The Psychiatric clinics of North America
-
This article discusses women who have sexual compulsivity, a disorder that is intensely shame-based and difficult to treat. The case studies presented show the family preconditioning of abandonment in childhood through inadequate care, abuse, neglect, and the presence of other addictions. As children, these women searched for something to soothe their distress when they could not rely on their caregivers. ⋯ Treatment can be successful if patients develop a capacity to bond, can tolerate the psychic pain of disclosure, are willing to be accountable, are resilient, and can forgive themselves and others. The rewards for this endeavor are great. The successful interruption and healing of patterns of abuse, shame, and distortions of intimacy and sexuality is a great contribution to society.
-
Psychiatr. Clin. North Am. · Mar 2008
Transforming mental health care: realities, priorities, and prospects.
A remarkable new analysis of mental health policy provides a lucid perspective on the status and impact of changes in mental health. The monograph is a systematic attempt to answer two questions: are people with a mental illness better off today than a generation ago, and if so why? This article considers that analysis and the prospects for transforming mental health care.
-
In the practice of psychosomatic medicine, the psychiatric consultant is likely to be confronted with questions at the interface of psychiatry and law. These issues generally emerge around questions of confidentiality and exceptions to confidentiality, assessments of a patient's ability to consent to and refuse treatment, and concerns about malpractice liability. ⋯ In addition, clinicians should be aware of the legal and risk management resources available to them should a complex situation arise. Finally, the psychiatric consultant should make use of consultation when complex issues emerge at the interface of psychiatry and law.
-
This article examines real-world antipsychotic use in the treatment of schizophrenia by comparing real-world prescribing with medication algorithms and guidelines, by evaluating the evidence underlying recommendations and guidelines, and by examining the roles of side effects and medication adherence in real-world prescribing decisions.
-
Psychiatr. Clin. North Am. · Sep 2006
ReviewPsychiatry malpractice and administrative inquiries of alleged physician misconduct.
Practicing psychiatrists face a range of professional liability from malpractice litigation and from inquiries and hearings conducted by health care agencies. The causes of an action and the standards by which physician conduct is measured vary widely between these two processes. Many psychiatrists do not appreciate sufficiently the gravity of the risks they may face from an administrative sanction. ⋯ Psychiatry is increasingly under the purview of regulations from multiple sources private and public. This article has reviewed medicolegal concepts and terms of psychiatrists' exposure to liability from a comparative point of view. Familiarity assists psychiatrists in navigating the complex legal arena in which they practice and provides a foundation for psychiatrists to work to change the multitude of laws and regulations when doing so is in the best interests of their patients and of their discipline of medicine.