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John J. Miller, MD

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hover:text-black border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/major-depressive-disorder"> Major Depressive Disorder </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-primary hover:underline px-2 pb-3 hover:text-black border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/schizophrenia"> | Schizophrenia/Psychosis </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-primary hover:underline px-2 pb-3 hover:text-black border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/mental-health-awareness"> | Mental Health Awareness Month </a><div class="mt-4 max-w-[125px]"></div></div></div></div></div></nav><div id="john-j-miller-md" class="container mx-auto flex m-1 min-h-[57vh] px-4"><div class="flex-auto w-[calc(100%-300px)] pr-0 md:pr-6 mt-16 sm:mt-0"><div class="pb-24 my-2"><h1 class="text-3xl">John J. Miller, MD</h1><div class="w-full mb-2 border border-secondary"></div><div class=" flex-1 py-2 text-sm"><a class="text-primary" href="/">home</a><a class="text-primary" href="/authors"> <!-- -->/<!-- --> <span class="">authors</span></a><span class="text-gray-400"> <!-- -->/<!-- --> <span class=" text-gray-400">john-j-miller-md</span></span></div><div class="flex justify-end gap-2"></div><div class="flex flex-col sm:flex-row"><div id="author-summary" class="mt-3 mr-[1rem] text-center sm:text-left sm:mr-4 sm:w-[100px]"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27100%27%20height=%27100%27/%3e"/></span><img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="border-radius:50%;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover"/><noscript><img srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa429e28c06070418331e927699954a278efa97c9-1500x2100.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=128&amp;q=75 1x, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa429e28c06070418331e927699954a278efa97c9-1500x2100.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=256&amp;q=75 2x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa429e28c06070418331e927699954a278efa97c9-1500x2100.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=256&amp;q=75" decoding="async" data-nimg="intrinsic" style="border-radius:50%;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" loading="lazy"/></noscript></span></div><div id="description-summary" class="py-2 text-sm text-gray-500 sm:w-[calc(100%-100px)]"><div class="blockText_blockContent__TbCXh"><p class="pb-2"><strong>Dr Miller</strong> <em>is Medical Director, Brain Health, Exeter, New Hampshire; Editor in Chief,</em> Psychiatric Times<em>; Staff Psychiatrist, Seacoast Mental Health Center, Exeter; and Consulting Psychiatrist, Insight Meditation Society, Barre, Massachusetts.</em></p></div></div></div><h3 class="text-xl">Articles</h3><div class="flex flex-wrap w-full"><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/real-psychiatry-broadening-the-psychiatric-family"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:56.25%"></span><img alt="Real Psychiatry: Broadening the Psychiatric Family" title="Real Psychiatry: Broadening the Psychiatric Family" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Real Psychiatry: Broadening the Psychiatric Family" title="Real Psychiatry: Broadening the Psychiatric Family" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4397a9a5835912c5606722cb61407166722cb2bc-1600x900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4397a9a5835912c5606722cb61407166722cb2bc-1600x900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4397a9a5835912c5606722cb61407166722cb2bc-1600x900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4397a9a5835912c5606722cb61407166722cb2bc-1600x900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4397a9a5835912c5606722cb61407166722cb2bc-1600x900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4397a9a5835912c5606722cb61407166722cb2bc-1600x900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4397a9a5835912c5606722cb61407166722cb2bc-1600x900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4397a9a5835912c5606722cb61407166722cb2bc-1600x900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4397a9a5835912c5606722cb61407166722cb2bc-1600x900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/real-psychiatry-broadening-the-psychiatric-family">Real Psychiatry: Broadening the Psychiatric Family</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/real-psychiatry-broadening-the-psychiatric-family"><span class="text-sm text-gray-500 pl-4">November 12th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Are you attending Real Psychiatry in January? </p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/schizophrenia-pharmacology-version-2-0"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:57.14909408426108%"></span><img alt="pharmacology" title="pharmacology" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="pharmacology" title="pharmacology" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F35d1f00931670ff03617de6b210f8376e4210447-4581x2618.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F35d1f00931670ff03617de6b210f8376e4210447-4581x2618.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F35d1f00931670ff03617de6b210f8376e4210447-4581x2618.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F35d1f00931670ff03617de6b210f8376e4210447-4581x2618.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F35d1f00931670ff03617de6b210f8376e4210447-4581x2618.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F35d1f00931670ff03617de6b210f8376e4210447-4581x2618.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F35d1f00931670ff03617de6b210f8376e4210447-4581x2618.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F35d1f00931670ff03617de6b210f8376e4210447-4581x2618.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F35d1f00931670ff03617de6b210f8376e4210447-4581x2618.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/schizophrenia-pharmacology-version-2-0">Schizophrenia Pharmacology: Version 2.0</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/schizophrenia-pharmacology-version-2-0"><span class="text-sm text-gray-500 pl-4">November 7th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The medication treatment of schizophrenia has finally diversified to a novel neurotransmitter system: the muscarinic cholinergic system.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="flex md:hidden justify-center items-center"></div><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/complex-ptsd-a-necessary-dsm-addition"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.66666666666666%"></span><img alt="PTSD" title="PTSD" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="PTSD" title="PTSD" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Ff3ea873dddb55db8bb52f6930353d73a53ff345a-4743x3162.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Ff3ea873dddb55db8bb52f6930353d73a53ff345a-4743x3162.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Ff3ea873dddb55db8bb52f6930353d73a53ff345a-4743x3162.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Ff3ea873dddb55db8bb52f6930353d73a53ff345a-4743x3162.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Ff3ea873dddb55db8bb52f6930353d73a53ff345a-4743x3162.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Ff3ea873dddb55db8bb52f6930353d73a53ff345a-4743x3162.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Ff3ea873dddb55db8bb52f6930353d73a53ff345a-4743x3162.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Ff3ea873dddb55db8bb52f6930353d73a53ff345a-4743x3162.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Ff3ea873dddb55db8bb52f6930353d73a53ff345a-4743x3162.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/complex-ptsd-a-necessary-dsm-addition">Complex PTSD: A Necessary DSM Addition</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/complex-ptsd-a-necessary-dsm-addition"><span class="text-sm text-gray-500 pl-4">October 11th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">There is still no formal or professional recognition of complex PTSD as a very different disorder than what DSM-5-TR describes for PTSD. </p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/meditation-is-not-what-you-think"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.74593737613952%"></span><img alt="meditation" title="meditation" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="meditation" title="meditation" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F55484ce8febac4c7cf2fa0f6e6227e98ca97bbb9-5046x3368.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F55484ce8febac4c7cf2fa0f6e6227e98ca97bbb9-5046x3368.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F55484ce8febac4c7cf2fa0f6e6227e98ca97bbb9-5046x3368.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F55484ce8febac4c7cf2fa0f6e6227e98ca97bbb9-5046x3368.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F55484ce8febac4c7cf2fa0f6e6227e98ca97bbb9-5046x3368.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F55484ce8febac4c7cf2fa0f6e6227e98ca97bbb9-5046x3368.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F55484ce8febac4c7cf2fa0f6e6227e98ca97bbb9-5046x3368.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F55484ce8febac4c7cf2fa0f6e6227e98ca97bbb9-5046x3368.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F55484ce8febac4c7cf2fa0f6e6227e98ca97bbb9-5046x3368.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/meditation-is-not-what-you-think">Meditation Is Not What You Think</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/meditation-is-not-what-you-think"><span class="text-sm text-gray-500 pl-4">September 6th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><div class="text-sm text-gray-500 py-1 pl-4"><div class="blockText_blockContent__TbCXh"></div></div><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/the-harms-and-consequences-of-untreated-ptsd"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:56.25%"></span><img alt="John J. 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Miller, MD</a></div><a href="/view/the-harms-and-consequences-of-untreated-ptsd"><span class="text-sm text-gray-500 pl-4">August 9th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">John J. Miller, MD, discusses the risks of untreated PTSD and the importance of implementing more therapeutic tools into treatment paradigms.