General Psychiatry
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Take a Breather: A Mindful Tactic for Borderline Dysphoria

June 10, 2020
Greg Sazima, MD.
Greg Sazima, MD. Senior Behavioral Faculty, Stanford/O’Connor Family Medicine Residency Program, San Jose, CA. Dr. Sazima has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Dysphoric states cause intense anxiety and an urgent need to get relief. They can drive patients to self-harm, substance abuse, and suicide. Greg Sazima describes a breathing technique that helps patients pass safely through these crises.
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EXPERT Q&A

A Pragmatic Approach to Borderline Personality Disorder

June 10, 2020
Lois Choi-Kain, MEd, MD

Lois Choi-Kain, MEd, MD
Director of the Gunderson Personality Disorders Institute at McLean Hospital, Belmont, MA. Co-editor of Applications of Good Psychiatric Management for Borderline Personality Disorders: A Practical Guide (APA, 2019) with the late John Gunderson, MD (1942–2019). Dr. Choi-Kain has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

You don’t need to be a psychoanalyst or DBT specialist to help patients with borderline personality disorder. Lois Choi-Kain developed a psychotherapeutic approach that can be woven into just about any psychiatric treatment, from the medication visit to the hospital wards.
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CLINICAL Q&A

The Modafinils in Bipolar Depression

June 10, 2020
Chris Aiken, MD.
Chris Aiken, MD. Editor-in-Chief of TCPR. Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Provigil and Nuvigil, the modafinils, may not work for full depressive episodes, but they do something else in bipolar disorder that’s important to patients. This article explores their cognitive effects, as well as their potential to cause addiction and mania.
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When Further Medication Trials Seem Futile

June 10, 2020
Joseph Goldberg, MD
Joseph Goldberg, MDJoseph Goldberg, MD

Dr. Goldberg is a clinical professor of psychiatry at the Mount Sinai School of Medicine and maintains a private practice focused on mood disorders. He has published three psychiatric textbooks and is completing a fourth on psychopharmacology. Dr. Goldberg has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Joe Goldberg believes we do a disservice by shuffling patients through medication trials that have little chance of working. He shares techniques to engage patients, motivate change, combat demoralization, as well as his top pharmacologic strategies for highly resistant depression.
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Autism: The Goal Posts Have Moved

June 10, 2020
Peter Smith, PsyD.
Peter Smith, PsyD. Dr. Smith has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
The mysterious rise in autism diagnoses has invited every type of conjecture, from vaccines to aging parents. By comparing it to the rate of schizophrenia, this study arrived at an answer that’s a little more mundane, but a lot less speculative.
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Locked-In Syndrome and Quality of Life

June 10, 2020
Eugene Rubin, MD.
Eugene Rubin, MD. Dr. Rubin has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
People can still find meaningful lives even in with the most debilitating medical disorders, including locked in syndrome. In this neurologic disorder, patients maintain full awareness but are unable to speak or move due to complete paralysis of nearly all voluntary muscles in the body.
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