprazine and brexpiprazole, which have mechanisms of action similar to that of aripiprazole, may also be associated with possible risks of impulse-control problems and pathologic gambling. (...
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: CLINICAL CASE DISCUSSIONS Source Type: research

Dramatic Weight Loss Following Addition of Aripiprazole to Olanzapine in a Patient With Treatment-resistant Schizophrenia: A Case Report
Discussion: The timing of the weight loss following the addition of aripiprazole and the exclusion of a medical cause point toward a causal relationship between the change in the patient’s medication and the dramatic change in his body weight. We propose that, in a subgroup of patients, the addition of aripiprazole to their antipsychotic regime (without stopping the offending antipsychotic in terms of weight gain) can result in very significant weight loss and even the reversal of antipsychotic-induced weight gain. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: CLINICAL CASE DISCUSSIONS Source Type: research

Aripiprazole and Delusional Disorder
We report the case of a patient with delusional disorder who had failed to respond to risperidone but improved markedly with aripiprazole. Aripiprazole may show promise as a treatment for delusional disorder, possibly as a result of its effects on both dopaminergic and serotonergic receptors. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: CLINICAL CASE DISCUSSIONS Source Type: research

Psychotherapy and Advocacy: Four Freedoms as Fundamental Patient Rights
This column differentiates the role of psychotherapist from the role of advocate for our patients. It introduces and provides an overview of areas worthy of advocacy efforts that are encapsulated as Four Freedoms that are inalienable rights of those struggling with the burden of mental disorders: freedom from stigma, freedom from dehumanizing treatment, freedom to pursue recovery, and freedom of access to effective, medically necessary treatment. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: COLUMNS Source Type: research

Drug-drug Interactions in Psychiatric Practice, Part 4: Classification of Neuropsychiatric Medications Based on Their Principal Mechanisms of Action (With Updated Neuroscience-based Nomenclature)
This column is the fourth in a series exploring drug-drug interactions (DDIs) with a special emphasis on psychiatric medications. This column discusses how drugs with multiple mechanisms of action have the potential to interact pharmacodynamically by the mechanism(s) mediating their therapeutic indication and for some drugs by other mechanisms (ie, drugs with multiple mechanisms of action). In this and the next column in this series, we present a classificatory system in the form of 2 tables that prescribers can use to predict the action of a neuropsychiatric drug when used alone as well as DDIs that can occur when it is u...
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: COLUMNS Source Type: research

Fidelity to Best Practices of Psychiatric Assessments in Army Behavioral Health Settings
This study evaluated the use of psychiatric CPGs’ assessment criteria by Army behavioral health providers (BHPs). In a weighted cross-sectional survey, 348 BHPs were evaluated on their assessment of a systematically selected patient on 15 total domains recommended by the Departments of Veterans Affairs and Defense CPGs for substance use disorders, posttraumatic stress disorder, and major depressive disorder. The proportion of BHPs providing high-quality assessment and the association between high-quality assessment and BHP and patient characteristics were examined. Using the weighted sample, 80% of BHPs provided a hi...
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: ARTICLES Source Type: research

Design, Implementation, and Assessment of a Public Comprehensive Specialty Care Program for Early Psychosis
Discussion: The development and implementation of this pioneering state-funded early psychosis program, based on the National Institute of Mental Health’s Recovery After an Initial Schizophrenia Episode (RAISE) initiative, provide experience and results to inform the implementation of future programs. Its demonstrated success, in spite of many implementation challenges, suggests the potential for future research, including randomized controlled trials to demonstrate substantial benefit and cost-effectiveness of early psychosis programs in real-world settings. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: ARTICLES Source Type: research

Best Practices for Aripiprazole Lauroxil Administration: From Formulation Development to Injection Technique
This article reviews the relationship between formulation technology and clinical practices for LAIs, with a focus on aripiprazole lauroxil, a long-acting atypical antipsychotic indicated for the treatment of schizophrenia. The formulation developed for aripiprazole lauroxil is an aqueous-based suspension suitable for use as a prefilled syringe that, after injection, will release aripiprazole slowly into the plasma. The clinical relationship between the aripiprazole lauroxil formulation and proper injection techniques is explained, including why tapping and shaking the syringe to resuspend the drug particles and rapid inje...
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: ARTICLES Source Type: research

Specialized Consultation for Suspected Recent-onset Schizophrenia: Diagnostic Clarity and the Distorting Impact of Anxiety and Reported Auditory Hallucinations
Early detection of psychotic disorders is now recognized as vital in reducing dysfunction, morbidity, and mortality. However, making the diagnosis of a psychotic disorder, especially earlier in the course of disease, can be challenging, and an incorrect diagnosis of a psychotic disorder may also have significant consequences. We therefore, conducted a retroactive chart review of 78 patients referred to a specialty early psychosis consultation clinic to examine the role of specialty clinics in clarifying the diagnosis of early psychosis, especially potential schizophrenia. Of the 78 patients, 43 (55%) had a primary diagnosi...
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: ARTICLES Source Type: research