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/do-no-harm-providing-guardrails-for-effective-ptsd-treatments"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:56.25%"></span><img alt="John J. Miller, MD" title="John J. Miller, MD" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="John J. Miller, MD" title="John J. Miller, MD" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/do-no-harm-providing-guardrails-for-effective-ptsd-treatments">Do No Harm: Providing Guardrails for Effective PTSD Treatments</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/do-no-harm-providing-guardrails-for-effective-ptsd-treatments"><span class="text-sm text-gray-500 pl-4">August 9th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Addressing the importance of safe treatments for PTSD, Dr John Miller discusses adverse effect management practices and the role of REMS protocols.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/unmet-needs-and-the-ptsd-treatment-pipeline"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:56.25%"></span><img alt="John J. Miller, MD" title="John J. Miller, MD" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="John J. Miller, MD" title="John J. Miller, MD" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/unmet-needs-and-the-ptsd-treatment-pipeline">Unmet Needs and the PTSD Treatment Pipeline</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/unmet-needs-and-the-ptsd-treatment-pipeline"><span class="text-sm text-gray-500 pl-4">August 9th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Focusing on the future of PTSD treatment, Dr John Miller outlines how novel treatments can address current challenges and unmet needs in the therapeutic landscape.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/the-challenges-of-ptsd-symptom-clusters"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:56.25%"></span><img alt="John J. Miller, MD" title="John J. Miller, MD" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="John J. Miller, MD" title="John J. Miller, MD" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/the-challenges-of-ptsd-symptom-clusters">The Challenges of PTSD Symptom Clusters</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/the-challenges-of-ptsd-symptom-clusters"><span class="text-sm text-gray-500 pl-4">August 9th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">John J. Miller, MD, provides an overview of the symptom clusters of PTSD and treatments that are being looked at to improve patient care.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="flex md:hidden justify-center items-center"></div><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/mdma-assisted-therapy-providing-the-brain-with-a-necessary-boost"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:56.25%"></span><img alt="John J. Miller, MD" title="John J. Miller, MD" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="John J. Miller, MD" title="John J. Miller, MD" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/mdma-assisted-therapy-providing-the-brain-with-a-necessary-boost">MDMA-Assisted Therapy: Providing the Brain With a Necessary Boost</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/mdma-assisted-therapy-providing-the-brain-with-a-necessary-boost"><span class="text-sm text-gray-500 pl-4">August 9th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The Psychiatric Times editor-in-chief shares perspectives on how a novel treatment, MDMA-assisted therapy, can potentially change the treatment landscape and improve patients’ lives.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/the-evolution-of-ptsd-diagnosis-and-treatment"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:56.25%"></span><img alt="John J. Miller, MD" title="John J. Miller, MD" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="John J. Miller, MD" title="John J. Miller, MD" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fa5f7c5cb21002f0a63239fe76fdb32a771ea942e-1920x1080.png%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/the-evolution-of-ptsd-diagnosis-and-treatment">The Evolution of PTSD Diagnosis and Treatment</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/the-evolution-of-ptsd-diagnosis-and-treatment"><span class="text-sm text-gray-500 pl-4">August 9th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">John J. Miller, MD, discusses how the diagnosis and treatment of posttraumatic stress disorder (PTSD) has evolved over time.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/weve-only-just-begun"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.66666666666666%"></span><img alt="psychiatry" title="psychiatry" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="psychiatry" title="psychiatry" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F1ae2e9e1f7ceb0721cbbc0735d2c96942bf7ec83-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F1ae2e9e1f7ceb0721cbbc0735d2c96942bf7ec83-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F1ae2e9e1f7ceb0721cbbc0735d2c96942bf7ec83-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F1ae2e9e1f7ceb0721cbbc0735d2c96942bf7ec83-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F1ae2e9e1f7ceb0721cbbc0735d2c96942bf7ec83-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F1ae2e9e1f7ceb0721cbbc0735d2c96942bf7ec83-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F1ae2e9e1f7ceb0721cbbc0735d2c96942bf7ec83-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F1ae2e9e1f7ceb0721cbbc0735d2c96942bf7ec83-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F1ae2e9e1f7ceb0721cbbc0735d2c96942bf7ec83-5376x3584.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/weve-only-just-begun">We’ve Only Just Begun…</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/weve-only-just-begun"><span class="text-sm text-gray-500 pl-4">August 8th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Psychiatry is such a young field attempting to improve functioning and quality of life for so many diverse and complex brain disorders that it should be no surprise that our treatment outcomes spread across the spectrum from much improved to progressive decline. </p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/medication-assisted-psychotherapy-moving-forward"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:50%"></span><img alt="brain psychedelic" title="brain psychedelic" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="brain psychedelic" title="brain psychedelic" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F5a1a057301a5ddb5122d0dc4f35430091188d0d5-6250x3125.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F5a1a057301a5ddb5122d0dc4f35430091188d0d5-6250x3125.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F5a1a057301a5ddb5122d0dc4f35430091188d0d5-6250x3125.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F5a1a057301a5ddb5122d0dc4f35430091188d0d5-6250x3125.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F5a1a057301a5ddb5122d0dc4f35430091188d0d5-6250x3125.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F5a1a057301a5ddb5122d0dc4f35430091188d0d5-6250x3125.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F5a1a057301a5ddb5122d0dc4f35430091188d0d5-6250x3125.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F5a1a057301a5ddb5122d0dc4f35430091188d0d5-6250x3125.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F5a1a057301a5ddb5122d0dc4f35430091188d0d5-6250x3125.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/medication-assisted-psychotherapy-moving-forward">Medication-Assisted Psychotherapy: Moving Forward</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/medication-assisted-psychotherapy-moving-forward"><span class="text-sm text-gray-500 pl-4">July 5th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The FDA did not vote to deny approval of MDMA-assisted psychotherapy on June 4, 2024, contrary to all the buzz in the media saying they did. Learn more here.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/insights-and-explorations-special-report"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:57.15%"></span><img alt="brain" title="brain" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="brain" title="brain" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fdfd7ead4a28656da525295b3aef9bfae1048aa1a-4000x2286.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fdfd7ead4a28656da525295b3aef9bfae1048aa1a-4000x2286.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fdfd7ead4a28656da525295b3aef9bfae1048aa1a-4000x2286.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fdfd7ead4a28656da525295b3aef9bfae1048aa1a-4000x2286.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fdfd7ead4a28656da525295b3aef9bfae1048aa1a-4000x2286.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fdfd7ead4a28656da525295b3aef9bfae1048aa1a-4000x2286.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fdfd7ead4a28656da525295b3aef9bfae1048aa1a-4000x2286.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fdfd7ead4a28656da525295b3aef9bfae1048aa1a-4000x2286.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fdfd7ead4a28656da525295b3aef9bfae1048aa1a-4000x2286.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/insights-and-explorations-special-report">Insights and Explorations</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. 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Miller, MD</a></div><a href="/view/a-curious-juxtaposition"><span class="text-sm text-gray-500 pl-4">June 10th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The Psychiatric Times Editor-in-Chief discusses the clinical uses and casual prescribing of ketamine for the treatment of psychiatric disorders.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/reviewing-the-fda-advisory-committee-decision-on-mdma"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.70020120724345%"></span><img alt="FDA" title="FDA" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="FDA" title="FDA" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F3b6eff396436e76ce42df225e14b01caf05d8245-7952x5304.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/reviewing-the-fda-advisory-committee-decision-on-mdma">Reviewing the FDA Advisory Committee Decision on MDMA</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. 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Miller, MD</a></div><a href="/view/bias-in-record-keeping-a-real-life-example"><span class="text-sm text-gray-500 pl-4">May 9th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Biases can be apparent in case notes. Psychiatric Times Editor-in-Chief sat down with us at the 2024 APA Annual Meeting to share more. </p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/long-acting-injectable-vs-oral-antipsychotics-part-2-of-a-conversation-with-peter-j-weiden-md"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:100%"></span><img alt="Peter J. 