Family members can tell you about your patient’s level of functioning, can confirm sleeping and eating schedules, and raise questions about cultural beliefs and values, says Alison Heru, MD, a professor of psychiatry at University of Colorado School of Medicine, and author of the book, “Working With Families in Medical...

Lithium’s effectiveness for mania in children is surprisingly robust. The Collaborative Lithium Trials, which is the largest double-blind placebo-controlled study to date, found lithium to be both effective and well tolerated in patients ages 7-17 with bipolar disorder (Findling et al, Pediatrics 2015; 136 (5):885-894).For bipolar disorder, lithium is typically...

In his article "How To Read a Research Article" from The Carlat Psychiatry Report, Joshua Sonkiss, MD, Medical Director for Fairbanks Community Mental Health Services and Boys and Girls Home of Alaska in Fairbanks, reviewed and explained the different types of study designs.Case reports: Someone writes up an interesting case...

When used appropriately, screen media can be useful rather than harmful. But with children, there must be limits, says Mary G. Burke, MD of the Sutter Pacific Medical Foundation in San Francisco, who covered the topic in The Carlat Child Psychiatry Report.Since screen time can be addictive for susceptible individuals,...

How common is physician burnout? One study estimated that 50% of U.S. physicians have “work-related distress” (Shanafelt TD, et al, Mayo Clin Proc. 2015;90(12):1600-13).John DiLallo, MD, a professor of psychiatry at the New York University School of Medicine, offered advice that might help you deal with practice stressors in The...

The decision to order lab tests can sometimes be a no-win situation. Tests are costly, and have the potential to yield false positive abnormalities, which may lead to further unnecessary testing. But if you don’t order tests, you could also miss a genuine problem.In an article from The Carlat Psychiatry...

All behavior is a code that a child uses to communicate, says Jessica Minahan, a board-certified behavior analyst and special educator, who co-authored The Behavior Code Companion. “Bad behavior” is often cloaked anxiety, and we can support education professionals by offering ideas that help anxious children.In an Expert Q&A in...

There are a lot of moving parts involved in closing your practice and retiring, says James T. Hilliard, an attorney and an assistant professor at Harvard Medical School. Subscribers can read the full article Hilliard wrote for the The Carlat Psychiatry Report. Here are four critical tasks:1. Inform your Board...

According to DSM-5, BPD is “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity.” Based on the eight DSM-5 criteria for BPD, here are some questions you can ask patients to confirm a diagnosis:Identity disturbanceAsk patients, “Do you have a sense of where you’re going...

Despite lots of scientific investigation, the cause of TD remains relatively unknown. Most investigations seem to implicate hyper-functioning dopamine circuits. At least one study showed that antipsychotic medications, which block dopamine transmission, are beneficial in suppressing tics. (Robertson, MM. Arch Dis Child Educ Pract Ed 2012;97(5):166-175).That said, before you consider...