tag:blogger.com,1999:blog-5098825386524965392011-07-30T13:45:59.941-04:00The Couch in CrisisPsychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.comBlogger371100tag:blogger.com,1999:blog-509882538652496539.post-82104770692669631532010-01-19T15:57:00.000-05:002010-01-19T15:57:14.031-05:00

When a soldier is killed while in the military service the President writes a condolence letter to the family. However, if a soldier is psychologically injured and then commits suicide, there is no Presidential letter of condolence. There is apparently an unwritten policy that this does not include families of soldiers who have committed suicide. It is easy to imagine how hurtful that must be

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com1tag:blogger.com,1999:blog-509882538652496539.post-82295608583939909732010-01-12T15:14:00.001-05:002010-01-12T15:15:17.636-05:00

In a very long essay in the Sunday (1/10/10) New York Times Magazine, entitled, “The Americanization of Mental Illness,” Ethan Watters suggests that a kind of psychiatric-cultural imperialism has been foisted on other countries and cultures by “the West.” Specifically, Watters claims that, “For more than a generation now, we in the West have aggressively spread our modern knowledge of mental

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com1tag:blogger.com,1999:blog-509882538652496539.post-18803596737194999952010-01-06T10:16:00.004-05:002010-01-07T10:18:14.001-05:00

I don’t know how many psychiatrists paid much attention to the climate-change conference in Copenhagen last month, but I came away convinced they need our help. Here’s why. Given the scientific consensus that human behavior is the major cause of the planet’s undesired warming, who better to understand the roots, manifestations, repercussions, and treatment of that behavior? But like much of our

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-7966686898307775352009-12-15T15:22:00.007-05:002009-12-15T16:53:02.933-05:00

Hired guns.” “Whores.” “Greedy, insensitive bastards. “ These are some of the more printable epithets used to describe psychiatric physicians who (allegedly) have “sold out to Big Pharma” ”—for example, by failing to disclose conflicts of interest, or to report large sums of money earned through their work with pharmaceutical companies. It may surprise some—but perhaps not many—that these terms

Susan Kweskinhttp://www.blogger.com/profile/06327532325495981699noreply@blogger.com1tag:blogger.com,1999:blog-509882538652496539.post-26219308762198508922009-11-30T10:25:00.003-05:002009-11-30T14:25:56.273-05:00

Psychosurgery. For some, the word connotes all the promising therapeutic applications of modern neuroscience; for others, it connotes all the baneful excesses of unregulated pseudoscience. In his recent front page story for the New York Times (Nov. 27), Benedict Carey presented a balanced and nuanced view of what is sometimes termed “psychiatric neurosurgery,” focusing mainly on cingulotomy,

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-5032420636356901892009-10-29T12:12:00.005-04:002009-11-06T11:46:43.460-05:00

The press reported it in various ways—either as a “brutal gang rape” or, more forensically, as a “2½-hour assault” on the Richmond High School campus. Anyway you look at it, the horrendous attack on a 15-year old girl raises troubling questions for theologians, criminologists, and, of course, psychiatrists. How do we understand an act as brutal as rape? What factors and forces in the rapist’s

Susan Kweskin, Editornoreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-1093653145967921182009-10-27T14:57:00.009-04:002009-10-28T09:51:36.638-04:00

I read with interest the posts of Dr John Grohol, PsyD regarding my commentary, "Twitter and YouTube: Unanticipated Consequences of the Self-Esteem Movement.” I had hoped it would bring attention to this topic and am glad that this has opened up an important dialogue. However, the author has missed the point. It was not my intention to blame the internet for creating more narcissists or for

Susan Kweskin, Editornoreply@blogger.com4tag:blogger.com,1999:blog-509882538652496539.post-43843611158684359092009-10-22T14:49:00.001-04:002009-10-22T14:52:43.078-04:00

When I thought of writing this letter, I was put in mind of Jean-Jacques Dessalines (1758 – 1806), the Emperor of the tiny nation of Haiti, writing to the most powerful man of that time, Napoleon Bonaparte. Like Dessalines, I am a grain of sand standing next to the huge mountain of the psychiatric establishment. Fortunately, there is Psychiatric Times (PT), which allows a "half-island nation"

Susan Kweskin, Editornoreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-88933771522381294322009-10-16T17:02:00.001-04:002009-10-16T17:06:31.045-04:00

Congratulations to Dr Alan A. Stone for taking the time to nail the bias contained in the Supplement discussed in his piece, “Reality-Checking: Case In Point.” And congratulations to Psychiatric Times for printing Dr Stone’s article. Perhaps PT is ready to take further steps in separating itself from the "educational efforts" sponsored by pharmaceutical companies that have so deeply corrupted the

