The Psychiatric clinics of North America
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This article reviews the clinical features and neurochemical hypotheses of obsessive-compulsive disorder (OCD) with a focus on the serotonin system. In DSM-5, OCD was moved from the anxiety disorders to a new category of Obsessive-Compulsive and Related Disorders. OCD is a common, typically persistent disorder marked by intrusive and disturbing thoughts (obsessions) and repetitive behaviors (compulsions) that the person feels driven to perform. ⋯ A role of the glutamatergic system in OCD has been gaining traction based on imaging data, genomic studies and animal models of aberrant grooming behavior. These findings have spurred interest in testing the efficacy of medications that modulate glutamate function. A role of glutamate is compatible with circuit-based theories of OCD.
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Psychiatr. Clin. North Am. · Dec 2013
ReviewLate life depression: a global problem with few resources.
Mental health disorders in terms of an aging population are discussed in this review. Statistics on depression in later life are presented with a discussion of physical health comorbidities. This presentation postulates that the health care infrastructure currently in place is inadequate to meet the present, much less the future, needs of this population. The care of the depressed elder will require the coordinated effort of psychiatrists, psychologists, social workers, nurse practitioners and advanced practice psychiatric nurses, internal medicine gerontologists, internal medicine and family medicine general physicians, community agencies, and volunteers.
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Psychiatr. Clin. North Am. · Dec 2013
ReviewThe role of electroconvulsive and neuromodulation therapies in the treatment of geriatric depression.
Geriatric depression is associated with increased mortality because of suicide and decreases in functional and physical health. Many elders' depression is resistant to psychotherapy and medication and can become chronic. ⋯ Therapies that combine both strategies could be safer but may not be as effective as ECT. This review covers the evidence on the safety and efficacy of ECT and the neuromodulation therapies in geriatric depression.
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Psychiatr. Clin. North Am. · Sep 2013
First person: a mental health mission to post-earthquake El Salvador.
In this article the author excerpts and discusses salient quotes or moments from the journal he compiled while visiting El Salvador in February 2001 as head of Disaster Psychiatry Outreach (DPO) to assist survivors of a major earthquake. This case discussion of a single disaster mental health response exemplifies key issues related to both short and long term mental health service delivery to disaster affected communities.
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Psychiatr. Clin. North Am. · Sep 2013
The Great East Japan Earthquake, tsunami, and Fukushima Daiichi nuclear power plant accident: a triple disaster affecting the mental health of the country.
The Great East Japan Earthquake in 2011 caused 2 other serious disasters: a tsunami and a nuclear power plant accident. A chronic shortage of mental health resources had been previously reported in the Tohoku region, and the triple disaster worsened the situation. ⋯ Japan now advocates using psychological first aid to educate first responders. This article extracts key lessons from relevant literature.