The patient is a 31-year-old, single female attorney, who was referred by her primary care physician for somatic complaints that have been worked up thoroughly, with normal results. In the past, she has been worried about and has pursued various diagnoses, including endometriosis, neurofibromatosis, and ovarian cancer, and has doctor-shopped...

Dr. Twersky-Kengmana is an early-career psychiatrist, trained in a mainstream residency, and she prescribes medication to the majority of her patients. Yet, about 10% of her practice is psychoanalytic. In this article, she discusses the current status of psychoanalysis, some of the evidence for its efficacy, and why she has found it so useful for her patients.

Patient details have been fictionalized in this presentation of real cases that represent common critical issues.

Psychoanalytic training may not be right for you, but here are some analytic concepts that can be useful to anyone practicing psychiatry.

We know that childhood trauma can scar our patients psychologically—but new research suggests it might actually change their genes.

Psychoanalysis is both a form of treatment and a theory of mind and development. The treatment involves the exploration of the unconscious meaning of symptoms and behaviors. The idea is that many of our patients’—and our own—personality traits and behaviors are governed by unconscious forces.

The diagnosis of conduct disorder started with patients who were generally labeled as “bad kids”—juvenile delinquents, so to speak—and then professionals came to the realization that these kids are not necessarily “bad” but that there may be some kind of psychiatric pathology underlying their actions. In this interview, Akeem Marsh, MD, presents his perspective as a psychiatrist providing diagnostic evaluations, medication management, individual therapy, and treatment planning in a juvenile detention setting in New York City.

Nearly one in three foster children have significant psychiatric problems during their time in foster care—especially those related to trauma and neglect that brought them into the system. This article is a brief primer on how foster care works, and how psychiatrists get involved.

Foster children tend to be over-medicated. Surveys show that foster youth receive 5 times the number of psychotropic medications, frequently three or four simultaneously, as privately insured children. What else, beside medications, can we offer foster children who are often struggling with psychiatric issues and difficult and unfamiliar family environments?