Pain Medications, Heroin, and You

Prescription opiates can be very useful in the treatment of pain; however, opiate abuse is an increasing problem leading to addiction and premature death. More people are making the transition from using prescription pain medications to abusing heroin, and middle class young people are now the common faces of heroin addiction.

Criminality and Dementia

Criminal behaviors that begin in mid or late life may be a consequence of dementia. The types of crimes committed by persons with Alzheimer’s disease differ from those committed by persons with frontotemporal dementia.

Laughing Gas as a Treatment for Depression?

Nitrous oxide (aka “laughing gas”) is an anesthetic and analgesic often administered by dentists to minimize discomfort during dental procedures. Investigators recently reported that this drug may be helpful in treating severe depression.

Can Brain Magnetic Stimulation Help People Quit Smoking?

Less than 10% of people who attempt to quit smoking are successful. High frequency, but not low frequency, transcranial magnetic stimulation is reported to more than triple the success rate of quitting.

Is Your Brain the Same after Hospitalization in the ICU?

About 25% of patients recovering from serious illnesses that required hospitalization in an intensive care unit have cognitive dysfunction involving memory and attention that persists long after hospitalization.

An Experimental Medication to Treat Social Anxiety Disorder

A new type of medication is reported to be highly effective at diminishing symptoms of social anxiety disorder. This drug is administered as a nasal spray and appears to work quickly without need for chronic administration.

What happens to depressed preschoolers over time?

Preschool-aged children can develop depressive symptoms, and about half of these children develop major depression when they reach school age. Preschool depression also is associated with anxiety disorders and ADHD in school-aged children.

A New England Journal of Medicine Article about Marijuana

With increased availability of marijuana, more young people are likely to use and abuse this drug. Some of the medical and societal consequences associated with increased use are discussed in a recent medical review.

Can Antidepressants Help Prevent Alzheimer Disease?

A commonly used antidepressant appears to substantially decrease the production of beta amyloid, a substance involved in the pathology of Alzheimer disease. Inhibiting amyloid build-up during the “silent” phase of the illness might delay onset of symptoms. More research is needed to find out whether this is so.

Psychiatry Is in the Midst of Major Transformation

The need to utilize psychiatrists’ expertise more efficiently is leading to changes in mental health care delivery. New knowledge about the brain is leading to new ways to diagnose and treat psychiatric illnesses. Changes in medical education should improve treatment of mentally ill individuals. Psychiatry is undergoing major transformations as a clinical discipline.

High-Dose, Short-Term Psychotherapy

We discuss a clinical trial demonstrating that cognitive therapy administered intensively over 5 to 7 days works as well as cognitive therapy administered weekly over 3 months in reducing PTSD symptoms.

Stressors and Suicidal Behavior

Major life events had only a modest influence on suicidal behaviors during a 2-year follow-up of persons with major depression. In depressed individuals with borderline personality disorder, stressful life events did not predict suicidal behaviors.

Brain Dysfunction Common to Schizophrenia & Bipolar Disorder

Researchers have found that persons with psychotic symptoms have abnormalities in the function of a brain system that helps people balance their internal ("daydreaming") world with their ability to focus attention on external tasks.

Physicians Who Take Their Own Lives

The rate of suicide is higher among physicians than among the general population, and the factors predisposing to suicide appear to differ between these two groups. We discuss research that examines the relationship of these predisposing factors to physician and non-physician suicides.

Large Increase in Suicide Rates Among 35 to 64 Year Olds

A recent report by the Centers for Disease Control and Prevention shows a substantial increase in the suicide rate of persons 35 to 64 years old. No increase in suicide rates were observed in younger or older age groups. Suicide accounts for more deaths than motor vehicle accidents. Why might suicides be increasing in middle-aged people?

Excessive Drinking Among High School Seniors

Twenty percent of high school seniors say they have engaged in binge drinking during the previous 2 weeks. Ten percent admitted drinking 10 or more beers during a binge and about 5% downed 15 or more beers in a row.

Rewiring the Brain to Eliminate Fear

Brain cells routinely change their connections to other brain cells. The patterns of these connections influence all aspects of mental function including learning, memory, and emotions. Behavioral treatments for phobias and anxiety disorders may work better when they are administered together with a pulse of medication that influences the molding of cell connections.

The Financial Cost of Dementia

The costs associated with dementia are staggering. Most are not covered by insurance, and patients, together with their loved ones, pay out of pocket. We review a recent study that examines these costs. Delaying the onset of Alzheimer's disease would have a substantial impact on the economic burden.

Obesity, Addiction, and Personalized Medicine

As we learn more about the regulation of food intake, a variety of causes for obesity are being identified. Some people are thought to develop an addiction to food that has some similarities to drug addiction. Tools are becoming available to aid in determining specific causes of obesity. Once specific causes are determined, personalized treatments can be developed.

Stopping Drug Use, Once Started

A recent study looked at illicit drug use over a 3-year period. Nearly 5% of those who were initially abstinent began using drugs during the study; over half of these people developed problematic drug use behaviors. On the other hand, about half of those exhibiting problematic drug use behaviors at the beginning of the study stopped abusing drugs over the study period.

Recent Findings Related to Fibromyalgia

Fibromyalgia is a complex disorder with distressing physical and behavioral symptoms. Recent research demonstrates abnormalities in a specific type of nerve fiber. This work helps clarify the nature of this painful disorder.

Can a Blood Pressure Medicine Help Treat Psychotic Symptoms?

We discuss a provocative new study demonstrating that a single 4-hour infusion of sodium nitroprusside, a drug used in emergency situations to treat high blood pressure, substantially decreased acute psychotic symptoms in patients with schizophrenia.

Persons with Psychiatric Illnesses Die Prematurely

People suffering from a variety of psychiatric illnesses die years earlier than those without psychiatric illness. These early deaths commonly result from heart disease, strokes, and cancer. Suicides account for about 14% of excess deaths.

A Recently Described Autoimmune Illness and Psychiatry

In her book "Brain on Fire: My Month of Madness," Susannah Cahalan describes her battle with a recently discovered neuropsychiatric illness. This disorder may occur more often than originally thought and may have significant implications for the field of psychiatry.

Suicidal Behaviors in Adolescents

We review several issues regarding suicidal behaviors in adolescents, including the age of onset and progression of such behaviors. We discuss whether these behaviors are associated with psychiatric disorders and whether adolescents with such behaviors have been seen by someone in the mental health system.

Bipolar Disorder and Schizophrenia—Similar and Different

Schizophrenia and bipolar disorder are characterized by different clinical symptoms. Recent research indicates that there are abnormalities in the interactions between brain regions that are unique to each disorder and other interactions that are shared by both.

Safely Prescribing Antipsychotic Medications

The use of antipsychotic medications has increased substantially over the last decade. Decisions about whether to prescribe them for particular patients should involve doctors, patients, and, when appropriate, family members.

Opiate Medications: Pain Management Versus Addiction

Although powerful medications such as opiates are often necessary to treat acute and chronic pain, opiates are highly addictive. Physicians may be inadvertently contributing to the increasing problem of opiate addiction through efforts to keep their patients pain free. What can be done about this?

Phone Therapy for Depression

Can cognitive behavioral therapy be successfully administered over the phone? Thinking out-of-the-box and out-of-the-office may lead to creative and effective ways of helping more people with the limited mental health resources that currently exist.

Public Health Enemy No. 1

Sixteen percent of the US population 12 years of age and older report being addicted to legal or illicit substances. What is the public health impact of these behaviors?