54%–75% of adolescents "wish for more sleep" It is widely recognized that many older Americans suffer from a variety of sleep disorders. In fact, more than half of all Americans older than age 65 have a sleep problem, and disturbed sleep is among the most frequently cited problems affecting institutionalized older Americans. As the population ages, it is estimated that at the end of this decade nearly 80 million Americans will ... Read More

The American Psychiatric Association (1983) reports that recurrent episodes occur in at least 50% of patients who seek treatment for major depressive disorder (MDD). Most studies, though, have examined only single occurrences. To help describe the episodic nature of MDD, the National Institute of Mental Health initiated the Collaborative Program on the Psychobiology of Depression, a prospective, naturalistic, longitudinal investigation. This program's early research found the cumulative probability of recurrence ... Read More

Success shown with drugs and psychotherapy People plagued by panic attacks need not fear one thing: Treatment works. Panic disorders respond well to psychotherapy, drug treatment and a combination of the two, according to one of the largest studies of the condition. Panic disorder affects several million Americans, crippling them with recurrent bouts of profound anxiety and physical symptoms that can include chest pain and pounding, as well as rapid heartbeats and shortness ... Read More

Depression treatment in the United States has been getting a bad name in a number of quarters recently. Patients who responded to Caredata.com's 1999 Commercial Health Plan Survey, for example, ranked treatment of depression as one of the most poorly rated of the 27 conditions studied. Of those respondents, 20% rated their depression care as "not adequate," and another 38% said it was only "adequate." Of the 74 health plans ... Read More

Question. I recently heard of the use of a low dose of Thorazine for the treatment of depression. Are you familiar with this treatment? Answer. I am not aware of any controlled, persuasive evidence that Thorazine (chlorpromazine) or any standard antipsychotic - in low doses or high - is particularly effective as an antidepressant. The exception to this claim may be in so-called delusional depression, in which psychotic features are present; ... Read More

Question. I have read several articles that refer to the use of certain types of music that is supposed to help people who suffer from depression, but none of them mention the specific type of music. Do you have any information or resources that lists specific music for therapy? Answer. Music has been used to treat various anxiety and stress-related states, including postoperative pain. However, in my literature search, I was ... Read More

A recent study adds to the body of evidence suggesting that the drug Paxil (paroxetine HCl) is effective in treating social anxiety disorder / social phobia. * note: social anxiety disorder is characterized by the fear of being observed or evaluated by others; sufferers report an overwhelming fear of embarrassment in social and performance situations. * researchers at the University of Southampton conducted a 12-week, multi-centre, double-blind, placebo-controlled clinical trial to compare ... Read More

Historically, St. John’s wort has been used as an herbal remedy for depression, anxiety, diuresis, gastritis and insomnia. Recent studies demonstrate that the extract, primarily hypericin, is a strong, and nearly irreversible, inhibitor of monoamine oxidase types A and B. Patient Presentation and History JS is a 37-year-old female who comes to the pharmacy intending to purchase St. John’s wort. She has heard that it can relieve depression, and she firmly believes ... Read More

Managing Mental Health Problems. A Practical Guide for Primary Care Nick Kates, Marilyn Craven Hogrefe & Huber Publishers, 12 Bruce Park Ave, Toronto, ON M4P 2S3 1998/390 pp Strengths Practical, useful instruction Weaknesses Not comprehensive For a long time, managing mental health problems in primary care has been poorly understood and criticized by physicians not principally involved in primary care. I believe this misunderstanding stems in part from not having defined the skill set unique to family practice. Therefore, ... Read More

Linda Denise Oakley, Claudette Potter Mosby-Year Book, Inc, 11830 Westline Industrial Dr, St Louis, MO 63146 USA 1997/448 pp Strengths Assessment and DSM-IV diagnosis Weakness Specific pharmacologie treatment Audience Family physicians and allied mental health professionals The authors of this ambitious book state, "We have developed a book for primary care practitioners that presents everything from basic mental concepts and terms to clinical examples of psychiatric primary care." The book is divided into five parts that deal with basic concepts ... Read More