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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 13.

Precision Medicine for Mental Disorders
Precision medicine seems to be the new hot topic in the research world. President Obama spoke about precision medicine in his State of the Union speech (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - February 3, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Psychiatry is devalued: And patients suffer because of it
This past week I spoke with a patient who noted that since his wife’s death six months ago, he had lost 40 pounds, slept a maximum of four hours nightly, and stopped enjoying activities he used to take pleasure in. He found it difficult to concentrate at work, and getting out of bed each morning was described as his greatest struggle. While relaying this story, the man was on the verge of tears. His voice was soft and pleading; he needed help. While the exact line between a “normal” grief reaction and new-onset major depression is controversial, my attending explained to this patient that — given the length and...
Source: Kevin, M.D. - Medical Weblog - February 2, 2015 Category: Journals (General) Authors: Tags: Conditions Psychiatry Source Type: blogs

Always Err on the Side of Compassion
The best piece of marital advice I’ve ever heard came from an ex-priest, a kind and gentle man who has been married to his bride for longer than I’ve been alive. “Always err on the side of compassion,” he told me when I called him up all upset one afternoon after my husband and I got into a fight. I don’t even remember what the fight was about. Something stupid. But I remembered his advice and I’ve been trying to apply it not only to my marriage but to my life, in general. In fact, it has become my mantra. Always err on the side of compassion. It sounds so easy, but is so difficult to execute. The mo...
Source: World of Psychology - February 1, 2015 Category: Psychiatrists and Psychologists Authors: Therese J. Borchard Tags: Depression Disorders General Health-related Motivation and Inspiration Personal Bipolar Disorder Cognitive Behavioral Therapy Intrusive Thoughts Major Depressive Disorder Mood Disorder Psychomotor retardation Seasonal Affective Dis Source Type: blogs

The APA and The Helping Families in Mental Health Crisis Act
If you are not familiar with Representative Tim Murphy's legislation to overhaul America's broken mental health system, this post isn't for you.  The legislation died when congress convened, but Rep. Murphy is planning to reintroduce the legislation to this congress, and he has 115 co-sponsors for the bill.  In the last session, APA took no stance on the bill; they wrote a letter supporting the idea of legislative change and said they looked forward to working with Murphy on this.  Rep. Murphy has said that the new legislation to be proposed will have some changes, changes that APA finds more in alignment wi...
Source: Shrink Rap - January 31, 2015 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

Doctor Evil
This is extremely disgusting. Doctors in California, who receive payments and other benefits from drug companies, have been prescribing anti-psychotics to kids in foster care -- kids who are not psychotic at all, but who are being drugged into a stupor in lieu of properly addressing their behavioral problems. According to the investigation by the San Jose Mercury News, drug companies spent $14 million from 2010 to 2013 to bribe doctors into making these prescriptions.According to the investigation, nearly 25% of California foster children age 10-18 were prescribed antipsychotic drugs. I have written about these drugs here ...
Source: Stayin' Alive - January 30, 2015 Category: American Health Source Type: blogs

The day the music died and how a hospital lost its joy
There’s a great song by Don McLean called “American Pie.” The chorus talks about “the day the music died.” I thought about that song in my hospital a couple years ago, when the music died there, too. I’ve noticed that our physician burnout and nurse frustration have increased in the years since the music died. Could it be a coincidence? Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - January 30, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

It’s All In Your Head
The following post originally ran on Disruptive Woman to Watch Lisa Suennen’s blog Venture Valkyrie on January 26th. “Mental health needs a great deal of attention. It’s the final taboo and it needs to be faced and dealt with.” That quote is from the great philosopher and clinician, oh wait I mean 80’s post-punk rocker Adam Ant. Seriously. But he is so right on. Back in 1998 I was part of the management team of a company called Merit Behavioral Care, also once known as American Biodyne. The company was the first of its kind: a company that delivered what we now know as population health for people with menta...
Source: Disruptive Women in Health Care - January 30, 2015 Category: Consumer Health News Authors: dw at Tags: Mental Health Source Type: blogs

