Dr. Morgentaler, as a urologist with particular expertise in male sexual dysfunction, what kind of advice might you have for psychiatrists in terms of helping us to differentiate psychogenic from organic sexual problems?

If you've seen the new movie “Kinsey,” you already know that the famed sex researcher first made his name writing about the decidedly un-sexy topic of gall wasps. He was fascinated by these creatures because of the marked variability among individuals--a theme that later emerges in his work on human sexuality.

Rarely have we been exposed to a more bewildering array of data and opinions as over the past year on the subject of antidepressants in children. Ever more definitive meta-analyses and databases are published on a weekly basis. Researcher-clinicians of impeccable credentials look at the same data and deliver opposite opinions.

Let's face it. With our most troubled, desperate patients, each visit is an exercise in doing something that may very well be impossible: predicting whether they are going to attempt suicide.

Psychiatrists, once relatively immune from malpractice lawsuit, are being sued at an increasing rate. Only about 2% of psychiatrists were sued in 1975; this figure increased to 8% in 1995. And most of these suits are for negligence related to suicides.

Dr. Shea, in your classic book, The Practical Art of Suicide Assessment (John Wiley & Sons, 2002), you describe the CASE approach to evaluating suicidal ideation. What is the CASE approach?

Roger is a 52 year-old business owner in Massachusetts who has struggled with bipolar disorder and suicidal ideation through much of his life.

The suicide-prevention organization Samaritans was founded in 1953 in the UK by a Church of England vicar named Chad Varah. He writes, "It had been 18 years since I made my debut in the ministry by burying a 14-year old girl who'd killed herself when her periods started, thinking it was VD."

While sleeping pills have been around for a long time, the modern age of hypnotics began December 16, 1992, when the FDA approved Ambien (zolpidem). Sonata (zaleplon), a late bloomer, received approval in 1999.

The FDA may not like it, but Provigil (modafinil) is hot, and getting hotter.