In May 2009, an Action paper was passed by the APA Assembly calling for the development of an APA Position Paper on the Clinical Application of Brain Imaging in Psychiatry. This action paper was developed in response to questions raised by claims being made that brain imaging technology had already reached the point that it was useful for making a clinical diagnosis and for helping in treatment selection.
After the announcement of the DSM-5 Work Group membership in May 2008, the American Psychiatric Association (APA) received many inquiries regarding the workgroup named to address the entities included under Gender Identity Disorder (GID) in versions III through IVTR of the Diagnostic and Statistical Manual of Mental Disorders™ (DSM). These inquiries most often dealt with treatment controversies regarding GID, especially in children, rather than issues related specifically to the DSM text and diagnostic criteria. In addition, the APA Committee on Gay, Lesbian, and Bisexual Issues had previously raised concerns about the lack of evidence-based guidelines for GID, and questions about whether such guidelines could and should be developed.
Ongoing stressors in the lives of physicians across the life span raise the risk for burnout, stress related illness and impairment. Psychiatrists have a unique vantage point in contributing to the overall health and wellbeing of all physicians. Recent studies have shown that physicians who personally practice healthy behaviors are significantly more likely to advise their own patients to adopt healthy behaviors. It is therefore imperative to promote the overall personal health of physicians at each stage of their development.
The APA published a Task Force report, “Clinical Aspects of the Violent Individual,” in 1974 (1). Since then, the assessment of violence risk by psychiatrists has assumed increased prominence (2, 3). At the same time, significant changes have taken place both in the contexts in which psychiatrists assess risk and in the techniques that help them do so.
Prepared by the Committee on Hispanic Psychiatrists While prejudice is defined as an evaluation (usually negative) of a social group or individual that is significantly based on their group membership, xenophobia can be considered a form of negative prejudice directed against a national or ethnic group. Historically, xenophobia has been associated with various large scale destructive acts of violence between peoples or by persons against other persons belonging to the “other” group. These include wars (from the Crusades to both World Wars and beyond) and genocidal acts and disasters (such as against defenseless peoples such as the indigenous peoples of the Americas, African slaves across the Diaspora, Jews during the Inquisition and during World War II, Armenians (during World War I), Gypsies (during World War II), and, in the last 20 years, Hutu tribesmen in Rwanda, Muslims in the Balkans, Kurds in Iraq and Turkey, and Saharan Africans in Dharfour and Sudan.
Use of medication in treating childhood and adolescent depression: Information for patients and families
This revision of the original 2005 Parents Medical Guide to the treatment of depression in children and adolescents is a joint project of the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry. It has been updated to include important research that has added to our knowledge about effective treatments for child and adolescent depression. Its goal is to help parents and families make informed decisions about getting the best care for a child with depression. For easy use, it is presented in Frequently Asked Questions (FAQ) format.
The goal of this resource document is to address the major areas of the use of the internet in communication with patients and the public in the practice of psychiatry. The rate of change of technological capabilities and their implementation is so rapid that the workgroup believes that it would be inappropriate to promulgate fixed rules for constantly changing situations. Rather, we seek to provide some questions to be considered when implementing any new communication technology with patients or the public. In order to assist the practitioner, references to resource materials will be given. However, the reference is not an endorsement by either the APA or the members of the work group of the material contained therein.
The Management of Depression during Pregnancy: A Report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists
Objective—To address the maternal and neonatal risks of both depression and antidepressant exposure and develop algorithms for periconceptional and antenatal management. Method—Representatives from the American Psychiatric Association, the American College of Obstetricians and Gynecologists and a consulting developmental pediatrician collaborated to review English language articles on fetal and neonatal outcomes associated with depression and antidepressant treatment during childbearing. Articles were obtained from Medline searches and bibliographies. Search keywords included pregnancy, pregnancy complications, pregnancy outcomes, depressive disorder, depressive disorder/dt, abnormalities/drug-induced/epidemiology, abnormalities/drug-induced/et. Iterative draft manuscripts were reviewed until consensus was achieved.
Resource Document on Access to Firearms by People with Mental Illness Approved by the Joint Reference Committee, June 2009 Reports of mass shootings and other serious firearmrelated violence, such as the Columbine shootings of 1999 and the Virginia Tech shootings in 2007, are often accompanied by indications that the perpetrator had some emotional disturbance or mental illness. These incidents have raised growing concern about access to firearms (1) by people with mental disorders. Current federal law (2) and the laws of several states (3) bar purchase of firearms by specified categories of people, including persons with certain mental health histories, particularly involuntary hospitalization. These statutes aim to prevent sale of firearms to ineligible persons by requiring dealers to confirm the person’s eligi-bility by running a “check” through the National Instant Criminal Background Check System (NICS). However, as became evident in the wake of the Virginia Tech shootings, most states do not now report information on mental health histories to the NICS. By enacting the NICS Improvement Act of 2007 (4), Congress sought to encourage the states to establish registries of persons who have had the mental health histories that make them ineligible to purchase firearms under federal law.
Complementary and Alternative Medicine (CAM) is a term used to represent a number of specific treatments with potentially high public health importance and benefits. That which constitutes conventional or mainstream medicine is subjective and evolves over time. “Complementary” refers to approaches that are not considered mainstream or conventional, but are consistent with Western concepts based on the biomedical model. “Alternative” approaches are usually considered outside of the traditional Western medical conceptual framework. “Integrative” medicine refers to the combination of CAM and conventional treatments with the goal of achieving the best clinical outcomes for patients. CAM has also been defined as “a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine” (NCCAM, 2002).
Guidelines for psychiatrists in consultative, supervisory or collaborative relationships with nonphysician clinicians
The practice of psychiatry and of other mental health disciplines frequently occurs in the framework of organized health delivery systems. Psychiatrists are working with other professionals and nonprofessionals in hospital settings, community mental health centers, health maintenance organizations, as well as in group practices, and in consultative work with schools, family agencies, court clinics, etc. Interprofessional relationships are an essential aspect of good patient care and should be encouraged. They serve as a valuable educational experience and contribute to the continuing development of all who are concerned with patient care. The addition of other professionals and extenders to the health team enlarges the capacity to provide service. In turn, this requires a review of the role and responsibilities of psychiatrists in the entire range of consultative, supervisory, and collaborative relationships.
Vagal nerve stimulation for treatment resistant epilepsy has been available in the United States since 1997, and improved mood noted in epilepsy patients led to studies examining the use of VNS for treatment resistant depression. VNS implantation consists of placement of the stimulator in the chest wall that is attached by wires tunneled through the skin to the left vagus nerve in the carotid sheath. Potential side effects include voice alteration, hoarseness, coughing, paresthesia, dyspnea and rarely vocal cord paralysis and infection1.