The power of the specialist physician — and stewardship
My latest column over at discusses the disordered balance of power in the doctor-patient relationship. As most of you know, I harbor strong biases about the quality of medical decisions, especially in the elderly. Attached. Yes, I am attached to the issue of decision quality. Nearly all of electrophysiology, and much of cardiology, involves preference-sensitive decisions. This means doctors are called to align treatments with the goals of the patient. We hold great power; we must use it justly and wisely. My latest essay arose from an unusual source. The prominent medical journal Circulation Outcomes publishes...
Source: Dr John M - January 30, 2015 Category: Cardiology Authors: Dr John Source Type: blogs

The Ignorance Project
Attending the World Economic Forum this past week, I was struck by two trends. The first was that brain research has emerged as a hot topic. Not only was brain science or brain health a new theme at the meeting, research on the brain emerged in discussions about next generation computing, global cooperation, and even models of economic development as well as being linked to mental health or mindfulness. In a meeting frequented largely by economists and business leaders, I was surprised by the number of non-scientists who have become enchanted by brain science. Clearly this is the era of the brain, with mental health now pa...
Source: NIMH Directors Blog - January 29, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Wall Street Journal readers weigh in on PAS
Last Saturday, the Wall Street Journal carried an excellent op-ed piece, “Dr. Death Makes a Comeback” (subscription required), by Dr. Paul McHugh, former chief psychiatrist at Johns Hopkins Hospital.  In it, Dr. McHugh opposes physician-assisted suicide (PAS), making three key points: The practice will tend to spread beyond terminally ill people to those who are “treatable but mentally troubled.”  He appeals to the experience in... // Read More » (Source:
Source: - January 29, 2015 Category: Medical Ethics Authors: Jon Holmlund Tags: Health Care Allocation / Access / Public Health bioethics end of life Health Care Practice syndicated Source Type: blogs

Top 10 PTSD Blogs of 2014
Post-traumatic stress disorder (PTSD) often is linked to military veterans, but it can affect anyone following a traumatic event. There are five subtypes: normal stress response, acute stress disorder, uncomplicated PTSD, comorbid PTSD and complex PTSD. Sleep disturbances and flashbacks, where the sufferer relives the trauma, are hallmarks of the disease. PTSD has several other symptoms, some of which overlap with other disorders. These include a loss of interest in regular activities, feeling depressed, anxious and difficulty concentrating. A person with PTSD may find it difficult to relate to loved ones. Instead they are...
Source: World of Psychology - January 29, 2015 Category: Psychiatrists and Psychologists Authors: Kim Lyon Tags: Best of the Web Brain and Behavior Disorders General Mental Health and Wellness Military Psychology PTSD Stress Trauma Violence and Aggression abuse best ptsd blogs combat veterans Complex post-traumatic stress disorder Postt Source Type: blogs

Research and Reviews in the Fastlane 068
Welcome to the 68th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out the...
Source: Life in the Fast Lane - January 29, 2015 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Cardiology Education Emergency Medicine Infectious Disease Intensive Care LITFL Microbiology Psychiatry and Mental Health critical care examination LITFL R/V R&R in the FASTLANE recommendations Review Source Type: blogs

Infestation Anxiety: The Enemy Within
As Ebola fears wane, don’t be fooled. The next great threat is always upon us. There is a little-known psychological disorder called “Ekbom syndrome” in which a person believes that insects are crawling underneath their skin. Patients often tear their skin off in an attempt to extract the invisible vermin. Even though it’s a rare disorder affecting about 100,000 Americans, somehow we can all relate to the maddening anxiety of those afflicted. There is something universally cringe-worthy about the experience of infestation. I was reminded of this during the Ebola scare that swept the nation over the past few...
Source: World of Psychology - January 28, 2015 Category: Psychiatrists and Psychologists Authors: Evan Fisher Tags: Brain and Behavior General Green and Environment Health-related Psychology anxiety Collective Unconscious ebola Fear Foreign Policy Immune System infestation News Media Object Relations Sensationalism social media Source Type: blogs

