Author | Jay M. Pomerantz, MD

Articles

Update on Coverage Mandates for Patients With Autism

June 04, 2010

The treatment of patients with autism spectrum disorders (ASDs) and their various complications has become one of the most discussed and demanded insurance coverage mandates in multiple states. Insurance mandates are being heavily pushed by advocacy groups, especially Autism Speaks, with good success.

The Silent Patient

April 16, 2010

Phillip arrived at the appointment for his first psychiatric outpatient session, filled out the paperwork, told me he was depressed, shed a tear, and became completely silent. No amount of coaxing from me could get him to talk. He looked down or into space, avoiding my eyes, and just sat there for the entire 50-minute session.

Hyperparathyroidism Resulting From Lithium Treatment Remains Underrecognized

March 26, 2010

Until recently, I never paid much attention to the possibility that abnormalities of the parathyroid glands could be relevant to patients in my practice. But I decided to learn more about this issue when one of my patients with bipolar disorder who had been treated with lithium told me that she had been given a diagnosis of a parathyroid adenoma after her primary care physician noted hypercalcemia on routine testing.

Untreated Chronic Mental Illness

December 07, 2009

My interest in mental health began before I was a psychiatrist-it started in a small Central American country where I arrived as a primary care physician in the early years of the Peace Corps.

SSRIs and Sexual Dysfunction

November 23, 2009

SSRIs and related antidepressants are great drugs for the treatment of depression, anxiety, premenstrual disorders, and other conditions. However, sexual dysfunction is very common and affects 30% to 70% of patients,1 or 36% to 43% of patients depending on the particular medications and the study protocol.2 Men are somewhat more likely than women to have difficulty, especially with the desire phase of sexual function. However, it is clear that patients of both sexes may have either phase-specific or global sexual dysfunction while taking antidepressants.

Storytelling as a Psychotherapeutic Technique

October 08, 2009

Many psychotherapists adhere to psychotherapy protocols such as cognitive-behavioral therapy, interpersonal therapy, dialectic behavioral therapy, or psychoanalytically oriented psychotherapy. Nonetheless, what actually goes on between therapist and patient is often variable and sometimes unique.

Atypical Antipsychotics for Treating Major Depression

September 20, 2009

Major depressive disorder (MDD) does not always respond to antidepressants. Whether we are using SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclics, monoamine oxidase inhibitors, or heterocyclics (trazodone, nefazodone, bupropion), the result often falls short of full remission of symptoms.

A New Kind of Prior Authorization Hassle

August 02, 2009

I hear from my physician friends that the “hassle factor” to obtain health plan coverage of prescribed therapy is increasing exponentially and that many of them are thinking of retiring or cutting back their practices. That is my experience and reaction as well.

Treating Chronic Suicidality

July 18, 2009

Suicidal behavior describes not only death caused by suicide but also intentional, nonfatal, self-injurious acts committed with or without the intent to cause death. Less severe suicidal attempts are particularly characteristic of persons with borderline personality disorder (BPD).

Behavioral Approaches to Overcoming PTSD

May 18, 2009

As readers of April’s column titled “Surge in Mental Health Conditions in War Veterans” know, posttraumatic stress disorder (PTSD) is a problem for many military veterans returning from Iraq and Afghanistan. PTSD is also a significant issue in civilian life, where it affects more women than men, and is usually precipitated by physical attack, adult rape, or even childhood sexual molestation.1,2