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Weiden, MD</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/peter-j-weiden-md">Peter J. Weiden, MD</a><span class="mr-1 ml-[1px]">;</span><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/long-acting-injectable-vs-oral-antipsychotics-part-2-of-a-conversation-with-peter-j-weiden-md"><span class="text-sm text-gray-500 pl-4">May 8th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Peter J. Weiden, MD, sat down with Psychiatric Times’ Editor-in-Chief at the 2024 Annual Meeting. 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Weiden, MD</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/peter-j-weiden-md">Peter J. Weiden, MD</a><span class="mr-1 ml-[1px]">;</span><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/long-acting-injectables-part-1-of-a-conversation-with-peter-j-weiden-md"><span class="text-sm text-gray-500 pl-4">May 8th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Peter J. Weiden, MD, sat down with Psychiatric Times’ Editor-in-Chief at the 2024 Annual Meeting. 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Goldberg, MD</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/joseph-f-goldberg-md">Joseph F. Goldberg, MD</a><span class="mr-1 ml-[1px]">;</span><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/an-artisanal-approach-to-care-a-conversation-with-joseph-f-goldberg-md"><span class="text-sm text-gray-500 pl-4">May 5th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Joseph F. Goldberg, MD, sat down with Psychiatric Times&#x27; Editor-in-Chief at the 2024 APA Annual Meeting. </p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/suicide-april-2024-editorial"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.73913043478261%"></span><img alt="suicide" title="suicide" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="suicide" title="suicide" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F69b650f58c38fa6a65c4181316b0d12294fb38b2-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F69b650f58c38fa6a65c4181316b0d12294fb38b2-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F69b650f58c38fa6a65c4181316b0d12294fb38b2-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F69b650f58c38fa6a65c4181316b0d12294fb38b2-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F69b650f58c38fa6a65c4181316b0d12294fb38b2-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F69b650f58c38fa6a65c4181316b0d12294fb38b2-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F69b650f58c38fa6a65c4181316b0d12294fb38b2-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F69b650f58c38fa6a65c4181316b0d12294fb38b2-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F69b650f58c38fa6a65c4181316b0d12294fb38b2-7360x4912.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/suicide-april-2024-editorial">Suicide</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/suicide-april-2024-editorial"><span class="text-sm text-gray-500 pl-4">April 12th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Suicide is a word that conjures a wide range of intense emotions.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/exploring-the-star-d-controversy"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:100%"></span><img alt="exploding pill" title="exploding pill" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="exploding pill" title="exploding pill" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fd35222b42c1c029a3290772980bbe56135743689-3900x3900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fd35222b42c1c029a3290772980bbe56135743689-3900x3900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fd35222b42c1c029a3290772980bbe56135743689-3900x3900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fd35222b42c1c029a3290772980bbe56135743689-3900x3900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fd35222b42c1c029a3290772980bbe56135743689-3900x3900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fd35222b42c1c029a3290772980bbe56135743689-3900x3900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fd35222b42c1c029a3290772980bbe56135743689-3900x3900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fd35222b42c1c029a3290772980bbe56135743689-3900x3900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fd35222b42c1c029a3290772980bbe56135743689-3900x3900.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/exploring-the-star-d-controversy">Exploring the STAR*D Controversy</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/exploring-the-star-d-controversy"><span class="text-sm text-gray-500 pl-4">March 5th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">STAR*D trial is one of the most important foundational studies in psychiatry to guide the treatment of unipolar major depression. Get ready to explore a dialogue between the original STAR*D authors and a group of authors who call STAR*D into question.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="flex md:hidden justify-center items-center"></div><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/mass-shootings-relationship-to-mental-illness"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:70.27027027027027%"></span><img alt="mass shooting" title="mass shooting" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="mass shooting" title="mass shooting" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F791bbb3b571ccb80162f80623ce26a714682f247-3774x2652.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F791bbb3b571ccb80162f80623ce26a714682f247-3774x2652.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F791bbb3b571ccb80162f80623ce26a714682f247-3774x2652.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F791bbb3b571ccb80162f80623ce26a714682f247-3774x2652.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F791bbb3b571ccb80162f80623ce26a714682f247-3774x2652.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F791bbb3b571ccb80162f80623ce26a714682f247-3774x2652.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F791bbb3b571ccb80162f80623ce26a714682f247-3774x2652.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F791bbb3b571ccb80162f80623ce26a714682f247-3774x2652.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F791bbb3b571ccb80162f80623ce26a714682f247-3774x2652.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/mass-shootings-relationship-to-mental-illness">Mass Shootings’ Relationship to Mental Illness</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/mass-shootings-relationship-to-mental-illness"><span class="text-sm text-gray-500 pl-4">February 15th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">If all violence in the US that is due to mental disorders could be eliminated, 95% to 97% of violent behavior would remain.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/medication-pipeline-antidepressants-and-adhd-rx"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:56.043956043956044%"></span><img alt="pipeline" title="pipeline" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="pipeline" title="pipeline" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbb44c3ebcfa153093442297be15a0ccacc548b9d-5824x3264.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbb44c3ebcfa153093442297be15a0ccacc548b9d-5824x3264.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbb44c3ebcfa153093442297be15a0ccacc548b9d-5824x3264.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbb44c3ebcfa153093442297be15a0ccacc548b9d-5824x3264.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbb44c3ebcfa153093442297be15a0ccacc548b9d-5824x3264.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbb44c3ebcfa153093442297be15a0ccacc548b9d-5824x3264.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbb44c3ebcfa153093442297be15a0ccacc548b9d-5824x3264.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbb44c3ebcfa153093442297be15a0ccacc548b9d-5824x3264.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fbb44c3ebcfa153093442297be15a0ccacc548b9d-5824x3264.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/medication-pipeline-antidepressants-and-adhd-rx">Medication Pipeline: Antidepressants and ADHD Rx</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. Miller, MD</a></div><a href="/view/medication-pipeline-antidepressants-and-adhd-rx"><span class="text-sm text-gray-500 pl-4">February 13th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Check out this broad range of innovative medications in development with the goal of providing psychiatric clinicians with novel treatments in the quest to decrease patient suffering and improve function and quality of life.</p><div class="pl-4"></div></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/medication-pipeline-schizophrenia-and-ptsd"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:50.03411416875142%"></span><img alt="Here&#x27;s an update on which medications are on the horizon for the treatment of schizophrenia and PTSD." title="Here&#x27;s an update on which medications are on the horizon for the treatment of schizophrenia and PTSD." src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Here&#x27;s an update on which medications are on the horizon for the treatment of schizophrenia and PTSD." title="Here&#x27;s an update on which medications are on the horizon for the treatment of schizophrenia and PTSD." sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F6787c354c1c9f9ce9c679b4a17a8f0c2446e91a7-4397x2200.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=640&amp;q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F6787c354c1c9f9ce9c679b4a17a8f0c2446e91a7-4397x2200.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=750&amp;q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F6787c354c1c9f9ce9c679b4a17a8f0c2446e91a7-4397x2200.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=828&amp;q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F6787c354c1c9f9ce9c679b4a17a8f0c2446e91a7-4397x2200.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1080&amp;q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F6787c354c1c9f9ce9c679b4a17a8f0c2446e91a7-4397x2200.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1200&amp;q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F6787c354c1c9f9ce9c679b4a17a8f0c2446e91a7-4397x2200.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=1920&amp;q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F6787c354c1c9f9ce9c679b4a17a8f0c2446e91a7-4397x2200.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=2048&amp;q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F6787c354c1c9f9ce9c679b4a17a8f0c2446e91a7-4397x2200.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F6787c354c1c9f9ce9c679b4a17a8f0c2446e91a7-4397x2200.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=3840&amp;q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/medication-pipeline-schizophrenia-and-ptsd">Medication Pipeline: Schizophrenia and PTSD</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/john-j-miller-md">John J. 