Using Clinical Scales in Child Psychiatry

Topics: Assessment | Diagnosis | Outcome tracking | Outcomes

CCPR: Welcome, Dr. Krishna. Could you tell us what drives your work in measurement-based care? Dr. Krishna: Sure. I have a PhD in computer engineering as well as being a child psychiatrist. I’m a member of the American Academy of Child and Adolescent Psychiatry Healthcare Access and Economics Committee. I am an engineer at heart, and I’m interested

ADHD Prevalence in the US Black Population

Topics: ADHD | Black youth | Diagnosis | Disparities | prevalence

REVIEW OF: Cénat JM et al, JAMA Psychiatry 2021;78(1):21–28 STUDY TYPE: Meta-analysis In the general population, the reported prevalence of ADHD is about 10%, with estimates varying from around 5% to 15%. Black individuals are typically underrepresented in these studies, and with fewer data, it is no surprise that the estimates are less precise

Treating Co-Occurring Psychiatric Disorders

Topics: Co-occurring disorders | Diagnosis | Substance Use Disorder

CATR: Why do you think clinicians should pay attention to psychiatric disorders co-occurring with addiction? Dr. Ross: The reason is that they’re very common. For example, about 80% of people with schizophrenia have nicotine use disorder, and 50% have a non-nicotine substance use disorder (SUD) (Miller SC, Fiellin DA, Rosenthal RN, Saitz R, eds. ASAM

Diagnosing and Treating Stimulant Use Disorders

Topics: contingency management | Diagnosis | Harm reduction | online therapy | Pharmacotherapy | Psychotherapy | Stimulants

CATR: Welcome, Dr. dela Cruz. Tell us what you do. Dr. dela Cruz: I’m an assistant professor at UT Southwestern Medical School where I’m the adult psychiatry residency associate program director, and I teach medical students, residents, and fellows. Clinically, I’m an outpatient addiction psychiatrist where I treat a variety of patients with subs

How to Diagnose Bipolar Disorder

Topics: Bipolar Depression | Bipolar Disorder | Bipolar II | Diagnosis | DSM | Hypomania | Mania | Mixed Features | Mood

TCPR: When I ask a depressed patient if they’ve ever had manic symptoms, I often run into a problem. They say, “Of course I feel more confident, energetic, and happy ... when I’m not depressed.”Dr. Parker: As it can be hard to tease apart true hypomania from normal happiness, we’ve developed a rating scale to assist, the Sydney Bipolar Screene

The Schizophrenia-OCD Overlap

Topics: Antipsychotics | Aripiprazole | Clozapine | Comorbidity | Diagnosis | Lamictal | Lamotrigine | Obsessive Compulsive Disorder | OCD | olanzapine | Pharmacology Tips | polypharmacy | Quetiapine | Risperidone | Schizoaffective disorder | Schizophrenia

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

How to Diagnose ADHD in Bipolar Disorder

Topics: ADHD | ADHD Rating Scale-5 | Attention Deficit Hyperactivity Disorder | Bipolar Disorder | Bipolar II | Comorbidity | Diagnosis | Diagnostic Testing | Hypomania | Psychiatric interviewing

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

Overdiagnosis in Psychiatry

Topics: Adult ADHD | Bipolar II | Borderline Personality Disorder | BPD | Diagnosis | DSM | PTSD | Stigma

TCPR: Which disorders are the most overdiagnosed in psychiatry? Dr. Paris: At the top of the list are major depression, PTSD, bipolar II, adult ADHD, and—this one is a recent addition because it used to be underdiagnosed—borderline personality disorder. Each of these conditions may be underdiagnosed in some settings as well, but they have also been

Autism: The Goal Posts Have Moved

Topics: Autism | Autism Spectrum Disorder autism spectrum disorder | Diagnosis | Research Update

Review of: Rødgaard EM et al, JAMA Psychiatry 2019;76(11):1124–1132 Study Type: Meta-analysis of meta-analyses We’ve heard a lot about the increasing prevalence of autism, up from 1 in 2,000 in 1965 to 1 in 45 in 2015. What we have not heard are definitive answers as to why. This study used a novel design to explore whether the research has i

Adult-Onset 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