psychosis - Page 1 | CARLAT PUBLISHING

You Work in the Inpatient Unit, and You Probably Don't Do Enough Therapy

June 3, 2025

When patients are acutely psychotic, manic, or suicidal, our impulse is to fine tune the meds. But a few years ago—while working primarily inpatient—I realized I was leaning too heavily on medication. My patients needed more.

Expert Q&A

Sorting Out Psychotic-Like Experiences in Children and Teens

April 1, 2025

Kristin Cadenhead, MD

Kristin Cadenhead, MD, Professor of psychiatry, director of Cognitive Assessment and Risk Evaluation (CARE) early psychosis research and treatment program, University of California San Diego, San Diego, CA.

Dr. Cadenhead has no financial relationships with companies related to this material.

What are psychotic-like experiences (PLE) in children and teens, and what is the prognosis for those who have them? Should we treat immediately with antipsychotics? Watch and wait? Our interview with Dr. Kristin Cadenhead gives you the guidance you need to assess and manage PLE.

Expert Q&A

Treatment Challenges in Atypical Parkinsonism

July 1, 2024

Alice Flaherty, MD, PhD

Alice Flaherty, MD, PhD.

Neurologist, Massachusetts General Hospital; associate professor of neurology and psychiatry, Harvard Medical School, Cambridge, MA.

Dr. Flaherty has no financial relationships with companies related to this material.

Patients with atypical parkinsonism are less responsive to levodopa, and psychiatric medications can exacerbate motor symptoms. Dr. Flaherty advises how to choose the right treatment in patients with parkinsonism accompanied by psychosis, apathy, anxiety, and depression.

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Clinical Update

Causes of Psychosis in Older Adults

July 1, 2024

Julia Cromwell, MD and Christianne Gonzalez Davidson, MD

Julia Cromwell, MD. Medical Director, Senior Adult Psychiatry Unit, Salem Hospital, Salem, MA.

Christianne Gonzalez Davidson, MD candidate 2024. Tufts University School of Medicine, Boston, MA.

Late-life psychosis has many causes—we’ll walk you through this important differential.

Clinical Update

Don’t Delay: Interventions in Early Psychosis

July 1, 2024

Brian Holoyda, MD, MPH, MBA

Brian Holoyda, MD. Chief Psychiatrist, Contra Costa County Detention Health Services, Martinez, CA. Dr. Holoyda has no financial relationships with companies related to this material.

We highlight the profound difference early intervention makes in the trajectory of psychotic disorders, reducing symptom severity, suicide risk, and functional impairment.

Expert Q&A

Substance-Induced Psychosis: Diagnostic Dilemmas and Treatment Options

January 31, 2024

Nicholas Athanasiou, MD, MBA, DFASAM

Nicholas Athanasiou, MD, MBA, DFASAM.

Associate clinical professor, Psychiatry and Biobehavioral Sciences (DGSOM), UCLA Olive View Psychiatry Residency Program; Supervising Mental Health Psychiatrist, Los Angeles County Department of Mental Health, Los Angeles, CA.

Dr. Athanasiou has no financial relationships with companies related to this material.

Substance-induced psychosis (SIP) presents diagnostic challenges in distinguishing it from primary psychotic disorders, with substance timing, symptom type, and duration being key differentiators. Effective treatment combines antipsychotic medications and substance cessation strategies. Dr. Athanasiou reviews key points in the management of SIP.

Clinical Update

Negative Symptoms of Schizophrenia

January 1, 2024

Chris Aiken, MD and Paul Riordan, MD.

Chris Aiken, MD. Editor-in-Chief, The Carlat Psychiatry Report. Assistant Professor, NYU Langone Department of Psychiatry. Practicing psychiatrist, Winston-Salem, NC.

Paul Riordan, MD. Assistant Consulting Professor of Psychiatry, Duke University, Durham, NC.

The authors have no financial relationships with companies related to this material.

Negative symptoms are the primary cause of disability in schizophrenia, and we identify a few antipsychotics and a few add-on therapies that can help.

Clinical Update

Tapering Antipsychotics

November 1, 2023

Charmi Patel Rao, MD, DFAACAP

Charmi Patel Rao, MD, DFAACAP. Director of Psychiatric Services, Positive Development; Health Sciences Assistant Clinical Professor, Department of Psychiatry, Child and Adolescent Psychiatry; UCSD, San Diego, CA.

Dr. Patel Rao has no financial relationships with companies related to this material.

Antipsychotics offer remarkable, even lifesaving treatment for children and adolescents, however, their side effects include metabolic and neurologic problems, including neurotoxicity. This clinical update guides you through a rational process for employing these powerful medications when necessary but also reducing and discontinuing them when possible.

CLINICAL UPDATE

The Psychodynamics of Psychopharmacology: Reimagining the “Med Check”

September 12, 2023

Ronald Pies, M.D.

Ronald W. Pies, MD. Professor Emeritus of Psychiatry and Lecturer on Bioethics and Humanities, SUNY Upstate Medical University; Professor Emeritus of Psychiatry, Tufts University School of Medicine; and Editor-in-Chief Emeritus of Psychiatric Times.

Dr. Pies has no financial relationships with companies related to this material.

The role of unconscious psychodynamic factors, the therapeutic alliance, and the transitional object in shaping medication adherence and treatment outcomes.

Recognizing and Treating Psychosis in Autism

August 21, 2023

Joshua Feder, MD and Mara Goverman

Is it autism or psychosis or both? Autistic traits and psychotic symptoms can look a lot alike. How common is psychosis in autism? And how can we differentiate co-occurring autistic traits from psychotic symptoms? Dr. Kristin Cadenhead gives us an approach for sorting through the history and addressing these problems separately.