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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 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 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 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 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 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...
AskMen.com January 21, 2002 Joshua Levine	Dealing With Anxiety Attacks If you or anybody you know has ever had the urge to freeze, gasp or run away in terror over the most trivial of things, now you will finally understand the causes of and treatments for anxiety attacks...
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 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...
Nursing April 2008 Kathryn Murphy	Shedding the burden of depression & anxiety Learn about types of depression and available treatments.
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 December 15, 2003 Bradley D. Grinage	Diagnosis and Management of Post-traumatic Stress Disorder Although PTSD is a debilitating anxiety disorder that may cause significant distress and increased use of health resources, the condition often goes undiagnosed. Treatment relies on a multidimensional approach, including supportive patient education, cognitive behavior therapy, and psychopharmacology.
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 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 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 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 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 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 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...
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
AskMen.com Jasper Anson	Anxiety Disorders In the United States alone, there are more than 40 million Americans who are suffering from some form of anxiety disorder. Here are some of the most common disorders and a few specific treatment options.
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 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 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.
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 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.
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 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 October 1, 2000	What You Should Know About Generalized Anxiety Disorder What is generalized anxiety disorder?... How do I know if I have GAD?... How is GAD treated?...
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 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 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 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 October 1, 2002 Bhatia & Bhatia	Diagnosis and Treatment of Premenstrual Dysphoric Disorder From 2 to 10 percent of women of reproductive age have severe distress and dysfunction caused by premenstrual dysphoric disorder, a severe form of premenstrual syndrome. Current research implicates mechanisms of serotonin as relevant to etiology and treatment.
American Family Physician December 1, 2001 John Koo	Psychodermatology: The Mind and Skin Connection Psychodermatology, or psychocutaneous medicine, focuses on the boundary between psychiatry and dermatology. Understanding the psychosocial and occupational context of skin diseases is critical to the optimal management of psychodermatologic disorders...
American Family Physician October 15, 2006	Anxiety and Panic: Getting Control over Your Feelings A patient guide: What is anxiety?... Are there different types of anxiety?... Panic Attack Symptoms... What is generalized anxiety disorder?... etc.
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 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 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...
Nurse Practitioner January 2012 Hedges & Ruggiero	Treatment Options for Insomnia Nurse practitioners must be prepared to screen patients for this common sleep disorder as well as understand the latest treatment options for optimal patient outcomes.
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.
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 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 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 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 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.
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.
American Family Physician March 15, 2005 Swartz & Longwell	Treatment of Vertigo As patients age, vertigo becomes an increasingly common presenting complaint. Most cases of vertigo can be diagnosed clinically and managed in the primary care setting.
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 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.