General Psychiatry https://www.thecarlatreport.com/rss en-us 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.
]]> http://www.thecarlatreport.com/blogs/2/post/6293 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 shutterstock_2782224449.jpg 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 We examine the unpublished study at the center of the controversy.
]]> http://www.thecarlatreport.com/blogs/2/post/6292 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 shutterstock_2779245507-2.jpg 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.



]]> http://www.thecarlatreport.com/blogs/1/post/6291 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 1773347357045.jpeg 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.

]]> http://www.thecarlatreport.com/articles/6278 Thu, 07 May 2026 15:54:07 -0400 https://www.thecarlatreport.com/articles/6278-helping-patients-tolerate-anti-manic-treatments TCPR_May2026_Issue_Image_Patient.png 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.
]]> http://www.thecarlatreport.com/blogs/2/post/6273 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 shutterstock_2775830779.jpg 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.

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


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

]]> http://www.thecarlatreport.com/articles/6274 Fri, 01 May 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/6274-cme-post-test-borderline-personality-disorder-tcpr-may-2026 Diagnosing Borderline Personality Dr. Zimmerman explains why BPD is underdiagnosed and how a single high-yield screening question can change your assessment.

]]> http://www.thecarlatreport.com/articles/6279 Fri, 01 May 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6279-diagnosing-borderline-personality TCPR_QA_MarkZimmerman_headshot_sm.png 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.


]]> http://www.thecarlatreport.com/articles/6277 Fri, 01 May 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6277-do-other-events-trigger-post-traumatic-stress-disorder 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.

]]> http://www.thecarlatreport.com/articles/6275 Fri, 01 May 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/6275-treating-antipsychotic-induced-weight-gain-with-glp-1-agonists 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.
]]> http://www.thecarlatreport.com/blogs/2/post/6262 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 shutterstock_2772531237.jpg Table: Psychiatric Medications in Pregnancy and Lactation Table: Psychiatric Medications in Pregnancy and Lactation]]> http://www.thecarlatreport.com/articles/6261 Fri, 24 Apr 2026 17:00:36 -0400 https://www.thecarlatreport.com/articles/6261-table-psychiatric-medications-in-pregnancy-and-lactation 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.

]]> http://www.thecarlatreport.com/articles/5320 Fri, 24 Apr 2026 17:00:36 -0400 https://www.thecarlatreport.com/articles/5320-use-of-psychiatric-medications-in-breastfeeding-patients Dissociative Identity Disorder: Diagnosis and Treatment Occasionally you will encounter patients who report having multiple personalities or distinct identities, also called alters. Formerly called “multiple personality disorder,” this condition is now termed dissociative identity disorder (DID). 

]]> http://www.thecarlatreport.com/articles/5225 Fri, 24 Apr 2026 16:38:54 -0400 https://www.thecarlatreport.com/articles/5225-dissociative-identity-disorder-diagnosis-and-treatment Lithium Goes Mainstream p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

In the 1950s, a young Danish psychiatrist named Mogens Schou staked his career — and his family — on a mineral most of his colleagues dismissed as dangerous nonsense. This is the story of how lithium went from fringe curiosity to the gold standard for bipolar disorder, and the bitter scientific battle that nearly derailed it.
]]> http://www.thecarlatreport.com/blogs/2/post/6152 Mon, 20 Apr 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/6152-lithium-goes-mainstream shutterstock_2769345501.jpg Are We Preparing Autistic Patients for Adulthood? We support autistic children. We abandon autistic adults. 

In our latest Child Psychiatry Report, Mary Baker-Ericzen, research professor at San Diego State University and clinical psychologist at the Intricate Mind Institute, asks clinicians to consider a different question at every visit: Is this patient building the skills they'll need when the system stops showing up for them?


]]> http://www.thecarlatreport.com/blogs/1/post/6048 Fri, 17 Apr 2026 18:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/6048-are-we-preparing-autistic-patients-for-adulthood 1773072497189.jpeg Lithium: From 7UP to Table Salt p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Before lithium became a cornerstone of psychiatry, it was in soda, spa water, and salt shakers. Trace lithium’s journey from Victorian health fad to life-saving mood stabilizer, and discover why the uric acid theory that launched it may be making a comeback.
]]> http://www.thecarlatreport.com/blogs/2/post/5925 Mon, 13 Apr 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5925-lithium-from-7up-to-table-salt shutterstock_2766290053.jpg A Dangerous Myth in Child Psychiatry Autism doesn't protect against suicide. It hides it. 

