Journal of Psychiatric Practice 

About: Journal of Psychiatric Practice is an academic journal published by Lippincott Williams & Wilkins. The journal publishes majorly in the area(s): Medicine & Mental health. It has an ISSN identifier of 1527-4160. Over the lifetime, 1557 publications have been published receiving 27097 citations. The journal is also known as: Psychiatric practice.

Testosterone and depression: systematic review and meta-analysis.

Abstract: Background.Studies suggest that testosterone (TT) replacement may have an antidepressant effect in depressed patients.Objective.The objective of this study was to explore the effect of TT administration on depression using both a systematic review of the literature and a meta-analysis.Methodology.A

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

Abstract: For the large number of people who are still suffering from the effects of trauma, despite the tremendous advances in the treatment of posttraumatic stress disorder (PTSD) made in the last 20 years, this book offers new insights into psychopathology and recovery. Part scholarly review, part case series, part history, part philosophy, and part memoirs, Dr van der Kolk uses anecdotes elegantly to illustrate evidence-based concepts in a way that patients can grasp yet experts will not find simplistic. Providers, patients, and families will inevitably find that the science and stories resonate with their own experiences. Like all great innovations, this book builds on past innovations. Seemingly unrelated neuroimaging, neurochemistry, endocrinology, animal studies, attachment, interpersonal, psychodynamic, cognitive, and behavioral concepts are woven together, creating an intricate but coherent, unifying tapestry that helps reveal how trauma can change survivors. Freud and Pavlov are referenced alongside films, novels, Galen, and Yogi Berra. Contradictions that have long mystified observers—simultaneously not wanting but needing to talk about trauma, coming alive in the present only when recounting the past, repetition compulsions, maintaining connections with abusers, recklessness resulting in calmness, finding pain in pleasure and pleasure in pain, avoiding treatment for fear recovery will result in forgetting dead comrades, reacting to minor irritations as if life-threatening yet having little apparent reaction to further assaults— suddenly become clearer. Just as he explains how trauma can disturb circuits, hormones, sensorimotor systems, and “how we think and what we think about,” van der Kolk describes how these can be recalibrated. He defines 3 avenues for recovery: “top down” through the medial prefrontal cortex (ie, talking, processing, reconnecting), medicine changing the way the brain organizes and reacts to stimuli, and “bottom up” through the “reptilian brain” (ie, the body having experiences that contradict the physical and emotional impacts of trauma). Not everyone will respond to the same treatments, and most will require a combination to recover. He laments how clinicians often spend more time managing problem behaviors than trying to understand their causes. For some, medications can “deflect attention from dealing with underlying issues” and from relationships, and only talking about trauma can sometimes be counterproductive due to reinforcing a focus on the past instead of the present, or is thwarted by triggering dissociation (his neuroimaging studies found that the brain’s speech centers deactivate in some when trying to recall trauma, making it nearly impossible for this subset of traumatized patients to talk about the trauma). The book pays particular attention to those for whom typical treatments may not be effective: those who freeze, dissociate, have personality disorders, suffer physical collapse, and who have persistent heartbreaking and gut-wrenching sensations as “the body continues to defend against a threat that belongs in the past.” For them, “the body needs to learn that the danger has passed and to live in the reality of the present.” In addition to typical Marcia L. Verduin, MD, Book Editor

Medication Adherence: A Review of the Literature and Implications for Clinical Practice

Abstract: Adherence is defined as the extent to which a patient's behavior coincides with medical or prescribed health advice. Adherence is considered non-judgmental and is preferred over the term "compliance," which carries negative connotations and suggests blame for the patient. A major challenge in the field of psychiatry has been to understand why patients may or may not adhere to medication and other treatment recommendations. A comprehensive review of the literature on medication adherence among patients with psychiatric illnesses was conducted with the following objectives: (1) to better understand the impact of medication nonadherence, (2) to identify risk factors for medication nonadherence, and (3) to study interventions designed to improve patient adherence. The authors initially searched the Ovid Medline electronic database using the key words "medication adherence" and "compliance" to identify all articles written in the English language published through early 2008. This produced over 2000 references. The search was then narrowed to publications specific to psychotropic medication. The ultimate goal of the review was to increase awareness of this critical issue and to discuss strategies that the psychiatric clinician can implement to address patient adherence to prescribed medications. The authors chose to include articles that were deemed to be clinically useful to the practicing clinician.Studies that have specifically investigated adherence to psychiatric medications vary in the definitions of adherence and methodology that were used, making interpretation of results across studies difficult. Psychoeducational interventions have long been the mainstay of treatment for adherence problems. However, there is growing evidence that other approaches such as cognitive-behavioral strategies and motivational interviewing may be effective. Based on a comprehensive literature review, the authors recommend the following strategies for addressing adherence problems: focus on strengthening the therapeutic alliance; devote time in treatment specifically to address medication adherence; assess patients' motivation to take prescribed medications; and identify and address potential barriers to treatment adherence.

The expert consensus guideline series. Treatment of behavioral emergencies 2005.

Abstract: Objectives.Due to inherent dangers and barriers to research in emergency settings, few data are available to guide clinicians about how best to manage behavioral emergencies. Key constructs such as agitation are poorly defined. This lack of empirical data led us to undertake a survey of expert opini