Psychiatry 2006 - ISSN: 1550-5952 - Volume 3 - Issue 9 - September 2006
Feature Article:
Schizophrenia with obsessive compulsive features
by Michael Y. Hwang, MD; Sun Young Yum, MD; Miklos F. Losonczy, MD, PhD; Grant Mitchell, MD; and Jun Soo Kwon, MD

While the obsessive compulsive (OC) phenomena in schizophrenia have been described over the years, the condition has received increasing attention in recent years. The clinical and biological significance of OC symptoms in schizophrenia, however, still remain controversial. Although OC symptoms in schizophrenia were once thought to occur rarely and were associated with more benign clinical courses, recent studies have shown greater prevalence rate and poor outcome. In addition, the OC subgroup of schizophrenia responds poorly to the traditional antipsychotic treatments, but may respond positively to adjunctive anti-OCD regimen according to the emerging clinical evidence.1 While further systematic studies are needed to explore the clinical neurobiological implications of OC phenomena in patients with schizophrenia, current evidence suggests that these patients require specific symptom assessment and individualized pharmacological and psychotherapeutic treatment interventions for optimal
A Review of Bipolar Disorder in Adults
by Donald M. Hilty, MD; Martin H. Leamon, MD; Russell F. Lim, MD; Rosemary H. Kelly, MD, MPH; and Robert E. Hales, MD, MBA

Abstract Objective: This article reviews the epidemiology, etiology, assessment, and management of bipolar disorder. Special attention is paid to factors that complicate treatment, including nonadherence, comorbid disorders, mixed mania, and depression. Methods: A Medline search was conducted from January of 1990 through December of 2005 using key terms of bipolar disorder, diagnosis, and treatment. Papers selected for further review included those published in English in peer-reviewed journals, with preference for articles based on randomized, controlled trials and consensus guidelines. Citations de-emphasized original mania trials as these are generally well known. Results: Bipolar disorder is a major public health problem, with diagnosis often occurring years after onset of the disorder. comorbid conditions are common and difficult to treat. Management includes a lifetime course of medication, usually more than one, and attention to psychosocial issues for patients and their famili
Delusional Misidentification Syndromes: Separate Disorders or Unusual Presentations of Existing DSM-IV Categories?
by Kamil Atta, MD; Nicholas Forlenza MA; Mariusz Gujski, MD, PhD; Seema Hashmi, MD; and George Isaac, MD

Abstract During the past 80 years, delusional misidentification syndromes (DMS), especially the Fregoli and Capgras syndromes, have posed challenges to mental health professionals due to a lack of comprehensive understanding of the syndromes and a lack of effective treatment. An issue that remains to be unresolved is whether DMS (either in its pure form or as embedded symptoms of other diagnoses) can be accommodated in the present Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). During the past two decades, neurophysiological and neuroimaging studies have pointed to the presence of identifiable brain lesions, especially in the right frontoparietal and adjacent regions, in a considerable proportion of patients with DMS. Prior to the advent of such studies, DMS phenomena were explained predominantly from the psychodynamic point of view. Deficits in working memory due to abnormal brain function, are considered to play causative roles in DMS. In this article
Dialectical Behavior Therapy: Current Indications and Unique Elements
by Alexander L. Chapman, PhD

Abstract Dialectical behavior therapy (DBT) is a comprehensive, evidence-based treatment for borderline personality disorder (BPD). The patient populations for which DBT has the most empirical support include parasuicidal women with borderline personality disorder (BPD), but there have been promising findings for patients with BPD and substance use disorders (SUDs), persons who meet criteria for binge-eating disorder, and depressed elderly patients. Although DBT has many similarities with other cognitive-behavioral approaches, several critical and unique elements must be in place for the treatment to constitute DBT. Some of these elements include (a) serving the five functions of treatment, (b) the biosocial theory and focusing on emotions in treatment, (c) a consistent dialectical philosophy, and (d) mindfulness and acceptance-oriented interventions.

Key Words: dialectical behavior therapy, borderline personality disorder, suicide attempts, emotion, mindfulness

Letters to the Editor:
Duloxetine Withdrawal Seizure
Abdul Qadir, MD; and Naveed Haider, MD

The Interface:
Psychiatry and Primary Care
by Randy A. Sansone, MD, and Lori A. Sansone, MD

Trend Watch:
Recent Changes in Prescriptions for Antipsychotics in Children and Adolescents
by Elisa F. Cascade; and Amir H. Kalali, MD
Expert Commentary�Antipsychotic Use Among Children and Adolescents
by Joseph V. Penn, MD, CCHP
Expert commentary�Antipsychotic Use Among Children and Adolescents
by David Feifel, MD, PhD