Treat the diagnosis or the person?
 I happily return to Jung. I am reminded of this quote: It is generally assumed in medical circles that the examination of the patient should lead to a diagnosis of his illness, so far as this is possible at all, and that with the establishment of the diagnosis an important decision has been arrived at as regards prognosis and therapy. Psychotherapy forms a startling exception to this rule: the diagnosis is a highly irrelevant affair since, apart from afixing a more or less lucky label to a neurotic condition, nothing is gained by it, at least as regards prognosis and therapy...The content of a ...
Source: Jung At Heart - January 28, 2015 Category: Psychiatrists and Psychologists Source Type: blogs

New book on neuroplasticity by Norman Doidge: The Brain’s Way of Healing
Rewired: Learning to tame a noisy brain. (Or, how you can use the power of neuroplasticity) (The Globe and Mail): “His first book popularized the idea that the brain is actually a dynamic, adaptive organ with incredible potential to change. Now, Dr. Norman Doidge is sharing incredible stories of recovery from the sci-fi-like frontier of energy-based therapies… It was Doidge, a psychiatrist and faculty member of both the University of Toronto and Columbia University’s Center for Psychoanalytic Training and Research, who introduced the lay reader to the revolutionary idea that the brain is not fixed, that it is neuropl...
Source: SharpBrains - January 28, 2015 Category: Neurologists Authors: SharpBrains Tags: Cognitive Neuroscience Education & Lifelong Learning book brain Brain-Plasticity neuroplasticity neuroplasticity book Norman Doidge book Norman-Doidge The-Brain-That-Changes-Itself Source Type: blogs

Medical conferences feel like funerals. Here’s why.
A friend just got back from a big medical conference at a fancy hotel. The cleaning ladies actually pulled her aside to ask, “What’s with all the grim faces and sad eyes?” Do doctors realize medical conferences look like funerals? That’s what the cleaning ladies think. I bet they’re not the only ones. Why do medical conferences feel like funerals? Maybe because doctors are dying by suicide at twice the rate of their patients. Why? The truth is doctors are dying from despair. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how...
Source: Kevin, M.D. - Medical Weblog - January 27, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

A Quick Guide to Identifying the Mentally Ill for Puposes of Preventing Gun Violence.
I often hear people talk about how we have to keep guns away from the mentally ill.  A judge friend recently said it quite bluntly, "What's the issue with guns and the mentally ill?  They shouldn't have them." A cousin posted a link to a story about a man who killed his family and then himself.  Cousin commented, "We have to find a way to keep guns from the mentally ill."  The article mentioned nothing about a history of mental disorder or psychiatric treatment or distress in the man who killed his family and himself; people were shocked, there was no clear motive, the gun was owned legally.  Grant...
Source: Shrink Rap - January 26, 2015 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

The gifts of burnout: An evolutionary wake-up call for doctors
It has been fourteen years since I graduated from the University of Michigan Medical School. I have journeyed far from the field of medicine, and yet my heart keeps hearing the call to return to my physician communities and share what I have learned. I simply cannot ignore my sense that the pain within our health care system – now felt at every level, including patients, physicians, and payors — is a resounding call to wake us up to our next stage of evolution. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: K...
Source: Kevin, M.D. - Medical Weblog - January 24, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

Funding Science
Several papers in the past few weeks have commented on the dismal state of funding for U.S. biomedical research1,2,3,4 (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - January 23, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

