Demystifying Psychiatry

A resource for patients and families.

by Charles Zorumski, M.D., and Eugene Rubin, M.D., Ph.D.

Does Gender Matter in the Addicted Brain’s Response to Stress?

Current research indicates that a person goes through three phases when developing a drug addiction and that particular brain regions are associated with each phase. Read More

Can Talk Therapy Help Persons with Schizophrenia?

Schizophrenia is a very disabling psychiatric illness affecting about 2 to 3 million Americans. Contrary to popular perception, it has nothing to do with a “split personality.” Read More

Binge Drinking in Young Adults and Older People

Many people binge drink, which is defined as having 5 or more drinks in a short period of time for men and 4 for women. Of major concern is binge drinking by college students, but adults do it, too. Read More

Treating Depression With Deep Brain Stimulation

A recent paper in the Archives of General Psychiatry, a leading psychiatric journal, describes a study investigating deep brain stimulation (DBS) for the treatment of depression. Read More

Marijuana, Spice, and Our Youth

Although marijuana may have some medical uses, the rapid surge in the number of people obtaining this drug via prescriptions suggests that recreational users might be taking advantage of the medical system. Read More

Excessive Amounts of Acetaminophen Can Be Fatal

Acetaminophen is a commonly used pain medication found in numerous over-the-counter and prescription preparations. It is often sold as Tylenol or a Tylenol derivative, but it is also found in other products such as Excedrin. When used according to directions, acetaminophen can be very effective for treating pain. Read More

Gut Bacteria and Your Emotions

It is well known that there are relationships between gastrointestinal (GI) disorders such as irritable bowel syndrome and psychiatric disorders including anxiety disorders. Read More

Depression: Relationship to Strokes, Heart Disease, and Other Illnesses

Clinical depressions are serious disorders not only because of their psychiatric consequences, but also because of their impact on physical health. A recent article in the Journal of the American Medical Association (JAMA) indicates that depression increases the risk for stroke (cerebrovascular accidents). Read More

The Medicalization of Marijuana

We were astounded to learn from a recent article in the American Journal of Psychiatry (AJP) about a dramatic increase in the number of persons who have registered to obtain medical marijuana in Colorado. Read More

What Has Neuroscience Done for Psychiatry Lately?

We have argued that psychiatry's clinical future is increasingly tied to an understanding of basic neurosciences. Some have challenged this notion and ask for examples of clinically relevant advances that have resulted from neuroscience research. Read More

The New Psychiatry

A major theme of our postings on Demystifying Psychiatry has been the importance of psychiatrists understanding brain structure and function, and becoming more conversant in modern neuroscience. Read More

What Is the Diagnosis?

Ms. X was a successful high school math teacher and was well liked by her students and co-workers. When she was 45 years old, her husband and children began noticing that she exhibited uncharacteristic lewd and rude behaviors. Read More

Bipolar Spectrum Disorder: A Problematic Concept

About 1% of our population suffers from "no doubt about it" bipolar affective disorder (bipolar I disorder). Persons with this disorder experience serious episodes of both depression and mania that can last for weeks to years. Read More

Do Personality Disorders Ever “Go Away?”

Personality disorders involve long term, problematic behaviors that typically are first exhibited during adolescence and cause marked distress and impairment. The very definition of personality disorders as "chronic maladaptive patterns of behavior" implies that symptoms are stable over time; however, recent studies indicate that symptoms improve and may even completely remit over the yea Read More

Good Psychiatrists Should...

Always be interested in learning more about their patients. Aim to keep medication regimens simple and stable. Spend enough time with patients to understand how their psychiatric disorder is influencing their lives and overall health. Realize that "informal therapy" is very powerful. Informal therapy includes caring, listening, and educating patients about their illness. Read More

Is Your Doctor Conducting a Drug Study?

Years ago, most drug trials were conducted in academic settings. This is no longer the case. Today, the majority of "clinical trials" investigating the efficacy and safety of new drugs are conducted by physicians practicing in the community. Pharmaceutical companies apparently find that community doctors are better able to meet recruitment goals in a timely manner and at lower Read More

How Many People Are Treated for Depression?