Second Opinions
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - March 1, 2019 Category: Psychiatry Tags: From the Editor Source Type: research

Long-term Psychodynamic Psychotherapy: A Basic Text, 3rd Edition
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: BOOK REVIEWS Source Type: research

How People Change: Relationships and Neuroplasticity in Psychotherapy
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: BOOK REVIEWS Source Type: research

Evaluation of a Symptom-triggered Protocol for Alcohol Withdrawal for Use in the Emergency Department, General Medical Wards, and Intensive Care Unit
Background: Alcohol withdrawal is common in hospitalized patients and symptom-triggered guidelines have been shown to reduce treatment duration, length of stay, and need for mechanical ventilation. Objectives: To assess the feasibility of incorporating symptom-triggered alcohol withdrawal guidelines early in the hospital course and to evaluate outcomes of patients before and after implementation of the guidelines. Methods: This was a retrospective pre-post study of adult patients admitted from the emergency department to an urban, academic, tertiary care center. Subjects in the preguideline (PRE) group were given b...
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: PRACTITIONER’S CORNER Source Type: research

Variant Creutzfeldt-Jakob Disease Presenting as New-onset Psychosis
The case of a patient with a first presentation psychotic episode secondary to variant Creutzfeldt-Jakob Disease (vCJD) is presented. While psychiatric symptoms are considered a prominent feature of vCJD, they may precede characteristic neurological symptoms, which can delay diagnosis. The psychotic symptoms in this case differed in quality from typical psychotic presentations, which could have helped with earlier diagnosis. The patient’s symptomatology suggested that errors in cognition and perception were largely contributing to his psychiatric symptoms. These errors appeared to be the result of prion destruction o...
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: CLINICAL CASE DISCUSSIONS Source Type: research

Gardner-Diamond Syndrome in an Adolescent With Suicidal Ideation: A Case Report
Gardner-Diamond syndrome (GDS) is a rare disease often seen in young women involving painful localized inflammation and ecchymosis. Ecchymosis usually develops spontaneously after emotional stress. The pathophysiology of the disease is not fully understood, and little is known about management modalities for this syndrome. The primary approach of health professionals in the evaluation of this rare condition should involve identification of cases and investigation of potential accompanying psychiatric pathologies. The case presented here highlights the importance of assessing for GDS and reviews descriptions of GDS in the c...
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: CLINICAL CASE DISCUSSIONS Source Type: research

Therapeutic Risk Management: Chain Analysis of Suicidal Ideation and Behavior
Structural approaches to suicide risk assessment (eg, evaluating the frequency and intensity of suicidal ideation and classifying types of suicidal behavior) often fall short of providing an idiographic and dynamic analysis of the factors driving and maintaining an individual’s suicide risk. Structural approaches can be bolstered through chain analysis which facilitates an exploration of the factors maintaining suicidal ideation and behavior based on positive and negative reinforcement. By uncovering the factors causing suicidal ideation and behavior to persist, efficient intervention strategies can be selected to ta...
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: COLUMNS Source Type: research

Psychotherapy With Suicidal Patients Part 2: An Alliance Based Intervention for Suicide
This column, which is the second in a 2-part series on the challenge of treating patients struggling with suicide, reviews one psychodynamic approach to working with suicidal patients that is consistent with the elements shared across evidence-based approaches to treating suicidal patients that were the focus of the first column in this series. Alliance Based Intervention for Suicide is an approach to treating suicidal patients developed at the Austen Riggs Center that is not manualized or a stand-alone treatment, but rather it is a way of establishing and maintaining an alliance with suicidal patients that engages the iss...
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: COLUMNS Source Type: research

Drug-Drug Interactions (DDIs) in Psychiatric Practice, Part 3: Pharmacokinetic Considerations
This column is the third in a series exploring drug-drug interactions (DDIs) with a special emphasis on psychiatric medications. The first column in this series discussed why patients being treated with psychiatric medications are at increased risk for taking multiple medications and thus experiencing DDIs and how to recognize such DDIs, and strategies for avoiding them. The second column in the series further discussed strategies for avoiding and/or minimizing adverse outcomes from DDIs. This third column deals with pharmacokinetic considerations concerning DDIs in psychiatric practice. Specifically, this column discusses...
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: COLUMNS Source Type: research

The Association Between Psychotropic Drug Use and Fertility Problems Among Male Subjects
This article summarizes the data with regard to the effects of 6 widely used psychotropic drugs—lithium, valproate, haloperidol, olanzapine, imipramine, and fluoxetine—on sexual function and sperm parameters in male subjects. In general, the reviewed data suggest that these medications can be associated with sexual function problems and negative effects on sperm parameters among male subjects. It is important to note that most of the data are based on preclinical studies and nonrandomized clinical trials with relatively small sample sizes, so that it is not possible to draw unequivocal conclusions with regard t...
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: ARTICLES Source Type: research

