Demystifying Psychiatry

A resource for patients and families

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

A Possible New Class of Antidepressants

Recent advances in knowledge about the generation of new brain cells throughout the lifespan are leading to the development of new drugs to treat neuropsychiatric illnesses.

Cognitive Impairment in Depression

Cognitive symptoms of depression may not respond well to treatment with antidepressant medications.

Three Phases of Addiction

Strong evidence suggests that addiction is a brain disease. Three stages of addiction involving changes in specific brain regions have been elucidated.

The Importance of Insight

Decreased insight is a frustrating aspect of many psychiatric disorders. Elucidating the mechanisms underlying insight may lead to better compliance with treatment recommendations.

The Relationship Between Schizophrenia and Dementia

In a recent study, schizophrenia was associated with a higher risk of developing dementia at an earlier age. Co-morbid medical conditions did not account for this elevated risk.

Why Do People With Schizophrenia Die Prematurely?

On average, individuals with schizophrenia die more than 25 years earlier than the general population. Both natural and unnatural causes are responsible for these premature deaths.

Alcohol and Marijuana

Alcohol and marijuana use disorders are common. Some individuals use both drugs simultaneously. With the increased use of both drugs, will it be more dangerous on the roads?

What Is Happening to Middle-Aged White People in the U.S.?

Previously decreasing mortality rates have reversed for 45- to 54-year-old white men and women in the U.S. due in large part to higher suicide rates and more accidental overdoses.

Creativity and Psychiatric Illnesses

Small effects of many genes may increase the risk of bipolar disorder and schizophrenia. Some of these same genes may also contribute to creativity. Increased creativity may be helpful in terms of human evolution.

One Potential Cause of Postpartum Psychosis

Postpartum psychosis is a serious disorder that can be treated effectively. A recent study demonstrates that about 4% of persons with postpartum psychosis may have an illness known as autoimmune encephalitis.

How Many Children and Adolescents Take Antipsychotics?

Antipsychotics are being prescribed to over 1% of boys and nearly 0.5% of girls between the ages 7 and 12. Most often, these drugs are used in combination with other psychoactive drugs. Decisions about using such drugs can be difficult especially when data are limited regarding their benefit and there is the potential for long-term risks.

What Happens to Children with Behavioral Disorders?

Children with common behavioral disorders can have compromised abilities in everyday functioning when they become young adults. Adult function may be compromised even in those children who outgrow clinical childhood symptoms and syndromes.

Do Kids With ADHD Grow Into Adults With ADHD?

Most children with ADHD do not grow up to become adults with ADHD. Most adults with ADHD did not have ADHD as children. ADHD in youngsters and adults may really be two different illnesses that have similar symptoms.

Does Chronic Anxiety Increase Dementia Risk in the Elderly?

People who develop Alzheimer’s disease have abnormal proteins accumulating in their brains decades prior to the appearance of symptoms. Individuals who have an anxiety disorder during the pre-symptomatic phase of dementia display more rapid cognitive deterioration than non-anxious individuals.

How Many People Take Benzodiazepines?

Benzodiazepines can be helpful in treating anxiety and insomnia. These medications are used more often by elderly adults than by younger people even though there are increased safety concerns with use by older individuals.

Should Elective Surgery Be Delayed for Very Young Children?

Accumulating evidence supports the possibility that general anesthetics have adverse effects on brain development in very young children. A recent New England Journal of Medicine editorial suggests that parents and doctors consider the risks and benefits of delaying elective surgery until children are 3 years old or older.

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.