What's New | Decker

Cognitive-behavioral therapy (CBT) is typically more structured and shorter duration and centers on identifying thoughts and beliefs and how they impact feelings and behaviors. The therapist helps individuals label and challenge these thoughts and beliefs, and often homework is assigned to identify and counter these as they occur in their daily life.
All guidelines agree that an antidepressant trial should be a minimum of 4 weeks and up to 8 to 12 weeks at an adequate duration and dose. Even with dozens of antidepressant therapies on the market, overall response rates are still suboptimal, and remission rates remain low.
There are few data on long-term use of antidepressants. Studying relapse and prevention therapies is challenging because of the heterogeneity of the disease and difficulty retaining subjects in long-term antidepressant studies.

Follow-up studies have shown the continuity of antisocial behaviors from childhood through the adult years.
Research has implicated brain regions that control judgment and impulse control.
Cognitive-behavioral therapy may be helpful in mild cases.

The two leading classification systems for diagnosing mental illness are the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association and the ICD-10, the most recent edition of the International Classification of Diseases published by the World Health Organization.
There is no standard medical workup for a patient presenting with depression. Health care providers use their clinical judgment in conjunction with a good history, review of medical systems, and physical examination. Indiscriminate ordering of laboratory tests in depressed patients rarely yields useful results. A pooled analysis of psychiatric inpatients showed the rates of clinically significant laboratory findings to be remarkably low.
Single-photon emission CT (SPECT) has been promoted by some as a reliable tool in diagnosing and treating a number of psychiatric disorders, including depression. SPECT measures regional cerebral blood flow using a gamma-emitting tracer in the blood.

Although borderline personality disorder has traditionally been perceived as difficult or impossible to treat, significant progress has been made in developing and validating treatments.
Specialized psychotherapy remains the treatment of choice.
Short-term or stepped care interventions may represent a more efficient treatment model.
Common factors, such as structured therapies, may be nearly as effective as specialized treatments.
Pharmacotherapy plays a limited role in treatment.

Discussion of the evolution of DSM substance use disorder diagnoses over time
Overview of the biological, environmental, and personal factors implicated in the development of substance use disorders
Critical reviews of the current diagnostic criteria, epidemiology, and clinical presentation of the major substances of misuse

Latest available ACC/AHA guidelines and ongoing controversy around optimal heart rate targets
Updated classification for patients with valvular and nonvalvular AF algorithm for maintenance of sinus rhythm
2019 AHA/ACC/HRS and 2020 ESC/EACTS practice guidelines delineated new and modified anticoagulation recommendations pertaining to NOACs.

Oppositional defiant disorder (ODD) has a high prevalence and substantial morbidity
Diagnosis of ODD is based on a careful history, interview, mental status examination, and collateral information from school.
Disruptive mood dysregulation disorder is a new DSM-5 diagnosis that should be carefully considered in the differential diagnosis of children and adolescents with ODD
Genetic and neuroimaging studies have examined the possible neurobiological basis of ODD, but to date there is no definitive biomarker or biological findings in ODD.
Parent behavioral management training and psychosocial interventions are the cornerstone of treatment planning for ODD.

Mood and Anxiety Disorders