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.

It's been a year and a half now since TCR last took up the perennially hot topic of SSRI use in pregnancy (TCR Vol 1, No 5, 2003).

Over the last few years, the concept of menopause has hit the national radar screen with a vengeance. One of the reasons for the onslaught of publicity was a nasty bit of research news released in 2002, when the initial results of the Women's Health Initiative Study were made public (JAMA. 2002; 288:321-333).

Dr. Viguera, what are your responsibilities in the Perinatal and Reproductive Psychiatry Program?

The concept of a difficult spell preceding the menstrual period in some women is not new. Hippocrates was said to have noted it, and in 1847, Dr. Ernst von Feuchtersleben said, "The menses in sensitive women is almost always attended by mental uneasiness, irritability, and sadness."

When we were planning this issue, several friends and readers were a bit surprised. "A whole issue on OCD? Is there anything new to say about it?" There's plenty to say that's both new and old.

When it comes to a neuroanatomical understanding of psychiatric symptoms, OCD is considered the superstar of the field. A wealth of data has implicated the involvement of a specific neuroanatomical loop in OCD.

You're a cutting edge psychiatrist. Not only are you great with meds, but you have a passing knowledge of CBT (cognitive-behavior therapy) techniques for the treatment of OCD. Sorry. You're already behind the curve.