Over the last five years California has enacted a number of laws and regulations that seek to make the healthcare insurance system fairer, but keeping track of all of these laws is a real challenge. At a recent symposium I ran into a colleague of mine who reminded me of a law that requires insurance companies to continue coverage of …
Genetics of bipolar disorder – update
Unraveling the genetics of bipolar disorder has been a much more complicated task than anyone thought. Although the best estimates suggest that genetic factors account for the very high percentage of the risk of developing bipolar, with an estimated an estimated 0.7 to 0.8 heritability (Sullivan), it has been remarkably difficult to find genes with significant individual effects that are replicated …
Depression and Inflammation
Is depression one of a series of illnesses caused by inflammation? There has been a lot of interest in the last year in the idea that inflammation (activation of the body’s immune system) might be a cause as well as a consequence of depression. One theory suggests that depression might be an inflammatory disorder, rather than a disorder of altered neurotransmitter levels. Certainly …
Common Over the Counter Medications Linked to Dementia
Common over-the-counter medications may increase your risk for dementia. That is the startling finding of a recently published journal article which used a number of approaches to examine the possible risk of using medications that have anticholinergic effects. This includes many psychiatric medications as well as many common over the counter antihistamine medications, medications for sleep, and for GI problems: …
Acceptance and Commitment Therapy Part 1: Acceptance and Willingness
Acceptance and Commitment Therapy (or ACT, pronounced as the word, not A-C-T) is a comprehensive, empirically driven model developed by Steve Hayes, PhD and colleagues with nearly 200 randomized controlled trials (methodologically sound studies) supporting its efficacy for numerous problems and concerns. I recently attended the Anxiety and Depression Association of America conference in Philadelphia, where I offered a two-hour …
Early intervention for depression helps
In a review of an article published in JAMA Psychiatry in early March 2016, Dr. Steven Dubovsky writes about encouraging findings about treatment efficacy of patients with major depression from a large study in Denmark. In the study, researchers reviewed 10 years worth of national data from the extensive population records capped in Denmark which provides nearly universal access to …
Disability
Given the severity of mood and anxiety symptoms and some of the people we treat, we often deal with issues related to short-term or long-term work disability. In this post we will talk about common questions that come up when someone is impaired as the result of a psychiatric condition. Functional Assessment It often comes as a surprise to our …
Doxy.me Telepsychiatry
This blog post provides information about Doxy.me a HIPAA compliant tele-psychiatry platform that we use at Gateway Psychiatric. Doxy.me is a simple and secure Web-based video solution designed for telemedicine. Doxy.me automatically works with popular internet browsers, such as Google Chrome and Mozilla Firefox, without requiring additional downloads or plug-ins to install. Doxy.me does not work with Safari or Internet Explorer. …
Testosterone for Older Men
Does testosterone supplementation help older men with low testosterone improve their quality of life, mood and energy? Some of the “low T” advertisements on TV made it seem like the magic hormone that conquered aging. More recently the FDA has been expressing its concern about over-prescribing by, among other things, adding black box warnings on the labels of gel formulations of …
Norepinephrine dopamine and depression
In an elegant set of studies published in February 2016 in Nature Neuroscience the team of Bruno Giros, a researcher at the Douglas Mental Health University Institute and Professor of Psychiatry at McGill University, reports the first-ever connection between noradrenergic neurons and vulnerability to depression. The study involved research using probably the most well developed animal model for depression – chronic or …