The Dzhokhar Tsarnaev defense: Will marijuana play a role?
January marked the start of what promises to be a four-month public reckoning: the trial of alleged Boston Marathon bomber Dzhokhar Tsarnaev. If the press reports about the evidence against him are accurate, most of the trial will not be about guilt or innocence; it will be about sentencing. Not a who-done-it, but a why-done-it. If Tsarnaev is found guilty, the death penalty will be on the table, and the proceedings will turn to a grave question, part jurisprudence, and part moral philosophy: Is this defendant the most evil and culpable of all? A human being who deserves the most severe of all punishments? Continue readi...
Source: Kevin, M.D. - Medical Weblog - January 20, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

Healthcare Update Satellite — 01-19-2015
Penicillin allergy? It’s associated with increased bad outcomes, but not for the reasons you think. The allergies themselves are mostly not allergies. And no, “my mother said I had a rash when I was a baby” isn’t an allergy. However, when compared with patients who don’t have penicillin “allergies”, patients with penicillin allergies have longer hospital stays and are between 14% and 30% more likely to get resistant infections while in the hospitals – possibly because the penicillin “allergic” patients are being treated with much stronger antibiotics that kill of...
Source: WhiteCoat's Call Room - January 19, 2015 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs

Holmes in the Bus in Baghdad
I was reading Sherlock Holmes (A Scandal in Bohemia) in the bus when a desire took a hold of me, the desire of becoming as perfect as he was in observation of details around him, so as I put down the book for a while and started observing the details that surrounded me. Thanks God the speakers were off. They look much better off in the sun. A heel of a shoe has found its role in this bus. At the end of the short story Holmes didn't shake the hands of king of Bohemia although the king had presented his hand. All that Holmes asked for was to guard the photo in his personal belongings, as if he was thinking tha...
Source: psychiatry for all - January 19, 2015 Category: Psychiatrists and Psychologists Source Type: blogs

My strange dream about Isis
Lately I read some articles in Arabic journals about terrorism. About what is happening in Syria, Iraq and lately, in France. Yesterday I dreamed as if seeing visually an article. If we were living in the ancient times I would be regarded as a prophet seeing a message from God. It was symbolic although I didn't get all the symbols. Here is the dream:"It is in an airport, a child in a wheelchair pushed by her mother, approaches in their walking by hazard a slim talk black man who looks like Sotigui Kouyate.He is so slim and wearing suspenders. The girl doesn't like the suspenders and thought that they look silly so she star...
Source: psychiatry for all - January 16, 2015 Category: Psychiatrists and Psychologists Source Type: blogs

Top stories in health and medicine, January 15, 2015
From MedPage Today: CDC: Most Nosocomial Infections Fall. Rates of most major types of healthcare-associated infections have declined markedly in recent years. RA Patients More Likely to Abandon Remicade. Rheumatoid arthritis (RA) patients were more likely to discontinue infliximab (Remicade) than adalimumab (Humira) and etanercept (Enbrel) in the first year of biologic treatment, and were more likely to stop adalimumab than etanercept. Vyvanse Effective Option for Treating Binge Eating. Adults with binge eating disorder treated with lisdexamfetamine dimesylate (Vyvanse) saw improvements in binge eating behavior and its ...
Source: Kevin, M.D. - Medical Weblog - January 15, 2015 Category: Journals (General) Authors: Tags: News Infectious disease Psychiatry Rheumatology Source Type: blogs

From Interprofessionalism Lite to the Real Thing
By: Jessica Early, a nurse practitioner fellow at the West Haven Veterans Affairs Center of Excellence in Primary Care Education (CoEPCE) During my time in nursing school, the constant refrain was that interprofessional teamwork is the foundation of patient-centered care. In lectures and seminars, we were told that, as nurse practitioners (NPs), our effectiveness depended on collaboration with all members of the health care team—social workers, RNs, physicians, and specialty providers. Ironically, we were encouraged to develop the communication and teamwork skills needed for this collaboration in a classroom full of ...
Source: Academic Medicine Blog - January 15, 2015 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective Center of Excellence in Primary Care Education health care teams interprofessionalism patient centered care Source Type: blogs

