A randomized controlled trial was conducted to determine whether a manual-based psychodynamic treatment, labeled dynamic deconstructive psychotherapy (DDP), would be feasible and effective for individuals with co-occurring borderline personality disorder (BPD) and alcohol use disorder. Thirty participants were assessed every 3 months during a year of treatment with either DDP or treatment as usual (TAU) in the community. DDP participants showed statistically significant improvement in parasuicide behavior, alcohol misuse, institutional care, depression, dissociation, and core symptoms of BPD, and treatment retention was 67% to 73%. Although TAU participants received higher average treatment intensity, they showed only limited change during the same period. The results support the feasibility, tolerability, and efficacy of DDP for the co-occurring subgroup and highlight the need for further research. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
The internet as a widespread source of communication is already having a significant influence in medicine and psychiatry. Although the internet has great potential in psychiatric education, clinical care, and research, its impact on social issues should not be underestimated. Firstly, the internet as a means of communication may encourage suicidal behavior by depicting ways by which suicide may be committed. Secondly, some internet websites may discourage people with mental illness from seeking psychiatric help, condone suicide, and forbid entry to anyone offering to discourage users from committing suicide. However, the internet could be a resource to help a potentially suicidal person get help, and can be used to identify those at risk for suicide, communicate with them, and potentially prevent suicide. If used appropriately, the internet is a powerful communication tool that can be used to benefit suicidal patients.
Objective: Delirium is a common condition frequently seen in consultation-liaison psychiatry. It is especially common among medically compromised patients, and is an indicator of the severity of the medical illness. In addition, it is associated with a higher morbidity, mortality, and longer hospitalization. Traditionally, haloperidol has been used to treat agitation as it may occur in delirium. However, atypical antipsychotics are being increasingly used to treat delirium. Method: In this article, we will describe two cases of delirium successfully treated with aripiprazole. Results: Both patients had significant improvement in their delirium as measured by the delirium rating scale. Conclusion: Aripiprazole appears to be effective in reducing the symptoms of delirium.
Agitation is a common and significant problem in the medically ill elderly. It is responsible for diminished quality of life for not only the patient, but the caregivers as well as the patient's relatives. This paper will illustrate the concept of agitation and different modes of classification. The major emphasis will be placed on discussing prompt, correct diagnosis of the underlying cause of agitation and effective treatment of both the cause of agitation and the symptoms of agitation itself.
Sickle Cell Disease (SCD) is a common condition among African Americans. It is associated with severe complications including severe pain in the chest, back, abdomen, or extremities. Individuals with SCD also have a reduced life span. Post traumatic stress disorder (PTSD) is a condition increasingly being recognized. In this article we discuss, to our knowledge, the first case of a patient with comorbid sickle cell disease and post-traumatic stress disorder.