Current psychiatry reports
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Alcohol dependence (AD) and, more generally, alcohol use disorders (AUDs) predispose individuals to adverse consequences that extend beyond the expected damage from alcohol-direct toxicity. Research has shown that the relationship of alcohol use to health outcomes is complex, as is the etiology of AD, and that the individual and social costs of alcohol-related problems are increasing. We review advances in alcohol science that explore the role of alcohol consumption and patterns of drinking in a range of medically comorbid conditions. Although new knowledge can assist in the development of appropriate medical management strategies, AUDs account for an important percentage of the global burden of disease and require approaches that are not uniquely focused on the identification and treatment of AD.
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Suicidal behavior (ie, thoughts and attempts) in children is an issue of serious concern. In the past, suicide in young children has been largely denied and ignored. However, this is no longer possible, as accumulating evidence supports the existence of suicidal thoughts and actions in preadolescent children. This article explores suicidal behavior in preadolescent children and highlights areas of needed research.
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Curr Psychiatry Rep · Apr 2007
ReviewSuicide risk factors in children and adolescents with bipolar disorder.
Suicidal behavior in children and adolescents with bipolar disorder is a major public health problem that remains understudied. Most research on suicidal behavior in bipolar disorder has been conducted in older adolescents and adults and is limited by retrospective design. ⋯ More systematic research is needed to better understand suicidal behavior in bipolar children and adolescents. Increased knowledge of the risk factors that contribute to suicidal behavior should lead to better prevention and treatment.
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Curr Psychiatry Rep · Feb 2007
ReviewDelirium and cognitive dysfunction in the intensive care unit.
Delirium is an under-recognized, highly prevalent form of organ dysfunction in the intensive care unit (ICU). It is imperative to be aware of risk factors for delirium in the ICU, some of which are modifiable. ⋯ The tool, the Confusion Assessment Method for the Intensive Care Unit, has enabled determination of the serious sequelae of delirium, including increased mortality, higher cost, longer length of hospital stay, failure of extubation, and burdensome, long-term cognitive impairment. This article reviews prevention and treatment options, and current pharmacologic and nonpharmacologic approaches to delirium, acknowledging limited but improving quality of evidence to date.
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Curr Psychiatry Rep · Oct 2006
ReviewChronic pain and comorbid mood and substance use disorders: a biopsychosocial treatment approach.
Chronic pain is a colossal health care problem that is devastating to the individual afflicted with unremitting pain and frustrating to the beleaguered health care provider attempting to adequately manage this multifaceted disease. The biopsychosocial model of pain management is a promising approach that emphasizes evidence-based medication management in conjunction with cognitive-behavioral therapy and a graded exercise program. ⋯ Effective pharmacologic management of pain and comorbid mood disorders, including the thoughtful use of opioids, can have a dramatic effect in improving the quality of life in patients with chronic pain. The high prevalence of chronic pain in our society and the scarcity of experienced pain medicine physicians necessitate the development of a community-based systems approach to this complex patient population.