Graduate Medical Education: The Need For New Leadership In Governance And Financing
In conclusion, we have recently proposed rejuvenating COGME with expanded resources and membership. If accomplished, COGME should be able to serve the role recommended for the GME Council described in the IOM report, thereby creating new leadership for GME reform. As an immediate first step, we have proposed reauthorization of the THCGME program, with Medicare GME funding appropriated to assure sustainability. This small addition to the Medicare budget would have great value by encouraging optimism within this program’s broad constituency that the importance of ambulatory training is now recognized by Congress. Furthermo...
Source: Health Affairs Blog - January 14, 2015 Category: Health Management Authors: Richard Rieselbach, David Sundwall, and Kenneth Shine Tags: All Categories Disparities Hospitals Medicaid Medicare Physicians Policy Primary Care Workforce Source Type: blogs

The lovely wife on the psych ward
I have one thing to say about Mark Lukach's essay, "My lovely wife on the psych ward."  That one thing is: Read it!  It's beautiful.  Mr. Lukach does a masterful job of describing his feelings as he plows through two months' long episodes of psychosis with his wonderful wife. When a friend gives him a copy of R.D. Laing's The Divided Self: An Existential Study in Sanity and Madness, Mr. Lukach learns about the world of anti-psychiatry and psychiatric survivors.  He struggles through with wanting to be a good husband, to help his wife get better, but he questions whether what he is doing is right, and he...
Source: Shrink Rap - January 14, 2015 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

What does it mean to be a competent psychiatrist?
What defines a competent psychiatrist?  To staunch critics of the field, perhaps nothing.  Some believe psychiatry has done far more harm than good, or has never helped anyone, rendering moot the question of competency.  What defines a competent buffoon?  A skillful brute?  An adroit half-wit?  Having just finished Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, a reader might easily conclude that psychiatric competency is a fool’s errand.  From directing dank 19th Century asylums, to psychoanalyzing everyone for nearly a...
Source: Kevin, M.D. - Medical Weblog - January 13, 2015 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

What Caused This to Happen?
“What caused this to happen?” is usually one of the first questions asked by patients and their families following a psychotic episode, suicide attempt, or manifestation of any serious mental illness. In earlier times, the explanations ranged from an imbalance of the “humours” to demonic possession. More recently, there have been “schizophrenogenic” or “refrigerator” mothers and “abusive” or “toxic” fathers. Modern scientists and clinicians point to a mix of genetic and environmental factors but these explanations are rarely satisfying and do little to stem the tide of guilt, shame, and blame that s...
Source: NIMH Directors Blog - January 13, 2015 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

Tot Therapy: Psychiatrists Join Up With Pediatricians
More pediatricians are embedding mental-health professionals into their practices, where they can help spot problems early, provide care fast or reassure parents that a child’s behavior is normal. (Source: Health Journal)
Source: Health Journal - January 13, 2015 Category: Consumer Health News Tags: FREE Source Type: blogs

Psychologists and psychiatrists feel less empathy for patients when their problems are explained biologically
The idea that mental illness is related to brain abnormalities or other biological factors is popular among some patients; they say it demystifies their experiences and lends legitimacy to their symptoms. However, studies show that biological explanations can increase mental health stigma, encouraging the public perception that people with mental illness are essentially different, and that their problems are permanent. Now Matthew Lebowitz and Woo-young Ahn have published new evidence that suggests biological explanations of mental illness reduce the empathy that mental health professionals feel towards patients.Over two h...
Source: BPS RESEARCH DIGEST - January 12, 2015 Category: Psychiatrists and Psychologists Authors: Research Digest Source Type: blogs

Technical Assistant in the Fedorenko Lab (EvLab), MGH/MIT
POSITION OPENING: Technical Assistant in the Fedorenko Lab (EvLab), MGH/MIT, to assist with all aspects of research on the cognitive and neural architecture of the language system.  Target start date is June 1 but earlier would be preferable.RESPONSIBILITIES: Designing, programming, and conducting behavioral (including web-based) and fMRI experiments; analyzing behavioral and fMRI data; creating and updating the lab website; implementing and maintaining analysis software; technical support for lab personnel; and some basic administrative duties.REQUIREMENTS: Candidates must have ALL of the following: i) strong math, s...
Source: Talking Brains - January 12, 2015 Category: Neurologists Authors: David Poeppel Source Type: blogs

