Collections A Primer on Psychiatry

A Primer on Psychiatry

Created for Psychiatric residents. Useful for any interested mental health professional.
Kenneth S Kendler, Kathryn Tabb, John Wright
Western psychiatry emerged as a medical specialty caring for the mentally ill over the course of the late 18th and early 19th centuries. This emergence was a contingent process, dependent on the co-occurrence of three historical developments that together shaped the young discipline. The first was the rise of the mind as an entity with numerous active faculties in the conceptual space between the body and the Christian soul. Only by the latter half of the 18th century was it common to conceptualize conditions like mania or melancholy as mental illnesses...
May 2022: American Journal of Psychiatry
Chittaranjan Andrade
The half-life of a drug is most commonly defined as the time taken for the plasma or blood level of the drug to fall by half. Elimination half-life, pharmacologic half-life, and biologic half-life are interchangeably used most commonly to describe the half-life of drugs that follow first-order or linear pharmacokinetics; that is, in single-compartment models, where the fall in blood level is proportionate to the concentration of the drug in blood. In 2 compartment models, where the drug equilibrates between blood and (for example) adipose tissue, during elimination there is a sharp initial fall in blood levels followed by a gradual subsequent fall; when drugs display this biphasic elimination pattern, the half-life corresponding to the second phase is what is clinically relevant, and this half-life is known as the terminal half-life...
July 25, 2022: Journal of Clinical Psychiatry
Jo Ellen Wilson, Matthew F Mart, Colm Cunningham, Yahya Shehabi, Timothy D Girard, Alasdair M J MacLullich, Arjen J C Slooter, E Wesley Ely
Delirium, a syndrome characterized by an acute change in attention, awareness and cognition, is caused by a medical condition that cannot be better explained by a pre-existing neurocognitive disorder. Multiple predisposing factors (for example, pre-existing cognitive impairment) and precipitating factors (for example, urinary tract infection) for delirium have been described, with most patients having both types. Because multiple factors are implicated in the aetiology of delirium, there are likely several neurobiological processes that contribute to delirium pathogenesis, including neuroinflammation, brain vascular dysfunction, altered brain metabolism, neurotransmitter imbalance and impaired neuronal network connectivity...
November 12, 2020: Nature Reviews. Disease Primers
Margo D M Faay, Iris E Sommer
No abstract text is available yet for this article.
March 1, 2021: American Journal of Psychiatry
George A Keepers, Laura J Fochtmann, Joan M Anzia, Sheldon Benjamin, Jeffrey M Lyness, Ramin Mojtabai, Mark Servis, Art Walaszek, Peter Buckley, Mark F Lenzenweger, Alexander S Young, Amanda Degenhardt, Seung-Hee Hong
No abstract text is available yet for this article.
September 1, 2020: American Journal of Psychiatry
Michael Marshall
No abstract text is available yet for this article.
May 2020: Nature
Glen O Gabbard
No abstract text is available yet for this article.
June 2020: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
D L Rosenhan
It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals. The hospital itself imposes a special environment in which the meanings of behavior can easily be misunderstood. The consequences to patients hospitalized in such an environment-the powerlessness, depersonalization, segregation, mortification, and self-labeling-seem undoubtedly countertherapeutic. I do not, even now, understand this problem well enough to perceive solutions. But two matters seem to have some promise. The first concerns the proliferation of community mental health facilities, of crisis intervention centers, of the human potential movement, and of behavior therapies that, for all of their own problems, tend to avoid psychiatric labels, to focus on specific problems and behaviors, and to retain the individual in a relatively non-pejorative environment...
January 19, 1973: Science
Charles F Zorumski
No abstract text is available yet for this article.
February 1, 2020: JAMA Psychiatry
Giovanni A Fava, Fiammetta Cosci
Withdrawal symptoms commonly occur during tapering and/or after discontinuation of antidepressant drugs, particularly selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. Withdrawal symptomatology does not necessarily subside within a few weeks and may be associated with other manifestations of behavioral toxicity (loss of treatment efficacy, refractoriness, switch into mania/hypomania, or paradoxical reactions). The oppositional model of tolerance provides a pathophysiologic basis for understanding and managing withdrawal syndromes...
November 26, 2019: Journal of Clinical Psychiatry
Caleb Gardner, Arthur Kleinman
New England Journal of Medicine, Volume 381, Issue 18, Page 1697-1699, October 2019.
