CARLAT PUBLISHING The Carlat Report https://www.thecarlatreport.com/rss/articles Why We Miss Suicide Risk in Autistic Youth p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

What if the patients we assume are safest from suicide are actually the ones we miss? Today we're talking about suicide risk in autistic youth, why it's higher than many clinicians expect, how distress shows up differently, and what small changes in our assessment process and treatment can make a real difference.
]]> Mon, 01 Jun 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6306-why-we-miss-suicide-risk-in-autistic-youth http://www.thecarlatreport.com/blogs/2/post/6306 CBD for Trauma-Related Anxiety: Does the Hype Add Up? Millions of people experience trauma-related symptoms that fall short of PTSD. 

]]> Mon, 01 Jun 2026 00:00:58 -0400 https://www.thecarlatreport.com/articles/6299-cbd-for-trauma-related-anxiety-does-the-hype-add-up http://www.thecarlatreport.com/articles/6299 Learning Objectives, Therapy for Bipolar Disorder, TCPR, June/July 2026 After reading these articles, you should be able to…


]]> Mon, 01 Jun 2026 00:00:53 -0400 https://www.thecarlatreport.com/articles/6305-learning-objectives-therapy-for-bipolar-disorder-tcpr-june-july-2026 http://www.thecarlatreport.com/articles/6305 Street Smarts in Psychopharm: What Every Clinician Needs to Know Patients are arriving with scripts from TikTok and Reddit coaching them to obtain controlled substances. Structured assessments and firm but compassionate boundaries are your best defense.

]]> Mon, 01 Jun 2026 00:00:46 -0400 https://www.thecarlatreport.com/articles/6304-street-smarts-in-psychopharm-what-every-clinician-needs-to-know http://www.thecarlatreport.com/articles/6304 Therapy for Bipolar Disorder Personalized CBT can build rapport and transform how patients with bipolar disorder understand and manage their own episodes.

]]> Mon, 01 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6303-therapy-for-bipolar-disorder http://www.thecarlatreport.com/articles/6303 Digital Addictions Apps are engineered to hook users. Here’s how to recognize and treat digital addiction in your patients.

]]> Mon, 01 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6302-digital-addictions http://www.thecarlatreport.com/articles/6302 The Obsessive-Compulsive Disposition OC traits are common and easily mistaken for ADHD, mood disorders, or oppositional behavior in children. Recognizing them can prevent misdiagnosis and inappropriate stimulant prescribing.

]]> Mon, 01 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6301-the-obsessive-compulsive-disposition http://www.thecarlatreport.com/articles/6301 Does Ketamine’s Effect on Suicidality Stick Around? Ketamine is one of the few medications in psychiatry that reduces suicidal ideation (SI). 

]]> Mon, 01 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6300-does-ketamines-effect-on-suicidality-stick-around http://www.thecarlatreport.com/articles/6300 Legal Gender Change Stability More patients with gender dysphoria (GD) are seeking legal and medical transition. 

]]> Mon, 01 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6298-legal-gender-change-stability http://www.thecarlatreport.com/articles/6298 Propranolol Plus Sertraline for Panic in Women Propranolol is commonly used off-label for anxiety, but high-quality data are sparse regarding its use in panic disorder—especially as an SSRI add-on.

]]> Mon, 01 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6297-snris-appear-less-harmful-to-bone-than-ssris-in-postmenopausal-women http://www.thecarlatreport.com/articles/6297 SNRIs Appear Less Harmful to Bone Than SSRIs in Postmenopausal Women SSRIs have been linked to bone thinning and fractures, which matters most for postmenopausal women already at risk. Whether SNRIs carry the same concern has been unclear.