Susan Kweskin, Editornoreply@blogger.com1tag:blogger.com,1999:blog-509882538652496539.post-30802364012082974812009-09-17T17:43:00.001-04:002009-09-17T17:46:19.046-04:00

I read the article by Dr Frances and was impressed by its intelligence. I then read the response by the APA in the person of Dr Schatzberg et al. I was shocked by its sleazy attack on Dr Frances’ integrity. Dr Frances was accused of arguing because of anticipated personal financial gain. The accusation that Dr Frances was arguing ad hominem was the pot calling the kettle black. The whole

Susan Kweskin, Editornoreply@blogger.com2tag:blogger.com,1999:blog-509882538652496539.post-44025277898128845972009-09-16T12:32:00.003-04:002009-09-16T12:37:24.040-04:00

We were surprised to read of the open letter by Drs Frances and Spitzer regarding the creation of DSM-V. Over time we have been puzzled by a succession of Diagnostic and Statistical Manuals, and have been forced to conclude the long-term purpose of the DSM is to abolish mental illness from American society. Currently only half of all Americans fit the criteria in DSM-IV to be diagnosed with one

Susan Kweskin, Editornoreply@blogger.com1tag:blogger.com,1999:blog-509882538652496539.post-50920177606259334382009-09-03T16:10:00.007-04:002009-09-03T17:02:14.942-04:00

The APA DSM-V Task Force’s response to Dr. Frances’s critique of DSM-V noted that his royalties for DSM-IV products would cease when DSM-V is published. However, Dr. Frances’ critique called for DSM-V developers to make fewer changes- - not more, and he made no call for longer DSM-V field trials; in fact he proposed additions such as prodromal and subthreshold syndromes to be put in an appendix

Susan Kweskin, Editornoreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-38558752212906643162009-09-03T15:43:00.002-04:002009-09-03T15:52:20.411-04:00

I agree with Drs Schatzberg, Scully, Kupfer and Regier. In my busy clinical practice, I do not see DSM-IV doing justice to clinical reality. Less than 25% of my patients have a genuinely good syndromatic fit with specific DSM diagnoses. With diagnostic criteria strictly applied, I find myself with numerous NOS diagnoses with little in terms of treatment or prognosis utility. Preserving the

lauriehttp://www.blogger.com/profile/07191992926945173560noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-81183734324947613412009-09-02T11:37:00.005-04:002009-09-09T14:48:12.154-04:00

In response to Dr. Johnson’s post, “Like Writing a Letter to Santa Claus,” UK Patient Advocate Suzy Chapman notes that Web-based platforms like Wiki and Facebook are likely to be viewed as little more than token nods in the direction of transparency and stakeholder participation.[Note: Comment slightly edited from original.]In June of this year, I raised inquiries with the DSM-V Task Force in

lauriehttp://www.blogger.com/profile/07191992926945173560noreply@blogger.com1tag:blogger.com,1999:blog-509882538652496539.post-6413340212027518942009-09-01T14:34:00.001-04:002009-09-01T14:36:11.087-04:00

I read the article by Dr Frances and was impressed by its intelligence. I then read the response by the APA in the person of Dr Schatzberg et al. I was shocked by its sleazy attack on Dr Frances’ integrity. Dr Frances was accused of arguing because of anticipated personal financial gain. The accusation that Dr Frances was arguing ad hominem was the pot calling the kettle black. The whole business

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-76978422635981090802009-09-01T14:29:00.004-04:002009-09-02T10:20:47.489-04:00

A reader sent us a note regarding his experiences in providing feedback to the DSM-V committee: "I responded to the chance to upload to the DSM-V website an article I published with suggested DSM-V criteria for addiction - perhaps 6 months ago. There was never a response. My comments went off into cyberspace. I had my administrator try to follow up with a call to the head of the DSM-V committee,

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com2tag:blogger.com,1999:blog-509882538652496539.post-23619818982225427462009-09-01T14:15:00.000-04:002009-09-01T14:15:47.381-04:00

Thank you Dr. Frances for making explicit what has been an implicit, sad trend in our profession. I also believe we have slowly sold out to the pharmaceuticals. Perhaps, first, it was to legitimize ourselves as part of "real" medicine. I could have lived with the psychiatry of twenty or even ten years ago. The pens, dinners, and drug samples did not pose any heart-wrenching ethical dilemmas for

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-86077421977137266412009-08-26T17:02:00.003-04:002009-08-26T17:13:02.770-04:00

In a 138-page report released on Wednesday, August 5th, the American Psychological Association said that there is little evidence to suggest that efforts to change a person's sexual orientation from gay or lesbian to heterosexual are successful. In fact, such efforts can cause harm. The findings of the American Psychological Association Task Force of Appropriate Therapeutic Responses to Sexual