Link Feast
Our pick of the best psychology and neuroscience links from the past week or so:Dos and don’ts of a January detoxAs we start a new year, David Robson at BBC Future takes a scientific look at how to get healthier'Detoxing' has been debunked. Maybe it's time to debunk thatOliver Burkeman argues that scepticism about the benefits of detoxing has gone too farAre Understandings of Mental Illness Mired in the Past?In the latest issue of The Psychologist magazine, Vaughan Bell and John Cromby disagree about the place of biology in our understanding of psychiatric illness. Flicker: Your Brain on Movies by Jeffrey Zacks – how H...
Source: BPS RESEARCH DIGEST - January 10, 2015 Category: Psychiatrists and Psychologists Authors: Research Digest Source Type: blogs

I’m happy: A social worker’s story
On my voice mail is a message from Donald Wyatt. He doesn’t often call, but every Monday morning he comes to see me at the Louisville, Kentucky, mental health clinic where I’m a social worker. His message is brief: “I’m not feeling well, and I am planning a trip to either St. Louis or Elizabethtown.” I smile, wondering at the odd pairing. Elizabethtown is a small city of 50,000 people. And, well, St. Louis is St. Louis, a metropolis. This behavior is not unusual for Donald. He’s disappeared before, always out of state and by bus. He doesn’t have the money to travel any other way, a...
Source: Kevin, M.D. - Medical Weblog - January 9, 2015 Category: Journals (General) Authors: Tags: Patient Psychiatry Source Type: blogs

Once More, the Hospital CEO as Scrooge - Cape Cod Healthcare CEO Collected Millions in Severance After Laying Off Hundreds of Health Professionals, and Being Sanctioned by the State Medical Board
The theme of non-profit hospital CEO as Scrooge seems to be persisting in the media even beyond the holiday season.  (Our last post on this theme was in December, 2014).  The previous cases we discussed (also here) involved  marked contrasts between how well top hired managers of non-profit hospitals were doing, and how their institutions were doing.Turning Around the Hospital, but Turning Away Employees The background to this story comes from an article in the Cape Cod (MA) Times from January, 2014.  Cape Cod Healthcare, a regional non-profit hospital system, hired Dr Richard Saluzzo as CEO to turn aro...
Source: Health Care Renewal - January 8, 2015 Category: Health Management Tags: boards of trustees Cape Cod Healthcare executive compensation perverse incentives Source Type: blogs

Tweet Tweet
You may have noticed that I don't write on Shrink Rap as often as I used to.  Somewhere in there, I got busy with our book, and I also started to use Twitter more.   Instead of a real post, I thought I would put up a sample of things I've been Tweeting.Can we customize the treatment of depression by predicting who will respond to different treatments? …CMS is holding Medicare claims for the first 2 weeks of 2015. Find out why: Gabrielle Giffords @GabbyGiffords  ·  ...
Source: Shrink Rap - January 8, 2015 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

Improve the inequalities among physicians
This article pertains to only the provider portion. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - January 7, 2015 Category: Journals (General) Authors: Tags: Physician Pediatrics Primary care Psychiatry Source Type: blogs

Cases: Benign Prostatic Hypertrophy (BPH) as a hospice diagnosis?
Conclusion: In this case, a simple condition that is easily treatable in most men became one that we expected to lead to Mr. K’s death. However, the diagnosis that led it to become life-limiting was Mr. K’s dementia, and the heavy burden which BPH treatments would have placed on him. Mr. K’s daughter based her decision on Mr. K’s values, saying that if the father she was raised by was able to see himself in his current condition, he would have wanted both to stay in place and to be allowed to die with dignity. Forced catheterization and antipsychotic treatment might have prolonged his life by years but would have c...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 6, 2015 Category: Palliative Carer Workers Tags: cases childers emergency care hospice medications POLST urology Source Type: blogs