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Miller, MD</a></div><a href="/view/star-d-dethroned"><span class="text-sm text-gray-500 pl-4">December 12th 2023</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Since 2006, STAR*D stands out as an icon guiding treatment decisions of major depressive disorder. 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src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%27180%27%20height=%27100%27/%3e"/></span><img alt="Mini Quiz: DSM-5 Basics" title="Mini Quiz: DSM-5 Basics" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" class="shrink-0 object-cover" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover"/><noscript><img alt="Mini Quiz: DSM-5 Basics" title="Mini Quiz: DSM-5 Basics" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2bd7c3e90cd493265431d6bde3f2b59e68a64c8f-172x163.gif%3Ffit%3Dcrop%26auto%3Dformat&amp;w=256&amp;q=75 1x, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2bd7c3e90cd493265431d6bde3f2b59e68a64c8f-172x163.gif%3Ffit%3Dcrop%26auto%3Dformat&amp;w=384&amp;q=75 2x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F2bd7c3e90cd493265431d6bde3f2b59e68a64c8f-172x163.gif%3Ffit%3Dcrop%26auto%3Dformat&amp;w=384&amp;q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" class="shrink-0 object-cover" loading="lazy"/></noscript></span></div><div class="jsx-41d2ec0c9882d016 flex flex-col pb-3"><div class="jsx-41d2ec0c9882d016"><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500">Published: <!-- -->August 3rd 2015</span><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500"> | Updated: <!-- -->November 27th 2024</span></div><div 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src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F29ebfd060ede83ef19527a7e6dcb2c7cf26c6422-1000x377.jpg%3Ffit%3Dcrop%26auto%3Dformat&amp;w=384&amp;q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" class="shrink-0 object-cover" loading="lazy"/></noscript></span></div><div class="jsx-41d2ec0c9882d016 flex flex-col pb-3"><div class="jsx-41d2ec0c9882d016"><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500">Published: <!-- -->March 23rd 2021</span><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500"> | Updated: <!-- -->November 27th 2024</span></div><div class="jsx-41d2ec0c9882d016 font-bold text-sm pb-1">Poor DSM-5—So Misunderstood!</div></div></a><a class="jsx-41d2ec0c9882d016 recent-article" 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style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover"/><noscript><img alt="Mini Quiz: Methods of Suicide" title="Mini Quiz: Methods of Suicide" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4c03aa45fd0fb22f30945a57b83178d3e14974e3-172x163.gif%3Ffit%3Dcrop%26auto%3Dformat&amp;w=256&amp;q=75 1x, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4c03aa45fd0fb22f30945a57b83178d3e14974e3-172x163.gif%3Ffit%3Dcrop%26auto%3Dformat&amp;w=384&amp;q=75 2x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4c03aa45fd0fb22f30945a57b83178d3e14974e3-172x163.gif%3Ffit%3Dcrop%26auto%3Dformat&amp;w=384&amp;q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" class="shrink-0 object-cover" loading="lazy"/></noscript></span></div><div class="jsx-41d2ec0c9882d016 flex flex-col pb-3"><div class="jsx-41d2ec0c9882d016"><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500">Published: <!-- -->January 21st 2016</span><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500"> | Updated: <!-- -->November 27th 2024</span></div><div class="jsx-41d2ec0c9882d016 font-bold text-sm pb-1">Mini Quiz: Methods of Suicide</div></div></a><a class="jsx-41d2ec0c9882d016 recent-article" href="/view/mini-quiz-medical-catatonia"><div class="jsx-41d2ec0c9882d016 min-h-[65px] min-w-[65px] max-w-[65px] mr-2 lg:mt-1"><span 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style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" class="shrink-0 object-cover" loading="lazy"/></noscript></span></div><div class="jsx-41d2ec0c9882d016 flex flex-col pb-3"><div class="jsx-41d2ec0c9882d016"><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500">Published: <!-- -->May 12th 2017</span><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500"> | Updated: <!-- -->November 27th 2024</span></div><div class="jsx-41d2ec0c9882d016 font-bold text-sm pb-1">Mini Quiz: Medical Catatonia</div></div></a><a class="jsx-41d2ec0c9882d016 recent-article" href="/view/mini-quiz-characterizing-sexual-deviation"><div class="jsx-41d2ec0c9882d016 min-h-[65px] min-w-[65px] max-w-[65px] mr-2 lg:mt-1"><span 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style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:cover" class="shrink-0 object-cover" loading="lazy"/></noscript></span></div><div class="jsx-41d2ec0c9882d016 flex flex-col pb-3"><div class="jsx-41d2ec0c9882d016"><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500">Published: <!-- -->January 23rd 2017</span><span class="jsx-41d2ec0c9882d016 text-sm text-gray-500"> | Updated: <!-- -->November 27th 2024</span></div><div class="jsx-41d2ec0c9882d016 font-bold text-sm pb-1">Mini Quiz: Characterizing Sexual Deviation</div></div></a></div></div></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div class="collapse-container " style="overflow:hidden;max-height:900px;transition:max-height .4s ease-in-out"></div></div></div></div><div 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Thus, a professor of history and philosophy—in an article titled, “Forget talking, just fill a script: how modern psychiatry lost its mind”—","_key":"ad3923e532df0"},{"_key":"f0928d2e9911","_type":"span","marks":["14d18f83fb1e"],"text":"wrote"},{"_type":"span","marks":[],"text":"","_key":"a8fcf47fef95"},{"_key":"94bc6be6ea4d","_type":"span","marks":[],"text":":"}],"_type":"block","style":"normal","_key":"a6383326d262","upload_doc":null},{"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"marks":[],"text":"In clinical practice, DSM-III led to a “Chinese menu” approach to psychiatric diagnosis: a specific mental illness can be diagnosed if a sufficient number of boxes can be ticked. This is only of limited value in clinical practice.","_key":"5aca93396c100","_type":"span"},{"_type":"span","marks":["superscript"],"text":"3","_key":"94b44aaa353d"}],"_type":"block","style":"blockquote","_key":"0a28fab4df2f","upload_doc":null},{"style":"normal","_key":"bab7d1828d16","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"_key":"7c5dce4cd2ce","blank":true,"_type":"link","href":"https://www.psychologytoday.com/us/blog/freud-fluoxetine/202006/psychiatric-diagnosis-20-the-myth-the-symptom-checklist"},{"_key":"a40e0494c206","blank":true,"_type":"link","href":"https://dsm.psychiatryonline.org/"}],"children":[{"_type":"span","marks":[],"text":"Indeed, merely checking off boxes of symptoms (and signs) ","_key":"dd87609bcfdd0"},{"marks":["em"],"text":"is","_key":"dd87609bcfdd1","_type":"span"},{"text":" of very limited clinical value—","_key":"dd87609bcfdd2","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"but that is not at all what DSM-5 calls for.","_key":"dd87609bcfdd3"},{"_type":"span","marks":[],"text":" As my colleague, Dr Mark Ruffalo, and I ","_key":"dd87609bcfdd4"},{"_type":"span","marks":["7c5dce4cd2ce"],"text":"pointed out","_key":"1343d1c8c660"},{"marks":[],"text":"","_key":"29a9eeaa7daa","_type":"span"},{"_type":"span","marks":[],"text":", the DSM-5 makes it crystal clear: Simply checking off symptoms ","_key":"95714023b2f1"},{"_type":"span","marks":["em"],"text":"cannot and does not constitute a psychiatric diagnosis—","_key":"dd87609bcfdd5"},{"marks":[],"text":"which requires a comprehensive ","_key":"dd87609bcfdd6","_type":"span"},{"_type":"span","marks":["em"],"text":"case formulation.","_key":"dd87609bcfdd7"},{"text":"4","_key":"7b7908229203","_type":"span","marks":["em","superscript"]},{"_type":"span","marks":["superscript"],"text":" ","_key":"dd87609bcfdd8"},{"text":"As the ","_key":"4981780c6043","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"Manual ","_key":"dd87609bcfdd9"},{"_key":"dd87609bcfdd10","_type":"span","marks":[],"text":"itself "},{"_key":"17931b7ccdaa","_type":"span","marks":["a40e0494c206"],"text":"notes"},{"_type":"span","marks":[],"text":"","_key":"52c6816f8f0f"},{"_type":"span","marks":[],"text":":","_key":"ae521907939c"}],"_type":"block"},{"_key":"097fbc5bf59d","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"The case formulation for any given patient must involve a careful clinical history and concise summary of the social, psychological and biological factors that may have contributed to developing a given mental disorder. ","_key":"85ab544a4f4a0"},{"_key":"85ab544a4f4a1","_type":"span","marks":["em"],"text":"Hence, it is not sufficient to simply check off the symptoms of the diagnostic criteria to make a mental disorder diagnosis "},{"_type":"span","marks":[],"text":"(emphasis added).","_key":"85ab544a4f4a2"},{"_type":"span","marks":["superscript"],"text":"5(p19)","_key":"33c92ab96b83"}],"_type":"block","style":"blockquote"},{"_key":"bb15b1acef8e","upload_doc":null,"content":[{"markDefs":[],"children":[{"_type":"span","marks":["em","strong"],"text":"\"You cannot snag a DSM diagnosis merely by collecting a group of signs and symptoms.