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American Family Physician December 15, 2001 Peggy R. Cyr & George K. Dreher	Neurotic Excoriations Neurotic excoriations are self-inflicted skin lesions produced by repetitive scratching. Because there is no known physical problem of the skin, this is a physical manifestation of an emotional problem...
American Family Physician September 15, 2000 Kim S. Griswold, M.D., M.P.H. & Linda F. Pessar, M.D.	Management of Bipolar Disorder A comprehensive management program, including collaboration between the patient's family physician and psychiatrist, should be implemented to optimize medical care...
American Family Physician October 1, 2000 Michael F. Gliatto, M.D.	Generalized Anxiety Disorder Patients with generalized anxiety disorder experience worry or anxiety and a number of physical and psychologic symptoms...
American Family Physician November 15, 2000 Son & Kirchner	Depression in Children and Adolescents Depression among children and adolescents is common but frequently unrecognized. It affects 2 percent of prepubertal children and 5 to 8 percent of adolescents...
American Family Physician September 1, 2000 Jennifer Travis Lange	Primary Care Treatment of Post-traumatic Stress Disorder Current treatment strategies combine patient education; pharmacologic interventions, such as selective serotonin reuptake inhibitors, trazodone and clonidine; and psychotherapy...
American Family Physician August 15, 2002 Ward & Zamorski	Benefits and Risks of Psychiatric Medications During Pregnancy Decisions regarding the use of psychiatric medications should be individualized, and the most important factor is usually the patient's level of functioning in the past when she was not taking medications.
American Family Physician October 15, 2004 Randy K. Ward	Assessment and Management of Personality Disorders Patients with personality disorders are common in primary care settings; caring for them can be difficult. The characteristics of these patients' personalities tend to elicit strong feelings in physicians, lead to the development of problematic physician-patient relationships, and complicate the task of diagnosing and managing medical and psychiatric disorders.
American Family Physician January 1, 2007 Shashi & Subhash Bhatia	Childhood and Adolescent Depression Safe and effective treatment of major depression in this age group requires accurate diagnosis, suicide risk assessment, and use of evidence-based therapies.
American Family Physician October 15, 2001 Michael L. Szymanski	Attention-Deficit/Hyperactivity Disorder: Management Attention-deficit/hyperactivity disorder (ADHD) is the most common psychiatric disorder of childhood and often persists into adulthood. With time and interest, the family physician can develop the skills needed to treat this disorder...
American Family Physician November 1, 2000 Searight, Burke & Rottnek	Adult ADHD: Evaluation and Treatment in Family Medicine Attention-deficit/hyperactivity disorder (ADHD) affects 30 to 50 percent of adults who had ADHD in childhood. Accurate diagnosis of ADHD in adults is challenging and requires attention to early development and symptoms of inattention, distractibility, impulsivity and emotional lability...
American Family Physician September 1, 2001 William D. Smucker & Marjaneh Hedayat	Evaluation and Treatment of ADHD Symptoms of attention-deficit/hyperactivity disorder (ADHD) are present in as many as 9 percent of school-age children. ADHD-specific questionnaires can help determine whether children meet diagnostic criteria for the disorder...
American Family Physician August 15, 2000 Robert L. Phillips, Jr.	Depression and Sexual Desire Asking a depressed patient about libido and sexual function and tailoring treatment to minimize adverse effects on sexual function can significantly increase treatment compliance and improve the quality of the patient's life...
American Family Physician May 15, 2004 Birrer & Vemuri	Depression in Later Life: A Diagnostic and Therapeutic Challenge Depression in elderly persons is widespread, often undiagnosed, and usually untreated. Because there is no reliable diagnostic test, a careful clinical evaluation is essential.
American Family Physician April 15, 2001 H. Russell Searight	Conduct Disorder: Diagnosis and Treatment in Primary Care 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...
American Family Physician August 15, 2001 Thomas P. Guck	Assessment and Treatment of Depression Following Myocardial Infarction Depression is an independent risk factor in the development of and mortality associated with cardiovascular disease in otherwise healthy persons...
American Family Physician October 15, 2002 Zamorski & Albucher	What to Do When SSRIs Fail: Eight Strategies for Optimizing Treatment of Panic Disorder Effective management of panic disorder is a common challenge for family physicians. Selective serotonin reuptake inhibitors (SSRIs) are the drugs of choice for this condition because of their safety and efficacy. But not all patients have a favorable response to SSRI therapy.