]]> http://www.thecarlatreport.com/blogs/1/post/5924 Sat, 11 Apr 2026 17:55:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/5924-a-dangerous-myth-in-child-psychiatry 1773071509084.jpeg When Autism Meets the Legal System: A Clinician’s Guide p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Legal questions come up in clinical care of autistic children and adults more often than many of us expect. A parent asks for a custody letter; a school requests documentation for services; a patient asks about disability benefits or driving. When autistic patients face legal systems, clinicians can help, but only if we stay within our role.
]]> http://www.thecarlatreport.com/blogs/2/post/5904 Mon, 06 Apr 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5904-when-autism-meets-the-legal-system-a-clinicians-guide PodcastImage56978.jpg The Side Effects that Quietly Destroy Teeth It's easy to treat xerostomia as a nuisance, low on the priority list when you're managing psychosis or depression. But left unaddressed, it quietly does real damage.


]]> http://www.thecarlatreport.com/blogs/1/post/5903 Fri, 03 Apr 2026 17:55:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/5903-the-side-effects-that-quietly-destroy-teeth 1771503682873.jpeg Learning Objectives, PTSD, TCPR, April 2026 After reading these articles, you should be able to…


]]> http://www.thecarlatreport.com/articles/5902 Wed, 01 Apr 2026 01:23:53 -0400 https://www.thecarlatreport.com/articles/5902-copy-of-learning-objectives-adhd-tcpr-march-2026 CME Post-Test, PTSD, TCPR, April 2026 By successfully completing the test you will be awarded a certificate for 1 CME credit.

]]> http://www.thecarlatreport.com/articles/5896 Wed, 01 Apr 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/5896-cme-post-test-ptsd-tcpr-april-2026 Deprescribing Benzodiazepines: A Practical Guide to Tapering A practical, patient-centered guide to safely tapering benzodiazepines, balancing long-term risks, withdrawal challenges, and strategies that improve success.

]]> http://www.thecarlatreport.com/articles/5901 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5901-deprescribing-benzodiazepines-a-practical-guide-to-tapering shutterstock_2425592969.jpg Studio shot photo of benzodiazepines Psychopharmacology for PTSD David Osser, MD, explains why treating sleep first is central to PTSD care—and how to use prazosin effectively despite lingering controversies.

]]> http://www.thecarlatreport.com/articles/5900 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5900-psychopharmacology-for-ptsd Lumateperone Eases Depression With Mixed Features A new placebo-controlled trial suggests lumateperone rapidly improves depressive and manic symptoms in mixed features—with minimal metabolic or EPS burden.

]]> http://www.thecarlatreport.com/articles/5899 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5899-lumateperone-eases-depression-with-mixed-features Exercise for Major Depressive Disorder Which types and doses of exercise work best for depression? A large meta-analysis offers practical targets while reinforcing flexibility in real-world care.

]]> http://www.thecarlatreport.com/articles/5898 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5898-exercise-for-major-depressive-disorder Digital Interventions for Adults Seeking Psychiatric Services A large trial finds small but meaningful benefits for depression and anxiety.

]]> http://www.thecarlatreport.com/articles/5897 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5897-digital-interventions-for-adults-seeking-psychiatric-services Jeffrey Epstein on the Couch: Part IV p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 12.0px Helvetica; color: #000000}

Narcissism, antisocial, pedophilia… A lot of psychiatric terms have been used to explain Jeffrey Epstein. We’ll look at what fits.
]]> http://www.thecarlatreport.com/blogs/2/post/5895 Mon, 30 Mar 2026 02:00:00 -0400 https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/5895-jeffrey-epstein-on-the-couch-part-iv shutterstock_2760429489.jpg The Anxiety Treatment Most U.S. Clinicians Haven’t Heard Of A German medication beat paroxetine for anxiety. Its approved in 20 countries. Most U.S. clinicians have never heard of it. 

]]> http://www.thecarlatreport.com/blogs/1/post/5894 Sat, 28 Mar 2026 18:00:00 -0400 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/5894-copy-of-depression-rarely-travels-alone 1770819589032.jpeg