The Psychiatric clinics of North America
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Psychiatr. Clin. North Am. · Sep 2010
ReviewEfficacy of cognitive behavioral therapy for anxiety disorders: a review of meta-analytic findings.
Numerous clinical trials have supported the efficacy of cognitive behavioral therapy (CBT) for the treatment of anxiety disorders. Accordingly, CBT has been formally recognized as an empirically supported treatment for anxiety-related conditions. This article reviews the evidence supporting the efficacy of CBT for anxiety disorders. ⋯ Thus, CBT provides incremental efficacy above and beyond nonspecific factors. For some anxiety disorders, CBT also tends to outperform other psychosocial treatment modalities. The implications of available meta-analytic findings in further delineating the efficacy and dissemination of CBT for anxiety disorders are discussed.
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Psychiatr. Clin. North Am. · Jun 2010
ReviewDepressive symptoms related to infertility and infertility treatments.
This article reviews depressive symptoms in women as they relate to infertility and infertility treatments. Common causes of infertility in women are discussed and the literature on depressive symptoms before and during various infertility treatments is presented. Recommendations are made from a psychiatric perspective regarding how to manage depressive symptoms in women in the context of infertility.
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Psychiatr. Clin. North Am. · Jun 2010
ReviewThe pathophysiology, diagnosis and treatment of fibromyalgia.
Research in fibromyalgia has increased understanding of the possible genetic and environmental factors that could be involved in the etiology of fibromyalgia. There is now substantial evidence for augmentation of central pain processing in fibromyalgia. Because the clinical presentation of fibromyalgia is heterogeneous, treatment recommendations must be individualized for each patient. The rapid growth of trials in fibromyalgia in recent years has resulted in new evidence-based approaches to pharmacological and nonpharmacological treatment.
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Sexual dysfunctions diminish the quality of life for many women, frequently causing enough distress to warrant the diagnosis of a sexual disorder. Problems with sexual function can occur in any stage of the sexual response cycle. Dysfunction is further influenced by a variety of factors: medical, psychiatric, cultural, and stage of life. A variety of treatment modalities exist, though current research has not yet provided Food and Drug Administration-approved therapies for sexual disorders in women.
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Psychiatr. Clin. North Am. · Mar 2010
ReviewPredictive and diagnostic genetic testing in psychiatry.
The recent advent of commercially available genetic tests for the diagnosis of several mental illnesses has led to intense controversy amongst the psychiatric research community. In this article the authors review these developments, and contrast these with the growing evidence from genome-wide association studies that highly heritable psychiatric conditions such as schizophrenia are due to the contributions and interaction of multiple allelic variants, each of small effect size. There is also evidence for the contribution of some highly penetrant rare de novo copy number variants, though the lack of disease specificity for these is of concern. ⋯ As the scientific discourse on genetic tests for complex disorders is not limited to psychiatry, the authors outline current thoughts on the significance of genome-wide association studies across health, and the phenomenon of direct-to-consumer tests in medicine. The attitudes and understanding of patients, families, and clinicians about the future (currently hypothetical) scenario of psychiatric genetic tests are discussed, as is the potential for such testing to increase, rather than diminish stigma. Finally, recommendations on the future development and availability of genetic tests in psychiatry are provided.