\"","_key":"b8e0da0891d1"}],"_type":"block","style":"normal","_key":"5eeefcbe8854"}],"medias":null,"uploadAudio":null,"_type":"sidebar"},{"_type":"block","style":"normal","_key":"568dfef4eabc","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"http://www.lacounseling.org/images/lca/Conference/DSM-5%20LCA%20Case%20Formulation%20Rev.pdf","_key":"277f401e0e25"}],"children":[{"_type":"span","marks":[],"text":"As Dr Gary G. Gintner has ","_key":"d92361110e490"},{"_type":"span","marks":["277f401e0e25"],"text":"explained","_key":"614ec03d46cf"},{"_type":"span","marks":[],"text":"","_key":"ad0054afc94c"},{"marks":[],"text":", the case formulation “. . . is a core clinical skill that links assessment information and treatment planning. It is a hypothesis about the mechanisms that cause and maintain the problem. It answers the question, ‘Why is this person, having this type of problem, now?’”","_key":"593064299bc4","_type":"span"},{"_type":"span","marks":["superscript"],"text":"6","_key":"ad00fead3832"}]},{"markDefs":[{"blank":true,"_type":"link","href":"https://en.wikipedia.org/wiki/DSM-5","_key":"6730571c1bd0"}],"children":[{"_type":"span","marks":[],"text":"In principle, the case formulation—and by extension, the final DSM diagnosis—requires medical knowledge, or at least access to medical consultation, in order to assess the “biological factors” that may have contributed to the patient’s problem. Finally, we should note that, in addition to meeting sign/symptom criteria for a mental disorder, virtually all the major ","_key":"90c06147a54a0"},{"text":"DSM-5 categories","_key":"76e7903202a7","_type":"span","marks":["6730571c1bd0"]},{"_key":"d887b4f66c33","_type":"span","marks":[],"text":""},{"_type":"span","marks":[],"text":" require evidence of “clinically significant distress or impairment in social, occupational or other important areas of functioning.” You cannot snag a DSM diagnosis merely by collecting a group of signs and symptoms. There must also be adverse consequences in the person’s life.","_key":"aa7780433f3d"}],"_type":"block","style":"normal","_key":"c33a1708e853","upload_doc":null,"medias":null,"uploadAudio":null},{"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"The DSM-5 Is “Biomedical”? Not So Much","_key":"13577f2f584d0"}],"_type":"block","style":"normal","_key":"7569c721b605","upload_doc":null,"medias":null},{"children":[{"marks":[],"text":"It is clear from the aforementioned description of the case formulation that the DSM-5 explicitly uses a “biopsychosocial” approach to diagnosis. In addition, DSM-5 has extensive coverage of cultural issues, as they impinge on differential diagnosis. Excellent examples of the “case conceptualization” using a bio-psychosocial-cultural approach may be found in the text by Sperry and Sperry.","_key":"4cbb04c594a80","_type":"span"},{"_key":"c4eb4d2cae95","_type":"span","marks":["superscript"],"text":"7"}],"_type":"block","style":"normal","_key":"aee8b68d7d35","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[]},{"_key":"a89b1bf1dc19","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://journals.sagepub.com/doi/abs/10.1177/0959353512467974","_key":"2cad2965cdb7"}],"children":[{"marks":[],"text":"Nonetheless, some commentators—mainly critics of psychiatric nosology—have asserted that DSM-5 represents the “biomedical” model. For example, 1 paper ","_key":"31f81735a0bf0","_type":"span"},{"_type":"span","marks":["2cad2965cdb7"],"text":"argues","_key":"ad2720f585c5"},{"text":"","_key":"c28d62decd5d","_type":"span","marks":[]},{"_type":"span","marks":[],"text":" that,","_key":"c07307108016"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_key":"4d7d5c8398940","_type":"span","marks":[],"text":"The "},{"text":"Diagnostic and Statistical Manual of Mental Disorders","_key":"4d7d5c8398941","_type":"span","marks":["em"]},{"_key":"4d7d5c8398942","_type":"span","marks":[],"text":" . . . offers a biomedical framing of people’s experiences of distress and impairment, and despite decades of criticism, it remains the dominant approach."},{"_type":"span","marks":["superscript"],"text":"8","_key":"7ad7cb0112b3"}],"_type":"block","style":"blockquote","_key":"40c18087430d","upload_doc":null,"medias":null,"uploadAudio":null},{"markDefs":[{"_key":"bcea9ca8aa06","blank":true,"_type":"link","href":"https://journals.sagepub.com/doi/abs/10.1177/0959353512467974"}],"children":[{"_key":"462ecf099e420","_type":"span","marks":[],"text":"These authors go on to argue that, “. . . a biomedical construction of ‘mental illness’ all too frequently fails to protect individuals from delegitimation and stigma.” That is a provocative claim worth examining but is beyond the scope of this essay. What is striking about the paper by these 2 psychologists is that the term “biomedical” is never fully defined. The authors do "},{"_type":"span","marks":["bcea9ca8aa06"],"text":"note","_key":"6bc99380248b"},{"marks":[],"text":"","_key":"0f6884a260d0","_type":"span"},{"marks":[],"text":" the biomedical model is oriented “around the problems of the body . . . such as genetics or neurochemistry.”","_key":"21a8318dcccb","_type":"span"},{"text":"8","_key":"c89e7cb62697","_type":"span","marks":["superscript"]}],"_type":"block","style":"normal","_key":"deba9e3ad206","upload_doc":null,"medias":null,"uploadAudio":null},{"_type":"block","style":"normal","_key":"39b09f4a19b7","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://www.psychiatrictimes.com/view/early-warnings-neuropsychiatric-manifestations-huntington-disease","_key":"0de6f0e3140c"}],"children":[{"_type":"span","marks":[],"text":"If we take that rough formulation as a guide, it can be readily seen that—with a few exceptions—there is very little in DSM-5 that invokes “genetics” or “neurochemistry.” True, DSM-5’s discussion of ","_key":"dce356c6a1660"},{"_type":"span","marks":["0de6f0e3140c"],"text":"Huntington disease","_key":"998e080ba613"},{"_type":"span","marks":[],"text":"","_key":"b0108c3ca6e7"},{"_type":"span","marks":[],"text":" does reference abnormalities on chromosome 4; and other neurocognitive disorders, such as Lewy body disease, are linked to genetic abnormalities. But such references to specific genetic abnormalities are by far the exception, particularly for the more classically “psychiatric” disorders, such as schizophrenia and bipolar disorders. (We do find, under the rubric of “Risk and Prognostic Factors,” the statement that “Schizophrenia and bipolar disorder likely share a genetic origin . . .”","_key":"c3733e7056ec"},{"_type":"span","marks":["superscript"],"text":"5","_key":"4801e82e8f19"},{"_type":"span","marks":[],"text":" but that is about as far as the ","_key":"2c93b622354d"},{"marks":["em"],"text":"Manual","_key":"dce356c6a1661","_type":"span"},{"_type":"span","marks":[],"text":" goes).","_key":"dce356c6a1662"}]},{"medias":null,"link":"https://cdn.sanity.io/images/0vv8moc6/psychtimes/34def3064505b4e400fdc8147dc7123c929c23f4-992x776.jpg?auto=format","upload_doc":null,"uploadAudio":null,"asset":{"_updatedAt":"2021-03-23T15:01:55Z","sha1hash":"34def3064505b4e400fdc8147dc7123c929c23f4","mimeType":"image/jpeg","url":"https://cdn.sanity.io/images/0vv8moc6/psychtimes/34def3064505b4e400fdc8147dc7123c929c23f4-992x776.jpg","assetId":"34def3064505b4e400fdc8147dc7123c929c23f4","_type":"sanity.imageAsset","metadata":{"palette":{"darkVibrant":{"title":"#fff","population":0.48,"background":"#3c8484","_type":"sanity.imagePaletteSwatch","foreground":"#fff"},"lightMuted":{"background":"#9dbec4","_type":"sanity.imagePaletteSwatch","foreground":"#000","title":"#fff","population":0.65},"vibrant":{"foreground":"#fff","title":"#fff","population":0.01,"background":"#3c7c8c","_type":"sanity.imagePaletteSwatch"},"dominant":{"title":"#fff","population":6.37,"background":"#2f4349","_type":"sanity.imagePaletteSwatch","foreground":"#fff"},"_type":"sanity.imagePalette","darkMuted":{"_type":"sanity.imagePaletteSwatch","foreground":"#fff","title":"#fff","population":6.37,"background":"#2f4349"},"muted":{"background":"#69828a","_type":"sanity.imagePaletteSwatch","foreground":"#fff","title":"#fff","population":1.9},"lightVibrant":{"foreground":"#000","title":"#fff","population":0.2,"background":"#b4cadc","_type":"sanity.imagePaletteSwatch"}},"hasAlpha":false,"lqip":"data:image/jpeg;base64,/9j/2wBDAAYEBQYFBAYGBQYHBwYIChAKCgkJChQODwwQFxQYGBcUFhYaHSUfGhsjHBYWICwgIyYnKSopGR8tMC0oMCUoKSj/2wBDAQcHBwoIChMKChMoGhYaKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCj/wAARCAAQABQDASIAAhEBAxEB/8QAFwAAAwEAAAAAAAAAAAAAAAAAAAQGBf/EAB4QAAICAgMBAQAAAAAAAAAAAAECAwQAERITUUEF/8QAFQEBAQAAAAAAAAAAAAAAAAAAAwT/xAAaEQACAwEBAAAAAAAAAAAAAAAAAQMREgJR/9oADAMBAAIRAxEAPwByKwVGjKoG/Mp6UVN4I5JSnYR9TeSS8yQwTYy0/MhtGpE8UKEcfMaRuiWJLRpVadJoQeiN9/eAwxuqLAhAdVU+AYYFsozz4f/Z","dimensions":{"height":776,"_type":"sanity.imageDimensions","width":992,"aspectRatio":1.2783505154639174},"isOpaque":true,"_type":"sanity.imageMetadata"},"extension":"jpg","_rev":"5q8DjueuIO7vq4ld9RpoHA","path":"images/0vv8moc6/psychtimes/34def3064505b4e400fdc8147dc7123c929c23f4-992x776.jpg","_createdAt":"2021-03-23T15:01:55Z","originalFilename":"PSY032021_PiesDSM_Table1.jpg","uploadId":"CIt12qnuyVAvA9XFe4KbVclvZW1t51Uh","_id":"image-34def3064505b4e400fdc8147dc7123c929c23f4-992x776-jpg","size":151048},"blank":true,"imgcaption":[{"style":"normal","_key":"6feec78dec53","markDefs":[],"children":[{"_key":"65990a6ffa25","_type":"span","marks":["strong"],"text":"Table 1. What DSM-5 Is and What It Is Not"}],"_type":"block"}],"alignment":"right","widthP":35,"_type":"figure","_key":"a3e1379b9f75"},{"markDefs":[],"children":[{"_key":"9977b2841c2e0","_type":"span","marks":["strong"],"text":"What About “Neurochemistry”?"}],"_type":"block","style":"normal","_key":"a16c790a0e87","upload_doc":null,"medias":null,"uploadAudio":null},{"_type":"block","style":"normal","_key":"ba2aa9da3917","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://dsm.psychiatryonline.org/","_key":"a0aeb0d0ce16"}],"children":[{"_type":"span","marks":[],"text":"As far as I know, discussion of “neurochemistry” as a ","_key":"4558c0fb942f0"},{"_type":"span","marks":["em"],"text":"causal or etiological factor","_key":"4558c0fb942f1"},{"_type":"span","marks":[],"text":" in any of the common psychiatric disorders is entirely lacking in DSM-5. (So much for “chemical imbalances”). With only a few exceptions, DSM-5 avoids commitments regarding etiology. Indeed, the ","_key":"4558c0fb942f2"},{"marks":["em"],"text":"Manual ","_key":"4558c0fb942f3","_type":"span"},{"_type":"span","marks":[],"text":"explicitly ","_key":"4558c0fb942f4"},{"text":"notes","_key":"4854258bf606","_type":"span","marks":["a0aeb0d0ce16"]},{"_key":"42e91efbcfe0","_type":"span","marks":[],"text":""},{"marks":[],"text":", “a diagnosis does not carry any necessary implications regarding the etiology or causes of the individual’s mental disorder. . .”","_key":"dd9ac997a7f8","_type":"span"},{"marks":["superscript"],"text":"5(p25)","_key":"08a9a0df8f98","_type":"span"},{"marks":[],"text":" One can see this as a serious deficiency in the DSM-5—but one cannot claim the ","_key":"b4306e79b14a","_type":"span"},{"_key":"4558c0fb942f5","_type":"span","marks":["em"],"text":"Manual "},{"_type":"span","marks":[],"text":"endorses anything resembling neurochemical etiologies or “chemical imbalances” for the major mental disorders.","_key":"4558c0fb942f6"}]},{"_type":"block","style":"normal","_key":"63200e276463","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://journals.sagepub.com/doi/abs/10.1177/0959353512467974","_key":"4a6c213a1875"}],"children":[{"text":"In sum, there is no credible basis for ","_key":"dec98c7ab62f0","_type":"span","marks":[]},{"text":"arguing","_key":"f761fd457434","_type":"span","marks":["4a6c213a1875"]},{"_type":"span","marks":[],"text":"","_key":"075f6897ed7b"},{"_type":"span","marks":[],"text":" that the DSM-5 “offers a biomedical framing of people’s experiences of distress and impairment.”","_key":"dd0a65d63a6e"},{"text":"8","_key":"1a8d78fa18fb","_type":"span","marks":["superscript"]},{"_type":"span","marks":[],"text":" Deacon, in a detailed review and critique, argues that “The biomedical model posits that mental disorders are brain diseases and emphasizes pharmacological treatment to target presumed biological