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.

While there are plenty of excessively complicated classifications of sleep disorders in this world, TCR, in the midst of a sleep-deprived delirium, has decided that psychiatrists should become most familiar with the following four common problems ...

Dr. Winkelman, could you recommend a practical approach for psychiatrists diagnosing sleep disorders?

In practicing addiction medicine and psychiatry, I have found that the judicious use of Ambien or Sonata has a place in the management of early abstinence, especially since insomnia is an oft-cited cause of relapse. However, the use of Benadryl and Vistaril are problematic in the treatment of insomnia and anxiety in the substance dependent population.

If you really want to understand Premenstrual Dysphoric Disorder (PMDD), you'd better have a pretty good understanding of the normal menstrual cycle.