Comorbidity Carlat Reports | Carlat Publishing

Clinical Update

What Gets in the Way of Antidepressants?

From The Carlat Psychiatry Report, ADHD

When patients don’t respond to an antidepressant, it’s a good idea to step back and look for anything that might be getting in the way. Major stress, substance use, medication nonadherence, anxiety, and medical and psychiatric comorbidities are high on that list, but recent research has added more possibilities that we’ll review in this article.

Expert Q&A

Addiction and Borderline Personality Disorder

From The Carlat Addiction Treatment Report, Personality Disorders and Addiction

Topics: Borderline Personality Disorder | Comorbidity | Dialectical Behavioral Therapy | Psychotherapy

CATR: Please introduce yourself. Dr. Pierson: I am a clinical psychologist and an assistant professor at Yale University School of Medicine. I serve as the director of dialectical behavior therapy (DBT) services at Yale New Haven Psychiatric Hospital. CATR: What is a useful way for addiction treatment providers to conceptualize borderline personal

Expert Q&A

Real-World Alcohol Use Disorder Treatment

From The Carlat Addiction Treatment Report, Alcohol Use Disorder

Topics: Alcohol use disorder | Comorbidity | Dual diagnosis | Psychopharmacology | Psychotherapy

CATR: Please tell us about yourself. Dr. Petrakis: I’m an addiction psychiatrist, professor at Yale School of Medicine, and the Chief of Mental Health for the VA Connecticut Healthcare System. I have several research focuses, one of which is the treatment of individuals with comorbid psychiatric illness and alcohol use disorder (AUD). CATR: We kno

Clinical Update

Using Smoking Cessation Medications in Patients With Mental Illness

From The Carlat Addiction Treatment Report, Smoking Cessation

Topics: Comorbidity | Smoking Cessation | Smoking Cessation Agents

As you have likely noted in your practice, smoking is very common among patients with mental illness. Studies have shown that nearly every psychiatric diagnosis is associated with an increased prevalence of smoking, and that there is a growing disparity in smoking rates between patients with mental illness and the general population (Dickerson F et al,

Research Update 2

Does Low to Moderate Alcohol Drinking Help or Hurt Cognition?

From The Carlat Addiction Treatment Report, Alternative Treatment in Addiction

Review of: Zhang R et al, JAMA Netw Open 2020;3(6):e207922 Is alcohol good or bad for cognition? The evidence is mixed. A new study brings additional clarity to this question by including a diverse patient population and by using longitudinal cognitive measurements of the subjects as opposed to cross-sectional evaluations at one time point. In an

Research Update

Can Buprenorphine Improve PTSD Symptoms?

From The Carlat Addiction Treatment Report, Legal Issues in Addiction Medicine

Review of: Lake EP et al, Am J Addict 2019;28(2):86–91 For many years, the mainstay of treatment for PTSD has been the SSRI class of medications, but many of our patients still suffer crippling symptoms despite optimal antidepressant medication dosing. PTSD is often accompanied by opioid misuse, sometimes in an effort to self-treat the hyperarousal

Clinical Update

How to Treat ADHD in Bipolar Disorder

From The Carlat Psychiatry Report, Bipolar Disorder

Topics: | | | | | | | | | | | | | | | | | | ADHD Alpha Agonists Amphetamines ArModafinil Atomoxetine Attention Deficit Hyperactivity Disorder Bipolar Disorder Bipolar II Comorbidity Guanfacine methylphenidate Modafinil Nuvigil Pharmacology Provigil Psychopharmacology Psychopharmacology Tips stimulant Stimulants

Patients with bipolar disorder often present with cognitive complaints. Our October 2021 issue laid out a diagnostic plan for these symptoms, and in this article, I’ll cover some treatment approaches for patients with a DSM-based ADHD-bipolar comorbidity (ie, the ADHD symptoms began in childhood and persist after the mood episodes have stabilized).

Expert Q&A

The Schizophrenia-OCD Overlap

From The Carlat Psychiatry Report, Mood Disorders

TCPR: What is schizo-obsessive disorder?Dr. Poyurovsky: Schizo-obsessive disorder (schizo-OCD) is not a DSM diagnosis. The term is used to refer to patients with schizophrenic disorders that have comorbid features of OCD. We see these obsessive-compulsive symptoms in schizophrenia more often than would be expected by chance. About one in four patients h

Clinical Update

How to Diagnose ADHD in Bipolar Disorder

From The Carlat Psychiatry Report, Mood Disorders

Hailey is a 24-year-old woman with bipolar II disorder who has recently come out of a mixed episode. Although her mood symptoms have resolved, she is distracted easily, has difficulty organizing her work, and often forgets important tasks. She read about ADHD online and asks if she can have a stimulant to help her focus. ADHD and hypomania share many

Clinical Update

Adult-Onset ADHD

From The Carlat Psychiatry Report, Adult ADHD

Topics: Comorbidity | Diagnosis

“My son was just diagnosed with ADHD, and I think I may have it, too,” says Alex, a 42-year-old salesman who presents for evaluation. In addition to being sad, anxious, and irritable, and meeting criteria for mild major depression, Alex says he is often bored at work, fidgety during meetings, and forgetful at home. He has had these problems since