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Psychiatric Clinics of North America

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https://www.readbyqxmd.com/read/29739532/psychodynamic-psychiatry-clinical-practical-patient-centered-and-evidence-based
#1
EDITORIAL
Thomas N Franklin
No abstract text is available yet for this article.
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739531/psychodynamic-psychiatry
#2
EDITORIAL
Harsh K Trivedi
No abstract text is available yet for this article.
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739530/engineering-neurobiological-systems-addiction
#3
REVIEW
Brian Johnson
Neurobiological engineering is the process of making models of brain function and psychoanalytic psychology as these interact in a social environment to hide complexity while remaining true to science. One-fourth of Americans are killed by drugs. The engineering model described is applied to psychodynamic therapy of addicted patients. It helps us understand why addiction is ubiquitous, hostile, malicious, and intractable. Drugs take over the will by changing the ventral tegmental dopaminergic SEEKING system...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739529/where-is-the-evidence-for-evidence-based-therapy
#4
REVIEW
Jonathan Shedler
The term evidence-based therapy is a de facto code word for manualized therapy, most often brief cognitive behavior therapy and its variants. It is widely asserted that "evidence-based" therapy is scientifically proven, superior to other forms of psychotherapy, and the gold standard of care. Research findings do not support such assertions. Research on evidence-based therapies demonstrates that they are weak treatments. They have not shown superiority to other forms of psychotherapy, few patients get well, and treatment benefits do not last...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739528/innovative-educational-initiatives-to-train-psychodynamic-psychiatrists-in-underserved-areas-of-the-world
#5
REVIEW
César A Alfonso, Marco Christian Michael, Sylvia Detri Elvira, Hazli Zakaria, Rasmon Kalayasiri, Aida Syarinaz A Adlan, Mahdieh Moinalghorabaei, Petrin Redayani Lukman, Mohammad San'ati, Katerina Duchonova, Timothy B Sullivan
Psychodynamic psychiatry remains a challenging subject to teach in underserved areas, where enthusiasm to learn is substantial. Besides logistical and psychiatric workforce shortcomings, sensible cultural adaptations to make psychodynamic psychiatry relevant outside of high-income countries require creative effort. Innovative pedagogical methods that include carefully crafted mentoring and incorporate videoconferencing in combination with site visits can be implemented through international collaborations. Emphasis on mentoring is essential to adequately train future psychodynamic psychotherapy supervisors...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739527/advocacy-for-psychodynamic-psychotherapy-challenges-and-benefits
#6
REVIEW
Katherine G Kennedy
Psychodynamic psychotherapy, also called psychodynamic therapy (PDT), is an effective mental health treatment that is currently under siege on several fronts. It is at risk of being effectively excluded from the future of American health care. Psychiatrists need to learn how to advocate for a future mental health care delivery system that assures their patients have access to PDT. This article examines the stigma against both psychiatrists and PDT, identifies some of the challenges to advocacy that psychiatrists face, and offers an approach to developing the necessary skills that psychiatrists need to advocate effectively for PDT...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739526/trauma-focused-psychodynamic-psychotherapy
#7
REVIEW
Fredric N Busch, Barbara L Milrod
The authors describe a psychodynamic psychotherapeutic approach to posttraumatic stress disorder (PTSD), trauma-focused psychodynamic psychotherapy. This psychotherapy addresses disruptions in narrative coherence and affective dysregulation by exploring the psychological meanings of symptoms and their relation to traumatic events. The therapist works to identify intrapsychic conflicts, intense negative affects, and defense mechanisms related to the PTSD syndrome using a psychodynamic formulation that provides a framework for intervention...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739525/the-overall-diagnosis-psychodynamic-psychiatry-six-minute-psychotherapy-and-patient-centered-care
#8
REVIEW
Elizabeth Weinberg, David Mintz
Optimal patient care in psychiatry necessitates attention to the treatment relationship and to the patient's experience as an individual. The growth of patient-centered medicine has led to an increased appreciation of the importance of the biopsychosocial formulation, the personhood of both the patient and the physician, the autonomy and authority of the patient, and the therapeutic alliance. Patient-centered medicine, developed by the seminal psychoanalytic theorist Michael Balint, has its roots in psychodynamic concepts...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739524/treatment-resistant-depression-the-importance-of-identifying-and-treating-co-occurring-personality-disorders
#9
REVIEW
Michael Young
Treatment-resistant depression (TRD) presents a significant burden to individuals and society, and comprehensive, individualized approaches are needed to address this complex clinical situation. Diagnostic reevaluation is indicated in cases of TRD to determine the numerous factors that could be playing a role in the treatment resistance. Factors to assess during the diagnostic reevaluation are discussed, including assessment for personality disorders, which are common contributors to treatment resistance and are often not adequately addressed...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739523/psychodynamic-psychiatry-the-biopsychosocial-model-and-the-difficult-patient
#10
REVIEW
Eric M Plakun
This article defines psychodynamic psychiatry as the intersection between general psychiatry and psychoanalysis as a theory of mind. Psychodynamic psychiatry is built on a biopsychosocial model for understanding and treating mental disorders. Currently, a narrower biomedical model is in ascendancy, but it has not lived up to its promise and is not supported by emerging science as robustly as is the biopsychosocial model. The "difficult patient" emerges in part from the limits of our treatment models and treatment methods...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739522/a-psychodynamic-approach-for-the-general-psychiatrist-using-transference-focused-psychotherapy-principles-in-acute-care-settings
