Daniel Carlat, MD
Editor-in-Chief, The Carlat Psychiatry Report
For this month’s issue, I asked two experts in family and couples therapy to remind us of how crucial it is to communicate with family members of patients. In the rush of a clinical day, it’s often easiest to simply deal with whomever shows up to the appointment—typically just the patient. I plead guilty. Recently I evaluated a man in his 60s who presented with depression. There was no prior psychiatric history, and his medical history was significant for successful removal of prostate cancer. The cause of his depression was a puzzle until his concerned wife called me, wondering if he had told me that—ever since his prostate surgery—he had erectile dysfunction. The patient had not shared this information, and further conversations revealed that his self-esteem and sense of masculinity had taken a hit, leading to depression. A combination of medications and empathy improved his mood, and the experience reminded me that my default procedure with all patients should be to at least touch base with the family. Do you typically involve family members or significant others in treatment? Let me know your thoughts at firstname.lastname@example.org.