Natalie Timoshinhttp://www.blogger.com/profile/09879699348361784658noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-46529935282594497122009-08-26T16:47:00.003-04:002009-08-26T17:00:34.956-04:00

The New York Times recently reported that the US Army plans to provide intensive mental stress training for its troops. In an effort to reduce potential mental health problems such as depression, posttraumatic stress disorder, and suicide, the US Army will require that all active-duty soldiers, reservists, and members of the National Guard undergo stress training. The training will also be

Natalie Timoshinhttp://www.blogger.com/profile/09879699348361784658noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-55016305349354234502009-08-10T10:57:00.003-04:002009-08-10T11:09:52.197-04:00

Thank you Psychiatric Times for your eulogies to the fallen mental health workers and patients at Camp Liberty last month ("Death of Psychiatrist and Other Soldiers Triggers Inquiry Into Military's Mental Health Care", July 2009). Dr Houseal and Springle were truly dedicated humanitarians and patriots. I extend my condolences to their families and the families of the fallen patients as well.I am

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-23245517335843714262009-08-04T15:15:00.002-04:002009-08-04T15:42:44.605-04:00

You know the drill, but in case you have repressed it, the antipsychiatry mantra goes something like this: “Real” disease is present only when we can point to a lump, bump, or lesion—or at least, to a specific physiochemical abnormality in association with a specific set of signs and symptoms. Anything else that we call “disease” is simply a label—a “social construct” akin to terms like “

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com2tag:blogger.com,1999:blog-509882538652496539.post-59024575233292934122009-07-30T11:38:00.003-04:002009-07-30T12:12:55.321-04:00

It is troubling to discover demonizing polarization in discussions of DSM-V. It has been bad enough witnessing such primitive splitting in our political life.While Dr. Frances (“A Warning Sign on the Road to DSM-V: Beware of Its Unintended Consequences,” Psychiatric Times, June 26, 2009) raises legitimate concerns regarding the "unintended consequences" of major diagnostic reform, he never fully

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com1tag:blogger.com,1999:blog-509882538652496539.post-81974536832799043892009-07-21T11:34:00.003-04:002009-07-22T16:54:49.183-04:00

Dr Stephen Rosenblum, Life Fellow, APA writes:"I found the American Psychiatric Association's response ("Setting the Record Straight", Psychiatric Times, July 1,2009) to Dr. Alan Frances's commentary ("A Warning Sign on the Road to DSM-V", Psychiatric Times, June 26, 2009) outlining his concerns about the DSM-V an embarrassing, black mark against the Association. As President of an organization

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-2442765043637014452009-07-16T12:10:00.002-04:002009-07-16T12:13:51.104-04:00

You have read the blogs and seen the placards a dozen times: doctors prescribe too many “drugs” for too many patients. Psychiatrists, in particular, are popular targets of politically-motivated language that seeks to conflate the words “medication” and “drug”—thereby tapping into the public’s understandable fears concerning “drug abuse” and our need to carry out a “War on Drugs”. Misleading radio

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-33534280481206263912009-07-14T11:12:00.004-04:002009-07-14T11:29:34.186-04:00

Dr Jane Costello, PhD, professor in the department of psychiatry and behavioral sciences at Duke University and former DSM-V Workgroup member resigned from the Child and Adolescent Workgroup in March after feeling that the development of the new edition was off-track. Dr Costello shared the letter she sent to Workgroup leader, Danny Pine, MD (NIMH). A copy of the letter she sent follows.Dear

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com1tag:blogger.com,1999:blog-509882538652496539.post-56676121610147551082009-07-08T15:31:00.002-04:002009-07-08T15:55:46.270-04:00

Drs Spitzer and Frances sent over the following in response to Dr Renato Alarcon's article, "Inside the DSM-V Process: Issues, Debates, and Reflections" (Psychiatric Times, July 2009, p 1).We have no argument at all with any of the DSM-V work group members, all of whom undoubtedly have the best of intentions and are working hard to do a good job in revising the diagnostic system. Indeed, we are

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-8890246817690062112009-07-06T15:16:00.003-04:002009-07-08T09:54:37.949-04:00

Psychiatric Times is collecting a library of images to use to illustrate our articles in print or online.If you would like your artwork to be considered for inclusion in our image library, please e-mail us a high-resolution file (TIFF, JPG, EPS, PDF - no more than 10mb) along with the title of the work and the medium used. Images will be reviewed by the editors and accepted art will be used

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-54789671389355079602009-07-02T10:48:00.004-04:002009-07-02T10:56:23.322-04:00

On Wednesday, the APA submitted a formal response to Dr. Frances' commentary, "A Warning Sign on the Road to DSM-V: Beware of Its Unintended Consequences Here's an excerpt:"The process for developing DSM-V has been the most open and inclusive ever. The process began with a planning session that led to 13 NIH-supported international research conferences and a series of monographs. These