October 31, 2019: New England Journal of Medicine
Robert A McCutcheon, Tiago Reis Marques, Oliver D Howes
IMPORTANCE: Schizophrenia is a common, severe mental illness that most clinicians will encounter regularly during their practice. This report provides an overview of the clinical characteristics, epidemiology, genetics, neuroscience, and psychopharmacology of schizophrenia to provide a basis to understand the disorder and its treatment. This educational review is integrated with a clinical case to highlight how recent research findings can inform clinical understanding. OBSERVATIONS: The first theme considered is the role of early-life environmental and genetic risk factors in altering neurodevelopmental trajectories to predispose an individual to the disorder and leading to the development of prodromal symptoms...
February 1, 2020: JAMA Psychiatry
Jari Tiihonen, Antti Tanskanen, Heidi Taipale
OBJECTIVE: It is generally believed that after the first episode of schizophrenia, the risk of relapse decreases with time in patients who are stabilized. Many treatment guidelines recommend that after stabilization, antipsychotic treatment should be continued for 1-5 years, and longer exposure should be avoided if possible. However, there is no published evidence to substantiate this view. The authors used nationwide databases to investigate this issue. METHOD: Prospectively gathered nationwide register data were used to study the risk of treatment failure (psychiatric rehospitalization or death) after discontinuation of antipsychotic treatment...
August 1, 2018: American Journal of Psychiatry
Kathleen Ries Merikangas, Jian-Ping He, Marcy Burstein, Sonja A Swanson, Shelli Avenevoli, Lihong Cui, Corina Benjet, Katholiki Georgiades, Joel Swendsen
OBJECTIVE: To present estimates of the lifetime prevalence of DSM-IV mental disorders with and without severe impairment, their comorbidity across broad classes of disorder, and their sociodemographic correlates. METHOD: The National Comorbidity Survey-Adolescent Supplement NCS-A is a nationally representative face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview...
October 2010: Journal of the American Academy of Child and Adolescent Psychiatry
Ronald C Kessler, Wai Tat Chiu, Olga Demler, Kathleen R Merikangas, Ellen E Walters
BACKGROUND: Little is known about the general population prevalence or severity of DSM-IV mental disorders. OBJECTIVE: To estimate 12-month prevalence, severity, and comorbidity of DSM-IV anxiety, mood, impulse control, and substance disorders in the recently completed US National Comorbidity Survey Replication. DESIGN AND SETTING: Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using a fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview...
June 2005: Archives of General Psychiatry
Wilson M Compton, Yonette F Thomas, Frederick S Stinson, Bridget F Grant
BACKGROUND: Current and comprehensive information on the epidemiology of DSM-IV 12-month and lifetime drug use disorders in the United States has not been available. OBJECTIVES: To present detailed information on drug abuse and dependence prevalence, correlates, and comorbidity with other Axis I and II disorders. DESIGN, SETTING, AND PARTICIPANTS: Face-to-face interviews using the Alcohol Use Disorder and Associated Disabilities Interview Schedule of the National Institute on Alcohol Abuse and Alcoholism in a large representative sample of US adults (N=43093)...
May 2007: Archives of General Psychiatry
R C Kessler, K A McGonagle, S Zhao, C B Nelson, M Hughes, S Eshleman, H U Wittchen, K S Kendler
BACKGROUND: This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. METHODS: The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview...
January 1994: Archives of General Psychiatry
William W Eaton, Kimberly B Roth, Martha Bruce, Linda Cottler, Litzy Wu, Gerald Nestadt, Dan Ford, O Joseph Bienvenu, Rosa M Crum, George Rebok, James C Anthony, Alvaro Muñoz
Subjects from the Epidemiologic Catchment Area Program, interviewed during 1979-1983, were linked to data in the National Death Index through 2007 to estimate the association of mental and behavioral disorders with death. There were more than 25 years of follow-up for 15,440 individuals, with 6,924 deaths amounting to 307,881 person-years of observation. Data were analyzed by using age as the time scale and parametric approaches to quantify the years of life lost due to disorders. Alcohol, drug use, and antisocial personality disorders were associated with increased risk of death, but there was no strong association with mood and anxiety disorders...
November 1, 2013: American Journal of Epidemiology
K S Kendler
In 1800, mania was conceptualized as an agitated psychotic state. By 1900, it closely resembled its modern form. This paper reviews the descriptions of mania in Western psychiatry from 1880 to 1900, when Kraepelin was training and developing his concept of manic-depressive illness. Psychiatric textbooks published 1900-1960 described 22 characteristic manic symptoms/signs the presence of which were recorded in 25 psychiatric textbooks and three other key documents published 1880-1900. Descriptions of mania in these nineteenth century textbooks closely resembled those in the twentieth century, recording a mean (s...
July 2018: Psychological Medicine
Manuel J Cuesta, Victor Peralta
No abstract text is available yet for this article.
October 1, 2016: JAMA Psychiatry
2017-08-18 01:52:04
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