Life-threatening illness has been identified as a stressor that can precipitate posttraumatic stress disorder (PTSD). Major advances in cancer treatment have led to increased survival periods. At the same time, there is a growing awareness of the psychological impact of cancer diagnosis and treatment on the patient. Cancer survivors report that cancer can elicit symptoms of traumatic stress. When cancer-related PTSD is untreated, medical and psychiatric morbidity increase. Despite the prevalence, impact, and morbidity of cancer-related PTSD, access to mental health care in cancer patients remains limited. It is important to increase mental health providers' awareness of cancer-related PTSD, given rising cancer rates and the potential for enhancing quality of life. This article presents an overview of the recognition, diagnosis, management, and follow-up of cancer-related PTSD for the mental health clinician.
Borderline personality disorder (BPD) is associated with functional impairment, characterized by marked impulsivity, instability of mood, interpersonal relationship problems, and suicidal behaviors with high suicide rates. It affects interpersonal relationships in all domains including child rearing, which can be a challenge for parents with BPD. BPD may also lead to poor socioeconomic outcomes due to frequent job losses and lack of productivity; criminal behavior from impulsivity; and increased resource use, resulting in high health care treatment costs. BPD is comorbid with other mental health disorders; therefore, its identification and treatment are paramount for management. The clinical challenge centers on managing chronic suicidality. Treatment consists of various modalities, including psychotherapy and psychopharmacology. [ Psychiatr Ann . 2020;50(1):14–18.]
Benzodiazepines have been around for nearly 60 years and are still widely used. Shortly after their introduction, their potential for abuse and dependence began to be recognized. Although their adverse effects are now widely known, their use and abuse continues to be a significant problem. They are useful drugs that are effective for a wide variety of psychiatric and nonpsychiatric conditions, but they do have a number of side effects even when used appropriately. More importantly, tolerance and dependence can develop rapidly, and management requires a number of different strategies depending on the extent of the abuse. Clinicians need to be wary of the potential long-term ramifications of prescribing these medications to their patients. [ Psychiatr Ann. 2018;48(8):360–365.]
The decision to hospitalize a patient exhibiting signs of psychiatric distress is made as a last resort after outpatient management has failed. In this article, we discuss the psychiatric signs, symptoms, and imminent risk factors that necessitate inpatient hospitalization. Types of self-harm, suicidal and nonsuicidal presentations, agitation, psychosis, and secondary gain are discussed. Particular attention is paid to tools used to stratify the level of risk to determine the best possible treatment outcome. [ Psychiatr Ann. 2018;48(1):36–41.]
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