psychiatry
j7uy5 | November 7, 2007A recent study indicates that the lifetime cost of medical
care for
Iraq and Afghanistan veterans will be greater than the cost of the war
to date. We really have no choice, but it is going to cost
us. A lot. Of course, the ones really paying are
the troops themselves. From Medscape (free registration
required).
href="http://www.medscape.com/viewarticle/565407">High
Rate of PTSD in Returning Iraq War Veterans
Bob Roehr
November 6, 2007 (Washington, DC)
—
Estimates of the rate of posttraumatic stress disorder (PTSD) among
veterans returning from Iraq range from 12% to 20%. With…
neurophilosophy | November 7, 2007The introductory chapter of Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression, by Frederick K. Goodwin and Kay Redfield Jamison, provides an excellent description of how Emil Kraepelin first classified manic depression (or bipolar disorder) and related conditions in the late 19th century, and how his work has influenced the way in which psychiatrists treat these illnesses today.
Kraepelin (1856-1926, right), who is considered to be the founder of modern psychiatry, was the first to distinguish between manic depression and schizophrenia, which were at the time both…
j7uy5 | November 6, 2007
href="http://www.researchblogging.org/">
alt="Blogging on Peer-Reviewed Research"
src="http://www.researchblogging.org/public/citation_icons/rb2_large_gray.png"
height="50" width="80">The
researchers did fMRI
of brains of persons with
href="http://en.wikipedia.org/wiki/Borderline_personality_disorder"
rel="tag">Borderline Personality Disorder, before
and after psychotherapy. This was a small study, using a
design that would be difficult to use routinely, but it is
provisionally interesting. Difficult, because the patients
received 12 weeks of inpatient therapy (perhaps…
j7uy5 | November 2, 2007
rel="tag">Anhedonia
is one of the most important symptoms of depression. I wrote
href="http://scienceblogs.com/corpuscallosum/2007/03/basic_concepts_anhedonia.php">a
post about it a while back, so I won't go into the definition
in this post, other than to summarize by saying that it is the
inability to experience pleasure in response to activities or events
that otherwise would be pleasurable.
It is difficult to do studies on the brain mechanisms involved in the
genesis of individual symptoms. Progress has been made, but
it has been slow.
When I was in residency, toward the end of…
j7uy5 | October 30, 2007
href="http://www.med.umich.edu/opm/newspage/2007/crazy.htm">Nov.
5 event at U-M will feature top experts discussing alternatives to
“criminalization” of America’s mentally
ill
ANN ARBOR, MI – Across America, prisons serve as an
unofficial holding system for the mentally ill. Families desperate to
get treatment for their loved ones’ psychiatric issues
instead wind up retrieving them from the police station. And judges
wrestle with the prospect of sentencing the same people again and again
for minor offenses, instead of steering them to effective mental health
programs.
These phenomena,…
j7uy5 | October 27, 2007Not much to add to this. I do want to make sure
that more people see it.
Why did you include a chapter on
your bout with postpartum depression and were you concerned that the
CIA would look unkindly on the fact that you sought help for your
condition?
I included the chapter on postpartum depression (PPD) frankly because
my publisher, Simon & Schuster, allowed me too, even though it
is a departure from the rest of the themes of my book. It is something
that I feel passionately about and was actually somewhat painful to
write. With the birth of my twins in 2000, I experienced serious…
sb admin | October 26, 2007In time for Halloween:
Trailer for Central State: Asylum for the Insane. A filmmaker prowls a closed mental institution to "...uncover the mysteries left behind when the facilities closed in 1994." There's lots of shaky handheld camerawork in poorly lit tunnels, and shakier rumours of ghosts, but no exploration into the disappearance of former patients. Homelessness and prisons, that's scary, not the supposed ghosts that a supposed psychic says are "like a tornado" in the building.
What's actually "menacing and still threatening" is not an old hospital but the stigma attached to mental…
j7uy5 | October 20, 2007BMC Psychiatry, an
open-access journal, has an article on
href="http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml"
rel="tag">Posttraumatic Stress Disorder (PTSD):
href="http://www.biomedcentral.com/1471-244X/7/56/abstract">Altered
oscillatory brain dynamics after repeated traumatic stress.
This is yet another indication that PTSD has an enduring
physiological basis.
The insula, as a site of multimodal
convergence, could play a key role in understanding the pathophysiology
of PTSD, possibly accounting for what has been called posttraumatic…
j7uy5 | October 16, 2007The Treatment for Adolescents with Depression Study (TADS)
is a
major NIH-sponsored study of the treatment of adolescents with
depression, in which
href="http://en.wikipedia.org/wiki/Fluoxetine" rel="tag">fluoxetine-only,
rel="tag">cognitive-behavioral therapy
only, combination treatment, and placebo are compared. The
study
is expected to generate a number of papers. One was published
a
few days ago in the Archives of General Psychiatry. The paper
is
not yet open-access. The study team, however, has a
href="https://trialweb.dcri.duke.edu/tads/index.html">website
with…
j7uy5 | October 11, 2007The Journal of Psychiatry and Neuroscience (Canadian,
bilingual), an open-access publication, has a regular column entitled
Psychopharmacology for the Clinician (Psychopharmacologie
pratique). Typically the column contains a case
report and a brief discussion of practical issues in treatment.
