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Fear And The High Risk Patient

Every day, doctors do risky things for their patients, often because they have no other options. Today is such a day for me.

I don’t know how it will go, and because of privacy laws I really can’t tell you about the case, I’m sorry. (Nor will you get an epilogue, that’s not the point of this post). But let’s just say that any normal person would consider the case I’m about to perform very high risk because of the patient’s condition. Even though you tell people they could die and take care to mention that fact time and time again, you wonder if they really can comprehend the significance of what you’re saying – after all, there is a fine line between being reassuring in a time of crisis and telling it like it is. Read more »

*This blog post was originally published at Dr. Wes*

Narcissism: No Longer A Personality Disorder?

Via an article in The New York Times entitled “Narcissism No Longer a Psychiatric Disorder”:

Narcissistic personality disorder, characterized by an inflated sense of self-importance and the need for constant attention, has been eliminated from the upcoming manual of mental disorders, which psychiatrists use to diagnose mental illness.

As Charles Zanor reports in today’s Science Times, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — due out in 2013 and known as D.S.M.-5 — has eliminated five of the 10 personality disorders that are listed in the current edition. The best known of these is narcissistic personality disorder.

So, blogging is normal then? Kinda takes the fun out of it…

*This blog post was originally published at GruntDoc*

ADHD: Fact Or Fiction? Join Me On Capitol Hill

adhdAttention-deficit/hyperactivity disorder (ADHD) is probably overdiagnosed by physicians. In the lay public, the term is often used jokingly to describe the common feeling of distraction we experience in a world filled with interruptions. With a constant stream of text messages, Facebook updates, TV commercials, and fast-paced Twittering, there’s little wonder that we all feel frazzled at times.

But the occasional experience of jangled nerves is not a proper basis for a diagnosis of ADHD. Unfortunately, there has been great confusion between the actual disorder, and its misuse as a label for simply feeling distracted.

So to help set the record straight and to tease out fact from fiction, I’ll be attending a forum on Capitol Hill with my co-bloggers Dr. Kevin Pho and Dr. Rob Lamberts.

If you’re in the DC area, please come and join us in person. If you’d like to view some of the event via the Internet, we’ll be conducting live interviews with the speakers on Ustream. You can join the conversation by asking your questions in real time in the chat room starting at 2:00PM (EST) on Thursday, September 16, 2010. Please save the Ustream link to join the conversation: http://www.ustream.tv/channel/fact-or-fiction-adhd-in-america. Read more »

Schizophrenia Caused By The Cat?

CatFrom the front page of [the August 1st] Baltimore Sun: Researchers Explore Link Between Schizophrenia, Cat Parasite. Frank D. Roylance writes:

Johns Hopkins University scientists trying to determine why people develop serious mental illness are focusing on an unlikely factor: a common parasite spread by cats. The researchers say the microbes, called Toxoplasma gondii, invade the human brain and appear to upset its chemistry — creating, in some people, the psychotic behaviors recognized as schizophrenia. If tackling the parasite can help solve the mystery of schizophrenia, “it’s a pretty good opportunity … to relieve a pretty large burden of disease,” said Dr. Robert H. Yolken, director of developmental neurobiology at the Johns Hopkins Children’s Center. Read more »

*This blog post was originally published at Shrink Rap*

Does Your Job Depress You?

Katina from OnlineCollege.org writes to inform us of a post about 10 Professions With The Highest Levels Of Depression. What I found interesting is the assumption that these jobs cause depression. For example:

Social Workers: If you had to deal with abused children, unkind foster parents and less-than-stellar family dynamics all day, you might be depressed too. Those working in this field are three times more likely to be depressed than the general population, and many are so focused on helping others they don’t get the help that they need themselves.

There’s nothing in the post that addresses the “chicken-or-egg” question. Maybe people with depression are drawn to certain fields? Artists are listed, with the statement that those who chose to work in the field “found it depressing.”

And everyone kind of gets it: Doctors, nurses, social workers, lawyers, artists, janitors, food service people, finance folks, and nursing home and childcare workers. What’s left? What’s the depression rate among bloggers?

*This blog post was originally published at Shrink Rap*

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IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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