#11
REVIEW
Richard G Hersh
Transference-focused psychotherapy (TFP) is one of the empirically validated treatments for patients with borderline personality disorder. TFP has roots in psychoanalytically informed psychotherapy, although important elements of the treatment have been adapted and refined for patients with significant personality disorder pathology. TFP's assessment process is informed by the structural interview, an approach that synthesizes standard DSM-5 nosology with the psychodynamic concept of the personality organization...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739521/the-psychodynamic-treatment-of-borderline-personality-disorder-an-introduction-to-transference-focused-psychotherapy
#12
REVIEW
Barry L Stern, Frank Yeomans
The authors describe the application of a twice-weekly exploratory psychotherapy, transference-focused psychotherapy (TFP), to patients with borderline personality disorder. The article describes the pathology of internal object relations that provides a framework for understanding borderline personality and how TFP establishes a treatment framework to address such pathology and set the stage for working at the level of internal psychological structure. An outline of the assessment and treatment protocol is described along with a case example to illustrate the same...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739520/the-place-for-psychodynamic-therapy-and-obstacles-to-its-provision
#13
REVIEW
Susan G Lazar
Psychodynamic treatment provides benefits for patients with personality disorders, chronic depressive and anxiety disorders, and chronic complex disorders, and its intensity and duration have independent positive effects. Obstacles to its provision include a bias privileging brief treatments, especially cognitive behavior therapy, seen as a gold standard of treatment, despite difficulties with the design of, and ability to generalize from, its supporting research and the diagnostic nosology of the illnesses studied...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739519/preserving-the-person-in-contemporary-psychiatry
#14
REVIEW
Glen O Gabbard
Psychodynamic psychiatry is a way of thinking that places the person at the heart of diagnostic understanding and treatment. This emphasis on unique characteristics of an individual is at odds with much of contemporary psychiatric thought, which is geared to identifying a set of criteria designed to identify discrete diagnostic categories with biological underpinnings. This article addresses component parts of the person that are linked to psychodynamic constructs and lie at the heart of diagnostic understanding and treatment in psychodynamic psychiatry...
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29739518/on-the-birth-of-psychodynamic-psychiatry
#15
REVIEW
Richard C Friedman, Jennifer I Downey, César A Alfonso
Psychodynamic psychiatry emerged from psychoanalytic theory, but the influence of the latter has been only partial. Equally important are other disciplines outlined within is article. Modern psychodynamic publications and presentations should honor all of the foundational pillars of the field. In this way, the new area lends itself to bio-psycho-social integrations that remain a challenge for all researchers and clinicians who seek to understand and treat patients with mental disorders.
June 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29412857/geriatric-psychiatry
#16
EDITORIAL
Dan G Blazer, Susan K Schultz
No abstract text is available yet for this article.
March 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29412852/geriatric-psychiatry
#17
Dan G Blazer, Susan K Schultz
No abstract text is available yet for this article.
March 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29412851/older-age-bipolar-disorder
#18
REVIEW
Annemiek Dols, Aartjan Beekman
Further understanding of older age bipolar disorder (OABD) may lead to more specific recommendations for treatment adjusted to the specific characteristics and needs caused by age-related somatic and cognitive changes. Late-onset mania has a broad differential diagnosis and requires full psychiatric and somatic work-up, including brain imaging. Research on pharmacotherapy in OABD is limited. First-line treatment of OABD is similar to that for adult bipolar disorder (BD), with specific attention to vulnerability to side effects and somatic comorbidity...
March 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29412850/electroconvulsive-therapy-in-geriatric-psychiatry-a-selective-review
#19
REVIEW
Justin P Meyer, Samantha K Swetter, Charles H Kellner
Electroconvulsive therapy (ECT) remains an important treatment of geriatric patients. ECT treats severe depression, mania, psychosis, catatonia, and comorbid depression and agitation in dementia. ECT also serves a crucial role in treating urgent illness requiring expedient recovery, such as catatonia, or in patients with severe suicidal ideation or intent. ECT is even more effective in the elderly than in mixed-age adult populations. ECT is a safe treatment option with few medical contraindications. Cognitive effects are largely transient, even in patients with preexisting cognitive impairment...
March 2018: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/29412849/evaluating-cognitive-reserve-through-the-prism-of-preclinical-alzheimer-disease
#20
REVIEW
Anja Soldan, Corinne Pettigrew, Marilyn Albert
The concept of cognitive reserve (CR) was proposed to account for the discrepancy between levels of brain pathologic features or damage and clinical and cognitive function. This article provides a detailed review of prospective longitudinal studies that have investigated the interaction between CR and Alzheimer's disease (AD) biomarkers on clinical and cognitive outcomes among individuals with preclinical AD. Current evidence shows that higher levels of CR are associated with a delay in the onset of symptoms of mild cognitive impairment and that there may be multiple pathways by which CR exerts its protective effects...
March 2018: Psychiatric Clinics of North America
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