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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 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.
Nurse Practitioner September 2010 Moloney & Cranwell-Bruce	Pharmacological Management of Migraine Headaches Migraine is one of the top 20 causes of disability worldwide, occurring in 17.6% of women and 5.7% of men
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, 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 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 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.
Nurse Practitioner May 2010 Townsend-Roccichelli et al.	Managing sleep disorders in the elderly This article will provide an overview of sleep physiology in the aging population, identify common sleep disorders, and suggest pharmacologic and nonpharmacologic treatment options.
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.
Nursing October 2009 Yvonne D'Arcy	Overturning barriers to pain relief in older adults This article will describe how to lower the barriers to effective pain control in older patients and provide practical tips for helping them receive the full benefit from pharmacologic and nonpharmacologic therapies.
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 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 June 15, 2001 Laurie Krambeer	Methadone Therapy for Opioid Dependence Methadone maintenance therapy is the most widely known and well-researched treatment for opioid dependency. Goals of therapy are to prevent abstinence syndrome, reduce narcotic cravings and block the euphoric effects of illicit opioid use...
American Family Physician December 15, 2004 Morris Maizels	The Patient with Daily Headaches Although the condition is challenging, appropriate treatment of patients with chronic daily headaches (CDH) can bring about significant improvement in the patient's quality-of-life.
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.
Nurse Practitioner August 2009 Fisher & Valente	Evaluating and managing insomnia Insomnia is the most frequent complaint in sleep disorders, and in the past, it had been viewed as a transient problem related only to other medical issues. That line of thought has changed
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 1, 2002 Mary-Anne Enoch & David Goldman	Problem Drinking and Alcoholism: Diagnosis and Treatment Although associated with considerable morbidity and mortality, alcoholism often goes unrecognized in a clinical or primary health care setting. Several brief screening instruments are available to quickly identify problem drinking, often a pre-alcoholism condition...
Nursing April 2012 Elliott et al.	Managing alcohol withdrawal in hospitalized patients A focused nursing assessment is critical in identifying the potential for alcohol withdrawal symptoms in all hospitalized patients. This article discusses how to assess patients at risk and how to use these assessment findings as a basis for nursing interventions.
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 February 1, 2005 Richard D. Blondell	Ambulatory Detoxification of Patients with Alcohol Dependence An appropriate candidate for outpatient detoxification should have arrangements to start an alcohol treatment program and a responsible support person who can monitor progress, and should not have significant, acute, comorbid conditions or risk factors for severe withdrawal.
Nurse Practitioner April 2012 Chaney & Sheriff	Evidence-based treatments for smoking cessation Smoking addiction is both physical and mental. The etiology of tobacco dependence is multidimensional and includes physiological, psychological, and social/behavioral factors.
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...
Nursing April 2008 Kathryn Murphy	Shedding the burden of depression & anxiety Learn about types of depression and available treatments.
American Family Physician December 1, 2002 Aukerman et al.	Management of the Acute Migraine Headache As many as 30 million Americans have migraine headaches. The impact on patients and their families can be tremendous, and treatment of migraines can present diagnostic and therapeutic challenges for family physicians.
Nurse Practitioner April 2012 Firestone et al.	Optimizing fibromyalgia management This article summarizes current information regarding the etiology, pathophysiology, clinical presentation, diagnostic standards, and pharmacologic and non-pharmacologic treatments necessary to successfully manage FM.
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.
Nursing February 2010 Daniel A. Hussar	New Drugs 2010, PART 1 In this article, you'll learn about 16 new drugs.
Nursing June 2008 Yvonne D'arcy	Nursing2008 Pain Management Survey Report See how your responses to this survey compare with those of nursing colleagues across the country and beyond.
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 April 1, 2003 David J. Mersy	Recognition of Alcohol and Substance Abuse Ten percent of the population abuses drugs or alcohol, and 20 percent of patients seen by family physicians have substance-abuse problems, excluding tobacco use. These patients can be identified by relying on regular screening or a high index of suspicion based on "red flags."
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.
Reason April 2004 Joli Jensen	Emotional Choices What story you choose to believe about antidepressants reveals a deeper truth about who you are.
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.
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 April 15, 2003 Dickerson et al.	Premenstrual Syndrome Premenstrual syndrome, a common cyclic disorder of young and middle-aged women, is characterized by emotional and physical symptoms that consistently occur during the luteal phase of the menstrual cycle.
American Family Physician March 15, 2004	Alcohol Withdrawal Syndrome The spectrum of alcohol withdrawal symptoms ranges from such minor symptoms as insomnia and tremulousness to severe complications such as withdrawal seizures and delirium tremens. This article covers evaluation and treatment of the patient.
Nurse Practitioner May 2009 Yvonne D'Arcy	Is Low Back Pain Getting on Your Nerves? The pain and disability of low back pain are the most common reasons patients seek healthcare. Here are tools for diagnosis and treatment options.
American Family Physician October 1, 2006 Susan Louisa Montauk	The Homeless in America: Adapting Your Practice In 2004, the National Guidelines Clearinghouse placed eight guidelines from the National Health Care for the Homeless Council on its Web site. Seven of the guidelines are on specific disease processes and one is on general care.
Nurse Practitioner May 2012 Diana L. Wadlund	Meeting the challenge of IBS IBS is the best studied, most common functional GI disorder, and is often characterized by debilitating symptoms without any pathologic findings. The predominant symptoms of IBS are abdominal pain and an alteration in bowel habits with an absence of organic pathology.
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 August 1, 2003 Stone et al.	Off-Label Applications for SSRIs Clinical experience supported by ongoing research continues to expand on the broad array of therapeutic applications for this class of medication.
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.
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.
Nurse Practitioner December 2011	Managing pain in obese patients Obesity-related pain conditions can limit the patient's efforts at increasing activity and limit quality of life. This article will offer information on these conditions and treatment options.
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 February 1, 2005 Maizels & McCarberg	Antidepressants and Antiepileptic Drugs for Chronic Non-Cancer Pain The development of newer classes of antidepressants and second-generation antiepileptic drugs has created unprecedented opportunities for the treatment of chronic pain. These drugs modulate pain transmission by interacting with specific neurotransmitters and ion channels.
Reason October 2005 Maia Szalavitz	In Defense of Happy Pills While psychotherapy validated by research has its place, there is no convincing reason why it should be considered inherently superior to drugs. Pleasure can be just as important for emotional recovery and growth as pain, if not more so.
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.