The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 1 CME credit. Read More
Open Dialogue, developed in the 1990s in Tornio, Finland, is both a way of communicating (while paying attention to one’s vocabulary) and a system of care. All communication about patients occurs in their presence and is based on respectful language that is often derived from the patient’s own words. Learn more about this technique as it applies to treating psychosis in this article.
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It’s important to realize that psychosis can result from many different non-psychiatric conditions—for example, substance use, electrolyte imbalances, thyroid abnormalities, systemic infections, nutritional deficiencies, brain tumors, and seizures, among others. By the time we see them, patients have usually already had a basic medical evaluation in an inpatient hospital or emergency room, and most non-psychiatric medical causes have been ruled out.
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I started prescribing ketamine two years ago. I generally tend to be conservative in trying newer treatments—especially ones not yet approved—but I was very impressed with both its safety and efficacy.
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Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.
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