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The Carlat Psychiatry Report

Improving Psychiatric Practice (October) | 2008

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Using Treatment Guidelines

October 1, 2008

One way to enhance the quality of our care of patients is to learn and implement expert practice guidelines. But there are some problems. First of all, there are so many guidelines out there that it is hard to know which ones to learn. Read More

Outcome Scales in Psychiatry

October 1, 2008

Should we use outcome scales in psychiatric practice? If so, which ones? Which are actually feasible in terms of time and utility? Read More

Using the PHQ-9 in Psychiatric Practice

October 1, 2008

The PHQ-9 is the Patient Health Questionnaire-9. It was adapted from an instrument originally funded by Pfizer, the PRIME-MD, which was developed as a tool for primary care doctors to screen their patients for psychiatric disorders. Read More

Little guidance provided for second- step antidepressant selection

October 1, 2008

The most recent findings from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial provided little help regarding which medication to prescribe if an initial SSRI trial failed to result in remission of depressive symptoms. Read More

Viagra reduces SSRI-induced sexual side effects in women

October 1, 2008

Sildefanil (Viagra) has been shown helpful in treating antidepressant-induced sexual dysfunction (AISD) in men, but no controlled trials had tested its effectiveness in women. In this trial, 98 women with SSRI associated sexual dysfunction were randomly assigned to either sildefanil or placebo; all participants continued their SSRI, and their sexual functioning was assessed at multiple times. Read More

Psychiatrists providing less psychotherapy

October 1, 2008

In a nationally representative sample of office-based psychiatrists, the percentage of patient visits involving at least 30 minutes of psychotherapy dropped from 44% in 1996-1997 to 29% in 2004-2005. Read More