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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...
American Journal of Nursing November 2008 Madeline A. Naegle	Screening for Alcohol Use and Misuse in Older Adults: Using the Short Michigan Alcoholism Screening Test--Geriatric Version The availability of accurate, easy-to-use screening tools to detect people in need of counseling can increase the number of older adults whose lives can be improved and even lengthened.
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 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 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."
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.
American Family Physician November 1, 2005 Steven H. Williams	Medications for Treating Alcohol Dependence Medications for treating alcohol dependence primarily have been adjunctive interventions, and only three medications -- disulfiram, naltrexone, and acamprosate -- are approved for this indication by the U.S. Food and Drug Administration.
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 May 15, 2004 Mark H. Ebell	Routine Screening for Depression, Alcohol Problems, and Domestic Violence This guide is one in a series that offers evidence-based tools to assist family physicians in improving their decision-making at the point of 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.
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 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 Journal of Nursing January 2011 Vicky Keys	Alcohol Withdrawal During Hospitalization For a chronic drinker, sudden alcohol withdrawal because of an unexpected hospitalization can lead to escalating withdrawal symptoms and even death if unrecognized and untreated.
Managed Care June 2007 Lisa A. Higgins	Sobering Stats Invite Insurers To Fight Alcoholism Effectively Health plans may not be able to control problem drinking by their members. They can, however, affect the way their contracted providers approach the problem. And that may be what makes the difference.
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 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 September 15, 2002 Sharp & Lipsky	Screening for Depression Across the Lifespan: A Review of Measures for Use in Primary Care Settings Depression is a common psychiatric disorder in children, adolescents, adults, and the elderly. Primary care physicians, not mental health professionals, treat the majority of patients with symptoms of depression.
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 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 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.
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.
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.
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 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...
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.
Nursing May 2010 Sharon M. Valente	Assessing patients for suicide risk This article will help you update your knowledge of suicide risk factors and prevention strategies, and provide guidelines for effective intervention.
American Family Physician July 15, 2004 Robertson & Montagnini	Geriatric Failure to Thrive Some elderly patients, including those who do not have acute illness or severe chronic disease, eventually undergo a process of functional decline, progressive apathy, and a loss of willingness to eat and drink that culminates in death.
American Family Physician March 15, 2004	Alcohol Abuse: How to Recognize Problem Drinking Questions and answers on alcohol abuse.
American Family Physician October 1, 2006 Mark B. Stephens	Preventive Health Counseling for Adolescents The key to providing relevant and useful preventive counseling for adolescent patients is developing the trust necessary to discuss the specific issues that impact this age group.
American Family Physician April 1, 2003	Substance Abuse--How To Recognize It Am I drinking too much?... Am I taking risks with alcohol or other mood-altering substances?... Has my drinking or drug use become a habit?... Is alcohol or drug use taking over my life?... Has drinking alcohol or using drugs become a problem for me?... etc.
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 1, 2003 Stovall & Domino	Approaching the Suicidal Patient In an attempt to help the family physician prevent suicide, this article reviews known risk factors and offers a strategy for assessing and addressing these factors in individual patients.
American Family Physician February 1, 2002	Problem Drinking -- How To Recognize It Guidelines for recognizing problem drinking and getting help if necessary...
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 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 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.
Managed Care February 2002 Heidi A. Sauder & Sheri Wallace	Push Is On for Improved Treatment of Women's Psychological Maladies Sure there are diagnostic and treatment challenges, but the money that can be saved for society might make this fertile ground for investment...
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 April 2008 Kathryn Murphy	Shedding the burden of depression & anxiety Learn about types of depression and available treatments.
American Family Physician March 15, 2007 Freedy & Simpson	Disaster-Related Physical and Mental Health: A Role for the Family Physician Family physicians should be prepared to work with other health care professionals in the community to share the collective load in meeting post-disaster health needs; such partnerships should be established well in advance of a disaster.
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 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...
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 July 15, 2002 John W. Thompson, Jr.	A Pregnant Woman Victimized by Physical Abuse Domestic violence in the United States is a problem of enormous proportions and represents a significant health concern. Here's how a physician can respond.
American Family Physician January 15, 2007 Kelly Colleen McDonald	Child Abuse: Approach and Management A multidisciplinary approach is recommended to adequately evaluate and treat child abuse victims; however, the responsibility often lies with the family physician to recognize and treat these cases at first presentation to prevent significant morbidity and mortality.
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 September 15, 2004 Thibault & Steiner	Efficient Identification of Adults with Depression and Dementia Family physicians must decide how to screen for depression or dementia and which patients to screen. Mental health questionnaires can be helpful, but are not without flaws.
American Family Physician March 1, 2002 Vyjeyanthi S. Periyakoil	Identifying and Managing Preparatory Grief and Depression at the End of Life Preparatory grief is experienced by virtually all patients who are dying and can be facilitated with psychosocial support and counseling...
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.