Tag archives for Mental health

Acute Agitation and Aggression in Psychiatric Illnesses. Part 3

Posted By Kelly On Wednesday, May 4th 2011   under:  Disorders   Tags: , , ,    
Causes There are two ways to describe the causes of agitation and aggression: by the underlying disease state (see Table 1), or the exact pathophysiology that causes the aggression. The DSM-IV-TR has several diagnostic categories describing the relationship between a medical condition or substance and the specific psychiatric symptoms or syndrome they cause. Examples of medical conditions that more commonly cause aggression and agitation symptoms include central nervous system disorders such ... Read More

Cultural Issues in the Treatment of Anxiety

Posted By Kelly On Tuesday, May 3rd 2011   under:  Book review   Tags: , , , , , , , ,    
Friedman S, editor New York, London: The Guilford Press; 1997. 261 pp. with index ISBN 1-57230-237-2 Anxiety is a profound human experience. Anxiety disorders are universal in human societies, although the diagnostic patterns vary over time and from one place to another. This volume describes some culturally bound anxiety syndromes, but dwells on the diagnostic categories of the Diagnostic and Statistical Manual of Mental Disorders, third (DSM-III), third ... Read More

Managing Resistant Depression. Part 8

Posted By Kelly On Monday, May 2nd 2011   under:  Depression   Tags: , , , , ,    
Absolute treatment resistance In most surveys, the number of patients with absolute treatment resistance is very small. In some specialized tertiary referral clinics, only about 7% of patients remain depressed after 1 year of extensive investigations and treatment. However, extensive treatment involves many drug trials, singly and in combination, as well as ECT. Typically, people with absolute treatment resistance are older (mean age about 55), have been depressed for a longer ... Read More

Treating mental illness in primary care

Posted By Kelly On Saturday, January 23rd 2010   under:  Book review   Tags: ,    
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

Mental Health Professional with Depression

Posted By Kelly On Thursday, January 14th 2010   under:  Question - Answer   Tags: , , , ,    
Question. I am a mental health professional. However, I also find myself searching for information to console me personally. I have been diagnosed with major depression. I go regularly to a psychiatrist and I am currently taking Wellbutrin SR. What is the potential for recurrence of depressive symptoms while taking a prescribed medication that has worked well for over three years? Can you give me some information about the number ... Read More

Risk Management with Suicidal Patients

Posted By Kelly On Saturday, November 28th 2009   under:  Book review   Tags: , , ,    
Risk Management with Suicidal Patients Bongar B, Berman AL, Mavis RW, Silverman MM, Harris EA, Pakman WL, editors New York: The Guilford Press; 1998.197 pp with index ISBN 1-57230-302-6 (cloth) This book was written in response to the fact that most psychiatrists lose a patient to suicide sometime during their professional life. Suicide cases are a leading reason for malpractice action against mental health professionals. Dr. Bongar begins ... Read More

Early detection of depression. Part 4

Posted By Kelly On Thursday, November 26th 2009   under:  Depression   Tags: , ,    
Special problems The early detection of depression is much more complex and challenging than the detection of other conditions seen in the primary care physician's office. Perhaps the most significant reason for this is how the natural history of depression differs from that of most conditions for which there are effective measures for prevention or early detection. The successful early detection of diseases or of ... Read More

Early detection of depression. Part 3

Posted By Kelly On Thursday, November 26th 2009   under:  Depression   Tags: , ,    
Effectiveness of early detection The critical question with any intervention for early detection and treatment is whether it does more good than harm as compared with the results of later diagnosis and intervention. The appropriate research tool for answering such a question is the randomized controlled trial. A MEDLINE search of the literature and subsequent secondary searches identified only four trials of sufficient methodologic ... Read More

Early detection of depression. Part 2

Posted By Kelly On Thursday, November 26th 2009   under:  Depression   Tags: , ,    
Are there acceptable routine screening tests? Instruments for routine case-finding in primary care settings must be of acceptable quality, brief and easy to use. Presumably the patients would complete the test while waiting to see their physician. Most self-administered tests have been designed for routine screening purposes and not as diagnostic aids. Some tests have been developed for settings in which the prevalence of ... Read More

Early detection of depression. Part 1

Posted By Kelly On Thursday, November 26th 2009   under:  Depression   Tags: , ,    
Depression is common and can usually be treated effectively. However, in many cases physicians may not recognize depression, especially in its early stages. Because the burden of suffering can be high, including death through suicide, early recognition and treatment are worth while. Such efforts are not as easy as they seem, and evidence of their effectiveness must be evaluated. All physicians must be sensitive to verbal ... Read More
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