abnormalities.”","_key":"fb4909ed388e"},{"_type":"span","marks":["superscript"],"text":"9","_key":"6f09945f91c8"},{"_type":"span","marks":[],"text":" I do not contest that description, but nothing in Deacon’s analysis shows that DSM-5 is essentially “biomedical” in the sense he explicates.","_key":"e23a3f8136b2"}]},{"upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Fuzzy Boundaries, Overlapping Symptoms, and Dimensions of Pathology","_key":"e6f630d9933d0"}],"_type":"block","style":"normal","_key":"61ff117070c1"},{"_type":"block","style":"normal","_key":"4f560435e5e8","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Another common claim is that DSM-5 is a strictly “categorical” framework that conceptualizes mental illness as a collection of discrete, diagnostically separable entities. As one paper puts it, “. . . the DSM-5 is a categorical system. Thus, individual disorders are regarded as discrete units—“you either have it, or you don't.”","_key":"e04600f374050"},{"_key":"70938dab549b","_type":"span","marks":["superscript"],"text":"10"},{"_key":"0edae070055e","_type":"span","marks":[],"text":" A related claim is that DSM-5 posits a clear and distinct separation between mental abnormality and “normal” mental or psychological states. "}]},{"_key":"4d793f1845fb","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://cdn.sanity.io/images/0vv8moc6/psychtimes/34def3064505b4e400fdc8147dc7123c929c23f4-992x776.jpg?auto=format","_key":"24338a1fb671"}],"children":[{"_type":"span","marks":[],"text":"In truth, neither claim is supported in the DSM-5 (","_key":"5c60fad957dd0"},{"_type":"span","marks":["strong","24338a1fb671"],"text":"Table 1","_key":"5c60fad957dd1"},{"text":"","_key":"279eb87df95b","_type":"span","marks":[]},{"_type":"span","marks":[],"text":"). On the contrary, the Introduction to the ","_key":"5c60fad957dd2"},{"_type":"span","marks":["em"],"text":"Manual ","_key":"56b2b05c3e89"},{"_key":"691b4ad75a36","_type":"span","marks":[],"text":"clearly states,"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_key":"78107f484f400","_type":"span","marks":[],"text":"The results of numerous studies of comorbidity and disease transmission . . . make strong arguments for what many astute clinicians have long observed: the boundaries between many disorder “categories” are more fluid over the life course than DSM-IV recognized, and many symptoms assigned to a single disorder may occur, at varying levels of severity, in many other disorders. These findings mean that DSM . . . should accommodate ways to introduce dimensional approaches to mental disorders, including dimensions that cut across categories . . . Although some mental disorders may have well-defined boundaries around symptom clusters, scientific evidence now places many, if not most, disorders on a spectrum with closely related disorders that have shared symptoms, shared genetic and environmental risk factors, and possibly shared neural substates . . . "},{"_type":"span","marks":["em"],"text":"In short, we have come to recognize that the boundaries between disorders are more porous than originally believed.","_key":"2d61b5d3ba19"},{"_key":"19facd202b8c","_type":"span","marks":[],"text":"” (Italics added)"},{"_type":"span","marks":["superscript"],"text":"5(pp5-6)","_key":"3fb484507689"},{"_key":"365491a27bc70","_type":"span","marks":[],"text":""}],"_type":"block","style":"blockquote","_key":"57dc0cc46007","upload_doc":null,"medias":null,"uploadAudio":null},{"children":[{"_type":"span","marks":[],"text":"Furthermore, the DSM-5 does not argue for a hard and fast boundary between “normal” and “abnormal” states and conditions. On the contrary, it states:","_key":"f299962ef90a0"}],"_type":"block","style":"normal","_key":"8d71057879ae","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[]},{"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"The boundaries between normality and pathology vary across cultures for specific types of behaviors…Hence, the level at which an experience becomes problematic or pathological will differ. The judgment that a given behavior is abnormal and requires clinical attention depends on cultural norms that are internalized by the individual and applied by others around them, including family members and clinicians.","_key":"875cbfd1866e0"},{"_key":"431cbcbebb25","_type":"span","marks":["superscript"],"text":"5"}],"_type":"block","style":"blockquote","_key":"dba9a96d6508","upload_doc":null},{"imgcaption":[{"markDefs":[],"children":[{"text":"Table 2. 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To be sure, many different approaches to psychiatric diagnosis have been ","_key":"5a6089611570"},{"marks":["f99e57bd700a"],"text":"proposed and debated","_key":"e59dbb7f245b","_type":"span"},{"text":"","_key":"4ead56afdde0","_type":"span","marks":[]},{"_type":"span","marks":[],"text":"—each with its pros and cons.","_key":"f49e75a15fe0"},{"_type":"span","marks":["superscript"],"text":"14","_key":"942f805d585e"},{"_key":"0dfaf38aca8e","_type":"span","marks":[],"text":" "}],"_type":"block","style":"normal"},{"_key":"4c6d89dae9a4","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://peh-med.biomedcentral.com/articles/10.1186/1747-5341-7-9","_key":"f7f35df24f73"},{"blank":true,"_type":"link","href":"https://cdn.sanity.io/images/0vv8moc6/psychtimes/609ade8b5182635e0794137012407eede1478403-979x861.jpg?auto=format","_key":"0f1c047ee704"}],"children":[{"text":"Personally, I favor a prototype-based diagnostic approach for every-day clinical work; and a parallel set of “research diagnostic criteria” for investigative purposes (","_key":"8e8f2ea67577","_type":"span","marks":[]},{"_type":"span","marks":["strong","0f1c047ee704"],"text":"Table 2","_key":"fe1ed015da421"},{"marks":[],"text":"","_key":"c5cb85b9d6c1","_type":"span"},{"_type":"span","marks":[],"text":"). “Prototype” diagnosis refers to the use of idealized models or archetypes of disease, rather than either “categorical” or “dimensional” methods of classification. ","_key":"fe1ed015da422"},{"marks":["f7f35df24f73"],"text":"Phillips and colleagues","_key":"fe1ed015da423","_type":"span"},{"marks":["superscript"],"text":"14","_key":"fe1ed015da424","_type":"span"},{"_type":"span","marks":[],"text":" discuss and debate various diagnostic models in a wide-ranging colloquium.","_key":"5edeba76678b"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_key":"ecc53e65abd80","_type":"span","marks":[],"text":"It seems very clear that diagnosis is, and will always remain, a necessary part of clinical care, both in general medicine and psychiatry. 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Otherwise, our treatment is likely to be misguided.","_key":"85a9f0b3a9f8"}],"_type":"block","style":"normal","_key":"e9bf0e5cde7c","upload_doc":null,"medias":null,"uploadAudio":null},{"markDefs":[{"_type":"link","href":"https://www.medscape.com/viewarticle/942694#vp_1","_key":"f5e26e0eaf4d","blank":true},{"_key":"bd7fde28952e","_type":"link","href":"https://www.psychiatry.org/"}],"children":[{"text":"No, whatever the lay press claims, DSM-5 is not “The Bible of psychiatry.’ It is not a sacred, eternal, and inviolable text, or even a very sophisticated diagnostic tool. 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So, I would hope people would not be bound by it, but be flexible and use their clinical judgment instead.”","_key":"6d51fa25d22c","_type":"span"},{"_type":"span","marks":["superscript"],"text":"16","_key":"e10d99057a89"}],"_type":"block","style":"normal","_key":"f20428555e02","upload_doc":null,"medias":null,"uploadAudio":null},{"upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"text":"I agree. But before we use the DSM-5’s text to line our bird cages—as a renowned British psychiatrist I once met described the utility of the DSM-III—we should at least understand what DSM-5 does, and does not, represent.","_key":"85ae6926e9850","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"7e515a3586b6"},{"children":[{"text":"Dr Pies","_key":"1494743e6aec0","_type":"span","marks":["strong"]},{"_key":"1494743e6aec1","_type":"span","marks":["em"],"text":" is professor emeritus of psychiatry and lecturer on bioethics and humanities, SUNY Upstate Medical University; clinical professor of psychiatry, Tufts University School of Medicine; and editor in chief emeritus of "},{"text":"Psychiatric Times","_key":"1494743e6aec2","_type":"span","marks":[]},{"_type":"span","marks":["em","superscript"],"text":"TM","_key":"1494743e6aec3"},{"_type":"span","marks":["em"],"text":" (2007-2010).","_key":"81cc63a101b8"}],"_type":"block","style":"normal","_key":"353d669181c3","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[]},{"style":"normal","_key":"a1580b85ff0e","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"mailto:PTEditor@mmhgroup.com","_key":"b931db2d80b6"}],"children":[{"_type":"span","marks":["strong","em"],"text":"Let us hear from you!","_key":"f34aa6cd02f60"},{"text":" Share comments with your colleagues by emailing ","_key":"f34aa6cd02f61","_type":"span","marks":["em"]},{"text":"PTEditor@mmhgroup.com","_key":"f34aa6cd02f62","_type":"span","marks":["b931db2d80b6","em"]},{"_type":"span","marks":["em"],"text":". Comments may be shared online pending review and editing for style.","_key":"f34aa6cd02f63"}],"_type":"block"},{"_type":"block","style":"normal","_key":"69c23961020e","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"text":"References","_key":"d552fbd715ca0","_type":"span","marks":["strong"]}]},{"upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://www.youtube.com/watch?v=WA_NnXyDDLk","_key":"7565756addbb"}],"children":[{"_type":"span","marks":[],"text":"1. jmm1000. Dr Pepper \"So Misunderstood\" feat Carol Kane - 1973-1974. YouTube. June 30, 2017. Accessed March 17, 2021. ","_key":"1cefe98664810"},{"_type":"span","marks":["7565756addbb"],"text":"https://www.youtube.com/watch?v=WA_NnXyDDLk","_key":"1cefe98664811"}],"_type":"block","style":"normal","_key":"da809d3e1dd1"},{"_type":"block","style":"normal","_key":"66a1eb4e0fad","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"2. Regier DA, Narrow WE, Clarke DE, et al. DSM-5 field trials in the United States and Canada, Part II: test-retest reliability of selected categorical diagnoses. ","_key":"5248ab0cc9fd0"},{"_type":"span","marks":["em"],"text":"Am J Psychiatry.","_key":"5248ab0cc9fd1"},{"_type":"span","marks":[],"text":" 2013;170(1):59-70.","_key":"5248ab0cc9fd2"}]},{"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://theconversation.com/forget-talking-just-fill-a-script-how-modern-psychiatry-lost-its-mind-9569","_key":"e024b1ca6628"}],"children":[{"marks":[],"text":"3. Pols H: Forget talking, just fill a script: how modern psychiatry lost its