The Goal of Life
One of my colleagues told me once: "Sami, excuse my remark, but you don't know what you want." I didn't like to discuss that with him, but the bottom line is I think that nobody knows what s/he wants form life. I took the bus today who was there waiting for me? now you already know, I hope. A Virginia Woolf of a kind. And we started chatting. VW: So where are you going today?S: To the University to see whether I can change my place of working.VW: Soooo, that meeaanzzz, you know where you are going to?S: welllll, ... - I looked in her eyes and saw that mixture of cleverness and ridicule so I took a deep breath and...
Source: psychiatry for all - January 4, 2015 Category: Psychiatrists and Psychologists Source Type: blogs

Lost with Woolf
I took the bus going back home and she was sitting there waiting for me. Who else but Virginia Woolf?She started telling me about that Society she and her friends had held. They were 6 or 7 of young women who thought that the objects of life are to produce good people and good books. Good people are produced by women, and good books are produced by men. Since it is up to women to start this circle of production, those young women thought that they must answer the question of whether men are producing good books or not, before going ahead and produce more men.They went to libraries, galleries, universities, army, and courts...
Source: psychiatry for all - January 4, 2015 Category: Psychiatrists and Psychologists Source Type: blogs

Gun Owners & Mental Illness -- Is there a "chilling effect" on seeking treatment?
As you may be aware,  we are in the process of doing research for a book called Committed: The Battle Over Forced Psychiatric Care.  Our plan is to include a chapter on guns and mental illness, and I'm interested in talking to gun owners who believe they are suffering with mental health issues, but won't seek care because they are worried this will impact their right to own firearms.  I'm well aware that gun owners often say they'd never see a therapist, or never take psychiatric medications, but what one does for a theoretical problem may well be different then what one does while they are actually sufferin...
Source: Shrink Rap - January 2, 2015 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

Will the psychologists involved in torture be held accountable?
What ever happened to “first, do no harm?” One of the findings included in a Senate investigative committee’s report on the U.S. government’s post-9/11 torture program was that it was designed by two psychologists.  They were paid “$80 million to develop torture tactics that were used against suspected terrorists in the wake of the September 11 attacks on the Pentagon and the World Trade Center” — including “waterboarding and mock burial on some of the CIA’s most significant detainees.”  (This isn’t the first time that the involvement of these two psychologists has been made public, but the ...
Source: Kevin, M.D. - Medical Weblog - December 30, 2014 Category: Journals (General) Authors: Tags: Policy Psychiatry Source Type: blogs

How the Anechoic Effect Persists: The Case of the Continued Punishment of Dr Elliott
We have frequently discussed the anechoic effect, how evidence and opinions that challenge the dysfunctional status quo in health care, and that might discomfit those in power in benefit from it, have few echoes.  One major reason for the anechoic effect is that people are afraid to speak up because thus disturbing the powers that be may have bad consequences for the speakers.    A December 21, 2014 article in the Minneapolis Star-Tribune updated an ongoing example of how the leaders of health care may seek to silence their critics.  The article updated the career trajectory of Dr Carl Elliott, a p...
Source: Health Care Renewal - December 29, 2014 Category: Health Management Tags: academic freedom adverse effects anechoic effect free speech intimidation manipulating clinical research mission-hostile management University of Minnesota Source Type: blogs

How physicians and psychologists agree to torture others
Atul Gawande posted a series of tweets, based on findings in the Senate CIA torture report, about the significant role physicians and psychologists played in torture. He comments, “But the worst for me is to see the details of how doctors, psychologists, and others sworn to aid human beings made the torture possible.” Agreed. Upon reading how these professionals used their knowledge to torture their fellow human beings I felt disappointed, sad, and sick. “How could those people sleep at night?” I exclaimed. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: ...
Source: Kevin, M.D. - Medical Weblog - December 29, 2014 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

