From the Pages of Psychiatric Times: September 2022

Experts weighed in on a wide range of psychiatric issues for the September 2022 issue of the Psychiatric Times.

In the September issue of psychiatric timesTM, we work with experts from multiple psychiatric areas to bring you thoughtful articles on a wide variety of psychiatric issues, from contingency management treatment for substance use disorders to burnout prevention tips for psychiatrists. Here are some highlights of the problem.

Serotonin or not, antidepressants work

Imagine that you, as a doctor, have just seen this headline on the Internet: “Depression Probably Not Caused by Excess Black Bile.” He was followed by a long speech about how an imbalance in the 4 bodily humors is not responsible for mood disorders. You might scratch your head and wonder why anyone in 2022 would bother to refute the Galenic-Medieval humoral theory.

As senior academic psychiatrists and psychopharmacologists, we reacted with similar perplexity to a recent global review and follow-up article by UK researchers. The review, conducted by Moncrieff et al and published in Molecular Psychiatry (hereinafter “the review”), argued that “there is no support for the hypothesis that depression is caused by low serotonin activity or concentrations” and that “the serotonin theory of depression is not empirically tested” . Keep reading

Contingency management is a powerful clinical tool for treating substance use Research evidence and new practice guidelines for use

Contingency management (CM) is an effective behavior change technique commonly used to treat substance use disorders (SUD). CM is one of the most effective behavioral interventions for initiating and maintaining abstinence from most types of commonly used drugs and alcohol.

Background and Justification

CM-based treatments for SUD originate from basic behavioral science, namely the operant conditioning literature. Operant conditioning is a type of learning in which behavior is modified or maintained through the consequences it produces. In the context of SUD treatment, the CM typically modifies substance use by providing tangible positive reinforcement (eg, prizes, coupons, or monetary reinforcement) in exchange for evidence of performance of the targeted behavior, such as submitting a negative test of drugs. urine sample. Keep reading

Just the tip of the iceberg: psychiatric implications of the rollover Roe vs. Wade

The United States Supreme Court defied court tradition and the expressed intentions of some of its members during its confirmation hearings by overturning 50-year precedent, Roe vs. Wade, which had established abortion as a right. Immediately after the Dobbs v Jackson Women’s Health Organization decision was issued on June 22, 2022, many states implemented or enacted laws that severely limited or prohibited abortion.

A week after the decision, a 10-year-old girl, pregnant from rape, was taken to Indiana after being denied an abortion in her home state of Ohio. She was at high risk, not only for exacerbations of the trauma she had already experienced, but also for complications of pregnancy and childbirth, not to mention childbearing. It is notable and relevant that the first responses of Mike DeWine (governor of Ohio), The Wall Street Journal, and other means was to declare that the story was false or could not be confirmed. No apology was offered when the rapist was arrested and confessed. The doctor who performed the abortion was then accused of failing to record the procedure as required by law. Keep reading

8 tips for psychiatrists to prevent burnout

In 2018, the American Psychiatric Association found that burnout among psychiatrists was nearly 50%. This number may be even higher as we persist through global endemic disease, social and political unrest, and increasing economic stressors. In many states, the collateral impact on health care will only be exacerbated by the recent Supreme Court decision to reverse Roe vs. Wade. This has led to an increased burden on psychiatrists, our patients, and our colleagues in the medical field who turn to us for help.

It is important to note that the term exhaustion itself can be polarizing and create stigma. It may blame the individual and does not take into account systemic or structural barriers that lead to adverse distress. At its core, burnout is an imbalance of empathy and self-compassion. Keep reading

View the full September issue psychiatric timesTM here. And be sure to stay up to date by subscribing to the psychiatric timesTM electronic newsletter.

Do you have any comments on any of these or other articles? Do you have a good idea for an article and want to write? Interested in sharing your perspectives? Write to us at [email protected]

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