Items in AFP with MESH term: Psychotherapy

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Conduct Disorder: Diagnosis and Treatment In Primary Care - Article

ABSTRACT: Conduct disorder is a common childhood psychiatric problem that has an increased incidence in adolescence. The primary diagnostic features of conduct disorder include aggression, theft, vandalism, violations of rules and/or lying. For a diagnosis, these behaviors must occur for at least a six-month period. Conduct disorder has a multifactorial etiology that includes biologic, psychosocial and familial factors. The differential diagnosis of conduct disorder includes oppositional defiant disorder, attention-deficit/hyperactivity disorder (ADHD), mood disorder and intermittent explosive disorder. Family physicians may provide brief, behaviorally focused parent counseling, pharmacotherapy and referral for more intensive family and individual psychotherapy.


Psychogenic Nonepileptic Seizures - Article

ABSTRACT: Psychogenic nonepileptic seizures are episodes of movement, sensation, or behaviors that are similar to epileptic seizures but do not have a neurologic origin; rather, they are somatic manifestations of psychologic distress. Patients with psychogenic nonepileptic seizures frequently are misdiagnosed and treated for epilepsy. Video-electroencephalography monitoring is preferred for diagnosis. From 5 to 10 percent of outpatient epilepsy patients and 20 to 40 percent of inpatient epilepsy patients have psychogenic nonepileptic seizures. These patients inevitably have comorbid psychiatric illnesses, most commonly depression, posttraumatic stress disorder, other dissociative and somatoform disorders, and personality pathology, especially borderline personality type. Many patients have a history of sexual or physical abuse. Between 75 and 85 percent of patients with psychogenic nonepileptic seizures are women. Psychogenic nonepileptic seizures typically begin in young adulthood. Treatment involves discontinuation of antiepileptic drugs in patients without concurrent epilepsy and referral for appropriate psychiatric care. More studies are needed to determine the best treatment modalities.


Treatment of Bulimia Nervosa - FPIN's Clinical Inquiries


Psychological Interventions for Noncardiac Chest Pain - Cochrane for Clinicians


Counseling or Antidepressants for Treating Depression? - FPIN's Clinical Inquiries


Depressive Disorders - Clinical Evidence Handbook


Psychosocial Interventions Delivered by Primary Care Physicians to Patients with Depression - FPIN's Clinical Inquiries


Depression in Post-MI Patients: An Opportunity for Primary Care - Editorials


Screening and Treatment for Major Depressive Disorder in Children and Adolescents - Putting Prevention into Practice


Recognition and Treatment of Obsessive-Compulsive Disorder - Article

ABSTRACT: Obsessive-compulsive disorder is relatively common; however, its actual incidence has only recently become clear. The neurotransmitter serotonin appears to have a central role in this disorder. Males and females are affected equally, with onset usually occurring in late adolescence. Symptoms include intrusive thoughts that lead the patient to perform repetitive rituals that interfere with daily living. Although patients are typically distressed by these thoughts and rituals, they seldom volunteer their symptoms. Successful diagnosis often requires specific questioning by the physician. Treatment is directed at symptom reduction; however, complete remission of symptoms is unusual. Pharmacologic therapy usually includes clomipramine or antidepressant treatment with selective serotonin reuptake inhibitors, but in dosage ranges higher than those typically used in the treatment of depression. Behavior therapy has also been proved effective, both alone and in conjunction with pharmacologic therapy.


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