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Conundrums in clinical Psychiatry

Martin P Paulus
Cognitive and affective processing has been the central focus of brain-related functions in psychology and psychiatry for many years. Much less attention has been paid to what could be considered the primary function of the brain, to regulate the function of the body. Recent developments, which include the conceptualization of interoception as a process consisting of integrating the information coming from the inside of the body in the central nervous system and the appreciation that complex emotional processes are fundamentally affected by the processing and regulation of somatic states, have profoundly changed the view of the function and dysfunction of the brain...
April 2013: Depression and Anxiety
Laura J Miller
The principles of autonomy, beneficence, nonmaleficence, and justice can guide clinicians in finding ethical approaches to the treatment of women who have psychiatric disorders during preconception, pregnancy, and postpartum. Table 1 summarizes some clinical dilemmas in perinatal mental health care, the ethical conundrums posed by these situations, and guiding principles or tools that can help clinicians resolve ethical conflicts. The concept of relational ethics helps resolve apparent mother-offspring ethical conflicts, and the practice of preventive ethics helps anticipate and reduce the risk of ethical dilemmas and adverse clinical outcomes...
June 2009: Psychiatric Clinics of North America
D J Newport, M M Wilcox, Z N Stowe
The majority of psychiatric illness onsets early in an individual's life, typically before or during the reproductive years. The increased incidence of major depression, dysthymia, and panic disorder in women compared with men underscores the likelihood that the clinician will encounter the clinical dilemma of medication use during pregnancy and lactation. The emergence of specialized clinics at several academic centers specifically to investigate and address issues in Perinatal psychiatry illustrates this conundrum best...
June 2001: Seminars in Perinatology
G Adshead
The general problem with research is that its purpose does not necessarily benefit an individual patient now. In psychiatry the specific problem is that psychiatric patients may have a reduced mental competence, because of their illness. Thus the specific clinical problems of the research subjects may impede the ethical requirements of the research. To try to solve this conundrum, we may need to move away from a vision of psychiatric ethics which is rights and individual based, and find another, which understand that ethical decision are made in the context of relationship: psychiatrist-patient, patient-society, analyst-patient, psychiatrist-society...
1997: Annali Dell'Istituto Superiore di Sanità
C McKenna, C Ross
Patients with substance dependence and psychiatric symptoms often present a diagnostic conundrum because each of these problems may mutually and reciprocally complicate the other. This may challenge the ability to identify dual-diagnosis patients who have both a substance abuse disorder and a definitive symptom-based psychiatric disorder. The main purpose of this explorative study was to identify variables suggestive of dual diagnosis in the population of substance-dependent patients with psychiatric symptoms...
November 1994: American Journal of Drug and Alcohol Abuse
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