The Psychiatric Patient's Right to Effective Treatment: Implications of .

Although never reached final court adjudication, the case generated widespread discussion in psychiatric, legal, and lay circles. The author served as a consultant to Dr. Osheroff and testified that Chestnut Lodge failed to follow through with appropriate biological treatment for its own diagnosis of depression, focusing instead on Dr.

Attitudes toward evidence-based clinical decision support tools to reduce exposure to ionizing radiation: The Canadian CT Head Rule.

Background And Purpose: A large degree of variation in clinical practice exists among clinicians evaluating and treating individuals with minor head injuries. Noncontrast head computerized tomography (CT) scans are commonly used to assess for intracranial damage in patients presenting with head injury. This practice is not supported by the evidence and poses harm to patients by increasing exposure to ionizing radiation.

Erectile dysfunction and depression: screening and treatment.

The comorbid conditions erectile dysfunction (ED) and depression are highly prevalent in men. Multiple regression analysis to control for all other predictors of ED indicate that men with high depression scores are nearly twice as likely to report ED than nondepressed men. Depression continues to be among the most common comorbid problems in men with ED, both in the community and in clinical samples.

Factors affecting change in private psychotherapy patients of senior psychoanalysts: an effectiveness study.

Each of 51 experienced psychiatrist/psychoanalysts was queried about the clinical characteristics of every private psychotherapy patient presently in treatment: 551 patients were included in the study; 88% of patients had an Axis I disorder, 59% had Axis I and Axis II disorders concurrently, and 11% Axis II only. Of these patients, 44% had been prescribed psychotropic medication on a daily basis for at least 2 weeks during the present treatment. Patients treated for the longest time (5 years or more) were the most seriously psychiatrically disturbed.

Legal, ethical and clinical implications of prescribing involuntary, life-threatening treatment: the case of the Sunshine Kid.

Involuntary treatment is a concept often familiar to psychiatrists. In clinical practice, it usually involves the hospitalization and pharmacological management of patients with severe mental disorders. However, the scope of involuntary treatment is not limited to the management of mental illness alone.

An open-label pilot study of divalproex sodium for posttraumatic stress disorder related to childhood abuse.

Background: Few effective pharmacotherapeutic strategies have been established for the treatment of symptoms associated with posttraumatic stress disorder (PTSD). Preliminary evidence supports the efficacy of serotonergic agents and anticonvulsants, such as divalproex sodium, for the treatment of PTSD symptoms, particularly in military populations.

Objective: The aim of this study was to obtain pilot data on the use of divalproex sodium for the treatment of PTSD among adult civilian outpatients with a history of childhood physical and/or sexual abuse.

Major depression as a risk factor for cardiovascular disease: therapeutic implications.

This review was conducted to analyze the literature regarding the association between psychological depression and cardiovascular disease (CVD). The literature was reviewed through Medline and Psychlit. Articles were located using search terms such as depression, CVD, coronary artery disease, and cardiac risk factor.

A pilot open trial of brief psychodynamic psychotherapy for panic disorder.

This is a complete report of an open trial of manualized psychodynamic psychotherapy for treatment of panic disorder, Panic-Focused Psychodynamic Psychotherapy (PFPP). Twenty-one patients with PD were entered into a trial of twice-weekly, 24-session treatment. Sixteen of 21 experienced remission of panic and agoraphobia.

Cognitive side effects of anticonvulsants.

The increasing use of anticonvulsant drugs in psychiatry has prompted greater awareness of their effects on a range of psychiatric domains, including cognition. Older versus newer antiepileptic drugs have been reported to either worsen or enhance cognitive performance in clinical populations, and the extent to which cognitive disturbances may reflect iatrogenic factors versus psychopathology is subject to debate. We review current information about the role of anticonvulsants in cognition, with particular emphasis on newer compounds (such as lamotrigine, gabapentin, and topiramate), the cognitive dimensions of affective illness, and the clinical approach to evaluating cognition in psychiatric patients taking anticonvulsant drugs over time.

Treatment guidelines: current and future management of bipolar disorder.

The emergence of new treatments for bipolar disorder has coincided with a proliferation of published treatment algorithm recommendations and practice guidelines. Several guidelines derive from critical appraisals of current treatment literature and, as such, may serve as a critical reference resource to complement individual clinical judgment. This review describes points of overlap and discordance across currently available treatment guidelines for bipolar disorder and presents common clinical situations in which the consultation of treatment guidelines may provide clinicians with useful information and a rationale for making sequential treatment decisions.

A history of substance abuse complicates remission from acute mania in bipolar disorder.

Background: Substance abuse frequently complicates the course of bipolar illness, promotes mixed states, and contributes to poor outcome in mania. Preliminary open trials suggest that anticonvulsant mood stabilizers may enhance remission rates and outcome for bipolar patients with substance abuse. This study compared remission patterns for mixed or pure manic episodes among bipolar inpatients with or without substance abuse histories.

Lesbians and the internalization of societal standards of weight and appearance.

ABSTRACT Findings from a study of body image, weight concern, and disordered eating in lesbians are presented. While lesbians were more critical of traditional social norms regarding the rights and roles of women in general than heterosexual controls, this difference disappeared in regard to norms concerning women's weight and appearance. Dieting was frequent, almost half of the participants were dissatisfied with their weight, and self-esteem was strongly influenced by body esteem.

Vaclav Havel: one man disturbing the peace.

In summary, I believe that the qualities that Havel exemplifies in his leadership style, namely, his sense of the absurd, his altruism in reluctantly assuming the responsibility for something he started, his amateurish political style, his apologetic stance, and his apolitical ideologies all serve to make him a flexible and idealistic leader who can, indeed must, be trusted and admired by his followers. Despite these personal and leadership qualities, it was fateful that Vaclav Havel was born in a place where his exemplary qualities could be used. Perhaps if he were born in another nation that did not have such a strong tradition of philosopher-kings or a peace-loving nature, he would not have been able to attain such political and idealistic heights.

"Healthy avenues of the mind": psychological theory building and the influence of religion during the era of moral treatment.

Objective: This article delineates the main psychological interventions used by American asylum superintendents practicing moral treatment between 1815 and 1875. Further, it explores the impact of Protestant religious ideas on specific aspects of moral treatment's theory and practice.

Method: Asylum annual reports written by superintendents (physicians dedicated to the treatment of the mentally ill) were studied along with volumes of the American Journal of Insanity from its premier issue in 1844 through the 1890s.

The nature and predictors of substance use among lesbians.

It has been suggested that lesbians lack mainstream coping resources and are thus at risk for maladaptive coping efforts, which include substance abuse, However, data for thus at risk for maladaptive coping efforts, which include substance abuse. However, data for this population are sparse. Levels of stress, coping styles, rates of problematic substance use and relationships among these variables were examined.

Rapid titration of mood stabilizers predicts remission from mixed or pure mania in bipolar patients.

Background: Recent investigations have suggested that the antimanic agents divalproex sodium and carbamazepine may each hasten hospital discharge and be especially beneficial in treating mixed-state mania. This study retrospectively compared the time to remission for pure versus mixed manic bipolar inpatients who were taking lithium, divalproex, or carbamazepine, or their combination, under naturalistic conditions.

Method: Records were reviewed for 120 bipolar inpatients from 1991 to 1995.