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com2tag:blogger.com,1999:blog-509882538652496539.post-18942283493695037682009-06-30T10:39:00.003-04:002009-06-30T10:54:02.050-04:00

The compelling article, "A Warning Sign on the Road to DSM-V," by Dr. Allen J. Frances,inspired me to pull a brittle, yellowed old tome off my bookshelf. Warren’s Household Physician, based on the work of Massachusetts physician, Dr. Ira Warren, was first published in 1859 as a “brief description, in plain language, of all the diseases of men, women and children . . .”. The chapter titled, “

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com2tag:blogger.com,1999:blog-509882538652496539.post-14577741185669424502009-06-29T11:29:00.005-04:002009-06-29T12:17:51.927-04:00

Chair of DSM-IV Task Force, Dr Allen Frances, has written a commentary, "A Warning Sign on the Road to DSM-V: Beware of Its Unintended Consequences." Here's an excerpt:"We should begin with full disclosure. As head of the DSM-IV Task Force, I established strict guidelines to ensure that changes from DSM-III-R to DSM-IV would be few and well supported by empirical data. Please keep this history in

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-685471366659247822009-06-26T10:38:00.003-04:002009-06-26T10:47:37.371-04:00

The article by Drs Hatters-Friedman and Resnick (“Parents Who Kill: Why They Do It,” Psychiatric Times, May) was a clinically useful overview of filicide—particularly with respect to the motives that underlie this disturbing and tragic pattern of intrafamilial violence.Lower IQ is associated with many neuropsychiatric disorders. Studies suggest that this may also be the case with filicide (

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-53175059668648549112009-06-19T12:17:00.001-04:002009-06-19T12:21:50.001-04:00

I was fortunate enough to get great training (SUNY-Upstate for MD and Oregon for residency/child fellowship). After graduating I promised myself I would be true to my psychodynamic roots (Hal Boeverman RIP), do thorough evaluations and provide the finest psychiatric care possible. After leaving Oregon I happened to travel through Montana on the way to visit my family back in NY State. I was

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com1tag:blogger.com,1999:blog-509882538652496539.post-57441908556766186502009-06-08T13:54:00.002-04:002009-06-08T14:03:24.933-04:00

If only we doctors could memorialize those defining moments in our careers as beautifully as did Richard Berlin in "Teaching Rounds."In my year of Neurology many moons ago I was called to the ward because a patient had died. On the bed lay this little boy. His skin was white as Carrara marble but blotched with purple marks from the hemorrhages of leukemia. All alone, at 3 in the morning with this

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-58309645394726532812009-06-01T16:51:00.003-04:002009-06-01T17:03:05.915-04:00

The off-label use of psychotropic medications was nicely reviewed by Judith G. Edersheim, MD, in the April 2009 issue of Psychiatric Times. Recently, there has been increasing interest in—some would say “hype” about—the use of atypical antipsychotics (AAPs) to treat a variety of nonpsychotic conditions or symptoms.Thus, there is intense interest in the use of AAPs for refractory depressive states

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com0tag:blogger.com,1999:blog-509882538652496539.post-23950173397932751522009-05-12T16:40:00.003-04:002009-05-12T17:06:04.805-04:00

I was only in callow adolescence in April of 1964, but I remember those times quite clearly. The country had just come through the assassination of JFK, and Vietnam was already looming on the national horizon. Simon and Garfunkel had just written their anthem of angst, “The Sounds of Silence”, and the nation would soon be roiled by student protests known as the Berkeley Free Speech Movement. More

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com4tag:blogger.com,1999:blog-509882538652496539.post-10212515689635872312009-04-01T12:19:00.002-04:002009-05-12T17:07:14.872-04:00

I used to be a doctor. Next I was a provider. Now, I’m a non-covered entity. I liked being a doctor…I still do. I never liked being a provider. But being a non-covered entity is a secret victory. I’ll explain.As a psychoanalyst and psychiatrist, my work depends entirely on confidentiality and respect for people as individuals. Treatment works only when my patients and I are able to explore very

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com2tag:blogger.com,1999:blog-509882538652496539.post-33930499477771772532009-03-31T12:07:00.003-04:002009-05-12T17:07:41.858-04:00

I couldn't help but notice that it has become possible lately to lift recent editions of the Sunday New York Times with only a single hand. Not too long ago, the Sunday edition had a lot more reassuring heft to it.If you are a print lover like me, it's hard to ignore the diminishing girth of most newspapers, magazines, and journals these days. Reeling from a sharp drop in advertising, many print

Psychiatric Timeshttp://www.blogger.com/profile/17693025786039214283noreply@blogger.com1