Understanding the Bipolar Spectrum: Tips on Diagnosis

Topics: Bipolar Disorder | Practice Tools and Tips

TCPR: Dr. Aiken, before we get into some of the controversies about the bipolar spectrum, can you give us a brief history of bipolar disorder? Dr. Aiken: Certainly. The modern conception of bipolar disorder dates to the early 20th century, mainly to German psychiatrist Emil Kraepelin, who was a very astute observer. Kraepelin noticed that some patien

Closing a Practice: Some Practical Suggestions

Topics: Free Articles | Practice Tools and Tips

Dr. R is a psychiatrist in his late 60s with a thriving private practice. One day, he suddenly feels dizzy and out of sorts. After being examined by another physician, he is diagnosed with a stroke. His neurologist cannot say if he will fully recover or be able to practice medicine again. Dr. R and his family know that he might suddenly need to retire.

Some Helpful CBT Techniques for Specific Disorders

Topics: Practice Tools and Tips | Psychotherapy | Registered Articles

When we first set about planning this article, its working title was “The Most Evidence-Based Psychotherapies.” But as we scoured the literature, it became clear that there’s no scientific consensus about which techniques are best (one exception to this being techniques for OCD—see page 3). In fact, the latest official statement on the subject b

Pharmacogenetic Testing: An Update

Topics: Diagnostic Testing | Free Articles | Genetics and Psychiatry | Laboratory Testing in Psychiatry | Practice Tools and Tips

Given how many essentially equivalent medications we have to choose from, how great would it be to have a test that tells us which drug to prescribe for which patient? Everybody wants personalized medicine, and in some other specialties, such as oncology, this is becoming a standard part of treatment. In this article, we’ll review some of the basics o

CME Post-Test - Street Drugs, CATR, March/April 2017

Topics: Addiction | Practice Tools and Tips | Psychopharmacology | Psychotherapy | Research Update | Substance Abuse

The post-test for this issue is available for one year after the publication date to subscribers only (December 31, 2017). By successfully completing the test you will be awarded a certificate for 2 CME credits. Click here to take your CME test. Note: All of the CME tests are available in the “My Account” section of the site when you are log

How to Treat Adult ADHD

Topics: ADHD | Free Articles | Practice Tools and Tips

Over the past decade, it’s become apparent that ADHD does not suddenly end when children grow up, and that the disorder often continues into adulthood. Since 2011, I have run a clinic specializing in adult ADHD. ADHD is relatively common in adults, with conservative estimates of a 4%–5% prevalence in the adult population, equal in men and women (htt

ADHD Overdiagnosis

Topics: ADHD | Practice Tools and Tips

TCPR: You run a screening clinic for adult ADHD at Queens University near Ottawa. You’ve had some interesting findings; can you describe them? Dr. Harrison: Sure. The people that I see are generally university students who think they have ADHD but who were never diagnosed. Most of them were referred by a family physician, a counselor, or an academ

Managing Pain: A Cognitive Behavioral Therapist’s Approach [Free Article]

Topics: Addiction | Pharmaceutical Industry | Practice Tools and Tips | Psychopharmacology Tips | Psychotherapy | Substance Abuse

Evaluating and Treating Pain in Psychiatric Patients

Topics: Addiction | Practice Tools and Tips | Psychopharmacology Tips | Psychotherapy | Substance Abuse

Managing Pain: A Cognitive Behavioral Therapist’s Approach

Topics: Addiction | Pharmaceutical Industry | Practice Tools and Tips | Psychopharmacology Tips | Psychotherapy | Substance Abuse

As a clinical psychologist with a specialty in chronic pain management, I am often referred patients with both chronic pain and psychiatric issues. Many of these patients see a psychiatrist and a therapist, and are taking with both psychotropic and pain medications. The referral is often made because there is a sense that psychological issues are compli

Five Psychoanalytic Concepts for Your Practice [Free Article]

Topics: Practice Tools and Tips | Psychotherapy

Citalopram Safety Warning Has Serious Consequences for VA Patients

Topics: Practice Tools and Tips | Psychopharmacology Tips | Research Updates

What’s New with the FDA Labeling for Pregnancy and Lactation?

Topics: Pharmaceutical Industry | Practice Tools and Tips | Psychopharmacology Tips | Women's Issues in Psychiatry

We’ve been hearing for some time now about the FDA’s plans to revise the long-standing categories A, B, C, D, and X designations for risk of using medications in pregnancy. The new rule (referred to as PLLR for Pregnancy and Lactation Labeling Rule) was proposed in 2008, finalized in 2014, and implementation began during the summer of 2015.

Psychopharmacology in Jails: An Introduction [Free Article]

Topics: Antidepressants | Antipsychotics | Anxiety Disorder | Free Articles | Gender & Sexuality | Practice Tools and Tips | Psychopharmacology Tips

Five Psychoanalytic Concepts for Your Practice

Topics: Practice Tools and Tips | Psychotherapy

Psychoanalytic training may not be right for you, but here are some analytic concepts that can be useful to anyone practicing psychiatry. ~ The unconscious: Patients are often unaware of patterns of behavior and their underlying conflicts. Unacceptable feelings like aggression and sadness may be banned from conscious thought, and therefore inaccessib

Anger, Anxiety, and Pain: A Description of an Analytic Session

Topics: Practice Tools and Tips | Psychotherapy

The patient is a 31-year-old, single female attorney, who was referred by her primary care physician for somatic complaints that have been worked up thoroughly, with normal results. In the past, she has been worried about and has pursued various diagnoses, including endometriosis, neurofibromatosis, and ovarian cancer, and has doctor-shopped when told h

The Experience of Correctional Psychiatry

Topics: Antidepressants | Antipsychotics | Anxiety Disorder | Gender & Sexuality | Practice Tools and Tips | Psychopharmacology Tips | PTSD

Psychopharmacology in Jails: An Introduction

Topics: Antidepressants | Antipsychotics | Anxiety Disorder | Gender & Sexuality | Practice Tools and Tips | Psychopharmacology Tips

If you are interested in part-time correctional work, the best place to start is often the local jail—as opposed to a prison. What’s the difference between the two? A jail is a criminal justice facility operated by a city or county. It houses people who are awaiting trial or who have received short sentences, typically one year or less. In c

Conduct Disorder and Oppositional Defiant Disorder: A Primer

Topics: Child Psychiatry | Cognitive Behavioral Therapy | Free Articles | Practice Tools and Tips | Psychotherapy

Vignette: Richie was a 15-year-old boy referred for evaluation after multiple run-ins with the police for drug possession, fighting, and shoplifting. Richie was the oldest of three boys and looked up to a gang-involved cousin who was in prison for drug trafficking. The patient was enrolled in multisystemic therapy (MST) for both treatment and further e

Telepsychiatry: What You Need to Know

Topics: Free Articles | Practice Tools and Tips

The Carlat Psychiatry Report last covered telepsychiatry back in 2010. At that point, it seemed like a cool technology that some of you might want to use. Since then, telemedicine in general has taken off, with an estimated 67% of physicians using or planning to use telehealth in their practices. The appeal of telemedicine is clear, especially for ps