The most recent (September 2007) issue describes a case of poststroke
pathological laughing and crying (PLC). PLC is a mysterious
condition, something that is impossible to explain using behavioral or
psychodynamic theory.
After a stroke, 7 to 48 percent of patients experience disinhibition of…
j7uy5 | October 1, 2007Actually, the full headline is:
href="http://www.huliq.com/36055/genetic-test-for-suicidal-ideation-in-patients-using-antidepressant-drugs%20">Genetic
test for suicidal ideation in patients using antidepressant drugs.
A company called Neuromark has made available a genetic test that it
claims can identify persons who would have an increased risk for
suicide after starting an antidepressant medication. They call
the test Mark-C™. It is based upon the finding that
persons with certain genetic markers seem to be at increased risk for
having thoughts of suicide after they start taking an…
neurophilosophy | September 22, 2007In an op-ed from yesterday's NY Times, Christopher Lane, a professor of English at Northwestern University, argues that shy kids are not mentally ill, and that they shouldn't be given medication.
The piece brought to mind this critique of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), by L. J. Davis:
Current among the many symptoms of the deranged mind are bad writing (315.2, and its associated symptom, poor handwriting); coffee drinking, including coffee nerves (305.90), bad coffee nerves (292.89), inability to sleep after drinking too much coffee (292.89), and…
neurophilosophy | September 21, 2007A study by a team of German researchers shows that the brains of paedophiles respond differently to those of healthy controls to erotic images.
Martin Walter, of the Department of Psychiatry at Otto-von-Guricke University in Magdeburg, and his colleagues used functional magnetic resonance imaging (fMRI) to compare neural activity in 13 paedophilic patients and 14 healthy control subjects during visual erotic stimulation.
They found that, compared to the controls, activity in several areas of the brain, including the hypothalamus, was reduced in the paedophilic patients.
The hypothalamus…
grrlscientist | September 20, 2007A couple days ago, I mentioned that I, along with several other blog writers, had been invited to participate in a conference call-interview with several experts who were going to discuss the topic of bipolar disorder with us so we could write about it on our blogs. Well, thanks to a friend here in NYC, who lent me his cell phone so I could make that call without using more of my severely limited daytime minutes, I did get to participate in this discussion. Even though I was not sure what to expect, I found it to be fascinating. I have not yet received the recording of the phone call, but I…
neurophilosophy | September 17, 2007
This drawing is a 4-year-old boy's depiction of Hurricane Katrina. It is one of 50 drawings, photographs and sculptures that went on display yesterday at the New Orleans Museum of Art, as part of an exhibition called Katrina - Through the Eyes of Children.
Involved in the exhibition is Karla Leopold, one of a team of art therapists that has been working with children who have been staying at a trailer park in Louisiana since their displacement by the hurricane two years ago.
The children's drawings are an indicator of how they are coping with the trauma of the hurricane. According to…
neurophilosophy | September 15, 2007This week, I've received three books which I'll be writing about in the near future:
My Lobotomy, by Howard Dully and Charles Fleming. Dully was lobotomized at the age of 12 at the behest of his stepmother - that's him on the right, holding an instrument identical to the one he was lobotomized with; this book is his memoir.
The Lobotomist, by Jack El-Hai, a biography of Walter Freeman, the psychiatrist who, in 1960, performed Dully's lobotomy.
The Body Has a Mind of Its Own, by Sandra and Matthew Blakeslee. This is about the somatosensory cortex, that part of the brain on which the body…
neurophilosophy | September 14, 2007The New York Times reports that the findings of a study published last week in the American Journal of Psychiatry, which links a drop in the use of specific serotonin reuptake inhibitors (SSRIs, e.g. Prozac) to an increase in the numbers of teenage suicide, are being disputed.
j7uy5 | September 8, 2007What is the world coming to?
title="Am J Psychiatry">AJP
has an article about "intensive" therapy for bipolar disorder.
Their definition of intensive? Thirty sessions over
a
period of nine months.
Back in the day, when you could struggle to stay awake during a seminar
when people read their process notes to their supervisors, and watch
brachiosaurids frolic outside the window, intensive therapy was at
least twice weekly. More like thrice weekly.
Gone are the sauropods. Now, you are likely to see
hitherto-unknown strange creatures with spiked hair and iPods race by
on their Razor…
j7uy5 | September 4, 2007In the 1950's, a new class of antipsychotic drugs was
discovered: the
antipsychotics.
href="http://en.wikipedia.org/wiki/Chlorpromazine" rel="tag">Chlorpromazine
(Thorazine®) was the first.
By the 1970's, several related compounds had been discovered.
In
1976, it was learned that there is a direct linear relationship between
the strength with with the compounds bind at the dopamine D2 receptor,
and the clinical potency of the drug.
face="Times New Roman, Times, serif">[Figure from Seeman,
Molecular Psychiatry (1998)3, 123-124]
The discovery of this direct relationship was taken…
neurophilosophy | September 3, 2007This is alarming: the New York Times has an article about a new study published in the Archives of General Psychiatry, which shows that the number of under 20s diagnosed with bipolar disorder has increased 40-fold (from 25 to 1003 per 100,000) between 1994 and 2003:
Bipolar disorder is characterized by extreme mood swings. Until relatively recently, it was thought to emerge almost exclusively in adulthood. But in the 1990s, psychiatrists began looking more closely for symptoms in younger patients.
Some experts say greater awareness, reflected in the increasing diagnoses, is letting…