Shrink Rap: Most Popular Posts for 2014
10.  Let's Keep Guns Out of the Hands of.....9. How Hard Is It To Find a Psychiatrist? Tell me your stories! 8. Insurance (or Not), Flotation Tanks, and Involuntary Commitment. 7. The doctor will see you NOW!6. Who are the Mentally Ill? Please take my Brief Survey!(please note: the survey is closed but the results can be found here ) 5. Does bad parenting cause mental illness?4. Should it be a Crime for a Therapist to Have Sex with a Patient? 3. Are Psychiatrists Evil?2. Why Psychiatrists Don't Participate with Insurance Networks  1. Is it Ok to Shrink your Sister in an Emergency?   ----- Listen to our lates...
Source: Shrink Rap - December 27, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs

A doctor wants to leave medicine to sell Tupperware
A letter received by Pamela Wible, MD. Dear Pamela: I can’t tell if I’m burned out or just don’t like being a doctor. My own medical school experience was so abusive. I wonder how other students like me fare when they enter abusive residency programs. I supposedly work at a place that values patients above all else, but it feels like everyone is exhausted and miserable and that the needs of our administration come first. And anyone who tries to say anything about it gets called lazy. I hope the new generation of physicians will demand better treatment, but even this week I could sense how much young doctors just crav...
Source: Kevin, M.D. - Medical Weblog - December 22, 2014 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

Go to Bed Early and Cure Your Negative Ruminations!
This study of hype in press releases will change journalismFootnotes1 Chronotype was dichotomously classified as evening type vs. moderately morning-type / neither type (not a lot of early birds, I guess). And only 75 students completed questionnaires in this part of the study.2 It's notable that the significance level for these correlations was not corrected for multiple comparisons in the first place.ReferencesNota, J., & Coles, M. (2014). Duration and Timing of Sleep are Associated with Repetitive Negative Thinking. Cognitive Therapy and Research DOI: 10.1007/s10608-014-9651-7Sumner, P., Vivian-Griffiths, S., B...
Source: The Neurocritic - December 21, 2014 Category: Psychiatrists and Psychologists Authors: The Neurocritic Source Type: blogs

Suicide: A doctor’s story
It is estimated that approximately 14 percent of U.S. physicians in training are depressed and another 10 percent experience suicidal ideation.  Some 400 U.S. physicians take their own lives each year.  Hampering efforts to deal with such problems is the stigma associated with them.  I knew a top medical student who was reluctant to seek mental health care in part because he feared doing so would tarnish his record.  Earlier this year, he took his own life. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - December 18, 2014 Category: Journals (General) Authors: Tags: Physician Psychiatry Source Type: blogs

Best of 2014
No question: this year’s big biomedical story was Ebola. Headlines, Sunday news shows, multiple Congressional hearings, a Presidential visit to NIH—autumn seemed to be all Ebola all the time. Thus far, the death count from Ebola has been one in the U.S. and over 6,000 in Africa. Less noticed, deaths from suicide in 2014 will probably surpass 40,000 in the U.S., roughly one every 13 minutes. According to a recent World Health Organization report (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - December 17, 2014 Category: Psychiatry Authors: Thomas Insel Source Type: blogs

On Studying the Epigenetics of Twins in Aging and Disease
Collections of twins are the closest that researchers can get in humans to an ideal study situation in which a large number of genetically identical individuals follow the same life courses. Comparison studies with as many factors as possible made the same are a good way to tease out relevant details from an exceedingly complex system that is still poorly understood as a whole. That system here is the sum total of human cell and tissue biology, and its changing operation over the course of a life span: the map of metabolism is at present really only a sketch of the outlines, and contains many large blank areas when it come...
Source: Fight Aging! - December 16, 2014 Category: Research Authors: Reason Tags: Daily News Source Type: blogs