American Family Physician November 15, 2003 Jones et al.	Common Problems in Patients Recovering from Chemical Dependency This article describes how to care for patients recovering from chemical dependency, including special concerns that arise during the treatment of common medical conditions, to avoid adverse outcomes or relapse into addiction.
American Family Physician July 1, 2000 Ted D. Epperly	Health Issues in Men: Part II. Common Psychosocial Disorders During screening examinations and, when appropriate, other health-related visits, family physicians should be alert for signs and symptoms of common psychosocial disorders in men. Health issues of concern include alcohol and substance abuse, domestic violence, midlife crisis and depression.
American Family Physician July 1, 2003 Springer et al.	Common Hair Loss Disorders Hair loss (alopecia) affects men and women of all ages and often significantly affects social and psychologic well-being. Although alopecia has several causes, a careful history, close attention to the appearance, and a few simple studies can quickly narrow the potential diagnoses.
Nurse Practitioner March 2012 Vanya Hamrin et al.	Evaluation and Management of Pediatric and Adolescent Depression The primary care setting is an appropriate venue for screening and identifying pediatric depression. Nurse practitioners can provide initial management or referral to psychiatric mental health professionals for evidence-based treatments.
American Family Physician November 15, 2005 Haas et al.	Management of the Difficult Patient All physicians must care for some patients who are perceived as difficult because of behavioral or emotional aspects that affect their care. Specific communication techniques and greater patient involvement in the process of care may enhance the relationship.
American Family Physician March 15, 2006 Shearer & Gordon	The Patient with Excessive Worry Worry is an effective short-term response to uncertainty that can become self-perpetuating with adverse long-term consequences. Evidence-based treatments for such disorders can assist family physicians in the management of this disorder.
Nursing April 2008 Kathryn Murphy	Shedding the burden of depression & anxiety Learn about types of depression and available treatments.
American Family Physician October 1, 2006 Kavan et al.	A Practical Guide to Crisis Management Physicians often are required to assist patients in crisis. An estimated 4% of visits to primary care physicians involve psychiatric or social crises.
ifeminists November 17, 2004 Byron Fraser	Review: Your Drug May Be Your Problem Excerpts from the book Your Drug May Be Your Problem: How and Why to Stop Taking Psychiatric Medications by Peter Breggin and David Cohen delineating the adverse effects of these medications and how to stop taking them.
American Family Physician October 15, 2003 Wanda P. Fremont	School Refusal in Children and Adolescents School refusal is a problem that is stressful for children, families, and school personnel. Failing to attend school has significant short- and long-term effects on children's social, emotional, and educational development.
American Family Physician January 15, 2003 Ables & Baughman	Antidepressants: Update on New Agents and Indications Many antidepressants have been released in the United States over the past two decades. This article is an update of information about the newer agents for depression and new indications for older antidepressants.
Nurse Practitioner February 2011 Heather Roebuck	Treatment options for rosacea with concomitant conditions This article discusses the presentation, pathophysiology, and management of rosacea with common concomitant skin disorders.
American Family Physician June 15, 2002 Jeffrey L. Cummings	Guidelines for Managing Alzheimer's Disease: Part II. Treatment Once the clinical diagnosis of Alzheimer's disease has been made, a treatment plan must be developed. Patient symptoms and care needs change as Alzheimer's disease progresses.
American Family Physician February 15, 2005 Ham, Waters & Oliver	Treatment of Panic Disorder Panic disorder with or without agoraphobia occurs commonly in patients in primary care settings. This article assesses multiple evidence-based reviews of effective treatments for panic disorder.
American Family Physician June 15, 2006 Prater & Zylstra	Medical Care of Adults with Mental Retardation Primary medical care of persons with mental retardation should involve continuity of care, maintenance of comprehensive treatment documentation, routine periodic health screening, and an understanding of the unique medical and behavioral disorders common to this population.
American Family Physician July 1, 2000 Nancy A. Phillips	Female Sexual Dysfunction: Evaluation and Treatment Sexual dysfunction includes desire, arousal, orgasmic and sex pain disorders (dyspareunia and vaginismus). Primary care physicians must assume a proactive role in the diagnosis and treatment of these disorders...
