The post-test for this issue is available for one year after the publication date to subscribers. By successfully completing the test you will be awarded a certificate for 1 CME credit.
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Excessive alcohol use is neurotoxic, but some studies have found that moderate alcohol intake might actually reduce the risk of dementia. Most of these studies, however, have focused on geriatric patients.
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Sleep problems are common in recovery, and they have many causes such as withdrawal states, circadian rhythm disruptions, and a host of psychiatric and medical comorbidities. It’s a two-way street: Insomnia raises the risk of substance misuse, and addiction can cause or worsen sleep problems.
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Jet lag happens when people fly across multiple time zones. The body’s internal clock gets out of sync with the outside signals of sunrise and sunset. The result is insomnia, poor concentration, fatigue, and gastrointestinal symptoms.
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Insomnia is different in PTSD. Some of that is explained by the symptoms of PTSD, such as nightmares, hyperarousal, anxiety, and physical restlessness. But there’s another thing we’re seeing that isn’t as obvious: sleep apnea.
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We’ve all been there. A 63-year-old patient comes to you with a chief complaint of memory loss. She tells you that she has a hard time remembering people’s names and forgets where she puts her keys. She lives and drives on her own without a problem, but asks, “Isn’t there some memory pill I can take?” What advice can we give her?
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Screening tests can also help distinguish normal aging from a Neurocognitive Disorder. The popular Mini Mental Status Exam is being replaced by more sensitive tests like the Montreal Cognitive Assessment (MOCA) and the Saint Louis University Mental Status Examination (SLUMS). Both of these can be completed in 10 minutes and are normed for Mild and Major Neurocognitive Disorders. An abbreviated form of the SLUMS, the Rapid Cognitive Screen, can be administered in 5 minutes.
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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.