]]> Mon, 01 Jun 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6296-snris-appear-less-harmful-to-bone-than-ssris-in-postmenopausal-women http://www.thecarlatreport.com/articles/6296 Gender Affirming Care in Exile: Origins p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

It's 1979, and Johns Hopkins has just shut down the first gender surgery clinic in the US. But investigations into the biological roots of gender identity are about to reopen those doors — and reshape how medicine thinks about sex, gender, and who gets to decide.
]]> Mon, 25 May 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6294-gender-affirming-care-in-exile-origins http://www.thecarlatreport.com/blogs/2/post/6294 Gender Affirming Care: Fall of the House of Hopkins p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

In 1966, Johns Hopkins opened the first gender surgery clinic in the US. Thirteen years later, a single study shut it down. We examine what the research said, what it didn't say, and how new standards of care emerged from the ashes.
]]> Mon, 18 May 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6293-gender-affirming-care-fall-of-the-house-of-hopkins http://www.thecarlatreport.com/blogs/2/post/6293 Gender Affirming Care in Exile: Targeting the Leader p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

The president of the US branch of WPATH built one of the largest youth gender clinics in the country, then watched it close under political fire. Now she's facing a malpractice lawsuit from a former patient. We examine the unpublished study at the center of the controversy.
]]> Mon, 11 May 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6292-gender-affirming-care-in-exile-targeting-the-leader http://www.thecarlatreport.com/blogs/2/post/6292 When Social Withdrawal Becomes Invisible Pathology Have you ever heard of hikikomori? Literally: "pulling inward."

First described by Japanese psychiatrist Tamaki Saito in 1998 — and for decades assumed to be a uniquely Japanese problem. 

It isn't.

A 2025 meta-analysis of 19 studies and 58,000+ participants found cases across Europe, North America, and beyond. US estimates put prevalence around 2–3%. Roughly 1 in 40 Americans.



]]> Fri, 08 May 2026 18:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6291-when-social-withdrawal-becomes-invisible-pathology http://www.thecarlatreport.com/blogs/1/post/6291 Assessing the Evidence in Child and Adolescent Psychiatry Not all studies are created equal — and in child psychiatry, the stakes of getting it wrong are high. Dr. Spielmans introduces the PICOT framework, exposes common sources of bias in clinical trials, and offers practical tools for vetting the research before it reaches your patients.

]]> Fri, 08 May 2026 12:41:38 -0400 https://www.thecarlatreport.com/articles/6288-assessing-the-evidence-in-child-and-adolescent-psychiatry http://www.thecarlatreport.com/articles/6288 SSRIs Help Modestly With Pediatric OCD SSRIs are standard for pediatric OCD, but how much do they actually move the needle? An individual participant data meta-analysis puts a number on it, and the answer is more nuanced than the guidelines suggest. Baseline severity, it turns out, matters more than most clinicians realize.

]]> Fri, 08 May 2026 12:16:47 -0400 https://www.thecarlatreport.com/articles/6283-ssris-help-modestly-with-pediatric-ocd http://www.thecarlatreport.com/articles/6283 Helping Patients Tolerate Anti-Manic Treatments Mania requires rapid treatment, but side effects often undermine adherence. Learn practical strategies to improve tolerability and when to consider off-label or behavioral options.

]]> Thu, 07 May 2026 15:54:07 -0400 https://www.thecarlatreport.com/articles/6278-helping-patients-tolerate-anti-manic-treatments http://www.thecarlatreport.com/articles/6278 Gender Affirming Care in Exile: The Trials p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Medical societies are reversing decades of support for gender-affirming care in youth — but is it the science driving the shift, or the politics? This episode walks through the evidence, from randomized trials to regret rates, and finds a more complicated picture than either side presents.
]]> Mon, 04 May 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6273-gender-affirming-care-in-exile-the-trials http://www.thecarlatreport.com/blogs/2/post/6273 Herpes Zoster Vaccination and Dementia Risk Could a shingles vaccine lower dementia risk? A natural experiment in Wales—where vaccine eligibility turned on a single birthdate—found a 20% relative reduction in new dementia diagnoses over seven years. It's not proof of causation, but it's the strongest quasi-experimental evidence yet, and one more reason to make the recommendation.