American Family Physician November 1, 2002 Prater & Zylstra	Autism: A Medical Primer Autistic disorder, a pervasive developmental disorder resulting in social, language, or sensorimotor deficits, occurs in approximately seven of 10,000 persons. Early detection and intervention significantly improve outcome.
Nursing Management May 2012 Joanne Lavin	Surviving posttraumatic stress disorder Posttraumatic stress disorder is an anxiety disorder that develops after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened.
American Family Physician February 15, 2006 Rayner et al.	Behavior Disorders of Dementia: Recognition and Treatment Psychosis may pose a greater challenge than cognitive decline for patients with dementia and their caregivers. Goals of treatment should include symptom reduction and preservation of quality of life.
American Family Physician August 2001 Marjorie E. Kaplan Seidenfeld	Impact of Anorexia, Bulimia and Obesity on the Gynecologic Health of Adolescents Dieting behaviors and nutrition can have an enormous impact on the gynecologic health of adolescents...
American Family Physician September 15, 2003 Scott Moses	Pruritus Pruritus is a common dermatologic problem that increases in incidence with age. In some patients, the condition may be so severe that it affects sleep and quality of life. While pruritus most commonly occurs in skin disorders, it may be an important dermatologic clue to the presence of an underlying systemic disease.
Nurse Practitioner August 2011 Davis et al.	Supportive approaches for Alzheimer Disease Alzheimer disease accounts for almost 80% of all dementia diagnoses. Currently, more than 5 million Americans suffer from this debilitating illness, with the highest prevalence in the oldest age groups.
American Family Physician May 1, 2001 Carla T. Herrerias	The Child with ADHD: Using the AAP Clinical Practice Guideline The American Academy of Pediatrics developed an evidence-based clinical practice guideline that provides recommendations for the assessment and diagnosis of school-aged children with attention-deficit/hyperactivity disorder...
American Family Physician September 15, 2002 W.F. Peate	Occupational Skin Disease Work-related skin diseases account for approximately 50 percent of occupational illnesses and are responsible for an estimated 25 percent of all lost workdays. These dermatoses are often underreported because their association with the workplace is not recognized.
American Family Physician February 15, 2002 Grace Brooke Huffman	Evaluating and Treating Unintentional Weight Loss in the Elderly Unintentional weight loss in the elderly patient can be difficult to evaluate. Accurate evaluation is essential, however, because this problem is associated with increased morbidity and mortality...
Nursing May 2012 Tim Blake	Three Medication Pathways for Bipolar Disorder No matter where you work, you're likely to care for patients with bipolar disorder, which affects about 2.6% of people age 18 and older per year.
Reason January 2003 Jacob Sullum	Head Games What are the rules for defining mental illness?
American Family Physician July 15, 2000 Anthony F. Jerant	Early Detection and Treatment of Skin Cancer The incidence of skin cancer is increasing by epidemic proportions...
American Family Physician March 1, 2003 C. Carolyn Thiedke	Alopecia in Women Alopecia can be divided into disorders in which the hair follicle is normal but the cycling of hair growth is abnormal and disorders in which the hair follicle is damaged.
American Family Physician November 1, 2006 Lurie et al.	Seasonal Affective Disorder Patients with seasonal affective disorder have episodes of major depression that tend to recur during specific times of the year, usually in winter. Like major depression, seasonal affective disorder probably is underdiagnosed in primary care settings.
Salon.com March 9, 2000 Lawrence H. Diller, M.D.	Kids on drugs A behavioral pediatrician questions the wisdom of medicating our children.
American Family Physician January 15, 2003 Pritts & Susman	Diagnosis of Eating Disorders in Primary Care Eating disorders are associated with devastating medical and psychologic consequences, including death, osteoporosis, growth delay, and developmental delay. Prompt diagnosis is linked to better outcomes.
Salon.com July 11, 2001 Amy Benfer	A history of failure Author and psychologist Bruce Levine pummels psychiatry, psychotropic drugs and the role both may have played in the case of Andrea Yates...
American Family Physician June 1, 2003 Motsinger et al.	Use of Atypical Antipsychotic Drugs in Patients with Dementia Increasingly, atypical antipsychotic drugs are prescribed for elderly patients with symptoms of psychosis and behavioral disturbances. To minimize side effects, these medications should be started at low dosages that are increased incrementally.