mind. ","_key":"f168f272ee680","_type":"span"},{"_type":"span","marks":["em"],"text":"The Conversation.","_key":"f168f272ee681"},{"_type":"span","marks":[],"text":" October 21, 2012. Accessed March 17, 2021. ","_key":"f168f272ee682"},{"text":"https://theconversation.com/forget-talking-just-fill-a-script-how-modern-psychiatry-lost-its-mind-9569","_key":"f168f272ee683","_type":"span","marks":["e024b1ca6628"]}],"_type":"block","style":"normal","_key":"f64f9b483afc","upload_doc":null,"medias":null},{"medias":null,"uploadAudio":null,"markDefs":[{"_key":"ffbca7489e39","blank":true,"_type":"link","href":"https://www.psychologytoday.com/us/blog/freud-fluoxetine/202006/psychiatric-diagnosis-20-the-myth-the-symptom-checklist"}],"children":[{"_type":"span","marks":[],"text":"4. Ruffalo ML. Pies RW. Psychiatric Diagnosis 2.0: The Myth of the Symptom Checklist. ","_key":"6af5f02f71600"},{"_type":"span","marks":["em"],"text":"Psychology Today.","_key":"6af5f02f71601"},{"text":" June 14, 2020. Accessed March 17, 2021. ","_key":"6af5f02f71602","_type":"span","marks":[]},{"marks":["ffbca7489e39"],"text":"https://www.psychologytoday.com/us/blog/freud-fluoxetine/202006/psychiatric-diagnosis-20-the-myth-the-symptom-checklist","_key":"6af5f02f71603","_type":"span"}],"_type":"block","style":"normal","_key":"60f9cdbdf6f1","upload_doc":null},{"medias":null,"uploadAudio":null,"markDefs":[{"_type":"link","href":"https://dsm.psychiatryonline.org/","_key":"6e46aa9a8f30","blank":true}],"children":[{"text":"5. American Psychiatric Association. ","_key":"edb7e3c6b25d0","_type":"span","marks":[]},{"marks":["6e46aa9a8f30"],"text":"Diagnostic and Statistical Manual of Mental Disorders","_key":"edb7e3c6b25d1","_type":"span"},{"marks":["6e46aa9a8f30"],"text":", 5th edition","_key":"edb7e3c6b25d2","_type":"span"},{"text":"","_key":"33c968533ba6","_type":"span","marks":[]},{"_key":"b63148cecbe3","_type":"span","marks":[],"text":". Washington, DC; American Psychiatric Publishing, Inc: 2013."}],"_type":"block","style":"normal","_key":"b7168d238e0f","upload_doc":null},{"uploadAudio":null,"markDefs":[{"_key":"da172dc45f25","blank":true,"_type":"link","href":"http://www.lacounseling.org/images/lca/Conference/DSM-5%20LCA%20Case%20Formulation%20Rev.pdf"}],"children":[{"text":"6. Gintner GG. Using DSM-5 in Case Formulation. Louisiana Counseling Association presentation. Accessed March 17, 2021. ","_key":"aeda64b6d95b0","_type":"span","marks":[]},{"marks":["da172dc45f25"],"text":"http://www.lacounseling.org/images/lca/Conference/DSM-5%20LCA%20Case%20Formulation%20Rev.pdf","_key":"1c11883fed39","_type":"span"},{"text":"","_key":"30af0136314e","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"d81d024c14c9","upload_doc":null,"medias":null},{"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"marks":[],"text":"7. Sperry L, Sperry J. ","_key":"245dd5cda7280","_type":"span"},{"text":"Case Conceptualization","_key":"245dd5cda7281","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":". ","_key":"245dd5cda7282"},{"_type":"span","marks":["em"],"text":"Mastering this Competency with Ease and Confidence.","_key":"245dd5cda7283"},{"marks":[],"text":" Routledge, 2012.","_key":"245dd5cda7284","_type":"span"}],"_type":"block","style":"normal","_key":"a3cbd570c424","upload_doc":null},{"markDefs":[{"_key":"2f4f2d398c39","_type":"link","href":"https://www.researchgate.net/scientific-contributions/Suzanne-McKenzie-Mohr-2024012959"},{"blank":true,"_type":"link","href":"https://journals.sagepub.com/doi/abs/10.1177/0959353512467974","_key":"02088501317c"}],"children":[{"_type":"span","marks":[],"text":"8. Lafrance MN, McKenzie-Mohr S. ","_key":"f9a0650bbb9c0"},{"_type":"span","marks":["02088501317c"],"text":"The DSM and its lure of legitimacy","_key":"f9a0650bbb9c3"},{"_type":"span","marks":[],"text":". ","_key":"f9a0650bbb9c4"},{"_type":"span","marks":["em"],"text":"Fem Psychol","_key":"f9a0650bbb9c5"},{"text":". 2013;23(1):119-140.","_key":"f9a0650bbb9c6","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"d44d804fd832","upload_doc":null,"medias":null,"uploadAudio":null},{"upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_key":"2a12c50fe55c0","_type":"span","marks":[],"text":"9. Deacon BJ. The biomedical model of mental disorder: a critical analysis of its validity, utility, and effects on psychotherapy research. "},{"marks":["em"],"text":"Clin Psychol Rev.","_key":"2a12c50fe55c1","_type":"span"},{"_type":"span","marks":[],"text":" 2013;33(7):846-861.","_key":"2a12c50fe55c2"}],"_type":"block","style":"normal","_key":"8d7ffcf8a0e6"},{"upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"10. van Heugten-van der Kloet D, van Heugten T. The classification of psychiatric disorders according to DSM-5 deserves an internationally standardized psychological test battery on symptom level. ","_key":"c9c91979e1cb0"},{"_type":"span","marks":["em"],"text":"Front Psychol","_key":"c9c91979e1cb1"},{"_type":"span","marks":[],"text":". 2015;6:1108.","_key":"c9c91979e1cb2"}],"_type":"block","style":"normal","_key":"1728e396d8eb"},{"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"https://www.cambridge.org/core/journals/psychological-medicine/article/abs/what-kinds-of-things-are-psychiatric-disorders/0E09E96725B4831DB5D5EBADF88C8361","_key":"10ee50be8680"}],"children":[{"_type":"span","marks":[],"text":"11. Kendler KS, Zachar P, Craver C. ","_key":"8eafdb35a2d20"},{"_type":"span","marks":["10ee50be8680"],"text":"What kinds of things are psychiatric disorders?","_key":"e5e5a45e93bf"},{"_type":"span","marks":[],"text":"","_key":"1801a89f6b63"},{"marks":[],"text":" ","_key":"457dd36dac37","_type":"span"},{"_type":"span","marks":["em"],"text":"Psychol Med.","_key":"8eafdb35a2d21"},{"marks":[],"text":" 2011;41(6):1143-1150.","_key":"8eafdb35a2d22","_type":"span"}],"_type":"block","style":"normal","_key":"1be29da81334","upload_doc":null,"medias":null},{"style":"normal","_key":"b13f09bfe11d","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"12. Gabor, GT. ‘Carving nature at its joint’: The Platonic method of division in Plato, Aristotle, and their Neoplatonic commentators. ","_key":"1fca78705c270"},{"_type":"span","marks":["em"],"text":"ETD Collection for Fordham University","_key":"1fca78705c271"},{"_type":"span","marks":[],"text":". AAI3466699. 2011. 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","_key":"bW0Wg9Ci"},{"_type":"span","marks":[],"text":"Firearms\n\nSource 1:  Centers for Disease Control and Prevention (CDC) Data \u0026 Statistics Fatal Injury Report for 2014. See National Suicide Statistics at ","_key":"PBZDhjQq"},{"_key":"Sbmfo8aF","_type":"span","marks":["href_1582646604803808227"],"text":"http://www.cdc.gov/ViolencePrevention/suicide/statistics/index.html"},{"_type":"span","marks":[],"text":".\n\nSource 2: McIntosh, JL; Drapeau, CW (November 28, 2012). U.S.A. Suicide: 2010 Official Final Data (PDF).  American Association of Suicidology. ","_key":"6zs33QSS"},{"text":"http://www.suicidology.org/Portals/14/docs/Resources/FactSheets/USA2012.pdf","_key":"QDV52QXE","_type":"span","marks":["href_1582646604877059242"]},{"_type":"span","marks":[],"text":". Accessed January 20, 2016.\n ","_key":"BypCUsvh"}],"_type":"block"}],"_type":"poll","_key":"d413f8c442e8c0fffd30ec3c5ceb0a6e","choices":[{"choiceAnswer":false,"choiceText":"A. 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Could you please provide the text of the article","thumbnail":{"_type":"mainImage","asset":{"_ref":"image-4c03aa45fd0fb22f30945a57b83178d3e14974e3-172x163-gif","_type":"reference"}},"taxonomyMapping":[{"name":"Suicide","perKeywordMapping":["Psychiatry","Neurology"],"_rev":"eiU4vIL9MbTVjQ5vTV4EF2","_id":"pst_taxonomy_395_suicide","identifier":"topics/suicide","cmeType":"per","_createdAt":"2020-03-26T06:11:21Z","_type":"taxonomy","_updatedAt":"2023-03-31T19:34:36Z","parent":{"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","_id":"pst_taxonomy_53202_clinical","parent":null,"identifier":"topics","isMainTopic":true,"_type":"taxonomy","name":"Topics","_updatedAt":"2023-03-31T19:15:59Z"}},{"name":"Quizzes","_id":"pst_taxonomy_341_quizzes","_updatedAt":"2020-06-10T19:45:36Z","identifier":"resources/quizzes","parent":{"_id":"pst_taxonomy_53203_resources","_updatedAt":"2021-10-07T14:44:15Z","identifier":"resources","parent":null,"_createdAt":"2020-03-26T06:11:21Z","_rev":"CT8kz40NBv9JvHKzAk1WJ4","_type":"taxonomy","name":"Resources"},"_createdAt":"2020-03-26T06:11:21Z","_rev":"snQqhhB4O8T5bi1viUSkee","_type":"taxonomy"},{"identifier":"psychiatric-practice/risk-management","parent":{"_rev":"xOG5peVv8n6C7S2w83Kd2Q","_type":"taxonomy","parent":null,"name":"Psychiatric Practice","_id":"pst_taxonomy_715_psychiatricpractice","_updatedAt":"2021-10-07T14:44:25Z","identifier":"psychiatric-practice","_createdAt":"2020-03-26T06:11:21Z"},"_createdAt":"2020-03-26T06:11:21Z","_rev":"D11KgTJvfWl6QB4QrUeMhC","_type":"taxonomy","name":"Risk Management","_id":"pst_taxonomy_354_riskmanagement","_updatedAt":"2020-06-14T14:19:22Z"}],"nodeId":"385286","summary":"What is the most common method of suicide in the US?"},{"gptTakeaways":"• The patient's symptoms and partial response to lorazepam suggest catatonia, despite normal vital signs and brain imaging.\n• Higher lorazepam doses increase sedation, necessitating alternative management strategies to address catatonia effectively.\n• Consideration of treatments like ECT or medications such as amantadine or memantine may be appropriate.\n• Multidisciplinary team collaboration and close monitoring are crucial for achieving optimal patient outcomes.","updatedOn":null,"url":"mini-quiz-medical-catatonia","thumbnail":{"_type":"mainImage","asset":{"_ref":"image-2bd7c3e90cd493265431d6bde3f2b59e68a64c8f-172x163-gif","_type":"reference"}},"seoTag":["Somatoform Disorder","Delirium","Quizzes"],"published":"2017-05-12T19:30:30Z","body":[{"markDefs":[],"children":[{"text":"CASE VIGNETTE","_key":"O0odKOwf","_type":"span","marks":["strong"]}],"_type":"block","style":"normal","_key":"y0SRM69A","upload_doc":null,"medias":null,"uploadAudio":null},{"_key":"2FBXQLr5","upload_doc":null,"medias":null,"uploadAudio":null,"markDefs":[{"blank":true,"_type":"link","href":"case-inflamed-feelings","_key":"href_1582646605124596620"}],"children":[{"text":"A 37-year-old female with a history of ","_key":"OFLRYE4v","_type":"span","marks":[]},{"_type":"span","marks":["href_1582646605124596620"],"text":"lupus","_key":"M1P7RarQ"},{"marks":[],"text":" is admitted to the hospital with rash, arthralgias, and altered mental status. On examination, the patient displays stupor, mutism, posturing, and echopraxia while vital signs, creatine kinase, and brain MRI are all normal. Lorazepam 2mg IV q6 partially improves her symptoms, but higher doses cause more sedation. 