]]> Sat, 02 May 2026 14:11:51 -0400 https://www.thecarlatreport.com/articles/6266-herpes-zoster-vaccination-and-dementia-risk http://www.thecarlatreport.com/articles/6266 Prazosin and Cyproheptadine for AUD: A Promising Combination When standard treatments fall short in alcohol use disorder, could a prazosin–cyproheptadine combination help? A new randomized trial suggests this pairing may significantly reduce high-risk drinking.

]]> Fri, 01 May 2026 15:45:20 -0400 https://www.thecarlatreport.com/articles/6276-prazosin-and-cyproheptadine-for-aud-a-promising-combination http://www.thecarlatreport.com/articles/6276 Learning Objectives, Borderline Personality Disorder, TCPR, May 2026 After reading these articles, you should be able to…


]]> Fri, 01 May 2026 01:23:53 -0400 https://www.thecarlatreport.com/articles/6280-learning-objectives-borderline-personality-disorder-tcpr-may-2026 http://www.thecarlatreport.com/articles/6280 CME Post-Test, Borderline Personality Disorder, TCPR, May 2026 By successfully completing the test you will be awarded a certificate for 1 CME credit.

]]> Fri, 01 May 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/6274-cme-post-test-borderline-personality-disorder-tcpr-may-2026 http://www.thecarlatreport.com/articles/6274 CME Post-Test, Therapy for Bipolar Disorder, TCPR, June/July 2026 By successfully completing the test you will be awarded a certificate for 2 CME credits.

]]> Fri, 01 May 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6295-cme-post-test-therapy-for-bipolar-disorder-tcpr-june-july-2026 http://www.thecarlatreport.com/articles/6295 Diagnosing Borderline Personality Dr. Zimmerman explains why BPD is underdiagnosed and how a single high-yield screening question can change your assessment.

]]> Fri, 01 May 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6279-diagnosing-borderline-personality http://www.thecarlatreport.com/articles/6279 Do “Other” Events Trigger Post-Traumatic Stress Disorder? What if a patient’s most traumatic experience doesn’t meet DSM-5 criteria? This study explores how other life events can trigger PTSD-level symptoms—challenging how we define trauma.


]]> Fri, 01 May 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6277-do-other-events-trigger-post-traumatic-stress-disorder http://www.thecarlatreport.com/articles/6277 Treating Antipsychotic-Induced Weight Gain with GLP-1 Agonists GLP-1 agonists have transformed obesity care—now emerging research suggests they may also reverse antipsychotic-induced weight gain without worsening psychiatric symptoms.

]]> Fri, 01 May 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6275-treating-antipsychotic-induced-weight-gain-with-glp-1-agonists http://www.thecarlatreport.com/articles/6275 Gender Affirming Care in Exile: The Lawsuits p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Two malpractice cases — one worth $2 million — are reshaping the standards of gender-affirming care. This episode traces what went wrong, what held up in court, and what every clinician needs to know when referring patients for gender affirming procedures.
]]> Mon, 27 Apr 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6262-gender-affirming-care-in-exile-the-lawsuits http://www.thecarlatreport.com/blogs/2/post/6262 Table: Psychiatric Medications in Pregnancy and Lactation Table: Psychiatric Medications in Pregnancy and Lactation]]> Fri, 24 Apr 2026 17:00:36 -0400 https://www.thecarlatreport.com/articles/6261-table-psychiatric-medications-in-pregnancy-and-lactation http://www.thecarlatreport.com/articles/6261 Use of Psychiatric Medications in Breastfeeding Patients When new mothers are admitted to the inpatient psychiatric unit, they might ask about the safety of taking psychiatric medications while breastfeeding.

]]> Fri, 24 Apr 2026 17:00:36 -0400 https://www.thecarlatreport.com/articles/5320-use-of-psychiatric-medications-in-breastfeeding-patients http://www.thecarlatreport.com/articles/5320