A recent paper in the Archives of General Psychiatry by Steven Marcus and Mark Olfson provides interesting data about recent trends in the treatment of depression. We thought it would be useful to review some of their findings. Read More

Religious Beliefs and Psychiatry

Should physicians be concerned about the religious or spiritual lives of their patients? Is such information relevant to medical care? Read More

The Most Harmful Abused Drug is ……?

What abused drug do you think is the most harmful? Do you think it's heroin, a drug that can cause a rush of pleasurable sensations and has strong addictive properties? Do you think it's crack cocaine, a drug that is associated with powerful feelings of well being and high energy and is also highly addictive? Read More

The Elderly and Psychiatric Drugs

As people age, they are more likely to deal with a variety of chronic medical conditions, including psychiatric disorders. Unfortunately, age does not protect a person from depression, bipolar disorder, schizophrenia, anxiety disorders, chronic pain disorders, and dementias. When used appropriately, medications can help treat such disorders. Read More

Can the Mentally Ill Be Hospitalized Against Their Will?

Can people with mental disorders be hospitalized against their will? The short answer is "yes," but only under specific circumstances. Read More

Will Increasing the Number of US Medical Students Translate into More Practitioners?

Recently, there has been movement towards substantial growth in the number of medical schools and in the number of medical students training in the US. About 15-18 new schools may be added to the 131 current schools. Also, medical schools have been encouraged to increase their enrollment. Read More

Possible New Therapeutic Uses for Recreational Drugs

A recent study suggests that "ecstasy," a commonly abused psychedelic drug, may help patients with chronic post traumatic stress disorder (PTSD). Other research suggests that ketamine (an anesthetic drug with similarities to angel dust or PCP) may help patients with treatment-resistant depression. What is going on here? Read More

Are All Relationships between the Pharmaceutical Industry and Academia Bad?

There are a variety of complex relationships between academic medical centers and the pharmaceutical industry. Before exploring issues related to industry support of basic and clinical research performed at academic medical centers, we want to clearly state our opinions regarding financial relationships between academic faculty members and industry. Read More

Is this Behavior Normal or Does It Suggests the Presence of an Illness?

In our book Demystifying Psychiatry, we define psychiatry as "the medical specialty that deals with disorders of the human mind and behavior." Some psychiatric patients have thoughts, feelings, or behaviors that most people would consider outside the boundaries of normal. Read More

Psychologists and Prescribing Privileges

Psychiatry is one of several medical specialties experiencing a physician shortage. Simply put, there are not enough psychiatrists to provide high quality care to the large number of individuals in need of services, particularly individuals living in disadvantaged inner cities and rural areas. Read More

The Human Brain Connectome and Psychiatry

Recently, there has been major progress in identifying brain systems associated with complex behavioral and mental functions. We believe that this work is relevant to clinical psychiatry because abnormalities occurring in specific brain systems are responsible for psychiatric symptoms and disorders. Read More

How Do We Utilize the Limited Number of Psychiatrists Most Effectively?

Over the next several decades, there will be a significant decrease in the number of psychiatrists per 100,000 people in the United States. Even now, there are not enough psychiatrists to provide care for the large number of patients with significant psychiatric illnesses. Read More

Is the Training of a Psychiatrist More Like That of a Neurologist or a Psychologist?

Recently, one of us was asked about the differences between a psychiatrist and a neurologist. This was an interesting question because over the years, many people have asked us about the differences between a psychiatrist and a psychologist. Read More

Can Your Brain Have Alzheimer’s Disease, But You Don’t Show Symptoms?

Can a person have the pathological brain changes associated with Alzheimer's disease and, yet, be totally without symptoms? If so, is there a way to determine if a person's brain has such changes? And if such changes are found, can the illness be stopped in its tracks before further changes lead to clinical symptoms? Read More

Eugene Rubin, M.D., Ph.D., is Professor and Vice-Chair for Education in the Department of Psychiatry at Washington University in St. Louis - School of Medicine.

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