When it comes to legal issues, prevention is by far the best medicine. In this article, we will talk about good forensic habits that will protect you from certified letters signed by attorneys. Much of this advice is gleaned from that classic textbook, Clinical Handbook of Psychiatry and the Law (Gutheil and Appelbaum, Lippincott Williams and Wilkins, 3rd ed., 2000).
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When HIPAA first came out, the big concern was that it would limit the release of psychiatric information and would place barriers to being able to talk to other members of a patient’s treatment team. But it turns out that HIPAA actually had the opposite effect in many ways.
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We generally think of major depression as a single disorder with various possible symptoms. The only specific profile that we sometimes look for is atypical depression, encompassing reverse neurovegetative symptoms and reactivity of mood.
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Because standard antipsychotics don’t do much for the negative symptoms of schizophrenia (such as affective flattening and paucity of speech), there has been a fair amount of interest in the so-called “hypoglutaminergic hypothesis” of schizophrenia.
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Medications only work modestly for the treatment of alcohol dependence. In TCPR’s last issue on substance abuse (June 2006) we reviewed the evidence on disulfiram (Antabuse), naltrexone, and acamprosate, and concluded that naltrexone works modestly, acamprosate works less well, and Antabuse has little high quality data but probably works modestly for highly motivated patients.
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Tatiana Tarasoff was a student at the University of California at Berkely in the late 1960s, and she met Prosenjit Poddar, a graduate student from India, at a folk dancing class.
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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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