Repetitive Transcranial Magnetic Stimulation in the Treatment of a Difficult to Treat Condition, Borderline Personality Disorder
Conclusions: Given the limited clinical evidence for efficacy on the basis of the results of these studies, future controlled studies involving larger samples and optimal stimulus parameters should be designed to confirm the short-term and long-term safety and efficacy of repetitive TMS and TBS in the treatment of BPD. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: ARTICLES Source Type: research

The Association of Lifetime Suicide Attempts With Anxiety Disorders in Patients With Bipolar Disorder
In this study, we hypothesized that certain types of ADs were related to the occurrence of past suicide attempts (SAs) independent of the severity of the BD, including the presence of past affective episodes. Lifetime diagnoses of BD and ADs were assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I Disorders (SCID-I). Of the total sample of 200 patients with BD, 32.0% had at least 1 past SA. The mean number of previous hospitalizations, a history of social AD, and a history of posttraumatic stress disorder were strongly associated wit...
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: ARTICLES Source Type: research

An Overview of Reviews on the Safety of Electroconvulsive Therapy Administered During Pregnancy
Conclusions: Our overview supports the conclusion, which has also been endorsed by the American College of Obstetricians and Gynecologists and the American Psychiatric Association, that administration of ECT during pregnancy is relatively safe. Conclusions about safety, however, will become better established with the availability of more data. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: ARTICLES Source Type: research

Suicide Revisited
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - January 1, 2019 Category: Psychiatry Tags: From the Editor Source Type: research

Complementary and Integrative Treatments in Psychiatric Practice
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2018 Category: Psychiatry Tags: BOOK REVIEWS Source Type: research

The Therapeutic Relationship in Cognitive-Behavioral Therapy
No abstract available (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2018 Category: Psychiatry Tags: BOOK REVIEWS Source Type: research

Second Opinions in Psychiatry: A Review
Conclusions: Second opinions are rarely obtained in psychiatry and there is little literature on this subject. The stigmatization of psychiatric disorders and patients and the uniqueness of the patient-doctor relationship in psychiatry, especially in psychotherapeutic care, may pose considerable obstacles to the use of second opinions in this field. In addition, more stakeholders, such as social workers, government agencies and regulators, health care and disability insurers, and social security agencies, are involved in the mental health compared with the somatic health sector, which may make it more difficult to achiev...
Source: Journal of Psychiatric Practice - November 1, 2018 Category: Psychiatry Tags: PRACTITIONER’S CORNER Source Type: research

Commentary: Role of the Endogenous Opiate System in Psychiatric Disorders Other Than Addiction
Two case reports explore opiate use in relation to 2 different psychiatric disorders. In the first case report, the authors reported the finding that opiate abuse appeared to mitigate premorbid Tourette syndrome in a small series of patients with opiate addiction and that this benefit was maintained with medically supervised opiate agonist therapy. In the second case report, the authors noted a significant correlation between prescription opiate use and delusions of infestation in a large psychodermatology clinic (as well as a separate, stronger correlation with stimulant use). These reports highlight the importance of the...
Source: Journal of Psychiatric Practice - November 1, 2018 Category: Psychiatry Tags: CLINICAL CASE DISCUSSIONS Source Type: research

Association Between Delusions of Infestation and Prescribed Narcotic and Stimulant Use
Discussion: Few data are available concerning the etiology and management of DOI. Findings from this study indicated an association between the diagnosis of DOI and the prescribing of narcotics and stimulants, even when sex and age were taken into account. This information may be used to assist with the diagnosis of patients presenting with DOI and possible treatment options. It will be important to determine if these medications are a cause of the condition, or are merely correlated with other medical conditions. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2018 Category: Psychiatry Tags: CLINICAL CASE DISCUSSIONS Source Type: research

Heroin Addiction in Serbian Patients With Tourette Syndrome
Conclusions: The observed reduction of tics during heroin dependence warrants further clinical research. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2018 Category: Psychiatry Tags: CLINICAL CASE DISCUSSIONS Source Type: research

Psychotherapy With Suicidal Patients Part 1: Expert Consensus Recommendations
This column reviews and discusses recommendations made by individual experts and by expert panels for treating suicidal patients in psychotherapy. Therapies for suicidal patients that were considered for the extraction of shared elements include cognitive behavioral, psychodynamic, and integrated psychotherapies. There is a large amount of convergence among expert consensus recommendations for treating suicidal patients. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - November 1, 2018 Category: Psychiatry Tags: COLUMNS Source Type: research

Knowledge of the Pharmacology of Antidepressants and Antipsychotics Yields Results Comparable With Pharmacogenetic Testing
Several companies offer pharmacogenetic testing for psychiatry on the basis of the claim that the outcome of drug selection is better when guided by such testing than when such testing is not used. This column examines the results of the GeneSight Psychotropic Test which groups various antidepressants and antipsychotics into 3 bins: green (“use as directed”), yellow (“use with caution”), and red (“use with increased caution and more frequent monitoring”). The authors examined how frequently the same drugs appeared in these different bins in 19 patients. They found that of the 22 antidepr...
Source: Journal of Psychiatric Practice - November 1, 2018 Category: Psychiatry Tags: COLUMNS Source Type: research