Comorbidity

Clinical Update

Using Smoking Cessation Medications in Patients With Mental Illness

Topics: Comorbidity | Smoking Cessation | Smoking Cessation Agents

As you have likely noted in your practice, smoking is very common among patients with mental illness. Studies have shown that nearly every psychiatric diagnosis is associated with an increased prevalence of smoking, and that there is a growing disparity in smoking rates between patients with mental illness and the general population (Dickerson F et al,

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Research Update 2

Does Low to Moderate Alcohol Drinking Help or Hurt Cognition?

Topics: Alcohol | Alcohol Use | Alcohol use disorder | Cognition | Cognitive Decline | Comorbidity

Review of: Zhang R et al, JAMA Netw Open 2020;3(6):e207922 Is alcohol good or bad for cognition? The evidence is mixed. A new study brings additional clarity to this question by including a diverse patient population and by using longitudinal cognitive measurements of the subjects as opposed to cross-sectional evaluations at one time point. In an

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Research Update

Can Buprenorphine Improve PTSD Symptoms?

Topics: Addiction | Addiction Treatment | Antidepressants | Buprenorphine | Co-occurring disorders | Comorbidity | Dual diagnosis | Medication | Opioid Use Disorder | Pharmacology | PTSD | Research Update | SSRIs

Review of: Lake EP et al, Am J Addict 2019;28(2):86–91 For many years, the mainstay of treatment for PTSD has been the SSRI class of medications, but many of our patients still suffer crippling symptoms despite optimal antidepressant medication dosing. PTSD is often accompanied by opioid misuse, sometimes in an effort to self-treat the hyperarousal

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Clinical Update

How to Treat ADHD in Bipolar Disorder

Topics: ADHD | Alpha Agonists | Amphetamines | ArModafinil | Atomoxetine | Attention Deficit Hyperactivity Disorder | Bipolar Disorder | Bipolar II | Comorbidity | Guanfacine | methylphenidate | Modafinil | Nuvigil | Pharmacology | Provigil | Psychopharmacology | Psychopharmacology Tips | stimulant | Stimulants

Patients with bipolar disorder often present with cognitive complaints. Our October 2021 issue laid out a diagnostic plan for these symptoms, and in this article, I’ll cover some treatment approaches for patients with a DSM-based ADHD-bipolar comorbidity (ie, the ADHD symptoms began in childhood and persist after the mood episodes have stabilized). S

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Expert Q&A

The Schizophrenia-OCD Overlap

Topics: Antipsychotics | Aripiprazole | Clozapine | Comorbidity | Diagnosis | Lamictal | Lamotrigine | Obsessive Compulsive Disorder | OCD | olanzapine | Pharmacology Tips | polypharmacy | Quetiapine | Risperidone | Schizoaffective disorder | Schizophrenia

TCPR: What is schizo-obsessive disorder?Dr. Poyurovsky: Schizo-obsessive disorder (schizo-OCD) is not a DSM diagnosis. The term is used to refer to patients with schizophrenic disorders that have comorbid features of OCD. We see these obsessive-compulsive symptoms in schizophrenia more often than would be expected by chance. About one in four patients h

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Clinical Update

How to Diagnose ADHD in Bipolar Disorder

Topics: ADHD | ADHD Rating Scale-5 | Attention Deficit Hyperactivity Disorder | Bipolar Disorder | Bipolar II | Comorbidity | Diagnosis | Diagnostic Testing | Hypomania | Psychiatric interviewing

Hailey is a 24-year-old woman with bipolar II disorder who has recently come out of a mixed episode. Although her mood symptoms have resolved, she is distracted easily, has difficulty organizing her work, and often forgets important tasks. She read about ADHD online and asks if she can have a stimulant to help her focus. ADHD and hypomania share many

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Clinical Update

Adult-Onset ADHD

Topics: Comorbidity | Diagnosis

“My son was just diagnosed with ADHD, and I think I may have it, too,” says Alex, a 42-year-old salesman who presents for evaluation. In addition to being sad, anxious, and irritable, and meeting criteria for mild major depression, Alex says he is often bored at work, fidgety during meetings, and forgetful at home. He has had these problems since

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