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Augmentation with memantine","_type":"pollText","choiceCount":217,"_key":"8a2c19ca6e330d9a4690d0349c7136d2"},{"choiceAnswer":false,"choiceText":"B. Switching from lorazepam to oral diazepam","_type":"pollText","choiceCount":283,"_key":"02a7c30f2df4d7f1473262d7d4303469"},{"_type":"pollText","choiceCount":256,"_key":"1daa7c73da2b3527e19ea82c7f1b1c47","choiceAnswer":false,"choiceText":"C. Addition of haloperidol"},{"_key":"f7e5ffa779ff1c6c862ebcf46e4191fe","choiceAnswer":false,"choiceText":"D. Transfer to psychiatry for ECT","_type":"pollText","choiceCount":485},{"choiceAnswer":false,"choiceText":"E. Addition of sertraline","_type":"pollText","choiceCount":117,"_key":"8598355e044ed3d47b752e58d815070a"}],"upload_doc":null,"medias":null,"uploadAudio":null,"question":"The next step in treatment might include:","response":[{"markDefs":[],"children":[{"text":"Answer A.","_key":"x0BAS3A2","_type":"span","marks":["strong"]},{"_key":"JKAscLtK","_type":"span","marks":[],"text":" Augmentation with memantine"}],"_type":"block","style":"normal","_key":"SYaLXDmt"},{"style":"normal","_key":"ncYjGEj6","markDefs":[],"children":[{"text":"Discussion:","_key":"GkXDthih","_type":"span","marks":["strong"]}],"_type":"block"},{"style":"normal","_key":"VHXDupg9","markDefs":[],"children":[{"marks":[],"text":"A variety of medical conditions can produce stupor, which is a decreased awareness and interaction with the external environment. Stupor can occur with preserved alertness, more often seen in catatonia, or with lethargy, more often seen in delirium. Differences between etiologies (psychiatric vs medical) do not appear to alter the general treatment approach for catatonia. Removal of suspected offending agents, treatment of the underlying medical condition, or management of drug withdrawal are essential.","_key":"vydeGmLJ","_type":"span"}],"_type":"block"},{"markDefs":[],"children":[{"text":"Potential adverse effects of high-dose intravenous lorazepam include anion gap acidosis from its solvent, propylene glycol. This risk increases with higher doses and in renal impairment, but toxicity has been reported with as little as 2 mg per hour. The osmolar gap (a marker for glycol toxicity) should be monitored every other day if the lorazepam infusion reaches 1 mg/kg daily.","_key":"ZNxIee2Z","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"49YROZ2j"},{"_key":"IGpiyw8N","markDefs":[],"children":[{"text":"Augmentation with memantine or amantadine may be helpful. Their hypothesized mechanism is N-methyl-d-aspartic acid (NMDA) receptor antagonism, which may be linked to GABA hypofunction. Memantine can be started at 5 to 10 mg daily and titrated based on medical status with monitoring of the QT interval. Improvement from memantine seems slower than with lorazepam, but both can be co-administered. Amantadine is started at 100 to 200 mg daily and titrated, but it should be used with caution if renal impairment or seizure risk is present. Mania, suicidal ideation, and withdrawal-emergent NMS have also been reported with administration of amantadine.","_key":"t7ubw40M","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"For more on this topic, see ","_key":"BnqPKWDn"},{"_type":"span","marks":["href_1582646605606298972"],"text":"Update on Medical Catatonia: Highlight on Delirium","_key":"BDocXbSS"},{"_type":"span","marks":[],"text":", by Jo Ellen Wilson, MD, MPH, Lex Denysenko, MD, and Andrew Francis, PhD, MD, on which this quiz is based.","_key":"oArdP8pf"}],"_type":"block","style":"normal","_key":"m3RvbaCN","markDefs":[{"_key":"href_1582646605606298972","blank":true,"_type":"link","href":"update-medical-catatonia-highlight-delirium"}]}],"_type":"poll","_key":"c522d0920927d5030717fa5181101826"}],"taxonomyMapping":[{"parent":{"parent":{"_updatedAt":"2023-03-31T19:15:59Z","identifier":"topics","isMainTopic":true,"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","name":"Topics","_id":"pst_taxonomy_53202_clinical"},"perKeywordMapping":["Psychiatry","Neurology"],"identifier":"topics/psychosomatics","_rev":"37333Uv1mHMuPikcnyBIO2","_type":"taxonomy","_id":"pst_taxonomy_351_psychosomatics","_createdAt":"2020-03-26T06:11:21Z","name":"Psychosomatics","_updatedAt":"2023-03-31T19:23:55Z","cmeType":"per"},"_createdAt":"2020-03-26T06:11:21Z","_rev":"BmvClBuXMtNlljYu6nhdr9","_type":"taxonomy","name":"Somatoform Disorder","_id":"pst_taxonomy_384_somatoformdisorder","_updatedAt":"2020-06-10T19:45:36Z","identifier":"topics/somatoform-disorder"},{"parent":{"_createdAt":"2020-03-26T06:11:21Z","_rev":"CT8kz40NBv9JvHKzAk1WJ4","_type":"taxonomy","name":"Resources","parent":null,"_id":"pst_taxonomy_53203_resources","_updatedAt":"2021-10-07T14:44:15Z","identifier":"resources"},"_createdAt":"2020-03-26T06:11:21Z","_rev":"snQqhhB4O8T5bi1viUSkee","_type":"taxonomy","name":"Quizzes","_id":"pst_taxonomy_341_quizzes","_updatedAt":"2020-06-10T19:45:36Z","identifier":"resources/quizzes"},{"parent":{"_createdAt":"2020-03-26T06:11:21Z","parent":{"identifier":"topics","isMainTopic":true,"_createdAt":"2020-03-26T06:11:21Z","_rev":"uvXJooXtzvjNOyx50HTt8m","_type":"taxonomy","name":"Topics","_id":"pst_taxonomy_53202_clinical","_updatedAt":"2023-03-31T19:15:59Z"},"_rev":"37333Uv1mHMuPikcnyBIO2","_type":"taxonomy","name":"Psychosomatics","_updatedAt":"2023-03-31T19:23:55Z","identifier":"topics/psychosomatics","perKeywordMapping":["Psychiatry","Neurology"],"_id":"pst_taxonomy_351_psychosomatics","cmeType":"per"},"_createdAt":"2020-03-26T06:11:21Z","_rev":"snQqhhB4O8T5bi1viUSkda","_type":"taxonomy","name":"Delirium","_id":"pst_taxonomy_129_delirium","_updatedAt":"2020-06-10T19:45:36Z","identifier":"topics/delirium"}],"_createdAt":"2020-02-25T16:04:30Z","_updatedAt":"2024-11-26T19:36:59Z","internalTag":["Somatoform Disorder","Delirium","Quizzes"],"title":"Mini Quiz: Medical Catatonia","contentCategory":{"_ref":"9e4880fc-85b8-4ffb-a066-79af8dfaa4e1","_type":"reference"},"nodeId":"387353","summary":"A patient with lupus presents with rash, arthralgias, and altered mental status. Various symptoms, including stupor and mutism, improve with treatment but higher doses of the drug cause more sedation. How would you proceed?","audioUrl":"https://s3.us-east-1.amazonaws.com/ai-generated-audios/www.psychiatrictimes.com/pst_poll_387353_1728751908334.44945443-0909-4b51-85e5-e8b7676d8f02.mp3","factCheckAuthors":null,"_type":"article","authorMapping":[{"_ref":"pst_author_316918","_type":"reference","_key":"f50580370197f87d821a1b4e5c2147b8"}],"is_visible":true,"_rev":"75rfQRjSti1FAZGj7wqPGw","authors":[{"displayName":"Andrew Francis, PhD, MD","url":"andrew-francis-phd-md"}],"_id":"pst_poll_387353","gptSummary":"The patient, a 37-year-old female with lupus, presents with neuropsychiatric symptoms including stupor, mutism, posturing, and echopraxia, while vital signs, creatine kinase, and brain MRI remain normal. Partial symptom improvement with lorazepam suggests a possible catatonia diagnosis. However, higher doses lead to increased sedation, indicating a need for alternative management strategies. Consideration of other treatments such as electroconvulsive therapy (ECT) or alternative medications like amantadine or memantine may be warranted. Close monitoring and collaboration with a multidisciplinary team are essential for optimal patient outcomes.","timeAgo":238032389},{"seoTag":["Sexual Disorders"],"url":"mini-quiz-characterizing-sexual-deviation","timeAgo":247434886,"factCheckAuthors":null,"_rev":"75rfQRjSti1FAZGj7vtBiO","is_visible":true,"_id":"pst_poll_386387","_updatedAt":"2024-11-26T17:24:46Z","taxonomyMapping":[{"perKeywordMapping":["Psychiatry","Neurology"],"_createdAt":"2020-03-26T06:11:21Z","name":"Sexual \u0026 Sexuality","parent":null,"_updatedAt":"2024-02-28T20:46:27Z","identifier":"topics/sex-sexuality","_rev":"O1wC9GkHdIg9ab2yABu5pL","_type":"taxonomy","_id":"pst_taxonomy_369_sexualdisorders","cmeType":"per"}],"authorMapping":[{"_type":"reference","_key":"74f513e08c34266befae253236a8cd14","_ref":"pst_author_330696"}],"thumbnail":{"_type":"mainImage","asset":{"_ref":"image-2bd7c3e90cd493265431d6bde3f2b59e68a64c8f-172x163-gif","_type":"reference"}},"authors":[{"displayName":"Renee Sorrentino, MD","url":"renee-sorrentino-md"}],"summary":"A quiz on significant changes in DSM-5 nomenclature as they relate to sexual disorders.","internalTag":["Sexual Disorders"],"_type":"article","gptTakeaways":"?","updatedOn":null,"contentCategory":{"_ref":"9e4880fc-85b8-4ffb-a066-79af8dfaa4e1","_type":"reference"},"nodeId":"386387","published":"2017-01-23T21:30:00Z","title":"Mini Quiz: Characterizing Sexual Deviation","gptSummary":"I'm sorry, but it seems there is no article text provided for me to summarize and extract key takeaways from. Could you please provide the text of the 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psychosexual disorders","_type":"pollText","choiceCount":510,"_key":"c89a56afb004bd1995f402274dca94e4","choiceAnswer":false},{"choiceText":"B. psychopathic personality disorders","_type":"pollText","choiceCount":151,"_key":"7b8fad3b726c26c5cd5524faf6460f2b","choiceAnswer":false},{"choiceAnswer":false,"choiceText":"C. personality disorders and certain other nonpsychotic mental disorders","_type":"pollText","choiceCount":206,"_key":"9ba9d007f25c003e0fb0e988eec7e536"},{"choiceAnswer":false,"choiceText":"D. sexual dysfunctions","_type":"pollText","choiceCount":304,"_key":"f975195923723b05448b7ef78b9d2209"}],"upload_doc":null,"medias":null,"uploadAudio":null,"question":"The DSM originally characterized sexual deviations as:","response":[{"_key":"9IUo5DG7","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Answer B.","_key":"89IZ7T8B"},{"marks":[],"text":" Psychopathic personality 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deviation.”","_key":"pYzpKtWZ"}],"_type":"block","style":"normal","_key":"C7AzvndN","markDefs":[]},{"markDefs":[{"blank":true,"_type":"link","href":"dsm-5-and-paraphilias-what-psychiatrists-need-know","_key":"href_1582646604145812519"}],"children":[{"marks":[],"text":"For more on this topic, see ","_key":"ghbh1isL","_type":"span"},{"_type":"span","marks":["href_1582646604145812519"],"text":"DSM-5 and Paraphilias: What Psychiatrists Need to Know","_key":"wRcu5vBs"},{"_type":"span","marks":[],"text":", on which this quiz is based.","_key":"yJTWv4SF"}],"_type":"block","style":"normal","_key":"N3spW1d7"}],"_type":"poll","_key":"0ce0e4832c5863eef840abba16f25c34"}]}],"videoData":{}},"queryString":{"slug":["authors","john-j-miller-md"]}},"host":"www.psychiatrictimes.com"},"__N_SSP":true},"page":"/[...slug]","query":{"slug":["authors","john-j-miller-md"]},"buildId":"XNF-0KWQSwEUzMWQPzbwR","isFallback":false,"gssp":true,"appGip":true,"scriptLoader":[]}</script></body></html>

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