Psychopharmacological enhancement: a conceptual framework

The availability of a range of new psychotropic agents raises the possibility that these will be used for enhancement purposes (smart pills, happy pills, and pep pills). The enhancement debate soon raises questions in philosophy of medicine and psychiatry (eg, what is a disorder?), and this debate in turn raises fundament questions in philosophy of language, science, and ethics. In this paper, a naturalistic conceptual framework is proposed for addressing these issues. This framework begins by contrasting classical and critical concepts of categories, and then puts forward an integrative position that is based on cognitive-affective research. This position can in turn be used to consider the debate between pharmacological Calvinism (which may adopt a moral metaphor of disorder) and psychotropic utopianism (which may emphasize a medical metaphor of disorder). I argue that psychiatric treatment of serious psychiatric disorders is justified, and that psychotropics are an acceptable kind of intervention. The use of psychotropics for sub-threshold phenomena requires a judicious weighing of the relevant facts (which are often sparse) and values

How Has McDonnell Affected Prosecutors’ Ability to Police Public Corruption? What Are Politicians And Lobbyists Allowed To Do, And What Are Prosecutors Able To Prosecute?

The question posed to the panelists on the first panel is: How has McDonnell affected prosecutors’ ability to police public corruption? What can politicians and lobbyists do and what can prosecutors prosecute

An integrative approach to psychiatric diagnosis and research

Much attention has been paid to revisions of psychiatric classification systems. Nevertheless, there remains significant dissatisfaction with the nosology. From a neuroscience perspective, diagnostic criteria have failed to incorporate neurobiological data, and a focus on “circuit-based behavioral dimensions” (1) will improve diagnosis. From a more critical perspective, given that psychiatric disorders do not represent valid disease entities (1), diagnosis merely medicalizes problems in living. These specific debates echo larger debates about classification in medicine, in which many emphasize notions of disease, arguing that clinicians must 51 be scientists who understand physiology, while others emphasize the experience of illness, stating that clinicians must be humanists who understand suffering (2). An integrative medicine and psychiatry arguably recognizes each of these aspects of being a good diagnostician and researcher (3,4)

Global mental health and neuroethics

BACKGROUND: Global mental health is a relatively new field that has focused on disparities in mental health services across different settings, and on innovative ways to provide feasible, acceptable, and effective services in poorly-resourced settings. Neuroethics, too, is a relatively new field, lying at the intersection of bioethics and neuroscience; it has studied the implications of neuroscientific findings for age-old questions in philosophy, as well as questions about the ethics of novel neuroscientific methods and interventions.DISCUSSION:In this essay, we address a number of issues that lie at the intersection of these two fields: an emphasis on a naturalist and empirical position, a concern with both disease and wellness, the importance of human rights in neuropsychiatric care, and the value of social inclusion and patient empowerment.SUMMARY:These different disciplines share a number of perspectives, and future dialogue between the two should be encouraged

Reproductive hormones as psychotropic agents?

The female preponderance in unipolar mood and anxiety disorders is well documented, with a double to triple lifetime prevalence compared to males. Much of this increased vulnerability is in the childbearing years. Hormones are a tempting explanation, although other biochemical factors such as cytokines may also be important. Psychosocial factors are clearly involved, including role issues.South African Psychiatry Review - May 200

The assessment and treatment of panic disorder in general practice

Panic disorder (PD) is an anxiety disorder that affects many South Africans. If undiagnosed or mismanaged, this condition may impact profoundly on an individual's functioning and quality of life. At the primary level, the assessment of panic attacks requires consideration of a number of differential diagnoses. General practitioners also play an invaluable role in the acute and long-term care and appropriate referral of individuals with PD. This article provides an overview of PD in general practice and includes a guideline for case identification and therapeutic options

On the economics of product differentiation in Auditing

https://egrove.olemiss.edu/dl_proceedings/1176/thumbnail.jp

Buspirone is an effective augmenting agent of serotonin selective re-uptake inhibitors in severe treatment-refractory depression

Background. Buspirone has previously been reported to be effective in the augmentation of the antidepressant effect of serotonin selective re-uptake inhibitors (SSRls) in depressed outpatients. We report on buspirone augmentation of SSRls in severe treatment-refractory depression in inpatients.Methods. A retrospective chart review was undertaken of patients diagnosed with DSM-III-R major depression and treated at our inpatient unit. All 14 patients had been given structured depression rating scales before and after addition of buspirone to a SSRLResults. Patients had previously failed mUltiple trials of antidepressants, often including lithium and/or thyroid augmentation, as well as, in 12 cases, electroconvulsive therapy. However, augmentation of an SSRI with buspirone led to a rapid and significant improvement in depression in 6 of 14 (43%) patients.Conclusion. Despite the limitations of the study design, our resutts support previous work. suggesting the need for further controlled research on the use of buspirone in the augmentation of the antidepressant response to the SSRls

A survey of participants in two internet support groups for people with hair-pulling

The original publication is available at http://www.biomedcentral.com/1471-244X/5/37Background: A substantial number of patients suffering from psychological problems or psychiatric disorders have turned to internet support groups for help. This paper reports on the perceived effectiveness of trichotillomania (TTM) internet support groups for people suffering from hair-pulling. Methods: A questionnaire was sent via e-mail to all subscribers of two mailing lists devoted to TTM, each of which takes a somewhat different approach to the condition. The questionnaire addressed the possible benefits and problems associated with belonging to a TTM virtual support group. Results: Subscribers had similar demographic features as clinical samples of trichotillomania patients. Subscribers to both internet lists found them helpful in terms of feeling supported and in obtaining information. The different approaches to TTM on the two lists were associated with differences in treatments attempted by participants. Conclusion: Internet support groups can potentially contribute to increasing awareness about and knowledge of psychiatric disorders such as TTM, as well as to their management. Nevertheless, additional effort is required to ensure that subscribers are able to make informed, evidence-based decisions